Time does not heal all wounds: a longitudinal study of memory biases in social phobia

Research into social phobia over the last 20 years has revealed the presence of information processing biases that involve attention and evaluation processes. However memory biases have been poorly studied and results are equivocal. In addition, very few studies have assessed whether memories of an event remain stable over time, or whether biases change significantly as time progresses. In Study 1, twenty five persons with social phobia and 16 controls completed a clinical interview, Social Phobia Scale, Social Interaction Anxiety scale, Depression and Anxiety and Stress scale, Brief Fear of Negative Evaluation Scale, and the Memory of Anxious Events Questionnaire designed to determine whether memory for events changed over time. The Memory of Anxious Events Questionnaire examined one\u27s recall of an anxiety event that the subjects actually experienced, and the evaluation of this event occurred at initial assessment, two weeks, and one month after initial presentation. The results indicated that time had a differential effect on the two groups. Over time, negative evaluative ratings of the anxiety event, both in global terms as well as in specific social evaluative terms, significantly reduced for the control group, but not for the social phobia group. Levels of distress followed a similar pattern. The degree of memory bias was related to the severity of psychopathology associated with social anxiety rather than to general psychopathology (anxiety and depression), suggesting the possibility that these biases were specific to social phobia. Participants in Study 2 included a social phobia group (SP) (n=15), an anxious control group (n=15), and a normal control group (n=17). Study 2 also included two schema congruent written scenarios for both social phobia and generalized anxiety disorder, in order to ascertain if persons with social phobia would also show memory biases in a scenario they could relate to, compared to an anxious control group suffering from generalized anxiety disorder. The results for Study 2 were similar to that of Study 1, with persons with social phobia reporting significantly more distress over anxious events than controls, and significantly different distress levels one month later. In addition, persons with social phobia recalled events more negatively over time compared to controls, as shown by a significant time by evaluation type by group interaction, with an increase from time one to time two on others\u27 evaluation of behaviour items. The results from the schema congruent scenarios indicated that persons with social phobia reported more negative general memory biases for both social phobia and generalized anxiety scenarios than the other two groups. They also reported more social evaluative biases for both scenarios compared to normal controls, and recalled more negative and fewer positive items on both scenarios than either of the control groups. These results further ratify the results from Study 1 and strongly suggest the existence of memory biases in social phobia. The theoretical implications of both studies to social phobia are discussed, together with recommendations for therapeutic interventions