THE INTERACTION OF INTERNAL AND EXTERNAL FOCUS IN SOCIAL ANXIETY: CLARIFYING COGNITIVE BEHAVIORAL MODELS

Abstract

The two preeminent cognitive behavioral models of social anxiety disorder (Clark & Wells, 1995; Rapee & Heimberg, 1997) indicate attentional bias as a process fundamental to the maintenance of the disorder. They differ, however, on their conceptualization of this process. Clark and Wells suggest that socially anxious persons look only to themselves, their thoughts, and their images during social situations. Although Rapee and Heimberg agree that socially anxious persons become highly self-focused, they also assert that self-focus and vigilance to threat in the environment coexist and interact throughout social situations. This study provides a direct test of this discrepancy, predicting that persons who scored high and low on a measure of communication anxiety would exhibit differences on measures of self-focused attention and environment-focused attention, in support of the model of Rapee and Heimberg. Participants in this study were randomly assigned to speak to audiences of confederates who were trained to demonstrate either mostly negative or mostly positive behaviors. Rapee and Heimberg's predictions were supported, but only on a measure of anxious participants' cognitions and in exploratory correlational analyses. Overall, the evidence was not sufficient to support one model over another. However, the current study is novel in its design, combination of assessment instruments, and examination of attentional processes that have thus far been studied in isolation.