After the fact: Post-Event Processing May Complicate Your Social Anxiety

How did it go?

How you answer these questions may depend on how much social anxiety you experience. Research indicates individuals with social anxiety disorder (SAD; characterized by a persistent fear of judgment, criticism, and negative evaluation in social or performance situations) tend to rate their performance in social interactions and performance situations more negatively than those without SAD do ^{1, 2, 3}. Simply put, in response to “how did it go?”, individuals with SAD are more likely than those without SAD to say that it went poorly.

Afterward, do you think about the event? If so, why?

Current research on SAD also indicates that individuals with SAD tend to have positive meta-cognitive beliefs, or positive beliefs about repeatedly thinking about the event ^{2, 4, 5}. For example, individuals with SAD may believe that thinking about the event will result in learning more about themselves and their performance. Thus, in response to “Afterward, do you think about the event? If so, why?”, individuals with SAD are more likely than those without SAD to say yes, because they believe that thinking about the event will be helpful.

What parts of the event did your focus on?

The current literature also indicates that individuals with SAD engage in post-event processing, a term that describes prolonged rumination and repetitive negative thinking following a social anxiety-provoking event. Individuals with SAD typically engage in post-event processing by repetitively thinking about the feelings of anxiety and the negative thoughts and self-perceptions that occurred during the social anxiety-provoking event ^{1, 2, 6}. Thus, in response to “what parts of the event did you focus on?”, individuals with SAD are more likely that those without SAD to say that they focused on the negative, rather than the positive, aspects of the event.

How can we use this information?

To put it all together, a recent study by Gavric and colleagues (2017) found that having positive meta-cognitive beliefs predicted post-event processing, which, as models of SAD indicate, is an important mechanism maintaining or exacerbating SAD ⁷. Such findings indicate that targeting positive meta-cognitive beliefs or post-event processing may be an effective strategy in treating SAD. For example, let’s say that John has SAD and has recently given a presentation. John is likely to believe that it is helpful to later think about his performance on the presentation, and subsequently do so. However, he is more likely to focus on the negative aspects of his performance. In doing so, the memory of the social event becomes encoded as being more negative and more anxiety-provoking than it really was, since John now remembers the presentation as only the anxious feelings and thoughts that he had. Consequently, John continues to experience anxiety about social situations, thus maintaining or exacerbating his SAD ⁷.

Currently, the preferred treatment is CBT with exposure. But future research may be able to use this information to highlight additional avenues for therapies to target SAD, such as changing John’s post-event processing to focus on positive or alternate outcomes instead. As an example, new research is focusing on ABBT with exposure techniques for SAD. And while further study is necessary to better examine positive meta-cognitive beliefs and post-event processing in the context of the therapy, the study does further pave the way for us to gain a better understanding of the cognitive factors maintaining SAD.