Exploring the relationship between fear of positive evaluation and social anxiety

Transcription

1 Journal of Anxiety Disorders 22 (2008) Exploring the relationship between fear of positive evaluation and social anxiety Justin W. Weeks a, Richard G. Heimberg a, *, Thomas L. Rodebaugh b, Peter J. Norton c a Adult Anxiety Clinic of Temple University, Department of Psychology, Philadelphia, PA, United States b Department of Psychology, Washington University at St. Louis, St. Louis, MO, United States c Department of Psychology, University of Houston, Houston, TX, United States Received 14 January 2007; received in revised form 20 April 2007; accepted 27 April 2007 Abstract Cognitive-behavioral theorists have proposed that fear of negative evaluation is the core feature of social anxiety [Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In: R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp ). New York: Guilford Press; Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behavior Research and Therapy, 35, ]. However, we have previously hypothesized that fear of evaluation in general is important in social anxiety, including fears of positive as well as negative evaluation, and we developed the Fear of Positive Evaluation Scale (FPES; Weeks, J. W., Heimberg, R. G., & Rodebaugh, T. L. (2007). The Fear of Positive Evaluation Scale: Assessing a proposed cognitive component of social anxiety disorder. Manuscript submitted for review.) to test this hypothesis. The present paper reviews several studies conducted for the purpose of extending the empirical examination of the construct of fear of positive evaluation (FPE). Consistent with hypothesis, FPE was positively associated with discomfort in response to receipt of positive social feedback and negatively associated with perceived accuracy of the feedback received. Furthermore, the FPES correlated significantly with several measures related to social anxiety, and lower correlations with measures of other constructs provided evidence of discriminant validity. Thus, findings from the present series of studies add to the developing support for the hypothesis that fear of positive evaluation is important in social anxiety. # 2007 Elsevier Ltd. All rights reserved. Keywords: Anxiety; Social anxiety disorder; Social phobia; Fear of positive evaluation; Fear of negative evaluation; Assessment Portions of this paper were presented at the annual meeting of the Anxiety Disorders Association of America: Miami, FL, March, * Corresponding author at: Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA , United States. Tel.: ; fax: address: heimberg@temple.edu (R.G. Heimberg). Cognitive-behavioral theorists have labeled fear of negative evaluation (FNE) a core feature of social anxiety (e.g., Clark & Wells, 1995; Rapee & Heimberg, 1997). For example, Rapee and Heimberg have proposed that socially anxious individuals form a biased image or mental representation of themselves as seen by others and simultaneously focus their attentional resources on the negative aspects of the image and toward monitoring the social environment for /$ see front matter # 2007 Elsevier Ltd. All rights reserved. doi: /j.janxdis

2 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) indicators of negative evaluation by others; perceived negative evaluation stimulates increases in anxiety as well as in other negative aspects of the image of the self as seen by others, creating a maladaptive feedback loop. Empirical support for FNE as a major feature of social anxiety (e.g., Coles, Turk, Heimberg, & Fresco, 2001; Hackman, Surawy, & Clark, 1998; Horley, Williams, Gonsalvez, & Gordon, 2004; Mansell & Clark, 1999) notwithstanding, current models may neglect an important component of socially anxious cognition: Socially anxious individuals may fear evaluation in general, experiencing fear of both positive and negative evaluation. This notion is consistent in part with the evolutionary account of social anxiety put forth by Gilbert (2001) and colleagues (e.g., Trower & Gilbert, 1989; Trower, Gilbert, & Sherling, 1990). Gilbert (2001) proposed that social anxiety is an evolutionary mechanism that facilitates non-violent interactions between individuals and suggested that socially anxious individuals may fear increases in status that could lead to conflict with more powerful others. Gilbert further suggested that socially anxious individuals may fear that they will not be able to maintain or defend social gains in the future and dubbed (p. 742) this concept the fear of doing well. Consistent with the notion, Wallace and Alden (1995, 1997) have reported that socially anxious individuals worry that positive evaluation of their performance raises the social standards by which they will be evaluated in the future, whereas they do not believe that their typical performance will change for the better. As a result, they predict that positive evaluation by others will ultimately result in failure. The Fear of Positive Evaluation Scale (FPES; Weeks, Heimberg, & Rodebaugh, 2007) was developed in order to test the assumption that fear of evaluation in general is important in social anxiety disorder, including fears of positive, as well as negative, evaluation. The FPES has demonstrated sound psychometric properties in a large undergraduate sample. Furthermore, initial findings suggest that FPE is distinct from FNE. Confirmatory factor analysis of the combined straightforwardly worded items from the FPES and the Brief Fear of Negative Evaluation Scale (BFNE; Leary, 1983a) in a sample of 410 undergraduates suggested that a two-factor fear of evaluation (FPE and FNE) model fit the data well and was superior to a single-factor model. Moreover, FPE accounted for significant variance in social interaction anxiety beyond that accounted for by FNE (Weeks et al., 2007). Thus, early empirical evidence favors the hypothesis that positive, as well as negative, evaluation is important to social anxiety. In the present series of studies, we sought to extend the empirical examination of FPE by Weeks et al. (2007). In the first study, we tested the relationships between FPE, responses to bogus positive social feedback, and social anxiety. The second and third studies further examined the convergent and discriminant validity of the FPES and extended previous reports (Weeks et al., 2007) that FPE accounts for variance in social anxiety above and beyond that contributed by FNE. 1. Study 1 In this study, we expected higher FPE to be associated with increased discomfort and lower perceptions of accuracy regarding positive social feedback, implying a tendency to reject this important, typically disconfirmatory, feedback. Given the data suggesting that FPE and FNE are distinct constructs (Weeks et al., 2007), we did not expect that FNE would predict responses to the receipt of positive feedback. We hypothesized that discomfort associated with receiving positive feedback would at least partially mediate the relationship between FPE and perceived overall accuracy of positive feedback received. We also conducted exploratory analyses to examine whether FPE mediates the relationship between social anxiety and responses to receipt of positive feedback. 2. Method 2.1. Participants Participants in the first study were undergraduates enrolled in an introductory psychology course at Temple University (N = 65) who received course credit for their participation. The majority of the sample was female (65.5%). In addition, 70.8% of participants were Caucasian, 5.2% were African American, 3.4% were Asian American, 3.4% were Hispanic, 10.3% were of other ethnicity, and 6.9% were of mixed ethnicity. Most participants were in their freshman year (65.5%), with a mean age of years (S.D. = 1.59) Measures Fear of Positive Evaluation Scale (FPES; Weeks et al., 2007) The 10-item FPES uses a 10-point Likert-type rating scale, ranging from 0 (not at all true) to 9 (very true).

3 388 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) Two reverse-scored items are included (for the purpose of potentially detecting response biases) but are not included in the FPES total score. Examples of FPES items include I am uncomfortable exhibiting my talents to others, even if I think my talents will impress them and I feel uneasy when I receive praise from authority figures. The FPES has demonstrated strong internal consistency (a =.80) and 5-week test retest reliability (intraclass correlation coefficient =.70) in undergraduate samples. Furthermore, consistent with hypothesis, the FPES correlated positively with selfreport measures of social interaction anxiety and fear of negative evaluation and was more strongly correlated with a measure of social interaction anxiety than with measures of depression, generalized anxiety, or worry. In addition, the FPES demonstrated strong factorial validity in a series of confirmatory factor analyses (Weeks et al., 2007) The Brief Fear of Negative Evaluation Scale straightforward items (BFNE-S: Rodebaugh et al., 2004; Weeks et al., 2005) The BFNE (Leary, 1983a) is a 12-item self-report measure of fear and distress related to negative evaluation from others. Items are rated on a 5-point Likert-type scale, ranging from 1 (Not at all characteristic of me) to5(extremely characteristic of me). Rodebaugh et al. (2004) and Weeks et al. (2005) have reported that the eight straightforwardly worded items are more reliable and valid indicators of fear of negative evaluation than the reverse-scored items in undergraduate and clinical samples, respectively. Consequently, Rodebaugh et al. and Weeks et al. have suggested utilizing only the eight straightforward (-S) BFNE items to calculate the total score. The BFNE-S has demonstrated excellent internal consistency (all a 0 s >.92), factorial validity, and construct validity in undergraduate (Rodebaugh et al., 2004) and clinical (Weeks et al., 2005) samples. The 12-item BFNE was administered; however, only the straightforward items (BFNE-S) were utilized in the present analyses. The BFNE-S was included to test the hypothesis that FNE would not significantly predict discomfort with or perceived accuracy of positive social feedback. The BFNE-S demonstrated excellent internal consistency in the present sample (a =.90). The Social Phobia Scale (SPS; Mattick & Clarke, 1998) measures anxiety associated with being observed by others. The SPS consists of 20 items, which are scored on a 5-point Likert-type rating scale ranging from 0 (Not at all characteristic or true of me) to4 (Extremely characteristic or true of me). The SPS has demonstrated strong internal consistency in clinical, community and undergraduate samples (as range from.89to.94)(mattick & Clarke, 1998), and adequate test retest reliability (r =.66) in a sample of undergraduates (Heimberg, Mueller, Holt, Hope, & Liebowitz, 1992). Furthermore, Mattick and Clarke (1998) demonstrated that scores on the SPS discriminate among patients with anxiety disorders (social anxiety disorder, agoraphobia, simple phobia) and between individuals with social anxiety disorder and control groups (undergraduate and community samples). The SPS was included to examine relationships between evaluative fears (i.e., FPE and FNE), anxiety about being observed by others, and responses to receipt of positive social feedback. The SPS demonstrated good internal consistency in the present sample (a =.87) Social Interaction Anxiety Scale- Straightforward score (SIAS-S; Rodebaugh et al., 2007) The Social Interaction Anxiety Scale (SIAS; Mattick & Clarke, 1998) is a measure of anxiety in dyads and groups, and consists of 20 items, which are scored on a five-point Likert-type scale ranging from 0 (Not at all characteristic or true of me) to 4 (Extremely characteristic or true of me). Examples of SIAS items include I find it easy to make friends of my own age and When mixing in a group, I find myself worrying I will be ignored. Rodebaugh and colleagues have reported that the 17 straightforwardly worded items of the SIAS are more valid indicators of social interaction anxiety than the reverse-scored items in both undergraduate and clinical samples. Consequently, Rodebaugh et al. suggested the scoring strategy of utilizing only the straightforward SIAS items to calculate the total score, thereby yielding a 17-item score, hereafter referred to as the SIAS-Straightforward (SIAS-S) score. The SIAS-S has demonstrated excellent internal consistency (a =.93) and factorial validity in undergraduate samples and has demonstrated strong construct validity in both undergraduate and clinical samples (Rodebaugh et al., 2007). The 20-item SIAS was administered to the overall sample; however, only the straightforward items (SIAS-S) were utilized in the present analyses. The SIAS-S was included to examine relationships between evaluative fears (i.e., FPE and FNE), social interaction anxiety, and responses to receipt of positive social feedback. The SIAS-S 1 One participant in Studies 1 and 2 did not complete the SPS.

4 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) demonstrated excellent internal consistency in the present sample (a =.93) Procedure Participants were told that the purpose of the present study was to examine the validity of a personality assessment technique and that they would be asked to complete this assessment and provide feedback on its accuracy. They were instructed to write an open-ended paragraph (three or more sentences) on a subject of their choosing and were informed that expert raters trained in the personality assessment technique would examine their paragraphs and provide them with personality profiles based on their responses. Following completion of the bogus personality task, the paragraphs were labeled with participant identification codes and collected from the participants. Questionnaire packets including the FPES, BFNE, SPS, and SIAS, among other measures, were then distributed. Participants were informed that the expert raters would review their paragraphs and complete their profile while the participants were completing the questionnaires. The experimenter then left the room under the pretense that the paragraphs were being distributed to the expert raters. In actuality, the paragraphs were not reviewed. Approximately 30 min after the paragraphs were taken out of the testing room by the experimenter, a research assistant knocked on the door of the testing room and delivered the participants personality profiles. Once all participants had completed the questionnaire battery, the questionnaires were collected, and the personality profiles were distributed. Each profile consisted of 10 identical feedback statements, which were hand-written (in the same order) and placed in sealed envelopes which were labeled with the participant s identification code. All statements included in the profile were positively oriented and pertained to a wide range of social evaluative contexts. Examples of the feedback statements included Your opinions are often highly valued and People assume that you have many talents. Participants were told they might be asked to discuss the accuracy of their profile with the expert raters after the study. Under the pretense that the study was intended to examine the validity of the personality assessment technique, participants were next instructed to provide two ratings of each statement in their personality profile. First, participants were instructed to rate the accuracy of each feedback statement on a scale ranging from 0 to 10, with 0 being not at all accurate or true of me and 10 being extremely accurate or true of me. Next, participants were informed that an additional way to examine the accuracy of profile statements is to rate the discomfort they experienced as they viewed each statement, because feedback statements which are less accurate would feel less comfortable. Thus, participants were instructed to provide a discomfort rating for each statement on a scale ranging from 0 to 100, with 0 indicating no discomfort at all and 100 signifying extreme discomfort. Following completion of the study, participants were asked whether they had suspected that deception had been utilized in the study to assess the validity of the procedure. Participants were debriefed, and the rationale for the deception was explained. 3. Results 3.1. Preliminary analyses The distribution of FPES scores (M = 22.72, S.D. = 11.91) was normal (skewness = 0.58, S.E. =.30; kurtosis = 0.49, S.E. = 0.59), and participant responses to the FPES exhibited good internal consistency (a =.82). No gender difference was found in the analysis of FPES scores, F(1, 64) = 2.17, p =.15. The data for nine participants were excluded from the analyses described below; six participants believed that their profiles were not generated on the basis of their responses to the personality assessment, and three participants failed to complete the ratings appropriately Examining relationships between fear of evaluation measures and response ratings Two standard regression equations examined whether FPES scores (a) positively predicted discomfort ratings in response to receiving positive feedback and (b) negatively predicted ratings of the accuracy of the feedback received. 3 As hypothesized, FPES scores significantly predicted both mean accuracy, F(1, 55) = 15.04, p <.001, and mean discomfort, F(1, 55) = 15.42, p <.001, ratings (see Table 1). These effects were both of medium strength (both Cohen s f 2 s > 0.28) (Cohen, 1988). Moreover, in separate 2 During the debriefing, these three individuals reported having incorrectly completed the feedback ratings because they did not understand the instructions delivered by the experimenter. 3 The correlation between overall accuracy (M = 8.29, S.D. = 1.11) and discomfort (M = 9.22, S.D. = 13.06) ratings (r =.53, p <.01) suggests that these ratings assessed distinct (albeit strongly related) constructs.

5 390 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) Fig. 1. Results for the hypothesized model in which discomfort mediates the relationship between fear of positive evalulation and perceived accuracy of positive social feedback (unstandardized rergression coefficients presented with partial correlation coefficients in parentheses; ** p <.01, * p <.05). Table 1 Regression weights from regression analyses examining the relationships between FPES scores and mean ratings of discomfort and accuracy in response to receiving positive feedback in Study 1 Variable B S.E. B Beta Overall Discomfort Overall accuracy Note. FPES: Fear of Positive Evaluation Scale. Adjusted R 2 =.20 for overall discomfort ratings and.21 for overall accuracy ratings. Both predictors were significant, ps <.001. regression equations, BFNE-S scores did not significantly predict either mean accuracy ratings, F(1, 55) = 0.27, p =.60, or discomfort ratings, F(1, 55) = 0.03, p = Mediational analyses In accordance with the recommendations of Baron and Kenny (1986), we conducted three separate regression equations for evaluating mediational models: (a) regressing the mediator on the predictor variable; (b) regressing the outcome variable on the predictor variable; and (c) regressing the outcome variable on both the predictor variable and the mediator. Accordingly, mediation is established if: (a) the predictor variable is related to the mediator in the first equation and the outcome variable in the second equation, (b) the mediator is related to the outcome variable in the third equation, and (c) the magnitude of the relationship of the predictor variable to the outcome variable is less in the third equation than in the second equation. Complete mediation is demonstrated if the predictor variable is unrelated to the outcome variable when the mediator is controlled, whereas partial mediation is demonstrated if the magnitude of this relationship is reduced when the mediator is controlled. The strength of the indirect effect was assessed using Sobel s (1982) test. We first examined whether discomfort upon receipt of positive social feedback mediated the relationship between FPE and perceived accuracy of positive feedback. Thus, a mediational model was tested with FPE serving as the predictor variable, mean discomfort ratings from the bogus personality assessment task as the mediator, and accuracy ratings as the outcome variable. This model is displayed in Fig. 1. In the first regression equation, FPES scores significantly predicted overall perceived accuracy (path c; B = 0.044, S.E. =.01, pc =.47, p <.001). 4 In the second regression equation, higher FPES scores predicted significantly greater discomfort (B = 0.51, S.E. =.13, pc =.46, p <.001). Upon controlling for discomfort, the prediction of overall accuracy by FPE was reduced (path c 0 : B = 0.026, S.E. =.01, pc =.29, p=.03) and the predictive power of rated discomfort was strong (path b: B = 0.034, S.E. =.01, pc =.41; p=.002). The reduction in the regression coefficient for FPE when discomfort ratings were included in the regression equation (B = reduced to B = 0.026) provides evidence of mediation and indicates that the discomfort associated with receiving positive feedback was a 4 Because the regression equations recommended by Baron and Kenny (1986) do not produce standardized regression coefficients, partial correlation (pc) coefficients were provided for comparison on a common metric.

6 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) partial mediator between FPE and perceived overall accuracy of positive feedback. Sobel s test of the indirect effect of FPE on overall perceived accuracy was significant, z = 2.45, p =.01. Moreover, upon reversing the roles of the predictor and mediator variables in this hypothesized model, the indirect effect of this alternative model was not significant (z = 1.87, p =.06), ruling out the alternative hypothesis that FPE mediates the relationship between discomfort with receipt of positive feedback and perceived accuracy of positive feedback received. Whereas the above tests suggest that discomfort mediates the relationship between FPE and rated accuracy, we explored several other models as well. Our hypothesis suggests that FPE should mediate the relationship between social anxiety and discomfort and accuracy ratings. However, given that social anxiety relates to FPE, an alternative hypothesis is that social anxiety mediates the relationship between FPE and ratings of discomfort and accuracy. We therefore tested several exploratory models to rule out the possibility that social anxiety is responsible for the effects observed. In brief, of the four exploratory mediational models tested, three met the Baron and Kenny (1986) criteria for mediation. Specifically, FPES scores completely mediated (a) the relationship between social interaction anxiety and discomfort ratings and (b) the relationship between anxiety associated with beingobservedbyothersanddiscomfortratings.fpes scores also partially mediated the relationship between social interaction anxiety and overall accuracy ratings. Moreover, Sobel s test of the indirect effect for all four models was significant (all ps <.05). In addition, upon reversing the roles of the predictor and mediator variables in each of these models, none of the indirect effects of these alternative models was significant (all ps >.07), ruling out the alternative hypothesis that social anxiety mediates the relationships between FPE and responses to receipt of positive feedback. Details of these analyses are available from the authors. 4. Study 2 Study 1 demonstrated that FPE is associated with discomfort about positive social feedback that is accompanied by (and may partially cause) a tendency to view such information as inaccurate. Furthermore, exploratory analyses suggested that FPE mediates the relationship between social anxiety and discomfort associated with receipt of positive feedback, and that FPE partially mediates the relationship between social interaction anxiety and perceived accuracy of positive feedback received. The primary purpose of Study 2 was to examine the relationships between the FPES and a variety of convergent and discriminant measures. A secondary purpose of this study was to replicate and extend findings reported by Weeks et al. (2007). The following hypotheses were tested in Study 2: (a) the FPES would correlate with self-report measures of social anxiety, fear of negative evaluation, and submissive behaviors; (b) the FPES would correlate more strongly with measures of social anxiety than with measures of other constructs; and (c) the FPES would account for significant variance in scores on measures of anxiety about being observed by others and social interaction anxiety above and beyond that accounted for by a measure of fear of negative evaluation (the BFNE-S). 5. Method 5.1. Participants The sample from Study 1 was utilized in this study Measures In addition to the FPES, BFNE-S, SPS, and SIAS-S, described in Study 1, several other measures were administered to assess the convergent and discriminant validity of the FPES Measure of submissive behavior (convergent validity) The Submissive Behavior Scale (SBS; Gilbert & Allan, 1994) The SBS is a 16-item self-report measure that assesses involuntary submissive behaviors. The SBS was designed to explore the relationship of evolved mental mechanisms of social rank to psychopathology and was derived from an earlier list developed by Buss and Craik (1986). The SBS has demonstrated adequate internal consistency in both clinical (a =.82) and nonanxious control (a =.74) samples (Schneier, Heimberg, Belzer, & Liebowitz, 2007). Furthermore, a strong correlation has been demonstrated between SBS scores and scores obtained on a clinician-administered measure of social anxiety, and patients with generalized social anxiety disorder obtained higher SBS scores than nonanxious controls (Schneier et al., 2007). The SBS demonstrated good internal consistency in the present sample (a =.76).

7 392 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) Measures for the assessment of other constructs (discriminant validity) Participant responses to the following measures were utilized to examine the discriminant validity of the FPES. Discriminant validity would be demonstrated if more robust correlations were exhibited between the FPES and measures of social anxiety than with the following measures: The Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) is a 21- item self-report measure of depression. The items of the BDI-II pertain to depressive symptoms and attitudes that can be rated from 0 to 3 in terms of intensity. Excellent internal consistency has been reported for the BDI-II in both outpatient (a =.92) and undergraduate (a =.93) samples (Beck et al., 1996), and convergent validity has been demonstrated by positive correlations between scores on the BDI-II and scores on measures of hopelessness and suicidal ideation. Furthermore, scores on the BDI-II are more strongly correlated with clinician-rated depression than with clinician-rated anxiety (Beck et al., 1996). The BDI-II demonstrated excellent internal consistency in the present sample (a =.89). The 36-item Anxiety Sensitivity Index-Revised (ASI- R; Taylor & Cox, 1998) is a measure of fear of anxietyrelated sensations and the extent to which they are considered catastrophic. The revised version of the Anxiety Sensitivity Index (Reiss, Peterson, Gursky, & McNally, 1986) was created to address potential lowerorder factors pertaining to anxiety sensitivity (Taylor, 1996). All items are scored on a 5-point Likert-type rating scale, ranging from Agree very little to Agree very much. The ASI-R yields a total score, as well as several subscale scores. Because no hypotheses of the present study pertained to the distinction between the various fears assessed by the ASI-R subscales, only the ASI-R total score was utilized. The ASI-R has demonstrated excellent internal consistency (a =.94) in a large undergraduate sample, and support for the convergent validity of the scale is provided by moderate correlations (rs range from.36 to.45, all ps <.001) between ASI-R total scores and measures of depression and anxiety (Deacon, Abramowitz, Woods, & Tolin, 2003). The ASI-R demonstrated excellent internal consistency in the present sample (a =.94). The Almost Perfect Scale-Revised (APS-R; Slaney, Rice, Mobley, Trippi, & Ashby, 2001) is a 23-item selfreport measure of perfectionism. Items are rated on a 7-point Likert-type scale, ranging from 1 (Strongly disagree) to 7(Strongly agree). The APS-R yields a total score, in addition to three subscale scores: high standards (7 items), order (4 items), and discrepancy (12 items; i.e., the extent to which the respondent consistently fails to meet up to his/her own perfectionistic standards). The APS-R total score and subscales exhibit good internal consistency (as range from.82 to.92), and the APS-R has demonstrated positive correlations with other measures of perfectionism, providing evidence of convergent validity (Slaney et al., 2001). The APS-R was included in this study to examine whether FPE is distinct from perfectionistic tendencies, including the extent to which individuals perceive themselves as failing to meet their own perfectionistic standards (i.e., the discrepancy subscale); the APS-R high standards and order subscales were included in the present analyses for exploratory purposes.the APS-R demonstrated good internal consistency in the present sample (a =.84). The Self Compassion Scale (SCS; Neff, 2003) is a 26- item self-report measure of self-compassion. Items are rated on a 5-point Likert-type scale, ranging from 1 (Almost never) to 5(Almost always). The SCS yields a total score, in addition to consisting of six subscales designed to assess the three basic components of selfcompassion: self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus over-identification. Evidence for the convergent validity of the SCS has been provided by significant correlations with other scales measuring similar constructs, and discriminant validity of the SCS is supported by a non-significant correlation with a measure of social desirability. Furthermore, evidence of the construct validity of the SCS is provided by the finding that individuals scoring higher on the SCS report that they are equally kind to self and others, whereas those who score lower on the SCS report being kinder to others than to themselves (Neff, 2003). The SCS was included in this study to examine whether FPE is empirically distinct from lack of self-compassion, which could ostensibly lead to rejection of positive evaluation (a potential confound in the assessment of FPE); the SCS subscales were included in the present analyses for exploratory purposes. The SCS demonstrated acceptable internal consistency in the present sample (a =.61) Procedure The above measures were included in the questionnaire battery given after completing the bogus personality assessment task in Study 1 (prior to receiving/rating the bogus feedback).

8 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) Table 2 Means and standard deviations of all study measures, and zero-order correlations with the Fear of Positive Evaluation Scale in Studies 2 and 3 Measure Study 2 Study 3 M S.D. r M S.D. r Fear of Positive Evaluation Scale Social Phobia Scale * * Social Interaction Anxiety Scale * * Interaction Anxiousness Scale * Submissive Behavior Scale * Brief Fear of Negative Evaluation Scale- Straightforward items * Beck Depression Inventory-II * Almost Perfect Scale-Revised Anxiety Sensitivity Index-Revised Self-Compassion Scale GAD-Questionnaire for DSM-IV * Yale-Brown Obsessive Compulsive Scale: Obsessive * Yale-Brown Obsessive Compulsive Scale: Compulsive * Panic Disorder Severity Scale-Self Report * Depression Anxiety Stress Scales: Depression * Depression Anxiety Stress Scales: Anxiety * Depression Anxiety Stress Scales: Stress * Note. ns vary from 61 to 65 in Study 2 and from 238 to 243 in Study 3 due to missing data. ( ): Measure not administered in study, or, for correlations in FPES row, not applicable. Bonferroni correction was calculated based on the total number of comparisons per study. * p = (.05/8) =.006 for Study 2; p = (.05/12) =.004 for Study Results Means and standard deviations for participants responses to all questionnaires are displayed in Table Convergent validity A Bonferroni correction (.05/8 =.00625) was applied, which controlled for the total number of comparisons between FPES scores and all other measures in Study 2 (see Table 2). The FPES was significantly and positively correlated with the SIAS-S, the SPS, and the SBS. The FPES did not correlate significantly with the BFNE-S Discriminant validity After Bonferroni correction, the FPES did not correlate significantly with any of the discriminant measure total scores (all rs <.32, all ps >.013). Furthermore, the FPES did not correlate significantly with any of the subscale scores of the APS-R (all ps >.05) or the SCS (all ps >.04), utilizing Bonferroni corrections calculated based on the number of subscale comparisons for each measure ( p =.0125 and p =.017, respectively). Significance tests were conducted to determine whether FPES scores correlated more strongly with measures of anxiety about being observed by others (the SPS) and social interaction anxiety (the SIAS-S) than with measures of depression, perfectionism, anxiety sensitivity, and self-compassion (Meng, Rosenthal, & Rubin, 1992). The FPES score was more strongly correlated with the SPS than with the APS-R total score or the SCS total score (both zs > 2.72, both ps <.004). FPES scores did not relate significantly more strongly to the SPS than the BDI-II and ASI-R (both zs < 1.42, both ps >.07). However, the relationship between the FPES and the SPS remained robust upon controlling for depressive symptoms and anxiety sensitivity (both ps <.004). In contrast, partial correlations of the FPES with the BDI-II and the ASI-R, upon controlling for social anxiety (SPS scores), were no longer significant. The FPES did not relate significantly more strongly to the SIAS-S than the discriminant measures (all zs < 1.08, all ps >.14). However, the relationship between the FPES and the SIAS-S remained robust upon controlling for depression, anxiety sensitivity, perfectionism, and self-compassion scores (all ps <.043). In contrast, partial correlations of the FPES with the ASI-R, the APS-R, and the SCS upon controlling for social interaction anxiety (SIAS-S scores) were no longer significant (all ps >.16). However, the relationship between the FPES and the BDI-II remained significant (without correction for multiple tests) upon controlling for SIAS-S scores ( p =.03).

9 394 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) Table 3 Regression weights from hierarchical regression analyses examining the unique variance in anxiety about being observed by others (Social Phobia Scale) Accounted for by the Fear of Positive Evaluation Scale (FPES) above and beyond the contribution of the straightforwardly worded items of the Brief Fear of Negative Evaluation Scale (BFNE-S) Variable Study 2 Study 3 B S.E. b Beta Partial r B S.E. b Beta Partial r Step 1 BFNE-S Step 2 BFNE-S FPES Notes. Overall adjusted R 2 =.28, S.E. = 7.60; R 2 D =.14, F(1, 61) = 12.50, p <.001 for Study 2; overall adjusted R 2 =.52, S.E. = 9.50; R 2 D =.09, F(1, 237) = 44.04, p <.001 for Study 3. Table 4 Regression weights from hierarchical regression analyses examining the unique variance in social interaction anxiety (social interaction anxiety scale) accounted for by the Fear of Positive Evaluation Scale (FPES) above and beyond the contribution of the straightforwardly worded items of the Brief Fear of Negative Evaluation scale (BFNE-S) Variable Study 2 Study 3 B S.E. b Beta Partial r B S.E. b Beta Partial r Step 1 BFNE-S Step 2 BFNE-S FPES Notes. Overall adjusted R 2 =.22, S.E. = 10.19; R 2 D =.07, F(2, 62) = 8.56, p <.001 for Study 2; overall adjusted R 2 =.53, S.E. = 9.72; R 2 D =.07, F(2, 240) = , p <.001 for Study Unique variance in SPS and SIAS-S scores accounted for by fear of positive evaluation Two hierarchical regression analyses were conducted to examine whether fear of positive evaluation accounted for variance in anxiety about being observed by others and social interaction anxiety beyond that already accounted for by the measure of fear of negative evaluation. Specifically, in both equations, the BFNE-S total score was entered in the first step of the equation, and the FPES was entered in the second step. In the first equation, the SPS score was the criterion variable. After the first step in the regression, the BFNE-S was significantly and positively related to the SPS, R 2 =.16, F(1, 62) = 12.07, p <.001, in the expected direction. In the second step, the FPES was also significantly and positively related to, and significantly improved the prediction of, SPS scores, R 2 D =.14, F(1, 61) = 12.50, p <.001. Thus, the FPES accounted for significant variance in anxiety about being observed by others beyond that accounted for by the BFNE-S (see Table 3). In the second equation, the SIAS-S score was the criterion variable. After the first step, the BFNE-S was significantly and positively related to the SIAS-S, R 2 =.22, F(1, 63) = 10.55, p =.002, in the expected direction. In the second step, the FPES was also significantly and positively related to, and significantly improved the prediction of, the SIAS-S, R 2 D =.07, F(1, 62) = 5.75, p =.02. Thus, FPES scores accounted for significant variance in social interaction anxiety beyond that accounted for by the BFNE-S (see Table 4). 7. Study 3 The purpose of this study was to test whether the findings of Study 2 would replicate in an independent sample and extend these findings using additional comparison measures. 8. Method 8.1. Participants Participants in the third study were undergraduates enrolled in an introductory psychology course at the University of Houston (n = 243). The majority of the sample was female (70.4%); In addition, 37.3% of the sample were Asian, 20.8% were Hispanic, 19.5%

10 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) were Caucasian, 15.3% were African American, 3.0% were multiracial, 1.7% were Middle Eastern, 1.3% were Native Hawaiian, and 1.1% were of other ethnicity. Furthermore, the majority of participants were in their freshman year (81.9%), with a mean age of years (S.D. = 1.20) Measures Participants in Study 3 completed a battery of questionnaires that included the FPES, BFNE, SPS, SIAS, and BDI-II. Each of these measures demonstrated good internal consistency in the present sample (all as >.81). In addition, other measures were administered to further assess the convergent and discriminant validity of the FPES (see below) Additional measure of social anxiety (convergent validity) The Interaction Anxiousness Scale (IAS; Leary, 1983b) is a 15-item self-report measure that assesses social anxiety in but not avoidance of situations in which the respondent is directly interacting with others. The IAS has demonstrated good internal consistency (a =.89) and good 8-week test retest reliability (r =.80) in an undergraduate sample (Leary, 1983b). Furthermore the IAS correlates as expected with other measures of social anxiety and demonstrates sensitivity to increases in anxiety during actual social interactions (Leary & Kowalski, 1983). The IAS demonstrated good internal consistency in the present sample (a =.82) Additional measures of other constructs (discriminant validity) Participant responses to the following measures were utilized to further examine the discriminant validity of the FPES. Discriminant validity would be demonstrated if more robust correlations were exhibited between the FPES and various measures of social anxiety than with various measures of symptoms associated with other anxiety disorders, stress, and depression. The Generalized Anxiety Disorder Questionnaire for DSM-IV (GAD-Q-IV; Newman et al., 2002) is a selfreport measure for the diagnosis of generalized anxiety disorder based on DSM-IV (American Psychiatric Association, 1994) criteria. The GAD-Q-IV demonstrated adequate 2-week test retest reliability in an undergraduate sample, k =.64. Support for the convergent and discriminant validity of the GAD-Q-IV is provided by the finding that it correlates more strongly with a measure of excessive and uncontrollable worry (r =.66) than with a measure of PTSD symptoms (r =.45) or the SIAS (r =.34) (Newman et al., 2002). The Yale-Brown Obsessive Compulsive Scale (Y- BOCS; Goodman, Price, Rasmussen, Mazure, Fleischmann, et al., 1989), an assessment of severity of obsessive-compulsive disorder (OCD), consists of 10 items rated on a five-point Likert-type scale ranging from 0 (None) to 4 (Extreme). Although designed as a clinician-administered assessment, a self-report version of the Y-BOCS was used for this study. Psychometric estimates of the Y-BOCS suggest excellent reliability (all as >.96) and validity in both clinician-rated (Goodman, Price, Rasmussen, Mazure, Fleischmann, et al., 1989; Goodman, Price, Rasmussen, Mazure, Delgado, et al. 1989) and self-report (Steketee, Frost, & Bogart, 1996) formats. Respondents rate both obsessions and compulsions in terms of intensity, interference and distress, controllability, and resistance. The Y- BOCS yields a total score, as well as separate subscale scores for obsessions and compulsions. Each of the three Y-BOCS scores demonstrated good internal consistency in the present sample (all as >.81). The Panic Disorder Severity Scale-Self Report (PDSS-SR; Houck, Speigel, Shear, & Rucci, 2002) is a 7-item self-report assessment of overall panic disorder severity, modified from the original clinician-administered PDSS (Shear et al., 1997). Items are rated on a 5- point Likert-type scale ranging from none to extreme. The PDSS-SR has demonstrated excellent internal consistency (a =.92; Houck et al., 2002), good twoweek retest reliability (r =.84; Newman, Holmes, Zuellig, Kachin, & Behar, 2006), and has demonstrated sensitivity to cognitive-behavioral therapy for panic disorder (Houck et al., 2002; Penava, Otto, Maki, & Pollack, 1998). The PDSS-SR demonstrated excellent internal consistency in the present sample (a =.90). The 42-item Depression Anxiety Stress Scales (DASS; Lovibond & Lovibond, 1995) comprise a self-report measure designed to differentially assess depression and anxiety symptoms. Specifically, the DASS consists of three subscales: depression, anxiety, and stress. The DASS exhibits strong internal consistency (all as >.89) (Clara, Cox, & Enns, 2001; Lovibond & Lovibond, 1995) and factorial validity, with a replicated three-factor structure reflecting the three subscales (Brown, Chorpita, Korotitsch, & Barlow, 1997; Lovibond & Lovibond, 1995). Evidence for the convergent validity of the DASS is provided by significant correlations between the relevant DASS subscale scores and other measures of depression and anxiety (Antony, Bieling, Cox, Enns & Swinson 1998;

11 396 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) Brown et al., 1997). Each of the DASS subscales demonstrated excellent internal consistency in the present sample (all as >.88) Procedure Participants completed the above measures in partial fulfillment of research requirements for their Introductory Psychology course. 9. Results Means and standard deviations for participants responses to the questionnaires are displayed in Table Preliminary analyses The distribution of FPES scores (M = 22.80, S.D. = 13.58) was normally distributed (skewness = 0.26, S.E. =.16; kurtosis = 0.82, S.E. = 0.31) in the University of Houston sample, and participant responses to the FPES exhibited good internal consistency (a =.81). Furthermore, there was no gender difference in FPES scores, F(1, 240) = 1.05, p = Convergent validity A Bonferroni correction (.05/12 =.004) was applied, which controlled for the total number of comparisons between FPES scores and all other measures in Study 3 (see Table 2). The FPES was significantly and positively correlated with all four of the convergent measures in the third study Discriminant validity Following Bonferroni correction, the FPES correlated significantly with the total scores of all of the discriminant measures administered (all ps <.001), as well as with each of the subscale scores of the Y-BOCS and the DASS (all ps <.001) (see Table 2). Significance tests were conducted to determine whether FPES scores correlated more strongly with measures of anxiety about being observed by others (the SPS) and social interaction anxiety (the SIAS-S and IAS) than with measures of generalized anxiety, depression, obsessivecompulsive disorder, panic disorder, and anxiety and stress in general (Meng et al., 1992). Consistent with hypothesis, the FPES related more strongly to the SPS 5 Two individuals in Study 3 did not report their gender. (all zs > 3.86, all ps <.001), the SIAS-S (all zs > 3.18, all ps <.001), and the IAS (all zs > 2.39, all ps <.001) than to all discriminant measures administered in the third study Unique variance in SPS and SIAS-S scores accounted for by fear of positive evaluation The regression analyses conducted in Study 2 to examine whether fear of positive evaluation accounts for variance in anxiety about being observed by others and social interaction anxiety beyond that already accounted for by the measure of fear of negative evaluation were also conducted in this study. In the first equation (utilizing the SPS score as the criterion variable), after the first step, the BFNE-S was significantly and positively related to the SPS, R 2 =.43, F(1, 241) = , p <.001. In the second step, the FPES was also significantly and positively related to, and significantly improved the prediction of, the SPS, R 2 D =.09, F(1, 240) = 45.08, p <.001. Thus, FPES scores again accounted for significant variance in anxiety about being observed by others beyond that accounted for by the BFNE-S (see Table 3). In the second equation, the SIAS-S score was utilized as the criterion variable. After the first step in the regression, the BFNE-S was significantly and positively related to the SIAS-S, R 2 =.46, F(1, 241) = , p <.001. In the second step of the regression, the FPES was also significantly and positively related to, and significantly improved the prediction of, the SIAS-S, R 2 D =.07, F(1, 240) = 36.24, p <.001. Thus, FPES scores again accounted for significant variance in social interaction anxiety beyond that accounted for by the BFNE-S (see Table 4). 10. Discussion The purpose of the present series of studies was to extend the empirical examination of the construct of fear of positive evaluation and the psychometric evaluation of the FPES. Several analyses were conducted that provide information about the relationships between FPE and responses to the receipt of positive social feedback, as well as relationships between FPE and measures of various convergent and discriminant constructs. All hypotheses in the first study received support. Specifically, FPE related positively to discomfort associated with receiving positive feedback and negatively to perception of the accuracy of the feedback; in contrast, FNE did not relate significantly to either discomfort associated with, or perceived accuracy of, positive feedback. Furthermore, FPE s association with

12 J.W. Weeks et al. / Journal of Anxiety Disorders 22 (2008) perception of the accuracy of positive feedback was partially mediated by discomfort experienced on the receipt of that feedback. In addition, several exploratory analyses demonstrated that FPE mediates the relationships between social anxiety (both social interaction anxiety and anxiety about being observed by others) and discomfort experienced in response to receipt of positive social feedback, and that it partially mediates the relationship between social interaction anxiety and ratings of the accuracy of that feedback. Consistent with the hypothesis that fear of evaluation in general is important to social anxiety (Weeks et al., 2007), social anxiety appears to lead to increased levels of FPE and discomfort in response to receipt of positive social feedback, as well as to decreased levels of perceived accuracy of such feedback; FPE leads (in part) to further exacerbations of these emotional and cognitive state responses to positive feedback. Findings from the second and third studies provide additional support for the construct validity of the FPES. Similar to the findings of Weeks et al. (2007), FPE correlated moderately to strongly with several measures of anxiety about being observed by others and social interaction anxiety in two independent samples. Furthermore, FPE related strongly and positively to self-report of submissive behaviors, a finding of some note because FPE and submissiveness are both constructs based on a psycho-evolutionary conception of social anxiety. In addition, FPE related positively to FNE in Study 3. Unexpectedly, FPE did not significantly correlate with FNE in Study 2. However, given that Weeks et al. (2007) reported that the correlation between the latent constructs of FPE and FNE was strong (r =.74) in a large undergraduate sample and that FPE correlated strongly (r =.60) with FNE in the larger sample in Study 3, it seems reasonable to conclude that a strong relationship generally exists between these constructs in unselected undergraduate samples. The present studies provide additional support for the distinction between FPE and various other constructs. Study 2 demonstrated that the FPES did not correlate significantly with measures of depression, anxiety sensitivity, perfectionism, or self-compassion. Moreover, FPE related significantly more strongly to anxiety about being observed by others than to perfectionism and self-compassion. In addition, FPE correlated with anxiety about being observed by others upon controlling for depressive and anxiety sensitivity symptoms, but depressive and anxiety sensitivity symptoms did not correlate with FPE upon controlling for social anxiety. An unexpected finding was that FPE correlated equivalently with measures of social interaction anxiety, depression, anxiety sensitivity, perfectionism, and self-compassion in Study 2. Although FPE correlated with a measure of social interaction anxiety upon controlling for scores on measures of depression, anxiety sensitivity, perfectionism, and self-compassion, scores on measures of anxiety sensitivity, perfectionism, and self-compassion were no longer correlated with FPE upon controlling for social interaction anxiety. FPE was, however, found to correlate with depressive symptoms upon controlling for social interaction anxiety in Study 2, a finding addressed in greater detail below. In addition, in Study 3, FPE correlated more strongly with several measures of anxiety about being observed by others and social interaction anxiety than with measures of GAD, OCD, panic disorder, depression, and anxiety and stress. Overall, these findings provide strong additional support for the discriminant validity of the FPES. Although FPE was not found to relate more strongly with social interaction anxiety than with depressive symptoms in Study 2, given that (a) FPE related more strongly to anxiety about being observed by others than to depressive symptoms in Studies 2 and 3; (b) FPE related more strongly to social interaction anxiety than to depressive symptoms in Study 3 (as well as in Weeks et al., 2007); and (c) FPE did not correlate significantly with depressive symptoms in Study 2 upon Bonferroni correction, it seems reasonable to conclude that FPE generally relates more strongly to social anxiety (overall) than to depressive symptoms in unselected undergraduate samples. Thus, the relationship of FPE to social anxiety appears to be specific, rather than reflecting a general relationship with anxious or depressive states. In addition, the hierarchical regression analyses in Studies 2 and 3 replicated and extended the findings of Weeks et al. (2007), suggesting that positive and negative evaluative fears contribute uniquely to both social interaction anxiety and anxiety about being observed by others. Overall, the present findings provide additional support for the hypothesis that fear of evaluation in general is important to social anxiety, regardless of the valence of the evaluation (Weeks et al., 2007). Thus, the present findings suggest that social threat could entail any experience of conspicuousness/ self-consciousness in which the person might receive either positive or negative evaluation. This explanation is indirectly supported by findings of a positive association between trait social anxiety and public self-consciousness (Bruch, Gorsky, Collins, & Berger, 1989; Hope & Heimberg, 1988).