A Cognitive Behavioral Model of Social Anxiety Disorder

This chapter focuses on the original 1997 cognitive behavioral model for social anxiety disorder (SAD), which delineates the processes by which SAIs are affected by their fear of negative evaluation in potentially social-evaluative situations. The original model has provided a solid framework for understanding the factors that comprise and maintain SAD. Since the publication of Rapee and Heimberg (1997), updates are provided in the form of reviews of the literature that support various aspects of the model, applied the model to a case study of a person with SAD, and conducted a comparison between the model and the very influential and productive model proposed by Clark and Wells. Given that there has been over a decade of intervening research, however, there are areas in the model that warrant expansion, as well as additional factors that necessitate inclusion in the model. The chapter presents a revised cognitive behavioral model of SAD and the research supporting these modifications. The chapter's primary focus are five areas: the important role of imagery (and imagery perspective), PEP, the combined cognitive biases hypothesis, fear of positive evaluation (FPE), and the potential role of difficulties in the regulation of emotional responses, including but not limited to anxiety.