Treatment of Social Anxiety Disorder: Mechanisms, Techniques, and Empirically Supported Interventions



Social anxiety disorder (SAD) is a prevalent condition negatively affecting one’s sense of self and interpersonal functioning. Relying on cognitive but integrating interpersonal and evolutionary models of SAD as our theoretical base, we review basic processes contributing to the maintenance of this condition (e.g., self-focused attention, imagery, avoidance), as well as the treatment techniques geared to modify such processes (e.g., exposure, attention modification, imagery rescripting). We discuss cognitive-behavioral treatments (CBT) as combining multiple treatment techniques into intervention “packages.” Next, we review the existing empirical evidence on the effectiveness of CBT. Although CBT has accumulated the most support as superior to other credible interventions, we suggest that many treatment challenges remain. We conclude by discussing the ways to enhance the efficacy of CBT for SAD. Specifically, we highlight the need to (a) elucidate the complex relationship between basic processes and techniques, (b) advance personalized interventions, and (c) include a more diverse and comprehensive array of outcome measures.

General Information

Keywords: social anxiety, mechanism of change, cognitive biases, treatment techniques, personalized interventions

Journal rubric: Theoretical Research

Article type: scientific article


Funding. The reported study was funded by Israel Science Foundation, 740-15, and awarded to Eva Gilboa-Schechtman

Received: 16.05.2021


For citation: Gilboa-Schechtman E., Azoulay R. Treatment of Social Anxiety Disorder: Mechanisms, Techniques, and Empirically Supported Interventions [Elektronnyi resurs]. Klinicheskaia i spetsial'naia psikhologiia = Clinical Psychology and Special Education, 2022. Vol. 11, no. 2, pp. 1–21. DOI: 10.17759/cpse.2022110201.

Full text


Most of us can recall getting intensely self-conscious and uneasy on some occasions, such as giving a speech, interviewing for a job, or getting ready for a date. Whereas for most people, such mental states happen only occasionally, for others, they are frequent and intense, causing a substantial impairment in multiple aspects of daily life, such as work, study, and relationships [3]. Individuals with social anxiety disorder (SAD) experience marked fear of one or more social or performance situations in which they are exposed to unfamiliar people or possible scrutiny [6]. Socially anxious individuals frequently attempt to avoid such feared situations altogether or to regulate their anxiety by subtler avoidance strategies, such as minimizing eye contact with others or speaking in brief sentences.

Social anxiety disorder is the third most common mental health disorder after depression and substance abuse, with lifetime prevalence rates of around 12% in industrialized countries [66]. SAD typically has an early onset and chronic course [79; 95; 103]. Most individuals with SAD experience a comorbid disorder during their lifetime, with the onset of SAD preceding the development of these comorbid conditions [27]. Despite its prevalence, severity, and association with suicide [116], SA lacks the “public relations” of its sibling disorders such as depression or substance abuse [65]. However, SAD has begun attracting scientific attention in the last several decades, leading to rapidly accumulating empirical data regarding the effectiveness of treatment techniques and “treatment packages” geared to alleviate the distress associated with this condition. These scientific efforts resulted in increased knowledge of psychopathological processes involved in SAD maintenance and the effectiveness of treatment techniques and intervention packages. However, the successful treatment of SAD remains a challenge, as even the best available psychological treatments are associated with only about 65% response and only 40% remission [101].

In the present review, we outline the existing state of knowledge regarding the psychological treatment of SAD, focusing on cognitive models and processes. We integrate and expand these cognitive models with interpersonal and evolutionary perspectives on SAD. We then focus on the treatment techniques geared to modify core maintaining processes. Next, we review the existing empirical evidence on the effectiveness of cognitive-behavioral therapy (CBT) for SAD, in which these techniques are utilized. We conclude by discussing ways to enhance the effectiveness of CBT in SAD. Specifically,
we highlight the need to (a) elucidate the complex relationship between basic processes and techniques, (b) advance personalized interventions, and (c) include a more diverse and comprehensive array of outcome measures.

Cognitive Models of SAD

Cognitive models differentiate between etiological and maintaining factors of SAD. Genetic, neurobiological, and temperamental factors, as well as the nature of the early environment, are postulated to be involved in the etiology of this condition [95; 97]. Specifically, the risk of developing SAD is increased by over-controlling, critical and cold parenting; insecure attachment; emotional, physical, and sexual maltreatment, and aversive social experiences [89]. Thus, SAD appears to develop via a complex interplay of biological and psychological factors.

According to cognitive models, socially anxious individuals firmly believe that it is important to make a favorable impression on others and the uncertainty regarding their ability to do so [23; 50; 54; 72; 83; 96]. SAD individuals tend to evaluate their social abilities and skills as low [41] and the standards needed to make a favorable impression as high [84]. Such negative beliefs are activated in social settings, generating a sense of threat and alarm [54]. This perception of threat engenders a chain of cognitive, affective, and behavioral responses, which prevents the disconfirmation of the maladaptive beliefs about self and others. These models emphasize several interrelated processes: self-focused attention, biased information processing (attention, evaluation, memory), negative imagery, enhanced avoidance, and anticipatory and post-event processing.

Recently, the “classical” cognitive models of SAD have been expanded and refined by interpersonal and evolutionary perspectives. The interpersonal perspective highlights the functioning of the affiliation system, which guides people towards potentially rewarding social situations and appears to be critical in the development and maintenance of satisfying social relationships [17]. Indeed, high-SA individuals display fewer approach behaviors such as initiation of social encounters, nonverbal displays of warmth and friendliness, and self-disclosure than low-SA individuals [10; 106].Significantly, this perspective emphasizes the need to enhance affiliative behaviors in the treatment of SAD.

Recently, cognitive approaches to SAD also incorporated some insights from the evolutionary perspective. According to this perspective, social cautiousness is rooted in an ancient system that regulates social order and controls behaviors that may elicit conflict and disrupt such order — the social-rank system [36]. Specifically, avoidance tendencies seen in SAD are viewed as evolutionary-shaped mechanisms to avoid confrontations with dominant others [36; 37; 44; 108; 110]. Consequently, regulating negative emotions (e.g., shame, humiliation, [71]), reducing submissive behaviors [38; 40; 110], and correcting self-deprecating cognitions regarding social status [18; 41; 44] have been emphasized.

Maintaining Processes in SAD

There is considerable overlap among the processes proposed by cognitive, interpersonal, and evolutionary models for maintaining SAD: all highlight self-focused attention, biased processing of social cues and situations, and self-concealing behaviors. There are also important distinctions between the models, with cognitive models highlighting intrapersonal processes (such as memory, imagery, and emotion-regulation [16]) and interpersonal and evolutionary models emphasizing interpersonal processes (such as enhanced social avoidance and decreased affiliation). Integration of the three models suggests several central core processes detailed below.

Self-focused Attention. In SA, the perception that one is observed by others can lead to heightened self-focused attention. This shift of mental focus is experienced as enhanced attention toward one’s physiological symptoms, negative images of the self, or thoughts regarding the negative ways one is judged by others [23; 55]. Indeed, under the perceived scrutiny of others, socially anxious individuals become more aware of their bodily sensations (sweating, blushing). These sensations, in turn, are perceived as visible and indicative of weakness. Such internally focused processing may prevent an individual from concentrating on the emotions and reactions of others and thus miss important social
cues [81].

Attention Biases. Selective attention to, and difficulties with, disengagement from social threats (e.g., facial expressions and features; voice) are viewed as central in maintaining SAD [43; 52; 91; 92]. Evidence that individuals with SAD exhibit enhanced vigilance, early engagement, and difficulty disengagement from threats have been documented [70; 107]. Moreover, some evidence suggests that attention bias modification alleviates SA symptoms [15]. Although many conceptual and methodological issues remain [114], attentional biases among high-SA individuals may interfere with learning new, benign information from one’s surroundings and may result in avoidant behaviors, thereby preventing disconfirmation or inhibition of one’s beliefs about oneself and others.

Evaluation Biases. Evaluation biases include interpreting ambiguous information and estimating the probability and cost of non-ambiguous events. SA appears to be specifically and positively related to the propensity to negatively interpret ambiguous social information and negatively related to the formation of positive interpretations
[11; 32; 58; 105]. Moreover, SA is associated with the tendency to evaluate the cost of social mishaps as high [39]. Decreasing individuals’ probabilities and consequences of negative social events (e.g., loss of affiliation or social status) appear to be promising for alleviating SA [12; 76] and is indeed present in many CBT interventions [23; 82].

Memory Biases. Memories of social events recalled by individuals with SAD contain more self-referential information and fewer external sensorial details than memories recalled by non-anxious individuals [84]. Moreover, SA-severity is related to the re-living of socially stressful events [12; 100] and seeing these events as central and identity-defining [42]. Importantly, socially anxious individuals exhibit a greater tendency to remember social (but not neutral) events from an external “observer” perspective than from their own “field” perspective [29].

Negative Images. SA individuals commonly experience involuntary and distressing negative self-images during social encounters [49]. In such situations, they may picture themselves as unattractive or incompetent and as behaving in embarrassing, shameful, or humiliating ways [85].SA individuals then mistakenly assume that these images are accurate reflections of the way they appear to others [53]. Importantly, whereas negative self-evaluations and self-perceptions are found in many psychopathologies [112], negative self-images appear to be uniquely associated with SA [58].

Emotion Regulation. Several maladaptive emotional processes are postulated to be involved in social anxiety. First, emotion differentiation (i.e., the ability to distinguish between various affective states and classify felt experiences into discrete emotion categories) is impaired in SA [60; 62; 63]. Lack of differentiation, particularly concerning negative emotions, may impair emotion regulation and result in a low perceived emotional control [60]. Emotion regulation refers to the processes by which individuals influence which emotions they have, when they have them, and how they experience and express them [47; 48]. Such strategies include cognitive reappraisal and response modulation
(e.g., emotion suppression). Dysfunctional regulation of negative and positive emotions is viewed as one of the core vulnerabilities in SAD [30; 45; 59; 68]. Enhancing the use of
a wide repertoire of emotion regulation skills to dampen and control negative affect [67] as well as to upregulate positive affect [70] is seen as promising to alleviate SA-related distress [46].

Anticipatory and Post-Event Processing. This processing refers to mental activities and content preceding and following social situations. Although temporally distinct, post- and pre-event evaluations are correlated and influence each other [115]. During anticipatory processing, socially anxious individuals mentally preview upcoming social interactions and possible rejection, embarrassment, or humiliation scenarios. This focus enhances anticipatory anxiety and avoidance behaviors. Similarly, post-event processing typically involves reviewing the social event, focusing on one’s anxious feelings and assumed (negative) image. This process may cause interpersonal interactions to be encoded negatively, resulting in shame, self-blame, and negative predictions regarding future interactions [1; 13].

Enhanced Avoidance. Avoidant behaviors are believed to be central in maintaining SAD. Direct avoidance of social situations involves refraining from attending social events such as work events, parties, and one-to-one meetings. More subtle avoidance strategies include looking at one’s phone during a party, refraining from disclosing self-relevant information, and maintaining a “low-key” appearance. Although partially effective in regulating SA in the short run, these avoidance strategies tend to increase anxiety in the long run, most likely because they impede the modification and updating of prior negative predictions [23] and prevent the accumulation of novel social experiences. Indeed, engaging in avoidant behaviors is found to lead to impaired performance [99], enhanced feelings of inauthenticity and incompetence (low social rank), and decreased feelings of belongingness and affiliation [94].

Reduced Affiliation. SAD is characterized by a dysregulation of the affiliative system [10; 109]. Individuals with SAD tend to display lower frequency and intensity of affiliative intent (e.g., smiling) during relationship formation [90] and show less unintentional movement synchrony, a marker of affiliative mode. Self-protective motivation and discounting positive social signals may maintain social impairment in SA. They affect high-SA individuals’ ability to engage in actions that lead to emotional closeness [35]. Combined, enhanced avoidance and reduced affiliation contribute to the persistence of SA by decreasing opportunities for rewarding interaction.

Modifying Maladaptive Processes in SAD: Main Techniques

In the following, we list the main techniques geared to modify the maladaptive processes contributing to the maintenance of SAD. Importantly, in a context of a full-fledged individualized intervention, these techniques are embedded in a secure and authentic therapeutic relationship [34]. Establishing a secure bond and a close and supportive alliance with the therapist is central to most intervention programs. It is particularly important in treating individuals with SAD, given their reduced utilization of affiliative modes of interaction [36].

Psychoeducation in CBT typically includes familiarization with the clinical picture of the condition and the model underlying the treatment (such as the model used by Clark & Wells [23]). It further includes information regarding the factors contributing to treatment success, such as self-observation and engagement in treatment-related activities outside of therapeutic sessions. It is emphasized that the treatment includes a set of skills and that practice is encouraged to achieve proficiency in these skills.

Attentional Control is a common strategy to counteract painful self-awareness. These exercises may take the form of concentrating on non-threatening aspects of the environment, such as the actual behaviors and emotions of others [81]. For example, the ability to focus on the appearance of others or learn a new fact about them may offer a way out of painful self-awareness. Alternatively, direct attentional control training was also found to reduce this self-awareness [33].

Exposure is the most efficient way to counteract avoidance behaviors is by enhancing exploratory and approach behaviors. Exposure is a collaborative process in which the client, guided by the therapist, chooses to engage in challenging situations voluntarily and systematically. Importantly, the process of exposure differs in several ways from spontaneously encountering anxiety-provoking situations. First, the client actively chooses and plans these encounters, facilitating a sense of agency. Second, exposures are planned with pre-specified goals (e.g., to ask one’s boss for a raise). It is the therapist’s role to navigate the treatment such that exposures have a chance to modify the client’s beliefs regarding the outcome of these social situations. It is emphasized that the importance of examining one’s predictions is more central than achieving the “social” goal (such as actually getting a raise). Third, exposures are planned to be conducted systematically so that easier tasks and encounters are followed by more challenging ones. An exposure hierarchy is created to allow for gradual progression (and a fair amount of repetition) of those tasks. Fourth, exposures are preceded and followed by an “envelope” of collaborative discussion between the therapist and the client. Before exposure, the therapist attempts to elicit specific predictions regarding the most likely outcome of the exposure (e.g., “My boss would be angry with me for even trying to get a raise”). Exposures are effective primarily when new, belief-inconsistent information is encountered (e.g., “Although my boss did not agree to the raise, I was able to state my case clearly. My boss was not angry, and even expressed appreciation of my work”). The construction of specific predictions allows for
a more effective correction of faulty prior beliefs. To facilitate these corrective experiences, clients are invited to reflect on what was learned during the exposure. Finally, the collaborative work with the therapist before and after the exposures emphasizes the potential of affiliative bonds that include sharing thoughts and feelings in a close and empathic setting, a rare context for many individuals with SAD [36].

Cognitive Restructuring refers to a therapeutic technique involving multiple sub-components:(а) understanding the range of emotions elicited by a particular situation (emotion identification and emotion differentiation), (b) linking these emotions to components of the situation and their meaning, and (c) question this meaning, usually engaging in re-appraisal. This sequence is geared to allow new perspectives to emerge [24]. The cognitive restructuring may begin with work on emotion differentiation between emotion-infused thoughts and actual emotions (“I feel stupid” vs. shame) or between distinct emotions (shame vs. guilt). It is emphasized that specific emotions are associated with certain core meanings (e.g., shame is associated with hypothesizing that unsavory characteristics of the self are revealed). Next, meaning-questioning entails identifying, evaluating, and modifying unhelpful thinking [48; 111]. Identifying unhelpful thinking involves recognizing an event (internal or external) in which a negative emotion was experienced. The therapist then invites the clients to attend to their thoughts at the time of, before, and after the event’s occurrence. Next, the client and the therapist can evaluate how helpful such thoughts were in the given context. This process calls for examining the evidence for and against a certain thought and the utility of focusing on certain aspects of the event. Finally, in the modification stage, the therapist facilitates the discovery of additional information and examination of other possible points of view. As a result, a more helpful and balanced viewpoint can be adopted. Learning to differentiate between emotions, link them to meaning, and question these meanings are discussed as acquired skills.

Imagery Rescripting is a therapeutic technique that aims to update core negative representations of the self and modify the meaning of socially stressful memories [98]. Clients are invited to relive a painful past autobiographical experience and then re-imagine this experience in a way in which the needs of the younger self are understood and addressed [9]. Thus, clients may be invited to express compassion for their younger selves or imagine them behaving differently than they did [98]. Imagery rescripting has been found to effectively reduce SA and promote significant changes in negative self-beliefs (see [75] for review). Although the significance of imagery versus verbal processing of memories is still debated [80], the amassed evidence points to the importance of detailed processing of autobiographical memories to reduce SA severity.

Effectiveness of CBT for SAD

So far, we have focused on distinct processes presumed to maintain SA and the associated techniques aimed to rectify the operation of these processes. As our previous review illustrates, some studies examine the effects of single techniques on alleviating SA distress. However, most existing data on the effectiveness of empirically-based treatment of SAD are grounded in examining the effectiveness of “packages” of techniques. The most researched type of such a package is CBT. Most empirically supported CBT programs are implemented throughout approximately 12–16 sessions. CBT consists of a group of different but theoretically related interventions, each emphasizing a different intervention “package.” For example, cognitive therapy (based on Clark & Wells’s [23]) typically includes psychoeducation, attentional control, cognitive processing, and memory rescripting. In addition, it includes behavioral experiments to test ominous predictions,
a technique bearing a resemblance to exposure. Based on Rapee and Heimberg’s conceptualization [96], a model includes psychoeducation, exposure, and cognitive restructuring. Despite the differences between these packages, they share significant similarities, thus being reviewed as a single interventional modality.

Empirical data examining the effectiveness of CBT compares this intervention either to the wait-list control condition, to placebo, or to other intervention “packages.” The effect size of CBT compared to the wait-list condition varies from 0.81 to 1.56 [78]. A meta-analysis of randomized controlled trials for SAD [21] found a mean controlled effect size of 0.41 for CBT compared to a placebo condition. Importantly, CBT for SAD has also been found to be effective in naturalistic conditions [104], and most individuals with SAD exhibit some improvement over just a short course of CBT (up to 16 sessions [73]). CBT was also compared to alternative treatments using a randomized design. CBT was found to be more efficacious than interpersonal psychotherapy (IPT, [102]), as well as acceptance and commitment therapy (ACT, [51]). Other studies compared CBT to a manualized version of psychodynamically oriented therapy (PDT) for SAD (e.g., [74]). Results of PDT and CBT were comparable for social anxiety and depression symptom improvement, with CBT outperforming PDT concerning remission rates and reduction of interpersonal problems.

Providing access to state-of-the-art interventions for SAD is a major societal challenge. There has been a fair amount of progress toward advancing this important frontier by developing variants of well-established CBT protocols in the form of guided internet-based interventions [8; 28]. Internet-based CBT typically entails some contact with therapists who guide the treatment [7]. Importantly, the efficacy of CBT has been demonstrated in individuals [2; 21; 78], groups [113], in virtual reality exposure [20; 22] and in internet-delivered interventions [61; 88].

The UK and the German governments publish treatment guidelines based on the recommendations of independent societies synthesizing the available research evidence. The German [14] and British (NICE, [86]) guidelines for treating SAD recommend CBT as the first line of treatment. According to the German guidelines, individuals with SAD should be offered PDT only if CBT is unavailable, was shown to be ineffective, or if the adequately informed patient expresses a preference for this treatment [14].

Despite these encouraging findings, the treatment of SAD remains a considerable challenge: many patients either do not stay in therapy (attrition rates tend to be around 20%, [57]), fail to respond to CBT (40–57%), do not exhibit clinically significant symptom reduction even after completing the full course [26], or remain considerably symptomatic at the end of treatment (only 40% reach remission, [101]). Moreover, even following a full course of CBT, many patients reported reduced well-being and satisfaction with the quality of their interpersonal relationships [31].


In the following, we consider the reasons for the limited effectiveness of CBT. First, these difficulties may stem from a complex and only partially understood association between maintaining processes and treatment techniques. Importantly, the relationship between techniques and processes is unlikely to be adequately modeled by one-on-one associations (see [19; 56]. Rather, each treatment technique (e.g., exposure) may impact multiple processes (such as attention, interpretation, and emotion regulation). Similarly,
a modification in a specific process may be a part of several distinct techniques (e.g., attention control may be involved in the exposure and cognitive restructuring). In other words, the mechanism of change in SA (as well as in other disorders) is likely to be multidetermined and multifactorial.

Second, the “packaging” of treatments is likely lacking in nuance, imperfectly capturing the maladaptive processes of a specific individual. This suggests that an intervention needs to be individually tailored, drawing from a range of theoretically-sound and empirically tested techniques and adapting them to a specific individual in a given societal, cultural, and life-span context [93]. Moreover, based on the central mechanisms postulated to be implicated in the disorder, a clinical evaluation may provide an individualized profile, allowing a precise selection of therapeutic techniques. However, such personalized interventions may only become clinically relevant if we can predict the treatment outcome at the level of a single patient. Unfortunately, most predictions so far rely on group-based methods that do not yield predictions suitable for individual patients. Thus, novel analytical methods are needed [77].

Third, the partial success of CBT may be due, at least in part, to a rather partial view of vulnerability in SAD, which focuses almost exclusively on negative affect in the context of the social-rank system (e.g., assertiveness). Many studies examining the outcome of CBT address only a subset of inter-and intra-personal outcomes. For example, a sense of authenticity and belongingness and the ability to experience and savor positive emotions (such as pride, [25; 45; 64]) typically remain outside the scope of many assessments.
The importance of addressing both social approach and avoidance (in the context of hierarchical and affiliative relationships) is underscored by the partial independence of these systems [87]. Indeed, a CBT treatment enhanced by affiliative approach techniques resulted in significantly greater satisfaction with social relationships immediately after and 12 month after treatment with a more standard CBT-like package [4; 5]. These findings strongly favor addressing positive social functioning in SAD interventions. 

The endpoint of therapy for SAD is to enable clients to increase self-compassion and become authentic and relaxed in the presence of others. Developing and empirically assessing the utility of single therapeutic techniques, feeding these efforts back to the understanding of basic processes, and assessing the impact of combinations of these techniques remains the best way to enhance the effectiveness and precision of our interventions.


  1. Abbott M.J., Rapee R.M. Post-event rumination and negative self-appraisal in social phobia before and after treatment. Journal of Abnormal Psychology, 2004, vol. 113 (1),
    pp. 136–144. DOI: 10.1037/0021-843X.113.1.136
  2. Aderka I.M. Factors affecting treatment efficacy in social phobia: the use of video feedback and individual vs. group formats. Journal of Anxiety Disorders, 2009, vol. 23, pp. 12–17. DOI: 10.1016/j.janxdis.2008.05.003
  3. Aderka I.M., Hofmann S.G., Nickerson A. et al. Functional impairment in social
    anxiety disorder. Journal of Anxiety Disorders, 2012, vol. 26 (3), pp. 393–400. DOI: 10.1016/j.janxdis.2012.01.003
  4. Alden L.E., Buhr K., Robichaud M. et al. Treatment of social approach processes in adults with social anxiety disorder. Journal of Consulting and Clinical Psychology, 2018, vol. 86 (6), pp. 505–517. DOI: 10.1037/ccp0000306
  5. Alden L.E., Taylor C.T. Relational treatment strategies increase social approach behaviors in patients with Generalized Social Anxiety Disorder. Journal of Anxiety Disorders, 2011, vol. 25, pp. 309–318. DOI: 10.1016/j.janxdis.2010.10.003
  6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing, 2013. 947 p.
  7. Andersson G. Internet-delivered psychological treatments. Annual Review of Clinical Psychology, 2016, vol. 12, pp. 157–179. DOI: 10.1146/annurev-clinpsy-021815-093006
  8. Andersson G., Titov N. Advantages and limitations of Internet-based interventions
    for common mental disorders. World Psychiatry, 2014, vol. 13 (1), pp. 4–11. DOI: 10.1002/wps.20083
  9. Arntz A. Imagery rescripting as a therapeutic technique: Review of clinical trials, basic studies, and research agenda. Journal of Experimental Psychopathology, 2012, vol. 3 (2), pp. 189–208. DOI:10.5127/jep.024211
  10. Auyeung K.W., Alden L.E. Accurate empathy, social rejection, and social anxiety disorder. Clinical Psychological Science, 2020, vol. 8 (2), pp. 1–14. DOI: 10.1177/ 2167702619885410
  11. Azoulay R., Berger U., Keshet H. et al. Social anxiety and the interpretation of morphed facial expressions following exclusion and inclusion. Journal of Behavior Therapy and Experimental Psychiatry, 2020, vol. 66, 101511. DOI: 10.1016/j.jbtep.2019.101511
  12. Azoulay R., Gilboa-Schechtman E. Social construction and evolutionary perspectives on gender differences in post-traumatic distress: The case of status loss events. Frontiers in Psychiatry, 2022. DOI: 10.3389/fpsyt.2022.858304
  13. Badra M., Schulze L., Becker E.S. et al. The association between ruminative thinking and negative interpretation bias in social anxiety. Cognition and Emotion, 2017, vol. 31 (6), 1234–1242. DOI: 10.1080/02699931.2016.1193477
  14. Bandelow B., Lichte T., Rudolf S. et al. The German guidelines for the treatment of anxiety disorders. European Archives of Psychiatry and Clinical Neuroscience, 2015, vol. 265 (5), pp. 363–373. DOI: 10.1080/02699931.2016.1193477
  15. Beard C., Amir N. A multi-session interpretation modification program: Changes in interpretation and social anxiety symptoms. Behaviour Research and Therapy, 2008, vol. 46 (10), pp. 1135–1141. DOI: 10.1016/j.brat.2008.05.012
  16. Beck J.S., Beck A.T. Cognitive behavior therapy. New York, NY: Basics and beyond. Guilford Publication, 2011. 391 p.
  17. Blalock D.V., Kashdan T.B., McKnight P.E. High risk, high reward: Daily perceptions of social challenge and performance in social anxiety disorder. Journal of Anxiety Disorders, 2018, vol. 54, pp. 57–64. DOI: 10.1016/j.janxdis.2018.01.006
  18. Blay Y., Keshet H, Friedman L. et al. Interpersonal motivations in social anxiety: Weakened approach and intensified avoidance motivations for affiliation and social rank. Personality and Individual Differences, 2021, vol. 170, 110449. DOI: 10.1016/j.paid. 2020.110449
  19. Bruijniks S.J., De Rubeis R.J., Hollon S.D. et al. The potential role of learning capacity in cognitive behavior therapy for depression: A systematic review of the evidence and future directions for improving therapeutic learning. Clinical Psychological Science, 2019, vol. 7 (4), pp. 668–692. DOI: 10.1177/2167702619830391
  20. Carl E., Stein A.T., Levihn-Coon A. et al. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of Anxiety Disorders, 2019, vol. 61, pp. 27–36. DOI: 10.1016/j.janxdis.2018.08.003
  21. Carpenter J.K., Andrews L.A., Witcraft S.M. et al. Cognitive-behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 2018, vol. 35 (6), pp. 502–514. DOI: 10.1002/da.22728
  22. Chesham R.K., Malouff J.M., Schutte N.S. Meta-analysis of the efficacy of virtual reality exposure therapy for social anxiety. Behaviour Change, 2018, vol. 35(3), pp. 152–166. DOI: 10.1017/bec.2018.15
  23. Clark D.M., Wells A. A cognitive model of social phobia. In R.G. Heimberg(ed.), Social Phobia: Diagnosis, Assessment, and Treatment. New York, NY: Guilford Press, 1995, pp. 69–93.
  24. Clark G.I., Egan S.J. Clarifying the role of the Socratic method in CBT: A survey of expert opinion. International Journal of Cognitive Therapy, 2018, vol. 11 (2), pp. 184–199. DOI: 10.1007/s41811-018-0016-y
  25. Cohen L., Huppert J.D. Positive emotions and social anxiety: The unique role
    of pride. Cognitive Therapy and Research, 2018, vol. 42 (4), pp. 524–538. DOI: 10.1007/s10608-018-9900-2
  26. Craske M.G., Niles A.N., Burklund L.J. et al. Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators. Journal of Consulting and Clinical Psychology, 2014, vol. 82 (6), 1034. DOI: 10.1037/a0037212
  27. Crome E., Grove R., Baillie A.J. et al. DSM-IV and DSM-5 social anxiety disorder in the Australian community. Australian & New Zealand Journal of Psychiatry, 2015, vol. 49 (3), pp. 227–235.DOI: 10.1177/0004867414546699
  28. Dagoo J., Asplund R.P., Bsenko H.A. et al. Cognitive behavior therapy versus interpersonal psychotherapy for social anxiety disorder delivered via smartphone and computer: A randomized controlled trial. Journal of Anxiety Disorders, 2014, vol. 28 (4), pp. 410–417. DOI: 10.1016/J.JANXDIS.2014.02.003
  29. D'Argembeau A., Van der Linden M., d'Acremont M. Et al. Phenomenal characteristics of autobiographical memories for social and non-social events in social phobia. Memory, 2006, vol. 14 (5), pp. 637–647. DOI: 10.1080/09658210600747183
  30. Dryman M.T., Heimberg R.G. Emotion regulation in social anxiety and depression: A systematic review of expressive suppression and cognitive reappraisal. Clinical Psychology Review, 2018, vol. 65, pp. 17–42. DOI: 10.1016/j.cpr.2018.07.004
  31. Eng W., Heimberg R.G., Hart T.A. et al. Attachment in individuals with social anxiety disorder: the relationship among adult attachment styles, social anxiety, and depression. Emotion, 2001, vol. 1 (4), pp. 365–380. DOI: 10.1037/1528-3542.1.4.365
  32. Everaert J., Bronstein M.V., Cannon T.D. et al. Looking through tinted glasses: Depression and social anxiety are related to both interpretation biases and inflexible negative interpretations. Clinical Psychological Science, 2018, vol. 6 (4), pp. 517–528. DOI: 10.1177/2167702617747968
  33. Fergus T.A., Wheless N.E. The attention training technique causally reduces self-focus following worry provocation and reduces cognitive anxiety among self-focused individuals. Journal of Behavior Therapy and Experimental Psychiatry, 2018, vol. 61, pp. 66–71. DOI: 10.1016/j.jbtep.2018.06.006
  34. Fluckiger C., Del A.C., Wampold B.E. et al. The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 2018, vol. 55 (4), pp. 316–340. DOI: 10.1037/ pst0000172
  35. Fung K., Alden L.E. Social anxiety compared to depression better accounts for enhanced acquisition of self-reported anxiety towards faces paired with negative evaluation in a conditioning task. Journal of Experimental Psychopathology, 2020, vol. 11 (1), article 2043808719888309. DOI: 10.1177/2043808719888309
  36. Gilbert P. Evolutionary models: Practical and conceptual utility for the treatment and study of social anxiety disorder. In J.W. Weeks (ed.), Handbook of Social Anxiety Disorder. Hoboken, NJ: Wiley Blackwell, 2014, pp. 24–52. DOI: 10.1002/97811186 53920.ch2
  37. Gilbert P., Trower P. Evolution and process in social anxiety. In W.R. Crozier, L.E. Alden (eds.), International Handbook of Social Anxiety: Concepts, Research and Interventions Relating to the Self and Shyness. Hoboken, NJ: John Wiley & Sons Ltd., 2001, pp. 259–279.
  38. Gilboa-Schechtman E. A dual-system model of social anxiety disorder: The interplay of the social-rank and affiliation biopsychosocial systems. Clinical Psychology and Special Education, 2020, vol. 9 (3), pp. 15–33. DOI: 10.17759/cpse.2020090302
  39. Gilboa-Schechtman E., Franklin M.E., Foa E.B. Anticipated reactions to social events: Differences among individuals with generalized social phobia, obsessive compulsive disorder, and non-anxious controls. Cognitive Therapy and Research, 2000, vol. 24 (6), pp. 731–746. DOI: 10.1023/A:1005595513315
  40. Gilboa-Schechtman E., Galili L., Sahar Y. et al. Being “in” or “out” of the game: subjective and acoustic reactions to exclusion and popularity in social anxiety. Frontiers in Human Neuroscience, 2014, vol. 8, pp. 147–159. DOI: 10.3389/fnhum.2014.00147
  41. Gilboa-Schechtman E., Keshet H., Livne T. et al. Explicit and implicit self-evaluations in social anxiety disorder. Journal of Abnormal Psychology, 2017, vol. 126 (3), pp. 285–290. DOI: 10.1037/abn0000261
  42. Gilboa-Schechtman E., Keshet H., Peschard V. et al. Self and identity in social anxiety disorder. Journal of Personality,2020, vol. 88 (1), pp. 106–121. DOI: 10.1111/jopy.12455
  43. Gilboa-Schechtman E., Shachar-Lavie I. More than a face: a unified theoretical perspective on nonverbal social cue processing in social anxiety. Frontiers in Human Neuroscience, 2013, vol. 7 (December), 904. DOI: 10.3389/fnhum.2013.00904
  44. Gilboa-Schechtman E., Shachar I., Helpman L. Evolutionary Perspective on Social Anxiety. In Social Anxiety: Clinical, Developmental, and Social Perspectives: 3rd ed. Cambridge, MA: Academic Press, 2014, pp. 599–622. DOI: 10.1016/B978-0-12-394427-6.00021-2
  45. Gilboa-Schechtman E., Shachar I., Sahar Y. Positivity impairment as a broad-based feature of social anxiety. In J.W. Weeks (ed.), Handbook on Social Anxiety Disorder. Hoboken, NJ: Wiley-Blackwell, 2014, pp. 409–432. DOI: 10.1002/9781118653920.ch19
  46. Goldin P.R., Lee I., Ziv M. et al. Trajectories of change in emotion regulation and social anxiety during cognitive-behavioral therapy for social anxiety disorder. Behaviour Research and Therapy, 2014, vol. 56, pp. 7–15. DOI: 10.1016/j.brat.2014.02.005
  47. Gross J.J. Emotion regulation: Сurrent status and future prospects. Psychological Inquiry, 2015, vol. 26(1), pp. 130–137. DOI: 10.1080/1047840X.2014.940781
  48. Gross J.J. The emerging field of emotion regulation: An integrative review. Review of General Psychology, 1998, vol. 2 (3), pp. 271–299. DOI: 10.1037/1089-2680.2.3.271
  49. Hackmann A., Clark D.M., McManus F. Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 2000, vol. 38 (6), pp. 601–610. DOI: 10.1016/S0005-7967(99)00161-8
  50. Heimberg R.G., Brozovich F.A., Rapee R.M. A cognitive behavioral model of social anxiety disorder: Update and extension. In S.G. Hofmann, P.M. DiBartolo (eds.), Social Anxiety. Cambridge, MA: Academic Press, 2010, pp. 395–422. DOI: 10.1016/B978-0-12-375096-9.00015-8
  51. Herbert J.D., Forman E.M., Kaye J.L. et al. Randomized controlled trial of acceptance and commitment therapy versus traditional cognitive behavior therapy for social anxiety disorder: Symptomatic and behavioral outcomes. Journal of Contextual Behavioral Science, 2018, vol. 9, pp. 88–96. DOI: 10.1016/j.jcbs.2018.07.008
  52. Hirsch C.R., Clark D.M. Information-processing bias in social phobia. Clinical Psychology Review, 2004, vol. 24 (7), pp. 799–825. DOI: 10.1016/j.cpr.2004.07.005
  53. Hirsch C.R., Clark D.M., Mathews A. et al. Self-images play a causal role in social phobia. Behaviour Research and Therapy, 2003, vol. 41 (8), pp. 909–921. DOI: 10.1016/S0005-7967(02)00103-1
  54. Hofmann S.G. Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 2007, vol. 36 (4), pp. 193–209. DOI: 10.1080/16506070701421313
  55. Hofmann S.G. Interpersonal emotion regulation model of mood and anxiety disorders. Cognitive Therapy and Research, 2014, vol. 38 (5), pp. 483–492. DOI: 10.1007/ s10608-014-9620-1
  56. Hofmann S.G., Curtiss J.E., Hayes S.C. Beyond linear mediation: Toward a dynamic network approach to study treatment processes. Clinical Psychology Review, 2020, vol. 76, 101824. DOI: 10.1016/j.cpr.2020.101824
  57. Hoyer J., Wiltink J., Hiller W. et al. Baseline patient characteristics predicting outcome and attrition in cognitive therapy for social phobia: Results from a large multicentre trial. Clinical Psychology &Psychotherapy, 2016, vol. 23 (1), pp. 35–46. DOI: 10.1002/cpp.1936
  58. Huppert J.D., Pasupuleti R.V., Foa E. B. et al. Interpretation biases in social anxiety: Response generation, response selection, and self-appraisals. Behaviour Research and Therapy, 2007, vol. 45 (7), pp. 1505–1515. DOI: 10.1016/j.brat.2007.01.006
  59. Jazaieri H., Morrison A.S., Goldin P.R. et al. The role of emotion and emotion regulation in social anxiety disorder. Current Psychiatry Reports, 2015, vol. 17 (1), article 531. DOI: 10.1007/s11920-014-0531-3
  60. Kalokerinos E.K., Erbas Y., Ceulemans E. et al. Differentiate to regulate: Low negative emotion differentiation is associated with ineffective use but not selection of emotion-regulation strategies. Psychological Science,2019, vol. 30 (6), pp. 863–879. DOI: 10.1177/0956797619838763
  61. Kampmann I.L., Emmelkamp P.M.G., Morina N. Meta-analysis of technology-assisted interventions for social anxiety disorder. Journal of Anxiety Disorders, 2016, vol. 42, pp. 71–84. DOI: 10.1016/j.janxdis.2016.06.007
  62. Kashdan T.B., Barrett L.F., McKnight P.E. Unpacking emotion differentiation. Current Directions in Psychological Science, 2015, vol. 24 (1), pp. 10–16. DOI : 10.1177/0963721414550708
  63. Kashdan T.B., Farmer A.S. Differentiating emotions across contexts: comparing adults with and without social anxiety disorder using random, social interaction, and daily experience sampling. Emotion, 2014, vol. 14 (3), pp. 629–638. DOI: 10.1037/a0035796
  64. Kashdan T.B., Steger M.F. Expanding the topography of social anxiety: An experience-sampling assessment of positive emotions, positive events, and emotion suppression. Psychological Science, 2006, vol. 17 (2), pp. 120–128. DOI: 10.1111/j.1467-9280.2006.01674.x
  65. Katzelnick D.J., Greist J.H. Social anxiety disorder: An unrecognized problem in primary care. Journal of Clinical Psychiatry, 2001, vol. 62 (suppl. 1), pp. 11–16.
  66. Kessler R.C., Chiu W.T., Demler O. et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 2005, vol. 62 (6), pp. 617–627. DOI: 10.1001/archpsyc.62.6.617
  67. Kivity Y., Huppert J.D. Does cognitive reappraisal reduce anxiety? A daily diary study of a micro-intervention with individuals with high social anxiety. Journal of Consulting and Clinical Psychology,2016, vol. 84 (3), pp. 269–283. DOI: 10.1037/ ccp0000075
  68. Kivity Y., Huppert J.D. Emotion regulation in social anxiety: a systematic investigation and meta-analysis using self-report, subjective, and event-related potentials measures. Cognition and Emotion, 2019, vol. 33 (2), pp. 213–230. DOI: 10.1080/02699931.2018.1446414
  69. Kok B.E., Fredrickson B.L. Upward spirals of the heart: Autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts positive emotions and social connectedness. Biological Psychology, 2010, vol. 85 (3), pp. 432–436. DOI: 10.1016/ j.biopsycho.2010.09.005
  70. Lazarov A., Abend R., Bar-Haim Y. Social anxiety is related to increased dwell time on socially threatening faces. Journal of Affective Disorders, 2016, vol. 193, pp. 282–288. DOI: 10.1016/j.jad.2016.01.007
  71. Lazarus G., Shahar B. The role of shame and self-criticism in social anxiety: a daily-diary study in a nonclinical sample. Journal of Social and Clinical Psychology, 2018, vol. 37 (2), pp. 107–127. DOI: 10.1521/jscp.2018.37.2.107
  72. Leary M.R. Social anxiety as an early warning system: A refinement and extension of the self-presentation theory of social anxiety. In S.G. Hofmann, P.M. DiBartolo (eds.), Social Anxiety: Clinical, developmental, and social perspectives. Cambridge, MA: Elsevier Academic Press, 2010, pp. 471–486. DOI: 10.1016/B978-0-12-375096-9.00018-3
  73. Ledley D.R., Heimberg R.G., Hope D.A. et al. Efficacy of a manualized and workbook-driven individual treatment for social anxiety disorder. Behavior Therapy, 2009, vol. 40 (4), pp. 414–424. DOI: 10.1016/j.beth.2008.12.001
  74. Leichsenring F., Salzer S., Beutel M.E. et al. Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: A multicenter randomized controlled trial. The American Journal of Psychiatry, 2013, vol. 170 (7), pp. 759–767. DOI: 10.1176/ appi.ajp.2013.12081125
  75. Lloyd J., Marczak M. Imagery rescripting and negative self-imagery in social anxiety disorder: a systematic literature review. Behavioural and Cognitive Psychotherapy, 2022, vol. 50 (3), pp. 280–297. DOI: 10.1017/S135246582200008X
  76. Maner J. K., Miller S.L., Schmidt N.B. Submitting to defeat: Social anxiety, dominance threat, and decrements in testosterone. Psychological Science, 2008, vol. 19, pp. 264–268. DOI: 10.1111/j.1467-9280.2008.02154.x
  77. Månsson K.N.T., Lueken U., Frick A. Enriching CBT by Neuroscience: Novel Avenues to Achieve Personalized Treatments. Journal of Cognitive Therapy, 2021, vol. 14, pp. 182–195. DOI: 10.1007/s41811-020-00089-0
  78. Mayo-Wilson E., Dias S., Mavranezouli I. et al. Psychological and pharmacological interventions for social anxiety disorder in adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 2014, vol. 1 (5), pp. 368–376. DOI: 10.1016/S2215-0366(14)70329-3
  79. McEvoy P.M., Grove R., Slade T. Epidemiology of anxiety disorders in the Australian general population: Findings of the 2007 Australian National Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry, 2011, vol. 45 (11), pp. 957–967. DOI: 10.3109/00048674.2011.624083
  80. McEvoy P.M., Hyett M.P., Bank S.R. et al. Imagery-enhanced v. verbally-based group cognitive behavior therapy for social anxiety disorder: A randomized clinical trial.Psychological Medicine, 2020, pp. 1–10. DOI: 10.1017/S0033291720003001
  81. Mogg K., Bradley B.P. Anxiety and threat-related attention: Cognitive-motivational framework and treatment. Trends in Cognitive Sciences, 2018, vol. 22 (3), pp. 225–240. DOI: 10.1016/j.tics.2018.01.001
  82. Morrison A.S., Heimberg R.G. Social anxiety and social anxiety disorder. Annual Review of Clinical Psychology, 2013, vol. 9, pp. 249–274. DOI: 10.1146/annurev-clinpsy-050212-185631
  83. Moscovitch D.A. What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioral Practice, 2009, vol. 16 (2), pp. 123–134. DOI: 10.1016/j.cbpra.2008.04.002
  84. Moscovitch D.A., Gavric D.L., Merrifield C. et al. Retrieval properties of negative vs. Positive mental images and autobiographical memories in social anxiety: Outcomes with a new measure. Behaviour Research and Therapy, 2011, vol. 49 (8), pp. 505–517. DOI: 10.1016/j.brat.2011.05.009
  85. Moscovitch D.A., Vidovic V., Lenton-Brym A.P. et al. Autobiographical memory retrieval and appraisal in social anxiety disorder. Behaviour Research and Therapy, 2018, vol. 107, pp. 106–116. DOI: 10.1016/j.brat.2018.06.008
  86. National Institute for Health and Care Excellence. Social anxiety disorder: recognition, assessment and treatment of social anxiety disorder. NICE ClinicalGuideline, 2013, vol. 159. 19 p. URL: (Accessed: 25.05.2022).
  87. Nikitin J., Schoch S. Social approach and avoidance motivations. In R.J. Coplan, J.C. Bowker, L.J. Nelson (eds.), The Handbook of Solitude: Psychological Perspectives on Social Isolation, Social Withdrawal, and Being Alone, 2nd ed. New York, NY: Wiley Blackwell, 2021, pp. 191–208. DOI: 10.1002/9781119576457.ch14
  88. Niles A.N., Axelsson E., Andersson E. et al. Internet-based cognitive behavior therapy for depression, social anxiety disorder, and panic disorder: Effectiveness and predictors of response in a teaching clinic. Behaviour Research and Therapy, 2021, vol. 136, 103767. DOI: 10.1016/j.brat.2020.103767
  89. Norton A.R., Abbott M.J. The role of environmental factors in the aetiology of social anxiety disorder: A review of the theoretical and empirical literature. Behaviour Change, 2017, vol. 34 (2), pp. 76–97. DOI: 10.1017/bec.2017.7
  90. Pearlstein S.L., Taylor C.T., Stein M.B. Facial affect and interpersonal affiliation: displays of emotion during relationship formation in social anxiety disorder. Clinical Psychological Science, 2019, vol. 7 (4), pp. 826–839. DOI: 10.1177/2167702619825857
  91. Peschard V., Ben-Moshe S., Keshet H. et al. Social anxiety and sensitivity to social-rank features in male faces. Journal of Behavior Therapy and Experimental Psychiatry, 2019, vol. 63, pp. 79–84. DOI: 10.1016/j.jbtep.2018.10.005
  92. Peschard V., Gilboa-Schechtman E., Philippot P. Selective attention to emotional prosody in social anxiety: A dichotic listening study. Cognition and Emotion, 2017, vol. 31 (8), pp. 1749–1756. DOI: 10.1080/02699931.2016.1261012
  93. Piccirillo M.L., Rodebaugh T.L. Personalized networks of social anxiety disorder and depression and implications for treatment. Journal of Affective Disorders, 2022, vol. 298, pp. 262–276. DOI: 10.1016/j.jad.2021.10.034
  94. Plasencia M.L., Taylor C.T., Alden L.E. Unmasking one’s true self facilitates positive relational outcomes. Clinical Psychological Science, 2016, 4 (6), pp. 1002–1014. DOI: 10.1177/2167702615622204
  95. Rapee R.M., Fardouly J., Forbes M.K. et al. Adolescent development and risk for the onset of social-emotional disorders: A review and conceptual model. Behaviour Research & Therapy,2019, vol. 123, 103501. DOI: 10.1016/j.brat.2019.103501
  96. Rapee R.M., Heimberg R.G. A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 1997, vol. 35 (8), pp. 741–756. DOI:10.1016/s0005-7967(97)00022-3
  97. Rapee R.M., Spence S.H. The etiology of social phobia: Empirical evidence and an initial model. Clinical Psychology Review, 2004, vol. 24 (7), pp. 737–767. DOI: 10.1016/j.cpr.2004.06.004
  98. Romano M., Moscovitch D.A., Saini P. et al. The effects of positive interpretation bias on cognitive reappraisal and social performance: Implications for social anxiety disorder. Behaviour Research and Therapy, 2020, vol. 131, 103651. DOI: 10.1016/ j.brat.2020.103651
  99. Rowa K., Paulitzki J.R., Ierullo M.D. et al. A false sense of security: Safety behaviors erode objective speech performance in individuals with social anxiety disorder. Behavior Therapy, 2014, vol. 46 (3), pp. 304–314. DOI: 10.1016/j.beth.2014.11.004
  100. Sapach M.J.T., Carleton R.N. Can words be worse than stones? Understanding distressing social events and their relationship with social anxiety. Journal of Anxiety Disorders, 2020, vol. 72, 102225. DOI: 10.1016/j.janxdis.2020.102225
  101. Springer K.S., Levy H.C., Tolin D.F. Remission in CBT for adult anxiety disorders: A meta-analysis. Clinical Psychology Review, 2018, vol. 61, pp. 1–8. DOI: 10.1016/ j.cpr.2018.03.002
  102. Stangier U., Schramm E., Heidenreich T., Berger M. et al. Cognitive therapy versus interpersonal psychotherapy in social phobia: A randomized controlled trial. Archives of General Psychiatry, 2011, vol. 68, pp. 692–700. DOI: 10.1001/archgenpsychiatry.2011.67
  103. Stein D.J., Lim C.C., Roest A.M. et al. The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC Medicine, 2017, vol. 15(1), article 143. DOI: 10.1186/s12916-017-0889-2
  104. Stewart R.E., Chambless D.L. Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: a meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, 2009, vol. 77 (4), pp. 595–606. DOI: 10.1037/a0016032
  105. Stopa L., Clark D.M., Social phobia and interpretation of social events. Behaviour Research and Therapy, 2000, vol. 38 (3), pp. 273–283. DOI: 10.1016/S0005-7967(99) 00043-1
  106. Taylor C.T., Alden L.E. Safety behaviors and judgmental biases in social anxiety disorder. Behaviour Research and Therapy, 2010, vol. 48 (3), pp. 226–237. DOI: 10.1016/ j.brat.2009.11.005
  107. Taylor C.T., Cross K., Amir N. Attentional control moderates the relationship between social anxiety symptoms and attentional disengagement from threatening information. Journal of Behavior Therapy and Experimental Psychiatry, 2016, vol. 50,
    pp. 68–76. DOI: 10.1016/j.jbtep.2015.05.008
  108. Trower P., Gilbert P. New theoretical conceptions of social anxiety and social phobia. Clinical Psychology Review, 1989, vol. 9 (1), pp. 19–35. DOI: 10.1016/0272-7358(89)90044-5
  109. Weeks J.W., Heimberg R.G. Editorial — special issue positivity impairments: Pervasive and impairing (yet non-prominent?) features of social anxiety disorder. Cognitive Behaviour Therapy, 2012, vol. 41 (2), pp. 79–82. DOI: 10.1080/16506073.2012.680782
  110. Weeks J.W., Heimberg R.G., Heuer R. Exploring the role of behavioral submissiveness in social anxiety. Journal of Social and Clinical Psychology, 2011, vol. 30 (3), pp. 217–249. DOI: 10.1521/jscp.2011.30.3.217
  111. Wenzel A. Cognitive reappraisal. In S.C. Hayes, S.G. Hofmann (eds.), Process-based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy, 1st ed. Oakland, CA: New Harbinger Publications, 2018, pp. 325–338.
  112. Werner A.M., Tibubos A.N., Rohrmann S. et al. The clinical trait self-criticism and its relation to psychopathology: A systematic review — Update. Journal of Affective Disorders, 2019, vol. 246, pp. 530–547. DOI: 10.1016/j.jad.2018.12.069
  113. Wersebe H., Sijbrandij M., Cuijpers P. Psychological group-treatments of social anxiety disorder: a meta-analysis. PloS One, 2013, vol. 8 (11), e79034. DOI: 10.1371/ journal.pone.0079034
  114. Wieser M.J., Keil A. Attentional threat biases and their role in anxiety: A neurophysiological perspective. International Journal of Psychophysiology. 2020. DOI: 10.31234/
  115. Wong Q.J. Anticipatory processing and post‐event processing in social anxiety disorder: An update on the literature. Australian Psychologist, 2016, vol. 51 (2), pp. 105–113. DOI: 10.1111/ap.12189
  116. Wunderlich U., Bronisch T., Wittchen H.U. Comorbidity patterns in adolescents and young adults with suicide attempts. European Archives of Psychiatry and Clinical Neuroscience, 1998, vol. 248 (2), pp. 87–95. DOI: 10.1007/s004060050023

Information About the Authors

Eva Gilboa-Schechtman, PhD, Professor, Director of Emotional Processing Laboratory, Psychology Department and the Gonda Brain Science Center, Bar Ilan University, Ramat-Gan, Israel, ORCID:, e-mail:

Roy Azoulay, MA (Psychology) of the Psychology Department and the Gonda Brain Science Center, Bar-Ilan University, Ramat-Gan, Israel, ORCID:, e-mail:



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