Date of Award

2021

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Abstract

Social anxiety disorder (SAD) is characterized by a fear of negative evaluation that often results in behaviors such as avoidance intended to mitigate the risk of making a negative impression on others or making their social anxiety known (American Psychiatric Association, 2013). Engaging in self-focused attention is a covert manner in which individuals with SAD can protectively monitor their speech, behavior, and physical symptoms of anxiety (e.g., blushing) in an effort to compensate for their perceived susceptibility to negative evaluation (Clark & Wells, 1995). Self-focused attention in social anxiety has been widely studied and found to elevate rather than alleviate anxiety during social interactions (Gaydukevych & Kocovski, 2012; Mellings and Alden, 2000; Woody & Rodriguez, 2000). Although cognitive-behavioral therapy with exposure is currently the gold standard intervention for SAD, mindfulness meditation has been identified as an additional avenue to treating social anxiety (Feske & Chambless, 1995; Goldin et al., 2009). One of the ways mindfulness meditation has been found to impart its mental health benefits is by cultivating nonattachment, or the ability to let go” of desired outcomes, including the desire to make a good impression on others, and embrace whatever transpires in ones present reality (Sahdra et al., 2010). In the present study, it was expected that high trait nonattachment would be associated with lower self-reported anxiety and cardiovascular reactivity in response to two role-play tasks designed to elicit social anxiety related to maintaining ones level of competence (agency) and/or ability to get along with others (communion). Given that the desire to make a good impression is understood to catalyze self-focused attention in the first place (Clark & Wells, 1995), it was expected that lower levels of self-focused attention during the first task would account for lower levels of social stress in participants higher in nonattachment. Rumination following the first task was also expected to serve as an additional mediator given findings that rumination perpetuates social anxiety and that rumination is negatively associated with nonattachment (Coffey & Hartman, 2008; Mellings & Alden, 2000; Rachman et al., 2000; Wong & Moulds, 2011). Given previous literature that suggests reducing self-focused attention facilitates habituation to stressful social tasks (e.g., Renner et al., 2017; Wells & Papageorgiou, 1998), self-focused attention was expected to mediate the relationship between social evaluative threat and reduction in psychophysiological reactivity from the first to second task. Although these hypothesized relationships were not supported, nonattachment was found in ancillary analyses to be associated with lower levels of self-reported pre-task anxiety and rumination during the second exposure. In additional analyses, cardiovascular reactivity while listening to ones conversation partner via an audio recording was found to be highest in participants who reported higher levels of self-focused attention and were in a condition that enhanced agency threat. Finally, individuals under agency threat who experienced a greater decrease in self-focused attention from the first to second task were found to experience significantly less cardiovascular reactivity during the second listening task. The implications of these findings for future clinical research, especially with regard to ways in which mindfulness meditation could be optimally integrated into exposure therapy, are discussed.

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