The pernicious Effects of Post-event Processing in Social Anxiety Disorder

Aims Post-event processing (PEP) in social anxiety disorder (SAD) involves ruminating about social encounters after the fact. There is a clear relationship between PEP and SAD, but less is known about the negative effects of PEP. The goal of the current study was to investigate these negative effects in a sample of people with SAD. We hypothesized that PEP would contribute to decreased willingness to try a similar task again and to increased anxiety about engaging in a similar task. We also hypothesized that the degree of PEP would mediate the relationship between initial self-evaluation of performance and follow-up self-evaluation. Methods Forty-one individuals with a principal diagnosis of SAD completed the study. Participants completed baseline measures of symptom severity and state affect and then completed an impromptu speech task. After completing the speech, they completed a self-evaluation of their performance. Five days later, they rated the degree to which they engaged in PEP about their speech performance, indicated their willingness and anxiety about completing a similar speech task in the future, and completed a second self-evaluation of their performance. Results PEP contributed unique and significant variance to willingness (R 2 change = .12, p < .05) but not to anxiety ratings (R 2 change = .027, p = .13) once symptom severity, depressive symptoms, and state anxiety were controlled for. Using bias-corrected bootstrapping, PEP mediated the relationship between initial and follow-up performance ratings. Conclusions The more people engage in PEP, the less willing they appear to be to re-enter difficult social situations, likely perpetuating a cycle of avoidance. PEP also appears to be one factor that keeps negative self-perceptions “alive” after a challenging social situation. The current study provides unique evidence of the negative consequences of PEP for individuals with SAD.