Social anxiety disorder (SAD) is characterised by a marked and persistent fear of social or performance situations. Cognitive models suggest that self-focused cognitive processes play a crucial role in generating and maintaining social anxiety, and that self-focused cognition occurs prior to, during, and following social situations (Clark & Wells, 1995; Rapee & Heimberg, 1997). There is a substantial body of empirical evidence demonstrating that socially anxious individuals engage in self-focused cognition during and following a social or performance situation. A smaller but growing body literature suggests that a similar process occurs prior to such situations, and that these three processes are interdependent. Furthermore, the vast majority of research to date indicates that self-focused cognitive processes are detrimental, and that they generate and maintain social anxiety in a variety of ways. However, there remains considerable scope for research to further explicate the role of these processes in the maintenance of SAD, and to enhance interventions designed to ameliorate their negative effects.

The purpose of this work was to study the relationship between self-focusedattention and mindfulness in participants prone to hallucinations and others whowere not. A sample of 318 healthy participants, students at the universities ofSevilla and Almería, was given the Launay-Slade HallucinationsScale-revised (LSHS-R, Bentall & Slade, 1985). Based on this sample, two groups were formed:participants with high (n = 55) and low proneness(n = 28) to hallucinations. Participants with ascore higher than a standard deviation from the mean in the LSHS-R were includedin the high proneness group, participants with a score lower than a standarddeviation from the mean in the LSHR-R were included in the second one. Allparticipants were also given the Self-Absorption Scale (SAS, McKenzie& Hoyle, 2008) and theSouthampton Mindfulness Questionnaire (SMQ, Chadwick et al., 2008). The results showed thatparticipants with high hallucination proneness had significantly higher levelsof public (t(80) = 6.81, p< .001) and private (t(77) = 7.39,p < .001) self-focused attention and lower levelsof mindfulness (t(81) = -4.56, p< .001) than participants in the group with low hallucinationproneness. A correlational analysis showed a negative association betweenself-focused attention (private and public) and mindfulness (r= -0.23, p < .001; r= -0.38, p < .001 respectively). Finally,mindfulness was found to partly mediate between self-focused attention andhallucination proneness. The importance of self-focused attention andmindfulness in understanding the etiology of hallucinations discussed andsuggest some approaches to their treatment.

Background and Aims: Several studies have shown that cognitive therapy is an effective treatment for social anxiety disorder (SAD). However, it remains unclear which of the complex interventions are associated with an anxiety reduction during the course of treatment. The aim of this study was to examine the impact of the intervention referred to as the “self-focused attention and safety behaviours experiment” on treatment outcome. Method: This study was part of a randomized controlled trial including 16 sessions of either individual cognitive therapy (CT) or interpersonal therapy (IPT) for SAD. Of particular importance, a concomitant time-series analysis was used to investigate the impact of the self-focused attention and safety behaviours experiment on subsequent social anxiety (1, 2, 3, and 4 weeks after the intervention) in 32 patients with SAD, who are receiving cognitive treatment. Results: The results revealed a significant reduction of social anxiety after the self-focused attention and safety behaviours experiment during the subsequent month of treatment. Conclusion: The findings of the current study confirm current cognitive theories of SAD and demonstrate the importance of interventions that target self-focused attention and safety behaviour in cognitive therapy for SAD.

Self-focused attention, also thought of a self-absorption, has been linked to a variety of affective states and clinical syndromes, including depression, panic disorder, social anxiety, schizophrenia, and alcoholism. Ingram (1990b) has suggested that self-focus may be a “nonspecific process” that is common across psychopathologies. Studies with nonclinical samples have supported this contention, and the current study assessed whether self-focus was common across various clinically diagnosed groups. A second issue, given this commonality, was to examine the factors across diagnostic conditions to which self-focus was related. One hundred and thirty-eight outpatients were included, and were divided into three groups based on primary diagnosis: “depression”, “panic”, and “other anxiety”. They were assessed with the ADIS-R/IV and completed measures assessing self-focus, affective states, global psychopathology, and problem-solving. Self-focus was common across groups, with minor valence variations. Severity of primary diagnosis predicted total self-focus, with level of depression and trait anxiety predicting negative self-focus. Correlational analyses suggested that self-focused attention is related to general measures of psychopathology and severity, and negatively related to problem-solving. The pattern with negative self-focus was even more pronounced, with significant relationships to all measures of psychopathology, clinician-rated severity, and a negative relationship with problem-solving. Results are discussed in terms of differences between “normal” and problematic self-focus, the causal direction in the relationship between self-focus and negative affect, and the link between self-focus and problem-solving.

The present study examined the effect of self-focused attention on the startle reflex and heart rate and assessed the assumption that socially anxious individuals become self-focused in evaluative situations. Twenty-five high and 30 low socially anxious men performed a digit recall task under evaluative or nonevaluative instructions. Half of the trials were performed under self-focused conditions and half under non-self-focused conditions. Self-focus led to larger startle responses among socially anxious individuals and had no effect on heart rate. Self-focus combined with evaluation led to poorer recall performance among all subjects. Results provide evidence against a directional change in attention during self-focused attention and favor the view that self-focus increases access to self-relevant thought content and decreases available processing resources.