Search

The Bivalent Fear of Evaluation (BFOE) model of social anxiety proposes that fear of negative evaluation (FNE) and fear of positive evaluation (FPE) play distinct roles in social anxiety. Research is however lacking in terms of how FPE is related to perfectionism and how these constructs interact to predict social anxiety. Participants were 382 individuals from the general community and included an oversampling of individuals with social anxiety. Measures of FPE, FNE, perfectionism, and social anxiety were administered. Results were mostly consistent with the predictions made by the BFOE model and showed that accounting for confounding variables, FPE correlated negatively with high standards but positively with maladaptive perfectionism. FNE was also positively correlated with maladaptive perfectionism, but there was no significant relationship between FNE and high standards. Also consistent with BFOE model, both FNE and FPE significantly moderated the relationship between maladaptive perfectionism and social anxiety with the relationship strengthened at high levels of FPE and FNE. These findings provide additional support for the BFOE model and implications are discussed.

Social anxiety disorder (SAD) and avoidant personality disorder (AvPD) are frequently co-occurring psychiatric disorders with symptomatology related to fear of social situations. It is uncertain to what degree the 2 disorders reflect the same genetic and environmental risk factors. The current study addresses the stability and co-occurrence of SAD and AvPD, the factor structure of the diagnostic criteria, and genetic and environmental factors underlying the disorders at 2 time points. SAD and AvPD were assessed in 1,761 young adult female twins at baseline and 1,471 of these approximately 10 years later. Biometric models were fitted to dimensional representations of SAD and AvPD. SAD and AvPD were moderately and approximately equally stable from young to middle adulthood, with increasing co-occurrence driven by environmental factors. At the first wave, approximately 1 in 3 individuals with AvPD had SAD, increasing to 1 in 2 at follow-up. The diagnostic criteria for SAD and AvPD had a two-factor structure with low cross-loadings. The relationship between SAD and AvPD was best accounted for by a model with separate, although highly correlated (r = .76), and highly heritable (.66 and .71) risk factors for each disorder. Their genetic and environmental components correlated .84 and .59, respectively. The finding of partially distinct risk factors indicates qualitative differences in the etiology of SAD and AvPD. Genetic factors represented the strongest time-invariant influences, whereas environmental factors were most important at the specific points in time., ((c) 2016 APA, all rights reserved.)

According to cognitive models, post-event processing (PEP) is a key factor in the maintenance of social anxiety. Given that decreasing PEP can be challenging for socially anxious individuals, it is important to identify potentially useful strategies. Although distraction may help to decrease PEP, the findings have been equivocal. The primary purpose of this study was to examine whether a brief distraction period immediately following a speech would lead to less PEP the next day. The secondary aim was to examine the effect of distraction following an initial speech on anticipatory anxiety for a second speech, via reductions in PEP. Participants (N = 77 undergraduates with elevated social anxiety; 67.53% female) delivered a speech and were randomly assigned to a distraction, rumination, or control condition. The following day, participants reported levels of PEP in relation to the first speech, as well as anxiety regarding a second, upcoming speech. As expected, those in the distraction condition reported less PEP than those in the rumination and control conditions. Additionally, distraction following the first speech was indirectly related to anticipatory anxiety for the second speech, via PEP. Distraction may represent a potentially useful strategy for reducing PEP and other maladaptive processes that may maintain social anxiety.

Objective: Problematic Internet use (PIU) is an emerging health concern that lacks screening measures validated for use with adolescents and young adults. This study aimed to validate the Problematic and Risky Internet Use Screening Scale (PRIUSS) for use with older adolescents and to increase its clinical utility by determining scoring guidelines and assessing the relationship between PIU and other mental health conditions., Methods: This cross-sectional survey study took place at a large, public Midwestern university among 330 older adolescents aged 18 to 25 years. Confirmatory factor analysis and Spearman's correlations were used to assess the PRIUSS' structural and construct validity, respectively. A risk-based scoring cutoff was estimated using a Bayesian latent class modeling approach to computing a receiver operating characteristic curve., Results: The confirmatory factor analysis indices for the 3-factor model indicated an acceptable fit (goodness-of-fit index 0.89, root mean square error of approximation 0.07). A cutoff of 25 (sensitivity 0.80, 95% confidence interval [CI] 0.47-0.99; specificity 0.79, 95% CI 0.73-0.84) is proposed for identifying those at risk for PIU. Participants at risk for PIU were at significantly greater odds of also reporting symptoms of attention-deficit/hyperactivity disorder (odds ratio [OR] 2.36 95% CI 1.21-4.62, P = .009), depression (OR 3.25, 95% CI 1.65-6.42, P = .008), and social anxiety (OR 3.77, 95% CI 2.06-6.89, P < .000)., Conclusions: The PRIUSS demonstrated validity as a PIU screening instrument for adolescents and young adults. Screening for PIU may also help to identify those at high reciprocal risk for other mental health conditions., (Copyright © 2015. Published by Elsevier Inc.)

Our aim was to study the inter-correlations and developmental pathways of mothers' and fathers' social and emotional loneliness during pregnancy (20th pregnancy week), infancy (child aged 8 months), and early childhood (child aged 18 months). Moreover, we aimed to study whether mothers and fathers who have different developmental profiles (identified by latent growth curve mixture models) differ in their experiences of marital dissatisfaction (RDAS), social phobia (SPIN) and depression (BDI) during pregnancy. Both mothers' social and emotional loneliness and fathers' social and emotional loneliness were highly stable, and within individuals these loneliness factors were strongly correlated. However, the correlations between mothers' loneliness experiences and fathers' loneliness experiences were weaker than expected. Separate latent growth curve groups were identified, which differed in feelings of marital dissatisfaction, social phobia, and depression. These groupings revealed that the higher the loneliness was, the more the parents experience these other psychosocial problems., (© 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

Background: Course and predictors of persistence of attention deficit hyperactivity disorder (ADHD) in adults are still largely unknown. Neurobiological and clinical differences between child and adult ADHD raise the need for follow-up studies of patients diagnosed during adulthood. This study investigates predictors of ADHD persistence and the possibility of full remission 7 years after baseline assessment., Method: A 7-year follow-up study of adults with ADHD (n = 344, mean age 34.1 years, 49.9% males) was conducted. Variables from different domains (social demographics, co-morbidities, temperament, medication status, ADHD measures) were explored with the aim of finding potential predictors of ADHD persistence., Results: Retention rate was 66% (n = 227). Approximately a third of the sample (n = 70, 30.2%) did not maintain ADHD criteria and 28 (12.4%) presented full remission (<4 symptoms), independently of changes in co-morbidity or cognitive demand profiles. Baseline predictors of diagnostic persistence were higher number of inattention symptoms [odds ratio (OR) 8.05, 95% confidence interval (CI) 2.54-25.45, p < 0.001], number of hyperactivity/impulsivity symptoms (OR 1.18, 95% CI 1.04-1.34, p = 0.01), oppositional defiant disorder (OR 3.12, 95% CI 1.20-8.11, p = 0.02), and social phobia (OR 3.59, 95% CI 1.12-11.47, p = 0.03)., Conclusions: Despite the stage of brain maturation in adults suggests stability, approximately one third of the sample did not keep full DSM-IV diagnosis at follow-up, regardless if at early, middle or older adulthood. Although full remission is less common than in childhood, it should be considered as a possible outcome among adults.

The dot-probe task has been widely used in research to produce an index of biased attention based on reaction times (RTs). Despite its popularity, very few published studies have examined psychometric properties of the task, including test-retest reliability, and no previous study has examined reliability in clinically anxious samples or systematically explored the effects of task design and analysis decisions on reliability. In the current analysis, we used dot-probe data from 3 studies in which attention bias toward threat-related faces was assessed at multiple (≥5) time-points. Two of the studies were similar (adults with social anxiety disorder, similar design features) whereas 1 was more disparate (pediatric healthy volunteers, distinct task design). We explored the effects of analysis choices (e.g., bias score formula, outlier handling method) on reliability and searched for convergent findings across the 3 studies. We found that, when concurrently considering the 3 studies, the most reliable RT index of bias used data from dot-bottom trials, comparing congruent to incongruent trials, with rescaled outliers, particularly after averaging across more than 1 assessment point. Although reliability of RT bias indices was moderate to low, within-session variability in bias (attention bias variability; ABV), a recently proposed RT index, was more reliable across sessions. Several eyetracking-based indices of attention bias (available in the pediatric healthy sample only) showed reliability that matched the optimal RT index (ABV). On the basis of these findings, we make specific recommendations to researchers using the dot-probe, particularly those wishing to investigate individual differences and/or single-patient applications., ((c) 2015 APA, all rights reserved).)

Dominant theoretical models of social anxiety disorder (SAD) suggest that people who suffer from function-impairing social fears are likely to react more strongly to social stressors. Researchers have examined the reactivity of people with SAD to stressful laboratory tasks, but there is little knowledge about how stress affects their daily lives. We asked 79 adults from the community, 40 diagnosed with SAD and 39 matched healthy controls, to self-monitor their social interactions, social events, and emotional experiences over 2 weeks using electronic diaries. These data allowed us to examine associations of social events and emotional well-being both within-day and from one day to the next. Using hierarchical linear modeling, we found all participants to report increases in negative affect and decreases in positive affect and self-esteem on days when they experienced more stressful social events. However, people with SAD displayed greater stress sensitivity, particularly in negative emotion reactions to stressful social events, compared to healthy controls. Groups also differed in how previous days' events influenced sensitivity to current days' events. Moreover, we found evidence of stress generation in that the SAD group reported more frequent interpersonal stress, though temporal analyses did not suggest greater likelihood of social stress on days following intense negative emotions. Our findings support the role of heightened social stress sensitivity in SAD, highlighting rigidity in reactions and occurrence of stressful experiences from one day to the next. These findings also shed light on theoretical models of emotions and self-esteem in SAD and present important clinical implications., ((PsycINFO Database Record (c) 2015 APA, all rights reserved).)

Virtual reality exposure therapy (VRET) applications use high levels of fidelity in order to produce high levels of presence and thereby elicit an emotional response for the user (like fear for phobia treatment). State of research shows mixed results for the correlation between anxiety and presence in virtual reality exposure, with differing results depending on specific anxiety disorders. A positive correlation for anxiety and presence for social anxiety disorder is not proven up to now. One reason might be that plausibility of the simulation, namely including key triggers for social anxiety (for example verbal and non-verbal behavior of virtual agents that reflects potentially negative human evaluation) might not be acknowledged in current presence questionnaires. A German scale for measuring co-presence and social presence for virtual reality (VR) fear of public speaking scenarios was developed based on a translation and adaption of existing co-presence and social presence questionnaires. A sample of N = 151 students rated co-presence and social presence after using a fear of public speaking application. Four correlated factors were derived by item- and principle axis factor analysis (Promax rotation), representing the presenter's reaction to virtual agents, the reactions of the virtual agents as perceived by the presenter, impression of interaction possibilities, and (co-)presence of other people in the virtual environment. The scale developed can be used as a starting point for future research and test construction for VR applications with a social context.

Olfactory reference syndrome (ORS) is a person's fear of exuding an offensive body odour which is not perceived by others. The objective of this case report is to highlight the challenges in diagnosing olfactory reference syndrome due to the lack of diagnostic criteria as well as its similarities to other psychiatric illnesses. We report a case of a young Chinese gentleman who was preoccupied with the belief that he had an offensive body odour which was not noticeable by others since the age of 10. As a result of this, he developed compulsive behaviour, social anxiety and avoidance, as well as depression. The patient had an array of psychiatric symptoms. He had symptoms which fulfilled criteria for obsessive compulsive disorder (OCD), delusional disorder somatic type, and social anxiety disorder. ORS remains a diagnostic challenge. Further studies are needed in this area for a better understanding of the disorder.

Background: The Behavioral Inhibition Observation System (BIOS) is a brief clinician-report scale for detecting behavioral inhibition (BI) from direct observation. This study aims to compare the validity coefficients obtained in the natural context of use of the BIOS (i.e., a clinical situation) with those obtained using the BIOS after standardized observation., Method: The participants were 74 randomly selected preschool children who were exposed to systematic observation., Results: The results indicate excellent internal consistency (α = .91) and moderate to good inter-rater reliability for all items (ICC from .55 to .88). The correlations with observational measures of BI ranged from .40 to .70, and were mostly equivalent to those of the previous study. The correlations with parents', teachers', and clinicians' measures of BI and related constructs ranged from .30 to .60, and were also equivalent to those obtained in the natural context of use of the BIOS (i.e., clinical situation)., Conclusions: The validity coefficients obtained with the BIOS in a non-structured natural observation are mostly equivalent to those obtained in an experimental situation, thus supporting that the BIOS is a cost-efficient instrument for measuring BI from observation in a clinical situation.

Background: Social Anxiety Disorder (SAD) and Williams-Beuren Syndrome (WS) are two conditions which seem to be at opposite ends in the continuum of social fear but show compromised abilities in some overlapping areas, including some social interactions, gaze contact and processing of facial emotional cues. The increase in the number of neuroimaging studies has greatly expanded our knowledge of the neural bases of facial emotion processing in both conditions. However, to date, SAD and WS have not been compared., Methods: We conducted a systematic review of functional magnetic resonance imaging (fMRI) studies comparing SAD and WS cases to healthy control participants (HC) using facial emotion processing paradigms. Two researchers conducted comprehensive PubMed/Medline searches to identify all fMRI studies of facial emotion processing in SAD and WS. The following search key-words were used: "emotion processing"; "facial emotion"; "social anxiety"; "social phobia"; "Williams syndrome"; "neuroimaging"; "functional magnetic resonance"; "fMRI" and their combinations, as well as terms specifying individual facial emotions. We extracted spatial coordinates from each study and conducted two separate voxel-wise activation likelihood estimation meta-analyses, one for SAD and one for WS., Results: Twenty-two studies met the inclusion criteria: 17 studies of SAD and five of WS. We found evidence for both common and distinct patterns of neural activation. Limbic engagement was common to SAD and WS during facial emotion processing, although we observed opposite patterns of activation for each disorder. Compared to HC, SAD cases showed hyperactivation of the amygdala, the parahippocampal gyrus and the globus pallidus. Compared to controls, participants with WS showed hypoactivation of these regions. Differential activation in a number of regions specific to either condition was also identified: SAD cases exhibited greater activation of the insula, putamen, the superior temporal gyrus, medial frontal regions and the cuneus, while WS subjects showed decreased activation in the inferior region of the parietal lobule., Conclusions: The identification of limbic structures as a shared correlate and the patterns of activation observed for each condition may reflect the aberrant patterns of facial emotion processing that the two conditions share, and may contribute to explaining part of the underlying neural substrate of exaggerated/diminished fear responses to social cues that characterize SAD and WS respectively. We believe that insights from WS and the inclusion of this syndrome as a control group in future experimental studies may improve our understanding of the neural correlates of social fear in general, and of SAD in particular., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Purpose: Those with anxiety use safety behaviors when attempting to prevent negative outcomes. There is evidence that these behaviors contribute to the persistence of anxiety disorders. Safety behaviors have been prominent in the cognitive behavior therapy literature during the last decade, particularly with social phobia management. However, nothing is known of safety behavior use by those who stutter. This is surprising given the high prevalence of social phobia in the stuttering population who seek clinical help., Method: Clinical psychologists and speech-language pathologists (SLPs) created a list of safety behaviors that might be used by adults during treatment for stuttering. Participants were 160 SLPs who were asked whether they advised adults who stutter to use any of these safety behaviors., Results: SLPs commonly recommend safety behaviors during stuttering management. Factor structures were found for the following 5 safety behavior categories: (a) general safety behaviors, (b) practice and rehearsal, (c) general avoidance, (d) choosing safe and easy people, and (e) control-related safety behaviors., Conclusions: There is a need to determine the frequency with which adults who receive stuttering treatment follow these clinician recommendations. In addition, there is a need to experimentally determine whether following such recommendations prevents fear extinction at long-term follow-up.