E-ISSN : 2733-4538
This study aimed to explore the effects of uncertainty on approach and avoidance behavior in socially anxious individuals, focusing on emotional facial expressions. A total of 409 male and female students completed surveys measuring their levels of social anxiety. The high and low social anxiety groups each comprised 30 participants. Two groups were assigned to uncertain and certain conditions, and the Approach-Avoidance Task (AAT) was administered to measure avoidance and approach to facial expressions. The high social anxiety group showed a lower negative AAT score than the low social anxiety group and a higher positive AAT score for anger expression under certain conditions than uncertain conditions. In addition, the levels of intolerance of uncertainty and social anxiety predicted the levels of avoidance tendency. This study suggests the importance of uncertainty in the study of social anxiety. Clinical implications, limitations of the study, and suggestions for future research are discussed.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publication.
Boelen, P. A., & Reijntjes, A. (2009). Intolerance of uncertainty and social anxiety. Journal of Anxiety Disorders, 23, 130-135.
Bruin, G. O., Rassin, E., & Muris, P. (2006). Worrying in the lab:Does intolerance of uncertainty have predictive value? Behaviour Change, 23, 138-147.
Buhr, K., & Dugas, M. J. (2002). The intolerance of uncertainty scale: psychometric properties of the English version. Behaviour Research and Therapy, 40, 931-945.
Carleton, R. N., Collimore, K. C., & Asmundson, G. J. (2010). It’s not just the judgements—It’s that I don’t know: Intolerance of uncertainty as a predictor of social anxiety. Journal of Anxiety Disorders, 24, 189-195.
Chen, S., Yao, N., & Qian, M. (2018). The influence of uncertainty and intolerance of uncertainty on anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 61, 60-65.
Cho, M. J., & Kim, K. H. (1993). Diagnostic validity of the CES-D (Korean version) in the assessment of DSM-III-R major depression. Journal of Korean Neuropsychiatric Association, 32, 381-399.
Chon, K. K., Choi, S. J., & Yang, B. C. (2001). Integrated adaptation of CES-D in Korea. Korean Journal of Health Psychology, 6, 59-76.
Clark, D. M., & McManus, F. (2002). Information processing in social phobia. Biological Psychiatry, 51, 92-100.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment and treatment. New York, NY: Guildford.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. Social Phobia: Diagnosis, Assessment, and Treatment, 41, 22-23.
Constans, J. I., Penn, D. L., Ihen, G. H., & Hope, D. A. (1999). Interpretive biases for ambiguous stimuli in social anxiety. Behaviour Research and Therapy, 37, 643-651.
Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001). Intolerance of uncertainty and worry: Investigating specificity in a nonclinical sample. Cognitive Therapy and Research, 25, 551-558.
Dugas, M. J., Schwartz, A., & Francis, K. (2004). Intolerance of uncertainty, worry, and depression. Cognitive Therapy and Research, 28, 835-842.
Dugas, M. J., Hedayati, M., Karavidas, A., Buhr, K., Francis, K., &Phillips, N. A. (2005). Intolerance of uncertainty and information processing: Evidence of biased recall and interpretations. Cognitive Therapy and Research, 29, 57-70.
Furnham, A., & Marks, J. (2013). Tolerance of ambiguity: A review of the recent literature. Psychology, 4, 717-728.
Gosselin, P., Ladouceur, R., Morin, C. M., Dugas, M. J., & Baillargeon, L. (2006). Benzodiazepine discontinuation among adults with GAD: A randomized trial of cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 74, 908-919.
Grenier, S., Barrette, A. M., & Ladouceur, R. (2005). Intolerance of uncertainty and intolerance of ambiguity: Similarities and differences. Personality and Individual Differences, 39, 593-600.
Heuer, K., Rinck, M., & Becker, E. S. (2007). Avoidance of emotional facial expressions in social anxiety: The approach–avoidance task. Behaviour Research and Therapy, 45, 2990-3001.
Hezel, D. M., Stewart, S. E., Riemann, B. C., & McNally, R. J. (2019). Standard of proof and intolerance of uncertainty in obsessivecompulsive disorder and social anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 64, 36-44.
Holaway, R. M., Heimberg, R. G., & Coles, M. E. (2006). A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 20, 158-174.
Hui, C., & Zhihui, Y. (2017). Group cognitive behavioral therapy targeting intolerance of uncertainty: A randomized trial for older Chinese adults with generalized anxiety disorder. Aging Mental Health, 21, 1294-1302.
Jang, H. S. (2008). Exploratory study for developmental tasks and beginning time of early adulthood. The Korean Journal of Developmental Psychology, 21, 109-126
Kim, S. H. (2010). The relationship of fear of negative and positive evaluation, intolerance of uncertainty, and social anxiety (master’s thesis). Ewha Womans University, Seoul, Korea.
Kim, H. S. (2001). Memory bias in subtypes of social phobia (master’s thesis). Seoul National University, Seoul, Korea.
Kirschner, H., Hilbert, K., Hoyer, J., Lueken, U., & Beesdo-Baum, K. (2016). Psychophsyiological reactivity during uncertainty and ambiguity processing in high and low worriers. Journal of Behavior Therapy and Experimental Psychiatry, 50, 97-105.
Koerner, N., & Dugas, M. J. (2008). An investigation of appraisals in individuals vulnerable to excessive worry: The role of intolerance of uncertainty. Cognitive Therapy and Research, 32, 619-638.
Kuckertz, J. M., Strege, M. V., & Amir, N. (2017). Intolerance for approach of ambiguity in social anxiety disorder. Cognition and Emotion, 31, 747-754.
Ladouceur, R., Gosselin, P., & Dugas, M. J. (2000). Experimental manipulation of intolerance of uncertainty: A study of a theoretical model of worry. Behaviour Research and Therapy, 38, 933-941.
Mahoney, A. E., & McEvoy, P. M. (2012). Changes in intolerance of uncertainty during cognitive behavior group therapy for social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 43, 849-854.
Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470.
McEvoy, P. M., & Mahoney, A. E. (2012). To be sure, to be sure: intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behavior Therapy, 43, 533-545.
Meeten, F., Dash, S. R., Scarlet, A. L. S., & Davey, G. C. L. (2012). Investigating the effect of intolerance of uncertainty on catastrophic worrying and mood. Behaviour Research and Therapy, 50, 690-698.
Mogg, K., Philippot, P., & Bradley, B. P. (2004). Selective attention to angry faces in clinical social phobia. Journal of Abnormal Psychology, 113, 160.
Mohlman, J., Carmin, C. N., & Price, R. B. (2007). Jumping to interpretations:social anxiety disorder and the identification of emotional facial expressions. Behaviour Research and Therapy, 45, 591-599.
Morriss, J., McSorley, E., & Van Reekum, C. M. (2018). I don’t know where to look: The impact of intolerance of uncertainty on saccades towards non-predictive emotional face distractors. Cognition and Emotion, 32, 953-962.
Noh, H. M. (2016). An effect that emotional processing way on social anxiety in an uncertain situation: Comparison of the effects of reflective pondering and brooding in the rumination (master’s thesis). Keimyung University, Daegu, Korea.
Oglesby, M. E., Stentz, L. A., Portero, A. K., King, S. L., & Schmidt, N. B. (2019). Exaggerated interpretation bias for uncertain information as a predictor of anxiety-related symptoms: A new method of assessment for IU. Journal of Behavior Therapy and Experimental Psychiatry, 64, 64-71.
Park, S. J., Hyun, M. H., Lee, J. H., & Lee, J. A. (2007). Social anxiety and interpretation bias of ambiguous social situations. Korean Journal of Health Psychology, 12, 95-110.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
Reinecke, A., Becker, E. S., Hoyer, J., & Rinck, M. (2010). Generalized implicit fear associations in generalized anxiety disorder. Depression and Anxiety, 27, 252-259.
Riskind, J. H., Tzur, D., Williams, N. L., Mann, B., & Shahar, G. (2007). Short-term predictive effects of the looming cognitive style on anxiety disorder symptoms under restrictive methodological conditions. Behaviour Research and Therapy, 45, 1765-1777.
Roelofs, K., Putman, P., Schouten, S., Lange, W. G., Volman, I., &Rinck, M. (2010). Gaze direction differentially affects avoidance tendencies to happy and angry faces in socially anxious individuals. Behaviour Research and Therapy, 48, 290-294.
Schlenker, B. R., & Leary, M. R. (1982). Social anxiety and self-presentation:A conceptualization model. Psychological Bulletin, 92, 641-669.
Simmons, A., Matthews, S. C., Paulus, M. P., & Stein, M. B. (2008). Intolerance of uncertainty correlates with insula activation during affective ambiguity. Neuroscience Letters, 430, 92-97.
Song, J. S. (2012). Relationships among intolerance of uncertainty, experiential avoidance, and social anxiety in undergraduate students (master’s thesis). Chungbuk National University, Cheong-Ju, Korea.
Yang, H. I. (2015). Approach-avoidance tendency of facial expression in social anxiety (master’s thesis). Keimyung University, Daegu, Korea.
Yang, J. W., Chung, K. M., & Chong, S. C. (2018). Yonsei university facial expressions database. Unpublished raw data.
Yoon, K. L., & Zinbarg, R. E. (2008). Interpreting neutral faces as threatening is a default mode for socially anxious individuals. Journal of Abnormal Psychology, 117, 680-685.