The role of mindfulness in social anxiety in people living with visible skin conditions

The research reported in this thesis examined social anxiety in people with visible skin conditions to identify potential targets for intervention. Mindfulness refers to the tendency to pay attention to the present and cultivates a non-judgmental attitude towards experiences. Disengaging from negative patterns of thinking by paying attention to the present, could target rumination which maintains social anxiety. The findings of Study 1, an interpretative phenomenological analysis (N=10) indicated that social anxiety in people living with visible skin conditions arises as a result of an interaction between negative self-appraisals, fear of negative evaluation and previous reactions of others. Targeting this evaluative process using mindfulness techniques could be beneficial in reducing social anxiety; therefore, Study 2 examined the relationship between mindfulness and psychosocial distress in people with visible skin conditions (N=120). Mindfulness explained 41% of the variance in social anxiety, after controlling for subjective severity. These findings suggest that increasing mindfulness, particularly awareness, and non-judgment of inner experience could reduce social anxiety. To examine the potential of mindfulness interventions to reduce social anxiety, a systematic review was conducted. Findings highlighted that mindfulness is effective in reducing social anxiety. Potential mechanisms for the effects of mindfulness include reduced reactivity to negative self-referential information and increased attentional control. Study 3 tested the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) for social anxiety in people with visible skin conditions. A multiple baseline single case series was used to examine individual change profiles over time. Reliable and/or clinically significant reductions in social anxiety and at least one other area of psychosocial distress were reported by treatment completers (N = 7). The findings suggest that MBCT is a promising intervention for social anxiety in dermatology patients, and further research is warranted. Feasibility studies may provide important information regarding recruitment and attrition when considering randomised control trials