The role of self-criticism and self-compassion in social anxiety

Author: Jeremy Stevenson

Stevenson, Jeremy, 2019 The role of self-criticism and self-compassion in social anxiety, Flinders University, College of Education, Psychology and Social Work

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Social Anxiety Disorder (SAD) produces significant suffering and functional impairment for millions of people worldwide. Current gold-standard treatments for SAD (e.g., Cognitive Behavioural Therapy; CBT) are effective, but there are still a considerable number of individuals who do not respond adequately to these treatments. As such, there remain gaps in our knowledge about what maintains this disorder and what alternative treatments might exist. In order to address these gaps, this thesis set out to investigate the role of self-criticism and self-compassion in social anxiety. More specifically, I aimed to determine whether these self-attitudes might contribute to the maintenance of social anxiety, and if so, through what mechanisms these relationships might function. Furthermore, I examined for whom self-compassion might be effective when compared with cognitive restructuring in the treatment of social anxiety. The thesis begins with a review of the literature on self-criticism and self-compassion, which demonstrates that these self-attitudes are risk and protective factors, respectively, for numerous psychological problems. I then review the specific literature on mediators and report evidence for various constructs such as negative self-beliefs and activation of the soothing system. I also review literature on the moderators of self-compassion, finding some evidence for constructs such as self-criticism and fear of self-compassion.

In my first study, I conducted a three-wave longitudinal study over seven months in a general community sample (N = 506), testing whether self-criticism and self-kindness prospectively predicted social anxiety through indirect effects mediated by negative self-beliefs (as well as self-criticism for self-kindness). I did not find support for any of these models, but concluded that there may have been insufficient variance to detect such mediational effects. In my second study, I administered a brief two-week online experimental study comparing self-compassion with cognitive restructuring in a sample with clinical levels of social anxiety across five assessment points (N = 119). I found that both interventions led to significant decreases in trait social anxiety which persisted at the final five-week follow-up assessment. No differences between the treatment conditions were found for social anxiety outcomes. Similarly, there were no measures that differentially mediated the effect of treatment condition on social anxiety. Furthermore, I did not find support for the models proposed in Study 1, this time tested in a context of greater variance. I also did not find support for a theory-driven mediational model of self-compassion affecting social anxiety through the activation of the soothing system. Notably, neither self-criticism nor fear of self-compassion moderated the effect of the interventions. One exploratory moderator which did show a significant effect was baseline social anxiety as measured by the Social Phobia Inventory (SPIN). However, this effect appeared to moderate just the trajectory of social anxiety between groups, rather than final outcomes, and was the only significant moderator finding in the context of a large number of analyses.

Integrating these findings and the wider literature, I suggest that self-attitudes may not be important maintenance factors of social anxiety. Furthermore, I propose that self-compassion may be a viable alternative treatment to cognitive restructuring for social anxiety, but suggest that unique aspects of self-compassion may not be responsible for reductions in social anxiety symptoms. I also propose a range of future research avenues to advance knowledge in the area of self-attitudes and SAD.

Keywords: self-compassion; self-criticism; cognitive-restructuring; intervention; social anxiety; clinical; online; mediator; moderator.

Subject: Psychology thesis

Thesis type: Doctor of Philosophy
Completed: 2019
School: College of Education, Psychology and Social Work
Supervisor: Professor Reg Nixon