GGeeoorrggiiaa SSttaattee UUnniivveerrssiittyy SScchhoollaarrWWoorrkkss @@ GGeeoorrggiiaa SSttaattee UUnniivveerrssiittyy Psychology Dissertations Department of Psychology 8-12-2016 TThhee IImmppaacctt ooff SSoocciiaall IIddeennttiittiieess oonn tthhee PPrreesseennttaattiioonn aanndd TTrreeaattmmeenntt ooff SSoocciiaall AAnnxxiieettyy DDiissoorrddeerr Suzanne Johnson Follow this and additional works at: https://scholarworks.gsu.edu/psych_diss RReeccoommmmeennddeedd CCiittaattiioonn Johnson, Suzanne, "The Impact of Social Identities on the Presentation and Treatment of Social Anxiety Disorder." Dissertation, Georgia State University, 2016. doi: https://doi.org/10.57709/8678016 This Dissertation is brought to you for free and open access by the Department of Psychology at ScholarWorks @ Georgia State University. It has been accepted for inclusion in Psychology Dissertations by an authorized administrator of ScholarWorks @ Georgia State University. For more information, please contact [email protected]. THE IMPACT OF SOCIAL IDENTITIES ON THE PRESENTATION AND TREATMENT OF SOCIAL ANXIETY DISORDER by SUZANNE JOHNSON Under the Direction of Page Anderson, Ph.D. ABSTRACT The overall theme for this European-style dissertation is an examination of how social identities are represented in treatment studies for social anxiety disorder and how fears of confirming stereotypes about one’s social identities affect social anxiety disorder in the form of stereotype confirmation concerns. In the first chapter, I introduce social anxiety disorder (SAD), describe cognitive behavioral therapy for SAD, review recruitment strategies to increase the representation of social minority groups in treatment research, discuss the importance of accurately reporting the social identities represented in samples, describe the particular relevance of stereotypes for social anxiety disorder, and provide a theoretically grounded rationale for the ways in which stereotype confirmation concerns may impact the experience and treatment of social anxiety disorder. For the second chapter, I present a study that examines the extent to which the demographic characteristics of participants (e.g., age, gender) are reported in treatment outcome research for social anxiety disorder. The findings from this study illuminate who participates in clinical trials for social anxiety (and therefore, to whom they may apply), as well as the infrequency with which some social identities are reported. Failure to report demographic characteristics of participants treated for social anxiety disorder makes it impossible to determine the external validity of the empirical literature. It also begs the question of whether we may be failing to identify salient constructs related to the social identities of our participants that affect our understanding of the social anxiety disorder and its treatment. The third and fourth chapters present two papers on the effects of stereotype confirmation concerns on both the experience and the treatment of social anxiety disorder. The final chapter describes how the series of studies presented in this dissertation fits into research on social anxiety disorder, as well as directions for future research. INDEX WORDS: Social anxiety, Social identities, Culture, Treatment, Reporting standards THE IMPACT OF SOCIAL IDENTITIES ON THE PRESENTATION AND TREATMENT OF SOCIAL ANXIETY DISORDER by SUZANNE JOHNSON A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in the College of Arts and Sciences Georgia State University 2016 Copyright by Suzanne Johnson 2016 THE IMPACT OF SOCIAL IDENTITIES ON THE PRESENTATION AND TREATMENT OF SOCIAL ANXIETY DISORDER by SUZANNE JOHNSON Committee Chair: Page Anderson Committee: Erin Tone Wing Chan Ciara Smalls-Glover Electronic Version Approved: Office of Graduate Studies College of Arts and Sciences Georgia State University May 2016 iv DEDICATION Thank you to my pack of people who supported this endeavor. Also thank you to the clinic diversity committee whose conversations about identities and cultural competency enriched my graduate school training and the lens through which I view this work. v ACKNOWLEDGEMENTS This collection of work would not have been possible with the support of my advisor, Page Anderson and the encouragement of my committee. Thank you to the wonderful system of people that contributed to each step of this process. vi TABLE OF CONTENTS ACKNOWLEDGEMENTS ............................................................................................. v LIST OF TABLES ............................................................................................................ x LIST OF FIGURES ......................................................................................................... xi 1 INTRODUCTION....................................................................................................... 1 1.1 Social Anxiety ....................................................................................................... 1 1.2 Cognitive Behavioral Treatment for Social Anxiety Disorder ......................... 1 1.3 Recruiting to Achieve Diverse Samples in Treatment Research ..................... 3 1.4 Effective Generalizability Depends on Accurate Reporting: How Are We Doing? 4 1.5 The Importance of Social Identities .................................................................... 6 1.5.1 Multidimensional Model of Racial Identity ................................................... 7 1.6 Effects of Stereotypes ........................................................................................... 8 1.6.1 Stereotype Threat ............................................................................................ 9 1.7 Stereotype Confirmation Concerns .................................................................. 13 1.7.1 Stereotype Confirmation Concerns: Taking an Intersectionality Perspective on the Experience of Stereotypes ......................................................................................... 14 1.7.2 The Current Model of Social Anxiety .......................................................... 16 1.8 Incorporating Social Identities into the Current Model of Social Anxiety Disorder 17 vii 1.8.1 Step 1: Perceived Audience .......................................................................... 17 1.8.2 Step 2: Mental Representation of the Self as Seen by the Audience .......... 18 1.8.3 Step 3: Comparison of Image of Self with Expected Standards of the Audience 20 1.8.4 Step 4: Estimation of the Likelihood and Consequences of Negative Evaluation 21 1.9 The Potential Impact of Stereotype Confirmation Concerns......................... 22 2 FIRST ARTICLE...................................................................................................... 24 2.1 Abstract ............................................................................................................... 24 2.2 Introduction ........................................................................................................ 25 2.3 Methods ............................................................................................................... 28 2.3.1 Article Collection .......................................................................................... 28 2.3.2 Coding ........................................................................................................... 28 2.3.3 Measures ....................................................................................................... 29 2.3.4 Data analytic plan ......................................................................................... 30 2.4 Results ................................................................................................................. 31 2.5 Discussion ............................................................................................................ 32 2.6 Limitations .......................................................................................................... 35 2.7 Final Conclusions ............................................................................................... 35 2.8 References ........................................................................................................... 36