ABSTRACT
Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.
Subject(s)
Phobia, Social , Psychosocial Intervention , Adult , Humans , Phobia, Social/therapy , AnxietyABSTRACT
Cognitive models have consistently recognised pre-event and post-event rumination as maintaining factors in Social Anxiety Disorder (SAD). This study aimed to investigate the psychometric properties of a state-based measure of pre-event and post-event rumination in SAD: The Socially Anxious Rumination Questionnaire (SARQ), which was formerly known as the Thoughts Questionnaire. In particular, we examined the factor structure, internal consistency, test-retest reliability, construct validity, sensitivity to treatment response, clinical cut-off scores (relative to non-clinical participants), and associated test performance indicators of the SARQ. The sample comprised 505 adults with a principal diagnosis of SAD and 130 non-clinical controls. Pre-event and post-event rumination were assessed in relation to a three-minute impromptu speech. Results indicated single factors for the SARQ: Pre-event and SARQ: Post-event scales, along with excellent internal consistency, good test-retest reliability, sound sensitivity to cognitive-behavioural treatment response, and a clear ability to discriminate between individuals with a principal diagnosis of SAD and non-clinical controls. The findings justify the SARQ's use as a robust and reliable measure of state rumination for individuals with SAD that can be used both before and after encountering a social threat.
Subject(s)
Phobia, Social , Adult , Anxiety , Humans , Psychometrics , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
The aim of this study was to select developmentally valid and reliable items for inclusion in criterion-referenced (pass > 90%) posttraumatic amnesia (PTA) scale for children aged 4 to 7 years in a prospective cohort study. Fifty-two typically developing children (26 male/26 female) aged 4 to 7 years were administered a set of 10 items (5 orientation, 5 memory) over 3-4 days. The total score obtained on the set of 10 items had poor developmental validity and test-retest reliability. Nevertheless, individual item analysis identified five items (three orientation and two memory items) that were consistently passed by >90% of the children on each day of testing. For these five items the total scores did not differ significantly either between age groups or between days of testing. Test-retest was extremely high (close to 1). The five items had excellent developmental validity and test-retest reliability. This study identified 5 (3 orientation and 2 memory) items that met our selection criterion and form a new PTA scale, the Sydney PTA scale (SYPTAS), for children aged 4 to 7 years.