Modelling the Relationship Between Cost/Probability Bias, Attention, and Perceived Anxiety Control in Social Anxiety Disorder

In the cognitive-behavioral model of social anxiety disorder, fear of negative evaluation by others, estimated social cost, self-focused attention, and perceived anxiety control are considered the key maintaining components in a social situation. This study examined the relationship between cognitive biases and social anxiety symptoms using a cross-sectional design. All of the 309 participants were Japanese individuals with social anxiety disorder at outpatient medical institutions. The hypothesized model's path analysis was conducted. The models assumed that fear of negative evaluation by others affected the relationship between each cognitive bias and that biases influenced social anxiety symptoms. The best-fit model by path analysis showed that self-focused attention and perceived anxiety control have the influence on cost/probability bias and cost bias highly affected social anxiety symptoms. These results indicate cognitive biases may function to maintain social anxiety symptoms. Hence, a reduction in cost bias can be effective in improving excessive anxiety in social situation.