Social Interaction in Major Depressive Disorder, Social Phobia, and Controls: the Importance of Affect

Mutual eye gaze and vocal pitch in relation to social anxiety and depression: A virtual interaction task

BACKGROUND

Individuals with high social interaction anxiety (SIA) and depression often behave submissively in social settings. Few studies have simultaneously examined the associations between objectively assessed submissive behaviors and SIA or depression, despite their high comorbidity and unknown mechanisms regarding submissiveness.

METHODS

A sample of 45 young adults self-reported trait SIA and depression, state positive/negative affect (PA/NA) before and after a virtual social interaction. Participants engaged in a four-minute conversation with a confederate who was trained to behave neutrally. Mutual eye gaze, via eye-tracking, and vocal pitch were assessed throughout the interaction.

RESULTS

Depression and SIA were positively correlated with NA, poorer self-rated performance, and vocal pitch. Highly socially anxious women engaged in less mutual eye gaze than highly socially anxious men. Also, vocal pitch was inversely associated with mutual eye gaze and positively related to NA and (nonsignificantly) to self-ratings of poor performance. Finally, our data partially replicated past research on the use of vocal pitch during social stress to detect social anxiety disorder.

LIMITATIONS

The current sample is relatively homogenous in educational attainment, age, and race. All research confederates were women. Future research should examine whether these archival data replicate with the latest telecommunication technologies.

CONCLUSION

Our findings highlight nuanced relationships among SIA, depression, emotions, self-perceptions, and biobehavioral indicators of submissive behavior-in response to an ambiguously negative/positive social interaction. Sex/gender may interact with these effects, emphasizing considerations for research method designs.

Studies of Social Anxiety Using Ambulatory Assessment: Systematic Review

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.

Studying Daily Social Interaction Quantity and Quality in Relation to Depression Change: A Multi-Phase Experience Sampling Study

Day-to-day social life and mental health are intertwined. Yet, no study to date has assessed how the quantity and quality of social interactions in daily life are associated with changes in depressive symptoms. This study examines these links using multiple-timescale data (iSHAIB data set; N = 133), where the level of depressive symptoms was measured before and after three 21-day periods of event-contingent experience sampling of individuals' interpersonal interactions (T = 64,112). We find weak between-person effects for interaction quantity and perceiving interpersonal warmth of others on changes in depressive symptoms over the 21-day period, but strong and robust evidence for overwarming-a novel construct representing the self-perceived difference between one's own and interaction partner's level of interpersonal warmth. The findings highlight the important role qualitative aspects of social interactions may play in the progression of individuals' depressive symptoms.

Predictors of Embarrassment in Daily Social Interactions in Social Phobia, Major Depression and Healthy Controls

Introduction: Embarrassment is a social affect. Once experienced in social interactions (SIs), it can be a precursor of clinical symptoms like depersonalization and ruminative thinking. This experience sampling study investigated predictors of embarrassment in social phobia (SP), major depressive disorder (MDD), and controls. Methods: For seven days, a total of n = 165 patients (n = 47 SP, n = 118 MDD) and n = 119 controls completed five surveys per day on their smartphones. The effect of social anxiety and depression facets on embarrassment was examined in contemporaneous and time-lagged models. Results: Individuals with SP or MDD experienced more embarrassing SIs than controls. Among facets of depression, feelings of guilt, and low self-worth significantly predicted embarrassment in contemporaneous, but not in time-lagged models. Among facets of social anxiety, worries about other people's opinion and worries of saying or doing something wrong during a social interaction significantly predicted embarrassment (contemporaneous and time-lagged; all p < .05). Discussion: The study reveals important cognitive factors that accompany embarrassment in SIs and that connect social experience and clinical symptoms. Targeting these putative dysfunctions could be an important strategy in therapy. The differential patterns in SP and MDD are discussed.

Post-Event Processing After Embarrassing Situations: Comparing Experience Sampling Data of Depressed and Socially Anxious Individuals

Background

Post-event processing (PEP) after social interactions (SIs) contributes to the persistence of social phobia (SP). This study investigated whether PEP as a transdiagnostic process also occurs in major depressive disorder (MDD) and controls. We also tested to what extent PEP was explained by trait levels of social anxiety (SA) or depression.

Method

For seven days, a total of n = 165 patients (n = 47 SP, n = 118 MDD) and n = 119 controls completed five surveys per day on their smartphones. Event-based experience sampling was used. PEP was assessed following subjective embarrassment in SIs with two reliable items from the Post-Event Processing Questionnaire. Data were analysed via multilevel regression analyses.

Results

Individuals with SP or MDD experienced more embarrassing SIs than controls and, accordingly, more PEP. The relative frequency of PEP after embarrassing SIs was equally high in all groups (86-96%). The groups did not differ regarding the amount of time PEP was experienced. After controlling trait depression, embarrassment occurred more frequently only in SP compared to controls. When controlling trait SA, between-group differences in indications of embarrassment, and consequently in PEP, dissipated.

Conclusions

PEP could be interpreted as a common coping strategy among all individuals, while more frequent embarrassment might be specific for clinical groups. Embarrassment was primarily driven by SA. The alleviation of SA could lead to the reduction of embarrassment and, further, of PEP. On this basis, a model describing PEP in MDD is proposed, while current models of PEP in SP are complemented.

Depersonalization and derealization in embarrassing social interactions: an experience sampling study in social phobia, major depression and controls

OBJECTIVE

The study explored the duration and frequency of depersonalization (DP) and derealization (DR) in embarrassing social interactions in the everyday life of individuals with social phobia (SP), major depressive disorder (MDD) and controls.

METHODS

Experience sampling was used (seven days, five surveys per day). A total of N = 165 patients (n = 47 SP, n = 118 MDD) and n = 119 controls were included. DP/DR were assessed whenever an interaction has been indicated as embarrassing.

RESULTS

Individuals with SP and MDD experienced more embarrassing social interactions than controls and, accordingly, more DP/DR. The frequency of DP in embarrassing social interactions was, compared to controls, only significantly higher in MDD (no difference between SP and MDD). Regarding DR, there were no between-group differences. The groups also did not differ regarding duration of DP/DR.

CONCLUSIONS

The study is the first to demonstrate in an ecologically valid manner that DP/DR regularly occur in relation to feelings of embarrassment in controls and in individuals suffering from SP or MDD. DP and DR might be responses to strong emotions, like embarrassment, or might be attempts at coping. The higher emergence of embarrassment itself might be viewed as an indicator of maladaptation. Treatment interventions correcting for these misinterpretations might reduce DP/DR.