Social Rejection in SAD

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Social rejection in social anxiety disorder:The role of performance deficits, evokednegative emotions and dissimilarity

Marisol J. Voncken1*, Lynn E. Alden2, Susan M. Bogels3

and Jeffrey Roelofs1

1Maastricht University, Maastricht, The Netherlands2University of British Columbia, Vancouver, British Columbia, Canada3University of Amsterdam, Amsterdam, The Netherlands

Objectives. Patients with social anxiety disorder (SAD) not only fear socialrejection, but accumulating evidence also shows that they are indeed less liked thantheir non-anxious counterparts. Three factors are hypothesized to play a role in thissocial anxiety–social rejection relationship: (1) social performance; (2) elicited negativeemotions, and (3) perceived similarity.

Method. PatientswithSAD (N ¼ 63) and control participants (N ¼ 27) were observedduring a 5 minutes ‘getting acquainted’ conversation with a male and female confederatewho rated their social performance. Video-observers rated their own negative emotionsand perceived similarity with the patients, while other video-observers rated their wish toengage in future contact with them (a measure of social rejection).

Results. Analysed by way of structural equation modelling (SEM), the resultssupported the social anxiety–social rejection relationship. More specifically, poor socialperformance was associated with perceived dissimilarity ratings and mediated byevoked negative emotions, both of which were in turn associated with social rejection.

Conclusion. These results suggest that a sequence of events links social anxiety tosocial rejection. Treatment should aim to improve social performance and perceivedsimilarity to reverse SAD’s vicious, negative interpersonal cycle.

A core feature of people with social anxiety disorder (SAD) is fear of negative evaluationin social interactions. Cognitive models of SAD emphasize that distorted interpretations

of social interactions lead people with SAD to believe that others evaluate them

negatively (Clark, 2001; Rapee & Heimberg, 1997). But are these interpretations indeed

inaccurate? Research suggests that socially anxious individuals in fact evoke negative

responses in others. For example, they have been judged by independent raters as less

* Correspondence should be addressed to Marisol J. Voncken, Clinical Psychological Science, Maastricht University, Maastricht6200 MD, The Netherlands (e-mail: [email protected]).

TheBritishPsychologicalSociety

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British Journal of Clinical Psychology (2008), 47, 439–450

q 2008 The British Psychological Society

www.bpsjournals.co.uk

DOI:10.1348/014466508X334745


likeable and less comfortable to be around (Meleshko & Alden, 1993); less friendly,

assertive, relaxed, and attractive ( Jones & Russell, 1982; Pilkonis, 1977); and moodier,

more sensitive to demands, more self-pitying, and lacking meaning in life (Creed &

Funder, 1998) than their non-anxious counterparts. This pattern has also emerged in

SAD patients, who were viewed as less warm, interested, and likeable by their partners

in social interaction compared to non-SAD controls (Alden & Wallace, 1995).If others indeed have negative views of socially anxious people, it may be that

individuals with SAD actually experience more social rejection than their non-socially

anxious counterparts. These negative social outcomes could be a powerful reinforcing

factor in SAD: both interpersonal and cognitive models suggest that people with SAD

establish negative interpersonal cycles that help maintain their social anxiety (Alden &

Taylor, 2004; Clark, 2001; Rapee & Heimberg, 1997).

A number of variables have been proposed as playing a role in the relationship

between social anxiety and social rejection. First, growing evidence shows thatindependent raters judge people with social anxiety as less socially skilled than their

non-socially anxious counterparts. This pattern is found in both non-clinical (e.g. Beidel,

Turner, & Dancu, 1985; Bogels, Rijsemus, & De Jong, 2002; Lewin, McNeil, & Lipson,

1996; Thompson & Rapee, 2002) and clinical samples (Baker & Edelmann, 2002;

Fydrich, Chambless, Perry, Buergener, & Beazley, 1998; Stopa & Clark, 1993; Voncken &

Bogels, in press). According to the cognitive model of SAD, social performance

problems might reflect the effects of in-situation safety behaviours (Clark, 2001) such as

avoiding eye-contact to protect oneself from seeing others’ negative reactions, givingshort answers to avoid saying something foolish, or talking too much to avoid being

regarded as boring. These behaviours are intended to avoid conveying a negative

impression and forestall negative outcomes; however, they are assumed to disturb social

interactions and lead to rejection (Clark, 2001; Leary & Kowalski, 1995). Moreover,

problematic social behaviours may produce negative emotions in others that contribute

to social rejection. Coyne (1976) demonstrated that people who had a 5-minutes phone

call with a depressed patient subsequently felt significantly more depressed, anxious,

hostile, and rejecting, a process referred to as emotional contagion. Since depressionand social anxiety are closely related (Brunello et al., 2000; Chartier, Walker, & Stein,

2003), it seems reasonable to suggest that the same process might occur in SAD.

Poor social performance might not only evoke negative emotions; the associated

behaviours may also lead others to perceive people with SAD as less similar to themselves.

According to the well-established similarity-attraction theory, we tend to form relationships

with people who we perceive to be similar to us (e.g. Byrne, 1971, 1997). Byrne showed

that this holds even when strangers meet. Socially awkward behaviours might cause others

to view people with SAD as dissimilar and lead to social rejection. Empirical evidence for therelationship between poor social performance and (dis)similarity has been found in a study

by Papsdorf and Alden (1998). More specifically, this study examined participants engaged

in a self-disclosure reciprocity task with a confederate. Results showed that overt signs of

social anxiety were inversely correlated with confederate and observers’ judgments of

similaritybetween themselves and the participant.Moreover, feelings of similarity predicted

willingness to engage in future social contact with participants (Papsdorf & Alden, 1998).

Taken together, poor social performance, evoked negative emotions, and perceived

(dis)similarity may explain the link between social anxiety and social rejection. To ourknowledge, these variables have not yet been examined simultaneously. The purpose of

this study was to evaluate a model of the social anxiety–social rejection relationship that

included the abovementioned variables. Drawing on previous findings we hypothesized

440 Marisol J. Voncken et al.


that social anxiety would be associated with problematic social performance, which in

turn would evoke negative emotions and reduce feelings of similarity in others. We also

hypothesized that both evoked negative emotion and feelings of dissimilarity would

then contribute to social rejection. The proposed model can be seen in Figure 1.

Method

ParticipantsPeople with SAD (N ¼ 63) were recruited from the ambulant community mental health

centre of Maastricht, The Netherlands. All were referred by their general practitionerand assessed before they entered treatment. Diagnostic status was determined with the

structured clinical interview for DSM-IV axis I disorders (SCID-I; First, Spitzer, Gibbon, &

Williams, 1996). Of the 88 patients asked to participate in this study, 64 (73%) agreed.

Reasons for refusing to participate were: confidentiality (N ¼ 5) (as they were students

or employees at Maastricht University); time investment (N ¼ 7); and anxiety (N ¼ 12).

One patient, overwhelmed by anxiety, dropped out during the assessment.

All patients suffered from the generalized subtype of SAD. Of the total, 44 (70%)

suffered from one or more current or remitted comorbid axis I diagnoses, includingdepressive disorders (N ¼ 41), anxiety disorders (N ¼ 17), substance dependence or

abuse (N ¼ 15), and other disorders (N ¼ 20) such as gambling or binge eating. One or

more personality disorders were diagnosed in 34 patients (54%), of whom 30 suffered

from avoidant personality disorder.

The non-clinical control group consisted of 27 participants, recruited from a general

list of people willing to participate in research, of similar sex, age, and education level to

the clinical group. All were screened by telephone with the SAD and the depression

section of the SCID-I. None of these participants fulfilled diagnostic criteria for eitherSAD or depression.

ProcedureThis study was part of a larger study in which participants were assessed during two

social tasks: a speech and a ‘getting acquainted’ conversation. For the current study only

the data from the conversation were used. The order of the speech and conversationtasks was randomly assigned to participants. Prior to the conversation task, they

received the following instruction:

We would like you to have a conversation with two people. The purpose of the conversationis to get to know each other. It is up to you to start the conversation and to keep theconversation going.

Figure 1. Graphic representation of the hypothesized social anxiety–social rejection model.

Social rejection in SAD 441


The confederates did not know whether the participants were patients or not; the

participants were informed of this and, to keep the confederates blind, were asked

not to talk about treatment or the study itself. After the 5-minute conversation, the

confederates completed the social performance rating scale (the SBA rating scale;

see below).

Confederates and video-ratersThree independent sets of raters (i.e. the confederates and two sets of video-raters) were

used to prevent carry-over effects between the three types of ratings: (1) social

performance; (2) evoked negative emotions and perceived similarity; and (3) social

rejection.

The confederates were trained to rate the social behaviours of the participants.

Three video-raters rated the emotions evoked by the participants and how similar they

felt to the participants. Three other independent video-raters rated the extent to which

they wished to engage in future contact with the participants, which is generallyconsidered to be an index of social rejection.

The confederates were 58 undergraduate students with a mean age of 24 (SD ¼ 2:72,

range 19–31). For each assessment two confederates participated: one male and one

female. All received a 3-hour training programme in which they learnt how to rate social

performance and maintain a consistent and neutral performance across participants.

They were instructed to leave the burden of the conversation with the participant, not

to change the subject, to take the initiative only after the participant was silent for

7 seconds, and to confine their answers to three pieces of information per answer. Theseinstructions were based on prior studies by Boone et al. (1999) and Ost, Jerremalm, and

Johansson (1981).

The video-observers were six undergraduate student research assistants, two men

and four women, between the ages of 18 and 22. They were subdivided into two groups

of one male and two females. Each group rated one half of the participants on social

rejection and the other half on similarity and evoked negative emotions.

Social phobia anxiety inventoryAll participants completed the social phobia scale of the Dutch version of the socialphobia and anxiety inventory (SPAI; Turner, Stanley, Beidel, & Bond, 1989; Dutch

validation by Bogels & Reith, 1999). Bogels and Reith (1999) found the SPAI’s social

phobia subscale to be highly reliable (Cronbach a ¼ :99) and to possess good

discriminative validity.

Social behaviour and anxiety rating scaleThe social behaviour and anxiety rating scale (SBA) is a 27-item scale modelled after

Bogels et al.’s (2002) rating scale, which was in-turn based on an earlier questionnaire

developed by Rapee and Lim (1992). Sample items for the scale are: ‘Did the participantmake eye-contact?’; ‘Was the participant nervous?’; and ‘Did the participant listen to

what you had to say?’ Each item was rated on a 9-point Likert-type scale with a high

score indicating better social performance. The internal consistency of the measure was

excellent (Cronbach a ¼ :94) and the inter-rater reliability for the two confederates on

the SBA rating scale was adequate (ICC ¼ :79, N ¼ 89).



Judgments of similarityThe video-raters assessed perceived similarity with the judgments of similarity scale,

which was adapted from previous research (Papsdorf & Alden, 1998). The scale

comprises three items (‘Was the participant a different kind of person than you?’; ‘Did

the participant act and talk like you?’; and ‘To what extent did the participant seem like

you?’) rated on 7-point Likert-like scales. The measure had high internal consistency,both in earlier research (Papsdorf & Alden, 1998) and in the current study (Coefficient

a ¼ :92). The inter-rater reliability was moderate (ICC ¼ :68, N ¼ 89).

Evoked negative emotionsThere is no psychometrically sound Dutch-language measure for assessing evokedemotions. The best available instrument is the Bockian Transtheoretical Counter-

transference Inventory (BTCI; Bockian, Bernstein, & Rusten, unpublished). In the BTCI,

video-raters use 5-point Likert-like scales (from 1, ‘the participant did not make me feel

this way at all’ to 5, ‘the participant really made me feel this way’) to rate the emotions

they experience while watching a video of a participant. The original BTCI items assess

48 emotions (Bockian et al., unpublished).1 Nine additional emotions which we believe

to be relevant for social phobia were added for this study. These included seven emotions

that had been excluded in a previous factor analysis by Bockian and colleagues(i.e. ashamed, embarrassed by, embarrassed for, curious, bored, amused, and responsible)

and two that were added by the current investigators (i.e. uncomfortable and

medelijden, which can be translated from Dutch as ‘pity’). Factor analysis of the entire

item set revealed a single factor solution that reflected a theme of positive versus negative

emotions.2 To derive a total score, the positive emotion items were reversed and a

mean was calculated across all ratings. The internal consistency of the resulting measure

was good (Cronbach a ¼ :94), as was inter-rater reliability (ICC ¼ :83, N ¼ 89).

Social rejectionSocial rejection was assessed by the desire for future interaction scale (DFI; Coyne,

1976). The DFI comprises eight items rated on 5-point Likert-type scales that measure

the extent to which the rater wishes to engage in future social activities with the

participant (sample items: ‘Would you like to spend time with the participant?’; ‘Would

you like to share a 3-hour bus ride with the participant?’; ‘Would you invite theparticipant to visit you?’). The DFI is a well-established questionnaire that is generally

interpreted as a measure of social rejection or liking. It has been shown to be highly

reliable (e.g. Boswell & Murray, 1981; Papsdorf & Alden, 1998; Winer, Bonner, Blaney, &

Murray, 1981); in this study, both internal consistency (Cronbach a ¼ :94) and inter-

rater reliability were high (ICC ¼ :94, N ¼ 89).

Data analysesThe Statistical Package for Social Sciences (SPSS version 13.0) was used for computing

descriptive statistics and carrying out t tests (i.e. to explore group differences on the

1 In the current study, the BTCI’s two somatic subscales (extremities and torso) were eliminated, as we were only interested inevoked emotions.2 More detailed information concerning the performed factor analysis can be requested via the first author.



questionnaire scores). LISREL (Joreskog & Sorbom, 1999; version 8.54) was used for SEM

to evaluate the goodness-of-fit of the proposed model (see Figure 1). LISREL provides a

series of fit indices that allow for an estimation of how well the specified model fits to the

data: (a) minimum fit function chi-squared; (b) root mean square error of approximation

(RMSEA); (c) the comparative fit index (CFI); and (d) the non-normed fit index (NNFI). The

minimum fit function chi-squared represents the distance between the specified modeland the saturated model (in which the maximum number of parameters is estimated).

The chi-squared value should be non-significant, indicating that the model does not differ

significantly from the saturated model. For the RMSEA, values below.05 or lower indicate a

close fit, whereas values up to .08 represent reasonable errors of approximation. For the

CFI and NNFI, values above .90 indicate a good fit, whereas values above .95 indicate a very

good fit. In cases where the model showed an inadequate fit to the data, modifi-

cation indices provided by LISREL were inspected. These indices provide information

on changes that can be made to the model in order to obtain a good fit to the data.

Results

General findingsTable 1 presents the mean and standard deviations for the total, SAD, and normal

control groups on the demographic and dependent variables. A chi-squared analysis

(sex) and ANOVAs (age, education) were used to compare the SAD and the normal

control group on demographic characteristics. No significant differences emerged.

Independent t tests revealed that, as expected, the SAD group obtained significantly

higher SPAI scores than the non-clinical control group: tð87Þ ¼ 10:2, p , :001. The

t tests also indicated that the SAD group evoked significantly more negative emotions,

tð87Þ ¼ 2:6, p , :01, and obtained lower social performance ratings than the control

group, tð87Þ ¼ 3:1, p , :005. Although the SAD group obtained a higher rating on social

rejection than the controls, this difference only approached significance, tð87Þ ¼ 1:7,p ¼ :09. No difference between the groups was found on similarity ratings. Table 2

presents the correlations between the five dependent variables for the total, SAD, and

normal control groups.

Table 1. Descriptive statistics of independent and dependent measures

MeasureTotal group(N ¼ 89)

Normal controls(N ¼ 26)

SAD group(N ¼ 63)

Age 32.2 (10.1) 33.0 (11.8) 31.8 (9.4)Sex (% male) 52% 46% 54%Level of education 8.00 (2.11) 7.88 (1.77) 8.03 (2.25)SPAI-social phobia 107.2 (44.1) 56.9 (29.1) 127.9 (30.3)*Social performance behaviour 6.57 (1.09) 7.11 (0.92) 6.35 (1.08)*Similarity 2.50 (0.96) 2.69 (0.89) 2.41 (0.98)Evoked negative emotions 2.31 (0.36) 2.17 (0.32) 2.38 (0.36)*Social rejection 2.99 (0.77) 3.21 (0.66) 2.90 (0.80)†

*Difference between the normal control and the SAD group are significant at p , :05 (two-tailed).†Difference between the normal control and the SAD group are borderline significant at p , :10(two-tailed).



Structural equation modellingSEM analyses were conducted to evaluate the proposed model. The resulting statistics

indicated an absence of fit between the model and the data x2ð5; N ¼ 89Þ ¼ 57:1,

p , :01, RMSEA ¼ :31, CFI ¼ :78, NNFI ¼ :56. See Figure 2 for the strength of

associations in the model. The modification indices provided by LISREL indicated that

the model fit would be improved by adding a path from negatively evoked emotions to

(dis)similarity and deleting the path from social performance to (dis)similarity. These

modifications resulted in a model with a reasonable to good fit: x2ð5; N ¼ 89Þ ¼ 9:6,

p ¼ :09, RMSEA ¼ :096, CFI ¼ :98, NNFI ¼ :96. Figure 3 presents a graphical

representation of the final model.

Although we did not have a priori expectations that the model would fit differently

in both samples, we did test the model in the SAD sample (N ¼ 66) but not the normal

control sample due to its small sample size. The results indicated that the final model

provided an excellent fit to the data in the SAD sample: x2ð5; N ¼ 63Þ ¼ 6:7, p ¼ :25,

RMSEA ¼ :054, CFI ¼ :99, NNFI ¼ :98.

Table 2. Correlations between independent and dependent measures for the total group (SAD

patients and normal controls combined), the SAD patients alone and the normal controls alone

Social performance SimilarityEvoked negative

emotions Social rejection

SPAI-social phobiaTotal group (N ¼ 89) 2 .43** 2 .30** .37** .38**SAD patients (N ¼ 63) 2 .23† 2 .33** .27* .35**Normal controls (N ¼ 26) 2 .51** 2 .24 .23 .47*

Social performanceTotal group (N ¼ 89) .60** 2 .66** 2 .60**SAD patients (N ¼ 63) .58** 2 .66** 2 .57**Normal controls (N ¼ 26) .62** 2 .51** 2 .61**

SimilarityTotal group (N ¼ 89) 2 .79** 2 .76**SAD patients (N ¼ 63) 2 .80** 2 .77**Normal controls (N ¼ 26) 2 .77** 2 .73**

Evoked negative emotionsTotal group (N ¼ 89) .74**SAD patients (N ¼ 63) .77**Normal controls (N ¼ 26) .60**

†p , :10; *p , :05; **p , :01.

Figure 2. Observed associations of the hypothesized social anxiety–social rejection model.



To investigate whether the relationship between social performance and similarity

was mediated by evoked negative emotions, we ran post hoc regression analyses

following the procedures recommended by Baron and Kenny (1986). In these analyses,

similarity was the dependent variable, and either social performance alone or both

social performance and evoked negative emotions were independent variables. Sobel’s

t test showed that for the total group (SAD and normal control samples combined), as

well as for the SAD sample alone, evoked emotions did indeed mediate the relationship

between social performance and similarity (whole group: t ¼ 5:71, p , :001; SADgroup: t ¼ 4:95, p , :001).

Discussion

The results of this study supported the social anxiety–social rejection relationship found

in previous work (Alden & Wallace, 1995; Creed & Funder, 1998; Jones & Russell, 1982;

Meleshko & Alden, 1993; Pilkonis, 1977). Thus, not only do patients with SAD fear social

rejection, but others actually do tend to reject them. Our primary goal, however, was to

gain insight into the negative link between social anxiety and social rejection. To do this,we evaluated a hypothesized model of the links between social anxiety, social

performance, evoked negative emotions, perceived similarity, and social rejection.

Although the original model did not provide an adequate fit to the data, two changes

suggested by the modification indices resulted in a revised model that had a very good

fit, both in the total sample and in the SAD group alone.

The results showed that, as predicted, social anxiety was associated with worse

social performance as rated by participants’ conversation partners (i.e. the

confederates). Also as predicted, poor social performance was associated with lowerperceived similarity ratings by the video-observers. However, two changes to the

proposed model were required to provide an adequate fit. Instead of a direct association

between poor social performance and dissimilarity, the adjusted model showed that this

relationship was mediated by evoked negative emotions. Apparently the emotions

evoked by the participants were stronger determinants of perceived similarity than their

social behaviour alone. Lower similarity and higher evoked negative emotions were in

turn associated with social rejection.

It is informative to consider the various links in the observed model from atheoretical perspective. In line with the well-established similarity-attraction theory

(Byrne, 1971, 1997), our study demonstrated that the extent to which we feel similar to

others predicts whether we like or reject them. Interestingly, this effect emerged even

when similarity and rejection were rated by different observers, a procedure used to

Figure 3. Observed pathways and strength of associations in the final social anxiety–social rejection

model.



prevent carry-over effects between these judgments. Also consistent with the proposed

model was the finding that evoked negative emotions predicted social rejection: people

were more likely to reject participants who elicited negative emotional reactions.

It should be noted, however, that the measure of evoked emotions used here combined

a variety of different emotion types. Although beyond the scope of this study, it would

be interesting to determine precisely which kinds of emotions are evoked by sociallyanxious individuals, and whether social rejection is mediated by the absence of positive

or the presence of negative emotions.

Earlier work by Papsdorf and Alden (1998) indicated that people use overt anxiety

symptoms (i.e. behavioural signs of anxiety) to determine whether they feel similar to

others. That, too, was our prediction here. The current results qualify the earlier finding

in that the relationship between social performance and perceived similarity was

mediated by evoked emotions. Thus, poor social performance evoked negative

emotions in the observers and led them to perceive participants as dissimilar tothemselves. It should be noted that Papsdorf and Alden (1998) only measured overt

signs of anxiety, whereas in this study, the social performance ratings combined overt

anxiety symptoms with other social behaviours such as eye-contact and ability to ask

questions. Results from our research laboratory suggest that overt signs of anxiety and

social behaviour in SAD patients are intertwined (Voncken & Bogels, in press). Those

results and the present findings indicate that there is no need to distinguish overt signs

of anxiety and other social behaviours when studying social performance problems in

social anxiety.In line with other studies, social anxiety was associated with poorer social

performance (e.g. Baker & Edelmann, 2002; Fydrich et al., 1998; Stopa & Clark, 1993).

We can speculate about the factors that explain this relationship. One likely explanation

is that the use of safety behaviours or self-protective strategies by socially anxious

people disrupts their social performance (Clark, 2001; Leary & Kowalski, 1995). Self-

focused attention has shown to have this negative effect as well (Bogels & Mansell,

2004). A third explanation is that socially anxious people lack social skills: they have

failed to learn the skills (such as self-disclosure) necessary to develop close relationships(see review by Alden & Taylor, 2004). As poor social performance appears to be an

important contributor to rejection of SAD patients, further studies are needed to unravel

these possibilities.

The treatment implications of these findings are twofold. First, the social

performance of SAD patients is the first factor in the process of social rejection.

Therefore, interventions that enhance performance could lead to greater social

acceptance. Possible ways to accomplish this are to reduce self-focused attention

(Bogels, 2006) and safety behaviours (Alden & Bieling, 1998; Clark, 2001; Wells, 1997),or teach specific social skills, such as self-disclosure (Collins & Miller, 1994). Second,

SAD patients should be encouraged to seek out people with similar characteristics and

interests. According to the attraction-similarity principle, this will increase the

likelihood of others responding positively to them. Moreover, SAD patients tend to focus

on dissimilarities (e.g. ‘I am more stupid than others’) rather than shared characteristics.

It may therefore be useful to help them identify similarities between themselves and

others, and to draw on those similarities in their social interactions.

This study has several limitations. First, it relied on a laboratory ‘getting acquainted’conversation; the extent to which the observed model generalizes to real-life-situations

is yet to be determined. Second, the cross-sectional design makes it impossible to draw

conclusions on cause–effect relationships. Third, one may argue that the sample size in



this study was somewhat small for SEM. In particular, a small sample may reduce

statistical power, resulting in a model having an inappropriate fit. The fit in our study,

however, was reasonable to good, indicating that the small sample size may not be

problematic. Fourth, we investigated social anxiety alone, but our findings may reflect

processes shared by other types of psychopathology – for example, SAD patients often

experience comorbid depressive symptoms. As discussed earlier, Coyne (1976)demonstrated that depressed patients evoke more negative social reactions than non-

depressed people. Although we did not expect a priori that the strength of the

associations in our model would differ for patients with or without comorbid

depression, the role of depression in these relationships requires further study. Finally,

observers rated a range of evoked emotions, from joy to fear and compassion to

depression. More work is needed to determine whether the nature of the evoked

emotional reaction is important to these relationships.

In summary, these results suggest that a sequence of events links social anxiety tosocial rejection. Further research to identify strategies that reverse these processes may

provide information that could help people with SAD develop more satisfying social

relationships.

Acknowledgements

This research was supported by a grant from The Netherlands Organization for Scientific Research

(NWO: 015.000.069). We would like to thank the experimenters Serife Alakir, Eline Smit, Anja

Hendriks, Saskia Nijst, Eshter Binnendijk, and Martine Smeets, the video-raters and the research

assistants of the DAC, especially Thamare van Roosmalen, Philippe Jacques, and Esin Demir. Our

gratefulness goes out to all the patients that were willing to participate in this anxiety provoking

study and to all the confederates. Moreover, we would like to thank all the therapists of the anxiety

programme at the RIAGG Maastricht, especially Guido Sijbers, Stefanie Duijvis, Rene Albers, and

Hannie van Genderen.

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Received 21 September 2007; revised version received 27 May 2008


Social Rejection in SAD

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