Mediators and moderators of the relation between social anxiety symptoms and positive emotions: a comparison of two reminiscence strategies

In recent years, fear of positive evaluation has emerged as one of the key aspects of social anxiety, alongside fear of negative evaluation. Fears of evaluation intensify during adolescence, a time when individuals are expected to navigate new, emotionally challenging situations. The purpose of this study was to examine the associations between social anxiety, fear of positive and negative evaluation, and three emotion regulation strategies relevant to social anxiety, i.e., suppression, acceptance, and rumination. To this end, data were collected from 647 adolescents via an online survey and analyzed using structural equation modeling. We found that fear of negative evaluation was significantly related to rumination, whereas fear of positive evaluation was significantly and negatively related to acceptance. We further found an indirect effect of social anxiety on suppression via fear of positive evaluation and acceptance in a serial mediation and an indirect effect of social anxiety on rumination via fear of negative evaluation. Not only do fears of positive and negative evaluation appear to be distinct constructs, but they are also differentially associated with three emotion regulation strategies pertinent to social anxiety. Fear of evaluation and its associations with emotion regulation deficits might hinder the therapeutic process by acting as a deterrent to positive reinforcement or potentially impeding the development of a successful therapeutic alliance.

Fear of negative and positive evaluation as mediators and moderators of treatment outcome in social anxiety disorder

BackgroundSocial anxiety has become a common psychological problem that seriously affects the mental health of contemporary youth. Although numerous studies have shown that childhood trauma is closely related to social anxiety in adulthood, the mediating role of evaluation of fear in this relationship remains unclear. This study aims to explore the relationships among childhood trauma, evaluation fear, and social anxiety among college students and their internal pathways.MethodsIn September 2023, a sample of 559 Chinese university students aged 18–22 years (mean age = 20.20, SD = 1.211; 229 males and 330 females) completed the Childhood Trauma Questionnaire, Liebowitz Social Anxiety Scale, Fear of Positive Evaluation Scale, and Brief Fear of Negative Evaluation Scale. Correlation analyses were conducted to explore the initial relationships among the main variables. Structural equation modeling was performed to examine the parallel mediating effects of fear of positive and negative evaluation on the relationship between childhood trauma and social anxiety.ResultsSignificant correlations were found among childhood trauma, social anxiety, fear of negative evaluation, and fear of positive evaluation. Childhood trauma significantly and positively predicted both fear of positive evaluation (β = 0.40, p < 0.001) and fear of negative evaluation (β = 0.31, p < 0.001). Fear of positive and negative evaluation also positively predicted social anxiety (β = 0.45, p < 0.001; β = 0.43, p < 0.001, respectively). The parallel mediation effects of fear of positive and negative evaluation on the relationship between childhood trauma and social anxiety were significant (effect size: 0.309, 95% CI = [0.240, 0.380]), with the mediation effects accounting for 60.78% of the total effect.ConclusionFear of positive and negative evaluation plays a mediating role in the impact of childhood trauma on social anxiety. This finding provides a new perspective for understanding the formation mechanism of social anxiety and offers a scientific basis for developing effective intervention strategies.

Neural responses to social evaluation: The role of fear of positive and negative evaluation

Fear of negative evaluation (FNE) is a recognised diagnostic feature of Social Anxiety Disorder (SAD). Recently, the role of fear of positive evaluation (FPE) as a factor contributing to SAD has been a focus of research: there is evidence that FPE is associated with measures of social anxiety independent of measures of FNE and that measures of FPE may be sensitive to interventions for SAD. The present study examined the relationships between FPE, FNE and measures of social anxiety and depression in a sample assessed as suitable for group cognitive behaviour therapy (CBT) for social anxiety (n = 35), and the responsiveness of measures of FPE and FNE to standard group CBT for social anxiety in a subset of this group (n = 20). Measures of FNE and FPE were positively associated with each other and with measures of social interaction anxiety, general social anxiety concerns, and depression. However, the relationship between the FPE measure and measures of general social anxiety concerns and depression was not significant when FNE was statistically controlled. This is consistent with the view that FPE is specifically related to social interaction anxiety. In this sample, a measure of FPE was reduced in a sample receiving standard group CBT for social anxiety compared to a waitlisted group. The implications of these findings for the conceptualisation of SAD and for the delivery of interventions for those with SAD are considered.

Available research suggests that fear of negative evaluation and fear of positive evaluation are related but distinct constructs that each contribute to social anxiety, implying a need to focus on these fears in treatment. Yet, this research is almost entirely based on cross-sectional data. We examined the longitudinal relationship between fears of positive and negative evaluation over three time points in a sample of undergraduate students. We tested competing models consistent with two basic positions regarding these fears: (1) that fear of positive evaluation only appears to affect social anxiety because it arises from the same, single underlying trait as fear of negative evaluation, and (2) fears of positive and negative evaluation are correlated, but clearly distinct, constructs. The best-fitting model was an autoregressive latent-trajectory model in which each type of fear had a separate trait-like component. The correlation between these trait-like components appeared to fully account for the relationships between these constructs over time. This investigation adds to the evidence in support of the second position described above: fear of positive evaluation is best interpreted as a separate construct from fear of negative evaluation.

Fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are independently associated with social anxiety symptoms in adolescence, though no study has tested these relations longitudinally. The current study examined longitudinal relations between FNE, FPE, and social anxiety symptoms using a multi-informant design, in addition to testing adolescent gender as a moderator. Adolescents (N = 113; Mage = 12.39; Girls = 44.2%) and parents completed measures of FNE, FPE, and two ratings of social anxiety approximately 6 months apart. FNE and FPE demonstrated significant stability over time, but neither predicted change in the other construct. Adolescent and parent-reported FNE, but not FPE, predicted increased social anxiety symptoms. Adolescent report of social anxiety symptoms predicted increased FPE over time, whereas parent report of social anxiety symptoms predicted increased FNE. Contrary to hypothesis, gender did not moderate any of the pathways in the model. Findings provide the first evidence that FNE may function as a risk factor for increased social anxiety in adolescence.

Objectives This study set a structural model that behavioral inhibition and social anxiety were sequentially mediated by fear of positive evaluation and negative interpretation of positive events and examined the goodness of fit and the mediating effect of the model.&#x0D; Methods A total of 295 undergraduate students in Gyeonggi-do participated in this study and completed a measure of Retrospective Self-Report of Inhibition, Fear of Positive Evaluation Scale, Interpretation of Positive Events Scale, Social Interaction Anxiety Scale, Social Phobia Scale.&#x0D; Results First, correlation analysis showed that behavioral inhibition, fear of positive evaluation, negative interpretation of positive events and social anxiety were significantly and positively correlated with each other. Second, fear of positive evaluation and negative interpretation of positive events sequentially mediated the relationship between behavioral inhibition and social anxiety. Third, there was a gender difference in the path of fear of positive evaluation and social anxiety. It was confirmed that when the fear of positive evaluation affected social anxiety, the influence could be greater in men than in women.&#x0D; Conclusions This study is meaningful in that it explained the occurrence and maintenance of social anxiety from an integrated perspective, including behavioral inhibition, which is a temperamental vulnerability that could affect cognitive vulnerabilities such as fear of positive evaluation and negative interpretation of positive events. In addition, there were gender differences in some paths in the research model, so based on this future research was discussed.

Social anxiety disorder (SAD) is associated with persistent fear of negative evaluation (FNE) and fear of positive evaluation (FPE), which play critical roles in the development and maintenance of anxiety symptoms. However, it remains unclear how FNE and FPE contribute to the common and different symptoms of social anxiety. In this review, we tried to elucidate the shared and distinct mechanisms underlying fear of evaluation and clarify the impact of FNE and FPE on social anxiety by integrating the theories, external expressions, and internal mechanisms. First, FNE and FPE share evolutionary functions but have distinct motivations for maintaining social role stability. Second, FNE and FPE share similar emotions and avoidance behaviors but contribute to distinct comorbid symptoms in SAD, including eating disorders and alcohol abuse. Third, FNE and FPE share emotional and social pain circuits but have different dysfunctions in the prefrontal, cingulate, and reward brain regions, which are associated with rejection sensitivity and anhedonia features. Overall, this review sheds light on the cognitive and neural mechanisms of SAD based on fear of evaluation, highlighting both the shared and distinctive aspects of FNE and FPE. These insights have important implications for the development of effective interventions for social anxiety.

Social anxiety disorder (SAD) models posit vigilance for external social threat cues and exacerbated self-focused attention as key in disorder development and maintenance. Evidence indicates a modified dot-probe protocol may reduce symptoms of SAD; however, the efficacy when compared to a standard protocol and long-term maintenance of treatment gains remains unclear. Furthermore, the efficacy of such protocols on SAD-related constructs remains relatively unknown. The current investigation clarified these associations using a randomized control trial replicating and extending previous research. Participants with SAD (n = 113; 71% women) were randomized to complete a standard (i.e. control) or modified (i.e. active) dot-probe protocol consisting of 15-min sessions twice weekly for four weeks. Self-reported symptoms were measured at baseline, post-treatment, and 4-month and 8-month follow-ups. Hierarchical linear modeling indicated significant self-reported reductions in symptoms of social anxiety, fear of negative evaluation, trait anxiety, and depression, but no such reductions in fear of positive evaluation. Symptom changes did not differ based on condition and were maintained at 8-month follow-up. Attentional biases during the dot-probe task were not related to symptom change. Overall, our results replicate support for the efficacy of both protocols in reducing symptoms of SAD and specific related constructs, and suggest a role of exposure, expectancy, or practice effects, rather than attention modification, in effecting such reductions. The current results also support distinct relationships between fears of negative and positive evaluation and social anxiety. Further research focused on identifying the mechanisms of change in attention modification protocols appears warranted.

Social anxiety and eating disorder comorbidity: The role of negative social evaluation fears

Recent studies have shown that fear of positive evaluation (FPE) is closely associated with social anxiety. However, studies examining the unique role of FPE and investigating the nature of the relationship between FPE and social anxiety are limited. This article presents two studies to address this gap. The first study (N = 314) examines the individual role of FPE on social anxiety while controlling for fear of negative evaluation (FNE) and maladaptive cognitions. The second study (N = 342) investigates the mediating role of self-focused attention in the relationship between FPE and social anxiety. Results of Study 1 demonstrated that FPE explains additional variances in social anxiety above and beyond FNE and maladaptive cognitions. Study 2 found that self-focus mediates the relationship between FPE and social anxiety when FNE is controlled. The current findings highlight the critical role of FPE on social anxiety and provide valuable information on how FPE contributes to social anxiety.

An Initial examination of fear of negative and positive evaluation in youth

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215–224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.

A Cross-Cultural Comparison of the Bivalent Fear of Evaluation Model for Social Anxiety