Parental Overprotection and Interpersonal Behavior in Generalized Social Phobia

Behavior Therapy 37 (2006) 14 --24 www.elsevier.com/locate/bt

Parental Overprotection and Interpersonal Behavior in Generalized Social Phobia Charles T. Taylor, Lynn E. Alden University of British Columbia

Forty-one people with generalized social phobia (GSP) and 42 community controls completed a measure of social developmental experiences and then participated in a social interaction with an experimental assistant whose behavior was either friendly or ambiguous. Following the interaction, confederates rated participants’ behavior and their desire to interact with their partner again. In people with social phobia, but not controls, perceptions of parental overprotection were associated with less responsiveness to partner behavior. Moreover, failure to reciprocate the friendly partner’s behavior led to social rejection. The results support the value of incorporating social developmental concepts into cognitive-behavioral models of social phobia and highlight the contribution of social learning experiences to the development of maladaptive interpersonal behavior in these individuals.

C O N T E M P O R A R Y D E V E L O P M E N TA L T H E O R I E S of anxiety posit that the family environment contributes to the development and maintenance of anxiety disorders (e.g., Chorpita & Barlow, 1998; Rapee, 2001; Rubin & Mills, 1991). Parental behavior is a key feature of that environment, and dysfunctional parenting has been shown to be associated with anxiety-related symptoms in children and adults (e.g., Hudson & Rapee, 2001; Mills & Rubin, 1998; Rapee, 1997). Of the dysfunctional parenting styles linked to anxiety, overprotective, controlling behavior has received the most attention.

Address correspondence to Lynn E. Alden, Department of Psychology, University of British Columbia, Vancouver, B.C., V6T 1Z4, Canada; e-mail: [email protected]. 0005-7894/06/014–024D1.00/0 n 2006 Association for Behavioral and Cognitive Therapies. Published by Elsevier Ltd. All rights reserved.

Although overprotection was initially studied in children selected on measures of general anxiety, developmental researchers are increasingly interested in understanding the contribution of overprotection to social anxiety. Several writers have proposed bidirectional models in which parental overprotection exacerbates and perpetuates social anxiety in biologically vulnerable children (e.g., Burgess, Rubin, Cheah, & Nelson, 2001; Rubin & Mills, 1991; Schmidt, Polak, & Spooner, 2001; Hudson & Rapee, 2000). If those models are accurate, parental overprotection may result in ongoing anxiety and dysfunctional behavioral patterns that persist into adulthood. However, the long-term effects of childhood overprotection in socially anxious populations have yet to be empirically studied. As a first step toward examining this issue, the current study examined the association between patients’ rectrospective reports of parental overprotection and their current interpersonal behavior.

Parental Overprotection Parker (1983) was one of the first writers to hypothesize a relationship between parental overprotection and the development of anxiety. He described overprotection as excessive parental involvement in controlling the child’s environment to minimize aversive experiences for the child, regardless of whether those situations represent actual threats. A number of researchers have examined overprotection in laboratory tasks intended to elicit collaborative behavior between mothers and their children (e.g., Dumas, LaFreniere, & Serketich, 1995; Hudson & Rapee, 2001). For example, Hudson and Rapee found that mothers of anxious children displayed more intrusive involvement during a laboratory problem-

parental overprotection solving task compared to mothers of nonanxious children. In addition, Dumas et al. (1995) determined that mothers of anxious children displayed the greatest degree of aversive control (i.e., attempts to elicit compliance through criticism, intrusion, and punishment) compared to mothers of nonanxious and aggressive children. Interestingly, this high level of aversive control led anxious children to actively refuse to comply to over half of their mother’s commands, a pattern of behavior that may serve to perpetuate the dysfunctional transactions between mothers and their anxious children.

Parental Overprotection and Social Anxiety Developmental models of social anxiety extended those ideas by focusing on the reciprocal relationship between social anxiety in children and their parents’ behavior (e.g., Burgess et al., 2001; Rubin & Mills, 1991). Developmental researchers have demonstrated that some children have a biological temperament toward social anxiety, which predisposes them to display signs of arousal and reticence in social situations (e.g., Kagan, Reznick, Snidman, Gibbons, & Johnson, 1988). According to developmental theorists, the child’s anxiety and reticence can elicit protective, controlling behavior from parents as they attempt to reduce their child’s distress (e.g., Burgess et al., 2001; Rubin & Mills, 1991). However, if parents engage in excessive control and protection, they can prevent the child from the social exploration necessary to overcome social anxiety, and thereby inadvertently perpetuate the child’s shyness. Research generally supports those theoretical propositions. For example, mothers of extremely anxious-withdrawn children were found to respond to their children’s shy, unskilled behavior with attempts to direct and control how the child behaved (e.g., Mills & Rubin, 1998). In a longitudinal investigation, parents’ perceptions of their child’s social wariness predicted their preference for socialization strategies that limited opportunities for the child to develop independence (Rubin, Nelson, Hastings, & Asendorpf, 1999). Of particular relevance to the current work is a longitudinal study by Rubin and his associates that assessed children at age 2 and age 4 (Rubin, Burgess, & Hastings, 2002). They found that an interaction of child inhibition and maternal behavior at age 2 predicted reticence at age 4. Specifically, in the high maternal intrusion/overprotection group, toddlers’ level of inhibition at age 2 was strongly correlated with reticence at age 4, whereas there was no relationship in the low to moderate maternal intrusion/overprotection group. Those results sug-

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gest that maternal overprotection played a role in perpetuating social reticence. Taken together, existing evidence increasingly supports a bidirectional relationship in which inhibited children and their parents display a cyclical interaction pattern that perpetuates the child’s social anxiety and avoidance.

Effects of Parental Overprotection Some theorists suggest that early experience with overprotective parents may cultivate a cognitive belief system in which events are interpreted as outside of one’s control (e.g., Chorpita & Barlow, 1998) or which heightens the person’s sense of threat (e.g., Hudson & Rapee, 2001). Consequently, these writers posit that overprotection may restrict the range of behaviors likely to be learned or exhibited by the child or constrain the child’s ability to manipulate and engage the environment autonomously. Studies examining locus of control, the belief that one has personal control over environmental events, provide indirect support for the first of these propositions. For example, parents who encourage their children to be more independent in exploring their environments are more likely to foster an internal locus of control in their children, whereas parental overprotection and intrusiveness were associated with an external locus of control (e.g., Gordon, Nowicki, & Wichern, 1981; see Carton & Nowicki, 1994, for a review). It is also notable that people with anxiety disorders perceive themselves to have less control over external and internal anxiety-relevant events (e.g., Cloitre, Heimberg, Liebowitz, & Gitow, 1992) and overestimate the likelihood of feared social outcomes (Clark & Wells, 1995). Interestingly, social phobic patients viewed events as being controlled by powerful others, whereas panic disorder patients viewed events as occurring in a random and unpredictable way. If individuals believe that they have little control over the outcome of social events or that such events represent a threat, one consequence may be for them to disengage from, or be less responsive during, social encounters. Consistent with this notion, developmental researchers found parental overcontrol to be associated with less child responsiveness to the social environment (e.g., Rubin & Burgess, 2001; Dumas et al., 1995). These findings support the notion that when faced with intrusive and controlling behaviors, anxious children tend to draw back from interactions. To date, research on overprotection has focused primarily on interactions between young children and their mothers within laboratory settings. Retrospective reports of adults with social phobia confirm

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developmental findings in that these patients described their parents as more overprotective and controlling than did nonphobic controls (e.g., Arrindell, Emmelkamp, Monsma, & Brilman, 1983; Bruch & Heimberg, 1994; Parker, 1979). Those studies indicate that overprotection may contribute to the development or maintenance of social phobia. However, no work has addressed how early experience with parental overprotection influences behavior patterns in adults with social phobia. This issue would appear to be of particular importance in the case of people with severe social anxiety, who can display dysfunctional patterns of interpersonal behavior. If behavioral patterns found in childhood persist into adulthood, then one would expect to find a similar pattern of nonresponsiveness to social cues in those adults who experienced early social environments characterized by parental overprotection. As with developmental models of social anxiety, adult models are increasingly considering the responses of other people in maintaining an individual’s social fears (see Alden & Taylor, 2004, for a review). Research suggests that socially anxious adults tend to elicit less positive social responses than do nonanxious individuals, and that these reactions are largely due to the social behavior of the anxious participants (e.g., Jones & Carpenter, 1986; Meleshko & Alden, 1993). Understanding the source of those negative interpersonal cycles would contribute to our understanding of social anxiety. For example, if overprotected individuals are indeed less responsive to the social environment, one might expect their behavior to affect other people’s responses to them. Those negative social responses, in turn, may help to maintain their social fears. Research has yet to examine that possibility.

Current Study Our goal in the present study was to examine the relationship between parental overprotection in childhood and the social behavior of adults with social phobia. Patients with social phobia and a comparison group of nonanxious controls completed a questionnaire that assessed their retrospective perceptions of their parents’ behavior and then engaged in a social interaction with an experimental confederate whose behavior was used to create either a positive or an ambiguous social environment. Following the conversation, confederates rated participants’ behavior and their desire to interact with their partner again. Two questions were addressed: (a) Is early experience with parental overprotection associated with a distinct pattern of interpersonal behavior in

adults with social phobia? (b) If so, how does this behavioral pattern influence their partner’s response to them? Following from theories of anxiety development and parental overprotection (e.g., Chorpita & Barlow, 1998), we predicted that parental overprotection would be associated with generalized social phobia (GSP) participants’ behavior, over and above severity of social anxiety alone. In keeping with earlier work on children (e.g., Rubin & Burgess, 2001), we anticipated that perceived parental overprotection would be related to less behavioral responsiveness during the interaction and that nonresponsive behavior would elicit negative responses from others.

Method participants Participants were 41 people (19 females, 22 males) seeking treatment for GSP and 42 people (20 females, 22 males) recruited from the general population who did not meet diagnostic criteria for any psychological disorder. GSP participants were recruited from notices sent to outpatient psychology clinics. Community control participants were recruited through announcements posted in newspapers, community centers, libraries, and other public buildings soliciting people without anxiety-related difficulties. All participants completed a telephone-screening interview before they were scheduled for the intake assessment. Diagnostic status was confirmed using the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV; Brown, DiNardo, & Barlow, 1994), a structured interview protocol shown to have high interrater reliability and good concurrent validity (Brown et al., 1994). Two graduate students who had training and 1 to 2 years of supervised experience with the ADIS-IV conducted assessments. Interrater agreement for GSP diagnoses was established by having a third graduate student with extensive ADIS-IV experience, and who was blind to diagnoses, rate 29% (24/83) of the interviews. Interrater agreement was high (kappa = .92). GSP participants were excluded if GSP was not their primary problem (n = 1), or if they displayed current substance abuse/dependence (n = 1), bipolar disorder (n = 0), or any psychotic disorder (n = 0). To participate, control participants were required not to meet diagnostic criteria for any clinical disorder. personnel Two graduate students (1 man, 1 woman) served as experimenters. These students were trained to follow a scripted protocol to deliver experimental

parental overprotection instructions and were blind to the participants’ experimental condition. Two undergraduate research assistants (1 man, 1 woman) served as experimental confederates. Confederates were trained to provide two sets of scripted verbal and nonverbal behaviors designed to convey either a positive or an ambiguous social response and to deliver the two roles in a natural rather than staged manner. To assess interrater agreement, a third undergraduate student served as an independent observer and was trained to rate confederate and participant behavior. Both the confederates and observer were blind to the experimental hypotheses. The observer was also blind to the experimental condition.

procedure Upon arriving at the laboratory, participants were informed that they would participate in a conversation with an experimental assistant of the opposite sex and that they should get to know their partner just as if they had met at a social event. Following the instructions, the confederate entered the room and was introduced to the participant. The experimenter indicated that the confederate should begin the conversation, and that both individuals should continue to talk until the experimenter returned. The interaction consisted of a 5-minute, open-ended “getting acquainted” discussion, a task chosen because such conversations are a first step in the development of friendships (e.g., Stravynski & Shahar, 1983). Participants were informed that they would be monitored during the interaction from behind a one-way mirror. The experimenter and observer rated confederate and participant behavior during the interaction (see below). After 5 minutes, the experimenter returned to the room, thanked the confederate, and asked the participant to complete the rating scales (described below). After leaving the room, the confederate rated the participant’s behavior and a measure reflecting the extent to which they would be willing to interact with the participant in the future. Experimental condition. Participants were randomly assigned to one of two conditions. In the positive condition the confederate displayed noticeably warm, friendly behavior toward the participants. She or he spoke in a warm tone, made encouraging comments, expressed personal opinions, asked frequent questions, and engaged in supportive nonverbal behavior (e.g., steady eye contact, frequent head nods). In the ambiguous condition the confederate acted in a reserved but not unfriendly manner toward participants. He or she spoke in a steady, neutral tone, expressed fewer encouraging comments or personal opinions, asked

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fewer questions and engaged in neutral nonverbal behavior (e.g., some glances away, fewer head nods). These protocols were modeled after previous research (e.g., Taylor & Alden, 2005). To check on conformity to role and consistency across participants, the experimenter conducted in vivo ratings of the confederates’ performances on three 7-point scales that assessed confederate warmth and friendliness, openness, and active engagement (anchors of not at all and very much). The ratings displayed high internal consistency (Cronbach’s alpha = .94) and therefore were summed to yield a single score that reflected confederate warmth and openness. The independent observer rated confederate behavior in approximately 25% of the interactions on the same three scales as those used by the experimenter. The intraclass correlation coefficient computed between the experimenter’s and observer’s ratings was .97 (p < .001), which indicated good interrater agreement.

measures Social anxiety. The Social Phobia Scale and the Social Interaction Anxiety Scale (SPS/SIAS; Mattick & Clarke, 1998) were used to assess participants’ social anxiety symptoms. The SPS reflects fears of being observed or evaluated in social situations, while the SIAS assesses fears of general social interactions. Both measures have demonstrated good reliability and validity (Brown et al., 1997; Mattick & Clarke, 1998). Depression. The Beck Depression Inventory–II (BDI-II; Beck, Steer, & Brown, 1996) is a 21-item self-report inventory that assesses severity of depression during the past 2 weeks. Investigators have reported good internal consistency, reliability, and validity for the BDI-II (e.g., Beck et al., 1996). The BDI-II was included to determine if results were influenced by dysphoric mood. Parental overprotection. The Parental Overprotection Scale of the Social History Questionnaire (SHQ; Alden, Mellings, Taylor, & Laposa, 2004) was used to assess participants’ descriptions of early experiences of parental control and intrusiveness within the family. Sample items include the following: “My parents would not let me do things on my own”; “My parents gave me the freedom to make my own mistakes” (reverse scored). Previous research indicates that this scale demonstrates good internal consistency, discriminates GSP patients from nonphobic individuals, and displays meaningful associations with established measures of early parent-child interactions (Alden et al., 2004; Taylor & Alden, 2005). For example, the SHQ overprotection scale exhibited a large correlation

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with the EMBU overprotection scale (see Winefield, Goldney, Tiggemann, & Winefield, 1989), r = .86, p < .001. The Cronbach alpha coefficient for the current sample was .83. Behavior ratings. Following the interaction, the confederate rated the participant’s behavior on seven items that reflected two dimensions: (a) prosocial behavior (self-disclosed, talkative, appeared friendly), and (b) anxiety-related behavior (appeared relaxed, trembled, looked embarrassed, fidgeted). Each item was rated on a 7-point scale with anchors of not at all and very much. Internal consistency of the two sets of items was adequate (Cronbach’s alpha = .71 and .83 for the prosocial behavior and anxiety-related behavior ratings, respectively). Therefore, each set of items was summed to yield a total score on that dimension. The two scales were correlated at a significant but moderate level, r = −.46, p < .001, which pointed toward the utility in assessing the two constructs separately. An observer watched 31% of the interactions from behind the one-way mirror to provide independent, in vivo ratings of the participant’s behavior. Internal consistency was adequate for the two behavior scales (Cronbach’s alpha = .79 and .89 for prosocial and anxiety-related behavior, respectively). Intraclass correlation coefficients computed between the confederate’s and observer’s ratings revealed acceptable interrater agreement, ICC = .80 and .79 for prosocial behavior, and anxiety-related behavior, respectively, both p < .001. Desire for future interaction scale. Confederates rated the extent to which they would be willing to engage in a variety of social activities with the participant. Items comprising this scale were taken from the Desire for Future Interaction Scale (DFI; Coyne, 1976), an inventory used extensively in interpersonal studies of depression. The individual items of the DFI have been shown to reliably load

on a single factor (e.g., Segrin, 1993), and DFI ratings are generally interpreted as reflecting liking or rejection of the target individual. For the purposes of the present study, the original DFI items were modified to reflect the nature of the present social interaction. Since our confederates were generally young (age 24 and 25), and our sample ranged from 20 to 61 years of age, DFI items were modified so as to limit age confounds in confederates’ ratings. Specifically, confederates indicated a preference to interact with the participant or someone similar to the participant again. To further control for the effects that age might have had on DFI ratings, analyses were repeated while entering participant age as a covariate. Results indicated that age was unrelated to confederates’ liking of their interaction partners, and therefore, only the original results will be reported here. The Cronbach alpha coefficient for this sample was .93.

Results preliminary analyses Demographic measures. Two (group) by two (condition) analyses of variance (ANOVA) conducted on participant age and years of education revealed no significant main or interaction effects, F range (1, 79) = .03 – 2.32, all p > .10. A chi-square analysis revealed no differences between the two groups and conditions in terms of the number of men and women participants, v2 = .01, p > .10. (See Table 1). Descriptive Measures. A two (group) by two (condition) MANOVA conducted on participants’ SIAS, SPS, and BDI-II scores revealed a significant multivariate effect for group, F(3, 77) = 169.02, p < .001. The condition, and group-by-condition interaction effects were not significant, F(3, 77) = .39, .61, respectively, both p > .10. Follow-up univariate analyses revealed that, as expected, GSP participants

Table 1 Means and standard deviations for participant measures Variable

Social Phobia

Control

Positive

Ambiguous

Positive

Ambiguous

Age Education SIAS SPS BDI-II SHQ-Overprotection Prosocial behavior Anxiety-related behavior DFI

30.70 (12.10) 14.80 (1.67) 54.07 (9.13) 36.85 (14.45) 20.25 (15.44) 12.30 (3.91) 16.60 (1.93) 10.75 (4.35) 31.45 (3.10)

34.14 (11.61) 15.71 (2.35) 51.07 (11.70) 32.81 (15.30) 16.05 (11.86) 10.94 (4.21) 14.71 (2.95) 13.33 (4.28) 29.19 (3.71)

32.38 (8.56) 15.48 (2.16) 10.67 (5.12) 4.90 (3.87) 6.19 (5.52) 8.45 (3.83) 17.71 (1.42) 7.33 (2.06) 33.29 (3.85)

33.33 (11.67) 16.05 (2.58) 11.97 (5.45) 6.29 (4.05) 5.59 (5.05) 8.45 (2.99) 16.86 (1.88) 7.38 (2.44) 31.86 (4.27)

Note. Standard deviations in parentheses. SIAS = Social Interaction Anxiety Scale; SPS = Social Phobia Scale; BDI-II = Beck Depression Inventory–II; SHQ = Social History Questionnaire; DFI = Desire for Future Interaction (confederate ratings).

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parental overprotection scored higher than controls on the SIAS, SPS, and BDI-II, F (1, 79) = 512.63, 151.00, 29.08, respectively, all p < .001. A two (group) by two (condition) ANOVA conducted on participant-reported parental overprotection revealed a significant main effect for group, F(1, 79) = 14.71, p < .001, with GSP participants reporting greater levels of overprotection in childhood compared to controls. The condition, and group-by-condition interaction effects were not significant, F(1, 79) = .68, .68, respectively, both p > .10. (See Table 1.) Confederate consistency. A 2 (group) by 2 (condition) by 2 (confederate) ANOVA conducted on experimenter ratings of confederate behavior revealed no significant effects for group or confederate, F(1, 75) = 1.48, .01, both p > .10. A significant main effect emerged for condition, F(1, 75) = 725.22, p < .001, which indicated that, as planned, the confederates were rated as more warm and open in the positive as compared to the ambiguous condition. None of the two-way or threeway interactions were significant (all p > .10), which indicated that both confederates’ behavior did not differ across participants within each condition.

main analyses Behavior ratings. To examine whether perceived parental overprotection in childhood was associat-

ed with participants’ behavior during the interaction, two hierarchical regression analyses were conducted, one to predict prosocial behavior and one to predict anxiety-related behavior. In each analysis, the SHQ overprotection scale, group (social phobia, control), and experimental condition (friendly, ambiguous) served as predictors. These three predictors were entered simultaneously in Step 1 of the regression equation. The conditionby-overprotection, group-by-overprotection, and condition-by-group interaction terms were entered in Step 2 of the regression analyses. The three-way interaction term (group by condition by overprotection) was entered in Step 3. The interaction terms allowed us to examine whether experimental condition and/or group moderated the relationship between overprotection and participants’ behavior. See Table 1 for dependent measure means and standard deviations. For prosocial behavior, condition, ΔR2 = .09, p = .003, and group, ΔR2 = .08, p = .007, both emerged as significant main effect predictors. Specifically, participants displayed fewer prosocial behaviors in the ambiguous condition, a finding that would be expected given that confederates were less prosocial themselves in this condition compared to the positive condition. Additionally, social phobic patients displayed fewer prosocial behaviors compared to control participants. The group-by-overprotection interaction was also

Table 2 Multiple regression of prosocial behavior and DFI on parental overprotection (N = 83) Variable

Step 1 Group Condition OP Step 2 Group Condition OP Condition × OP Group × OP Group × Condition Step 3 Group Condition Overprotection Condition × OP Group × OP Group × Condition Group × Condition × OP

Prosocial Behavior

DFI

B

SE B

β

1.42 −1.41 −.07

.51 .47 .03

.30 ⁎⁎ −.30 ⁎⁎ −.12

1.47 −1.54 −.04 −.02 −.21 .38

.48 .44 .06 .06 .06 .24

.31 ⁎⁎ −.33 ⁎⁎ −.07 −.04 −.33 ⁎⁎ .16

1.50 −1.45 −.04 −.03 −.21 .38 .03

.49 .49 .06 .06 .06 .24 .06

.32 ⁎⁎ −.31 ⁎⁎ −.06 −.05 −.34 ⁎⁎ .16 .05

Note. DFI = Desire for Future Interaction; OP = Overprotection. ⁎ p < .05. ⁎⁎ p < .01. ⁎⁎⁎ p < .001.

ΔR

2

B

SE B

2.05 −1.88 −.07

.90 .83 .11

.26 ⁎ −.24 ⁎ −.07

2.03 −1.98 −.05 −.09 −.14 .41

.91 .84 .12 .12 .12 .46

.26 ⁎ −.25 ⁎ −.05 −.09 −.13 .10

1.78 −2.71 −.09 −.05 −.11 .36 −.23

.90 .90 .12 .12 .12 .45 .12

.22 ⁎ −.34 ⁎⁎ −.09 −.05 −.11 .09 −.23 ⁎

.19 ⁎⁎⁎

.12 ⁎⁎

.00

β

ΔR 2 .11 ⁎⁎

.02

.04 ⁎

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significant, ΔR2 = .10, p < .001, suggesting that group moderated the overprotection-prosocial behavior relationship. The three-way interaction term was not significant, ΔR2 = .00, p > .10. (See Table 2). To explicate the nature of the significant interaction, post hoc analyses were conducted to examine the simple regression slopes of the overprotection factor in each group (see Aiken & West, 1991). Results revealed that perceived overprotection was negatively associated with prosocial behavior in the social phobia group, β = −.43, t = −3.20, p = .002, suggesting that patients who reported greater overprotection in childhood were less likely to display prosocial behaviors across both conditions. In contrast, the association between overprotection and prosocial behavior in the control group was not statistically significant, β = .29, t = 1.79, p = .08. Taken together, those results indicated that perceived overprotection was differentially associated with prosocial behaviors in social phobic compared to control participants. For anxiety-related behaviors, the results revealed that the regression models including the interaction terms were not significant improvements on the main effects model, ΔR2 = .03, .01, for the two-and three-way interaction models, respectively, both p > .10. In the main effects model, group emerged as the only significant predictor, ΔR2 = .23, p < .001, which indicated that social phobic participants displayed more anxiety-related behaviors compared to controls. Taken as a whole, the findings suggested that neither parental overprotection nor the experimental manipulation influenced participants’ anxiety-related behaviors in the context of the present interaction. Desire for future interaction. A hierarchical regression analysis was conducted to determine whether confederate DFI ratings could be predicted from perceived parental overprotection. Group, condition, and overprotection were entered simultaneously in Step 1 of the regression equation, and the two-and three-way interaction terms were entered in Steps 2 and 3, respectively (see Table 2). Results revealed that the third regression equation, which included the three-way group-bycondition-by-overprotection interaction term, explained significantly more of the variance than the equations including only the main effects predictors, or two-way interactions, ΔR2 = .04, p = .05. To follow up the significant three-way interaction, we isolated the simple effects of overprotection on DFI within the various groups and conditions using the procedures outlined in Aiken and

West (1991). For social phobic participants, results revealed that confederate DFI ratings were negatively associated with perceived overprotection in the positive condition, β = −.49, t = −2.21, p = .031, whereas the association between overprotection and DFI ratings was not significant in the ambiguous condition, β = .08, t = .37, p > .10. Within the control group, the relationship between DFI ratings and overprotection was not significant in either the positive condition, β = .21, t = .95, p > .10, or in the ambiguous condition, β = −.16, t = −.55, p > .10. Taken as a whole, those results indicated that for social phobic participants, perceived overprotection was associated with confederate rejection in the positive condition. Mediators of liking/rejection. Following previous research demonstrating that a lack of prosocial behaviors, such as self-disclosure, can elicit negative responses from others (e.g., Papsdorf & Alden, 1998), we examined whether the absence of prosocial behavior in social phobic participants during the interaction mediated the relationship between overprotection and confederate DFI ratings in the friendly condition. According to Baron and Kenny (1986), to establish the presence of a significant mediating pathway, several conditions must be met. There must be significant relationships between: (a) the independent variable and the dependent variable, (b) the independent variable and the potential mediator, and (c) the potential mediator and dependent variable. This assumption was tested in the GSP group within the positive condition with a series of regression equations as described by Baron and Kenny. Results revealed that (a) perceived parental overprotection significantly predicted confederate DFI ratings, β = −.61, p = .005; (b) overprotection predicted prosocial behaviors, β = −.50, p = .025; and (c) prosocial behaviors predicted confederate DFI ratings, β = .66, p = .002. The final requirement to establish mediation is that the effect of the independent variable on the dependent variable must be significantly less when entered in conjunction with the mediator than when entered alone. To examine this final assumption, overprotection and prosocial behaviors were entered in Steps 1 and 2 of a hierarchical regression analysis, respectively, in order to predict confederate DFI ratings in the friendly condition. Overprotection no longer predicted confederate DFI when entered together with prosocial behaviors, β = −.37, p > .10, and this represented a significant reduction compared to when overprotection was entered alone, t(17) = 2.12, p < .05. Together, these analyses indicated that prosocial behavior mediated the parental overprotection-confederate liking relationship in the

parental overprotection friendly condition. These findings suggested that GSP participants who reported greater parental overprotection were liked less by the friendly partners because they displayed fewer prosocial behaviors. Controlling emotional symptoms. A possible alternative explanation for the association between perceived parental overprotection, patient behavior, and social responses is that overprotection leads to more severe levels of social anxiety or depression, which in turn leads to more pronounced maladaptive interpersonal behavior. To examine that possibility, the previous hierarchical regression analyses for prosocial behavior and confederate DFI ratings were repeated using participants’ SIAS, SPS, and BDIII scores as covariates. Those symptom measures were entered in Step 1 of the regression equation, followed by overprotection, group, and condition in Step 2, and the two-and three-way interaction terms in Steps 3 and 4, respectively. For the regression model predicting prosocial behavior, perceived overprotection continued to be negatively associated with prosocial behavior in the social phobia group after controlling for social anxiety and depression, β = −.47, t = −3.50, p = .001. In a similar vein, confederate DFI ratings continued to be negatively associated with perceived overprotection in the positive condition for social phobic participants when controlling emotional symptoms, β = −.47, t = −2.02, p = .047. Taken together, those results suggested that perceived childhood overprotection, rather than severity of social anxiety or depression, predicted patients’ behavior and their partner’s responses during the interaction.

Discussion Among patients with GSP, perceived parental overprotection was associated with fewer prosocial behaviors during a social interaction task. This pattern of behavior was largely independent of the social cues exhibited by their partners, which suggested that participants who described their parents as overprotective were less responsive behaviorally. Those findings are consistent with earlier developmental research that revealed that parental overcontrol was associated with less child responsiveness to the social environment (e.g., Rubin & Burgess, 2001). To the extent that patients’ perceptions are an accurate reflection of their childhood experiences, the present findings suggest that the relationship between parental control and social nonresponsiveness may extend to adulthood.

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Perceived overprotection was not related to GSP participants’ anxiety-related behavior during the interaction in either condition. This finding suggests that those behaviors may be more a manifestation of being socially anxious in general, rather than the consequence of being overprotected in childhood. Thus, although all patients with social phobia display varying degrees of anxiety-related behaviors, the specific behavioral patterns they adopt to manage social events (e.g., degree of self-disclosure) may be more directly related to particular learning experiences. This speculation could be tested in future research by examining the influence of numerous social developmental factors on contemporary social behavior and anxiety. According to interpersonal writers, people with psychological disorders can inadvertently adopt patterns of interpersonal behavior that elicit negative social responses, thereby perpetuating their difficulties (see Alden & Taylor, 2004; Kiesler, 1983). Consistent with this proposition, social phobic patients who reported childhood overprotection engaged in behavior that led to rejection when their partners were trying to establish a friendly exchange. The fact that rejection was found only in the positive condition is in keeping with the well-established reciprocity effect, i.e., that people prefer others who reciprocate their level of intimacy (e.g., Collins & Miller, 1994; Papsdorf & Alden, 1998). In the ambiguous condition, the low level of disclosure and friendliness displayed by GSP participants matched the confederates’ own emotionally neutral, closed behavior. In contrast, in the positive condition, where confederates were friendly and self-disclosive, the absence of a friendly, open response would have been discordant. According to the reciprocity effect, a mismatch between the partner’s behavioral invitation to engage in a friendly exchange and the overprotected participant’s failure to respond should reduce the partner’s desire for further interaction, and that is exactly the pattern observed here. These results highlight the importance of considering both the social context and the interpersonal consequences of particular behavior patterns in individuals with social phobia. Moreover, they suggest that intimacy and self-disclosure is difficult for some GSP patients, and may need to be addressed more explicitly in treatment. Although the present work established a link between perceived overprotection in childhood and contemporary behavior patterns and social outcomes, some may argue that these findings are an artifact of severity of social anxiety. One might conjecture that parental overprotection leads to greater social anxiety, and hence less effective

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behavior, or that more severely anxious patients display negative biases in their perceptions of their parents’ behavior. The present results argue against either of those possibilities. The significant associations between overprotection and behavior remained even when severity of social anxiety and social phobia were controlled. These results are notable because they suggest that the behavior patterns displayed during the present interaction were not the result of these patients’ current level of social anxiety per se. The present findings are consistent with contemporary developmental theories, which posit that chronic social anxiety develops when people with an anxious or inhibited temperament experience social environments that either fail to help them overcome their innate timidity or exacerbate their fears through negative social interactions (e.g., Burgess et al., 2001; Rubin et al., 2002; Schmidt et al., 2001). In particular, developmental models highlight the bidirectional nature of parent-child social interactions in which the child’s anxiety can elicit overprotective parenting strategies from their parents, which in turn perpetuate social anxiety (e.g., Alden & Taylor, 2004; Rapee, 2001; Rubin & Mills, 1991). One explanation of the current findings is that parental overprotection contributes to the persistence of behavior patterns in childhood into adult interaction. Longitudinal studies are now needed to examine that speculation. Several possible explanations may account for the hypothesized relationship between parental control and social nonresponsiveness. First, some writers postulate that early experience with excessive parental control contributes to the development of the belief that one is unable to influence the outcome of external events (e.g., Chorpita & Barlow, 1998; Cloitre et al., 1992). A related possibility is that overprotection increases the vulnerable child’s sense of threat (e.g., Hudson & Rapee, 2000). A perceived lack of personal control and a heightened sense of threat may result in social avoidance and a subsequent failure to develop adequate cognitive and behavioral skills to deal with social events. For example, one study indicated that patients who reported childhood overprotection were less adept at taking in or discriminating social cues (Taylor & Alden, 2005). If these individuals have difficulties making fine-tuned social judgments, then they would be expected to have greater problems responding appropriately to their partner’s behavior (see also Cunningham & Strassberg, 1981). Finally, cognitive-behavioral formulations of social phobia posit that individuals with this disorder engage in self-protective beha-

viors in order to avoid negative social outcomes (e.g., Arkin, Lake, & Baumgardner, 1986; Clark & Wells, 1995). According to this perspective, the overprotected participants may have learned to display closed, socially neutral behavior as a way of avoiding attention and possible rejection. Further research is needed to determine which of those alternatives provides the best explanation for the behavioral nonresponsiveness associated with parental overprotection. A number of caveats should be considered when drawing conclusions from these results. First, parental overprotection was assessed through retrospective reports, and some have argued against the use of such data because memories can become biased or fade over time. There is no doubt that longitudinal studies are necessary to definitively establish a link between parenting styles in childhood and contemporary adult behavior. Nonetheless, research suggests that adequately reliable and valid accounts of many early experiences can be obtained (e.g., Brewin, Andrews, & Gotlib, 1993). For example, recalled childhood experiences have been shown to be stable over time (e.g., Parker, 1989) and to converge with reports from independent sources (e.g., Bifulco, Brown, Lillie, & Jarvis, 1997). Of particular relevance is a study by Gerlsma, Kramer, Scholing, and Emmelkamp (1994) that found social phobic patients’ recall of parenting styles did not change over the course of treatment despite significant improvements in anxiety, mood, and hostility. Finally, parental overprotection, as reported by our patients, is consistent with direct observation of parental control and overprotection in laboratory interactions between mothers and their anxious children (e.g., Hudson & Rapee, 2001; Mills & Rubin, 1998). Thus, there is reason to believe that the retrospective reports of parental overprotection in the current study provide meaningful leads for future studies. Second, previous research indicates that parental overprotection is found in other forms of psychopathology (e.g., Rapee, 1997). One such example is depression, a condition that is frequently comorbid with social phobia. It is well known that depressed individuals tend to withdraw from social interactions, and one might speculate that the diminished behavioral responsiveness exhibited by some patients in this study was a consequence of depressed affect. Additionally, past research has found that the behavior of depressed individuals can elicit negative interpersonal responses from others (e.g., Coyne, 1976). When severity of depression was controlled, however, the current findings did not change,

parental overprotection which suggested that the relationship between overprotection and behavior was not due to cooccurring depression. The latter results notwithstanding, as noted in the introduction, overprotective parenting is also found in children with general anxiety. Those findings raise the possibility that such developmental experiences influence social behavior in people with other anxiety disorders, not just social phobia. Comparative studies are needed to determine which interpersonal patterns are specific to each anxiety disorder and which are shared across conditions. What is notable is that a different pattern of behavior was observed in control participants who described their parents as overprotective compared to the GSP group, suggesting that overprotective parenting may exert different effects depending on dispositional vulnerabilities. Research is needed to test interaction models of social anxiety development (e.g., Burgess et al., 2001; Rubin et al., 2002; Schmidt et al., 2001) and to establish whether people with biological dispositions toward anxiety and other forms of psychopathology are particularly vulnerable to the adverse effects of parental overprotection and control. Several other cautions should be noted. Although controlling the confederates’ behavior achieved the experimental rigor of providing all participants with the same social stimulus, the behavior of overprotected GSP patients may “pull” different responses from others during real-life interactions (see Jones & Carpenter, 1986, for example). Future work should examine the generalizability of these findings to naturalistic settings. Furthermore, there is a need to determine whether the present results extend beyond first-meeting situations. Nonetheless, the first-meeting situation used in the current research is worthy of study because this type of interaction is a necessary first step in the development of intimate relationships. Finally, it is important to recognize that the modest sample size may have limited the power to detect statistically significant relationships in the post hoc regression analyses. All in all, work with larger samples is needed to replicate and extend these findings. In summary, the results support the incorporation of social developmental concepts into cognitive-behavioral models of social phobia. Moreover, these findings suggest that treatment for GSP may be enhanced by considering the interpersonal consequences of patients’ behavior, as well as the role of specific developmental experiences in shaping their contemporary interpersonal transactions. In particular, some GSP patients may benefit

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