Aim: In recent years, research has concluded that social anxiety plays a key role in quality of life. The overall aim of this research was to evaluate social anxiety in adolescents with respect to determining how social anxiety affects quality of life. Method: This study was a cross-sectional study. A pilot study was conducted to cross-culturally adapt all scales by the recommended translated and back-translated method. The correlations of socio-demographic parameters with the SAS-A scores were examined. Data from a sample of 564 students (273 boys 48.4%, 291 girls 51.6%) were analysed. Adolescents from Saudi Arabia and the United Kingdom were screened and compared. Confirmatory factor analysis was utilised to build the proposed model based on prior research and theoretical findings. Finding: No significant sex difference in the SAS-A total score, fear of negative evaluation and social avoidance were found. Comparing the boys and girls on SPIN scores, Fear, Avoidance and Authority Problems, the results showed that boys reported higher in SPIN total, fear and avoidance (except authority problem subscale score) than did girls. SAS-A scores were higher in those with a low socio-economic level. Moreover, social anxiety symptoms among Saudi adolescents were more severe in boys. Results showed that adolescents without social anxiety scored higher on quality of life and its subscales than adolescents with social anxiety as measured by ASA-A. No significant difference was found in psychical health. Adolescents without social anxiety scored higher on quality of life and its subscales than adolescents with social anxiety as measured by SIAS. Adolescents without social anxiety scored on Positive Individualism more than adolescents with social anxiety. No significant difference was found in Positive Relatedness. In the cross-cultural study, the results showed no significant difference on SIAS scores for Saudi adolescents and British adolescents. However, a marginally significant differences was found on BAI scores, where Saudi adolescents reported higher level of anxiety than British adolescents. The British sample reported higher on the fear of negative evaluation than the Saudi sample. Structural equation modelling (SEM) was utilised to test hypotheses on the links between scores on the study scales. The findings indicate that the overall fit of the SAS-A model was acceptable. Direct effects between the study variables and significant positive correlation between cognitive factors and social anxiety were found. Mediation effects of SAS-A and SPIN were investigated by reporting direct effects, indirect effects and total effects. Results indicte that social anxiety significantly mediated the relationships between subjective anxiety, positive individualism, and cognitive and environmental health. Conclusion: It is therefore imperative that socially anxious students be provided with appropriate consultations and treatment so that they can improve their quality of life through integrating better with social institutions. If untreated, the impairment caused by social phobia could lead to poor academic and professional outcomes, as well as poor psychosocial outcomes.

O transtorno de ansiedade social (TAS) ou fobia social se caracteriza por ansiedade e medo excessivos em relação à situação social. Os indivíduos diagnosticados com TAS evitam às situações sociais temidas ou as suportam com imenso medo ou ansiedade. Além disso, sentem uma forte sensação de insuficiência e de inadequação diante do outro, também têm um medo excessivo do julgamento alheio, por supor que ele seja sempre desfavorável. Estudos epidemiológicos indicam que o TAS tem grande impacto funcional negativo, tanto social quanto educacional e ocupacional. Os fóbicos sociais, normalmente, recorrem ao saber médico que tende a apresentar uma resposta clara e objetiva: trata-se de um transtorno neurobiológico que deve ser tratado via medicação. A psicanálise se contrapõe às pretensões da ciência de reduzir o ser humano ao corpo biológico e à sedação indiscriminada do sofrimento psíquico através de psicofármacos. Diante disso, o objetivo deste trabalho é abordar o TAS sob a perspectiva da psicanálise. Esse trabalho se baseia em um modelo de pesquisa qualitativa em psicanálise, que permite compreender os fenômenos em sua complexidade. Segundo Freud, a fobia é um meio encontrado pelo indivíduo para se livrar da angústia, que é produzida pelo ego frente à ameaça de castração. O que ocorre na fobia, no fundo, é a substituição de um perigo interno, pulsional, por um externo, perceptivo. Através do conceito de narcisismo, Freud pôde concluir que os sentimentos de inferioridade e de insuficiência, bem presentes no TAS, são decorrentes da impossibilidade de satisfação narcísica através do ideal do ego e da dificuldade de obter satisfação da libido objetal. Já o conceito de superego lhe permitiu compreender que o neurótico atribui ao outro o olhar vigilante do superego, assim como seus julgamentos e suas censuras. Por isso, o fóbico social teme tanto o olhar alheio e tem a sensação clara de estar sendo observado pelo outro. Esse quadro foi denominado por Freud de delírio de observação, o qual revela o quanto a realidade psíquica é composta por fantasias que para o indivíduo adquire o mesmo estatuto de realidade da percepção. A partir dessas considerações, o transtorno de ansiedade social seria, para a psicanálise, uma tentativa do indivíduo de solucionar seu conflito psíquico. Diante da relevância deste quadro, a psicanálise, por meio de sua teoria e de sua prática clínica, pode contribuir para o alívio desse sofrimento humano / The social anxiety disorder (SAD) or social phobia is characterized by an excessive anxiety and fear towards the social situation. The individuals that are diagnosed with SAD avoid the feared social situations or they endure it with an immense fear and anxiety. Moreover, they feel a strong sensation of insufficiency and inadequacy towards others, they also have a great amount of fear of being judged, for supposing that they will always be negatively evaluated. Epidemiological researchs indicate that SAD has a great negative functional impact, in the social, educational and occupational areas. The social phobics usually look for a physician, who generally have a clear and objective answer: it is a neurobiological disorder that must be treated with medication. The psychoanalysis opposes the science´s pretension of reducing the human being to the biological body and to the indiscriminated use of medication to mitigate the psychic suffering. Therefore, the purpose of this thesis is to understand how the psychoanalysis perceives the SAD. This study is based on a qualitative psychoanalysis research, which allows the understanding of the phenomena in its complexity. According to Freud, the phobia is a way that the individual finds to get rid of the anguish that is produced by the ego when dealing with the castration threat. What truly occurs in the phobia is the substitution of an internal, pulsional, fear for an external, perceptive, one. Through the concept of narcisism, Freud could conclude that the feelings of inferiority and insuficiency, widely present on SAD, are consequences of the impossible narcissistic satisfaction through the ideal of the ego and the difficulty of obtaining the objectal libido satisfaction. And the concept of superego allowed him to understand that the neurotics attribute to the other the scrutiny eye of the superego, as well as its judgments and censure. Therefore, the social phobic fears the scrutiny from others and has the clear sensation of being observed by others. Freud has called these symptons observational delirium, which reveals how much of the psychic reality is composed by fantasys, that acquires the same status of the perception´s reality for the individual. From these considerations, the social anxiety disorder would be, for psychoanalysis, an attempt of the individual to solve his psychic conflict. Given the importance of this matter, psychoanalysis, through its theory and clinical practice, may contribute to the mitigation of this human suffering

O Transtorno de Ansiedade Social (TAS) é um distúrbio de início precoce, com prevalência e comorbidades significativas, favorecendo prejuízos importantes no funcionamento laboral, familiar, social e acadêmico, especialmente em pessoas jovens. Dada tais características, faz-se necessária a identificação precoce e o diagnóstico preciso do TAS, o que requer instrumentos validados. Objetivou-se a avaliação sistemática do TAS, por meio de um conjunto de instrumentos validados quanto às suas qualidades psicométricas de fidedignidade e validade, em uma população de adultos jovens brasileiros, estudantes universitários, sob a perspectiva da auto e hetero-avaliação. Para tal, realizou-se a validação transcultural dos instrumentos auto-avaliativos: Social Phobia Inventory (SPIN) e Self Statements During Public Speaking Scale (SSPS versão traço e estado) e do instrumento hetero-avaliativo Brief Social Phobia Scale (BSPS), com aprovação prévia dos autores das versões originais. O delineamento metodológico envolveu três etapas. Na primeira, a amostra utilizada para avaliação dos instrumentos SPIN e SSPS foi composta por 2314 estudantes universitários da população geral. Na segunda etapa, para a validação dos instrumentos SPIN, SSPS e BSPS, utilizou-se de uma amostra de 178 estudantes universitários identificados como casos (N = 88) e não-casos (N = 90) de TAS, através da Entrevista Clínica Estruturada para o DSM-IV (SCID-IV). Na terceira etapa, 45 estudantes universitários também classificados como casos (N = 24) e não-casos (N = 21) de TAS compuseram a amostra para validação da SSPS-estado no contexto de um modelo experimental de falar em público. O SPIN apresentou boa consistência interna (=0,63- 0,90), validade concorrente com o Inventário de Ansiedade de Beck (BAI) (r = 0,10-0,63) e SSPS-traço (r = 0,22-0,65), validade discriminativa (sensibilidade = 0,84, especificidade = 0,87) e validade de construto. A análise fatorial indicou a presença de um número variável de fatores em função da amostra estudada. Destaca-se a versão reduzida deste instrumento, o Mini-SPIN, que também apresentou ótimos indicadores psicométricos (sensibilidade = 0,77, especificidade = 0,67). A SSPS-traço mostrou-se bastante adequada quanto à consistência interna ( = 0,64-0,94), validade concorrente com o BAI (r = 0,18-0,53) e SPIN (r = 0,22-0,65) e validade discriminativa entre casos e não-casos de TAS. A análise fatorial evidenciou a presença de dois fatores: auto-avaliação positiva e negativa. A BSPS aplicada com o suporte de um roteiro de perguntas-guia, apresentou excelentes confiabilidade inter-avaliadores (0,86-1,00) e validade discriminativa (sensibilidade = 0,84, especificidade = 0,83); adequadas consistência interna ( = 0,48-0,88), validade concorrente com o BAI (r = 0,21-0,62), SPIN (r = 0,24-0,82) e SSPS-traço (r = 0,23-0,31) e validade de construto. A análise fatorial apontou a presença de seis fatores que explicam 71,8% da variância dos dados. A SSPS-estado mostrou-se apropriada para avaliação dos aspectos cognitivos associados ao falar em público no contexto de um modelo experimental de simulação de falar em público, apresentando excelente validade discriminativa entre casos e não-casos de TAS, além de sensibilidade para discriminar os diferentes níveis de ansiedade nas fases do procedimento. Todos os instrumentos mostraram boas qualidades psicométricas, o que recomenda o uso na população de universitários brasileiros, podendo ser aplicados tanto em contextos experimentais como clínicos, favorecendo a detecção mais precisa do TAS, especialmente nos contextos de atenção primária à saúde. / Social Anxiety Disorder (SAD) is a condition of early onset and of significant prevalence and comorbidity, greatly impairing the functioning of young people in terms of job, family, social life and academic performance. In view of these characteristics, an early identification and precise diagnosis of SAD are necessary, requiring validated instruments. The objective of the present study was to perform a systematic evaluation of SAD by means of a set of instruments tested in a population of young Brazilian adults, college students, from the perspective of self- and hetero-evaluation. For this purpose, transcultural validation was performed of the self-evaluation instruments Social Phobia Inventory (SPIN) and Self Statements During Public Speaking Scale (SSPS trait and state version) and of the hetero-evaluation instrument Brief Social Phobia Scale (BSPS), after approval by the authors of the original versions. The methodological design involved three stages. In the first, the sample used for evaluation of the SPIN and SSPS instruments consisted of 2314 college students from the general population. In the second stage, a sample of 178 college students identified as cases (N = 88) and non-cases (N = 90) of SAD, confirmed by the Structured Clinical Interview for DSM-IV (SCID-IV) was used for the evaluation of the SPIN, SSPS and BSPS instruments. In the third stage, 45 college students, also classified as cases (N = 24) and non-cases (N = 21) of SAD, formed the sample for the evaluation of the SSPS-state within the context of an experimental public speaking model. SPIN presented good internal consistency ( = 0,63-0,90), validity in agreement with the Beck Anxiety Inventory (BAI) (r = 0,10-0,63) and SSPS-trait (r = 0,22-0,65), discriminative validity (sensitivity = 0,84, specificity = 0,87) and construct validity. Factorial analysis indicated the presence of a variable number of factors as a function of the sample studied. The reduced version of this instrument, the Mini-SPIN, is emphasized, also presenting excellent psychometric indicators (sensitivity = 0,77, specificity = 0,67). SSPS-trait proved to be quite adequate regarding internal consistency ( = 0,64-0,94), validity in agreement with the BAI (r = 0,18-0,53) and SPIN (r = 0,22-0,65), and discriminative validity between cases and non-cases of SAD. Factorial analysis demonstrated the presence of two factors, i.e., positive and negative self-evaluation. The BSPS applied with the support of a guidingquestion list, presented excellent inter-rater reliability (0,86-1,00) and discriminative validity (sensitivity = 0,84, specificity = 0,83), adequate internal consistency ( = 0,48- 0,88), validity in agreement with the BAI (r = 0,21-0,62), SPIN (r = 0,24-0,82) and SSPStrait (r = 0,23-0,31), and construct validity. Factorial analysis indicated the presence of six factors that explained 71,8% of the variance of the data. The SSPS-state proved to be appropriate for the evaluation of cognitive aspects associated with public speaking, presenting excellent discriminative validity between cases and non-cases of SAD, as well as sensitivity in the discrimination of the different levels of anxiety during the phases of the procedure. All instruments showed good psychometric qualities, a fact that recommends their use in the population of Brazilian college students, with the possibility of application both in the clinical and experimental context, favoring a more precise detection of SAD, especially within the context of primary health care.

O Transtorno de Ansiedade Social (TAS) é um distúrbio de início precoce, com prevalência e comorbidades significativas, favorecendo prejuízos importantes no funcionamento laboral, familiar, social e acadêmico, especialmente em pessoas jovens. Dada tais características, faz-se necessária a identificação precoce e o diagnóstico preciso do TAS, o que requer instrumentos validados. Objetivou-se a avaliação sistemática do TAS, por meio de um conjunto de instrumentos validados quanto às suas qualidades psicométricas de fidedignidade e validade, em uma população de adultos jovens brasileiros, estudantes universitários, sob a perspectiva da auto e hetero-avaliação. Para tal, realizou-se a validação transcultural dos instrumentos auto-avaliativos: Social Phobia Inventory (SPIN) e Self Statements During Public Speaking Scale (SSPS versão traço e estado) e do instrumento hetero-avaliativo Brief Social Phobia Scale (BSPS), com aprovação prévia dos autores das versões originais. O delineamento metodológico envolveu três etapas. Na primeira, a amostra utilizada para avaliação dos instrumentos SPIN e SSPS foi composta por 2314 estudantes universitários da população geral. Na segunda etapa, para a validação dos instrumentos SPIN, SSPS e BSPS, utilizou-se de uma amostra de 178 estudantes universitários identificados como casos (N = 88) e não-casos (N = 90) de TAS, através da Entrevista Clínica Estruturada para o DSM-IV (SCID-IV). Na terceira etapa, 45 estudantes universitários também classificados como casos (N = 24) e não-casos (N = 21) de TAS compuseram a amostra para validação da SSPS-estado no contexto de um modelo experimental de falar em público. O SPIN apresentou boa consistência interna (=0,63- 0,90), validade concorrente com o Inventário de Ansiedade de Beck (BAI) (r = 0,10-0,63) e SSPS-traço (r = 0,22-0,65), validade discriminativa (sensibilidade = 0,84, especificidade = 0,87) e validade de construto. A análise fatorial indicou a presença de um número variável de fatores em função da amostra estudada. Destaca-se a versão reduzida deste instrumento, o Mini-SPIN, que também apresentou ótimos indicadores psicométricos (sensibilidade = 0,77, especificidade = 0,67). A SSPS-traço mostrou-se bastante adequada quanto à consistência interna ( = 0,64-0,94), validade concorrente com o BAI (r = 0,18-0,53) e SPIN (r = 0,22-0,65) e validade discriminativa entre casos e não-casos de TAS. A análise fatorial evidenciou a presença de dois fatores: auto-avaliação positiva e negativa. A BSPS aplicada com o suporte de um roteiro de perguntas-guia, apresentou excelentes confiabilidade inter-avaliadores (0,86-1,00) e validade discriminativa (sensibilidade = 0,84, especificidade = 0,83); adequadas consistência interna ( = 0,48-0,88), validade concorrente com o BAI (r = 0,21-0,62), SPIN (r = 0,24-0,82) e SSPS-traço (r = 0,23-0,31) e validade de construto. A análise fatorial apontou a presença de seis fatores que explicam 71,8% da variância dos dados. A SSPS-estado mostrou-se apropriada para avaliação dos aspectos cognitivos associados ao falar em público no contexto de um modelo experimental de simulação de falar em público, apresentando excelente validade discriminativa entre casos e não-casos de TAS, além de sensibilidade para discriminar os diferentes níveis de ansiedade nas fases do procedimento. Todos os instrumentos mostraram boas qualidades psicométricas, o que recomenda o uso na população de universitários brasileiros, podendo ser aplicados tanto em contextos experimentais como clínicos, favorecendo a detecção mais precisa do TAS, especialmente nos contextos de atenção primária à saúde. / Social Anxiety Disorder (SAD) is a condition of early onset and of significant prevalence and comorbidity, greatly impairing the functioning of young people in terms of job, family, social life and academic performance. In view of these characteristics, an early identification and precise diagnosis of SAD are necessary, requiring validated instruments. The objective of the present study was to perform a systematic evaluation of SAD by means of a set of instruments tested in a population of young Brazilian adults, college students, from the perspective of self- and hetero-evaluation. For this purpose, transcultural validation was performed of the self-evaluation instruments Social Phobia Inventory (SPIN) and Self Statements During Public Speaking Scale (SSPS trait and state version) and of the hetero-evaluation instrument Brief Social Phobia Scale (BSPS), after approval by the authors of the original versions. The methodological design involved three stages. In the first, the sample used for evaluation of the SPIN and SSPS instruments consisted of 2314 college students from the general population. In the second stage, a sample of 178 college students identified as cases (N = 88) and non-cases (N = 90) of SAD, confirmed by the Structured Clinical Interview for DSM-IV (SCID-IV) was used for the evaluation of the SPIN, SSPS and BSPS instruments. In the third stage, 45 college students, also classified as cases (N = 24) and non-cases (N = 21) of SAD, formed the sample for the evaluation of the SSPS-state within the context of an experimental public speaking model. SPIN presented good internal consistency ( = 0,63-0,90), validity in agreement with the Beck Anxiety Inventory (BAI) (r = 0,10-0,63) and SSPS-trait (r = 0,22-0,65), discriminative validity (sensitivity = 0,84, specificity = 0,87) and construct validity. Factorial analysis indicated the presence of a variable number of factors as a function of the sample studied. The reduced version of this instrument, the Mini-SPIN, is emphasized, also presenting excellent psychometric indicators (sensitivity = 0,77, specificity = 0,67). SSPS-trait proved to be quite adequate regarding internal consistency ( = 0,64-0,94), validity in agreement with the BAI (r = 0,18-0,53) and SPIN (r = 0,22-0,65), and discriminative validity between cases and non-cases of SAD. Factorial analysis demonstrated the presence of two factors, i.e., positive and negative self-evaluation. The BSPS applied with the support of a guidingquestion list, presented excellent inter-rater reliability (0,86-1,00) and discriminative validity (sensitivity = 0,84, specificity = 0,83), adequate internal consistency ( = 0,48- 0,88), validity in agreement with the BAI (r = 0,21-0,62), SPIN (r = 0,24-0,82) and SSPStrait (r = 0,23-0,31), and construct validity. Factorial analysis indicated the presence of six factors that explained 71,8% of the variance of the data. The SSPS-state proved to be appropriate for the evaluation of cognitive aspects associated with public speaking, presenting excellent discriminative validity between cases and non-cases of SAD, as well as sensitivity in the discrimination of the different levels of anxiety during the phases of the procedure. All instruments showed good psychometric qualities, a fact that recommends their use in the population of Brazilian college students, with the possibility of application both in the clinical and experimental context, favoring a more precise detection of SAD, especially within the context of primary health care.

Purpose: The tendency to prioritize negative or threatening social information, a cognitive process known as cognitive bias, has been linked to the development of social anxiety. Given the increased risk for social anxiety among adolescents who stutter (aWS), this project extended the research on cognitive bias to aWS to inform our understanding of the psychosocial factors associated with stuttering in adolescence – the period of development when social anxiety typically emerges. The purpose of this two-part study was to examine group and individual differences in two forms of cognitive bias among aWS and typically fluent controls (TFC) – attentional and interpretation biases. Methods: A sample of 102 adolescents (49 aWS and 53 TFC; 13- to 19-years-old) completed a self-report measure of social anxiety, a computerized attentional bias task, and a computerized interpretation bias task. To assess attentional bias, neutral-negative face pairs were presented in a modified dot-probe paradigm in which response times to engaging and disengaging from neutral, fearful, and angry expressions were measured. To assess interpretation bias, ambiguous verbal and nonverbal social scenarios were presented in a vignette-based recognition task, after which participants endorsed possible negative and positive interpretations of those scenarios. Results: The aWS and TFC reported comparable degrees of social anxiety, although female aWS reported higher levels than male aWS. For the attentional bias task, aWS were faster to engage with fearful faces than to maintain attention on neutral faces, and they were also faster to disengage from fearful and angry faces than to maintain attention on those negative faces. TFC did not demonstrate an attentional preference for any particular face type. For the interpretation bias task, while aWS and TFC rated negative and positive interpretations of verbal and nonverbal scenarios similarly, social anxiety moderated the effect of interpretation characteristics on endorsement of those interpretations; participants with greater social anxiety endorsed negative interpretations of verbal scenarios to a greater degree than those with lower social anxiety, and participants with lower social anxiety endorsed positive interpretations of verbal and nonverbal scenarios to a greater degree than those with higher social anxiety. Conclusions: This study contributes to the existing literature in several meaningful ways. First, this sample of aWS and TFC demonstrated comparable rates of social anxiety, which counters many other reports of group differences in social anxiety in this population. Second, it supports previous preliminary accounts of attentional bias among individuals who stutter. The present findings are novel in that aWS’ rapid engagement with and rapid disengagement from negative faces were observed in the absence of group differences in social anxiety. Third, the results challenge the speculation that stuttering is associated with negative interpretation bias – a relationship that has been proposed in the literature but never empirically investigated. Taken together, these findings provide the groundwork for continued investigation into the role of social information processing on psychosocial outcomes for aWS.

In anticipation of a future social interaction, socially anxious individuals (SAIs) may imagine themselves appearing stupid or foolish and predict and exaggerate the probability and costs of conveying these undesirable social images both on oneself (e.g., “I will feel stupid”) and on others impressions of oneself (e.g., “Others will think I’m stupid”). However, there is a paucity of research examining the latter bias; moreover, research regarding SAIs estimates of the probability and costs of conveying a positive impression (e.g., “I will feel smart”) has typically been neglected. Thus, the a novel questionnaire was created in order to develop a more comprehensive model of SAIs estimates of probability and costs. We expected that positive and negative, self- and other-related judgments will represent four distinct, latent constructs that will be related to trait social anxiety indirectly through fears of positive and negative evaluation per the evolutionary model of social anxiety. Structural equation modeling was used to test study hypotheses. The final sample included four hounded and seventy-four college students (307 males and 167 females). Results generally supported study hypotheses. After minor theoretically justified modifications, the hypothesized model provided good fit to the data, χ2(94) = 151.78, CFI = .99, TLI = .99, RMSEA = .04. All social appraisals (or judgments) with the exception of other-negative appraisals were indirectly related to social anxiety through fears of positive and negative evaluation. Contrary to expectations, other-positive appraisals were negatively related to fear of negative evaluation and other-negative appraisals were uncorrelated with fear of positive evaluation, providing partial incremental validity of the novel questionnaire used in this study. Results provide preliminary evidence that suggests future research should extend evaluation of SAIs anticipatory social appraisals beyond negative, self-related social impact. Implications, limitations, and future directions of the research are be discussed.

Not having a child has significant psychosocial effects on women experiencing infertility problems. There is a gap in research on social anxiety, quality of life, and healthy lifestyle behaviors of women during infertility, fertility treatment, and subsequent pregnancy. The purpose of this quantitative comparative study was to investigate the social anxiety, quality of life, and healthy lifestyle behaviors of Turkish women with infertility issues and Turkish women who conceived after infertility treatment, as measured by the Liebowitz Social Anxiety Scale, the Fertility Quality of Life Questionnaire, and the Healthy Lifestyle Behavior Scale II. The social support and stress buffering theory and the health promotion model provided the framework for the study. Mann-Whitney U tests were used to evaluate 200 women undergoing infertility treatment and women who conceived after infertility treatment on social anxiety, quality of life, and healthy lifestyle behaviors. The results indicated that women undergoing infertility treatment had higher social anxiety and avoidance and higher nutritive healthy lifestyle behaviors than women who conceived after infertility treatment. There was no difference in quality of life between the groups. Findings may promote a better understanding of social anxiety, quality of life, and healthy lifestyle behaviors of women undergoing infertility treatment. This heightened awareness may be used to increase psychosocial well-being of women and may increase the success rate of infertility treatment.

This mixed methods case study examined the effect of reduced fear of negative evaluation and self focus on behaviors related to shyness in a church environment. A sample of 239 members, regular attenders, and visitors completed a survey, consisting of the Brief Fear of Negative Evaluation-Straightforward (BFNE-S) Scale; two checklists measuring perceived acceptance and levels of comfort in situations known to be difficult for shy people; and extended response questions regarding thoughts, feelings, and behaviors in six church situations. Confirmatory factor analysis revealed the BFNE-S (General and Context-specific) had acceptable fit compared with previous studies, and descriptive statistics were similar to those of previous studies. Lower self-reported levels of fear of negative evaluation and higher levels of perceived comfort, but not acceptance, in the church setting were found to be statistically significant, although the effect size was negligible. A repeated measures ANOVA revealed no statistically significant difference for gender or race for individuals in the church setting compared to the non church setting. A multiple regression failed to reveal a statistically significant relationship between depth and breadth of involvement in church activities and reduced fear of negative evaluation. The Clark-Wells (1995) model of social phobia explained 62% of self-reported behaviors, thoughts, and feelings of individuals with high levels of shyness when in social situations in the church setting. A statistically significant difference was found between focus of attention and quality of thought scores for individuals with minimal to low levels of shyness and high levels of shyness. To explore further the validity of scores obtained with the BFNE-S, it would be useful to conduct a study in different environments and seek to understand individuals in those environments with high and low fear of negative evaluation. Future research regarding the church setting should utilize a sample with fewer long-term members and regular attenders. Additionally, future studies could probe how religious beliefs help people cope with difficult situations, in particular shyness.

Self-focused information processing has become a central aspect of cognitive explanations of social anxiety disorder. Indeed, Clark and Wells (1995) theorized that the key feature of the disorder is the processing of the self as a social object. It is proposed that when socially anxious individuals enter feared situations, they shift their attention to a detailed monitoring of themselves. Such self-focused attention triggers recollections of negative experiences from the past and directs attention towards signs of threat. This interferes with the processing of the situation and leads to misinterpretation of others' behaviours. Although there is now considerable support for the Clark and Wells' model from research on imagery, post-event and anticipatory processing, there is surprisingly little evidence for memory disturbance. Unlike mood disorders, to date, deficits in accessing autobiographical memories have not been found for social anxiety. In this thesis it is argued that a possible reason for the lack of evidence of memory deficits in social anxiety is that researchers have not attempted to manipulate participants' levels of self-focus in conducting research on autobiographical memory. The focus of this thesis was on the accessibility and quality of the autobiographical memories of socially anxious and non-socially anxious individuals obtained under conditions of self-focus in comparison to responses obtained when not self-focused. The present research utilized a two-phase quasi-experimental design with a sample of 144 adults taken from an initial pool of 203 volunteers. The final sample comprised 30 men and 114 women, ranging in age from 17 to 67 years (M = 26, SD = 11.91, median age = 20 years). The sample consisted of 292 undergraduates and community participants recruited via advertisements. Group membership was based on selection criteria from a measure of social anxiety, the Social Phobia and Anxiety Inventory (SPAI; Turner, Beidel, Dancu & Stanley, 1989b), depression and general anxiety from the Depression, Anxiety and Stress Scale (DASS; Lovibond & Lovibond, 1995), and the anxiety disorder interview schedule (ADIS-IV-L; Di Nardo, Brown & Barlow, 1994). Initial respondents were allocated to socially anxious (SA), socially anxious depressed (SAD), and non-socially anxious (NSA) groups, with the SAD group forming a further control group of respondents with high scores in SPAI social anxiety and DASS depression. Approximately half of each group was primed to Self-focus, by making an impromptu speech which was videotaped and replayed to each participant individually, following an adaptation of a priming methodology by Perowne and Mansell (2002). The other half of the participants was not self-focused. Rather, they viewed video tape of a confederate giving a speech so as to Other-focus. The priming was prior to participants' provision of written responses to positive and negative (social anxiety) cue words using Williams' (2002) Autobiographical Memory Test. The quality of the memories was measured according to overgenerality for positive and negative cues. Reaction time was recorded for memories to the same valenced cues. The incidence of anxiety and depression content in the memories was determined using coding schemes devised by Gottschalk and Gleser (1969). As hypothesised, the results confirmed that greater levels of generality and longer reaction time to positive cues (not for negative cues) were evident when comparing self-focused SA with self-focused non-socially anxious (NSA) individuals, reflecting findings for other emotional disorders such as depression. Self-focused socially anxious (SA) individuals responded with greater levels of generality and longer reaction times for memories for valenced cues, particularly positive ones, than other-focused SA individuals. Further analysis for generality found that self-focused SA respondents were more general than other-focused socially anxious with comorbid depression (SAD) individuals for memories for positive cues. However, both groups were similar for negative memory cues. As confirmation for memory deficits as a function of the priming manipulation, greater generality and longer reaction times for memories for positive cues occurred when comparing self-focused SA individuals, to all control groups (NSA groups and other-focused SAD individuals). Without priming, SA individuals did not demonstrate autobiographical memory deficits in quality or accessibility compared to NSA controls. Exploration of the autobiographical memory content indicated that SA (compared to SAD and NSA) individuals, irrespective of focus, reported more depression than anxiety content in their memories. Additionally, self-focused SA in contrast to other-focused SA individuals, experienced heightened depression content in their memories, although none of the individual categories of depression was prominent. Predictions of SPAI social anxiety and DASS depression scores from the significant predictors associated with the memories, were undertaken separately for self- and other-focused individuals. Reaction time to positive cues was found to be the only stable predictor of both social anxiety and depression for the self-focused respondents. For the other-focused condition, only total anxiety content theme was found to predict social anxiety, albeit poorly. Overall, the present thesis established that the self-focusing manipulation unearthed a memory processing deficit in socially anxious individuals, similar to that found in most emotional disorders in terms of quality, accessibility, and content, of the memories. This result was particularly apparent in relation to responses to positive cues. The findings are consistent with the Clark and Wells' (1995) model of the disorder emphasising the role of the views of the self as the core element of the disorder. The results also show that the processing deficits of social anxious individuals are confined to the self-focus condition. It is suggested that more attention should be placed on the self-role in social anxiety and that mindfulness-based cognitive therapy, efficacious in mood disorders by reducing the overgenerality effects, is also relevant to social anxiety disorder. Future longitudinal research should be conducted with clinical groups of socially anxious patients, using a self-focus manipulation, to ascertain if the results of the present can be replicated and extended. Pre- and post-treatment measurements of the autobiographical memories of socially anxious patients should be measured and compared, to ascertain whether the deficits can be repaired through the use of mindfulness-based cognitive therapy (MBCT; Williams, Teasdale, Segal & Soulsby, 2000). Self-focus priming could also be used with other anxiety disordered individuals such as generalised anxiety disorder and panic individuals, as they too, appear to be likely candidates for the ruminative self-focus which has contributed to the memory processing deficits established in the autobiographical memories in social anxiety disorder.

Previous research has elucidated social competence as a prominent variable contributing to psychosocial adjustment in juveniles with chronic illness. In particular, early interactions with parents and peers play a large role in the development of social competence by teaching young people how to initiate and maintain satisfying and warm relationships. The current study examined developmental differences in relations among parent-child relationship variables (parental protectiveness), peer interaction variables (social skills, social anxiety), and social competence in juveniles with asthma and diabetes. Hierarchical multiple regression was used to evaluate mediated models using data from a sample of 178 preadolescent (ages 7-11) and adolescent (ages 12-16) juveniles. Results indicated that social anxiety and social skills mediated the relation between parental protectiveness and social competence in the adolescent age group, but not in the preadolescent age group. In contrast, social skills mediated the relation between parental protectiveness and social anxiety in the preadolescent group only. Attachment security evidenced a strong direct influence on social competence, which was not mediated by social skills or social anxiety. Because protective parenting styles were found to influence social competence through peer interaction variables posited to be directly impacted by chronic illness (i.e., social skills and social anxiety), it is suggested that they are an influential illness-specific determinant of psychosocial adjustment in young people with asthma or diabetes.