Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T19:27:00.817Z Has data issue: false hasContentIssue false
  • English
  • Français

Inflated sense of responsibility, explanatory style and the cognitive model of social anxiety disorder: a brief report of a case control study

Published online by Cambridge University Press:  01 April 2019

Matthew Jones  and
Sarah Rakovshik
Matthew Jones*
Affiliation:
Institute of Life Sciences 2, Swansea University School of Medicine, Swansea, UK
Sarah Rakovshik
Affiliation:
Oxford Cognitive Therapy Centre and Oxford University, Department of Psychiatry, Warneford Hospital, Oxford, UK
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

We sought to investigate situation-specific inflated sense of responsibility and explanatory style in social anxiety disorder (SAD) according to the cognitive model. Participants aged 17–68 years (mean = 31.9, SD = 11.1) included waiting list patients referred to a primary care mental health service for cognitive behavioural therapy for SAD (n = 18) and non-anxious control participants (n = 65). A battery of psychometric measures, including a bespoke measure of responsibility beliefs, was used. Compared with controls, participants with SAD were more likely to demonstrate an inflated sense of responsibility (p ≤ 0.001), and to adopt a negative explanatory style specific to social interaction (p ≤ 0.01). Inflated sense of responsibility was found to correlate with SAD symptomatology (r = 0.47, p ≤ 0.05), and with increased usage of safety behaviours (r = 0.47, p ≤ 0.05). Caseness (β = 1.45, p ≤ 0.01) and stability of causal attribution (β = 0.25, p ≤ 0.001) were found to predict inflated responsibility in our sample. To our knowledge this study represents the first attempt to investigate inflated responsibility within the context of SAD. Our results support the notion of inflated responsibility as a feature of SAD.

Key learning aims

  1. (1) To understand the cognitive behavioural components of Clark and Wells’ model of SAD, and their bi-directional nature.

  2. (2) To understand what the term ‘inflated sense of responsibility’ refers to, and how it relates to CBT.

  3. (3) To understand what the term ‘explanatory style’ refers to, and how this concept can also relate to CBT.

Keywords

causal attributionsCBTresponsibilitysocial anxiety disorder
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 12: Special Issue: Cultural Adaptations of CBT , 2019 , e19
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further reading

Clark, DM, Wells, A (1995). A cognitive model of social phobia. In Heimberg, RG, Liebowitz, MR, Hope, DA and Schneier, FR (eds), Social Phobia: Diagnosis, Assessment, and Treatment (pp. 69–93). New York, NY, USA: Guilford Press.Google Scholar
Salkovskis, P, Wroe, A, Gledhill, A, Morrison, N, Forrester, E, Richards, C, Thorpe, S (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy 38, 347–372. doi: 10.1016/s0005-7967(99)00071-6 CrossRefGoogle ScholarPubMed
Weiner, B (1986). An Attributional Theory of motivation and emotion, pp. 159–190. New York, NY, USA: Springer. doi: 10.1007/978-1-4612-4948-1_6 CrossRefGoogle Scholar

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC, USA: American Psychiatric Association.Google Scholar
Antony, MM, Coons, MJ, Mccabe, RE, Ashbaugh, A, Swinson, RP (2006). Psychometric properties of the social phobia inventory: further evaluation. Behaviour Research and Therapy 44, 1177–1185. doi: 10.1016/j.brat.2005.08.013 CrossRefGoogle ScholarPubMed
Arkin, RM, Appelman, AJ, Burger, JM (1980). Social anxiety, self-presentation, and the self-serving bias in causal attribution. Journal of Personality and Social Psychology 38, 23–35. doi: 10.1037//0022-3514.38.1.23 CrossRefGoogle ScholarPubMed
Bögels, SM, Alberts, M, Jong, PJ (1996). Self-consciousness, self-focused attention, blushing propensity and fear of blushing. Personality and Individual Differences 21, 573–581. doi: 10.1016/0191-8869(96)00100-6 CrossRefGoogle Scholar
Boisvert, CM, Faust, D (1999). Effects of the label ‘schizophrenia’ on causal attributions of violence. Schizophrenia Bulletin 25, 479–491. doi: 10.1093/oxfordjournals.schbul.a033395 CrossRefGoogle Scholar
Brozovich, F, Heimberg, RG (2011). The relationship of post-event processing to self-evaluation of performance in social anxiety. Behavior Therapy 42, 224–235. doi: 10.1016/j.beth.2010.08.005 CrossRefGoogle ScholarPubMed
Bruce, SE, Yonkers, KA, Otto, MW, Eisen, JL, Weisberg, RB, Pagano, M, et al. (2008). Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Focus 6, 539–548. doi: 10.1176/foc.6.4.foc539 CrossRefGoogle Scholar
Clark, DM, Ehlers, A, Hackmann, A, Mcmanus, F, Fennell, M, Grey, N, et al. (2006). Cognitive therapy versus exposure and applied relaxation in social phobia: a randomized controlled trial. Journal of Consulting and Clinical Psychology 74, 568–578. doi: 10.1037/0022-006x.74.3.568 CrossRefGoogle ScholarPubMed
Clark, DM, Ehlers, A, Mcmanus, F, Hackmann, A, Fennell, M, Campbell, H, et al. (2003). Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial. Journal of Consulting and Clinical Psychology 71, 1058–1067. doi: 10.1037/0022-006x.71.6.1058 CrossRefGoogle ScholarPubMed
Clark, DM, Wells, A (1995). A cognitive model of social phobia. In Heimberg, RG, Liebowitz, MR, Hope, DA and Schneier, FR (eds), Social Phobia: Diagnosis, Assessment, and Treatment (pp. 69–93). New York, NY, USA: Guilford Press.Google Scholar
Connor, KM, Davidson, JR, Churchill, LE, Sherwood, A, Weisler, RH, Foa, E (2000). Psychometric properties of the Social Phobia Inventory (SPIN). British Journal of Psychiatry 176, 379–386. doi: 10.1192/bjp.176.4.379 CrossRefGoogle Scholar
Crocker, PR, Eklund, RC, Graham, TR (2002). Evaluating the factorial structure of the Revised Causal Dimension Scale in adolescents. Research Quarterly for Exercise and Sport 73, 211–218. doi: 10.1080/02701367.2002.10609011 CrossRefGoogle ScholarPubMed
Cuming, S, Rapee, RM, Kemp, N, Abbott, MJ, Peters, L, Gaston, JE (2009). A self-report measure of subtle avoidance and safety behaviors relevant to social anxiety: development and psychometric properties. Journal of Anxiety Disorders 23, 879–883. doi: 10.1016/j.janxdis.2009.05.002 CrossRefGoogle ScholarPubMed
Dos Santos Silva, I (1999). Cancer Epidemiology: Principles and Methods. Lyon, France: International Agency for Research on Cancer.Google Scholar
Fernandez, E, Salem, D, Swift, JK, Ramtahal, N (2015). Meta-analysis of dropout from cognitive behavioral therapy: magnitude, timing, and moderators. Journal of Consulting and Clinical Psychology 83, 1108–1122. doi: 10.1037/ccp0000044 CrossRefGoogle ScholarPubMed
Fink, M, Akimova, E, Spindelegger, C, Hahn, A, Lanzenberger, R, Kasper, S (2009) Social anxiety disorder: epidemiology, biology and treatment. Psychiatria Danubina 21, 533–42.Google Scholar
Gilbert, P (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment 15, 199–208.CrossRefGoogle Scholar
Grant, BF, Hasin, DS, Stinson, FS, Dawson, DA, Goldstein, RB, Smith, S, et al. (2006). The epidemiology of DSM-IV panic disorder and agoraphobia in the United States. Journal of Clinical Psychiatry 67, 363–374. doi: 10.4088/jcp.v67n0305 CrossRefGoogle ScholarPubMed
Greca, AM, Lopez, N (1998). Social anxiety among adolescents: linkages with peer relations and friendships. Journal of Abnormal Child Psychology 26, 83–94.CrossRefGoogle ScholarPubMed
Heimberg, RG (1995). Social Phobia: Diagnosis, Assessment and Treatment. New York, USA: Guilford Press.Google Scholar
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593. doi: 10.1001/archpsyc.62.6.593 CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, JB, Löwe, B (2009). An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics 50, 613–621. doi: 10.1016/s0033-3182(09)70864-3 Google ScholarPubMed
Loerinc, AG, Meuret, AE, Twohig, MP, Rosenfield, D, Bluett, EJ, Craske, MG (2015). Response rates for CBT for anxiety disorders: need for standardized criteria. Clinical Psychology Review 42, 72–82. doi: 10.1016/j.cpr.2015.08.004 CrossRefGoogle ScholarPubMed
Löwe, B, Wahl, I, Rose, M, Spitzer, C, Glaesmer, H, Wingenfeld, K, et al. (2010). A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders 122, 86–95. doi: 10.1016/j.jad.2009.06.019 CrossRefGoogle ScholarPubMed
Mather, A, Cartwright-Hatton, S (2004). Cognitive predictors of obsessive-compulsive symptoms in adolescence: a preliminary investigation. Journal of Clinical Child and Adolescent Psychology 33, 743–749. doi: 10.1207/s15374424jccp3304_9 CrossRefGoogle ScholarPubMed
McAuley, E, Duncan, TE, Russell, DW (1992). Measuring causal attributions: the Revised Causal Dimension Scale (CDS-II). Personality and Social Psychology Bulletin 18, 566–573. doi: 10.1177/0146167292185006 CrossRefGoogle Scholar
McEvoy, PM, Kingsep, P (2006). The post-event processing questionnaire in a clinical sample with social phobia. Behaviour Research and Therapy 44, 1689–1697. doi: 10.1016/j.brat.2005.12.005 CrossRefGoogle Scholar
Mörtberg, E, Clark, DM, Sundin, Ö, Wistedt, AÅ (2007). Intensive group cognitive treatment and individual cognitive therapy vs. treatment as usual in social phobia: a randomized controlled trial. Acta Psychiatrica Scandinavica 115, 142–154. doi: 10.1111/j.1600-0447.2006.00839.x CrossRefGoogle ScholarPubMed
Pozza, A, Dèttore, D (2014a). Are inflated responsibility beliefs specific to OCD? Meta-analysis of the relations of responsibility to OCD, anxiety disorders, and depression symptoms. Clinical Neuropsychiatry: Journal of Treatment Evaluation 11, 170–181.Google Scholar
Pozza, A, Dèttore, D (2014b). The specificity of inflated responsibility beliefs to OCD: a systematic review and meta-analysis of published cross-sectional case-control studies. Research in Psychology and Behavioral Sciences 2, 75–85. doi: 10.12691/rpbs-2-4-1 CrossRefGoogle Scholar
Salkovskis, P, Wroe, A, Gledhill, A, Morrison, N, Forrester, E, Richards, C, et al. (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy 38, 347–372. doi: 10.1016/s0005-7967(99)00071-6 CrossRefGoogle ScholarPubMed
Startup, H, Davey, G (2003). Inflated responsibility and the use of stop rules for catastrophic worrying. Behaviour Research and Therapy 41, 495–503. doi: 10.1016/s0005-7967(02)00245-0 CrossRefGoogle ScholarPubMed
Stopa, L, Clark, DM (1993). Cognitive processes in social phobia. Behaviour Research and Therapy 31, 255–267. doi: 10.1016/0005-7967(93)90024-o CrossRefGoogle ScholarPubMed
Swift, JK, Greenberg, RP (2014). A treatment by disorder meta-analysis of dropout from psychotherapy. Journal of Psychotherapy Integration 24, 193–207. doi: 10.1037/a0037512 CrossRefGoogle Scholar
Teglasi, H, Fagin, SS (1984). Social anxiety and self-other biases in causal attribution. Journal of Research in Personality 18, 64–80. doi: 10.1016/0092-6566(84)90039-4 CrossRefGoogle Scholar
Van Ameringen, M, Mancini, C, Farvolden, P (2003). The impact of anxiety disorders on educational achievement. Journal of Anxiety Disorders 17, 561–571. doi: 10.1016/s0887-6185(02)00228-1 CrossRefGoogle ScholarPubMed
Vassilopoulos, SP (2004). Anticipatory processing in social anxiety. Behavioural and Cognitive Psychotherapy 32, 303–311. doi: 10.1017/s1352465804001377 CrossRefGoogle Scholar
Veale, D (2007). Cognitive behavioural therapy for obsessive-compulsive disorder. Advances in Psychiatric Treatment 13, 438–446. doi: 10.1192/apt.bp.107.003699 CrossRefGoogle Scholar
Watkins, D, Sachs, J, Regmi, M (1997). Confirmatory factor analysis of the Revised Causal Dimension Scale: a Nepalese investigation. Psychological Reports 81, 963–967. doi: 10.2466/pr0.1997.81.3.963 CrossRefGoogle Scholar
Weiner, B (1985). An attributional theory of achievement motivation and emotion. Psychological Review 92, 548–573.CrossRefGoogle ScholarPubMed
Weiner, B (1986). An Attributional Theory of Motivation and Emotion (pp. 159–190). New York, NY: Springer. doi: 10.1007/978-1-4612-4948-1_6 CrossRefGoogle Scholar
Yoshinaga, N, Matsuki, S, Niitsu, T, Sato, Y, Tanaka, M, Ibuki, H, et al. (2016). Cognitive behavioral therapy for patients with social anxiety disorder who remain symptomatic following antidepressant treatment: a randomized, assessor-blinded, controlled trial. Psychotherapy and Psychosomatics 85, 208–217. doi: 10.1159/000444221 CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.