Search

Men have been underrepresented in research investigating the pathway from social anxiety through loneliness to suicidality. The present study examined loneliness as a mediator between social anxiety and suicidality among men, along with exposure to childhood trauma as a moderator of this pathway. A nationally representative sample of 530 Canadian men completed study measures online. Bootstrapped tests of indirect effects indicated loneliness to be a significant mediator after controlling for depression symptoms, and this mediation effect was moderated by exposure to multiple types of childhood trauma. The link between social anxiety and loneliness--and the mediating effect of loneliness on suicidality--was strongest among men reporting two or more types of childhood trauma. Efforts to mitigate men's suicidality in the context of social anxiety may benefit from targeting loneliness, with particular attention to the effects of childhood trauma., Author(s): David Kealy [sup.1] , Simon M. Rice [sup.2] [sup.3] , Zac E. Seidler [sup.2] [sup.3] , John S. Ogrodniczuk [sup.1] , John L. Oliffe [sup.4] [sup.5] Author Affiliations: (1) [...]

Simpler and more precise tools are needed to measure Taijin Kyofusho which is a culture-bound anxiety disorder in East Asian countries. This study aimed to develop and validate a short form and a computerized adaptive test (CAT) of Taijin Kyofusho Scale (TKS), as well as compare the measurement precision of the short form, the CAT version and its original version. Item Response Theory (IRT) method was used to develop static short form and to simulate CAT. The short form consisted of 12 items (a 61% reduction) and the CAT version consisted of average 11.72 items (a 62% reduction) from the original TKS, respectively. Both short form and CAT version have similar levels of accuracy and precision in comparison to the original scale at the group level. However, at the individual level, the CAT version can maintain a more consistent level of precision across the continuum of severity than the short form. The short form of the TKS is sufficient for an initial assessment or screening in the community population. And the CAT version of the TKS is more suitable for tailored treatments in the clinical practice, which could detect detailed changes in the severity of Taijin Kyofusho., Author(s): Honglan Fan [sup.1] , Yan Cai [sup.1] , Siyu Wang [sup.1] , Dongbo Tu [sup.1] Author Affiliations: (1) grid.411862.8, 0000 0000 8732 9757, School of Psychology, Jiangxi normal university, [...]

Unique socio-behavioural phenotypes are reported for individuals with different neurodevelopmental disorders. Here, the effects of adult familiarity and nature of interaction on social anxiety and social motivation were investigated in individuals with fragile X (FXS; n = 20), Cornelia de Lange (CdLS; n = 20) and Rubinstein-Taybi (RTS; n = 20) syndromes, compared to individuals with Down syndrome (DS; n = 20). The Social Anxiety and Motivation Rating Scale was employed whilst participants completed four social tasks, each administered separately by a familiar adult, and also by an unfamiliar adult. Compared to participants with DS, those with FXS and RTS exhibited high levels of social anxiety but similar levels of social motivation. Participants with CdLS showed heightened social anxiety and reduced social motivation only during interactions with an unfamiliar adult when active participation was voluntary., Author(s): Hayley Crawford [sup.1] [sup.2] , Joanna Moss [sup.3] [sup.4] , Laura Groves [sup.3] , Robyn Dowlen [sup.3] [sup.5] , Lisa Nelson [sup.3] [sup.6] , Donna Reid [sup.3] , Chris [...]

Despite longstanding debate over the nature of the boundary between social anxiety disorder (SAD) and less severe social anxiety, no study has tested directly whether the defining features of the disorder' correspond to a latent category or dimension. The present study examined this question using data from the National Comorbidity Survey Replication (NCS-R) a nationally representative survey of the U.S. household population. Indicators representing the Diagnostic and Statistical Manual of Mental Disorders (4th ed.: DSM--IV: American Psychiatric Association, 1994) criteria for SAD were submitted to taxometric analyses in a subsample of adults (n = 2.166) who reported excessive social fear in their lifetime. Multiple taxometric procedures and consistency tests converged on a dimensional solution, suggesting that SAD is continuous with milder social anxiety. In follow-up analyses, a dimensional SAD diagnosis outperformed the DSM 1V diagnosis in predicting the subsequent onset of a range of clinically important outcoines. Large differences in associations with comorbid mood disorders, suicidality, and treatment seeking in particular favored the prognostic value of dimensional over categorical diagnosis. These findings support the validity and potential utility of a dimensional conceptualization of SAD that may inform efforts to revise the diagnosis for DSM V. Keywords: social anxiety disorder, social phobia, taxometrics, dimensional diagnosis, diagnostic utility DOI: 10.1037/a0019341

The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or neutral emotional expression cued different locations on the computer screen. In the attention modification program (AMP), participants responded to a probe that always followed neutral faces when paired with a threatening face, thereby directing attention away from threat. In the attention control condition (ACC), the probe appeared with equal frequency in the position of the threatening and neutral faces. Results revealed that the AMP facilitated attention disengagement from threat from pre- to postassessment and reduced clinician- and self-reported symptoms of social anxiety relative to the ACC. The percentage of participants no longer meeting Diagnostic and Statistical Manual (4th ed.) criteria for GSP at postassessment was 50% in the AMP and 14% in the ACC. Symptom reduction in the AMP group was maintained during 4-month follow-up assessment. These results suggest that computerized attention training procedures may be beneficial for treating social phobia. Keywords: social phobia, attention, treatment, information processing

The odds of a lifetime diagnosis of social anxiety disorder increases by 3.79 times for children who had a stable report of behavioral inhibition from their mothers. This finding has important implications for the early identification and prevention of social anxiety disorder.

Background: Functional brain imaging studies have demonstrated amygdala and insula hyper-reactivity to probes of social threat in participants with generalized social anxiety disorder (gSAD). The amygdala and insula are known to serve broad functions in emotional processing, including integration of affective information. However, few studies have examined brain responses in socially anxious participants during general emotional processing. We examined brain response to emotionally evocative images in patients with gSAD and matched healthy controls. Methods: Eleven patients with gSAD who were not taking psychotropic medications and did not have psychiatric comorbidities and 11 matched healthy controls underwent functional magnetic resonance imaging while viewing blocks of emotionally salient (positive, negative, neutral) pictures. Results: Participants with gSAD exhibited enhanced bilateral amygdala and insula reactivity to negative (v. neutral) images compared with healthy controls who did not exhibit enhanced reactivity. Within the gSAD group, the extent of amygdala activation was correlated with social anxiety severity, whereas the extent of insula activation was correlated with trait anxiety. Limitations: The small sample size may have limited our ability to detect group differences in other relevant brain regions and in behavioural measures. Conclusion: In addition to prior findings of probes of social information processing, our findings suggest that the amygdala and insula responses are hyper-reactive to general emotional images with negative emotional content and that these brain regions may play divergent roles in their representation of different phenotypes., Introduction Generalized social anxiety disorder (gSAD), also known as social phobia, is characterized by an exaggerated fear of negative scrutiny across interpersonal interactions. This exaggerated fear response may be in [...]

Background: The co-morbid occurrence of anxiety disorders and schizophrenia has recently begun to be investigated. Social anxiety may be especially important to diagnose and manage among patients with schizophrenia. Aim: To investigate the prevalence and correlates of social phobia in patients with schizophrenia. Method: Diagnosis of schizophrenia and schizoaffective disorders as well as co-morbid anxiety disorders was established according to DSM-IV and the Structured Clinical Interview for Diagnosis (SCID-P Hebrew version). Severity of psychotic symptoms and social anxiety symptoms was assessed with the Positive and Negative Symptom Scale (PANSS) and the Liebowitz Social Anxiety Scale (LSAS). Results: The cohort studied included 117 patients with schizophrenia. Thirteen patients were diagnosed as suffering from co-morbid social phobia (11%). There was a tendency for patients with co-morbid social phobia to have higher severity PANSS total score. There was a significant correlation between the score of the LSAS 'fear' and PANSS positive subscales. Avoidance scores were higher among patients with negative signs. Conclusion: Co-morbidity of schizophrenia and social anxiety disorder is not rare among patients with schizophrenia. Treatment implications need be further investigated. Key words: social anxiety, schizophrenia, fear, co-morbidity

Previous research has shown that both depression and social anxiety--2 facets of internalizing psychopathology--are characterized by low levels of extraversion/positive emotionality (E/PE). However, little is known about the relations of the facets of E/PE with the symptoms of depression and social anxiety. This study utilized multiple measures of each facet of E/PE, as well as depression and social anxiety symptoms. Self-report data were collected from large samples of college students and psychiatric outpatients. Separate factor analyses in each sample revealed a 4-factor structure of E/PE consisting of Sociability, Positive Emotionality, Ascendance, and Fun-Seeking. Structural equation modeling revealed that, after controlling for the higher order internalizing factor and the overlap among the E/PE facets, social anxiety was broadly related to all 4 facets of E/PE, whereas depression was strongly related to only low positive emotionality. Implications for hierarchical models of personality and psychopathology, assessment and treatment, and etiological models are discussed. Keywords: depression, extraversion, internalizing, positive emotionality, social anxiety Supplemental materials: http://dx.doi.org/10.1037/a0015637.supp

Previous research suggests that socially anxious individuals interpret ambiguous social information in a more threatening manner compared to non-anxious individuals. Recently, studies have experimentally modified interpretation and shown that this subsequently affected anxiety in non-anxious individuals. If similar procedures can modify interpretation biases in socially anxious individuals, they may lead to a reduction in social anxiety symptoms. In the current study, we examined the effect of a computerized Interpretation Modification Program (IMP) on interpretation bias and social anxiety symptoms, Twenty-seven socially anxious individuals were randomly assigned to the IMP or a control condition, Participants completed eight computer sessions over four weeks. The IMP modified interpretation by providing positive feedback when participants made benign interpretations and negative feedback in response to threat interpretations. The IMP successfully decreased threat interpretations, increased benign interpretations, and decreased social anxiety symptoms compared to the control condition. Moreover, changes in benign interpretation mediated IMP's effect on social anxiety. This initial trial suggests that interpretation modification may have clinical utility when applied as a multi-session intervention. Keywords: Social anxiety Interpretation Information processing Treatment Training

The authors of the present study used an incidental learning paradigm to investigate the interpretation of neutral facial expressions in socially anxious individuals. Participants were asked to detect the location of a target following the presentation of a facial picture (i.e., cue). Unbeknownst to participants, the target location was contingent on the valence of the cue, and participants thus learned to associate different target locations with either positive or negative facial expressions. The authors subsequently used this learned association to assess interpretive biases. If socially anxious individuals interpret neutral faces in a negative manner, they should be faster to detect a target that appears in the location that is associated with negative face cues when the target is presented after a neutral face cue. The authors also assessed whether the anticipation of a feared situation influenced interpretive biases by comparing participants with and without a speech threat on this task. Results indicate that socially anxious individuals are characterized by an interpretive bias regardless of the threat manipulation. In contrast, non-anxious individuals interpreted neutral faces in a negative manner only when they were in the threat condition. Keywords: social anxiety; interpretive bias; face

Two experiments examined the link between interpretation and memory in individuals diagnosed with Generalized Social Phobia (GSP). In Experiment 1, GSP and control participants generated continuations for nonsocial and ambiguous social scenarios. GSP participants produced more socially anxious and negative continuations for the social scenarios than did the controls. On the subsequent test of recalling the social scenarios, intrusion errors that shared meaning with the original continuations were made more frequently by the GSP group, producing false recall with emotionally negative features. To examine whether nonanxious individuals would also produce such errors if given emotional interpretations, in Experiment 2 the authors asked university students to read the scenarios plus endings produced by GSP participants in Experiment 1. The students either constructed vivid mental images of themselves as the main characters or thought about whether the endings provided closure. Low-anxious students in the closure condition produced fewer ending-based intrusions in recalling the social scenarios than did students in the other 3 conditions. Results illustrate the importance of examining the nature of source-monitoring errors in investigations of memory biases in social anxiety. Keywords: social anxiety, social phobia, memory, interpretation

The present study employed both exploratory and confirmatory factor analytic approaches with nationally representative samples of individuals with a lifetime diagnosis of social anxiety disorder (n = 1123; n = 3091, respectively) using split-halves of the National Comorbidity Replication Survey (n = 9282) and cross-validated with the Canadian Community Health Survey on Mental Health and Wellbeing (n = 36,984). Strong support was found for a three-factor solution. This model was obtained from exploratory factor analysis and was further evaluated using two confirmatory factor analytic investigations in the two national samples. The three social situational domains reflected (1) Social Interaction Fears, (2) Observation Fears, and (3) Public Speaking Fears. Individuals with generalized social anxiety disorder (i.e., those who endorsed 7 or more of 13 feared social situations assessed in the survey) were significantly more likely to report Social Interaction Fears and Observation Fears compared to individuals with non-generalized social anxiety disorder (i.e., those who endorsed only 6 or fewer of 13 feared social situations). Individuals with generalized social anxiety were particularly characterized by combinations of Public Speaking Fears plus Social Interaction Fears and Observation Fears. The clinical and classification implications of our study for DSM-V are discussed. Keywords: Social anxiety disorder situational domains; Social anxiety disorder subtypes; National Comorbidity Replication Survey; Canadian Community Health Survey; Generalized social anxiety disorder

The study investigated the possibility of score inflation in the Social Phobia and Anxiety Inventory due to underlying medical conditions in respondents. The Diagnostic and Statistical Manual of Mental Disorders provides an exclusionary rule disallowing a diagnosis of social phobia when the fear is based on the presence of a medical condition. A computer-administered procedure, designed to simulate visually this paper-and-pencil inventory was created and compared to the original in a pilot study with r of .94 between the two procedures. Analysis indicates such medically based responding is common among college men and women (N = 127, M age = 19.0). Specifically, 50% of respondents reported 0 or 1 medical condition(s), while those in the fourth quartile averaged 43 medical bases for their responses. The most frequent self-reports of medical conditions were stuttering (2.8%), acne (2.4%), dry mouth (2.1%), obesity (.9%), and scars (.9%). Several possible solutions were discussed in view of the overall conclusion of a substantive basis for medical responding on this inventory.

Cognitive models of social phobia predict that several cognitive processes will mediate the relationship between trait levels of social anxiety and the extent of anxiety experienced in a specific social-evaluative situation. The current study aimed to provide a test of these relationships. Over 200 clinical participants with social phobia completed measures of their general social anxiety and a week later performed a brief impromptu speech. They completed a measure of state anxiety in response to the speech as well as questionnaires assessing several cognitive constructs including focus of perceived attention, perceived performance, and probability and cost of negative evaluation. A week later, they completed measures of negative rumination experienced over the week, as well as a measure of the recollection of their perceived performance. Path analysis provided support for a model in which the cognitive factors mediated between general social anxiety and the degree of anxiety experienced in response to the speech. A second model supported the theory that negative rumination mediated between characteristic social anxiety and negative bias in the recollection of performance. Keywords: Social phobia; Cognition; Maintenance; State anxiety; Speech anxiety

This study reports the results of a 3-year follow-up assessment of children and adolescents diagnosed with social anxiety disorder (social phobia) and treated with Social Effectiveness Therapy for Children (SET-C), a comprehensive behavioral treatment program combining social skills training, peer generalization, and individualized exposure. Among 32 children initially treated with the protocol, 29 completed the follow-up assessment and were evaluated with a multidimensional assessment strategy, including self-report, parental report, clinician ratings, and behavioral assessment. Results indicated that the majority of posttreatment gains were maintained at 3-year follow-up, and 72% of treated children continued to be free of a social phobia diagnosis 3 years later. These findings support the long-term efficacy of SET-C for children and adolescents suffering from social phobia. Keywords: social phobia, children, behavior therapy, Social Effectiveness Therapy for Children, treatment follow-up

Axis I comorbidity is associated with greater severity of social anxiety disorder. However, the differential effects of comorbid mood and anxiety disorders on symptom severity or treatment outcome have not been investigated. We evaluated 69 persons with uncomplicated social anxiety disorder, 39 persons with an additional anxiety disorder, and 33 persons with an additional mood disorder (with or without additional anxiety disorders). Those with comorbid mood disorders reported greater duration of social anxiety than those with uncomplicated social anxiety disorder. They were also judged, before and after 12 weeks of cognitive-behavioral group treatment and at follow-up, to be more severely impaired than those with no comorbid diagnosis. In contrast, persons with comorbid anxiety disorders were rated as more impaired than those with no comorbid diagnosis on only a single measure. Type of comorbid diagnosis did not result in differential rates of improvement of social anxiety disorder. Keywords: Social phobia; Social anxiety disorder; Comorbidity; Treatment outcome

Some psychometric properties of the Brief Fear of Negative Evaluation Scale (BFNE) that is often used to assess fear of negative evaluation, which is the core feature of social anxiety disorder, are examined in large samples of socially anxious patients. The results suggest that the standard scoring of the BFNE may not be optimal for patients with social anxiety disorder.

Blushing is the most prominent symptom of social phobia, and fear perception of visible anxiety symptoms is an important component of cognitive behavioral models of social phobia. However, it is not clear how physiological and psychological aspects of blushing and other somatic symptoms are linked in this disorder. The authors tested whether social situations trigger different facial blood volume changes (blushing) between social phobic persons with and without primary complaint of blushing and control participants. Thirty social phobic persons, 15 of whom were especially concerned about blushing, and 14 control participants were assessed while watching an embarrassing videotape, holding a conversation, and giving a talk. Only when watching the video did the social phobic persons blush more than controls blushed. Social phobic persons who complained of blushing did not blush more intensely than did social phobic persons without blushing complaints but had higher heart rates, possibly reflecting higher arousability of this subgroup.

Four types of anxiety found in children are described. They are generalized anxiety disorder, panic disorder, social phobia and separation anxiety disorder. While outside care is usually needed, teachers can help students avoid things that make them anxious or help by making it easier for them to face what cannot be avoided.