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Clin Psychol Rev. 2002 Sep;22(7):947-75.

Self-focused attention in social phobia and social anxiety.

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Department of Psychology, University of Southampton, Southampton S017 1BJ, UK.


Self-focused attention is an awareness of self-referent information and is present in many emotional disorders. This review concentrates on the role of self-focused attention in social anxiety with particular reference to the Clark and Wells [Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. R. G. Heimberg, M. Liebowitz, D. A. Hope, & S. Scheier (Eds.), Social phobia: diagnosis, assessment and treatment. New York: Guilford.] model of social phobia. According to Clark and Wells, self-focused attention is an important maintaining factor in the disorder because it increases access to negative thoughts and feelings, can interfere with performance, and prevents the individual from observing external information that might disconfirm his or her fears. Clark and Wells also propose that socially phobic individuals construct a distorted impression of themselves, based on internally generated information, that takes the form of a visual image (often seen from the perspective of an observer) or felt sense. This paper describes the model and then reviews other theories of self-focused attention, and empirical evidence on self-focused attention. Two types of evidence are reviewed: one, studies that have been conducted from a variety of theoretical perspectives that have relevance either to social anxiety in general or to the Clark and Wells model in particular; two, studies that were designed as a direct test of Clark and Wells' predictions. The final section of the review summarizes the conclusions and suggests areas for future examination.

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