Flynn Aidan J, Yoon K Lira
University of Maryland, Baltimore County, Baltimore, USA.
University of Maryland, Baltimore County, Baltimore, USA.
J Anxiety Disord. 2025 Jan;109:102947. doi: 10.1016/j.janxdis.2024.102947. Epub 2024 Nov 28.
Graded exposure successfully reduces fear in specific phobias and anxiety disorders, yet social exposure in daily life often fails to mitigate social anxiety. Post-event processing, perseverative, negative, self-referential thinking that occurs following a social-evaluative event, may partly explain inhibited desensitization to social fears. Post-event processing has been studied extensively since its first description by Clark and Wells (1995) and previously reviewed (e.g., Brozovich & Heimberg, 2008; Wong, 2016). However, these reviews are now dated or limited in scope. In the present scoping review, we pay particular attention to contemporary research that addresses unanswered questions raised in past reviews (e.g., Brozovich & Heimberg, 2008), synthesizing existing knowledge. Specifically, we discuss post-event processing's evolving role in cognitive models of social anxiety disorder, its core features, its eliciting situations (e.g., performance vs. social interactions), its relation to other cognitive and affective constructs (e.g., memory, performance appraisal, self-focused attention), and its assessment. Our findings indicate that post-event processing is more frequent after performance situations than social interactions, is related to negative memory biases, is bi-directionally related to worsening performance appraisals, and may be precipitated by self-focused attention. Future research directions include elucidating post-event processing's course, clarifying post-event processing's potential causal role in the development of social anxiety disorder, and identifying factors that underlie post-event processing's deleterious nature.
分级暴露疗法能够成功减轻特定恐惧症和焦虑症中的恐惧情绪，但日常生活中的社交暴露往往无法缓解社交焦虑。社交评价事件后出现的事后加工，即持续的、消极的、自我参照式思维，可能部分解释了社交恐惧脱敏受阻的现象。自克拉克和韦尔斯（1995年）首次描述事后加工以来，该领域已得到广泛研究，此前也有相关综述（如布罗佐维奇和海姆伯格，2008年；王，2016年）。然而，这些综述现在已过时或范围有限。在本次范围综述中，我们特别关注当代研究，这些研究解决了过去综述中提出的未解决问题（如布罗佐维奇和海姆伯格，2008年），并综合了现有知识。具体而言，我们讨论了事后加工在社交焦虑障碍认知模型中不断演变的作用、其核心特征、引发情境（如表现与社交互动）、与其他认知和情感结构（如记忆、表现评估、自我关注）的关系以及其评估方法。我们的研究结果表明，事后加工在表现情境后比社交互动后更频繁，与消极记忆偏差有关，与表现评估恶化呈双向关系，并且可能由自我关注引发。未来的研究方向包括阐明事后加工的过程、明确事后加工在社交焦虑障碍发展中的潜在因果作用，以及确定构成事后加工有害性质的因素。
