Background: Cognitive behavioural therapy (CBT) has relatively poor outcomes for youth with social anxiety, possibly because broad-based CBT is not tailored to their specific needs. Treatment of social anxiety in youth may need to pay more attention to negative social cognitions that are considered a key factor in social anxiety development and maintenance. Aims: The aim of the present study was to learn more about the role of performance quality in adolescents’ cognitions about their social performance and, in particular, the moderating role social anxiety plays in the relationship between performance quality and self-cognitions. Method: A community sample of 229 participants, aged 11 to 18 years, gave a speech and filled in questionnaires addressing social anxiety, depression, expected and self-evaluated performance, and post-event rumination. Independent observers rated the quality of the speech. The data were analysed using moderated mediation analysis. Results: Performance quality mediated the link between expected and self-evaluated performance in adolescents with low and medium levels of social anxiety. For adolescents with high levels of social anxiety, only a direct link between expected and self-evaluated performance was found. Their self-evaluation was not related to the quality of their performance. Performance quality also mediated the link between expected performance and rumination, but social anxiety did not moderate this mediation effect. Conclusions: Results suggest that a good performance does not help socially anxious adolescents to replace their negative self-evaluations with more realistic ones. Specific cognitive intervention strategies should be tailored to the needs of socially anxious adolescents who perform well.

Background: Clark and Wells’ cognitive model of social anxiety proposes that socially anxious individuals have negative expectations of performance prior to a social event, focus their attention predominantly on themselves and on their negative self-evaluations during an event, and use this negative self-processing to infer that other people are judging them harshly. Aims: The present study tested these propositions. Method: The study used a community sample of 161 adolescents aged 14–18 years. The participants gave a speech in front of a pre-recorded audience acting neutrally, and participants were aware that the projected audience was pre-recorded. Results: As expected, participants with higher levels of social anxiety had more negative performance expectations, higher self-focused attention, and more negative perceptions of the audience. Negative performance expectations and self-focused attention were found to mediate the relationship between social anxiety and audience perception. Conclusions: The findings support Clark and Wells’ cognitive model of social anxiety, which poses that socially anxious individuals have distorted perceptions of the responses of other people because their perceptions are coloured by their negative thoughts and feelings.

Background: Cognitive-behavioural therapy (CBT) has proven to be effective for anxiety-based school refusal, but it is still unknown how CBT for school refusal works, or through which mechanisms. Aims: Innovative statistical approaches for analyzing small uncontrolled samples were used to investigate the role of self-efficacy in mediating CBT outcomes for anxiety-based school refusal. Method: Participants were 19 adolescents (12 to 17 years) who completed a manual-based cognitive-behavioural treatment. Primary outcomes (school attendance; school-related fear; anxiety) and secondary outcomes (depression; internalizing problems) were assessed at post-treatment and 2-month follow-up. Results: Post-treatment increases in school attendance and decreases in fear about attending school the next day were found to be mediated by self-efficacy. Mediating effects were not observed at 2-month follow-up. Conclusions: These findings provide partial support for the role of self-efficacy in mediating the outcome of CBT for school refusal. They contribute to a small body of literature suggesting that cognitive change enhances CBT outcomes for young people with internalizing problems. Regarding methodology, the product of coefficient test appears to be a valuable way to study mediation in outcome studies involving small samples.

Aims: The purpose of this study was to investigate the cognitions of anxious school refusers. The cognitive constructs under investigation included negative cognition commonly linked to youth anxiety (i.e. negative automatic thoughts and cognitive errors) and positive automatic thoughts. Method: The cognition of school refusers (n = 50) and youth from a community sample (n = 181) was assessed with the Children's Automatic Thoughts Scale-Negative/Positive and the Children's Negative Cognitive Error Questionnaire-Revised. Results: When controlling for anxiety, school refusers were found to report more negative automatic thoughts concerning personal failure, fewer negative automatic thoughts concerning hostility, and fewer positive automatic thoughts. Negative automatic thoughts concerning personal failure and hostility, and the negative cognitive error of overgeneralizing were found to independently predict school refusal. Conclusions: The findings underscore the importance of further researching the role of cognition in the development, maintenance, and treatment of anxiety-based school refusal.

Background: The effectiveness of cognitive-behaviour therapy with young people may be influenced by a young person's capacity for self-reflection and insight. Clinicians who assess clients' proficiencies in these cognitive capacities can better tailor cognitive and behavioural techniques to the client, facilitating engagement and enhancing treatment outcome. It is therefore important that sound instruments for assessing self-reflection and insight in young people are available. Aims: The aim of the current study was to translate and adapt the Self-Reflection and Insight Scale (SRIS) for use with a child and adolescent population (Study 1), and to evaluate the psychometric properties of the resulting measure, the Self-Reflection and Insight Scale for Youth (SRIS-Y; Study 2). Method: In Study 1 (n = 145), the comprehensibility of the SRIS-Y was assessed in a community sample of children and adolescents. Study 2 (n = 215) then explored the reliability and structural, convergent, and divergent validity of the SRIS-Y. Results: The SRIS-Y was found to be comprehensible to young people, and had good reliability and structural validity. Conclusions: It appears that the SRIS-Y is a sound instrument for assessing therapy-relevant cognitive capacities in young people, of potential benefit in both research and clinical contexts. Future research foci include the predictive validity of the instrument.