Psychology and Psychotherapy: Theory, Research and Practice

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Volume 88 Issue 4 (December 2015), Pages 351-480

The strategy does not matter: Effects of acceptance, reappraisal, and distraction on the course of anticipatory anxiety in social anxiety disorder (pages 366-377)

Objectives

Anticipatory anxiety is a core feature of social anxiety disorder (SAD); however, there is a paucity of data on effective strategies for dealing with this affective state. The present study examined the effects of reappraisal, acceptance, and distraction on the course of anticipatory anxiety.

Design

The study used an experimental design, randomly assigning participants to one of three strategy groups. Participants were instructed to employ these strategies during the anticipation of an impromptu speech.

Methods

Participants with SAD (= 67) and healthy controls (= 72) were compared with regard to their ability to adopt the prescribed strategies and with regard to the effects of strategy use on self‐reported and psychophysiological markers of arousal.

Results

SAD participants reported more problems in adopting the assigned strategies than controls, although the time spent with each strategy did not differ by group. In both groups, acceptance was rated as more difficult to adopt than reappraisal and distraction. Subjective ratings of anxiety decreased during the first 10 min of anticipation regardless of diagnostic group or strategy, but anxiety increased again immediately prior to the speech. Psychophysiological parameters were largely unaffected by group or strategy.

Conclusion

The results question whether there are differential benefits of different emotion regulation (ER) strategies in dealing with anticipatory anxiety. The observed rebound of anxiety prior to the social event calls into doubt the long‐term effectiveness of these strategies, at least during the regulation of anticipatory anxiety.

Practitioner points

  • Coping with anticipatory anxiety is an important issue in treating SAD.
  • Compared to healthy controls, individuals diagnosed with SAD experienced more problems in adopting prescribed ER strategies for dealing with anticipatory anxiety.
  • We found no differences between acceptance, reappraisal, and distraction, calling into question that one strategy should be generally recommended by clinicians.

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