An empirical analysis of Moscovitch’s reconceptualised model of social anxiety: How is it different from fear of negative evaluation?
Introduction
Social Anxiety Disorder (SAD) is a highly prevalent mental disorder, associated with high levels of chronicity, distress and functional impairment (Stein & Stein, 2008; Wong, Gordon, & Heimberg, 2014). First introduced in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 1980), it is currently defined as a marked and persistent fear of negative evaluation, embarrassment, rejection or offending others (American Psychiatric Association., 2013). Growing evidence now supports the existence of a continuum of social anxiety severity; meaning SAD reflects only a difference in the degree of social anxiety a person experiences in clinical and non-clinical presentations (Crome, Baillie, Slade, & Ruscio, 2010; Ruscio et al., 2008). The high personal, social and economic costs of clinical (Stein & Stein, 2008) and sub-clinical levels of social anxiety (Acarturk, de Graaf, Van Straten, Have & Cuijpers, 2008) highlights the need for understanding the processes involved in causing and maintaining social anxiety.
Two of the most influential cognitive models of social anxiety, Clark and Wells’ (1995) and Rapee and Heimberg’s (1997), posit that fear of negative evaluation is central to causing and maintaining social anxiety. Fear of negative evaluation encompasses feelings of apprehension about others’ evaluations, distress over these evaluations, and the expectation that others will evaluate one negatively. Individuals with high levels of social anxiety frequently try to reduce the potential for negative evaluation through safety behaviours (Wells et al., 1995); yet are also observed to have strong attentional biases toward threat-consistent information in social situations (see Heinrichs & Hofmann, 2001). Fear of negative evaluation is commonly measured by the Fear of Negative Evaluation scale (FNE; Watson & Friend, 1969) and the revised Brief Fear of Negative Evaluation Scale (BFNE; Leary, 1983). Scores on these measures predict various aspects of social anxiety behaviour including catastrophising, over-estimation of the visibility of anxiety to others, and increased focus on negative social cues (see Weeks et al., 2005).
However, Moscovitch (2009) argues that previous cognitive-behavioural models of social anxiety (e.g., Clark and Wells’, 1995; Rapee and Heimberg, 1997) are unsatisfactory because they confuse feared stimuli (i.e., the focus of anxiety) with feared consequences (i.e., feared outcomes when stimuli are present; e.g., negative evaluation: Moscovitch, 2009, p.124). Instead, he argues that theoretical focus should be directed toward the specific self-attributes that individuals with social anxiety perceive to be flawed or deficient. Rather than a general fear of negative evaluation, this model suggests fear of negative evaluation and embarrassment are feared consequences of deficient self-attributes being exposed to public scrutiny. In order to reduce potential exposure of flawed self-attributes, people may use safety behaviours as selective self-concealment strategies. In his original model, Moscovitch proposed four primary areas of perceived self-deficiencies: social skills and behaviours (e.g., I will do something stupid), showing signs of anxiety (e.g., I will sweat), physical appearance (e.g., I am ugly) and character (e.g., I am boring). However, after operationalising these in the Negative Self-Portrayal Scale (NSPS; Moscovitch and Huyder, 2011) only three were supported by factor analyses: concerns about social competence, physical appearance, and showing signs of anxiety. These three remaining subscales were highly correlated (r = .59–.77).
To date, Moscovitch and colleagues have provided empirical support for this revised model by demonstrating that the total scores on the NSPS predict patterns in a) safety behaviours, b) types of feared situations, and c) feared consequences. This includes findings that overall scores on the NSPS are strongly associated with existing measures of social anxiety and depression; yet account for a significant portion of unique variance in self-concealment over and above existing social interaction and performance measures (Moscovitch and Huyder, 2011; Moscovitch et al., 2013). There is also support for the specific individual self-attribute concerns being highly represented in the negative self-images that individuals with social anxiety report experiencing (Chiupka, Moscovitch, & Bielak, 2012; Moscovitch, Gavric, Merrifield, Bielak, & Moscovitch, 2011). This is consistent with Moscovitch’s (2009) suggestion that differences in self-attribute concerns may account for the heterogeneity commonly observed in social anxiety symptom expression (see Hofmann, Heinrichs, & Moscovitch, 2004; McManus, Sacadura, & Clark, 2008).
The utility of Moscovitch’s (2009) reconceptualised model of social anxiety has been questioned by Heimberg (2009) who suggested that it may not provide an entirely novel approach to the conceptualisation of social anxiety. In response to Moscovitch’s assertion that earlier models of social anxiety are unsatisfactory as they confused feared stimuli with feared consequences, Heimberg asserted that these constructs may be inextricably related, with the nature of the situations dictating what possible consequences could be. Heimberg also questioned the utility of assessing four highly correlated domains when a general fear of negative evaluation may be a more parsimonious explanation.
This study aims to empirically test Heimberg’s (2009) criticism by establishing whether Moscovitch’s (2009) model provides any unique information about aspects of social anxiety (including safety behaviours, triggering situations, and feared consequences) over and above fear of negative evaluation. Consistent with Heimberg’s (2009) criticism of the reconceptualised model, we hypothesised that the subscales of the NSPS (i.e., social competence, physical appearance, and signs of anxiety) would not significantly predict variance in any of the outcomes featured in Moscovitch’s model (i.e., safety behaviours, fear triggers/types of fears, and feared consequences), over and above a general measure of fear of negative evaluation.
Section snippets
Participants
A convenience sample of 286 participants were recruited through promotion within university and community settings in exchange for a prize draw (AU $50.00) or course credit. Recruitment strategies intended to capture individuals who identified as having some level of social fear by using statements such as “do you experience some anxiety in social situations?” in promotional materials. Further information and consent forms also highlighted that the survey related to social anxiety. The final
The relationship between Moscovitch’s model and existing measures of social anxiety
Pearson correlations highlighted strong positive associations between all variables of interest (p < .001), including the three subscales of the NSPS (Table 2, Table 3). Thus, participants who experienced a perceived deficit in one self-attribute were also highly likely to experience perceived deficits in the other self-attributes. The strong commonalities both within the subscales of the NSPS; and with fear of negative evaluation and measures of social anxiety, is consistent with Heimberg’s
Discussion
The present paper examined whether Moscovitch’s (2009) model of social anxiety disorder provides additional explanatory power in the understanding of aspects of social anxiety over and above fear of negative evaluation. Assessing perceptions of flawed attributes using as a measure such as the NSPS explains significant additional unique variance in safety behaviours, feared consequences, and feared triggers/types of fears over and above fear of negative evaluation. These findings are in line
Concluding remarks
Overall, the results of the study have demonstrated support for Moscovitch’s (2009) reconceptualised model of social anxiety. As proposed by Moscovitch (2009), feared deficits in three distinct self-attributes predicted a significant amount of variance in feared triggers/types of fears, feared consequences, and safety behaviours. Yet, some of this explained variation overlaps with general conceptualisations of fear of negative evaluation. More research is needed to answer the question of
Acknowledgements
All authors of this manuscript report no conflicts of interest related to this work. The research was conducted by the first author as part of a Bachelor of Psychology (Honours) degree under the supervision of the fourth author. Dr Crome received salary support from the NHMRC Centre of Research Excellence in Mental Health and Substance Use. We would like to thank Ms Jacqueline Frei, Ms Taylor-Jai McAlister, and Mr Daniel J. Yee for their assistance reviewing this manuscript.
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