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Cognitive behavioral models of social anxiety disorder (SAD) in adults suggest that self-focused attention maintains social anxiety. However, this hypothesis has not yet been tested in children. This study therefore examined self-focused attention in relation to social anxiety in children. Self-focused attention was experimentally varied (internal vs. external) in 20 children with SAD, 20 children with high social anxiety and 20 non-anxious controls while engaging in a performance task in front of two adults. As expected, a significant group effect was found for all dependent variables, with children suffering from social anxiety disorder reporting the highest levels of anxiety, negative mood, and negative cognitions, and the lowest levels of self-rated performance and positive cognitions, followed by socially anxious children and controls. A significant effect of the focus condition was that children with heightened internal self-focus reported more anxiety, worse expected performance evaluation by others and more frequent negative cognitions. Unexpectedly, no interaction between social anxiety group and focus condition was found. Taken together, the results provide important preliminary evidence for the generally detrimental role of self-focused attention on child anxiety in social situations.

Manipulating Self-Focused Attention in Children with Social Anxiety Disorder and in Socially Anxious and Non-Anxious Children