Measurement of social-evaluative anxiety

Neuronal signatures of anger and fear in patients with psychosis

The present study investigated the functional neuroanatomy in response to sentence stimuli related to anger-provoking situations and fear of negative evaluation in patients with psychosis. The tasks consisted of four active conditions, Self-Anger (SA), Self-Fear, Other-Anger (OA), and Other-Fear (OF), and two neutral conditions, Neutral-Anger (NA) and Neutral-Fear (NF). Several relevant clinical measures were obtained. Under all contrasts, significantly higher activation in the left inferior parietal gyrus or superior parietal gyrus and the left middle occipital gyrus or superior occipital gyrus was observed in patients compared to healthy controls (HCs). However, we observed significantly lower activation in the left angular gyrus (AG) and left middle temporal gyrus (MTG) under the OA vs. NA contrast, as well as in the left precuneus and left posterior cingulate gyrus (PCG) under the OF vs. NF contrast in patients. The mean beta values for the significant regions under the SA vs. NA and OF vs. NF contrasts were significantly associated with the total PI and PANSS scores, respectively. These findings indicate that patients with psychosis exhibit hypoactivation in the AG, MTG, precuneus, and PCG compared to HCs. The findings suggest that patients with psychosis are less efficient at recruiting neural responses in those regions for semantic processing and social evaluation.

More than doubling the clinical benefit of each hour of therapist time: a randomised controlled trial of internet cognitive therapy for social anxiety disorder

BACKGROUND

Cognitive therapy for social anxiety disorder (CT-SAD) is recommended by NICE (2013) as a first-line intervention. Take up in routine services is limited by the need for up to 14 ninety-min face-to-face sessions, some of which are out of the office. An internet-based version of the treatment (iCT-SAD) with remote therapist support may achieve similar outcomes with less therapist time.

METHODS

102 patients with social anxiety disorder were randomised to iCT-SAD, CT-SAD, or waitlist (WAIT) control, each for 14 weeks. WAIT patients were randomised to the treatments after wait. Assessments were at pre-treatment/wait, midtreatment/wait, posttreatment/wait, and follow-ups 3 & 12 months after treatment. The pre-registered (ISRCTN 95 458 747) primary outcome was the social anxiety disorder composite, which combines 6 independent assessor and patient self-report scales of social anxiety. Secondary outcomes included disability, general anxiety, depression and a behaviour test.

RESULTS

CT-SAD and iCT-SAD were both superior to WAIT on all measures. iCT-SAD did not differ from CT-SAD on the primary outcome at post-treatment or follow-up. Total therapist time in iCT-SAD was 6.45 h. CT-SAD required 15.8 h for the same reduction in social anxiety. Mediation analysis indicated that change in process variables specified in cognitive models accounted for 60% of the improvements associated with either treatment. Unlike the primary outcome, there was a significant but small difference in favour of CT-SAD on the behaviour test.

CONCLUSIONS

When compared to conventional face-to-face therapy, iCT-SAD can more than double the amount of symptom change associated with each therapist hour.

Specific facial signals associate with categories of social actions conveyed through questions

The early recognition of fundamental social actions, like questions, is crucial for understanding the speaker's intended message and planning a timely response in conversation. Questions themselves may express more than one social action category (e.g., an information request "What time is it?", an invitation "Will you come to my party?" or a criticism "Are you crazy?"). Although human language use occurs predominantly in a multimodal context, prior research on social actions has mainly focused on the verbal modality. This study breaks new ground by investigating how conversational facial signals may map onto the expression of different types of social actions conveyed through questions. The distribution, timing, and temporal organization of facial signals across social actions was analysed in a rich corpus of naturalistic, dyadic face-to-face Dutch conversations. These social actions were: Information Requests, Understanding Checks, Self-Directed questions, Stance or Sentiment questions, Other-Initiated Repairs, Active Participation questions, questions for Structuring, Initiating or Maintaining Conversation, and Plans and Actions questions. This is the first study to reveal differences in distribution and timing of facial signals across different types of social actions. The findings raise the possibility that facial signals may facilitate social action recognition during language processing in multimodal face-to-face interaction.

Comparison of Cognitive Behavioral Therapy and Cognitive Behavioral Group Therapy in the Treatment of Avoidant Personality Disorder

The primary aim of this study is to compile studies on cognitive behavioral therapy method in the treatment of avoidant personality disorder and present their data. Another aim is to discuss with the reasons, cognitive behavior group therapies may be more effective on this disorder than cognitive behavioral individual therapies, since the main problem in avoidant personality disorder stems from interpersonal communication and because the cognitive behavioral therapies applied as a group were found to be quite effective when the avoidant personality disorder was first defined. The aim of this study is to present recommendations together and to compile studies in which cognitive behavioral group therapies were applied on avoidant personality disorder. In this study, studies in domestic and foreign sources, which were conducted with a sample group with avoidant personality disorder and social anxiety disorder, were examined and the study was prepared by reviewing the literature, which is one of the secondary data collection techniques. Since there are not many studies on avoidant personality disorder in the literature, considering the high similarity and comorbidity of avoidant personality disorder with social anxiety disorder, studies on cognitive behavioral group therapies related to social anxiety disorder have also been compiled. As a result of the studies examined, it has been found that the symptoms of avoidant personality disorder are related to the distorted cognition of individuals and cognitive behavioral therapies are a very effective approach because they increase the awareness of the automatic thoughts in the minds of the clients, question their correctness and provide alternative thoughts to replace them.

Problem Solving and Emotion Coping Styles for Social Anxiety: A Meta-analysis of Chinese Mainland Students

Studies of how positive and negative coping styles affect social anxiety show mixed results. Hence, our two meta-analyses determined the overall effect sizes of problem solving-focused coping (PSC) styles and emotion-focused coping (EFC) styles on social anxiety in mainland China (PSC: k = 49 studies, N = 34,669; EFC: k = 52, N = 36,531). PSC was negatively linked to social anxiety (- .198), and EFC was positively linked to social anxiety (.223). In years with more national income, PSC's and EFC's effect sizes were larger. PSC's effect sizes were smaller among rural students (vs. urban students), larger among older students (university, high school, middle school), and larger in cross-sectional (vs. longitudinal) studies. When using SAD (vs. others) social anxiety measures, PSC effect sizes were larger, but EFC effect sizes were smaller. EFC effect sizes were larger in studies with convenience (vs. representative) samples. Gender, single child status, and coping style measurement showed no moderation effects. These findings suggest that using problem solving-focused coping styles rather than emotion-focused may reduce social anxiety, so future experimental studies can test this idea more rigorously.

Cosmetic satisfaction and patient-reported outcome measures following cranioplasty after craniectomy - A prospective cohort study

Introduction

Evaluating patient-reported outcomes (PROMs) helps optimize preoperative counseling and psychosocial care for patients who underwent cranioplasty.

Research question

This study aimed to evaluate cosmetic satisfaction, level of self-esteem, and fear of negative evaluation (FNE) of patients who underwent cranioplasty.

Material and methods

Patients who underwent cranioplasty from 1 January 2014 to 31 December 2020 ​at University Medical Center Utrecht and a control group consisting of our center' employees were invited to fill out the Craniofacial Surgery Outcomes Questionnaire (CSO-Q), consisting of an assessment of cosmetic satisfaction, the Rosenberg Self-Esteem Scale (RSES), and the FNE scale. To test for differences in results, chi-square tests and T-tests were performed. Logistic regression was used to study the effect of cranioplasty-related variables on cosmetic satisfaction.

Results

Cosmetic satisfaction was seen in 44/80 patients (55.0%) and 52/70 controls (74.3%) (p ​= ​0.247). Thirteen patients (16.3%) and 8 controls (11.4%) had high self-esteem (p ​= ​0.362), 51 patients (63.8%) and 59 controls (84.3%) had normal self-esteem (p ​= ​0.114), and 7 patients (8.8%) and 3 controls (4.3%) had low self-esteem (p ​= ​0.337). Forty-nine patients (61.3%) and 39 controls (55.7%) had low FNE (p ​= ​0.012), 8 patients (10.0%) and 18 controls (25.7%) had average FNE (p ​= ​0.095), and 6 patients (7.5%) and 13 controls (18.6%) had high FNE (p ​= ​0.215). Cosmetic satisfaction was associated with glass fiber-reinforced composite implants (OR 8.20, p-value ​= ​0.04).

Discussion and conclusion

This study prospectively evaluated PROMs following cranioplasty, for which we found favorable results.

The Aspects of Active-Learning Science Courses That Exacerbate and Alleviate Depression in Undergraduates

College science courses continue to transition from traditional lecture to active learning, which has been shown to have both alleviating and exacerbating effects on undergraduate mental health. Notably, existing studies have primarily examined the relationship between active learning and anxiety, and no studies have specifically assessed the relationship between active learning and depression. To address this gap, we conducted hourlong exploratory interviews with 29 undergraduates from six institutions who identify as having depression and who had been enrolled in at least one active-learning college science course. We probed how undergraduates' depression affects their experiences in active learning, and in turn, what aspects of active-learning practices exacerbate or alleviate students' depressive symptoms. Students described that their depression negatively impacted their cognitive domains, which could make learning and social interactions challenging. Additionally, we found that the underlying aspects of active-learning practices that impact students' depression fall into four overarching categories: opportunities to compare oneself with others, socializing with others while learning, frequent formative evaluation, and engagement in learning. Each of these aspects of active learning could alleviate and/or exacerbate depressive symptoms. This work supports recommendations to create more inclusive active-learning courses for students with depression.

Characteristics and influencing factors of social isolation in patients with breast cancer: a latent profile analysis

PURPOSE

The goal of this study is to investigate the social isolation (SI) subtypes of patients with breast cancer (BC) and to explore its influencing factors.

METHODS

A sample of 303 BC patients participated in the study from September to December, 2021. Latent profile analysis (LPA) was performed to identify SI clusters based on the three sub-scales of the Chinese version of the Social Anxiety Scale, the Chinese version of the Social Avoidance and Distress Scale, and the Chinese version of the Loneliness Scale.

RESULTS

We found that SI can be divided into three categories: high-level (Class 1), middle-level (Class 2), and low-level (Class 3), accounting for 20.46%, 33.00%, and 46.54%, respectively. Compared to Class 3, Class 1, which had the lower average monthly income per family member (RMB) (< 3000: OR = 5.298, P = .021; 3000 ~ 5000: OR = 5.320, P = .018), was more likely to suffer from SI due to occupation (Laborer: OR = 12.023, P = .009). Surgery (OR = 14.138, P < .001; OR = 2.777, P = .020), chemotherapy (OR = 10.224, P = .001; OR = 3.545, P = .001); poorer family functioning (OR = .671, P < .001; OR = .801, P = .002), and lower levels of self-transcendence (OR = .806, P < .001; OR = .911, P < .001) were important influencing factors for SI in Class 1 and Class 2 compared to Class 3.

CONCLUSION

SI is classifiably heterogeneous among patients with BC. Strategies that identify characteristics of SI and give targeted intervention focusing on family functioning and improving self-transcendence levels contribute to the prevention of SI among patients with BC.

Social distance of bystanders affects people's embarrassment via changing fear of negative evaluation and feelings of attachment security

BACKGROUND

Embarrassment is a self-conscious emotion with important social functions, but it is not well understood. The perception of bystanders is considered a precondition for embarrassment, which makes it unique from other self-conscious emotions. Studies have shown that socially close bystanders can reduce individuals' embarrassment. However, whether and how the embarrassment of individuals varies with the changes in social distance between them and their bystanders remained unclear, which indicates the key characteristics of embarrassment.

METHODS

The current research consists of two studies. Study 1 tested whether participants' embarrassment systematically varied with social distance by setting up three levels of social distance: close friends (i.e., short), casual friends (i.e., medium), and strangers (i.e., long), based on 159 participants. With two full mediation models, study 2 investigated whether and how the fear of negative evaluation and state attachment security mediated the influence of social distance on embarrassment based on 155 participants.

CONCLUSIONS

The current findings revealed that the social distance between bystanders and protagonists systematically influenced the embarrassment of protagonists and this effect occurred via two parallel pathways, i.e., by increasing the fear of negative evaluation and by reducing state attachment security. The findings not only showed the unique role of bystander characteristics on embarrassment, but also two cognitive processes behind this unique self-conscious emotion: fearing negative evaluation and seeking attachment for security.

Parental phubbing and academic burnout in adolescents: the role of social anxiety and self-control

Based on the limited resource model of self-control, we construct a chain mediation model to examine the relationship between parental phubbing and adolescents' academic burnout, and whether social anxiety and self-control play a mediating role in it. We used 4 questionnaires to investigate parental phubbing, social anxiety, self-control, and adolescents' academic burnout among 828 high school students in Wuhu and Huangshan City, Anhui Province, China. The findings indicated that: (1) parental phubbing, social anxiety, and self-control all significantly predict adolescents' academic burnout directly and (2) parental phubbing could indirectly influence adolescents' academic burnout through three pathways: the separate mediating effect of social anxiety and self-control, and the chain mediating effect on both. The results of this study help parents understand how their phubbing actions affect adolescents' academic burnout and the mechanism of action.

Modification of the therapist's facial expressions using virtual reality technology during the treatment of social anxiety disorder: a case series

Exposure therapy is a mainstream of treatment for social anxiety disorder (SAD). However, effort and time are required to recreate interpersonal situations that produce moderate anxiety. On the other hand, virtual reality exposure therapy can easily control anxiety-inducing conditions and allow for graduated exposure. However, artificial intelligence and animations that speak as naturally as actual humans are not yet practical, adding to the limitations of these treatments. The authors propose the use of a virtual reality technology that can transform facial expressions into smiling or sad faces in real time and display them on a monitor, potentially solving the above-mentioned problems associated with virtual reality animations. This feasibility study was conducted to determine whether this system can be safely applied to the treatment of SAD patients. A total of four SAD patients received 16 exposure therapy sessions led by an experienced therapist over a monitor; throughout the sessions, the facial expressions of the therapist were modified using software to display expressions ranging from smiling to sad on the monitor that was being viewed by the patient. Client satisfaction, treatment alliance, and symptom assessments were then conducted. Although one patient dropped out of the study, treatment satisfaction and treatment alliance were scored high in all the cases. In two of the four cases, the improvement in symptoms was sustained over time. Exposure therapy in which the interviewer's facial expressions are modified to induce appropriate levels of anxiety in the patient can be safely used for the treatment of SAD patients and may be effective for some patients.

The current state-of-the-art in pharmacotherapy for pediatric generalized anxiety disorder

INTRODUCTION

Anxiety disorders are the most prevalent psychiatric disorders among youth. Among the various anxiety disorders, generalized anxiety disorder is particularly prevalent. Youth with GAD appear at elevated risk of developing other anxiety disorders, mood disorder, and substance use disorders. Functional outcomes of youth with GAD can be improved through early recognition and treatment, thus promoting better longer-term outcomes.

AREAS COVERED

The current article summarizes evidence-based state-of-the-art pharmacotherapy for pediatric GAD based on open-label, randomized, and controlled trials. Two electronic databases (PubMed and Scopus) were systematically searched in April 2022 for relevant publications.

EXPERT OPINION

The literature supports a combination of psychotherapy and pharmacotherapy as being associated with better outcomes when compared to mono-therapies. While longer-term follow-ups are limited, one such study does challenge this notion. Both selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) have been found across studies to have moderate effect sizes in the treatment of pediatric anxiety disorders. SSRIs continue to be a first-line intervention, whereas SNRIs may be considered a second-line treatment. While more evidence is needed, there are emerging data indicating that SSRIs are associated with a more rapid and greater reduction in anxiety symptoms when compared to SNRIs.

A boost in self-esteem after positive social evaluation predicts social and non-social learning

Fluctuations in self-esteem resulting from social acceptance and rejection could guide social behaviour by putting us in a state that is more or less open to social experiences. However, it remains unclear whether social acceptance and rejection may shape learning from social information depending on individual differences in self-esteem changes. Here we used a social feedback paradigm to manipulate social acceptance and rejection in a between-subjects design. Subsequently, we administered a behavioural task that enables the assessment of how well individuals learn on the basis of own experiences versus social information. Participants receiving positive (N = 43) versus negative (N = 44) social evaluation demonstrated an increase in subjective self-esteem. Importantly, the effect of the social evaluation on social learning was moderated by self-esteem changes. Specifically, an increase in self-esteem, as induced by positive evaluation, was associated with increased learning from social, but decreased learning from individual information. A decrease in self-esteem in response to negative evaluation was associated with decreased learning from individual information. These data suggest that increases in self-esteem in response to positive evaluation can induce a shift in the inclination to use social versus non-social information and may open one up to constructive learning from others.

Context and domain matter: the error-related negativity in peer presence predicts fear of negative evaluation, not global social anxiety, in adolescents

BACKGROUND

Social anxiety symptoms are most likely to emerge during adolescence, a developmental window marked by heightened concern over peer evaluation. However, the neurocognitive mechanism(s) underlying adolescent social anxiety remain unclear. Emerging work points to the error-related negativity (ERN) as a potential neural marker of exaggerated self/error-monitoring in social anxiety, particularly for errors committed in front of peers. However, social anxiety symptoms are marked by heterogeneity and it remains unclear exactly what domain(s) of social anxiety symptoms are associated with ERN variation in peer presence, particularly within the adolescent period.

METHODS

To advance and deepen the mechanistic understanding of the ERN's putative role as a neural marker for social anxiety in adolescence, we leveraged a social manipulation procedure and assessed a developmentally salient domain of social anxiety during adolescence - fear of negative evaluation (FNE). Adolescents residing in Hanzhong, a small city in the southwestern region of mainland China, had EEG recorded while performing a flanker task, twice (peer presence/absence); FNE, as well as global social anxiety symptoms, was assessed.

RESULTS

Overall ERN increases in peer presence. FNE specifically, but not global levels of social anxiety symptoms, predicted ERN in peer presence.

CONCLUSIONS

These data are the first demonstration that the ERN relates to a specific domain of social anxiety in adolescents, as well as the first evidence of such relations within a non-WEIRD (Western, Educated, Industrialized, Rich and Democratic) sample. Results have important implications for theory and research into adolescent social anxiety.

The relationship between self-esteem and mobile phone addiction among college students: The chain mediating effects of social avoidance and peer relationships

Introduction

Mobile phone addiction has a negative impact on the physical and mental health of college students, which has attracted extensive attention from scholars.

Methods

In this study, we investigated the mechanism of the influence of self-esteem on mobile phone addiction among 694 college students using the Self-Esteem Scale, the Mobile Phone. Addiction Scale, the Peer Relationship Scale and the Social Avoidance and Distress Scale.

Results

The results showed that (1) self-esteem significantly and negatively predicted mobile phone addiction; (2) self-esteem influenced mobile phone addiction through the mediating effect of social avoidance; (3) self-esteem influenced mobile phone addiction through the mediating effect of peer relationships; and (4) social avoidance and peer relationships played a chain mediating role in the influence of self-esteem on mobile phone addiction.

Discussion

These findings can help researchers and educators better understand the underlying mechanisms of the relationship between self-esteem and mobile phone addiction and to provide practical and effective operational suggestions for the prevention and intervention of mobile phone addiction among college students.

Body talk on social networking sites and restrained eating among adolescents: A test of a multiple mediation model

The present study aimed to examine the link between body talk on social networking sites (SNS body talk) and restrained eating as well as the mediating roles of fear of negative appearance evaluation (FNAE) and body shame in this relationship. Furthermore, the moderating role of gender in the mediation model was also examined. A sample of 1481 Chinese middle and high school students (720 girls, mean age = 15.49 ± 1.84) completed self-reported measures of SNS body talk, FNAE, body shame, and restrained eating. Results showed that SNS body talk was positively associated with restrained eating. FNAE and body shame mediated the association between SNS body talk and restrained eating, separately and serially. Furthermore, gender difference emerged in the path from SNS body talk to body shame and the path from FNAE to body shame. Findings of the present study enrich the literature on social media and body image and eating behaviors, and have important implications for reducing negative body image and disordered eating among adolescents.

Using 360-degree immersive videos to assess multiple transdiagnostic symptoms: A study focusing on fear of negative evaluation, paranoid thoughts, negative automatic thoughts, and craving

Over the last 20 years, virtual reality (VR) has gained a great interest for both assessment and treatment of various psychopathologies. However, due to high costs and material specificity, VR remains disadvantageous for clinicians. Adopting a multiple transdiagnostic approach, this study aims at testing the validity of a 360-degree immersive video (360IV) for the assessment of five common psychological symptoms (fear of negative evaluation, paranoid thoughts, negative automatic thoughts, craving for alcohol and for nicotine). A 360IV was constructed in the Darius Café and included actors behaving naturally. One hundred and fifty-eight adults from the general population were assessed in terms of their proneness towards the five symptoms, were then exposed to the 360IV and completed measures for the five state symptoms, four dimensions of presence (place, plausibility, copresence and social presence illusions) and cybersickness. Results revealed that the five symptoms occurred during the immersion and were predicted by the participants' proneness towards these symptoms. The 360IV was also able to elicit various levels of the four dimensions of presence while producing few cybersickness. The present study provides evidence supporting the use of the 360IV as a new accessible, ecological, and standardized tool to assess multiple transdiagnostic symptoms.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10055-023-00779-y.

Parental Burnout and Adolescents' Development: Family Environment, Academic Performance, and Social Adaptation

The present study aimed to examine the effect and underlying mechanism of parental burnout on adolescents' development as well as the mediating role of parental psychological control. Adolescents' academic performance, and social distress were selected as developmental indicators. Data were collected on three different occasions using a time-lagged design. Questionnaires were distributed to 565 Chinese families. In the first phase of data collection, fathers and mothers were asked to provide data regarding their parental burnout separately. In the second phase, adolescents were asked to provide details regarding their perceived father and mother's psychological control. In the third phase, adolescents were asked to provide information on their social distress. At the end of their term, academic performance scores on the final exams were collected. In total, data of 290 students (135 boys; Mage = 13.85 years) and their parents (for fathers age M = 41.91, and for mothers M = 40.76) were matched. The results of the multi-group structural equation model showed that parental burnout was negatively related to adolescents' development indirectly through parental psychological control. Parental psychological control partial mediated the relation between parental burnout and academic performance, and fully mediated the relation between parental burnout with social adaptation. In addition, mothers' parental burnout showed a stronger effect than fathers'. Mothers' parental burnout generally showed significant effects on adolescents' development, while the same indirect effects were not significant in the sample of fathers. These results showed the importance of mothers' influence on adolescents in parenting activities, and therefore, attention should be paid to mothers in the intervention and prevention of parental burnout.

Fear of negative evaluation and suicidal ideation among college students: the moderating role of impulsivity-like traits

Objective: Fear of negative evaluation (FNE) is a key trait of social anxiety and has been linked to isolation and low self-esteem. Impulsivity has been shown to amplify the risk of socially anxious individuals engaging in risky behaviors such as suicidal behaviors; yet little research has examined associations between FNE and suicidality or the relationship between FNE and impulsivity. Participants/Methods: This study tested whether FNE was associated with suicidal ideation in a sample of 1,816 college students from 10 universities. Analyses also examined whether impulsivity-like traits moderated the relationship between FNE and suicidal ideation. Results: Results showed that FNE was significantly associated with suicidal ideation and the positive association between FNE and suicidal ideation was strongest among individuals with higher negative urgency and lower perseverance. Conclusions: These findings highlight FNE as an important risk factor of suicidal ideation in college students and illuminates potential influence of impulsivity on this relationship.

Measurement invariance of the Liebowitz Social Anxiety Scale-Self-Report

OBJECTIVE

The Liebowitz Social Anxiety Scale-Self Report (LSAS-SR) is a self-report measure of social anxiety (SA), which has shown adequate psychometric properties across cultures. However, no study has systematically evaluated its measurement invariance (MI) between (a) individuals with and without a diagnosis of social anxiety disorder (SAD) and (b) males and females. The current study addresses this issue.

METHODS

We collected data on 257 (158 females) Italian individuals diagnosed with SAD and 356 (232 females) community-dwelling adults.

RESULTS

We initially found support for the unidimensionality of the Italian LSAS-SR measurement model in all samples. Using the Graded Response Model, we obtained evidence of partial MI and differential item functioning between community-dwelling and SAD-diagnosed individuals and evidence of strong MI between male and female participants.

CONCLUSIONS

The results of this study suggest that the Italian LSAS-SR measures the same trait in the same way across the symptom continuum and sexes, making it a psychometrically sound tool for assessment, screening, and research purposes.

Development of social anxiety cognition scale for college students: Basing on Hofmann's model of social anxiety disorder

Introduction

To develop the Chinese version of the Social Anxiety Cognition Scale for College Students (SACS-CS) based on Hofmann's model of social anxiety disorder and examine its reliability and validity.

Methods

Based on literature analysis and structured interviews, a theoretical model was constructed and behavioral examples were collected. According to the results of participants' and experts' evaluations, the initial SACS-CS was developed. The study data were collected from a total of 500 valid participants, randomly divided into two samples. Sample 1 (n = 200) and sample 2 (n = 300) were considered for exploratory factor analysis and confirmatory factor analysis (CFA), respectively. Internal reliability and validity were examined using all 500 participants, and temporal reliability was established using sample 3 (n = 70), who completed the scale again after 4 weeks.

Results

The SACS-CS consists of 21 items, grouped under four factors: self-perception, social skills, emotional control, and cost estimation. The four-factor model fits well. The internal consistency coefficient of the scale and the four factors ranged from 0.87 to 0.96, and the test-retest reliability ranged from 0.76 to 0.84. The scores of the scale and the four factors were significantly correlated with the score of the Interaction Anxiousness Scale (r = 0.54-0.64).

Discussion

The SACS-CS possesses good reliability and validity and can be applied in the cognitive assessment of college students' social anxiety. The scale could help people with different social anxiety disorder conditions receive more personalized interventions.

Relationships among inferiority feelings, fear of negative evaluation, and social anxiety in Chinese junior high school students

Introduction

This study aimed to explore the relationship between feelings of inferiority and social anxiety in Chinese junior high school students. In addition, it examined the potential mediating effect of fear of negative evaluation in this relationship.

Methods

A survey was administered to a sample of 734 Chinese junior high school students. The Feelings of Inadequacy Scale, Brief Fear of Negative Evaluation Scale, and Social Avoidance Distress Scale were used.

Results

First, there were significant positive correlations between all subscales for the inferiority feelings, social anxiety, and fear of negative evaluation. Furthermore, fear of negative evaluation mediated the predictive effects of four inferiority subscales (i.e., self-esteem, academic ability, appearance, and physical ability) for social anxiety. However, the total score for the sense of inferiority and social confidence subscale lacked this mediating effect.

Conclusion

The inferiority feelings of self-esteem, academic ability, appearance, and physical ability may directly and indirectly predict social anxiety through fear of negative evaluation.

Aberrant neural correlates of multisensory processing of audiovisual social cues related to social anxiety: An electrophysiological study

BACKGROUND

Social anxiety disorder (SAD) is characterized by abnormal fear to social cues. Although unisensory processing to social stimuli associated with social anxiety (SA) has been well described, how multisensory processing relates to SA is still open to clarification. Using electroencephalography (EEG) measurement, we investigated the neural correlates of multisensory processing and related temporal dynamics in social anxiety disorder (SAD).

METHODS

Twenty-five SAD participants and 23 healthy control (HC) participants were presented with angry and neutral faces, voices and their combinations with congruent emotions and they completed an emotional categorization task.

RESULTS

We found that face-voice combinations facilitated auditory processing in multiple stages indicated by the acceleration of auditory N1 latency, attenuation of auditory N1 and P250 amplitudes, and decrease of theta power. In addition, bimodal inputs elicited cross-modal integrative activity which is indicated by the enhancement of visual P1, N170, and P3/LPP amplitudes and superadditive response of P1 and P3/LPP. More importantly, excessively greater integrative activity (at P3/LPP amplitude) was found in SAD participants, and this abnormal integrative activity in both early and late temporal stages was related to the larger interpretation bias of miscategorizing neutral face-voice combinations as angry.

CONCLUSION

The study revealed that neural correlates of multisensory processing was aberrant in SAD and it was related to the interpretation bias to multimodal social cues in multiple processing stages. Our findings suggest that deficit in multisensory processing might be an important factor in the psychopathology of SA.

[Mental disorders in blepharospasm]

OBJECTIVE

To analyze mental disorders in blepharospasm (BS) before and after botulinum therapy (BT).

MATERIAL AND METHODS

We examined 25 patients with BS (9 men and 16 women), aged 50 to 85 years (mean 64.1±18.5), with BS (main study group). The control group consisted of 20 healthy individuals (7 men and 13 women, mean age 63.5±8.5). Patients were examined before and after BT (after 3 weeks) using a diagnostic structured interview Mini International Neuropsychiatric Interview, GAD-7, PHQ-9, fear of negative assessment (short version) and The Liebowitz Social Anxiety Scale (LSAS).

RESULTS

Fifty-six percent of patients with BS, as assessed by the GAD-7, showed a high level of anxiety, while depression, measured by the PHQ-9 and found in 52% of patients, was mainly manifested by mild disorders. In the group of patients with BS, the mean scores were higher on the GAD-7, PHQ-9, fear of negative assessment (p<0.001) and LSAS (p<0.05) than in the control group. After treatment with BT, the levels of anxiety and depression in patients with BS decreased slightly and remained higher compared with the control group. Psychiatric examination in the majority (64%) of patients revealed mental disorders that could not be explained by the occurrence of BS. The remaining 36% of patients had adaptation disorders (nosogenic reactions) caused by BS. Affective mental pathology (recurrent depressive disorder and dysthymia) and anxiety disorders (social phobia and adjustment disorders) were more often observed in the main study group compared with the control group (24% versus 5% and 68% versus 10%, respectively).

CONCLUSION

A significant proportion of patients with BS have anxiety and depressive disorders, the severity of which does not depend only on the severity of motor symptoms and does not significantly decrease after successful BT, but is caused by mental disorders that preceded the manifestation of BS. Identification of mental disorders to varying degrees associated with BS, not only on the basis of psychometric scales, but also consultation with a psychiatrist, will allow, in addition to the correction of motor symptoms of BS, to differentiate the therapeutic approach through psychotherapy and psychopharmacotherapy.

Repeated stage exposure reduces music performance anxiety

Background

High heart rate (HR) and restlessness are two important features of music performance anxiety (MPA). In a case report of a cellist suffering from this condition, we showed that HR and restlessness decreased after repeated live performances of the same musical excerpt, thereby positively modulating objective performance criteria and subjective components. Here, we largely replicate these results in a group of 18 string players reporting MPA.

Methods

Objective measurement devices included a miniaturized electrocardiogram monitor and three 3-axis accelerometer loggers. Subjective measures included the Multidimensional Mental Health Questionnaire (MDBF) and a customized visual analogue scale (VAS) questionnaire for MPA. Non-artistic performance errors were assessed by music experts using a composite score for technical playing errors (i.e., intonation errors, omission of notes, and bowing noise). Data were collected from each study participant during three brief public solo performances of the same musical excerpt, with each performance occurring before a new audience on the same day.

Results

From the 1st to the 3rd performance, HR, VAS, and playing error scores decreased significantly. MDBF (RU scale) showed a significant increase in calmness from the 1st to the 3rd performance on stage. HR and RU, VAS, and RU, as well as bow acceleration and overall duration of playing correlated significantly across participants and performances.

Discussion and conclusion

We conclude that repeated stage exposure significantly reduces HR as well as restlessness and playing errors linked to MPA. Public performances are still successful when HR is significantly higher than during rest periods. These results underscore the importance of stage training to become accustomed to realistic public self-exposure. Musicians - especially students - should consider this component of stage training as an integral part of their practice routine. Therefore, stage training can reduce MPA, promote better live performances and prevent stress-related mental disorders and physical injuries. These result from excessive self-exercise strategies common in musicians experiencing MPA. HR monitoring should be an integral part of evaluating the effectiveness of interventions for better MPA management and efficient performance training.

Psychological needs satisfaction and smartphone addiction among Chinese adolescents: The mediating roles of social anxiety and loneliness

Objectives

Although previous studies have initially noted that psychological needs satisfaction (PNS) might be a significant risk factor for technology addiction (e.g. online gaming addiction and Internet addiction), specific mechanisms involved in the association between PNS and adolescent smartphone addiction are largely unknown. Based on self-determination theory, this cross-sectional study constructed a multiple mediation model to examine whether PNS will influence adolescent smartphone addiction through the mediating roles of social anxiety and loneliness.

Methods

Eight hundred and ninety-nine Chinese adolescents answered the questionnaire including measures of PNS, social anxiety, loneliness, and smartphone addiction. SPSS 24.0 was used for common method bias test, reliability test, and correlation analysis, and Mplus 7.4 was used to examine the mediating roles of social anxiety and loneliness in the multiple mediation model.

Results

This study found that (1) PNS was negatively associated with adolescent smartphone addiction; (2) loneliness significantly mediated the association between PNS and smartphone addiction while the mediating role of social anxiety in this association was nonsignificant; and (3) social anxiety and loneliness also sequentially mediated this association.

Conclusion

This study further enriched potential mechanisms linking PNS and smartphone addiction among adolescents, which may contribute to intervention and prevention programs for adolescent smartphone addiction from the perspective of improving both PNS and negative emotions including social anxiety and loneliness.

Influence of perceived discrimination on problematic smartphone use among Chinese deaf and hard-of-hearing students: Serial mediating effects of sense of security and social avoidance

BACKGROUND

Reducing the rate and impact of problematic smartphone use (PSU) among deaf and hard-of-hearing (DHH) students has become a social issue. Research has suggested that perceived discrimination is associated with PSU, although the underlying mechanism of this association for DHH students is not clear.

AIMS

This study explored the mediating roles of sense of security and social avoidance in the association between perceived discrimination and PSU among Chinese DHH students.

METHOD

Five hundred and seventy DHH students, selected through simple random sampling, participated in an online survey, which included measurements of perceived discrimination, sense of security, social avoidance, and PSU. The results were analyzed with SPSS 25.0 and Mplus 7.0.

RESULTS

(1) Perceived discrimination, sense of security, and social avoidance were significantly associated with PSU among DHH students; (2) sense of security and social avoidance played mediating roles separately in the association between perceived discrimination and PSU; (3) sense of security and social avoidance played serial mediating roles in the relationship between perceived discrimination and PSU.

CONCLUSIONS

The findings suggest that discriminatory experiences of DHH students are related to a relatively low sense of security and high social avoidance, which may lead to PSU. The results have important implications for the prevention of and intervention for PSU among DHH students.

Prevalence and Risk Factors Associated with Mental Health in Adolescents from Northern Chile in the Context of the COVID-19 Pandemic

The COVID-19 pandemic has affected the world population; however, there is limited knowledge about its impact on adolescents. The aim of this study was to estimate the prevalence and risk factors associated with mental health in the context of the COVID-19 pandemic in young people in northern Chile. The sample consisted of 1315 young people between the ages of 14 and 18. Univariate analysis and multiple logistic regression were performed to identify the risk factors associated to the considered symptomatology. Depressive symptomatology was reported at 36.3%, anxiety at 6%, and social phobia at 27.8%. Adolescent females reported a higher probability of presenting depressive (OR, 3.409), anxious (OR, 3.949), and social phobia (OR, 3.027) symptomatology. Young women between the ages of 17 and 18 were more likely to present anxiety (OR, 2.172); moreover, being a migrant was related to lower odds of presenting anxiety (OR, 0.259) and depression (OR, 0.662). Having a family member diagnosed with COVID-19 was associated with depressive symptomatology (OR, 1.369). The COVID-19 pandemic can have serious repercussions on the mental health of adolescents. It is important to generate interventions to meet the needs of youth during the post-confinement period.

Sleep Problems, Social Anxiety and Stuttering Severity in Adults Who Do and Adults Who Do Not Stutter

Background: While there is sufficient evidence that children and adolescents who stutter reported more impaired sleep compared to children and adolescents who did not stutter, findings among adults who stutter (AWS) were scarce. Furthermore, stuttering is associated with issues related to verbal communication in a social context. As such, it was conceivable that AWS reported higher scores for social anxiety, compared to adults who do not stutter (AWNS). In the present study, we tested whether AWS reported higher sleep complaints compared to AWNS. We further tested whether scores for social anxiety and stuttering independently predicted sleep disturbances. Methods: A total of 110 AWS (mean age; 28.25 years, 27.30% females) and 162 AWNS (mean age; 29.40 years, 51.20% females) completed a series of self-rating questionnaires covering sociodemographic information, sleep disturbances and social anxiety. Adults with stuttering further completed a questionnaire on stuttering. Results: Compared to AWNS, AWS reported a shorter sleep duration, a lower sleep efficiency, higher scores for drug use in terms of sleep-promoting medications (significant p-values and medium effect sizes), and an overall higher PSQI score (significant p-values and large effect size), when controlling for age and social anxiety. Next, while p-values were always significant for subjective sleep quality, sleep disturbances, and daytime functioning, when controlling for age and social anxiety, their effect sizes were trivial or small. For sleep latency, the p-value was not significant and the effect size was trivial. Among AWS, higher scores for stuttering and older age, but not social anxiety, predicted higher sleep disturbances. The association between higher sleep disturbances and higher stuttering severity was greatest among those AWS with highest scores for social anxiety. Conclusions: When compared to AWNS, AWS self-reported higher sleep disturbances, which were associated with older age, and higher scores for stuttering severity, but not with social anxiety. Adults who stutter might be routinely asked for their sleep quality.

The role of fear of negative evaluation on the effects of self-control on affective states and life satisfaction: a moderated mediation analysis

Previous studies have found a robust positive relationship between trait self-control and life satisfaction mediated by both positive and negative affect, but the simultaneous inclusion of the effect of apprehension of being evaluated by others is less commonly investigated. The present study aimed to examine (1) whether the relationship between self-control and life satisfaction was mediated by positive affect and negative affect in parallel, and (2) whether fear of negative evaluation would moderate the strengths of the mediational pathways. With a sample of two hundred fifty university students in Hong Kong, mediational analysis (ME) revealed that both positive affect and negative affect were the mediators between self-control and life satisfaction. Subsequent moderated mediation analysis (moME) supported the moderating role of fear of negative evaluation on the mediational pathway through positive affect, but not on the pathway through negative affect. In particular, higher scores on fear of negative evaluation would attenuate the strength of association between self-control and positive affect. Therefore, to optimize university students' well-being and mental health functioning, treatment modalities should target both behavioral (i.e., self-control) and socio-emotional (i.e., apprehension of being evaluated critically from others) aspects.

A mixed methods investigation of reasons underlying fear of positive evaluation

Fear of negative evaluation (FNE) is a hallmark feature of social anxiety disorder (SAD). There is also evidence that people with SAD fear receiving positive evaluation and that fear of positive evaluation (FPE) is distinct from FNE. However, researchers have speculated that concerns related to negative evaluation may actually underlie FPE. This study sought to advance our understanding of FPE by employing both quantitative and qualitative methods to assess the reasons underlying participants' endorsement of FPE on the Fear of Positive Evaluation Scale and the extent to which these reasons reflect FNE versus FPE in a sample of individuals with SAD (n = 47) and a nonclinical comparison group (n = 49). Results indicated that responses to the FPES items primarily reflected an underlying FNE. Consistent with contemporary cognitive-behavioural theories of SAD, fear of proximal or eventual negative judgement emerged as the most common reason for participants' responses on the FPES. However, participants reported other reasons that did not reflect FNE, such as fear of hurting people's feelings and uncertainty associated with positive evaluation. All of the reasons underlying participants' ratings on the FPES were reported by both the SAD group and the nonclinical comparison group; however, individuals with SAD endorsed each of the reasons to a greater extent. These findings suggest that the FPES does not exclusively assess FPE as intended; however, the emergence and endorsement of reasons other than FNE suggest that FPE exists as a distinct construct.

Clarifying the association of social anxiety with cognitive variables: The role of self-esteem, self-perception, fears of positive and negative evaluation, and post-event processing

Theoretical models of social anxiety disorder (SAD) have identified several cognitive factors (fear of negative evaluation [FNE], self-perception, self-esteem, and post-event processing [PEP]) that play a role in the maintenance of the disorder. The current study aimed at testing both the cognitive factors addressed in these different models and the fear of positive evaluation (FPE) in the same construct. A non-clinical emerging adulthood sample (N = 325) were subjected to structural equation modeling (SEM). The results of the SEM showed that FPE, FNE, and self-concepts (self-esteem and self-perception) were significantly associated with social anxiety. Effect sizes indicated that the variables that most affected social anxiety were FPE, self-perception, FNE, and self-esteem, respectively. However, although it was significant in the conceptual model, the direct effect of social anxiety on PEP was not significant in the full model. On the other hand, the present findings add further support to the roles of negative self-perception and low self-esteem in social anxiety. Moreover, FPE may not be just delayed/postponed FNE. Considering the effect size of FPE on social anxiety, targeting it when appropriate in treatment may reduce the severity of social anxiety.

Trajectories and predictors of social avoidance in female patients with breast cancer

Background

Social avoidance plays an important role in influencing quality of life among patients with breast cancer. Social avoidance behaviors change with treatment periods. However, the trajectory patterns and the predictive factors have not been fully studied.

Objective

This study examined the growth trajectory of social avoidance and its predictors in patients with breast cancer.

Materials and methods

A total of 176 patients with breast cancer in a university hospital in Shaanxi Province, China, were followed up four times over 6 months following surgery, and data from the final 144 patients were analyzed. The growth mixed model (GMM) was used to identify the trajectory categories, and the predictive factors of the trajectory types were analyzed by logistic regression.

Results

The best-fit growth mixture modeling revealed three class models: persistent high social avoidance group (Class 1), social avoidance increased first and then decreased group (Class 2), and no social avoidance group (Class 3), accounting for 13.89, 31.94, and 54.17% of patients, respectively. Single-factor analysis showed that family income per capita, residence, and temperament type were related to the social avoidance trajectory. Logistic regression analysis showed that only temperament type was an independent predictor of the social avoidance trajectory, and patients with melancholia were more likely to have persistent high social avoidance.

Conclusion

Our study proved the heterogeneity of social avoidance behaviors and the influencing effect of temperament type on the development of social avoidance behaviors in Chinese patients with breast cancer. Health professionals should pay more attention to patients who are at higher risk of developing a persistent social avoidance pattern and provide target interventions.

Psychosocial distress and psychological adjustment in patients with ocular loss: a framework analysis

BACKGROUND

Patients with ocular loss tend to have physical and psychosocial difficulties. Maxillofacial prosthetic specialists involved in the treatment should be trained with competence to manage psychological complications. However, due to the multifactorial origin of the psychosocial distress, designing such training activities can be challenging. This research aimed to construct a conceptual framework illustrating the effects of ocular loss on patients' physical and psychosocial well-being and their coping strategies, to propose the learning content of training sessions.

METHODS

A semi-structured interview and a topic guide were employed to explore the perceptions from patients who were receiving their first custom ocular prosthesis, fabricated by maxillofacial prosthodontists. The participants were selected using a purposeful sampling up until data saturation. The data were analyzed using framework analysis.

RESULTS

Twelve patients participated in this research. Four main themes emerged from the data analysis: (1) Impact of ocular loss, (2) Factors influencing psychosocial distress, (3) Psychological adjustment, and (4) Expected treatment outcomes. Each theme appeared to have influence on the other, rather than presenting itself independently. Although patients with ocular loss experienced both physical and psychosocial difficulties, psychological distress was greatly influenced by self-perceived disfigurement, etiology, and social status. Therefore, they needed to develop their coping strategies including rehabilitation with ocular prosthesis.

CONCLUSION

Various forms of psychological adjustments were necessary in these patients with ocular loss to resume their daily lives. The specialist involved in the treatment should also partake in patients' psychological adjustment and should be competent in psychological management skills, such as supporting patients to meet their expectations.

Does prediction error during exposure relate to clinical outcomes in cognitive behavior therapy for social anxiety disorder? A study protocol

Facing your fears, or exposure therapy, is an effective psychological intervention for anxiety disorders that is often thought to work through fear extinction learning. Fear extinction learning is a type of associative learning where fear reduces through repeated encounters with a feared situation or stimulus in the absence of aversive outcomes. Laboratory research suggests fear extinction learning is driven by threat prediction errors, defined as when fearful predictions do not eventuate. Threat prediction error and its relationship to exposure therapy outcomes haven't been studied enough in actual therapy settings. It remains unclear whether prediction error and extinction learning are central mechanisms of exposure therapy. We are conducting a longitudinal and observational study of how threat prediction error during exposure in social anxiety disorder (SAD) treatment relates to session-by-session symptom change and treatment outcome in addition to exposure surprise and learning outcome. We aim to recruit 65 adults with a primary diagnosis of SAD through an outpatient psychology clinic. Participants will receive 12 sessions of individual manualized cognitive behavioral therapy (CBT), adapted from an efficacious group protocol, that includes graded exposure. Exposure processes, including self-report measures of anxiety, threat prediction, threat outcomes, surprise, and learning outcome, will be measured with smartphone-based event-contingent ecological momentary assessments (EMAs) of all behavioral experiments completed during treatment. Clinical outcomes include self-reported social anxiety symptoms and social threat appraisals, at each session, post and 3-months after treatment. Prediction error will be operationalized as the mismatch between the threat prediction and threat outcome. The joint effect of threat prediction and threat outcome on session-by-session symptom change, treatment outcome, exposure surprise, and learning outcome will be explored using multilevel modeling. The present study will help determine whether threat prediction error during exposures in SAD treatment is related to theoretically implied clinical outcomes. This would contribute to the larger research aim of clarifying exposure therapy mechanisms.

Can selfies trigger social anxiety? A study on the relationship between social media selfie behavior and social anxiety in Chinese youth group

As modernization continues to advance the development of digital society, social media has become an important part of people’s daily life and an extension and expansion of real social interactions. In this process, social media use and individual social psychology have increasingly become the object of academic attention, among which the relationship between selfie behavior, as an important interaction practice of youth group in social media, and social anxiety needs to be further explored and discussed. The purpose of this study is to investigate the current situation of selfie behavior, body image, and social anxiety among young people in China. Using a combination of qualitative and quantitative empirical methods, a questionnaire survey was conducted in Chinese mainland (n = 920) to examine the mediating effects of social comparison and body image on social media selfie behavior and social anxiety, and found that there was a significant negative relationship between youth social media selfie behavior and social anxiety, while the sequence mediating effects of social comparison and body image were significant. The findings of the study provide new ideas and directions for exploring the intervention paths of youth social psychology in the era of image socialization.

Sociodemographic and psychological characteristics influencing patients' willingness to participate in clinical trials

BACKGROUND/AIMS

Clinical trials are fundamental for the development of new medicines and patient participation is based on free consent. Our study sought to identify psychological characteristics that may influence patient willingness to participate in a clinical trial.

METHODS

A total of 100 participants were invited to participate with 80% positive response rate. The psychological characteristics of each patient were evaluated using the following validated psychometric scales: Self-Efficacy Scale, Curiosity, Exploration Inventory-Trait, Social Support Satisfaction, State-Trait Anxiety Inventory and Social Avoidance and Distress, and Fear of Negative Evaluation.

RESULTS

Patients who agreed to participate in the clinical trial were significantly younger than those who refused (p=0.028). There were no differences in sex, lifestyle, employment status, monthly income or education. After adjusting for age and sex, patients who agreed to participate scored significantly higher in the following: self-efficacy total score (p<0.001), effectiveness in adversity (p<0.001), social effectiveness (p<0.001) and initiation and persistence (p<0.001); social support total score (p<0.001), family satisfaction (p=0.015), friendship satisfaction (p<0.001), social activities satisfaction (p=0.002) and intimacy (p<0.001); total curiosity score (p<0.001), absorption (p<0.001) and exploration (p<0.001). Compared with patients who agreed to participate, those who refused scored significantly higher for both state (p<0.001) and trait anxiety (p<0.001), fear of negative evaluation (p<0.001) and social avoidance and distress (p<0.001).

CONCLUSIONS

Patients who were willing to participate in clinical trials exhibited different psychological characteristics to patients who refused. Specifically, they were more curious and self-efficacious, less anxious and reported a higher level of social support than patients who declined to participate. Identifying characteristics that condition the individual's decision to participate in a clinical trial has important implications for the development of patient-focused communication strategies and improved recruitment approaches.

A moderated-mediation analysis of abusive supervision, fear of negative evaluation and psychological distress among Egyptian hotel employees

By integrating cognitive appraisal and social exchange theories, this paper examines the linkage of supervisors' abusive reactions with psychological distress through their subordinates' fear of negative evaluation. This paper also investigates the moderating role of negative reciprocity. Data were gathered from 412 employees at 15 five-star hotels in Egypt and analyzed using PROCESS 4.0 macro in SPSS (Model 5). The findings revealed that abusive supervision was strongly positively connected with psychological distress caused by FNE. Furthermore, negative reciprocity may reduce the abusive supervision-psychological distress relationship. The positive effect of abusive supervision on psychological distress was weaker among hotel employees who held high levels of negative reciprocity. The PROCESS and narratological results highlight the need of taking negative reciprocity into account while investigating undesirable workplace behavior (i.e., abusive acts of supervisors) in the hospitality context by providing fruitful theoretical and practical contributions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03822-4.

Fear of negative evaluation modulates the processing of social evaluative feedback with different valence and contexts

Fear of negative evaluation (FNE) is a susceptible and maintaining factor of social anxiety disorders. However, the question, how people process negative evaluation is influenced by individual differences in FNE, is poorly understood. To clarify the habitual processing characteristics of individuals with different levels of FNE, electroencephalography was recorded when two groups of participants with high FNE (hFNE) and low FNE (lFNE) performed a social evaluation perception task in which the feedback context/source (human vs. a computer) and valence (thumb-up/like vs. thumb-down/dislike) were manipulated. We found effects of feedback source and valence on N1, P2, and P3, which reflect early attention, integrated perception, and elaborative processing, respectively, as well as general reward effects on reward positivity (RewP) across contexts. Importantly, compared to the lFNE group, the hFNE group showed larger midfrontal N1 and theta oscillation in response to negative feedback indicating dislike (vs. like), and also showed larger P3. These findings suggest that individuals with hFNE are more attentional vigilance to negative (vs. positive) social feedback, implying that individuals with different levels of FNE assign different implicit threat values to social-evaluation threat stimuli.

Prediction of Specific Anxiety Symptoms and Virtual Reality Sickness Using In Situ Autonomic Physiological Signals During Virtual Reality Treatment in Patients With Social Anxiety Disorder: Mixed Methods Study

BACKGROUND

Social anxiety disorder (SAD) is the fear of social situations where a person anticipates being evaluated negatively. Changes in autonomic response patterns are related to the expression of anxiety symptoms. Virtual reality (VR) sickness can inhibit VR experiences.

OBJECTIVE

This study aimed to predict the severity of specific anxiety symptoms and VR sickness in patients with SAD, using machine learning based on in situ autonomic physiological signals (heart rate and galvanic skin response) during VR treatment sessions.

METHODS

This study included 32 participants with SAD taking part in 6 VR sessions. During each VR session, the heart rate and galvanic skin response of all participants were measured in real time. We assessed specific anxiety symptoms using the Internalized Shame Scale (ISS) and the Post-Event Rumination Scale (PERS), and VR sickness using the Simulator Sickness Questionnaire (SSQ) during 4 VR sessions (#1, #2, #4, and #6). Logistic regression, random forest, and naïve Bayes classification classified and predicted the severity groups in the ISS, PERS, and SSQ subdomains based on in situ autonomic physiological signal data.

RESULTS

The severity of SAD was predicted with 3 machine learning models. According to the F1 score, the highest prediction performance among each domain for severity was determined. The F1 score of the ISS mistake anxiety subdomain was 0.8421 using the logistic regression model, that of the PERS positive subdomain was 0.7619 using the naïve Bayes classifier, and that of total VR sickness was 0.7059 using the random forest model.

CONCLUSIONS

This study could predict specific anxiety symptoms and VR sickness during VR intervention by autonomic physiological signals alone in real time. Machine learning models can predict the severe and nonsevere psychological states of individuals based on in situ physiological signal data during VR interventions for real-time interactive services. These models can support the diagnosis of specific anxiety symptoms and VR sickness with minimal participant bias.

TRIAL REGISTRATION

Clinical Research Information Service KCT0003854; https://cris.nih.go.kr/cris/search/detailSearch.do/13508.

Factors Predicting Mental Effort Associated With Verbal Fluency: Cue Types, Switching, and Fear of Negative Evaluation

PURPOSE

Verbal fluency, a task frequently employed in neuropsychological assessment, provides important word productivity data but little information about subjective effort associated with demand monitoring and resource allocation. In two experiments, this study investigated the effects of task variables (semantic vs. phonemic cues; alternating vs. nonalternating conditions) and personal factors (fear of negative evaluation and trait anxiety) on subjective effort for a wide variety of verbal fluency tasks in neurotypical individuals.

METHOD

Twenty-one adults completed eight verbal fluency tasks in Experiment 1. The tasks were selected to examine effort reported for verbal fluency that differed in (a) cue types and (b) the disruptions of clustering strategies. In Experiment 2, a separate group of 50 adults completed two verbal fluency tasks twice in separate sessions. Participants also completed social-emotional measures including fear of negative evaluation and trait anxiety. Working memory was assessed as a control variable.

RESULTS

Experiment 1 showed greater effort for completing semantic than phonemic cue tasks and greater effort for alternating than nonalternating conditions. Alternating semantic verbal fluency yielded the greatest effort among all tasks. Differences in effort could not be accounted for by performance alone. Experiment 2 showed that greater fear toward negative evaluation was associated with greater effort. The relationship between fear and effort was not related to trait anxiety or moderated by performance levels or repeated testing.

CONCLUSIONS

Knowledge about factors that impact subjective effort in neurotypical individuals is fundamental to accurate interpretation of effort reported by clinical populations. This study demonstrated the multifaceted nature of subjective effort that could not be accounted for by performance alone. In addition to task variables, effort assessment needs to consider the impact of social-emotional factors such as fear toward negative evaluation.

Program for education and enrichment of relational skills (PEERS) training for social skills and depressed mood intervention in young adult with depression: Study protocol for a randomized controlled trial

Introduction

Depression is a common psychiatric disorder characterized by persistent low mood, reduced interest, and slowed thinking. Young adults are the main first-onset group for depression in all categories of the population. Program for education and enrichment of relational skills (PEERS) training, a program for the Education and Enrichment of Relational Skills, has been used in Europe and America for people with various types of social disorders with good results. A Chinese adaptation of the PEERS training program may be a new approach to help youth with depression return to society as soon as possible. This study aimed to construct and optimize a social skills training program for Chinese young adults with depression and to validate the impact of the program.

Materials and methods and analysis

The aim of this trial protocol is to evaluate the efficacy of the localized PEERS training program on social competence, depressed mood in a Chinese young adult population with depression. The primary outcome will be a change in self-reported depressive symptoms from baseline to week 3 post-randomization to week 6 post-randomization measured using the Liebowitz social anxiety scale (LSAS). Secondary outcomes include the rate of decline in severe social anxiety, the Social Avoidance and Distress Scale (SAD), the Social Self-Efficacy Scale (PSSE), and the Hamilton Depression Scale (HAMD-17). Data for each assessment will be collected at baseline, week 3 of the trial, and week 6 of the trial.

Ethics and dissemination

Ethics approval was obtained from the Hospital Ethics Committee. Findings will be disseminated through scientific journals, conferences, and university courses.

Trial registration number

[http://www.chictr.org.cn/], identifier [ChiCTR2100046050].

Interpersonally-Based Fears and Problematic Social Networking Site Use: The Moderating Role of Online Social Support

Within the Compensatory Internet Use Theory (CIUT) framework, online activities may compensate for psychosocial problems. However, those who attempt to satisfy their needs or mitigate their fears via Social Networking Sites (SNSs) may be at heightened risk for problematic use of SNSs (PSNSU), especially in cases when these fears have an interpersonal basis, and the individual effectively finds online social support. The current study hypothesizes that interpersonally-based fears (i.e., fear of no mattering, fear of intimacy, and fear of negative evaluation) predict PSNSU, and online social support moderates these associations. Four hundred and fifty Italian participants (Mage = 27.42 ± 7.54; F = 73.5%) take part in the study. As examined by path analysis, the three interpersonal fears were positively associated with PSNSU, and online social support significantly moderates the relationship between fear of negative evaluation and PSNSU. The model accounted for 19% of the variance of PSNSU and showed good fit indices. The associations' strengths decrease as age increases. Overall, the current study finds further support for the theory that motivations need to be taken into account when it comes to internet uses (i.e., CIUT) and extends our understanding by highlighting that online social support might reinforce the link between the fear of being negatively evaluated and PSNSU.

PROTOCOL: Effects of virtual reality exposure therapy versus in vivo exposure in treating social anxiety disorder in adults: A systematic review and meta-analysis

This is the protocol for a Campbell systematic review. The objectives are as follows: (a) to quantify the effect sizes for virtual reality exposure therapy (VRET) in the treatment of social anxiety disorder (SAD), targeting primary social anxiety symptoms, comorbid anxiety and depression symptoms and improvements in quality of life, when compared to WL, information control, care-as-usual and placebo; (b) to compare VRET to in vivo cognitive and cognitive-behavioral interventions in treating SAD, at posttest and follow-up, using between-group design; (c) to identify the key features which are linked to beneficial outcomes in the two formats in treating SAD and (d) to collect and interpret information on differences in treatment uptake, adherence and attrition, as well as clinical significance and therapist-time in both treatment formats.