Catastrophic imagery in social anxiety
Pilot Study of Examining and Targeting Negative ‘Flashforward’ Imagery in Children and Adolescents with Social Anxiety Disorder
In this study, we mapped catastrophic images of adolescents with social anxiety, and we evaluated whether changing these images with treatment (EMDR) helps.
Background
If you suffer from social anxiety, you are often afraid when you are together with other people or when you do something in front of other people. It seems like you have catastrophic images in your head of what could happen. In this study, we examined what kind of images adolescents with social anxiety experience when they are afraid. We also examined whether a short treatment helps adolescents to experience less aversive catastrophic images, and thereby become less afraid.
The results
• Six out of the seven assessed adolescents with social anxiety reported negative ‘flashforward’ images in certain social situations.
• Five out of the six adolescents showed improvements in anxiety symptoms and avoidance related to the feared social situations, after receiving the three EMDR flashforward sessions.
• The EMDR sessions were mostly followed by reduced negative images.
• Adolescents did not drop out during sessions and rated EMDR generally positively.
What do these results mean for practice?
The results of this research study increase our understanding of what kind of images adolescents with social anxiety experience when they are afraid, and if ‘EMDR flashforward’ treatment helps adolescents to become less afraid. This enables us to improve treatment.
The research study
In this study, together with the adolescent we mapped social situations that he or she fears. The adolescents and their parents filled out questionnaires, considering anxiety amongst other things, at three subsequent time points; one time before and two times after the short treatment. The adolescents were also interviewed on their (catastrophic) imagery at those three time points.
The short treatment that the adolescents received, consisted of three sessions of ‘EMDR flashforward’. The ‘EMDR flashforward’ treatment targets the catastrophic images (images of potential catastrophe, such as being laughed at or looking odd). The treatment aims to make the catastrophic images that the adolescents may experience in social situations less aversive, and thereby to become less afraid and more ready to enter the social situation.