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Clark and Wells (1995) posit that anticipatory processing before a social situation serves to maintain social anxiety. More specifically, ruminative processes similar to post-event processing (PEP) may occur in anticipation of anxiety provoking social events, and in this article, we have labelled this type of anticipatory rumination anticipatory event processing (AnEP). Participants (n 5 75) with social anxiety disorder (SAD) completed measures of anticipatory event processing, trait anxious rumination, social anxiety, state anxiety, and PEP, in the context of completing videotaped exposures twice as part of manual-based group cognitive behavioral therapy. AnEP was significantly positively associated with trait anxious rumination and social anxiety and was associated with state anxiety during the first videotaping. AnEP at the two time points was significantly correlated and decreased across the two taped exposures. Greater AnEP at the first taping was associated with greater PEP the following week. PEP after the first videotaped exposure then significantly related to AnEP for the second videotaped exposure several weeks later. Discussion focuses on the similarities between PEP and AnEP as well as implications for cognitive models and treatment of SAD.
Keywords: cognitive behavioral therapy; post-event processing; social anxiety disorder; cognition; rumination; anticipatory event processing
Social anxiety disorder (SAD) is an anxiety disorder characterized by marked fear in social situations, with a focus on fear of negative evaluation (Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM-5; American Psychiatric Association, 2013]). Cognitive models of SAD (Clark & Wells, 1995; Rapee & Heimberg, 1997) assert that prior to entering a social situation, individuals engage in anticipatory processing. During this anticipatory period, negative memories and beliefs from past social interactions are hypothesized to occur, with attendant focus on perceived social failures and corresponding predictions that they will perform poorly in the upcoming situation. Furthermore, cognitive-behavioral accounts of SAD suggest that upon entering social situations, individuals focus their attention internally on interoceptive cues (e.g., Woody, 1996) and generate negative images of themselves in their minds' eye (e.g., Makkar & Grisham, 2011) based on this negative arousal (Clark & Wells, 1995; Rapee & Heimberg, 1997). Finally, upon completion of the event, individuals with SAD engage in a postmortem analysis of the situation called "post-event processing" (PEP; e.g., Abbott & Rapee, 2004; Clark & Wells, 1995;...