94 Chapter 5 Outcome measures Symptom severity Social anxiety symptoms were assessed with the Social Phobia Scale (SPS; Mattick & Clarke, 1998), a self-report measure assessing the fear of being observed or watched during social or performance situations. The scale has shown good internal consistency; α = .94 (Mattick & Clarke, 1998); Dutch translation; α = .91 (Beurs et al., 2014); current study α = .86. The SPS was completed at baseline, post-assessment (after the second exposure session) and at one month follow-up (online). Fear levels Participants rated their fear levels, using a Subjective Units of Distress (SUDs) scale ranging from 0: no fear to 100: extreme fear (Wolpe & Lazarus, 1966). SUDs were assessed after the psychoeducation (initial SUDs), at the beginning of each exposure session (baseline SUDs), immediately prior to the speech (start SUDs), every 2 minutes during and immediately after the speech (end SUDs). Approach avoidance task To assess approach-avoidance tendencies toward facial expressions we used the Approach Avoidance Task (AAT; Rinck & Becker, 2007). In the AAT participants responded to emotional stimuli: happy, angry, neutral facial expressions presented on a computer screen by either pulling a joystick toward themselves or pushing it away as quickly as possible with their dominant hand. Instructions were indirect based on the color of the picture (grey or sepia). By doing this, the size of the picture increased (pulling movement) or decreased (pushing movement). After making a complete correct movement, the picture disappeared from the screen. Participants then moved the joystick back to its central position and, by pressing the fire button of the joystick, they initiated a new trial. The stimuli were selected from the Karolinska Directed Emotional Faces database based on quality of emotional expression (Goeleven, De Raedt, Leyman, & Verschuere, 2008; Lundqvist, Flykt, & Öhman, 1998). The three types of emotions were taken from the same models (5 females and 5 males). The task also included 20 checkerboards as control stimuli, resulting in 80 different pictures presented in random order twice. Reaction times (RTs) were recorded in ms. Relative faster execution of the push response compared to the pull response reflects heightened behavioral avoidance of the specific type of stimulus. In general, response latencies for affect-congruent (e.g., happy-approach and angry-avoid) are shorter compared to affect incongruent responses (e.g., happy-avoid and angry-approach). The task consisted of 30 practice trials (with different models) and
RkJQdWJsaXNoZXIy MTk4NDMw