Emotionsregulationsdefizite bei sozialer Phobie

Zusammenfassung (engl. summary) Many studies have demonstrated positive associations between emotion dysregulation and psychopathological symptoms (Aldao et al., 2010; Chaplin & Cole, 2005; Gross & John, 2003; John & Gross, 2004). However, in case of social anxiety (SA), only few existing results provide us with an idea of the specific emotional dysfunctions of this disorder. People high in SA are less able to describe and express their own emotions, pay less attention to their emotions, have a high rate on the construct of alexithymia, and tend to engage in suppressive strategies and negative post event rumination (Campbell-Sills, Barlow, Brown, & Hofmann, 2006; Edwards, Rapee, & Franklin, 2004; Fukunishi, Kikuchi, Wogan, & Tabuko, 1997; Turk, Luterek, Mennin, & Fresco, 2005; Kashdan & Roberts, 2006; Mennin, McLaughlin, & Flanagan, 2009; Werner, Goldin, Ball, Heimberg, & Gross, 2011). Nevertheless, it remains unclear whether these associations are merely an artifact of overall psychopathology (or rather specific in nature). In addition, anticipatory anxiety is one special form of fear experienced by people with SAD which is obviously hard to overcome for many patients concerned. To date, there are no scientific results on the effectiveness of emotion regulation (ER) strategies for handling anticipatory anxiety in SAD. Within the present dissertation project the first correlative, cross-sectional study investigated whether social anxiety symptoms are predicted by specific ER facets in the normal population. Global ER difficulties (DERS, Gratz & Roemer, 2004), SA symptoms (SPS/SIAS; Mattick & Clarke, 1998), and general psychopathology (SCL-27-plus; Hardt, 2008) were assessed via internet-based self reports. The second, experimental study examined the effects of three emotion regulation strategies (reappraisal, distraction, acceptance) on different indicators of anticipatory anxiety in SAD and healthy participants via an impromptu speech paradigm. For this purpose subjective anxiety and arousal, heart rate and blood pressure were measured at baseline and three time points. Results of the first study showed that general psychopathology declared only marginal amounts of variance of SA symptoms. The non-acceptance of negative emotions and impulse control difficulties were identified as significant predictors for social performance anxiety. For social interaction anxiety, the subjective lack of functional strategies was additionally important. The second study revealed that reappraisal, distraction and acceptance were not differentially effective for regulating subjective anticipatory anxiety as well as its physiological indicators (blood pressure and heart rate). There was no difference in regulation success between healthy and SAD participants. However, the results indicated that the strategies had only short term effects, as blood pressure and subjective arousal increased (again) in the last phase of anticipation. By trend, distraction decreased heart rates most effectively. The present dissertation project revealed that social performance and interaction anxiety are accounted for by specific emotion regulation facets, over and above general psychopathology. A process model is presented as a hypothetical illustration of the maladaptive regulation of social fears. Earlier results on the advantage of certain strategies for handling (social) anxiety could not be supported. Nevertheless, valuable insights could be reached concerning the course of anticipatory anxiety in SAD.