Clarifying the association of social anxiety with cognitive variables: The role of self-esteem, self-perception, fears of positive and negative evaluation, and post-event processing.

Theoretical models of social anxiety disorder (SAD) have identified several cognitive factors (fear of negative evaluation [FNE], self-perception, self-esteem, and post-event processing [PEP]) that play a role in the maintenance of the disorder. The current study aimed at testing both the cognitive factors addressed in these different models and the fear of positive evaluation (FPE) in the same construct. A non-clinical emerging adulthood sample (N = 325) were subjected to structural equation modeling (SEM). The results of the SEM showed that FPE, FNE, and self-concepts (self-esteem and self-perception) were significantly associated with social anxiety. Effect sizes indicated that the variables that most affected social anxiety were FPE, self-perception, FNE, and self-esteem, respectively. However, although it was significant in the conceptual model, the direct effect of social anxiety on PEP was not significant in the full model. On the other hand, the present findings add further support to the roles of negative self-perception and low self-esteem in social anxiety. Moreover, FPE may not be just delayed/postponed FNE. Considering the effect size of FPE on social anxiety, targeting it when appropriate in treatment may reduce the severity of social anxiety.

A mixed methods investigation of reasons underlying fear of positive evaluation.

Fear of negative evaluation (FNE) is a hallmark feature of social anxiety disorder (SAD). There is also evidence that people with SAD fear receiving positive evaluation and that fear of positive evaluation (FPE) is distinct from FNE. However, researchers have speculated that concerns related to negative evaluation may actually underlie FPE. This study sought to advance our understanding of FPE by employing both quantitative and qualitative methods to assess the reasons underlying participants' endorsement of FPE on the Fear of Positive Evaluation Scale and the extent to which these reasons reflect FNE versus FPE in a sample of individuals with SAD (n = 47) and a nonclinical comparison group (n = 49). Results indicated that responses to the FPES items primarily reflected an underlying FNE. Consistent with contemporary cognitive-behavioural theories of SAD, fear of proximal or eventual negative judgement emerged as the most common reason for participants' responses on the FPES. However, participants reported other reasons that did not reflect FNE, such as fear of hurting people's feelings and uncertainty associated with positive evaluation. All of the reasons underlying participants' ratings on the FPES were reported by both the SAD group and the nonclinical comparison group; however, individuals with SAD endorsed each of the reasons to a greater extent. These findings suggest that the FPES does not exclusively assess FPE as intended; however, the emergence and endorsement of reasons other than FNE suggest that FPE exists as a distinct construct.

Fear of positive evaluation differentially predicts social anxiety: a six-month longitudinal panel study.

This study investigated whether (a) fear of negative evaluation (FNE) and fear of positive evaluation (FPE) prospectively predict the other, (b) FPE predicts social anxiety controlling for FNE, and (c) FPE predicts social anxiety symptoms but not general anxiety and depression. Data were collected from a student sample at two time points over six months. The cross-lagged structural equation modeling results revealed that FNE and FPE do not prospectively predict the other, FPE positively predicts social anxiety symptoms controlling for FNE, and FPE does not significantly predict general anxiety or depression. These results confirmed that FNE and FPE are distinctively related to social anxiety. Moreover, the study findings indicated that FPE may be a factor unique to social anxiety.

A longitudinal assessment of the bivalent fear of evaluation model with social interaction anxiety in social anxiety disorder.

BACKGROUND: The Bivalent Fear of Evaluation Model proposes that the fears of positive and negative evaluation each uniquely contribute to social anxiety severity. However, the debate continues as to whether these are distinct constructs, and, if so, the degree of influence each has on social anxiety severity. This study used a longitudinal evaluation of these relationships in a clinical sample to identify whether the two fears differentially change over time and differentially relate to social anxiety severity. METHODS: Individuals with a social anxiety disorder (N = 105) completed measures of fears of negative and positive evaluation weekly, and social interaction anxiety monthly, for 12 weeks. Temporal relationships were assessed using residual dynamic structural equation modeling. RESULTS: Fears of positive and negative evaluation both predicted the future status of the other (ϕ = 0.18, 95% credibility interval [0.10-0.28] and ϕ = 0.22 [0.12-0.35], respectively). Fear of negative evaluation (ϕ = 0.16 [0.05-0.28]) but not positive evaluation (ϕ < 0.01 [-0.09 to 0.10]) directly predicted future social anxiety severity. Fear of positive evaluation only indirectly predicted anxiety severity via fear of negative evaluation. CONCLUSIONS: Previous fears of negative evaluation could not fully explain future fears of positive evaluation (or vice-versa), which is consistent with the two constructs being likely distinct in social anxiety disorder. Given its more direct relationship with social anxiety severity, fear of negative evaluation should be targeted in treatment, as this could both directly reduce social anxiety severity and minimize the indirect impact of fear of positive evaluation.

Targeting fear of positive evaluation in patients with social anxiety disorder via a brief cognitive behavioural therapy protocol: a proof-of-principle study.

BACKGROUND: Our aim was to develop a brief cognitive behavioural therapy (CBT) protocol to augment treatment for social anxiety disorder (SAD). This protocol focused specifically upon fear of positive evaluation (FPE). To our knowledge, this is the first protocol that has been designed to systematically target FPE. AIMS: To test the feasibility of a brief (two-session) CBT protocol for FPE and report proof-of-principle data in the form of effect sizes. METHOD: Seven patients with a principal diagnosis of SAD were recruited to participate. Following a pre-treatment assessment, patients were randomized to either (a) an immediate CBT condition (n = 3), or (b) a comparable wait-list (WL) period (2 weeks; n = 4). Two WL patients also completed the CBT protocol following the WL period (delayed CBT condition). Patients completed follow-up assessments 1 week after completing the protocol. RESULTS: A total of five patients completed the brief, FPE-specific CBT protocol (two of the seven patients were wait-listed only and did not complete delayed CBT). All five patients completed the protocol and provided 1-week follow-up data. CBT patients demonstrated large reductions in FPE-related concerns as well as overall social anxiety symptoms, whereas WL patients demonstrated an increase in FPE-related concerns. CONCLUSIONS: Our brief FPE-specific CBT protocol is feasible to use and was associated with large FPE-specific and social anxiety symptom reductions. To our knowledge, this is the first treatment report that has focused on systematic treatment of FPE in patients with SAD. Our protocol warrants further controlled evaluation.

Intolerance of uncertainty moderates the relations among religiosity and motives for religion, depression, and social evaluation fears.

OBJECTIVES: Intolerance of uncertainty (IU) underlies several psychological disorders, and religion may help some individuals cope with IU and/or protect against psychological symptoms. It was hypothesized that IU would moderate the relations between coping motives for being religious, as well as religiosity, and common psychological disorder symptoms: Depression and social evaluation fears. METHODS: Study 1 included 473 self-reporting community members (M age = 48, 48% female, 80% Protestant/Catholic). Study 2 included 412 self-reporting undergraduates ( M age = 19, 71% female, 76% Protestant/Catholic). RESULTS: For Study 1, coping-based motives related to greater depression for young adults with above-average IU and to lower depression for young adults with below-average IU. For Study 2, religiosity related to lower depression and fear of negative evaluation for individuals with above-average IU and to greater fear of positive evaluation for individuals with below-average IU. CONCLUSION: IU may be an important mechanism between aspects of religion and psychological disorder symptoms.

Malaise with praise: A narrative review of 10 years of research on the concept of Fear of Positive Evaluation in social anxiety.

Social anxiety is characterized by a fear of being negatively evaluated by others (i.e., Fear of Negative Evaluation [FNE]). In 2008, Weeks, Heimberg, and Rodebaugh proposed Fear of Positive Evaluation (FPE) as a second cognitive component in social anxiety. The article presents an overview of FPE, its psycho-evolutionary theoretical foundation and assessment by the Fear of Positive Evaluation Scale as well as relevant psychometric research on demographic characteristics. The relationship of FPE with a wide range of established dimensions from clinical, personality, and social psychology (i.e., self-esteem, perfectionism, or quality of life) will be reviewed. The role of FPE for psychological comorbidities such as other anxiety disorders, depression, eating, and substance use disorders as well as for treatment of social anxiety will be discussed. Future research might address questions of causality of FPE relative to related constructs, further data on psychometric properties, as well as on its independence from FNE in longitudinal studies. In sum, FPE seems to be a valid and reliable construct that explains cognitions, emotions, and behavior related to social anxiety at subclinical and clinical levels and therefore enriches the psychometric repertoire in the fields of social psychology, personality, and clinical psychology.

Longitudinal evaluation of anhedonia as a mediator of fear of positive evaluation and other depressive symptoms.

Fear of positive evaluation (FPE) is experiencing dread during real or potential praise. FPE is associated with social anxiety, but its relation to depressive symptoms is unclear. Anhedonia is a core symptom of depression related to symptoms of anxiety in cross-sectional research. The current study investigated the indirect effect of FPE on depressive symptoms via anhedonia over time. One-hundred ninety-six participants completed three waves of questionnaires over a total timespan of approximately four months via Amazon's Mechanical Turk, including measures of FPE, depressive symptoms, and anticipatory and consummatory anhedonia. Findings indicated that anticipatory anhedonia at Time 2 mediated the relationship between FPE at Time 1 and depressive symptoms at Time 3. Consummatory anhedonia, however, did not. Each model was contextualised by accounting for prospective covarying relationships, such as depressive symptoms predicting the same symptoms at later waves. The constellation of findings is considered within a reward devaluation framework.

Testing the Bivalent Fear of Evaluation Model of Social Anxiety: The Relationship between Fear of Positive Evaluation, Social Anxiety, and Perfectionism.

The Bivalent Fear of Evaluation (BFOE) model of social anxiety proposes that fear of negative evaluation (FNE) and fear of positive evaluation (FPE) play distinct roles in social anxiety. Research is however lacking in terms of how FPE is related to perfectionism and how these constructs interact to predict social anxiety. Participants were 382 individuals from the general community and included an oversampling of individuals with social anxiety. Measures of FPE, FNE, perfectionism, and social anxiety were administered. Results were mostly consistent with the predictions made by the BFOE model and showed that accounting for confounding variables, FPE correlated negatively with high standards but positively with maladaptive perfectionism. FNE was also positively correlated with maladaptive perfectionism, but there was no significant relationship between FNE and high standards. Also consistent with BFOE model, both FNE and FPE significantly moderated the relationship between maladaptive perfectionism and social anxiety with the relationship strengthened at high levels of FPE and FNE. These findings provide additional support for the BFOE model and implications are discussed.

Replication and extension of a hierarchical model of social anxiety and depression: fear of positive evaluation as a key unique factor in social anxiety.

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215-224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.

Cognitive constructs and social anxiety disorder: beyond fearing negative evaluation.

Pioneering models of social anxiety disorder (SAD) underscored fear of negative evaluation (FNE) as central in the disorder's development. Additional cognitive predictors have since been identified, including fear of positive evaluation (FPE), anxiety sensitivity, and intolerance of uncertainty (IU), but rarely have these constructs been examined together. The present study concurrently examined the variance accounted for in SAD symptoms by these constructs. Participants meeting criteria for SAD (n = 197; 65% women) completed self-report measures online. FNE, FPE, anxiety sensitivity, and IU all accounted for unique variance in SAD symptoms. FPE accounted for variance comparable to FNE, and the cognitive dimension of anxiety sensitivity and the prospective dimension of IU accounted for comparable variance, though slightly less than that accounted for by FNE and FPE. The results support the theorized roles that these constructs play in the etiology of SAD and highlight both FNE and FPE as central foci in SAD treatment.

Fear of negative and positive evaluation as mediators and moderators of treatment outcome in social anxiety disorder.

INTRODUCTION: Elevated fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are thought to play key roles in the maintenance of social anxiety disorder (SAD). Although efficacious therapies exist for SAD, the potential mediating and moderating effects of FNE and FPE on social anxiety treatment outcome have not been examined. METHODS: This sample comprised a secondary analysis of 210 individuals who participated in one of three randomized controlled trials for the treatment of SAD. Participants were randomized to: individual cognitive behavioral therapy (CBT), group CBT, community mindfulness-based stress reduction (MBSR), group MBSR, or they were randomized to waitlist and offered treatment after waitlist. Assessments were completed pre- and post-treatment/waitlist and, for the treatment groups, at three-month follow-up. RESULTS: CBT and MBSR led to greater reductions in FNE and FPE than waitlist, with CBT more efficacious in reducing FPE than MBSR. For both CBT (vs. waitlist) and MBSR (vs. waitlist), there were significant indirect effects on post-treatment social anxiety through both FNE and FPE, and the indirect effect through FPE was greater for CBT than MBSR. However, in the fully longitudinal model testing mediation, CBT and MBSR were not differentially mediated by FPE. Baseline FNE and FPE each moderated CBT treatment outcome compared to waitlist - higher baseline FNE and FPE were associated with higher baseline social anxiety and greater reductions in social anxiety during CBT. DISCUSSION: FNE and FPE contributed in sometimes similar and sometimes distinct ways to the mediation and moderation of psychosocial approaches for treating SAD. This supports the importance of distinguishing between fears of negative and positive evaluation in the assessment and treatment of SAD.

CyberStatus: Responses to status manipulation and fears of positive and negative evaluations.

Fear of positive evaluation (FPE) and fear of negative evaluation (FNE), which play distinct and central roles in social anxiety (SA), are postulated to reflect conflicting forces in hierarchal group contexts. Yet, experimental studies testing these assumptions are scarce. We examined the impact of status positions on FPE, FNE, and SA using a novel manipulation, CyberStatus. Participants (N = 557) provided self-descriptive statements before being randomly assigned to high, intermediate, or low-status conditions. Next, they reported their emotions, status, and belongingness-related cognitions and adjusted their self-presentation. FPE was more strongly linked to self-presentation modifications in the high- compared to intermediate-status conditions and positively associated with perceived status in the low vs. intermediate conditions. Furthermore, FPE and SA were more linked to belongingness in low vs. intermediate status conditions while FNE demonstrated the reversed pattern. These findings support and expand the evolutionary perspective on evaluation fears and emphasize the importance of assessing the linkage between status and belongingness systems in SA.

Development and validation of the positive evaluation core beliefs scale for social anxiety.

Fear of positive evaluation (FPE) is becoming recognised as an important component of social anxiety that is distinct from fear of negative evaluation (FNE). While core belief scales exist for fear of negative evaluation (FNE), none has been developed for FPE. Therefore, this paper describes the development and validation of a measure of core beliefs that is specific to FPE. An exploratory factor analysis was performed on 60 initial items with an Australian undergraduate sample, in which a confirmatory factor analysis was performed with an independent Australian general population sample. A series of further analyses were performed to test convergent and divergent validity. The Positive Evaluation Core Beliefs Scale (PECS) emerged as a 17-item two-factor psychometrically valid measure that correlates more strongly with measurement of FPE than FNE. The PECS measure offers a new opportunity for researchers and clinicians to better explore cognitions associated with social anxiety.

Re-assessing the assessment of fears of positive and negative evaluation: Scale development and psychometric evaluation of the Bivalent Fear of Evaluation Scale (BFOES).

The bivalent fear of evaluation (BFOE) model of social anxiety divides fear of evaluation into two distinct valences: fear of positive evaluation (FPE) and fear of negative evaluation (FNE). However, there is evidence that the two most widely utilized and psychometrically supported measures of FNE and FPE contain items which are ambiguous with regard to valence of evaluative fear. To formally address this, the BFOE Scale (BFOES) was developed, by merging items from measures of FNE and FPE into a single scale with an integrated response format. The present studies examined the psychometric profile of the BFOES across a large pooled archival dataset (N = 2216), which included approximately 10 % (n = 224) patients with social anxiety disorder (SAD). The factorial validity, internal consistency, and construct validity of the BFOES were examined. Additionally, item response theory analyses were employed for the purpose of merging items from self-report scales which utilized different Likert-type response formats. Results from both studies provided support for the psychometric profile of the BFOES. The implications of the BFOES for the assessment of social anxiety, and theoretical models of fear of evaluation and SAD, are discussed.

An Initial examination of fear of negative and positive evaluation in youth.

Fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are both core features of social anxiety. The majority of research with these constructs has been done with older adolescents and adults, with only one previous study examining FNE and FPE in childhood. However, this previous work relied exclusively on parent-report of youth FNE and FPE. Here, we examined the factor structure of FNE and FPE using youth self-reports. Moreover, we examined the associations with dimensions of internalizing and externalizing problems. We found that two-factor structure of FNE and FPE was a marginal fit to the data. Exploratory models identified three items that showed significant cross-loadings on non-target factors. Overall, we found that FNE was associated with dimensions of internalizing problems reported by youth and their mothers. FPE was associated with internalizing problems reported by youth, but not parents. Associations between FNE and clinical outcomes were stronger than those for FPE. This study demonstrates promise of FNE and FPE in youth and highlights important directions for future research.

Fear of Positive Evaluation and Loneliness: Mediating Role of Social Anxiety and Suppression.

Loneliness is a commonly observed problem that is associated with several mental and physical health outcomes. Although research shows that fear of negative evaluation is related to loneliness, no study has examined the role of fear of positive evaluation (FPE) on loneliness. This study investigated the mediator role of social anxiety and suppression in the relationship between FPE and loneliness using an undergraduate sample (N = 467). The results show that FPE is positively associated with loneliness and that this relationship is mediated by social anxiety and suppression. This study highlights the importance of the FPE in understanding loneliness and can guide intervention programs for loneliness.

Fear of positive evaluation mediates the relationship between self-efficacy and fear of negative evaluation in nursing students: A cross-sectional study.

BACKGROUND: Fear of evaluation (including the negative and positive ones) has been the focus of scholarly attention as one of the core components of social anxiety. However, most existing research has focused on participants with social anxiety. Previous research has suggested that self-efficacy and fear of positive evaluation are associated with fear of negative evaluation. Still, it remains unknown whether there is an association between the three. For undergraduate nursing students in complex social environments, understanding the association between self-efficacy and fear of positive and negative evaluation is essential to facilitate the high-quality development of nursing talent. OBJECTIVE: We aimed to explore the mediating role of fear of positive evaluation in the relationship between self-efficacy and fear of negative evaluation. METHODS: A cross-sectional survey was conducted on 824 undergraduate nursing students using the Brief Fear of Negative Evaluation Scale-Straightforward Items, the Fear of Positive Evaluation Scale, and the General Self-Efficacy Scale. Pearson correlation analysis was used to explore the correlation of the variables. t-test or ANOVA was used as a univariate analysis. A bootstrap test was conducted to verify the mediating effect through the SPSS macro plugin PROCESS v3.3, with P < 0.05 indicating a statistically significant difference. FINDINGS: Self-efficacy, fear of positive evaluation, and fear of negative evaluation were significantly associated. Self-efficacy directly and negatively predicted fear of negative evaluation (B = -3.14, p < 0.001). Fear of positive evaluation partially mediated between self-efficacy and fear of negative evaluation, with a mediating effect size of 38.22 %. DISCUSSION: Self-efficacy can directly and negatively influence fear of negative evaluation. Meanwhile, it can also indirectly reduce the fear of negative evaluation by reducing the fear of positive evaluation. Nursing educators can improve the fear of negative evaluation by increasing students' self-efficacy and encouraging them to view positive assessments correctly.

Fear of negative evaluation: A cross-sectional study among undergraduate nursing students.

OBJECTIVE: To understand the current fear of negative evaluation among undergraduate nursing students and analyse the factors influencing it. METHODS: A general information questionnaire, the scale of fear of negative evaluation, and the fear of positive evaluation scale were used to survey 546 undergraduate nursing students at Guizhou Medical University, China. RESULTS: Undergraduate nursing students scored a total of (15.90 ± 7.18) negative evaluation fears, which is at an intermediate level. Gender, left-behind experience, whether in a romantic relationship, personality, and fear of positive evaluation entered the multiple regression equation and explained 29.1 % of the total variance. CONCLUSIONS: The fear of negative evaluation among undergraduate nursing students was moderate. Nursing students' gender, left-behind experience, whether in a romantic relationship, personality, and fear of positive evaluation were important factors influencing their level of fear of negative evaluation. Nursing educators and administrators should be aware of nursing students' evaluation fears and select targeted evaluation strategies to promote the development of high-quality nursing talent.

The role of fear of evaluation in group perception.

Social anxiety disorder (SAD) is associated with interpersonal impairment. One possible reason for this dysfunction is that people with SAD evaluate others differently on dimensions of warmth and dominance compared to individuals without the disorder. In the current study, we examined whether two core constructs of SAD, fear of negative evaluation and fear of positive evaluation, affect the judgments that people make about groups based on warmth and dominance. We also investigated whether racial similarity (i.e., whether someone is the same race as those they're interacting with) and ethnic identity (i.e., one's sense of belonging to a particular social group) played a role in the types of evaluations people made. We created vignettes about groups varying in warmth and dominance, as well as photos varying in racial makeup. We presented photo-vignette pairs to participants and asked them to rate their desire to interact with the groups depicted in the photo-vignette. Participants in general reported greater desire to interact with warmer and less dominant groups. People with higher fear of negative evaluation reported higher desire for interaction with warmer groups, and those with higher fear of positive evaluation reported higher desire to interact with less dominant groups. We did not find any support for our hypothesis that people with stronger ethnic identity would show greater desire to interact with groups that were more similar to their race. Implications for treatment and directions for further research are discussed.