Effectiveness of Schema Therapy on Fear of Negative Evaluative in Female with Social Anxiety Disorder

Document Type : Original Article

Authors

• Kian Sabokbari ¹
• Rohollah Abbasi ²
• Nikta Gholami Baker ³

¹ Masters Learned, Clinical psychology, Allameh Tabatabai University, Tehran, Iran

² PhD Learned, Evaluating and Measuring, Allameh Tabatabai University, Tehran, Iran

³ PhD Student, Psychology, Faculty of Psychology, Islamic Azad University, Gorgan Branch, Gorgan, Iran

10.22067/tpccp.2022.72888.1182

Abstract

Purpose: The aim of this study was to determine the effect of group schema therapy on the fear of negative evaluation of girls with social anxiety.
Method: The design of the present study was quasi-experimental with control and experimental groups with pre-test and post-test with a follow-up period. The statistical population included all female students with social anxiety referred to Allameh Tabatabai University Counseling Center. Available sampling method was selected from 30 people and they were assigned to experimental and control groups. The experimental group underwent a 10-session group schema therapy and the follow-up period continued until two months after the end of treatment. In order to collect data in the pre-test and post-test stages for the two groups, the Young Schema Scale, the Social Anxiety Inventory (LSAS), and the Fear of Negative Assessment Questionnaire (FNE) were used. The obtained data were analyzed using a mixed analysis of variance test with repeated measures.
Findings: The results of evaluations at the end of treatment showed that schema therapy significantly reduced the fear of negative evaluation and continued its effect in the two-month follow-up phase in the experimental group. In general, it can be said that group therapy based on schema has the necessary efficiency and effectiveness in reducing the main goal of treatment, namely fear of negative evaluation in the sample of Iranian female students with social anxiety.

Keywords

• keyword: Schema therapy
• Fear of negative evaluation
• social anxiety

20.1001.1.22516352.1401.11.2.6.0

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References

Ahadi, H. M. F., Imani, F., & Rahgozar, M. (2011). Comparison of the clinical pattern of personality based on Millon Clinical Multiaxial Inventory in women. Journal Social Women, 2(4), 49-72. (in Persian)

Ahi, G., Mohammadifar, M., & Besharat, M. (2007). Reliability and validity of the short form of the Young Schema Questionnaire. Journal Psychology Education Science, 3(3), 5-20. (in Persian).

Asher, M., Asnaani, A., & Aderka, I. M. (2017). Gender differences in social anxiety disorder: A review. Clinical psychology review, 56, 1-12.

American Psychological Association. (2013). Diagnostic and statistical manual of mental disorders: American Psychiatric Publishing.

Baljé, A., Greeven, A., van Giezen, A., Korrelboom, K., Arntz, A., & Spinhoven, P. (2016a). Group schema therapy versus group cognitive behavioral therapy for social anxiety disorder with comorbid avoidant personality disorder: study protocol for a randomized controlled trial. Trials, 17(1), e487.

Baljé, A., Greeven, A., van Giezen, A., Korrelboom, K., Arntz, A., & Spinhoven, P. (2016b). Group schema therapy versus group cognitive behavioral therapy for social anxiety disorder with comorbid avoidant personality disorder: study protocol for a randomized controlled trial. Trials, 17(1), 1-13.

Bandelow, B., Torrente, A. C., Wedekind, D., Broocks, A., Hajak, G., & Rüther, E. (2004). Early traumatic life events, parental rearing styles, family history of mental disorders, and birth risk factors in patients with social anxiety disorder. European archives of psychiatry and clinical neuroscience, 254(6), 397-405.

Barlow, D., & Durand, V. (2011). Abnormal psychology: An integrative approach: Nelson Education.

Bautista, C. L., & Hope, D. A. (2015). Fear of negative evaluation, social anxiety and response to positive and negative online social cues. Cognitive Therapy and Research, 39(5), 658-668.

Beck, A. T., Davis, D. D., & Freeman, A. (2015). Cognitive therapy of personality disorders: Guilford Publications.

Calvete, E., Orue, I., & Hankin, B. L. (2013). Early maladaptive schemas and social anxiety in adolescents: The mediating role of anxious automatic thoughts. Journal of anxiety disorders, 27(3), 278-288.

Chiu, K., Clark, D. M., & Leigh, E. (2021). Cognitive predictors of adolescent social anxiety. Behaviour Research and Therapy, 137, 103801.

Craven, M. (2015). Effects of self-focused attention and fear of evaluation on anxiety and perception of speech performance. Ohio University,

Dadashzadeh, H., Yazdandoost, R., & Gharraee, B. (2012). Effectiveness of Cognitive-Behavioral Group Therapy and Exposure Therapy on Interpretation Bias and Fear of Negative Evaluation in Social Anxiety Disorder. Iranian Journal of Psychiatry & Clinical Psychology, 18(1). (in Persian)

Darcy, K., Davila, J., & Beck, J. G. (2005). Is social anxiety associated with both interpersonal avoidance and interpersonal dependence? Cognitive Therapy and Research, 29(2), 171-186.

de Lijster, J. M., Dieleman, G. C., Utens, E. M., Dierckx, B., Wierenga, M., Verhulst, F. C., & Legerstee, J. S. (2018). Social and academic functioning in adolescents with anxiety disorders: A systematic review. Journal of Affective Disorders, 230, 108-117.

Delaware, A. (2020). Research Methods in Psychology and Educational Sciences Fourth Edition ed.(in Persian).

Farrell, J. M., Shaw, I. A., & Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: a randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 40(2), 317-328.

Gal, M., Borg, V., & Gal, J. (2012). Qualitative and quantitative research methods in education and psychology. Tehran: samt.

Ghaderi, F., Kalantari, M., & Mehrabi, H. A. (2016). The Effectiveness of Group Schema Therapy on Modulating Early Maladaptive Behaviors and Reducing Symptoms of Social Anxiety Disorder. Journal of Clinical Psychology Studies, 6(24), 1-28. (in Persian).

Ghahari, Sh. (2017). Changing Schemes. Tehran: Roshd Publications(in Persian).

Gibb, B. E., Chelminski, I., & Zimmerman, M. (2007). Childhood emotional, physical, and sexual abuse, and diagnoses of depressive and anxiety disorders in adult psychiatric outpatients. Depression and anxiety, 24(4), 256-263.

Gray, E., Beierl, E. T., & Clark, D. M. (2019). Sub-types of safety behaviours and their effects on social anxiety disorder. Plos one, 14(10), e0223165.

Gros, D. F., Simms, L. J., Antony, M. M., & McCabe, R. E. (2012). Development and psychometric evaluation of the Multidimensional Assessment of Social Anxiety (MASA). Journal of Clinical Psychology, 68(4), 432-447.

Heimberg, R. G. (1995). Social phobia: Diagnosis, assessment, and treatment: Guilford Press.

Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive behaviour therapy, 36(4), 193-209.

Hofmann, S. G., & Bögels, S. M. (2006). Recent advances in the treatment of social phobia: Introduction to the special issue. Journal of Cognitive Psychotherapy, 20(1), 3- 5.

Khorshidzadeh, M., Borjali, A., Sohrabi, F., & Delaware, A. (2011). Effectiveness of Schema Therapy in the Treatment of Women with Social Anxiety Disorder. Journal of clinical psychology and counseling. 1 (2), 5-24. (in Persian)

Lampe, L. A. (2009). Social anxiety disorder: Recent developments in psychological approaches to conceptualization and treatment. Australian & New Zealand Journal of Psychiatry, 43(10), 887-898.

Liebowitz, M. R. (1987). Social phobia. Modern problems of pharmacopsychiatry. 22, 141-173.

Lobbestael, J., van Vreeswijk, M., Spinhoven, P., Schouten, E., & Arntz, A. (2010). Reliability and validity of the short Schema Mode Inventory (SMI). Behavioural and Cognitive Psychotherapy, 38(4), 437-458.

Mairet, K., Boag, S., & Warburton, W. (2014). How important is temperament? The relationship between coping styles, early maladaptive schemas and social anxiety. International Journal of Psychology and Psychological Therapy, 14(2), 171-190.

McCabe, R. E., Antony, M. M., Summerfeldt, L. J., Liss, A., & Swinson, R. P. (2003). Preliminary examination of the relationship between anxiety disorders in adults and self-reported history of teasing or bullying experiences. Cognitive Behaviour Therapy, 32(4), 187-193.

O’Connor, C. E., & Fitzgerald, A. (2020). A Psychometric Evaluation of the Social Anxiety Scale for Adolescents in an Educational Setting. Journal of Psychoeducational Assessment, 38(4), 519-528.

Pinto-Gouveia, J., Castilho, P., Galhardo, A., & Cunha, M. (2006). Early maladaptive schemas and social phobia. Cognitive Therapy and Research, 30(5), 571-584.

Piray, P., Ly, V., Roelofs, K., Cools, R., & Toni, I. (2019). Emotionally aversive cues suppress neural systems underlying optimal learning in socially anxious individuals. Journal of neuroscience, 39(8), 1445-1456.

Razmzan, Z. (2013). The effectiveness of the cognitive bias adjustment program - the component of interpretation and attention to the symptoms of social anxiety and fear of negative evaluation and the effect of the chain of these components in people with social anxiety disorder. Shiraz University, Faculty of Educational Sciences and Psychology,. (in Persian)

Reghuram, R., & Mathias, J. (2014). A study on occurrence of social anxiety among nursing students and its correlation with professional adjustment in selected nursing institutions at Mangalore. Nitte University Journal of Health Science, 4(2), 64-69.

Riso, L. P., Froman, S. E., Raouf, M., Gable, P., Maddux, R. E., Turini-Santorelli, N.,... Cherry, M. (2006). The long-term stability of early maladaptive schemas. Cognitive Therapy and Research, 30(4), 515-529.

Rivas, M. E. R. (2021). Attitudes towards people with mental illness among medical students: A qualitative research. Psychology, Society & Education, 13(2), 21-33.

Salavati, M., & Yekeh Yazdan Doost, R. (2012). Schema Therapy: A Special Guide for Clinical Psychologists. Tehran: Danjeh Publishing. (in Persian)

Simpson, S. G., Morrow, E., & Reid, C. (2010). Group schema therapy for eating disorders: a pilot study. Frontiers in psychology, 1, 1-10.

Spence, S. H., & Rapee, R. M. (2016). The etiology of social anxiety disorder: An evidence-based model. Behaviour Research and Therapy, 86, 50-67.

Stein, D. J., Lim, C. C., Roest, A. M., De Jonge, P., Aguilar-Gaxiola, S., Al-Hamzawi, A.,... Bruffaerts, R. (2017). The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC medicine, 15(1), 1-21.

Stein, M. B., & Stein, D. J.  (2008). Social anxiety disorder. The lancet, 371(9618), 1115-1125.

Stopa, L., & Clark, D. M. (2000). Social phobia and interpretation of social events. Behaviour research and therapy, 38(3), 273-283.

Väänänen, J.-M., Fröjd, S., Ranta, K., Marttunen, M., Helminen, M., & Kaltiala-Heino, R. (2011). Relationship between social phobia and depression differs between boys and girls in mid-adolescence. Journal of affective disorders, 133(1-2), 97-104.

Videler, A. A., van Royen, R. R., & van Alphen, S. B. (2012). Schema therapy with older adults: call for evidence. International Psychogeriatrics, 24(7), 1186-1187.

Watson, D., & Friend, R. (1969). Measurement of social-evaluative anxiety. Journal of consulting and clinical psychology, 33(4), 448-457.

Weeks, J. W., Heimberg, R. G., Fresco, D. M., Hart, T. A., Turk, C. L., Schneier, F. R., & Liebowitz, M. R. (2005). Empirical validation and psychometric evaluation of the Brief Fear of Negative Evaluation Scale in patients with social anxiety disorder. Psychological assessment, 17(2), 179-190.

Young, J. E., & Brown, G. (1994). Young schema questionnaire. Cognitive therapy for personality disorders: A schema-focused approach, 2, 63-76.

Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide: Guilford Press. Translated by Hamidpour H, Andouz A. Tehran : Arjmand. (in Persian)