The role of meta-cognition in social anxiety

THE UNIVERSITY OF MANCHESTERStyliani Gkika, Doctor of Philosophy (PhD)The role of meta-cognition in social anxiety; Year of submission: 2011ABSTRACTThis PhD investigated the theoretical and clinical applications of a meta-cognitive model of psychological disorders in social anxiety. The main objective was to identify potential associations between meta-cognitive knowledge (i.e. meta-cognitive beliefs) and social anxiety. These associations could be direct or indirect via information-processing mechanisms, such as anticipatory processing (AP), focus of attention, and post-mortem processing (PM). The current thesis reports six studies (N = 686). Study 1 explored cross-sectionally the potential contribution of meta-cognitive beliefs about general worry to social anxiety. The results showed that positive and uncontrollability beliefs along with AP were individual positive predictors of social anxiety. Furthermore, these beliefs had an indirect effect on social anxiety through anticipatory processing and the post-mortem. These results prompted further exploration of the nature of meta-cognitive beliefs in social anxiety. Study 2 employed semi-structured interviews to elicit meta-cognitive beliefs that could be specific to social anxiety. High and low socially anxious individuals reported beliefs about anticipatory processing, focusing on an observer perspective (OP) self-image, and the post-mortem. The high socially anxious group reported greater engagement in both AP and focusing on the OP, and spending greater time trying to control AP, OP, and the post-mortem. Moreover, the two groups differed in beliefs about these mechanisms, in coping strategies, and in stop signals. The beliefs elicited informed two new questionnaires that were investigated in Study 3. Each questionnaire revealed three subscales of positive and negative beliefs about AP and about the OP self-image, respectively. The subscales showed good reliability and stability. In addition, the new beliefs revealed further associations with social anxiety. Study 4 investigated whether meta-cognitive beliefs could affect attentional bias in social anxiety. High and low socially anxious individuals completed a dot-probe task with emotional, social and physical words matched with neutral words. The results indicated a potential moderation effect of social anxiety and positive meta-cognitive beliefs on attentional bias. Moreover, meta-cognitive beliefs predicted attentional bias in both social anxiety groups. The above results implicated meta-cognitive beliefs in the maintenance of social anxiety. Study 5 explored whether these beliefs could affect state anxiety in high socially anxious individuals that engaged in either AP or a distraction task prior to giving a speech. The results replicated previous findings that AP was associated with more anxiety compared with distraction. Additionally, uncontrollability beliefs were associated with increased state anxiety before the speech, while positive beliefs interfered with distraction and were associated with the maintenance of anxiety after the speech was over. Finally, Study 6 explored whether a meta-cognitive intervention could be effective in the treatment of social anxiety. In a cross-over design, high socially anxious individuals practiced detached mindfulness and thought challenging prior to giving a speech. The results showed that detached mindfulness was associated with greater reductions in negative beliefs, worry, and the OP. In conclusion, the results of a series of studies support the application of the meta-cognitive model to social anxiety.