An Investigation of Emotional and Cognitive Responses to Positive, Negative, and Neutral Social Evaluation Using a Face-to-Face Social Interaction Task in Social Anxiety Disorder

The bivalent fear of evaluation (BFOE) model posits that both fear of negative evaluation (FNE) and fear of positive evaluation (FPE) maintain social anxiety disorder (SAD). This study extends past research by using a face-to-face social interaction task to examine emotional and cognitive responses to positive, negative, and neutral feedback in people with SAD (n = 47) or a nonclinical control group (n = 49). Compared to the nonclinical control group, the SAD group reported significantly higher distress in response to negative and positive feedback over and above pre-task distress, which supports the BFOE model. Both groups rated negative feedback as significantly more distressing than positive and neutral feedback. Level of distress was the highest following the social interaction task, prior to receiving feedback. Unexpectedly, there were no significant group differences in the proportion of negative or positive thoughts in response to the feedback. Study limitations and clinical implications are discussed.