Flashes of feared social rejection

Social anxiety disorder is a highly prevalent disorder among young people, which comes with negative consequences for daily life and later development. Although treatment can lead to improvement, part of (young) individuals with social anxiety does not recover. It is therefore important to increase insight in factors that contribute to the persistence of social anxiety, and to develop interventions that effectively target these factors. One of the factors that could play an important role is catastrophic imagery of negative feared outcomes (flashforwards) such as social rejection. Marjolein Thunnissen’s research showed that a large part of adolescents and (young) adults with social anxiety indeed experienced such flashforward images and felt accompanying distress. The higher the intensity of the images, the stronger the anxiety symptoms. However, in an experiment, weakening intense flashforwards did not also directly lead to less social anxiety and avoidance. Furthermore, Thunnissen found that no research had been conducted on interventions directly targeting negative images in adolescents with social anxiety. In adults, targeting negative (social) memories with imagery rescripting had often been studied and appeared effective for reducing anxiety symptoms and distress. Thunnissen conducted a first pilot study in adolescents with social anxiety disorder, in which she targeted flashforwards with Eye Movement Desensitization and Reprocessing (EMDR). The effects were promising. Despite these findings, the results of this thesis did not yet provide sufficient evidence to conclude that intense flashforwards maintain social anxiety, or that (EMDR) flashforward interventions should be a standard part of treatment.

Dissertation: https://hdl.handle.net/11370/89fe3528-cb23-488a-bfe0-c3b3353c1fc8