Assessing Emotion Regulation in Social Anxiety Disorder: The Emotion Regulation Interview

  • Kelly H. Werner
  • Philippe R. Goldin
  • Tali M. Ball
  • Richard G. Heimberg
  • James J. Gross


Social anxiety disorder (SAD) is thought to involve emotional hyper-reactivity and emotion dysregulation. However, the precise nature of the emotion dysregulation in SAD has not been well characterized. In the present study, the Emotion Regulation Interview (ERI) was developed to quantify the frequency and self-efficacy of five emotion regulation strategies specified by Gross’s (Review of General Psychology 2: 271–299, 1998) process model of emotion regulation. Forty-eight individuals with SAD and 33 healthy controls (HCs) were interviewed about responses during (a) a laboratory speech task and (b) two recent social anxiety-evoking situations. Individuals with SAD reported greater use of avoidance and expressive suppression than HCs, as well as lesser self-efficacy in implementing cognitive reappraisal and expressive suppression. These regulation deficits were not accounted for by differences in emotional reactivity. These findings highlight specific emotion regulation deficits in SAD, and support the idea that the Emotion Regulation Interview may be usefully applied to other clinical disorders.


Emotion regulation Emotional reactivity Social anxiety disorder Social phobia 


  1. Asendorpf, J. (1990). The expression of shyness and embarrassment. In W. R. Crozier (Ed.), Shyness and Embarrassment: Perspectives from social psychology (pp. 87–118). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  2. Baker, S. L., Heinrich, N., Kim, H.-J., & Hoffman, S. G. (2002). The Liebowitz Social Anxiety Scale as a self-report instrument: A preliminary psychometric analysis. Behaviour Research and Therapy, 40, 1087–1098.CrossRefGoogle Scholar
  3. Bögels, S. M., & Mansell, W. (2004). Attention processes in the maintenance and treatment of social phobia: Hypervigilance, avoidance and self-focused attention. Clinical Psychology Review, 24, 827–856.PubMedCrossRefGoogle Scholar
  4. Campbell-Sills, L., & Barlow, D. H. (2007). Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 542–559). New York: Guilford.Google Scholar
  5. Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006). Acceptability and suppression of negative emotion in anxiety and mood disorders. Emotion, 6, 587–595.PubMedCrossRefGoogle Scholar
  6. Carthy, T., Horesh, N., Apter, A., Edge, M. D., & Gross, J. J. (2010). Emotional reactivity and cognitive regulation in anxious children. Behaviour Research and Therapy, 48, 384–393.PubMedCrossRefGoogle Scholar
  7. Carthy, T., Horesh, N., Apter, A., & Gross, J. J. (2010). Patterns of emotional reactivity and regulation in children with anxiety disorders. Journal of Psychological Behavioral Assessment, 32, 23–36.CrossRefGoogle Scholar
  8. Catanzaro, S. J., & Mearns, J. (1990). Measuring generalized expectancies for negative mood regulation: Initial scale development and implications. Journal of Personality Assessment, 54, 546–563.PubMedCrossRefGoogle Scholar
  9. Ciarrochi, J., Scott, G., Deane, F., & Heaven, P. (2003). Relations between social and emotional competence and mental health: A construct validation study. Personality and Individual Differences, 38, 1947–1963.CrossRefGoogle Scholar
  10. Clark, D. M. (2001). A cognitive perspective on social phobia. In W. R. Crozier & L. E. Alden (Eds.), International handbook of social anxiety: Concepts, research and interventions relating to the self and shyness (pp. 405–430). Chichester: Wiley.Google Scholar
  11. Clark, D. M., & McManus, F. (2002). Information processing in social phobia. Biological Psychiatry, 51, 92–100.PubMedCrossRefGoogle Scholar
  12. Di Nardo, P., Moras, K., Barlow, D. H., Rapee, R. M., & Brown, T. A. (1993). Reliability of DSM-III-R anxiety disorder categories. Using the Anxiety Disorders Interview Schedule-Revised (ADIS-R). Archives of General Psychiatry, 50, 251–256.PubMedGoogle Scholar
  13. Di Nardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV: Lifetime version (ADIS-IV-L). New York: Oxford University Press.Google Scholar
  14. Etkin, A., & Wager, T. D. (2007). Functional neuroimaging of anxiety: A meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. The American Journal of Psychiatry, 164, 1476–1488.PubMedCrossRefGoogle Scholar
  15. Fresco, D. M., Coles, M. E., Heimberg, R. G., Liebowitz, M. R., Hami, S., Stein, M. B., et al. (2001). The Liebowitz Social Anxiety Scale: A comparison of the psychometric properties of self-report and clinician-administered formats. Psychological Medicine, 31, 1025–1035.PubMedCrossRefGoogle Scholar
  16. Furmark, T. (2002). Social phobia: Overview of community surveys. Acta Psychiatrica Scandinavica, 105, 84–93.PubMedCrossRefGoogle Scholar
  17. Gilboa-Schechtman, E., Foa, E. B., & Amir, N. (1999). Attentional biases for facial expressions in social phobia: The face-in-the-crowd paradigm. Cognition & Emotion, 13, 305–318.CrossRefGoogle Scholar
  18. Goldin, P. R., Manber, T., Hakimi, S., Canli, T., & Gross, J. J. (2009). Neural bases of social anxiety disorder: Emotional reactivity and cognitive regulation during social and physical threat. Archives of General Psychiatry, 66, 170–180.PubMedCrossRefGoogle Scholar
  19. Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 36, 41–54.CrossRefGoogle Scholar
  20. Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2, 271–299.CrossRefGoogle Scholar
  21. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348–362.PubMedCrossRefGoogle Scholar
  22. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford.Google Scholar
  23. Heimberg, R. G. (2002). Cognitive-behavioral therapy for social anxiety disorder: Current status and future directions. Biological Psychiatry, 51, 101–108.PubMedCrossRefGoogle Scholar
  24. Heimberg, R. G., Horner, K. J., Juster, H. R., Safren, S. A., Brown, E. J., Schneier, F. R., et al. (1999). Psychometric properties of the Liebowitz Social Anxiety Scale. Psychological Medicine, 29, 199–212.PubMedCrossRefGoogle Scholar
  25. Hermann, C., Ofer, J., & Flor, H. (2004). Covariation bias for ambiguous social stimuli in generalized social phobia. Journal of Abnormal Psychology, 113, 646–653.PubMedCrossRefGoogle Scholar
  26. Hofmann, S. G. (2004). Cognitive mediation of treatment change in social phobia. Journal of Consulting and Clinical Psychology, 72, 393–399.PubMedGoogle Scholar
  27. Hofmann, S. G., Heinrichs, N., & Moscovitch, D. A. (2004). The nature and expression of social phobia: Toward a new classification. Clinical Psychology Review, 24, 769–797.PubMedCrossRefGoogle Scholar
  28. Kashdan, T. B. (2007). Social anxiety spectrum and diminished positive experiences: Theoretical synthesis and meta-analysis. Clinical Psychology Review, 27, 348–365.PubMedCrossRefGoogle Scholar
  29. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Rreplication. American Medical Association.Google Scholar
  30. Kring, A. M., & Werner, K. H. (2004). Emotion regulation and psychopathology. In P. Philippot & R. S. Feldman (Eds.), The Regulation of emotion (pp. 359–385). New York: Routledge.Google Scholar
  31. Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173.PubMedGoogle Scholar
  32. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.Google Scholar
  33. Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice, 9, 85–90.CrossRefGoogle Scholar
  34. Mischel, W. (1968). Personality and assessment. New York: Wiley.Google Scholar
  35. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121.PubMedCrossRefGoogle Scholar
  36. Rapee, R. M. (1995). Descriptive psychopathology of social phobia. In R. G. Heimberg (Ed.), Social phobia: Diagnosis, assessment, and treatment (pp. 41–66). New York: Guilford.Google Scholar
  37. Rytwinski, N. K., Fresco, D. M., Heimberg, R. G., Coles, M. E., Liebowtitz, M. R., Cissell, S., et al. (2009). Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depression and Anxiety, 26, 34–38.PubMedCrossRefGoogle Scholar
  38. Saarni, C. (1999). The development of emotional competence. New York: The Guilford.Google Scholar
  39. Schneier, F. R., Johnson, J., Hornig, C. D., Liebowitz, M. R., & Weissman, M. M. (1992). Social phobia. Comorbidity and morbidity in an epidemiologic sample. Archives of General Psychiatry, 49, 282–288.PubMedGoogle Scholar
  40. Spokas, M., Luterek, J. A., & Heimberg, R. G. (2009). Social anxiety and emotional suppression: The mediating role of beliefs. Journal of Behavior Therapy and Experimental Psychiatry, 40, 283–291.PubMedCrossRefGoogle Scholar
  41. Turk, C. L., Heimberg, R. G., Luterek, J. A., Mennin, D. S., & Fresco, D. M. (2005). Emotion dysregulation in generalized anxiety disorder: A comparison with social anxiety disorder. Cognitive Therapy and Research, 29, 89–106.CrossRefGoogle Scholar
  42. Weeks, J. W., Heimberg, R. G., Fresco, D. M., Hart, T. A., Turk, C. L., Schneier, F. R., et al. (2005). Empirical validation and psychometric evaluation of the Brief Fear of Negative Evaluation Scale in patients with social anxiety disorder. Psychological Assessment, 17, 179–190.PubMedCrossRefGoogle Scholar
  43. Wells, A., & Papageorgiou, C. (1998). Social phobia: Effects of external attention on anxiety, negative beliefs, and perspective taking. Behavior Therapy, 29, 357–370.CrossRefGoogle Scholar
  44. Werner, K. W., & Gross, J. J. (2009). Emotion regulation and psychopathology: A conceptual framework. In A. Kring & D. Sloan (Eds.), Emotion regulation and psychopathology. New York: Guilford.Google Scholar
  45. Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Palo Alto: Stanford University Press.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Kelly H. Werner
    • 1
  • Philippe R. Goldin
    • 1
  • Tali M. Ball
    • 3
  • Richard G. Heimberg
    • 2
  • James J. Gross
    • 1
  1. 1.Department of PsychologyStanford UniversityStanfordUSA
  2. 2.Department of PsychologyTemple UniversityPhiladelphiaUSA
  3. 3.Psychiatry DepartmentUniversity of California San DiegoCAUSA

Personalised recommendations