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Is Post-Event Processing a Social Anxiety Specific or Transdiagnostic Cognitive Process in the Anxiety Spectrum?

  • Judith M. Laposa (a1), Kelsey C. Collimore (a2) and Neil A. Rector (a3)

Background: Research on post-event processing (PEP), where individuals conduct a post-mortem evaluation of a social situation, has focused primarily on its relationship with social anxiety. Aims: The current study examined: 1) levels of PEP for a standardized event in different anxiety disorders; 2) the relationship between peak anxiety levels during this event and subsequent PEP; and 3) the relationship between PEP and disorder-specific symptom severity. Method: Participants with primary DSM-IV diagnoses of social anxiety disorder (SAD), obsessive compulsive disorder (OCD), panic disorder with/without agoraphobia (PD/A), or generalized anxiety disorder (GAD) completed diagnosis specific symptom measures before attending group cognitive behavioural therapy (CBT) specific to their diagnosis. Participants rated their peak anxiety level during the first group therapy session, and one week later rated PEP in the context of CBT. Results: The results indicated that all anxiety disorder groups showed heightened and equivalent PEP ratings. Peak state anxiety during the first CBT session predicted subsequent level of PEP, irrespective of diagnostic group. PEP ratings were found to be associated with disorder-specific symptom severity in SAD, GAD, and PD/A, but not in OCD. Conclusions: PEP may be a transdiagnostic process with relevance to a broad range of anxiety disorders, not just SAD.

Corresponding author
Reprint requests to Judith Laposa, Anxiety Disorders Clinic, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada. E-mail:
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Abbott, M. J. and Rapee, R. M. (2004). Post-event rumination and negative self-appraisal in social phobia before and after treatment. Journal of Abnormal Psychology, 113, 136144.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text rev.). Washington, DC: Author.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.
Baer, L., Brown-Beasley, M. W., Sorce, J. and Henriques, A. I. (1993). Computer-assisted telephone administration of a structured interview for obsessive-compulsive disorder. American Journal of Psychiatry, 150, 17371738.
Barnhofer, T. and Chitka, T. (2010). Cognitive reactivity mediates the relationship between neuroticism and depression. Behaviour Research and Therapy, 48, 275281.
Brown, T. A., Antony, M. M. and Barlow, D. H. (1992). Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behaviour Research and Therapy, 30, 3337.
Brozovich, F. and Heimberg, R. G. (2008). An analysis of post-event processing in social anxiety disorder. Clinical Psychology Review, 28, 891903.
Carleton, R. N., Collimore, K. C., McCabe, R. E. and Antony, M. M. (2011). Addressing revisions to the Brief Fear of Negative Evaluation Scale: measuring fear of negative evaluation across anxiety and mood disorders. Journal of Anxiety Disorders, 25, 822828.
Clark, D. M. and Wells, A. (1995). A cognitive model of social phobia. In Heimberg, R.G., Liebowitz, M.R., Hope, D.A. and Schneier, F.R. (Eds.), Social Phobia: diagnosis, assessment and treatment (pp. 6993). New York: Guilford Press.
Cody, M. W. and Teachman, B. A. (2010). Post-event processing and memory bias for performance feedback in social anxiety. Journal of Anxiety Disorders, 24, 468479.
Dannahy, L. and Stopa, L. (2007). Post event processing in social anxiety. Behaviour Research and Therapy, 45, 12071219.
Edwards, S. L., Rapee, R. M. and Franklin, J. (2003). Post event rumination and recall bias for a social performance event in high and low socially anxious individuals. Cognitive Therapy and Research, 27, 603617.
Ehring, T. and Watkins, E. (2008). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1, 192205.
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders: patient edition (SC1D-1/P, Version 2.0). New York: Biometrics Research, State Psychiatric Institute.
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders: research version, patient edition (SC1D-1/P). New York: Biometrics Research, State Psychiatric Institute.
Harvey, A. G., Watkins, E. R., Mansell, W. and Shafran, R. (2004). Cognitive Behavioral Processes across Psychological Disorders: a transdiagnostic approach to research and treatment. Oxford: Oxford University Press.
Heimberg, R.G. and Becker, R.E. (2002). Cognitive-Behavioural Group Therapy for Social Phobia: basic mechanisms and clinical strategies. New York: Guilford Press.
Heimberg, R. G., Mueller, G. P., Holt, C. S., Hope, D. A. and Liebowitz, M.R. (1992). Assessment of anxiety in social interaction and being observed by others: the social interaction anxiety scale and the social phobia scale. Behavior Therapy, 23, 5373.
Hodson, K. J., McManus, F. V., Clark, D. M. and Doll, H. (2008). Can Clark and Wells’ (1995) cognitive model of social phobia be applied to young people. Behavioural and Cognitive Psychotherapy, 36, 449461.
Houck, P. R., Speigel, D. A., Shear, M. K. and Rucci, P. (2002). Reliability of the self-report version of the panic disorder severity scale. Depression and Anxiety, 15, 183185.
Kertz, S. J., Bigda-Peyton, J. S., Rosmarin, D. H. and Björgvinsson, T. (2012). The importance of worry across diagnostic presentations: prevalence, severity and associated symptoms in a partial hospital setting. Journal of Anxiety Disorders, 26, 126133.
Kocovski, N. L., Endler, N. S., Rector, N. A. and Flett, G. L. (2005). Ruminative coping and post-event processing in social anxiety. Behaviour Research and Therapy, 43, 971984.
Kocovski, N. L. and Rector, N. A. (2007). Predictors of post-event rumination related to social anxiety. Cognitive Behaviour Therapy, 36, 112122.
Kocovski, N. L. and Rector, N. A. (2008). Post-event processing in social anxiety disorder: idiosyncratic priming in the course of CBT. Cognitive Therapy and Research, 32, 2336.
Laposa, J.M. and Rector, N.A. (2011). A prospective examination of predictors of post-event processing following videotaped exposures in group cognitive behavioural therapy for individuals with social phobia. Journal of Anxiety Disorders, 25, 568573.
Lundh, L. and Sperling, M. (2002). Social anxiety and the post-event processing of socially distressing events. Cognitive Behavioral Therapy, 31, 129134.
Mataix-Cols, D., Rosario-Campos, M. C. and Leckman, J. F. (2005). A multidimensional model of obsessive-compulsive disorder. American Journal of Psychiatry, 162, 228238.
Mattick, R. P. and Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455470.
McLaughlin, K. A. and Nolen-Hoeksema, S. (2011). Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 49, 186193.
Meyer, T. J., Miller, M. L., Metzger, R. L. and Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487495.
Muris, P., Roelofs, J., Rassin, E., Franken, I. and Mayer, B. (2005). Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Personality and Individual Differences, 39, 11051111.
Nolen-Hoeksema, S., Wisco, B. E. and Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3, 400424.
Perini, S. J., Abbott, M. J. and Rapee, R. M. (2006). Perception of performance as a mediator in the relationship between social anxiety and negative post-event rumination. Cognitive Therapy and Research, 30, 645659.
Rachman, S. J., Gruter-Andrew, J. and Shafran, R. (2000). Post-event processing in social anxiety. Behaviour Research and Therapy, 38, 611617.
Rapee, R. M. and Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741756.
Rector, N. A., Antony, M., Laposa, J. M., Kocovski, N. and Swinson, R. (2008). Assessing content domains of repetitive thought in the anxiety spectrum: rumination and worry in nonclinical and clinical samples. International Journal of Cognitive Therapy, 1, 352377.
Riskind, J. H. (1997). Looming vulnerability to threat: a cognitive paradigm for anxiety. Behavior Research and Therapy, 35, 685702.
Riskind, J. H., Rector, N. A. and Cassin, S. E. (2011). Examination of the convergent validity of looming vulnerability in the anxiety disorders. Journal of Anxiety Disorders, 25, 989993.
Roelofs, J., Huibers, M., Peeters, F. and Arntz, A. (2008). Effects of neuroticism on depression and anxiety: rumination as a possible mediator. Personality and Individual Differences, 44, 576586.
Roelofs, J., Huibers, M., Peeters, F., Arntz, A. and van Os, J. (2008). Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals. Behaviour Research and Therapy, 46, 12831289.
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., et al. (1997). Multicenter collaborative panic disorder severity scale. The American Journal of Psychiatry, 154, 15711575.
Spielberger, C. D., Gorsuch, R. L., Luschene, R. E., Vagg, P. R. and Jacobs, G. A. (1983). Manual for the State Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
Steketee, G., Frost, R. and Bogart, K. (1996). The Yale-Brown Obsessive Compulsive Scale: interview versus self-report. Behaviour Research and Therapy, 34, 675684.
Watkins, E. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134, 165206.
Wuyek, L. A., Antony, M. M. and McCabe, R. E. (2011). Psychometric properties of the panic disorder severity scale: clinician administered and self-report versions. Clinical Psychology and Psychotherapy, 18, 234243.
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