Effectiveness of Contextual Schema Therapy for Fear of Negative Evaluation and Fear of Positive Evaluation in Individuals with Social Anxiety Disorder: Single Subject Design

Emamzamani, Zahra; Rahimian Boogar, Isaac; Mashhadi, Ali

doi:10.22055/psy.2023.44088.3062

Effectiveness of Contextual Schema Therapy for Fear of Negative Evaluation and Fear of Positive Evaluation in Individuals with Social Anxiety Disorder: Single Subject Design

Document Type : Research Article

Authors

zahra emamzamani ¹

Isaac Rahimian Boogar ²

Ali Mashhadi ³

¹ PhD. Student of Psychology, Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.

² Associate Professor, Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.

³ Professor, Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

10.22055/psy.2023.44088.3062

Abstract

Introduction
Social anxiety disorder is an anxiety disorder characterized by intense anxiety or fear of social situations in which a person may be evaluated by others. People with this disorder worry about receiving negative and positive evaluations from others and avoid situations where they may be evaluated. Social anxiety disorder is related to lower quality of life and more interpersonal, occupational, and academic problems. A high percentage of people with this disorder also report comorbid disorders such as other anxiety disorders, depression, and some personality disorders. Despite high prevalence and important consequences of social anxiety disorder, studies show that one-third of people with this disorder receive treatments. Social anxiety disorder, if not treated, can turn into a chronic disorder that leads to problems, destruction, and comorbid or subsequent disorders such as anxiety disorders and depression. Contextual schema therapy is an approach that integrates Young's schema therapy with the concepts of third-wave therapies and corrects coping, inner critic, and child modes and strengthens healthy adult mode. This study aimed to investigate the effectiveness of contextual schema therapy on the fear of negative evaluation and the fear of positive evaluation in people with social anxiety disorder.

Method
The present study was performed in the frame of an A-B single-subject design. The statistical population consisted of all the people with social anxiety disorder in Mashhad city, in 1400, out of which 12 people were selected by convenience sampling. The subjects received contextual schema therapy for 16 weekly sessions of 1 hour. The tools were used in the study included the Carleton et al. Brief Fear of Negative Evaluation Scale-II and the Weeks et al. Fear of Positive Evaluation Scale. The data were analyzed using improvement percentage, reliable change index, non-overlapping effect size and visual analysis.

Results
The reliable change index (1.96 <), the improvement percentage (25% <) and the non-overlapping data showed the significant effect of the intervention in reducing the fear of negative evaluation and the fear of positive evaluation of all subjects. The improvement percentage at the follow-up stage indicated that the treatment was effective in reducing the fear of negative evaluation and the fear of positive evaluation.

Discussion
Based on the findings, contextual schema therapy by integrating the third wave approaches was effective in reducing the fear of negative evaluation and the fear of positive evaluation. Therefore, contextual schema therapy can be suggested as an effective treatment for social anxiety disorder.

Keywords

Contextual schema therapy

Fear of negative evaluation

Fear of positive evaluation

Social anxiety disorder

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