Attention Mechanisms of Social Anxiety in Daily Life: Unique Effects of Negative Self-Focused Attention on Post-Event Processing

Social anxiety disorder (SAD) is characterized by biased patterns of attention that are theorized to play a key role in maintaining symptoms. SAD has been linked to externally oriented attentional biases (i.e., towards social-evaluative threats) and internally oriented attentional biases (i.e., towards anxiety-laden thoughts and sensations), both of which might increase proneness for post-event processing (PEP), a form of rumination about the negative aspects of past social events. However, prior research examining attentional biases in SAD has primarily been conducted in laboratory settings, leaving unanswered questions about the naturalistic patterns of attention and cognition that most strongly characterize and maintain social anxiety. The present study applied ecological momentary assessment (EMA) to examine attentional biases during real-world social interactions and their effects on subsequent PEP in a sample of adults with high (n = 108) and low (n = 94) levels of social anxiety. Three times per day for one week, participants reported their attention orientation (i.e., internal versus external), the valence of their attentional foci (i.e., negative versus positive), and their degree of PEP following salient social events. Results revealed that high (vs. low) levels of social anxiety were associated with relatively more internally oriented and negatively valenced attention during social interactions, which in turn predicted increases in subsequent PEP. Findings highlight the salience of negative self-focused attention and ruminative thinking as maintenance factors in social anxiety, and suggest that interventions targeting these mechanisms could show promise in future research.