An extremely common psychological disorder, social anxiety in its clinical form involves extreme distress and impairment due to fear of being judged negatively by others. Even more prevalent are the symptoms of social anxiety, which can strike anyone at any time.
Perhaps you’ve felt highly self-conscious when standing up to speak in a neighborhood town hall, or you choked when answering a question in front of your boss because you were so frightened of being wrong. Even if you’ve never experienced these situations, you’ve undoubtedly seen a child freeze up while performing a solo at a recital. Having experienced such an emotionally trying situation, you begin to fear not just the situation, but the possibility of its repeating itself.
Diagnosing and treating social anxiety disorder is a process best left to the experts. However, it’s still possible to ascertain whether you, or someone close to you, can both detect and manage the symptoms of social anxiety. Ryerson University’s Meagan MacKenzie and colleagues (2017) developed an 8-item scale to assess not merely social anxiety’s symptoms but, in their view, the more important question of how people respond when their social anxiety is triggered. Their study on the Social Anxiety—Acceptance and Action Questionnaire (SA-AAQ) is based on the premise that it’s not enough to use the traditional cognitive-behavioral approach (known as CBT) to treat symptoms of social anxiety. Instead, people who experience the disorder, or its symptoms, can best be treated by learning how to accept these feelings and decide on their own how they wish to handle them, a process known as Acceptance and Commitment Therapy (ACT).
Thinking back on your own experiences, recall what happened when other people tried to talk you down out of your socially anxious moments, but to no avail. They’ve explained that the feelings aren’t rational, and tried to help you reinterpret a potentially anxiety-provoking situation (speaking in front of a small gathering) as a great opportunity to put your point of view across. Instead, based on ACT, you wouldn’t necessarily try to reinterpret the situation so it provokes less anxiety, but you would accept the fact that you feel anxious, determine whether it’s important for you to change these feelings, and then commit to a plan of action to change if you decide that you want to do so.
ACT is a variant of CBT, but as researchers are finding out, it can serve to help people who still feel dissatisfied with the fact that they continue to experience symptoms. Paradoxically, accepting the feelings of anxiety you have may make it easier for you to change them, as is claimed by ACT advocates. MacKenzie et al. wished to use an existing tool to measure what they call “experiential avoidance, or lack of acceptance, of thoughts and feelings” (p. 342). The version of the Acceptance and Action Questionnaire they began with had shown some promise as a tool to assess whether people show this lack of acceptance, but it had some notable shortcomings from a statistical point of view. Further, it was a general questionnaire not pegged to a particular set of concerns, and so had to be adapted to specific types of symptoms. One of these, used to measure social anxiety, was translated into a number of languages and seemed to work quite well, but analysis showed that it could be improved by shortening the length, to decrease the number of questions respondents must answer, and to make it more feasible for therapists to administer the questionnaire several times over the course of treatment.
Across two studies, one with an undergraduate sample and the other with a clinical sample, the Canadian researchers found that they could indeed improve the SA-AAQ by reducing it from 19 items to 8. In the sample of individuals diagnosed with social anxiety disorder, the brief SA-AAQ (B-SA-AAQ) related, as expected, to well-established clinical inventories of depression, rumination (the tendency to brood over your symptoms), emotion regulation, mindfulness, and severity of social anxiety symptoms. Within the B-SA-AAQ, half of the items measure acceptance and half measure action; both of these together show, then, whether you try to fight your feelings of anxiety and then try to commit to a plan to change, should these feelings make you unhappy.
Let’s take a look now at the eight items on the brief version of the social anxiety questionnaire. Rate yourself (or try to rate someone you care about) on a 1 to 7 scale of never true (1) to always true (7).
The instructions are stated here:
Social anxiety is the type of anxiety that is experienced when you are in situations where you may be observed, judged, or evaluated by others. People vary in the amount of social anxiety they experience, but most people experience at least some social anxiety in at least a few situations. Common situations that provoke social anxiety include giving a presentation or speech, attending a job interview, going to a party, meeting new people, and going on a blind date. Please think about the anxiety you may experience when you are in these types of situations while you answer the questions below:
1. Being socially anxious makes it difficult for me to live a life I value.
2. I tell myself I shouldn’t have certain thoughts about social anxiety.
3. I would gladly sacrifice important things in my life to be able to stop being socially anxious.
4. I criticize myself for having irrational or inappropriate social anxiety.
5. My social anxiety must decrease before I can take important steps in my life.
6. I make judgments about whether my thoughts about my social anxiety are good or bad.
7. My social anxiety does not interfere with the way I want to live my life.
8. I disapprove of myself when I feel socially anxious.
The odd-numbered items reflect the action component, and the even-numbered items reflect acceptance. For all but number 7 (which is reverse scored), a rating close to 7 suggests that you are indeed trying to resist acknowledging your feelings of social anxiety. If you’re scoring close to 7’s on the odd numbered items, it means that you’re ready to commit to reducing these feelings.
One of the advantages of the B-SA-AAQ from the standpoint of dealing with common situations like a blind date or going to a party is that the questions are tied to behavior but also are linked to specific feelings: You can think about how you feel in those situations and then analyze those feelings accordingly. Participants in the college sample study averaged between about 4.5 and 5 out of 7 on each of the items, signifying that they were handling their feelings of social anxiety reasonably well (i.e., they accepted their feelings and were committed to changing them). In the clinical sample, though, all scores were consistently lower; if you’re scoring around 2.5 to 3.5, you may be someone who could benefit from treatment.
The fundamental premise of ACT is that you don’t try to squash your feelings but are able to notice and accept them while committing yourself to a path toward change. ACT’s approach is one that you can apply to a variety of psychological issues, allowing you to fulfill your own potential in a way consistent with your values and goals.
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Copyright Susan Krauss Whitbourne 2017
MacKenzie, M. B., Kocovski, N. L., Blackie, R. A., Carrique, L. C., Fleming, J. E., & Antony, M. M. (2017). Development of a brief version of the Social Anxiety – Acceptance and Action Questionnaire. Journal of Psychopathology And Behavioral Assessment, 39(2), 342-354. doi:10.1007/s10862-016-9585-3