Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-26T13:50:12.345Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence and features of spontaneous recurrent images in social anxiety disorder: findings from a Korean community sample

Published online by Cambridge University Press:  24 October 2019

Da Eun Suh Open the ORCID record for Da Eun Suh [Opens in a new window] ,
Kyung-Ah Chang ,
Ji Un Hwang  and
Jung-Hye Kwon
Da Eun Suh
Affiliation:
Department of Psychology, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, 136-701, Republic of Korea
Kyung-Ah Chang
Affiliation:
Department of Psychology, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, 136-701, Republic of Korea
Ji Un Hwang
Affiliation:
Department of Psychology, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, 136-701, Republic of Korea
Jung-Hye Kwon*
Affiliation:
Department of Psychology, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, 136-701, Republic of Korea
*
*Corresponding author. Email: junghye@korea.ac.kr
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Previous studies have indicated that people with social anxiety disorder (SAD) often experience spontaneous, recurrent images (SRI). It was assumed that Koreans with interdependent self-views may contain more features related to social contexts in their self-images than those reported in Western cultures.

Aims:

In the present study, we aimed to explore the prevalence and content of SRIs in individuals with SAD in Korea. Furthermore, we investigated the relationship between features of SRIs and variables of SAD.

Method:

Sixty-four individuals with SAD (27.00 ± 7.42 years, 64.1% female), diagnosed with SAD, completed self-report questionnaires related to social anxiety. Afterwards, a semi-structured interview was used to assess features and content of the individuals’ SRI.

Results:

Thirty (47%) of the participants reported experiencing SRIs in social situations. The content of the SRIs were classified under three themes: negative self-images, negative images of others, and abstract images. The distress level of SRIs was positively associated with social phobia scales (r = .385, p < .05) and physical anxiety symptoms (r = .478, p < .05). Frequency of SRIs was positively associated with avoidance scores (r = .402, p < .05).

Conclusions:

The results demonstrated differences in the prevalence and content of the SRIs between Western and non-Western cultures. Fewer individuals with SAD in Korea reported having SRIs, and the content of these SRIs involved people other than the self. Some features of SRIs were associated with variables of SAD.

Keywords

assessmentcultureimageryinterviewnegative self-imagesocial anxiety disorder
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 2 , March 2020 , pp. 172 - 184
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, B., Goldin, P. R., Kurita, K., & Gross, J. J. (2008). Self-representation in social anxiety disorder: linguistic analysis of autobiographical narratives. Behaviour Research and Therapy, 46, 1119–1125. https://doi.org/10.1016/j.brat.2008.07.001 CrossRefGoogle ScholarPubMed
Bywaters, M., Andrade, J., & Turpin, G. (2004). Intrusive and non‐intrusive memories in a non‐clinical sample: the effects of mood and affect on imagery vividness. Memory, 12, 467–478. doi: 10.1080/09658210444000089 CrossRefGoogle Scholar
Carroll, J. S. (1978). The effect of imagining an event on expectations for the event: an interpretation in terms of the availability heuristic. Journal of Experimental Social Psychology, 14, 88–96. https://doi.org/10.1016/0022-1031(78)90062-8 CrossRefGoogle Scholar
Clark, D. M., & 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. 69–93). New York, USA: Guilford Press.Google Scholar
Cuming, S., Rapee, R. M., Kemp, N., Abbott, M. J., Peters, L., & Gaston, J. E. (2009). A self-report measure of subtle avoidance and safety behaviors relevant to social anxiety: development and psychometric properties. Journal of Anxiety Disorders, 23, 879–883. https://doi.org/10.1016/j.janxdis.2009.05.002 CrossRefGoogle ScholarPubMed
Gendlin, E. T. (1996). Focusing Oriented Psychotherapy: A Manual of the Experiential Method. New York, USA: Guilford Press.Google Scholar
Gross, J. J. (1998). The emerging field of emotion regulation: an integrative review. Review of General Psychology, 2, 271–299. doi: 10.1037/1089-2680.2.3.271 CrossRefGoogle Scholar
Hackmann, A., Clark, D. M., & McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601–610. https://doi.org/10.1016/S0005-7967(99)00161-8 CrossRefGoogle ScholarPubMed
Hackmann, A., Surawy, C., & Clark, D. M. (1998). Seeing yourself through others’ eyes: a study of spontaneously occurring images in social phobia. Behavioural and Cognitive Psychotherapy, 26, 3–12. doi: 10.1017/S1352465898000022 CrossRefGoogle Scholar
Heimberg, R. G., Horner, K. J., Juster, H. R., Safren, S. A., Brown, E. J., Schneier, F. R., & Liebowitz, M. R. (1999). Psychometric properties of the Liebowitz social anxiety scale. Psychological Medicine, 29, 199–212. doi: 10.1017/s0033291798007879 CrossRefGoogle ScholarPubMed
Heimberg, R. G., Mueller, G. P., Holt, C. S., Hope, D. A., & 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, 53–73. https://doi.org/10.1016/S0005-7894(05)80308-9 CrossRefGoogle Scholar
Heine, S. J., Kitayama, S., & Lehman, D. R. (2001). Cultural differences in self-evaluation: Japanese readily accept negative self-relevant information. Journal of Cross-Cultural Psychology, 32, 434–443. https://doi.org/10.1177/0022022101032004004 CrossRefGoogle Scholar
Hirsch, C. R., Clark, D. M., Mathews, A., & Williams, R. (2003a). Self-images play a causal role in social phobia. Behaviour Research and Therapy, 41, 909–921. https://doi.org/10.1016/S0005-7967(02)00103-1 CrossRefGoogle ScholarPubMed
Hirsch, C. R., Mathews, A., Clark, D. M., Williams, R., & Morrison, J. (2003b). Negative self-imagery blocks inferences. Behaviour Research and Therapy, 41, 1383–1396. https://doi.org/10.1016/S0005-7967(03)00057-3 CrossRefGoogle ScholarPubMed
Hirsch, C., Meynen, T., & Clark, D. (2004). Negative self‐imagery in social anxiety contaminates social interactions. Memory, 12, 496–506. https://doi.org/10.1080/09658210444000106 CrossRefGoogle ScholarPubMed
Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 36, 193–209. https://doi.org/10.1080/16506070701421313 CrossRefGoogle ScholarPubMed
Holmes, E. A., Geddes, J. R., Colom, F., & Goodwin, G. M. (2008). Mental imagery as an emotional amplifier: application to bipolar disorder. Behaviour Research and Therapy, 46, 1251–1258. https://doi.org/10.1016/j.brat.2008.09.005 CrossRefGoogle ScholarPubMed
Homer, S., & Deeprose, C. (2017). Voluntary and involuntary imagery in social anxiety. Behavioural and Cognitive Psychotherapy, 45, 285–299. doi: 10.1017/S1352465817000017 CrossRefGoogle ScholarPubMed
Homer, S. R., Deeprose, C., & Andrade, J. (2016). Negative mental imagery in public speaking anxiety: forming cognitive resistance by taxing visuospatial working memory. Journal of Behavior Therapy and Experimental Psychiatry, 50, 77–82. https://doi.org/10.1016/j.jbtep.2015.05.004 CrossRefGoogle ScholarPubMed
Hulme, N., Hirsch, C., & Stopa, L. (2012). Images of the self and self-esteem: do positive self-images improve self-esteem in social anxiety? Cognitive Behaviour Therapy, 41, 163–173. https://doi.org/10.1080/16506073.2012.664557 CrossRefGoogle ScholarPubMed
Kim, S., Yoon, H. Y., & Kwon, J. H. (2013). Validation of the Short Form of the Korean Social Interaction Anxiety Scale (K-SIAS) and the Korean Social Phobia Scale (K-SPS). Cognitive Behavior Therapy in Korea, 13, 511–535.Google Scholar
Kim, Y., Kasser, T., & Lee, H. (2003). Self-concept, aspirations, and well-being in South Korea and the United States. The Journal of Social Psychology, 143, 277–290. https://doi.org/10.1080/00224540309598445 CrossRefGoogle ScholarPubMed
Koo, H. J., Yang, E. J., & Kwon, J.-H. (2012). Validation of Korean version of Subtle Avoidance Frequency Examination (SAFE). Korean Journal of Clinical Psychology, 31, 693–712.Google Scholar
Lee, S. W., & Kwon, J.-H. (2013). The efficacy of Imagery Rescripting (IR) for social phobia: a randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 44, 351–360. https://doi.org/10.1016/j.jbtep.2013.03.001 CrossRefGoogle ScholarPubMed
Lee, J. Y., Nam, S. K., Lee, M. K., Lee, J. H., & Lee, S. M. (2009). Rosenberg’ Self-Esteem Scale: analysis of item-level validity. Korean Journal of Counseling and Psychotherapy, 21, 173–189.Google Scholar
Lim, Y.-J., & Kim, J.-H. (2012). Korean Anxiety Sensitivity Index-3: its factor structure, reliability, and validity in non-clinical samples. Psychiatry Investigation, 9, 45–53.CrossRefGoogle ScholarPubMed
Makkar, S. R., & Grisham, J. R. (2011). Social anxiety and the effects of negative self-imagery on emotion, cognition, and post-event processing. Behaviour Research and Therapy, 49, 654–664. https://doi.org/10.1016/j.brat.2011.07.004 CrossRefGoogle ScholarPubMed
Mathews, A., Ridgeway, V., & Holmes, E. A. (2013). Feels like the real thing: imagery is both more realistic and emotional than verbal thought. Cognition and Emotion, 27, 217–229. doi: 10.1080/02699931.2012.698252 CrossRefGoogle ScholarPubMed
Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455–470. https://doi.org/10.1016/S0005-7967(97)10031-6 CrossRefGoogle ScholarPubMed
McCann, R. M., & Honeycutt, J. M. (2006). A cross-cultural analysis of imagined interactions. Human Communication Research, 32, 274–301. doi: 10.1111/j.1468-2958.2006.00276.x CrossRefGoogle Scholar
Markus, H. R., & Kitayama, S. (1991). Culture and the self: implications for cognition, emotion, and motivation. Psychological Review, 98, 224–253. https://dx.doi.org/10.1037/0033-295X.98.2.224 CrossRefGoogle Scholar
Matsumoto, D., Yoo, S. H., & Nakagawa, S. (2008). Culture, emotion regulation, and adjustment. Journal of Personality and Social Psychology, 94, 925–937. https://psycnet.apa.org/doi/10.1037/0022-3514.94.6.925 CrossRefGoogle Scholar
Moscovitch, D. A., Gavric, D. L., Merrifield, C., Bielak, T., & Moscovitch, M. (2011). Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: outcomes with a new measure. Behaviour Research and Therapy, 49, 505–517. https://doi.org/10.1016/j.brat.2011.05.009 CrossRefGoogle ScholarPubMed
Norenzayan, A., Choi, I., & Nisbett, R. E. (2002a). Cultural similarities and differences in social inference: evidence from behavioral predictions and lay theories of behavior. Personality and Social Psychology Bulletin, 28, 109–120. https://doi.org/10.1177/0146167202281010 CrossRefGoogle Scholar
Norenzayan, A., Smith, E. E., Kim, B. J., & Nisbett, R. E. (2002b). Cultural preferences for formal versus intuitive reasoning. Cognitive Science, 26, 653–684.CrossRefGoogle Scholar
Osman, S., Cooper, M., Hackmann, A., & Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder. Memory, 12, 428–436. doi: 10.1080/09658210444000043 CrossRefGoogle ScholarPubMed
Osman, A., Gutierrez, P. M., Smith, K., Fang, Q., Lozano, G., & Devine, A. (2010). The Anxiety Sensitivity Index-3: analyses of dimensions, reliability estimates, and correlates in nonclinical samples. Journal of Personality Assessment, 92, 45–52. https://doi.org/10.1080/00223890903379332 CrossRefGoogle ScholarPubMed
Pearson, J., Naselaris, T., Holmes, E. A., & Kosslyn, S. M. (2015). Mental imagery: functional mechanisms and clinical applications. Trends in Cognitive Sciences, 19, 590–602. https://doi.org/10.1016/j.tics.2015.08.003 CrossRefGoogle ScholarPubMed
Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741–756. https://doi.org/10.1016/S0005-7967(97)00022-3 CrossRefGoogle ScholarPubMed
Silber, E., & Tippett, J. S. (1965). Self-esteem: clinical assessment and measurement validation. Psychological Reports, 16 (suppl), 1017–1071. https://doi.org/10.2466/pr0.1965.16.3c.1017 CrossRefGoogle Scholar
Spurr, J. M., & Stopa, L. (2002). Self-focused attention in social phobia and social anxiety. Clinical Psychology Review, 22, 947–975. https://doi.org/10.1016/S0272-7358(02)00107-1 CrossRefGoogle ScholarPubMed
Smith, C. P. (2000). Content analysis and narrative analysis. In Reis, H.T. and Judd, C. M. (eds), Handbook of Research Methods in Social and Personality Psychology (pp. 313–335). Cambridge, UK: Cambridge University Press.Google Scholar
Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., …& Coles, M. (2007). Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. Psychological Assessment, 19, 176–188. https://psycnet.apa.org/doi/10.1037/1040-3590.19.2.176 CrossRefGoogle ScholarPubMed
Wells, A., Clark, D. M., & Ahmad, S. (1998). How do I look with my mind’s eye: perspective taking in social phobic imagery. Behaviour Research and Therapy, 36, 631–634. https://doi.org/10.1016/S0005-7967(98)00037-0 CrossRefGoogle Scholar
Wild, J., Hackmann, A., & Clark, D. M. (2007). When the present visits the past: updating traumatic memories in social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 38, 386–401. https://doi.org/10.1016/j.jbtep.2007.07.003 CrossRefGoogle ScholarPubMed
Yeh, C. J., & Hwang, M. Y. (2000). Interdependence in ethnic identity and self: implications for theory and practice. Journal of Counseling & Development, 78, 420–429. doi: 10.1002/j.1556-6676.2000.tb01925.x CrossRefGoogle Scholar
Yu, E., Ahn, C., & Park, K. (2007). Factor structure and diagnostic efficiency of a Korean version of the Liebowitz social anxiety scale. Korean Journal of Clinical Psychology, 26, 251–270.Google Scholar
Submit a response

Comments

No Comments have been published for this article.