The role of perfectionism and cognitive biases in social anxiety

Author: Bruna Medeiros Ciprovac

Medeiros Ciprovac, Bruna, 2021 The role of perfectionism and cognitive biases in social anxiety, Flinders University, College of Education, Psychology and Social Work

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Social anxiety disorder is a common condition associated with significant impairments. Prominent cognitive models of social anxiety explain the development and maintenance of the disorder, and highlight two key characteristics: 1) the discrepancy between one’s own or perceived high social standards from others and one’s perceived ability to attain such standards (also a feature of perfectionism); and 2) cognitive biases that maintain social anxiety. Based on these propositions, this thesis sought to investigate the relationships among social anxiety, perfectionism, and cognitive biases.

Despite numerous cross-sectional studies linking the dimensions of perfectionistic concerns and perfectionistic strivings to social anxiety, longitudinal evidence for the direction of these relationships is scarce and results are inconsistent. Moreover, negative interpretation bias, negative self-imagery, and post-event processing are cognitive biases empirically shown to be related to social anxiety and perfectionism separately, but research investigating these elements simultaneously is currently lacking. Hence, the aims of current thesis were as follows: 1) to clarify the direction of the relationship between social anxiety and perfectionism dimensions; 2) to understand the longitudinal relationships of social anxiety and perfectionism to cognitive biases; and 3) to investigate the role of these cognitive biases as mediators of the relationship between social anxiety and perfectionism dimensions.

Studies 1 and 2 addressed these aims using longitudinal designs. Study 1 employed a six-month, three-wave design, whereas Study 2 was conducted over two weeks and in the context of a social interaction task. The main finding of Studies 1 and 2 was a role for negative interpretation bias as a transdiagnostic process across social anxiety and perfectionistic concerns. Negative self-imagery emerged as a maintenance factor of social anxiety in Study 2, but this cognitive bias, along with postevent processing, had no mediator role in the relationships between social anxiety and perfectionism dimensions in either Study 1 or 2. There was a direct relationship from social anxiety to perfectionistic concerns in Study 2, but only when cognitive biases were not included in the analysis. Taken together, findings suggest that relationships between social anxiety and perfectionism dimensions are best understood in conjunction with cognitive biases.

Based on these results, Study 3 tested the effect of interpretation bias modification on social anxiety and perfectionism dimensions in individuals with high levels of social anxiety. Overall, the intervention and control groups showed reductions in negative interpretation bias, but no corresponding reduction in state anxiety and perfectionism across trait social anxiety or perfectionistic concerns levels. However, despite the lack of relationships between negative interpretation bias and perfectionistic strivings in Studies 1 and 2, interpretation bias modification appeared effective for those high in perfectionistic strivings. Future research should refine the interpretation bias modification protocol to extend its effectiveness also to those high in perfectionistic concerns and social anxiety.

Overall, the current thesis provided novel evidence regarding the contribution of cognitive biases to social anxiety and perfectionism dimensions. Moreover, it uncovered that transdiagnostic biased information processing underlies social anxiety and perfectionistic concerns. Limitations notwithstanding, the findings provide theoretical and clinical contributions to the areas of social anxiety and perfectionism.

Keywords: Social anxiety, social anxiety disorder, perfectionism, perfectionistic concerns, perfectionistic strivings, cognitive bias, interpretation bias, negative self-imagery, post-event processing, rumination, longitudinal

Subject: Psychology thesis

Thesis type: Doctor of Philosophy
Completed: 2021
School: College of Education, Psychology and Social Work
Supervisor: Prof Eva Kemps