Experiencing an anxiety-provoking social situation from another person’s perspective — through a role reversal task — helps people with social anxiety disorder correct their negative beliefs about being judged by others. These findings come from a new study published in the Journal of Behavior Therapy and Experimental Psychiatry.
A key feature of social anxiety disorder (SAD) is the endorsement of negative beliefs about one’s social abilities. For example, people with SAD tend to exaggerate the extent that they are negatively perceived by others and to believe that the consequences of these negative judgments are worse than they actually are. Study authors Hanieh Abeditehrani and her colleagues say that negative cognitions play a major role in the maintenance of SAD and reducing these beliefs is crucial for effective treatment.
One way to address negative cognitions is to face them through role-playing, by acting out a social interaction with a therapist. Taking it one step further, Abeditehrani and her team wanted to explore the effects of role reversal — acting out an interaction but switching roles with another person. The researchers proposed that by observing themselves from another person’s perspective, people with SAD might be able to correct their distorted self-images.
A total of 36 adults with SAD were asked to think of a social situation where they feel they would be negatively judged by another person. The participants were then asked to list their negative beliefs about how the other person would judge their social performance. Half of the group were then assigned to role-play the situation with a confederate over two sessions. The other half were assigned to role-play the situation a single time and then to act out the situation a second time with the roles reversed. During the role reversal, the confederate played the part of the participant, mimicking the participant’s anxious behavior from the first session.
At the beginning of the study, and in between each role-playing session, the participants rated the believability of each of the negative cognitions they had listed. They also rated how probable and costly it would be to be judged negatively in this situation.
Overall, both conditions were found to weaken participants’ negative self-beliefs. However, the role reversal condition stood out.
Participants who took part in two role-playing sessions rated their negative cognitions as less believable after the first role-playing session and negative judgment as less probable. However, these ratings did not drop any lower after the second session. On the other hand, those who participated in both role-playing and role reversal rated their negative self-beliefs as less believable and negative judgment as less probable and costly with each session. These findings suggest that the combination of role-playing and role reversal was more effective at reducing negative self-cognitions than two sessions of role-playing.
Previous research suggests that people with social anxiety tend to view social situations from the perspectives of other people, over-focusing on how others will judge them. The role reversal scenario allowed the patients with SAD to step into the observer’s perspective and witness their behavior as played by the confederate. The exercise likely offered them a new outlook on their social behavior, challenging their negative beliefs and, ultimately, reducing them.
The study design came with a notable limitation — there was no control condition. This meant that researchers could not assess for any effects due to the passage of time between the two sessions. Nonetheless, the findings offer promising evidence that role reversal can effectively reduce the negative self-beliefs that are characteristic of SAD and may be an appropriate addition to therapy.
The study, “Beneficial Effects of Role Reversal in Comparison to role-playing on negative cognitions about Other’s Judgments for Social Anxiety Disorder”, was authored by Hanieh Abeditehrani, Corine Dijk, Mohsen Dehghani Neyshabouri, and Arnoud Arntz.
