People with Social Anxiety Disorder (SAD) often feel like others are watching them. The simple act of walking through a crowd becomes a challenge when an individual is overwhelmed with the fear of every passerby scrutinizing their appearance.
Many SAD patients think, “Everyone is watching me." A study published on September 10, 2014, in PLOS ONE investigated how strongly socially anxious individuals felt like they were being watched. Led by Olivia C. Bolt from the National Institute for Health Research (NIHR) and Mental Health Biomedical Research Centre at South London, the team hypothesized that socially anxious individuals would overestimate the number of people looking at them.
Looking At All the Faces In A Crowd
The Brief Fear of Negative Evaluation Scale (bFNES) and Albany Panic and Phobia Questionnaire Social Phobia Subscale (APPQSPS) were used to measure the intensity of social anxiety in a pool of individuals: the highest and lowest scoring groups were selected for the study. The Beck Depression Inventory (BDI) was also administered. Those showing strong signs of depression were excluded from the study. At the end of the recruiting process, Bolt selected 48 people with low social anxiety and 48 people with high social anxiety.
All subjects participated in a computer exercise called “Faces In A Crowd." On the screen were 18 headshots of strangers. Some of the people were staring directly at the participant, others had their heads turned in another direction. The program simulated the feeling of being in a crowd of people and was supposed to evoke feelings of social anxiety. There were 11 virtual crowds that varied in:
- Number of people directly looking at the participant
- Facial expressions
Bolt asked participants to estimate what percentage of the people on the screen were staring at them.
Differentiating Between Self-Focused Attention and Being The Center of Attention
One of the key cognitive exercises for the socially anxious is to learn how to discern between being the center of attention and self-focused attention. More often than not, patients are overly critical of themselves and project these thoughts onto others. This creates the illusion that others are judging them.
To address this cognitive behavior, Bolt used mirror manipulation. Four mirrors were added to the computer setup during the Faces In A Crowd exercise: two next to the monitor and two in the participant's peripherals. The goal of the mirrors was to measure how much the participant would focus on themselves and not the screen.
The More Socially Anxious You Are, The More Likely You've Miscalculated
The study found that, on average, the high socially anxious group estimated a larger percentage of people watching them. Consistent with past research, the mirror manipulation “enhanced self-focused attention and anxiety in high and low socially anxious individuals, but only enhanced self-evaluation in the high socially anxious participants." Bolt hopes that this data can be used to help patients with SAD understand that “they may be estimating the extent to which they are the focus of others' attention as higher than people without SAD."
Date of original publication: September 13, 2014.
Updated on December 16, 2016.
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