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Fernández-Álvarez J, Colombo D, Gómez Penedo JM, Pierantonelli M, Baños RM, Botella C. Studies of Social Anxiety Using Ambulatory Assessment: Systematic Review. JMIR Ment Health 2024; 11:e46593. [PMID: 38574359 PMCID: PMC11027061 DOI: 10.2196/46593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 01/28/2024] [Accepted: 02/07/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND There has been an increased interest in understanding social anxiety (SA) and SA disorder (SAD) antecedents and consequences as they occur in real time, resulting in a proliferation of studies using ambulatory assessment (AA). Despite the exponential growth of research in this area, these studies have not been synthesized yet. OBJECTIVE This review aimed to identify and describe the latest advances in the understanding of SA and SAD through the use of AA. METHODS Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic literature search was conducted in Scopus, PubMed, and Web of Science. RESULTS A total of 70 articles met the inclusion criteria. The qualitative synthesis of these studies showed that AA permitted the exploration of the emotional, cognitive, and behavioral dynamics associated with the experience of SA and SAD. In line with the available models of SA and SAD, emotion regulation, perseverative cognition, cognitive factors, substance use, and interactional patterns were the principal topics of the included studies. In addition, the incorporation of AA to study psychological interventions, multimodal assessment using sensors and biosensors, and transcultural differences were some of the identified emerging topics. CONCLUSIONS AA constitutes a very powerful methodology to grasp SA from a complementary perspective to laboratory experiments and usual self-report measures, shedding light on the cognitive, emotional, and behavioral antecedents and consequences of SA and the development and maintenance of SAD as a mental disorder.
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Affiliation(s)
- Javier Fernández-Álvarez
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellon de la Plana, Spain
- Fundación Aiglé, Buenos Aires, Argentina
| | - Desirée Colombo
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellon de la Plana, Spain
| | | | | | - Rosa María Baños
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
- Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Madrid, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellon de la Plana, Spain
- Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Madrid, Spain
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Ladis I, Toner ER, Daros AR, Daniel KE, Boukhechba M, Chow PI, Barnes LE, Teachman BA, Ford BQ. Assessing Emotion Polyregulation in Daily Life: Who Uses It, When Is It Used, and How Effective Is It? AFFECTIVE SCIENCE 2023; 4:248-259. [PMID: 37304559 PMCID: PMC10247655 DOI: 10.1007/s42761-022-00166-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/15/2022] [Indexed: 06/13/2023]
Abstract
Most research on emotion regulation has focused on understanding individual emotion regulation strategies. Preliminary research, however, suggests that people often use several strategies to regulate their emotions in a given emotional scenario (polyregulation). The present research examined who uses polyregulation, when polyregulation is used, and how effective polyregulation is when it is used. College students (N = 128; 65.6% female; 54.7% White) completed an in-person lab visit followed by a 2-week ecological momentary assessment protocol with six randomly timed survey prompts per day for up 2 weeks. At baseline, participants completed measures assessing past-week depression symptoms, social anxiety-related traits, and trait emotion dysregulation. During each randomly timed prompt, participants reported up to eight strategies used to change their thoughts or feelings, negative and positive affect, motivation to change emotions, their social context, and how well they felt they were managing their emotions. In pre-registered analyses examining the 1,423 survey responses collected, polyregulation was more likely when participants were feeling more intensely negative and when their motivation to change their emotions was stronger. Neither sex, psychopathology-related symptoms and traits, social context, nor subjective effectiveness was associated with polyregulation, and state affect did not moderate these associations. This study helps address a key gap in the literature by assessing emotion polyregulation in daily life. Supplementary Information The online version contains supplementary material available at 10.1007/s42761-022-00166-x.
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Affiliation(s)
- Ilana Ladis
- Department of Psychology, University of Virginia, P.O. Box 400400, Charlottesville, VA 22904-4400 USA
| | - Emma R. Toner
- Department of Psychology, University of Virginia, P.O. Box 400400, Charlottesville, VA 22904-4400 USA
| | - Alexander R. Daros
- Department of Psychology, University of Virginia, P.O. Box 400400, Charlottesville, VA 22904-4400 USA
| | - Katharine E. Daniel
- Department of Psychology, University of Virginia, P.O. Box 400400, Charlottesville, VA 22904-4400 USA
| | - Mehdi Boukhechba
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA USA
| | - Philip I. Chow
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA USA
| | - Laura E. Barnes
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA USA
| | - Bethany A. Teachman
- Department of Psychology, University of Virginia, P.O. Box 400400, Charlottesville, VA 22904-4400 USA
| | - Brett Q. Ford
- Department of Psychology, University of Toronto, Toronto, ON Canada
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Emotions in social anxiety disorder: A review. J Anxiety Disord 2023; 95:102696. [PMID: 36878132 DOI: 10.1016/j.janxdis.2023.102696] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/05/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Extant cognitive behavioral models of social anxiety disorder (SAD) have primarily focused on cognitions and behaviors that maintain the disorder. Emotional aspects of SAD have been investigated but have not been sufficiently integrated into current models. To facilitate such integration, we reviewed the literature on emotional constructs (emotional intelligence, emotional knowledge, emotional clarity, emotion differentiation, and emotion regulation), and discrete emotions (anger, shame, embarrassment, loneliness, guilt, pride, and envy) in SAD and social anxiety. We present the studies conducted on these constructs, summarize the main findings, suggest areas for future research, discuss the findings in the context of existing models of SAD and attempt to integrate the findings into these existing models of the disorder. Clinical implications of our findings are also discussed.
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Bettis AH, Burke TA, Nesi J, Liu RT. Digital Technologies for Emotion-Regulation Assessment and Intervention: A Conceptual Review. Clin Psychol Sci 2022; 10:3-26. [PMID: 35174006 PMCID: PMC8846444 DOI: 10.1177/21677026211011982] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
The ability to regulate emotions in response to stress is central to healthy development. While early research in emotion regulation predominantly employed static, self-report measurement, the past decade has seen a shift in focus toward understanding the dynamic nature of regulation processes. This is reflected in recent refinements in the definition of emotion regulation, which emphasize the importance of the ability to flexibly adapt regulation efforts across contexts. The latest proliferation of digital technologies employed in mental health research offers the opportunity to capture the state- and context-sensitive nature of emotion regulation. In this conceptual review, we examine the use of digital technologies (ecological momentary assessment; wearable and smartphone technology, physical activity, acoustic data, visual data, and geo-location; smart home technology; virtual reality; social media) in the assessment of emotion regulation and describe their application to interventions. We also discuss challenges and ethical considerations, and outline areas for future research.
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Affiliation(s)
| | | | | | - Richard T Liu
- Harvard Medical School
- Massachusetts General Hospital
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Goodman FR, Daniel KE, Eldesouky L, Brown BA, Kneeland ET. How do people with social anxiety disorder manage daily stressors? Deconstructing emotion regulation flexibility in daily life. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Beltzer ML, Ameko MK, Daniel KE, Daros AR, Boukhechba M, Barnes LE, Teachman BA. Building an emotion regulation recommender algorithm for socially anxious individuals using contextual bandits. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61 Suppl 1:51-72. [PMID: 33583059 DOI: 10.1111/bjc.12282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/24/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Poor emotion regulation (ER) has been implicated in many mental illnesses, including social anxiety disorder. To work towards a scalable, low-cost intervention for improving ER, we developed a novel contextual recommender algorithm for ER strategies. DESIGN N = 114 socially anxious participants were prompted via a mobile app up to six times daily for five weeks to report their emotional state, use of 19 different ER strategies (or no strategy), physical location, and social context. Information from passive sensors was also collected. METHODS Given the large number of ER strategies, we used two different approaches for variable reduction: (1) grouping ER strategies into categories based on a prior meta-analysis, and (2) considering only the ten most frequently used strategies. For each approach, an algorithm that recommends strategies based on one's current context was compared with an algorithm that recommends ER strategies randomly, an algorithm that always recommends cognitive reappraisal, and the person's observed ER strategy use. Contextual bandits were used to predict the effectiveness of the strategies recommended by each policy. RESULTS When strategies were grouped into categories, the contextual algorithm was not the best performing policy. However, when the top ten strategies were considered individually, the contextual algorithm outperformed all other policies. CONCLUSIONS Grouping strategies into categories may obscure differences in their contextual effectiveness. Further, using strategies tailored to context is more effective than using cognitive reappraisal indiscriminately across all contexts. Future directions include deploying the contextual recommender algorithm as part of a just-in-time intervention to assess real-world efficacy. PRACTITIONER POINTS Emotion regulation strategies vary in their effectiveness across different contexts. An algorithm that recommends emotion regulation strategies based on a person's current context may one day be used as an adjunct to treatment to help dysregulated individuals optimize their in-the-moment emotion regulation. Recommending flexible use of emotion regulation strategies across different contexts may be more effective than recommending cognitive reappraisal indiscriminately across all contexts.
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Affiliation(s)
- Miranda L Beltzer
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Mawulolo K Ameko
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, Virginia, USA
| | - Katharine E Daniel
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Alexander R Daros
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Mehdi Boukhechba
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, Virginia, USA
| | - Laura E Barnes
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, Virginia, USA
| | - Bethany A Teachman
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
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Pitcho-Prelorentzos S, Heckel C, Ring L. Predictors of social anxiety among online dating users. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2020.106381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Effectiveness of Ego-state Therapy in Reducing Trypanophobia. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Daniel KE, Baee S, Boukhechba M, Barnes LE, Teachman BA. Do I really feel better? Effectiveness of emotion regulation strategies depends on the measure and social anxiety. Depress Anxiety 2019; 36:1182-1190. [PMID: 31652383 DOI: 10.1002/da.22970] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/23/2019] [Accepted: 10/10/2019] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Katharine E Daniel
- Department of Psychology, University of Virginia, Charlottesville, Virginia
| | - Sonia Baee
- Department of Systems and Information Engineering, University of Virginia, Charlottesville, Virginia
| | - Mehdi Boukhechba
- Department of Systems and Information Engineering, University of Virginia, Charlottesville, Virginia
| | - Laura E Barnes
- Department of Systems and Information Engineering, University of Virginia, Charlottesville, Virginia
| | - Bethany A Teachman
- Department of Psychology, University of Virginia, Charlottesville, Virginia
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