Social anxiety and emotion regulation in daily life: spillover effects on positive and negative social events

Moderation effect of emotion regulation on the relationship between social anxiety, drinking motives and alcohol related problems among university students*

Background

Accumulated evidence suggests that individuals with social anxiety disorder (SAD) are at particular risk of developing alcohol use disorder (AUD). Yet, little is known about the mechanisms under this high comorbidity. This study aimed to elucidate the process of the development of alcohol related problems among individuals with elevated social anxiety. We investigated the moderation effect of difficulties in emotion regulation on the relationship between symptoms of social anxiety, coping and conformity motives and alcohol related problems.

Methods

In a sample of university students (N = 647) in South Korea, we examined whether cognitive (fear of negative evaluation), behavioral (social avoidance), and physiological symptoms (concerns over physiological symptoms) of social anxiety affect alcohol related problems with the mediation of coping and conformity motives. Furthermore, difficulties in emotion regulation were hypothesized to moderate each mediational path.

Results

Results showed that the fear of negative evaluation and concerns over physiological symptoms were associated with alcohol related problems with the mediation of conformity and coping motives, respectively. As hypothesized, each path was moderated by difficulties in emotion regulation.

Conclusions

Findings suggest that coping and conformity motives to cope with cognitive and physiological symptoms of social anxiety were related to alcohol related problems. In addition, individuals with high levels of difficulties in emotion regulation were prone to exhibit more alcohol related problems.

The Suppression Paradox: A Cross-Cultural Comparison of Suppression Frequency, Suppression Ability, and Depression

The habitual use of expressive suppression (suppression frequency) is consistently associated with a number of negative outcomes, but paradoxically, the ability to suppress when there is a situational need (suppression ability) is usually linked to positive outcomes. The two sides of the paradox, suppression frequency and suppression ability, have been found to be unrelated. Given that these findings have emerged in largely western samples, the present studies examined whether the coupling of suppression frequency and ability depends on cultural contexts, and whether this can explain the previously established cultural difference in the costs of suppression frequency. In an initial study, we examined the relations among suppression frequency, suppression ability, and depression in a Chinese sample (Study 1; N = 310), and then, using two new samples, we compared these relations between Chinese and the US samples (Study 2; N = 392). Results showed that suppression frequency was related to depression in two distinct ways. In both cultures, suppression frequency had a direct, positive association with depression. In Chinese culture only, however, suppression frequency also had an indirect association, such that higher suppression frequency was related to higher suppression ability and in turn related to fewer depressive symptoms. Our findings show that suppression frequency is related to suppression ability only among Chinese participants, and can serve as a potential explanation for why suppression frequency is less related to depression in Chinese culture.

Dynamical systems modeling of day-to-day signal-based patterns of emotional self-regulation and stress spillover in highly-demanding health professions

As hospital workers face a growing number of patients and have to meet increasingly rigorous standards of care, their ability to successfully modulate their emotional reactions and flexibly handle stress presents a significant challenge. This paper examines a multimodal signal-driven way to quantify emotion self-regulation and stress spillover through a dynamical systems model (DSM). The proposed DSM models day-to-day changes of emotional arousal, captured through speech, physiology, and daily activity measures, and its interplay with daily stress. The parameters of the DSM quantify the degree of self-regulation and stress spillover, and are associated with work performance and cognitive ability in a multimodal dataset of 130 full-time hospital workers recorded over a 10-week period. Linear regression experiments indicate the effectiveness of the proposed features to reliably estimate individuals' work performance and cognitive ability, providing significantly higher Pearson's correlations compared to aggregate measures of emotional arousal. Results from this study demonstrate the importance of quantifying oscillatory behaviors from longitudinal ambulatory signals and can potentially deepen our understanding of emotion self-regulation and stress spillover using signal-driven measurements, which complement self-reports and provide estimates of the psychological constructs of interest in a fine-grained time resolution.

The effectiveness of acceptance and commitment therapy for social anxiety disorder: a randomized clinical trial

OBJECTIVE

Acceptance and commitment therapy has been used to treat anxiety disorders recently. The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy for psychological symptoms in students with social anxiety disorder, including difficulty in emotion regulation, psychological flexibility based on experiential avoidance, self-compassion, and external shame.

METHODS

This study was a semi-experimental clinical trial. Twenty four students with social anxiety disorder were randomly divided into two groups after initial evaluations: an experimental group (12 subjects) and a control group (12 subjects). The experimental group received 12 treatment sessions based on a protocol of acceptance and commitment therapy for anxiety disorders, and the control group was put on a waiting list. Self-Compassion (SCS), Difficulty in Emotion Regulation (DERS), External Shame (ESS), Social Anxiety (SPIN), and Acceptance and Action (AAQ-II) questionnaires were used to assess participants. Data were analyzed using SPSS.

RESULTS

Acceptance and commitment therapy was shown to be effective at the post-test and follow up stages for reducing external shame, social anxiety, and difficulty in emotion regulation and its components, and for increasing psychological flexibility and self-compassion (p < 0.05). The largest effect size of treatment was for increase of psychological flexibility and the lowest efficacy was for the components "difficulty in impulse control" and "limited access to emotional strategies" at the post-test and follow-up stages, respectively.

CONCLUSION

Acceptance and commitment therapy may be an appropriate psychological intervention for reducing the symptoms of students with social anxiety disorder and helping them to improve psychological flexibility. Emotion and related problems can be identified as one of the main targets of this treatment.

CLINICAL TRIAL REGISTRATION

Iranian Registry of Clinical Trials, IRCT20180421039369N1.

Involuntary autobiographical memories and future projections in social anxiety

Intrusive involuntary memories and images are a cardinal phenomenon in a range of psychological disorders, but not systematically examined in social anxiety. We examined potential biases upon generating involuntary versus voluntary memories and future projections in individuals with high and low levels of social anxiety. Participants recorded involuntary and voluntary autobiographical events, and their associated emotional response in a structured mental time travel diary. High social anxiety was associated with more intense anxiety and embarrassment and greater use of a range of emotion regulation strategies upon generating all types of autobiographical events. Involuntary (versus voluntary) memories and future events were associated with a heightened emotional response independent of social anxiety, and memories were associated with more embarrassment than imagined future events. The effects of high versus low social anxiety and involuntary versus voluntary generation process were independent from each other. The findings have implications for affective and cognitive models of involuntary memories and future projections in emotional disorders.

Age differences in emotion regulation strategy use, variability, and flexibility: An experience sampling approach

Life span developmental theories suggest that as individuals age, they accumulate knowledge about how to deploy emotion regulation (ER) strategies effectively and learn how to match their ER strategy use with changes in situational demands. Using an event-contingent experience sampling design wherein 150 adults Age 18 to 89 years reported on 64,213 social interactions (M = 427.41, SD = 145.66) during 9 weeks of daily life, this study examines (a) age-related differences in individuals' usual ER strategy use (reappraisal, suppression) during everyday social interactions, (b) age-related differences in how much individuals' use of these two strategies varies across social situations-ER variability, and (c) age-related differences in the extent to which ER strategy use covaries with relational (close vs. nonclose others) and emotional (happy, sad) contextual features of those social situations-ER flexibility. In line with a small body of prior work, usual ER strategy use did not differ across adulthood and ER variability was lower at older ages. Results from multilevel models of intraindividual covariation suggested that individuals flexibly matched their ER strategy implementation to changes in emotional context-especially when interacting with close others. The results also provided evidence that the intraindividual covariation between relational context and use of suppression was weaker at older ages. Beyond these specific findings, this study demonstrated the utility of experience sampling designs, event-contingent reports, and the measurement/modeling of intraindividual variation and covariation for study of emotional development across the life span. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The momentary benefits of positive events for individuals with elevated social anxiety

Understanding how individuals with varying levels of social anxiety respond to daily positive events is important. Psychological processes that increase positive emotions are being widely used as strategies to not only enhance well-being but also reduce the symptoms and impairment tied to negative emotional dispositions and conditions, including excessive social anxiety. At present, it is unclear whether and how levels of social anxiety impact the psychological benefits derived from momentary positive events. We used ecological momentary assessment to examine the impact of trait social anxiety on momentary changes in emotions, sense of belonging, and social approach versus avoidance motivation following positive events in daily life. Over the course of a week, people with elevated social anxiety experienced greater momentary anxiety and social avoidance motivation and lower momentary happiness and sense of belonging on average. Despite these impairments, individuals with elevated social anxiety experienced greater psychological benefits-in the form of reduced anxiety and motivation to avoid social situations, and an increased sense of belonging-following positive events during the past hour that were rated as particularly intense. This pattern of findings was not specific to social anxiety, with evidence of similar effects for other forms of internalizing psychopathology (general anxiety and depression). These observations detail circumstances in which individuals with social anxiety, and other emotional disturbances, can thrive-creating potentially important targets for intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Understanding and Taking Stock of Positive Emotion Disturbance

The prevailing view on positive emotions is that they correlate with and confer psychological health benefits for the individual, including improved social, physical and cognitive functioning. Yet an emerging wave of scientific work suggests that positive emotions are also related to a range of suboptimal psychological health outcomes, especially when the intensity, duration, or context do not optimize the individual's goals or meet current environmental demands. This paper provides an overview of the 'other side' of positive emotion, by describing and reviewing evidence supporting the emerging field of Positive Emotion Disturbance (PED). We review relevant emotion processes and key themes of PED and apply this framework to example emotional disorders, and discuss implications for psychological change and future research agendas.

Do I really feel better? Effectiveness of emotion regulation strategies depends on the measure and social anxiety

BACKGROUND

Effective emotion regulation (ER) is important to long-term healthy functioning, but little is known about what constitutes effective ER in the moment or how social anxiety symptoms and different strategies influence short-term effectiveness outcomes.

METHODS

Intensive ecological momentary data from N = 124 college students illustrate how different ways of operationalizing ER effectiveness leads to different conclusions about the short-term effectiveness of different strategies in daily life.

RESULTS

When effectiveness is operationalized as the degree to which participants judged that their ER attempts made them feel better, social anxiety severity was negatively associated with effectiveness, and avoidance-oriented strategies were judged to be less effective than engagement-oriented strategies. In contrast, when effectiveness is operationalized as the degree of change in self-reported affect following ER attempts, social anxiety severity was not related to effectiveness, and avoidance-oriented strategies were more effective than engagement-oriented strategies. Social anxiety and ER strategy type did not interact in either model, regardless of how effectiveness was measured.

CONCLUSIONS

The study highlights discrepancies when examining two common but distinct ways of measuring the same overarching effectiveness construct, and raises intriguing questions about how forms of psychopathology that are intimately tied to emotion dysregulation, like social anxiety, moderate different ways of measuring the effectiveness of ER attempts.

Changes in Empathy Mediate the Effects of Cognitive-Behavioral Group Therapy but Not Mindfulness-Based Stress Reduction for Social Anxiety Disorder

Social anxiety disorder (SAD) has been shown to be associated with difficulty in the ability to vicariously share others' positive emotions (positive affective empathy). Mixed evidence also suggests potentially impaired recognition of the positive and negative emotions of others (cognitive empathy) and impaired or enhanced sharing of the negative emotions of others (negative affective empathy). Therefore, we examined whether two efficacious treatments for SAD, cognitive-behavioral group therapy (CBGT) and mindfulness-based stress reduction (MBSR), improve empathy in SAD relative to a wait-list condition and whether improvements in empathy mediate improvements in social anxiety. In the context of a randomized controlled trial, participants with SAD completed an empathy task at baseline, posttreatment/wait-list (N = 81), and 1-year follow-up (N = 37). Relative to both MBSR and wait-list, CBGT resulted in significant improvements in positive affective empathy. CBGT-related changes in positive affective empathy also mediated improvements in social anxiety at both posttreatment/wait-list and at 1-year follow-up. Other indices of empathy did not change differentially across the three conditions. Therefore, one way in which CBGT may specifically confer benefits to individuals with SAD is through increasing their ability or willingness to share in the positive emotions of others.

Examining the Relation Between Adolescent Social Anxiety and Positive Affect Regulation: Self-Report vs. Observation

Social anxiety symptomatology is associated with disruptions in positive affect, though no study has examined deficits in responses to positive affect related to adolescent social anxiety symptoms. The present study tested whether adolescents' self-reported and observed social anxiety symptoms were uniquely associated with specific responses to positive affect. Moreover, we examined whether adolescent gender moderated these relations. Ninety adolescents (ages 11 to 18, M_age = 14.26, SD = 2.03; girls = 62%; white = 79%) completed self-report measures, participated in a social stressor task, and engaged in two positively-valenced interaction tasks with their female caregivers. Adolescent self-reported social anxiety symptoms were not uniquely associated with responses to positive affect. However, observed social anxiety symptoms were uniquely related to greater self-reported inhibiting positive affect responses and fewer observed positive affect maximizing behaviors. These findings highlight the need to examine self-reported and observed social anxiety symptoms in understanding associated disruptions in positive affect regulation.

Estimating Determinants of Attrition in Eating Disorder Communities on Twitter: An Instrumental Variables Approach

BACKGROUND

The use of social media as a key health information source has increased steadily among people affected by eating disorders (EDs). Research has examined characteristics of individuals engaging in online communities, whereas little is known about discontinuation of engagement and the phenomenon of participants dropping out of these communities.

OBJECTIVE

This study aimed to investigate the characteristics of dropout behaviors among eating disordered individuals on Twitter and to estimate the causal effects of personal emotions and social networks on dropout behaviors.

METHODS

Using a snowball sampling method, we collected a set of individuals who self-identified with EDs in their Twitter profile descriptions, as well as their tweets and social networks, leading to 241,243,043 tweets from 208,063 users. Individuals' emotions are measured from their language use in tweets using an automatic sentiment analysis tool, and network centralities are measured from users' following networks. Dropout statuses of users are observed in a follow-up period 1.5 years later (from February 11, 2016 to August 17, 2017). Linear and survival regression instrumental variables models are used to estimate the effects of emotions and network centrality on dropout behaviors. The average levels of attributes among an individual's followees (ie, people who are followed by the individual) are used as instruments for the individual's attributes.

RESULTS

Eating disordered users have relatively short periods of activity on Twitter with one half of our sample dropping out at 6 months after account creation. Active users show more negative emotions and higher network centralities than dropped-out users. Active users tend to connect to other active users, whereas dropped-out users tend to cluster together. Estimation results suggest that users' emotions and network centralities have causal effects on their dropout behaviors on Twitter. More specifically, users with positive emotions are more likely to drop out and have shorter lasting periods of activity online than users with negative emotions, whereas central users in a social network have longer lasting participation than peripheral users. Findings on users' tweeting interests further show that users who attempt to recover from EDs are more likely to drop out than those who promote EDs as a lifestyle choice.

CONCLUSIONS

Presence in online communities is strongly determined by the individual's emotions and social networks, suggesting that studies analyzing and trying to draw condition and population characteristics through online health communities are likely to be biased. Future research needs to examine in more detail the links between individual characteristics and participation patterns if better understanding of the entire population is to be achieved. At the same time, such attrition dynamics need to be acknowledged and controlled when designing online interventions so as to accurately capture their intended populations.

Psychosocial associations of emotion-regulation strategies in young adults residing in the United Arab Emirates

The management and expression of emotions can have a positive impact on psychological health and overall functioning. Thus, it is crucial to focus on the study of emotion regulation and the strategies young adults employ to achieve it, namely cognitive reappraisal and expressive suppression, as well as their associations with the long neglected psychosocial factors. The current study aimed at exploring the associations between psychosocial factors and the two emotion-regulation strategies, after controlling for potential sociodemographic confounders. This study used a sample of 136 participants from the Indian subcontinent living in Dubai, United Arab Emirates, aged 18-25 years, who completed instruments measuring social anxiety, social support, and parenting styles (authoritative, authoritarian, permissive) as well as the use of the emotion-regulation strategies of suppression and reappraisal. The results indicated that having experienced authoritarian parenting and perceiving low social support were associated with the use of suppression, while having experienced authoritative parenting and low levels of social anxiety were associated with the use of emotional reappraisal. Our study provides evidence on the importance of psychosocial factors for the use of emotion-regulation strategies and suggests their modification for the promotion of adaptive ways of managing emotions.

How Does Emotion Regulation Strategy Use and Psychological Wellbeing Predict Mood in Adults With and Without Autism Spectrum Disorder? A Naturalistic Assessment

The aim of this study was to identify emotion regulation (ER) strategies that most strongly impact momentary mood in a sample of 23 adults with and 19 without autism spectrum disorder (ASD). Participants completed cognitive and behavioural assessments, online questionnaires, and experience sampling methodology questions. In the ASD group, the use of dampening and other-blame reduced mood while savouring and emotional acceptance improved mood. The use of self-blame and avoidance negatively impacted mood only in the non-ASD group, suggesting the use of these two strategies do not reduce mood in individuals with ASD. ER and mental health interventions should capture ER strategy use and aim to decrease maladaptive strategy use and increase adaptive strategy use.

Partners' Support During Good Times: Associations With Fears of Positive and Negative Evaluation

Capitalization interactions within romantic couples, in which they share positive events with each other, are significantly tied to their satisfaction and overall wellbeing. Recent work suggests that social anxiety is negatively associated with beneficial capitalization interactions (i.e., making capitalization bids and responding with active and constructive responses). To further investigate this understanding, we offer a deeper and differentiating look at two core components of social anxiety: fears of positive and negative evaluation. In addition, we offer an innovative look at the varying self-disclosures of capitalization recipients, by using a novel index—Relevant Talking Time (RTT) which examines the duration of relevantly disclosing and discussing one's own good event. We reasoned that the two types of evaluative fears might have different connections to capitalization processes, considering provision, receipt, and self-disclosure. Our findings (N = 74; 37 community couples in a lab-videotaped‘ interaction) suggest that high fear of positive evaluation is associated with poorer provision of active-constructive capitalization, whereas high fear of negative evaluation is associated with a reduced disclosers' RTT. In addition, our results interestingly demonstrate that disclosers' RTT is tied to their partners' anxiety characteristics as well. We discuss the possible implications and explanations of our findings.

Are individuals diagnosed with social anxiety disorder successful in regulating their emotions? A mixed-method investigation using self-report, subjective, and event-related potentials measures

BACKGROUND

Models of social anxiety emphasize the role of emotion dysregulation, but the nature of these impairments needs clarification.

METHODS

We utilized a mixed-method approach to examine impairments in cognitive reappraisal and expressive suppression in social anxiety disorder. Forty nine treatment-seeking individuals diagnosed with social anxiety disorder and 35 healthy controls completed self-reports and a lab-based task of suppression and reappraisal. Unpleasantness ratings and event-related potentials (ERPs) were collected while participants regulated their emotions in response to shame-arousing pictures. ERP analyses focused on the late positive potential, a measure of increased attention to emotional stimuli that is reduced during emotion regulation.

RESULTS

Participants with social anxiety reported less frequent and effective use of reappraisal and more frequent and effective use of suppression than controls. Counter to most models and our hypotheses, participants with social anxiety were more successful than controls in lab-based reappraisal as measured by unpleasantness ratings, but no differences emerged for ERPs. No differences were found in measures of lab-based suppression.

LIMITATIONS

Use of standardized, and not participant-generated, materials in the lab-based task of emotion regulation may limit the generalizability of the findings.

CONCLUSIONS

Subjective appraisals of self-efficacy and frequency suggest strong impairments in emotion-regulation in social anxiety that are not revealed in the laboratory. Models and treatment protocols should specify the exact nature of emotion dyregulation in social anxiety, highlighting difficulties in implementation of potentially intact emotion regulation abilities.

Social anxiety and interpersonal stress generation: the moderating role of interpersonal distress

BACKGROUND AND OBJECTIVES

Existing models of social anxiety scarcely account for interpersonal stress generation. These models also seldom include interpersonal factors that compound the effects of social anxiety. Given recent findings that two forms of interpersonal distress, perceived burdensomeness and thwarted belongingness, intensify social anxiety and cause interpersonal stress generation, these two constructs may be especially relevant to examining social anxiety and interpersonal stress generation together.

DESIGN

The current study extended prior research by examining the role of social anxiety in the occurrence of negative and positive interpersonal events and evaluated whether interpersonal distress moderated these associations.

METHODS

Undergraduate students (N = 243; M = 20.46 years; 83% female) completed self-report measures of social anxiety, perceived burdensomeness, and thwarted belongingness, as well as a self-report measure and clinician-rated interview assessing negative and positive interpersonal events that occurred over the past six weeks.

RESULTS

Higher levels of social anxiety were associated only with a higher occurrence of negative interpersonal dependent events, after controlling for depressive symptoms. This relationship was stronger among individuals who also reported higher levels of perceived burdensomeness, but not thwarted belongingness.

CONCLUSIONS

It may be important to more strongly consider interpersonal stress generation in models of social anxiety.

Social Anxiety and the Quality of Everyday Social Interactions: The Moderating Influence of Alcohol Consumption

Most research on the link between social anxiety and alcohol consumption has examined problematic outcomes without consideration of potential adaptive functions. Alcohol is an anxiolytic that has the short-term benefit of reducing anxiety; consumption may act as a social lubricant that facilitates higher quality social interactions. Using experience-sampling methodology, we examined how consuming alcohol attenuates the adverse effects of social anxiety in naturally occurring social interactions. Participants (N = 160) completed demographic and trait measures, then completed daily assessments for 14 consecutive days. Results from multilevel model analyses revealed that during face-to-face social interactions, state social anxiety was inversely related to 10 indicators of healthy social interactions (e.g., enjoyment, laughter, feelings of acceptance). Alcohol consumption moderated seven of these associations, such that when participants consumed alcohol in social situations, state social anxiety was no longer associated with social interaction quality. The quantity of alcoholic drinks consumed moderated two of these associations. Furthermore, we found evidence for directionality, such that social anxiety in a given social interaction predicted alcohol consumption in a subsequent social interaction, but not the reverse (i.e., alcohol consumption did not prospectively predict state social anxiety). In social situations that involved alcohol, experiences of social anxiety no longer thwarted one's ability to derive social benefits. These results should be interpreted in the context of a participant sample with relatively low levels of trait social anxiety and frequency of alcohol use. Nonetheless, obtaining social rewards may be a reinforcement mechanism that maintains the link between social anxiety and alcohol consumption.

Positive and Negative Affect as Links Between Social Anxiety and Depression: Predicting Concurrent and Prospective Mood Symptoms in Unipolar and Bipolar Mood Disorders

The co-occurrence of social anxiety and depression is associated with increased functional impairment and a more severe course of illness. Social anxiety disorder is unique among the anxiety disorders in sharing an affective profile with depression, characterized by low levels of positive affect (PA) and high levels of negative affect (NA). Yet it remains unclear how this shared affective profile contributes to the covariation of social anxiety and depressive symptoms. We examined whether self-reported PA and NA accounted for unique variance in the association between social anxiety and depressive symptoms across three groups (individuals with remitted bipolar disorder, type I [BD; n = 32], individuals with remitted major depressive disorder [MDD; n = 31], and nonpsychiatric controls [n = 30]) at baseline and follow-ups of 6 and 12 months. Low levels of PA, but not NA, accounted for unique variance in both concurrent and prospective associations between social anxiety and depression in the BD group; in contrast, high levels of NA, but not PA, accounted for unique variance in concurrent and prospective associations between social anxiety and depression in the MDD group. Limitations include that social anxiety and PA/NA were assessed concurrently and all measurement was self-report. Few individuals with MDD/BD met current diagnostic criteria for social anxiety disorder. There was some attrition at follow-up assessments. Results suggest that affective mechanisms may contribute to the high rates of co-occurrence of social anxiety and depression in both MDD and BD. Implications of the differential role of PA and NA in the relationship between social anxiety and depression in MDD and BD and considerations for treatment are discussed.

Daily fluctuation of emotions and memories thereof: Design and methods of an experience sampling study of major depression, social phobia, and controls

Symptom fluctuations and the dynamic contexts provoking these are poorly understood. This deficit is compounded by people's limited ability to accurately report about such dimensions in retrospect. Utilizing the advantages of experience sampling methodology (ESM), this study rigorously describes and tests proximal environmental, neurobiological and psychological factors associated with symptoms and mood states. Participants were assigned to three diagnostic groups: Major Depressive Disorder (MDD; n = 118), Social Phobia (SP; n = 47), or a Control Group without SP or MDD (CG; n = 119). Laboratory assessments included cognitive abilities, memory, constructs, and brain derived neurotrophic factor (BDNF). ESM lasted seven days, with six assessments per day covering symptoms, affect, daily events, social interactions, post-event processing, well-being, etc. Morning cortisol and actigraphy were also assessed during ESM. Thereafter, participants provided subjective retrospective recall estimates of the emotions they reported during ESM. The multi-level data of >10,000 observations will allow for thorough examination of fluctuations of psychopathology and well-being in two highly prevalent disorders. Using two clinical groups and a non-affected control group, the clinical specificity versus generalizability of processes can be directly tested, thus providing stimulating information about the overlap and differences between anxiety and affective disorders. This research informs about the development, fluctuation, and maintaining factors of emotions and symptoms and examines the accuracy with which participants recall these dimensions.

Social anxiety and emotion regulation flexibility: considering emotion intensity and type as contextual factors

BACKGROUND AND OBJECTIVES

Individuals with social anxiety disorder have often been considered inflexible in their emotion regulation. The aim of this study was to investigate emotion regulation flexibility in socially anxious individuals in response to two contextual factors, namely different levels of emotion intensity and emotion type.

METHODS

A daily diary approach was employed, investigating emotion regulation (i.e., experiential avoidance, expressive suppression and cognitive reappraisal) in college students scoring high (N = 62; HSA) and low (N = 52; LSA) on social anxiety.

RESULTS

Results revealed that HSAs were found to use more experiential avoidance than LSAs, especially at higher levels of negative intensity. The use of this emotion regulation strategy appeared to be driven by guilt, nervousness, and sadness. There were no between-group differences concerning the other strategies in response to varying levels of emotional intensity.

CONCLUSIONS

Together, the results provide evidence for inflexible emotion regulation in HSAs, reflected in an unwillingness to experience negative emotions.

The relationship between emotion regulation strategies and job search behavior among fourth-year university students

The job search process is a stressful experience. This study investigated the effect of emotion regulation strategies on job search behavior in combination with anxiety and job search self-efficacy among Chinese university fourth-year students (N = 816, mean age = 21.98, 31.5% male, 34.9% majored in science, 18.0% from "211 Project" universities). Results showed that cognitive reappraisal was positively related to job search behavior, while expressive suppression was negatively related to job search behavior. Additionally, anxiety was negatively related to job search behavior, while job search self-efficacy was positively associated with job search behavior. Moreover, both anxiety and job search self-efficacy mediated the relationship between emotion regulation strategies and job search behavior. In general, emotion regulation strategies played an important role in job search behavior. Implications include the notion that emotion regulation interventions may be helpful to increase job search behavior among university students.

Trait self-consciousness predicts amygdala activation and its functional brain connectivity during emotional suppression: an fMRI analysis

The present functional magnetic resonance imaging study investigated how trait neuroticism and its heterogeneous subdimensions are related to the emotional consequences and neural underpinnings of emotion regulation. Two levels of neuroticism assessments were conducted with 47 female subjects, who were required to attend to, suppress emotion displays to, or cognitively reappraise the meanings of negative images. The results showed reduced emotional experience and bilateral amygdala activation during reappraisal, and this regulation effect is unaffected by individual differences in neuroticism and its subdimensions. By contrast, the emotion downregulation effect of suppression in the right amygdala is compromised with increasing self-consciousness but not overall neuroticism dimension. This association holds robust after controlling the potential contribution of habitual suppression. Moreover, the psychophysiological interaction (PPI) analysis revealed that self-consciousness predicts weaker functional coupling of the right amygdala to supplementary motor area and putamen during expressive suppression, two regions mediating the control and execution of motor actions. These findings suggest that self-consciousness predicts increased difficulty in emotional regulation using expressive suppression; and that the heterogeneous nature of trait neuroticism needs to be considered in exploring the association of neuroticism and emotion regulation.

Empathy for positive and negative emotions in social anxiety disorder

Social anxiety disorder (SAD) is associated with elevated negative and diminished positive affective experience. However, little is known about the way in which individuals with SAD perceive and respond emotionally to the naturally-unfolding negative and positive emotions of others, that is, cognitive empathy and affective empathy, respectively. In the present study, participants with generalized SAD (n = 32) and demographically-matched healthy controls (HCs; n = 32) completed a behavioral empathy task. Cognitive empathy was indexed by the correlation between targets' and participants' continuous ratings of targets' emotions, whereas affective empathy was indexed by the correlation between targets' and participants' continuous self-ratings of emotion. Individuals with SAD differed from HCs only in positive affective empathy: they were less able to vicariously share others' positive emotions. Mediation analyses revealed that poor emotional clarity and negative interpersonal perceptions among those with SAD might account for this finding. Future research using experimental methodology is needed to examine whether this finding represents an inability or unwillingness to share positive affect.

Development and Validation of a State-Based Measure of Emotion Dysregulation

Existing measures of emotion dysregulation typically assess dispositional tendencies and are therefore not well suited for study designs that require repeated assessments over brief intervals. The aim of this study was to develop and validate a state-based multidimensional measure of emotion dysregulation. Psychometric properties of the State Difficulties in Emotion Regulation Scale (S-DERS) were examined in a large representative community sample of young adult women drawn from four sites ( N = 484). Exploratory factor analysis suggested a four-factor solution, with results supporting the internal consistency, construct validity, and predictive validity of the total scale and the four subscales: Nonacceptance (i.e., nonacceptance of current emotions), Modulate (i.e., difficulties modulating emotional and behavioral responses in the moment), Awareness (i.e., limited awareness of current emotions), and Clarity (i.e., limited clarity about current emotions). S-DERS scores were significantly associated with trait-based measures of emotion dysregulation, affect intensity/reactivity, experiential avoidance, and mindfulness, as well as measures of substance use problems. Moreover, significant associations were found between the S-DERS and state-based laboratory measures of emotional reactivity, even when controlling for the corresponding original DERS scales. Results provide preliminary support for the reliability and validity of the S-DERS as a state-based measure of emotion regulation difficulties.

Vigilance-avoidance and disengagement are differentially associated with fear and avoidant behaviors in social anxiety

BACKGROUND

Individuals with Social Anxiety Disorder (SAD) often exhibit preferential attention for social threat, demonstrating abnormal orientation to threat (i.e., vigilance-avoidance) and/or difficulty disengaging from threat. However, no research has compared the relationship between attention indices (i.e., vigilance-avoidance, difficulty disengaging from threat) and characteristic features of the disorder such as fear during social situations (social fear) and avoidant behaviors (social avoidance).

METHOD

To address this issue, seventy adults (19.29±1.47 years, 33 females) were separated into low (n=37) or high (n=33) socially anxious groups using clinical cutoff scores on the Social Interaction Anxiety Scale (SIAS). Participants in both groups completed a dot-probe task with congruent, incongruent, and neutral trials to obtain measures of vigilance-avoidance and difficulty disengaging. Using linear regression, we examined the associations each attention index shared with self-reported social fear and social avoidance.

RESULTS

Exclusively in the high anxious group, greater vigilance towards threat was associated with higher self-reported social fear, but not with social avoidance. However, difficulty disengaging was not associated with either social measure. In the low anxiety group, no relationships between attention indices and either social measure emerged.

LIMITATIONS

Future research with clinical samples is necessary to replicate and extend these findings. The small sample size studied may have limited our ability to detect other smaller effects.

CONCLUSIONS

Indices of attention bias may contribute differently to the etiology and maintenance of SAD, which offers important implications for novel treatments that target attention.

Furcht vor positiver sozialer Bewertung: Übersetzung und Validierung einer deutschsprachigen Version der FPES

Zusammenfassung. Neuere Forschung deutet darauf hin, dass neben der Furcht vor negativer Evaluation (FNE) auch die Furcht vor positiver Evaluation (FPE) eine wesentliche Rolle für die soziale Phobie spielt. Zur Untersuchung dieses Konstrukts entwickelten Weeks, Heimberg und Rodebaugh (2008) die Fear of Positive Evaluation Scale (FPES). Da die FPE bislang nicht im deutschsprachigen Raum untersucht wurde, werden in dieser Arbeit eine Übersetzung der FPES und ihre Validierung anhand von 4 Studien vorgestellt. Neben einem einfaktoriellen Messmodell konnten interne Konsistenz und die Abgrenzung zur FNE gefunden werden. Zudem demonstrierte die Skala eine angemessene Test-Retest-Reliabilität sowie gute Konstruktvalidität, Kriteriumsvalidität und Sensitivität bei sozial phobischen Patientinnen und Patienten. Zusammenfassend weist die deutsche FPES gute psychometrische Eigenschaften auf und trägt zu einer verbesserten Erfassung von sozialer Phobie bei.

Emotion-induced loss aversion and striatal-amygdala coupling in low-anxious individuals

Adapting behavior to changes in the environment is a crucial ability for survival but such adaptation varies widely across individuals. Here, we asked how humans alter their economic decision-making in response to emotional cues, and whether this is related to trait anxiety. Developing an emotional decision-making task for functional magnetic resonance imaging, in which gambling decisions were preceded by emotional and non-emotional primes, we assessed emotional influences on loss aversion, the tendency to overweigh potential monetary losses relative to gains. Our behavioral results revealed that only low-anxious individuals exhibited increased loss aversion under emotional conditions. This emotional modulation of decision-making was accompanied by a corresponding emotion-elicited increase in amygdala-striatal functional connectivity, which correlated with the behavioral effect across participants. Consistent with prior reports of ‘neural loss aversion’, both amygdala and ventral striatum tracked losses more strongly than gains, and amygdala loss aversion signals were exaggerated by emotion, suggesting a potential role for this structure in integrating value and emotion cues. Increased loss aversion and striatal-amygdala coupling induced by emotional cues may reflect the engagement of adaptive harm-avoidance mechanisms in low-anxious individuals, possibly promoting resilience to psychopathology.

fMRI neurofeedback facilitates anxiety regulation in females with spider phobia

Background: Spider phobics show an exaggerated fear response when encountering spiders. This fear response is aggravated by negative and irrational beliefs about the feared object. Cognitive reappraisal can target these beliefs, and therefore has a fear regulating effect. The presented study investigated if neurofeedback derived from functional magnetic resonance imaging (fMRI) would facilitate anxiety regulation by cognitive reappraisal, using spider phobia as a model of anxiety disorders. Feedback was provided based on activation in left dorsolateral prefrontal cortex and right insula, as indicators of engagement and regulation success, respectively.

Methods: Eighteen female spider phobics participated in a randomized, controlled, single-blinded study. All participants completed a training session in the MRI scanner. Participants assigned to the neurofeedback condition were instructed to shape their regulatory strategy based on the provided feedback. Participants assigned to the control condition were asked to adapt their strategy intuitively.

Results: Neurofeedback participants exhibited lower anxiety levels than the control group at the end of the training. In addition, only neurofeedback participants achieved down-regulation of insula activation levels by cognitive reappraisal. Group differences became more pronounced over time, supporting learning as a mechanism behind this effect. Importantly, within the neurofeedback group, achieved changes in insula activation levels during training predicted long-term anxiety reduction.

Conclusions: The conducted study provides first evidence that fMRI neurofeedback has a facilitating effect on anxiety regulation in spider phobia.

Stress sensitivity and stress generation in social anxiety disorder: a temporal process approach

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

The role of emotion and emotion regulation in social anxiety disorder

Many psychiatric disorders involve problematic patterns of emotional reactivity and regulation. In this review, we consider recent findings regarding emotion and emotion regulation in the context of social anxiety disorder (SAD). We first describe key features of SAD which suggest altered emotional and self-related processing difficulties. Next, we lay the conceptual foundation for a discussion of emotion and emotion regulation and present a common framework for understanding emotion regulation, the process model of emotion regulation. Using the process model, we evaluate the recent empirical literature spanning self-report, observational, behavioral, and physiological methods across five specific families of emotion regulation processes-situation selection, situation modification, attentional deployment, cognitive change, and response modulation. Next, we examine the empirical evidence behind two psychosocial interventions for SAD: cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR). Throughout, we present suggestions for future directions in the continued examination of emotion and emotion regulation in SAD.

Physiological and emotional responses to subjective social evaluative threat in daily life

BACKGROUND AND OBJECTIVES

This study examined concurrent and delayed emotional and cardiovascular correlates of naturally occurring experiences with subjective social evaluative threat (SSET) and tested whether individual differences in social interaction anxiety moderated those associations.

METHODS

Sixty-eight participants wore ambulatory blood pressure monitors for three days. Following each blood pressure reading, participants reported on SSET and negative emotions, yielding 1770 momentary measures.

RESULTS

Multilevel modeling suggested that reports of greater SSET uniquely predicted elevations in anxiety and embarrassment, with elevations in anxiety, embarrassment, and shame extending to the hour following SSET. Reports of concurrent and previous-hour SSET also predicted cardiovascular elevations. Linkages between SSET and anxiety and shame, but not cardiovascular measures, were moderated by social interaction anxiety. Those higher in social interaction anxiety showed especially strong associations between SSET and both concurrent and delayed anxiety and greater delayed shame.

CONCLUSIONS

This research suggests an important role for anxiety, embarrassment, and shame as emotional consequences of naturally occurring evaluative threat, especially for those who are more socially anxious. Further, this work replicates other naturalistic studies that have documented increased blood pressure at times of SSET and extends that work by documenting cardiovascular responses into the following hour.

Increased default mode network activity in socially anxious individuals during reward processing

Background

Social anxiety has been associated with potentiated negative affect and, more recently, with diminished positive affect. It is unclear how these alterations in negative and positive affect are represented neurally in socially anxious individuals and, further, whether they generalize to non-social stimuli. To explore this, we used a monetary incentive paradigm to explore the association between social anxiety and both the anticipation and consumption of non-social incentives. Eighty-four individuals from a longitudinal community sample underwent functional magnetic resonance imaging (fMRI) while participating in a monetary incentive delay (MID) task. The MID task consisted of alternating cues indicating the potential to win or prevent losing varying amounts of money based on the speed of the participant’s response. We examined whether self-reported levels of social anxiety, averaged across approximately 7 years of data, moderated brain activity when contrasting gain or loss cues with neutral cues during the anticipation and outcome phases of incentive processing. Whole brain analyses and analyses restricted to the ventral striatum for the anticipation phase and the medial prefrontal cortex for the outcome phase were conducted.

Results

Social anxiety did not associate with differences in hit rates or reaction times when responding to cues. Further, socially anxious individuals did not exhibit decreased ventral striatum activity during anticipation of gains or decreased MPFC activity during the outcome of gain trials, contrary to expectations based on literature indicating blunted positive affect in social anxiety. Instead, social anxiety showed positive associations with extensive regions implicated in default mode network activity (for example, precuneus, posterior cingulate cortex, and parietal lobe) during anticipation and receipt of monetary gain. Social anxiety was further linked with decreased activity in the ventral striatum during anticipation of monetary loss.

Conclusions

Socially anxious individuals may increase default mode network activity during reward processing, suggesting high self-focused attention even in relation to potentially rewarding stimuli lacking explicit social connotations. Additionally, social anxiety may relate to decreased ventral striatum reactivity when anticipating potential losses.

A contextual approach to experiential avoidance and social anxiety: evidence from an experimental interaction and daily interactions of people with social anxiety disorder

Experiential avoidance (EA), the tendency to avoid internal, unwanted thoughts and feelings, is hypothesized to be a risk factor for social anxiety. Existing studies of experiential avoidance rely on trait measures with minimal contextual consideration. In two studies, we examined the association between experiential avoidance and anxiety within real-world social interactions. In the first study, we examined the effect of experiential avoidance on social anxiety in everyday life. For 2 weeks, 37 participants with Social Anxiety Disorder (SAD) and 38 healthy controls provided reports of experiential avoidance and social anxiety symptoms during face-to-face social interactions. Results showed that momentary experiential avoidance was positively related to anxiety symptoms during social interactions and this effect was stronger among people with SAD. People low in EA showed greater sensitivity to the level of situational threat than high EA people. In the second study, we facilitated an initial encounter between strangers. Unlike Study 1, we experimentally created a social situation where there was either an opportunity for intimacy (self-disclosure conversation) or no such opportunity (small-talk conversation). Results showed that greater experiential avoidance during the self-disclosure conversation temporally preceded increases in social anxiety for the remainder of the interaction; no such effect was found in the small-talk conversation. Our findings provide insight into the association between experiential avoidance on social anxiety in laboratory and naturalistic settings, and demonstrate that the effect of EA depends upon level of social threat and opportunity.

Differentiating emotions across contexts: comparing adults with and without social anxiety disorder using random, social interaction, and daily experience sampling

The ability to recognize and label emotional experiences has been associated with well-being and adaptive functioning. This skill is particularly important in social situations, as emotions provide information about the state of relationships and help guide interpersonal decisions, such as whether to disclose personal information. Given the interpersonal difficulties linked to social anxiety disorder (SAD), deficient negative emotion differentiation may contribute to impairment in this population. We hypothesized that people with SAD would exhibit less negative emotion differentiation in daily life, and these differences would translate to impairment in social functioning. We recruited 43 people diagnosed with generalized SAD and 43 healthy adults to describe the emotions they experienced over 14 days. Participants received palmtop computers for responding to random prompts and describing naturalistic social interactions; to complete end-of-day diary entries, they used a secure online website. We calculated intraclass correlation coefficients to capture the degree of differentiation of negative and positive emotions for each context (random moments, face-to-face social interactions, and end-of-day reflections). Compared to healthy controls, the SAD group exhibited less negative (but not positive) emotion differentiation during random prompts, social interactions, and (at trend level) end-of-day assessments. These differences could not be explained by emotion intensity or variability over the 14 days, or to comorbid depression or anxiety disorders. Our findings suggest that people with generalized SAD have deficits in clarifying specific negative emotions felt at a given point of time. These deficits may contribute to difficulties with effective emotion regulation and healthy social relationship functioning.