Examining the Role of Perfectionism and Intolerance of Uncertainty in Postevent Processing in Social Anxiety Disorder

  • Bethany Shikatani
  • Martin M. Antony
  • Stephanie E. Cassin
  • Janice R. Kuo


Postevent processing (PEP) is proposed to be a key maintenance factor of social anxiety disorder (SAD; e.g., Clark and Wells 1995). The goal of the current study was to examine the independent roles of two transdiagnostic variables, namely perfectionism and intolerance of uncertainty (IU), as unique predictors of PEP in SAD above and beyond social anxiety and depressive symptoms. Fifty-six adults with SAD and high levels of speech anxiety completed measures of perfectionism, IU, social anxiety, and depression. They gave an impromptu speech to induce PEP, and completed measures assessing degree of PEP and its associated distress. Significant positive correlations were found between perfectionism and negative PEP degree and distress, as well as between IU and negative PEP distress. The perfectionism subscales of parental expectations and parental criticism significantly predicted negative PEP degree and distress over and above social anxiety and depressive symptoms. Perfectionism, as well as IU, were significantly and positively correlated with positive PEP distress, and significantly predicted positive PEP distress above and beyond social anxiety and depressive symptoms. The study design was cross-sectional; hence, experimental and longitudinal studies are needed to further understand the roles of perfectionism and IU as they relate to PEP. Individuals with SAD who are high in perfectionism or IU appear to be more prone to engaging in, or experiencing distress associated with, negative PEP. Specific strategies for decreasing negative PEP in this vulnerable population, especially for those high in perfectionism, may be necessary for optimal treatment outcome.


Postevent processing Social anxiety disorder Perfectionism Intolerance of uncertainty 



Funding from a Canadian Psychological Association Foundation student research grant award and a Social Sciences and Humanities Research Council Joseph-Armand Bombardier Canada doctoral graduate scholarship awarded to the first author was used to financially support this study.

Conflict of Interest

Bethany Shikatani, Martin M. Antony, Stephanie E. Cassin and Janice R. Kuo declare that they have no conflict of interest.

Experiment Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. Abbott, M. J., & Rapee, R. M. (2004). Postevent rumination and negative self-appraisal in social phobia before and after treatment. Journal of Abnormal Psychology, 113, 136–144.CrossRefPubMedGoogle Scholar
  2. Alden, L. E., Taylor, C. T., Mellings, T. M. B., & Laposa, J. M. (2008). Social anxiety and the interpretation of positive social events. Journal of Anxiety Disorders, 22, 577–590.CrossRefPubMedGoogle Scholar
  3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.Google Scholar
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
  5. Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998a). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychological Assessment, 10, 176–181.CrossRefGoogle Scholar
  6. Antony, M. M., Purdon, C. L., Huta, V., & Swinson, R. P. (1998b). Dimensions of perfectionism across the anxiety disorders. Behaviour Research and Therapy, 36, 1143–1154.CrossRefPubMedGoogle Scholar
  7. Antony, M. M., Coons, M. J., McCabe, R. E., Ashbaugh, A., & Swinson, R. P. (2006). Psychometric properties of the social phobia inventory: further evaluation. Behaviour Research and Therapy, 44, 1177–1185.CrossRefPubMedGoogle Scholar
  8. Ashbaugh, A., Antony, M. M., Liss, A., Summerfeldt, L. J., McCabe, R. E., & Swinson, R. P. (2007). Changes in perfectionism following cognitive-behavioral treatment for social phobia. Depression and Anxiety, 24, 169–177.CrossRefPubMedGoogle Scholar
  9. Brown, J. R., & Kocovski, N. L. (2014). Perfectionism as a predictor of post-event rumination in a socially anxious sample. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 32, 150–163.CrossRefGoogle Scholar
  10. Brunello, N., den Boer, J. A., Judd, L. L., Kasper, S., Kelsey, J. E., Lader, M., Lecrubier, Y., Lepine, J. P., Lydiard, R. B., Mendlewicz, J., Montgomery, S. A., Racagni, G., Stein, M. B., & Wittchen, H. U. (2000). Social phobia: Diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment. Journal of Affective Disorders, 60, 61–74.CrossRefPubMedGoogle Scholar
  11. Buhr, K., & Dugas, M. J. (2002). the intolerance of uncertainty scale: psychometric properties of the english version. Behaviour Research and Therapy, 40, 931–945.CrossRefPubMedGoogle Scholar
  12. Carleton, R. N., Collimore, K. C., & Asmundson, G. J. G. (2010). “It’s not just the judgements—it’s that I don’t know”: intolerance of uncertainty as a predictor of social anxiety. Journal of Anxiety Disorders, 24, 189–195.CrossRefPubMedGoogle Scholar
  13. Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). New York: Guilford Press.Google Scholar
  14. Connor, K. M., Davidson, J. R. T., Churchill, E. L., Sherwood, A., Weisler, R. H., & Foa, E. (2000). Psychometric properties of the social phobia inventory: new self-rating scale. British Journal of Psychiatry, 176, 379–386.CrossRefPubMedGoogle Scholar
  15. Crippa, J. A. S., De Lima Osório, F., Del-Ben, C. M., Filho, A. S., Da Silva Freitas, M. C., & Loureiro, S. R. (2008). Comparability between telephone and face-to-face structured clinical interview for DSM-IV in assessing social anxiety disorder. Perspectives in Psychiatric Care, 44, 241–247.CrossRefPubMedGoogle Scholar
  16. Daly, J. A. (1978). The assessment of social-communicative anxiety via self-reports: a comparison of measures. Communication Monographs, 45, 204–218.CrossRefGoogle Scholar
  17. Dannahy, L., & Stopa, L. (2007). Postevent processing in social anxiety. Behaviour Research and Therapy, 45, 1207–1219.CrossRefPubMedGoogle Scholar
  18. Edwards, S. L., Rapee, R., & Franklin, J. (2003). Postevent rumination and recall bias for social performance event in high and low socially anxious individuals. Cognitive Therapy and Research, 27, 603–617.CrossRefGoogle Scholar
  19. Field, A. P., & Morgan, J. (2004). Postevent processing and the retrieval of autobiographical memories in socially anxious individuals. Journal of Anxiety Disorders, 18, 647–663.CrossRefPubMedGoogle Scholar
  20. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured clinical interview for DSM-IV axis I disorders—patient edition. New York: New York Psychiatric Institute, Biometrics Research Department.Google Scholar
  21. Fisak, B., & Hammond, A. N. (2013). Are positive beliefs about post-event processing related to social anxiety? Behaviour Change, 30, 36–47.CrossRefGoogle Scholar
  22. Freeston, M. H., Rhéaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17, 791–802.CrossRefGoogle Scholar
  23. Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449–468.CrossRefGoogle Scholar
  24. Frost, R. O., Heimberg, R. G., Holt, C. S., Mattia, J. L., & Neubauer, A. L. (1993). A comparison of two measures of perfectionism. Personality and Individual Differences, 14, 119–126.CrossRefGoogle Scholar
  25. Gilkinson, H. (1942). Social fears reported by students in college speech classes. Speech Monographs, 9, 131–160.CrossRefGoogle Scholar
  26. Heimberg, R. G., Salzman, D. G., Holt, C. S., & Blendell, K. A. (1993). Cognitive-behavioral group treatment for social phobia: effectiveness at five-year follow-up. Cognitive Therapy and Research, 17, 325–339.CrossRefGoogle Scholar
  27. Heimberg, R. G., Brozovich, F. A., & Rapee, R. M. (2010). A cognitive behavioral model of social anxiety disorder: Update and extension. In S. G. Hofmann & P. M. DiBartolo (Eds.), Social anxiety: Clinical, development, and social perspectives (pp. 396–422). San Diego: Academic.Google Scholar
  28. Hofmann, S. G., Newman, M. G., Ehlers, A., & Roth, W. T. (1995). Psychophysiological differences between subgroups of social phobia. Journal of Abnormal Psychology, 104, 224–231.CrossRefPubMedGoogle Scholar
  29. Juster, H. R., Heimberg, R. G., Frost, R. O., Holt, C. S., Mittia, J. I., & Faccenda, K. (1996). Social phobia and perfectionism. Personality and Individual Differences, 21, 403–410.CrossRefGoogle Scholar
  30. Kocovski, N. L., Endler, N. S., Rector, N. A., & Flett, G. L. (2005). Ruminative coping and postevent processing in social anxiety. Behaviour Research and Therapy, 43, 971–984.CrossRefPubMedGoogle Scholar
  31. Laposa, J. M., Cassin, S. E., & Rector, N. A. (2010). Interpretation of positive social events in social phobia: an examination of cognitive correlates and diagnostic distinction. Journal of Anxiety Disorders, 24, 203–210.CrossRefPubMedGoogle Scholar
  32. Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343.CrossRefPubMedGoogle Scholar
  33. Lundh, L., & Öst, L. (2001). Attentional bias, self-consciousness and perfectionism in social phobia before and after cognitive-behaviour therapy. Scandinavian Journal of Behaviour Therapy, 30, 4–16.CrossRefGoogle Scholar
  34. Mahoney, A. E. J., & McEvoy, P. M. (2012). Changes in intolerance of uncertainty during cognitive behavior group therapy for social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 43, 849–854.CrossRefPubMedGoogle Scholar
  35. McEvoy, P. M., & Mahoney, A. E. J. (2011). Achieving certainty about the structure of intolerance of uncertainty in a treatment-seeking sample with anxiety and depression. Journal of Anxiety Disorders, 25, 112–122.CrossRefPubMedGoogle Scholar
  36. Mellings, T. M. B., & Alden, L. E. (2000). Cognitive processes in social anxiety: the effects of self-focus, rumination and anticipatory process. Behaviour Research and Therapy, 38, 243–257.CrossRefPubMedGoogle Scholar
  37. Paul, G. L. (1966). Insight vs desensitization in psychotherapy. Stanford: Stanford University Press.Google Scholar
  38. Perini, S. J., Abbott, M. J., & Rapee, R. M. (2006). Perception of performance as a mediator in the relationship between social anxiety and negative postevent rumination. Cognitive Therapy and Research, 30, 645–659.CrossRefGoogle Scholar
  39. Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741–756.CrossRefPubMedGoogle Scholar
  40. Shikatani, B., Antony, M. M., Kuo, J. R., & Cassin, S. E. (2014). The impact of cognitive restructuring and mindfulness strategies on postevent processing and affect in social anxiety disorder. Journal of Anxiety Disorders, 28, 570–579.CrossRefPubMedGoogle Scholar
  41. Terry-Short, L. A., Owens, R. G., Slade, P. D., & Dewey, M. E. (1995). Positive and negative perfectionism. Personality and Individual Differences, 18, 663–668.CrossRefGoogle Scholar
  42. Wong, Q. J. J., & Moulds, M. L. (2009). Impact of rumination versus distraction on anxiety and maladaptive self-beliefs in socially anxious individuals. Behaviour Research and Therapy, 47, 861–867.CrossRefPubMedGoogle Scholar
  43. Wong, Q. J. J., & Moulds, M. L. (2010). Do socially anxious individuals hold positive metacognitive beliefs about rumination? Behavior Change, 27, 69–83.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Bethany Shikatani
    • 1
  • Martin M. Antony
    • 1
  • Stephanie E. Cassin
    • 1
  • Janice R. Kuo
    • 1
  1. 1.Department of PsychologyRyerson UniversityTorontoCanada

Personalised recommendations