A prospective examination of predictors of post-event processing following videotaped exposures in group cognitive behavioural therapy for individuals with social phobia

Following social events, individuals with social phobia engage in post-event processing (PEP), namely a post-mortem detailed analysis of a social situation. This study aimed to examine cognitive and symptom correlates of PEP, as well as stability of PEP, in the context of videotaped exposures that occurred during treatment at sessions four and eight. Before treatment, 75 individuals with DSM-IV diagnosed social phobia completed measures of social anxiety, anxious rumination, fear of causing discomfort to others, and negative interpretation of positive social events. They rated their peak anxiety during the taped exposure. Then, they completed a measure of PEP one week after each videotaped exposure exercise. Results revealed that baseline social anxiety symptoms, state anxiety during the videotaping, anxious rumination, fear of causing discomfort to others, and negative interpretation of positive social events were all positively associated with PEP for the first taped exposure. Regression analyses demonstrated that unique predictors of PEP over and above baseline social anxiety were state social anxiety during the exposure, and anxious coping-focused rumination. This was largely replicated in the second taped exposure. In addition, PEP following two videotaped exposures separated by four weeks showed a moderate-to-large positive correlation. These findings highlight symptom and cognitive correlates of PEP, and underscore importance of state anxiety in social situations, as well as general anxiety focused rumination in social phobia.

Research highlights► Social anxiety, anxious rumination, fear of causing discomfort to others, and negative interpretation of positive social events were all positively associated with post event processing (PEP) for the first taped exposure. ► The unique predictors of PEP for the first taped exposure over and above baseline social anxiety were state social anxiety during the exposure, and anxious coping-focused rumination; this was largely replicated in the second taped exposure. ► PEP following two videotaped exposures separated by four weeks was significantly correlated.