Counterfactual thinking and repetitive thought in social anxiety

Abstract

Research suggests that those experiencing Social Anxiety (SA) symptoms are more likely to engage in repetitive thought (RT), including upward counterfactual thinking (U-CFT). Findings indicate that these cognitive patterns may lead to deleterious thoughts and emotions, particularly when U-CFT focuses on non-repeatable, uncontrollable situations and negative self-appraisals. The present dissertation consisted of two complementary studies. Study 1 attempted to 1) validate new measures of state and trait U-CFT, 2) examine the relationship between U-CFT and established measures of RT and mood, and 3) explore the relationship between SA symptoms and counterfactual thinking within a student population. Results indicated that the U-CFT-S (trait measure of U-CFT) and the Counterfactual Likelihood scales (state measure of U-CFT) evidenced sound psychometrics in terms of internal consistency, factor structure, and relationships with related questionnaires. Factor analyses revealed that the Maladaptive U-CFT-S scale clustered with negative mood, rumination, and learned helplessness, while the Adaptive U-CFT subscale clustered with measures of positive mood and self-efficacy. Finally, symptoms of SA correlated positively with state and trait U-CFT generation. Study 2 1) compared patterns of U-CFT and emotions such as guilt and self-blame between a diagnosed Social Anxiety Disorder (SAD) group and a Healthy Control (HC) group 2) determined if disorder-specific content impacts U-CFT generation, and 3) piloted a brief, CBT-based, video intervention targeting maladaptive U-CFT. Results indicated that the SAD group evidenced higher amounts of U-CFT in response to the socially-based scenarios than the HC group and in response to social than non-social scenarios. The SAD group evidenced higher levels of unhelpful emotions (e.g., guilt) both pre- and post-CFT generation than HC participants. Finally, the CBT intervention was generally unsuccessful at reducing maladaptive U-CFT, but was more likely to be effective among SAD than HC participants. Implications of this dissertation include: 1) the benefit of including state- and trait-based measures of U-CFT in future research, 2) the importance of conceptualizing U-CFT as a multifaceted construct, 3) addressing that those with SAD are engaging in maladaptive U-CFT and experiencing consequent guilt and self-blame, and 4) the direction of creating more comprehensive, brief interventions aimed at targeting maladaptive U-CFT.