Facilitating public speaking fear reduction by increasing the salience of disconfirmatory evidence

Abstract: The primary objective of the current study was to investigate whether adding videotape feedback procedures to exposure treatment would facilitate public speaking fear reduction. Participants meeting DSM-IV criteria for social phobia were randomized to receive non-pill placebo, exposure without videotape feedback, exposure with audience videotape feedback, or exposure with performance videotape feedback. Assessments were conducted at pretreatment, posttreatment, and 1-month follow-up. Having participants contrast actual audience responses to responses they imagined did not facilitate changes in participants’ predictions about the negative consequences of appearing anxious in front of others, nor did it result in greater anxiety reduction compared to exposure alone. On the other hand, having participants contrast their imagined performance to their actual performance accelerated the speed of improvement in public speaking anxiety. Further, this differential effect appeared to be cognitively mediated. Specifically, the speedier improvement in the performance videotape feedback condition was partially accounted for by changes in participants’ estimates of the likelihood of an anxious appearance when performing in front of others. Follow-up data revealed no differences among the exposure treatment conditions, suggesting that the enhanced efficacy associated with performance feedback was not durable. In general, the pattern of the findings underscored that social phobia is a severe form of anxiety pathology, that warrants a high dose of treatment. Theoretical and clinical implications are discussed.