Whether, how, and when social anxiety shapes positive experiences and events: A self-regulatory framework and treatment implications

Experiential processing increases positive affect and decreases dampening appraisals during autobiographical memory recall in an anhedonic sample

Anhedonia is characterized by diminished reward processing, which may be explained in part by dampening appraisals, or thoughts that blunt positive emotions. Experiential processing, or attending to sensory and bodily experience, may curb dampening appraisals, as compared to analytical processing, or conceptually thinking about an event. In this study, 96 participants with elevated anhedonia completed writing tasks, in which they recalled positive autobiographical memories. Participants recalled the first memory as they naturally would to assess spontaneous use of processing mode and were then randomized to recall the second positive memory using either experiential, analytical, or control instructions. Both spontaneous and instructed experiential processing were associated with greater positive affect and less dampening compared to analytical processing. Clinical implications include savoring pleasant sensations to reduce dampening and enhance positive affect in anhedonia.

Dating in social anxiety disorder: A daily diary study

Romantic relationships are vital for health, well-being and quality of life, and an increasing percentage of romantic relations begin via use of dating apps and subsequently progress to dates. In the present study we examined dating application use and dates among individuals with SAD (n = 54) and without SAD (n = 54). Our sample included young adults (age range 18 to 33) who were not in a romantic relationship at the time of the study. For both individuals with SAD and without SAD, half of the participants were men, and half were women. We used a daily diary measurement in which participants reported on their dating application use and dates, as well as on concomitant emotions and perceptions for 21 consecutive days. We found that individuals with and without SAD did not differ in the frequency/duration of application use nor in the number of dates attended. However, individuals with SAD experienced dates as more negative compared to individuals without SAD (Cohen's d = 0.65). Interestingly, individuals with SAD did not significantly differ in their experience of dates as positive compared to individuals without SAD. Moreover, use of dating applications/going on dates were associated with increases in shame (Cohen's d = 0.59) and embarrassment (Cohen's d = 0.45) and this was found to a greater extent among individuals with SAD compared to individuals without SAD (Cohen's d = 0.50, 0.39 for shame and embarrassment respectively). Findings are discussed in the context of cognitive behavioral models of SAD and implications for treatment are considered.

From personality types to social labels: the impact of using MBTI on social anxiety among Chinese youth

Introduction

As the Myers-Briggs Type Indicator (MBTI) gains popularity among Chinese young people, it has undergone a gradual transition from being perceived as a personality assessment tool to being regarded as a social label. The objective of this study was to ascertain whether the use of the MBTI as a social label has an impact on social anxiety among Chinese youth groups.

Methods

A questionnaire survey was conducted on social media platforms to recruit Chinese youth aged 18 to 35. A total of 247 males and 222 females participated in the study, and the data was analyzed quantitatively using SPSS software and the Process macro plugin.

Results

The study found no strong correlation between MBTI as a social label and social anxiety. Moreover, this study introduced ego identity, belonging, and impression management as mediating variables and found that, under the influence of ego identity and impression management, the use of MBTI has a significant impact on social anxiety.

Discussion

The research reveals the complex role of MBTI among Chinese youth and provides a new perspective for understanding the impact of online social labels on the mental health of youth groups. Of course, this study also has limitations in terms of sample size and variable control. Future research should expand the sample size, introduce more potential influencing factors, and further validate and expand the existing conclusions.

Social Motivation Differentiates Social Anxiety and Depression: A Daily Diary Study

Because social anxiety and depression commonly co-occur, it can be challenging to disentangle the emotional and motivational features of these conditions in everyday life contexts. In this daily diary study, we sought to understand the interplay between daily social anxiety and depression symptoms and emotion and motivation, determining whether daily symptoms are independently linked with positive affect, negative affect, and social motivation (desire to approach or to withdraw from others). Community-dwelling adults (N = 269) with a wide range of social anxiety and depression symptoms completed daily assessments for 14 consecutive days (a total of 2,986 daily surveys). Within-person analyses found that increases in social anxiety and depression symptoms were uniquely associated with elevated negative affect; only increases in depression symptoms were associated with diminished positive affect. Increases in social anxiety symptoms were associated with an elevated desire to approach others but not a desire to withdraw from others. By contrast, increases in depression symptoms were associated with a diminished desire to approach others and an elevated desire to withdraw from others. Desire for social connection may distinguish social anxiety from depression. Examining patterns of daily social motivation may enhance clinicians' ability to differentiate the difficulties that arise from social anxiety from those that arise from depression.

The Effect of Negative Physical Self on Social Anxiety in College Students: The Bidirectional Chain Mediation Roles of Fear of Negative Evaluation and Regulatory Emotional Self-Efficacy

Purpose

The detrimental effects of social anxiety on college students require urgent mitigation. To explore the influencing factors and underlying mechanisms of social anxiety among college students, this study aims to examine the relationship between negative physical self and social anxiety, and the mediating effects of fear of negative evaluation and regulatory emotional self-efficacy.

Methods

The Negative Physical Self Scale, Brief Fear of Negative Evaluation Scale, Regulatory Emotional Self-Efficacy Scale, and Interaction Anxiousness Scale were administered to 924 Chinese college students. SPSS 26.0 was used for analysis, and the Bootstrap method was used to test the significance level of the mediating effect.

Results

Negative physical self was significantly and positively related to social anxiety in college students. Fear of negative evaluation and regulatory negative emotional self-efficacy played independent mediating roles between negative physical self and social anxiety. Fear of negative evaluation and regulatory negative emotional self-efficacy showed a bidirectional chain mediating effect between negative physical self and social anxiety.

Conclusion

This study elucidates the mechanistic pathways between negative physical self and social anxiety. The relationship between negative physical self and social anxiety is influenced by the mediating effects of fear of negative evaluation, regulatory negative emotional self-efficacy, and the bidirectional chain mediating effect of fear of negative evaluation and regulatory negative emotional self-efficacy. This finding provides a reference for policy makers and educators to develop interventions for social anxiety in college students.

A Brief Measure of Positive and Negative Interpretation Biases: Development and Validation of the Ambiguous Social Scenarios Questionnaire

Positive and negative interpretation biases have been conceptualized as distinct constructs related to anxiety and social anxiety, but the field lacks psychometrically sound self-report measures to assess positive and negative interpretations of social ambiguity. This study examined the psychometric properties of the Ambiguous Social Scenarios Questionnaire (ASSQ) in two samples of 2,188 and 454 undergraduates with varying levels of anxiety. Results supported a bifactor model with a general interpretation bias factor and specific factors assessing positive and negative interpretation biases. The ASSQ demonstrated measurement invariance across genders and levels of social anxiety, as well as convergent and incremental validity with two existing measures of interpretation bias. It also demonstrated concurrent validity with attentional control, intolerance of uncertainty, total anxiety, and social anxiety and discriminant validity with emotional awareness. Findings support the ASSQ as a brief, valid, and reliable measure of positive and negative interpretation biases toward ambiguous social situations.

Positive and negative affect change following psychotherapeutic treatment for anxiety-related disorders: A systematic review and meta-analysis

BACKGROUND

Anxiety-related disorders feature elevated negative affect (NA), and in some cases, diminished positive affect (PA). It remains unclear how well extant psychotherapies for anxiety-related disorders improve PA versus NA.

METHODS

We systematically searched the Cochrane Central Register of Controlled Trials, PubMed, PsychInfo, and Web of Science databases. Records included studies involving (1) patients with a principal or co-principal diagnosis of at least one anxiety-related disorder (i.e., generalized anxiety, social anxiety, panic, agoraphobia, health anxiety, specific phobia, obsessive-compulsive disorder, or posttraumatic stress disorder), and (2) pre- and post-treatment PA and NA scores or a change index between pre- and post-treatment PA and NA scores. Effect sizes were calculated for meta-analyses.

RESULTS

Fourteen studies with 1001 adults with an anxiety-related disorder were included. Psychotherapeutic interventions included cognitive behavioral, present-centered, and imagery-based approaches. Treatments reduced NA (g = -0.90; 95%CI [-1.19, -0.61]) to a greater extent than they improved PA (g = 0.27; 95%CI [0.05, 0.59]), Z = -5.26, p < .001. The limited number of studies available precluded analyses of the relationship between changes in affect and symptoms.

LIMITATIONS

Results should be considered with caution given the small number and heterogeneity of included studies.

CONCLUSIONS

Current psychotherapeutic interventions for anxiety-related disorders may not improve PA and NA to comparable levels.

Effectiveness of behavioral activation and mindfulness in increasing reward sensitivity and reducing depressive symptoms - A randomized controlled trial

Reward insensitivity is a potential key mechanism regarding the maintenance of depression. However, there is a lack of research examining and comparing the effectiveness of different psychological interventions in modifying reward insensitivity. This four-arm randomized controlled trial (RCT) investigated a two-week online intervention. After screening for eligibility, a total of 336 participants were randomized, and 224 participated per-protocol. Participants were assigned to either a) behavioral activation, b) mindfulness and gratitude, c) a combination of both, or d) a waitlist control condition. They received videos and implemented daily exercises. Reward sensitivity and depressive symptoms served as primary outcomes. Behavioral activation and mindfulness significantly improved depressive symptoms and reward sensitivity. However, the effects of behavioral activation were not superior. The combination treatment versus the waiting group was insignificant regarding reward insensitivity. Explorative analyses revealed that all intervention groups reduced anhedonia substantially. Our findings imply that brief online interventions with behavioral activation and mindfulness-based approaches can impact reward insensitivity, while effects for a combination were less clear. Nonetheless, our results do not allow us to infer the differential effectiveness of the interventions. There is a clear need for treatments better targeting maintaining factors of depression, such as reward insensitivity. Clinical trial registration number: NCT05402150.

Neurocognitive Model of Schema-Congruent and -Incongruent Learning in Clinical Disorders: Application to Social Anxiety and Beyond

Negative schemas lie at the core of many common and debilitating mental disorders. Thus, intervention scientists and clinicians have long recognized the importance of designing effective interventions that target schema change. Here, we suggest that the optimal development and administration of such interventions can benefit from a framework outlining how schema change occurs in the brain. Guided by basic neuroscientific findings, we provide a memory-based neurocognitive framework for conceptualizing how schemas emerge and change over time and how they can be modified during psychological treatment of clinical disorders. We highlight the critical roles of the hippocampus, ventromedial prefrontal cortex, amygdala, and posterior neocortex in directing schema-congruent and -incongruent learning (SCIL) in the interactive neural network that comprises the autobiographical memory system. We then use this framework, which we call the SCIL model, to derive new insights about the optimal design features of clinical interventions that aim to strengthen or weaken schema-based knowledge through the core processes of episodic mental simulation and prediction error. Finally, we examine clinical applications of the SCIL model to schema-change interventions in psychotherapy and provide cognitive-behavior therapy for social anxiety disorder as an illustrative example.

Transdiagnostic considerations of the relationship between reward sensitivity and psychopathological symptoms - a cross-lagged panel analysis

BACKGROUND

Reward sensitivity constitutes a potential key mechanism regarding the etiology and maintenance of mental disorders, especially depression. However, due to a lack of longitudinal studies, the temporal dynamics are not clear yet. Although some evidence indicates that reward processing could be a transdiagnostic mechanism of disorders, these observations could be also a product of comorbidity with depression. This study aimed at investigating the temporal dynamics of reward sensitivity and the course of psychopathological symptoms in a longitudinal investigation, while taking a possible mediating role of depression into account.

METHODS

We conducted a three-wave longitudinal online survey with a 4-week interval. A total of N = 453 participants filled out all three questionnaires. Reward sensitivity was assessed with the Positive Valence System Scale-21 (PVSS-21), depression with the Patient Health Questionnaire (PHQ-9), eating disorder symptoms with the Eating Disorder Examination-Questionnaire-8 (EDE-Q-8), social anxiety with the Mini-social phobia inventory (Mini-SPIN) and alcohol consumption with the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Cross-lagged panels and mediation analyses were calculated using path analyses.

RESULTS

Depressive and eating disorder symptoms predicted reward insensitivity at later points in time. Effects were larger from T2 to T3. A bidirectional relationship concerning social anxiety was found. Higher alcohol consumption predicted higher reward sensitivity. Depression at T2 fully mediated the association between psychopathological symptoms at T1 and reward sensitivity at T3 for social anxiety and eating disorder symptoms.

CONCLUSIONS

Our findings imply that reduced reward sensitivity seems to be a consequence rather than an antecedent of psychopathological symptoms. Comorbid depression plays a crucial role in other mental disorders regarding observed hyposensitivity towards rewards. Therefore, our results do not support a transdiagnostic notion of reward sensitivity, but they indicate a potential role of reward sensitivity for symptom persistence.

TRIAL REGISTRATION

The study was preregistered at the Open Science Framework (OSF) ( https://archive.org/details/osf-registrations-6n3s8-v1 ; registration DOI https://doi.org/10.17605/OSF.IO/6N3S8 ).

Brain mediators of biased social learning of self-perception in social anxiety disorder

Social anxiety disorder (SAD) is characterized by an excessive fear of social evaluation and a persistently negative view of the self. Here we test the hypothesis that negative biases in brain responses and in social learning of self-related information contribute to the negative self-image and low self-esteem characteristic of SAD. Adult participants diagnosed with social anxiety (N = 21) and matched controls (N = 23) rated their performance and received social feedback following a stressful public speaking task. We investigated how positive versus negative social feedback altered self-evaluation and state self-esteem and used functional Magnetic Resonance Imaging (fMRI) to characterize brain responses to positive versus negative feedback. Compared to controls, participants with SAD updated their self-evaluation and state self-esteem significantly more based on negative compared to positive social feedback. Responses in the frontoparietal network correlated with and mirrored these behavioral effects, with greater responses to positive than negative feedback in non-anxious controls but not in participants with SAD. Responses to social feedback in the anterior insula and other areas mediated the effects of negative versus positive feedback on changes in self-evaluation. In non-anxious participants, frontoparietal brain areas may contribute to a positive social learning bias. In SAD, frontoparietal areas are less recruited overall and less attuned to positive feedback, possibly reflecting differences in attention allocation and cognitive regulation. More negatively biased brain responses and social learning could contribute to maintaining a negative self-image in SAD and other internalizing disorders, thereby offering important new targets for interventions.

Stability and spread: A novel method for quantifying transitions within multivariate binary time series data

We present a novel method for quantifying transitions within multivariate binary time series data, using a sliding series of transition matrices, to derive metrics of stability and spread. We define stability as the trace of a transition matrix divided by the sum of all observed elements within that matrix. We define spread as the number of all non-zero cells in a transition matrix divided by the number of all possible cells in that matrix. We developed this method to allow investigation into high-dimensional, sparse data matrices for which existing binary time series methods are not designed. Results from 1728 simulations varying six parameters suggest that unique information is captured by both metrics, and that stability and spread values have a moderate inverse association. Further, simulations suggest that this method can be reliably applied to time series with as few as nine observations per person, where at least five consecutive observations construct each overlapping transition matrix, and at least four time series variables compose each transition matrix. A pre-registered application of this method using 4 weeks of ecological momentary assessment data (N = 110) showed that stability and spread in the use of 20 emotion regulation strategies predict next timepoint affect after accounting for affect and anxiety's auto-regressive and cross-lagged effects. Stability, but not spread, also predicted next timepoint anxiety. This method shows promise for meaningfully quantifying two unique aspects of switching behavior in multivariate binary time series data.

State and Trait Emotion Regulation Diversity in Social Anxiety

Emotion regulation (ER) diversity, defined as the variety, frequency, and evenness of ER strategies used, may predict social anxiety (SA) severity. In a sample of individuals with high (n=113) or low (n=42) SA severity, we tested whether four trait ER diversity metrics predicted group membership. We generalized existing trait ER diversity calculations to repeated-measures data to test if state-level metrics (using two weeks of EMA data) predicted SA severity within the higher severity group. As hypothesized (osf.io/xadyp), higher trait ER diversity within avoidance-oriented strategies predicted greater likelihood of belonging to the higher severity group. At the state-level, higher diversity across all ER strategies, and within and between avoidance- and approach-oriented strategies, predicted higher SA severity (but only after controlling for number of submitted EMAs). Only diversity within avoidance-oriented strategies was significantly correlated across trait and state levels. Findings suggest that high avoidance-oriented ER diversity may co-occur with higher SA severity.

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.

Stress generation in social anxiety and depression: A two-study community assessment

BACKGROUND

Stress generation theory suggests that people engage in certain behaviors that causally generate "dependent" stressful life events. Stress generation has primarily been studied in the context of depression with limited consideration of anxiety. People with social anxiety exhibit maladaptive social and regulatory behaviors that may uniquely generate stress.

METHOD

Across two studies, we examined if people with elevated social anxiety experienced more dependent stressful life events than those lower in social anxiety. On an exploratory basis, we examined differences in perceived intensity, chronicity, and self-blame of stressful life events. As a conservative test, we examined whether observed relationships held after covarying depression symptoms. Community adults (Ns = 303; 87) completed semi-structured interviews about recent stressful life events.

RESULTS

Participants with higher social anxiety symptoms (Study 1) and social anxiety disorder (SAD; Study 2) reported more dependent stressful life events than those with lower social anxiety. In Study 2, healthy controls rated dependent events as less impactful than independent events; those with SAD rated dependent and independent events as equally impactful. Regardless of social anxiety symptoms, participants placed greater blame on themselves for the occurrence of dependent than independent events.

LIMITATIONS

Life events interviews are retrospective and preclude conclusions about short-term changes. Mechanisms of stress generation were not assessed.

CONCLUSIONS

Results provide initial evidence for the role of stress generation in social anxiety that may be distinct from depression. Implications for assessing and treating unique and shared features of affective disorders are discussed.

Neural responsiveness to reward and suicidal ideation in social anxiety and major depression before and after psychotherapy

Suicidality is prevalent in Social Anxiety Disorder (SAD) and Major Depressive Disorder (MDD). Limited data indicate the reward positivity (RewP), a neurophysiological index of reward responsivity, and subjective capacity for pleasure may serve as brain and behavioral assays for suicide risk though this has yet to be examined in SAD or MDD in the context of psychotherapy. Therefore, the current study tested whether suicidal ideation (SI) relates to RewP and subjective capacity for anticipatory and consummatory pleasure at baseline and whether Cognitive Behavioral Therapy (CBT) impacts these measures. Participants with SAD (n = 55) or MDD (n = 54) completed a monetary reward task (gains vs. losses) during electroencephalogram (EEG) before being randomized to CBT or supportive therapy (ST), a comparator common factors arm. EEG and SI data were collected at baseline, mid-treatment, and post-treatment; capacity for pleasure was collected at baseline and post-treatment. Baseline results showed participants with SAD or MDD were comparable in SI, RewP, and capacity for pleasure. When controlling for symptom severity, SI negatively corresponded with RewP following gains and SI positively corresponded with RewP following losses at baseline. Yet, SI did not relate to subjective capacity for pleasure. Evidence of a distinct SI-RewP association suggests RewP may serve as a transdiagnositic brain-based marker of SI. Treatment outcome revealed that among participants with SI at baseline, SI significantly decreased regardless of treatment arm; also, consummatory, but not anticipatory, pleasure increased across participants regardless of treatment arm. RewP was stable following treatment, which has been reported in other clinical trial studies.

Childhood Trauma Predicts Positive Expressive Suppression During Social Affiliation in Adults With Anxiety and/or Depression: Implications for Social Functioning

Experiencing childhood trauma (CT) can create barriers for developing relationships and is a risk factor for anxiety and depression. Expressive suppression (ES; i.e., reducing expression associated with experiencing emotions) might explain the link between CT and relationship formation difficulties. We examined the association between (1) CT and ES during a dyadic paradigm intended to facilitate connectedness between unacquainted partners and (2) ES and desire for future interaction (DFI). Individuals with an anxiety or depressive disorder diagnosis (N = 77) interacted with a trained confederate; partners answered a series of increasingly intimate questions about themselves. Participant ES for positive and negative emotions, and participant and confederate DFI were collected during the task. Participants completed global anxiety, depression, and CT measures. CT correlated with positive (r = .35, p = .002), but not negative, ES (r = .13, p = .273). In a multiple linear regression model, CT predicted positive ES beyond symptom variables and gender, β = .318, t = 2.59, p = .012. Positive ES correlated with participant (r = -.38, p = .001) and confederate DFI (r = -.40, p<.01); and predicted participant DFI beyond symptom variables and ethnicity, β = -.358, t = -3.18, p = .002, and confederate DFI, β = -.390, t = -3.51, p = .001, beyond symptom variables. Mediation analyses suggested positive ES accounted for the relationship between greater CT severity and less desire for future interaction from participants, 95%CI [-0.26, -0.02], and confederates, [-0.38, -0.01]. Positive ES may be an important factor in the reduced capacity to form new social relationships for individuals with a history of CT, anxiety, and depression.

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.

Moment-to-Moment Interplay Among Stress Appraisals and Emotion Regulation Flexibility in Daily Life

Flexible use of emotion regulation (ER) strategies in daily life is theorized to depend on appraisals of occurring stressful events. Yet, to date, little is known about (a) how appraisals of the current situation modulate the use of ER strategies in daily life and (b) how individual differences in affective symptoms impact these relations among appraisals and ER strategy use. This study attempted to address these two limitations using a 5-day experience sampling protocol, with three surveys administered per day in a sample of 97 participants. Each survey measured momentary appraisals of stress intensity and controllability as well as ER strategy use (i.e., rumination, reappraisal, avoidance, and active coping). Results showed that, in situations of low-stress intensity, higher stress controllability was related to greater use of reappraisal and rumination. In situations of high-stress intensity, higher controllability was related to reduced use of rumination. This pattern of flexible use of ER strategies depending on momentary stress appraisals was found for both rumination and avoidance and occurred specifically in individuals reporting lower levels of depression and/or anxiety levels. These findings provide new insight into how flexible use of ER strategies in daily life is modulated by interactions between stress intensity and controllability appraisals at varying levels of affective symptoms.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s42761-022-00122-9.

How Does Shyness Affect Chinese College Students' Tendency to Mobile Phone Addiction? Testing the Mediating Roles of Social Anxiety and Self-Control

Background and Aims

Mobile phone addiction among college students has gained considerable research attention because of its adverse effects on their health and academic performance. However, little is known about the mechanisms underlying the relationship between shyness and mobile phone addiction among college students.

Methods

Four questionnaires were used to examine whether mobile phone addiction tendency was predicted by shyness and the mediating roles of social anxiety and self-control among 3,189 Chinese college students. Correlation and mediation analyses were conducted using Hayes PROCESS.

Results

The results showed that (1) social anxiety (indirect effect = 0.22, 95% CI = 0.18–0.26) and self-control (indirect effect = 0.23, 95% CI = 0.21–0.25) played a partial mediating role in the relationship between shyness and mobile phone addiction tendency; (2) social anxiety and self-control also mediated the link between shyness and mobile phone addiction tendency sequentially (indirect effect = 0.10, 95% CI = 0.09 to 0.12).

Conclusion

These results suggest that mobile phone addiction among shy college students could be eliminated by alleviating social anxiety and strengthening self-control.

The Relation Between College Students' Social Anxiety and Mobile Phone Addiction: The Mediating Role of Regulatory Emotional Self-Efficacy and Subjective Well-Being

The present study explores the underlying mechanism of the relationship between college students' social anxiety and mobile phone addiction. Adopting college students' social anxiety scale, regulatory emotional self-efficacy scale, subjective well-being scale and mobile phone addiction scale, this research tested valid samples of 680 Chinese college students. The results indicated that social anxiety exerted a significant and positive impact on mobile phone addiction. Regulatory emotional self-efficacy played a partial mediating role between social anxiety and mobile phone addiction. Subjective well-being also played a partial mediating role between social anxiety and mobile phone addiction. Moreover, both regulatory emotional self-efficacy and subjective well-being were found to play a chain mediating role between social anxiety and mobile phone addiction. The study provides valuable insights into the impact of college students' social anxiety on mobile phone addiction.

Social anxiety and negative interpretations of positive social events: What role does intolerance of uncertainty play?

OBJECTIVE

Although previous studies have demonstrated the association between social anxiety symptom severity and the tendency to appraise positive social events negatively among individuals with social anxiety disorder, no study has examined mediators of this relationship. The current study sought to examine whether intolerance of uncertainty and its subfactors mediate the relationship between social interaction anxiety and the tendency to interpret positive social events negatively.

METHOD

One hundred and sixty-five individuals with social anxiety disorder completed measures of social interaction anxiety symptom severity, intolerance of uncertainty, and negative interpretations of positive social events.

RESULTS

Total intolerance of uncertainty and the inhibitory-intolerance of uncertainty subscale scores significantly mediated the relationship between social interaction anxiety and negative interpretations of positive events. Exploratory post-hoc analyses regarding the possible contributing role of depression demonstrated mixed results. The same mediation pattern was found in the full sample as well as those without a secondary comorbid mood disorder diagnosis. In contrast, serial mediation showed a mediating role of depressive symptom severity.

CONCLUSION

Inhibitory-intolerance of uncertainty plays a role in the relationship between social interaction anxiety and negative interpretations of positive social events.

Psychological Treatments for Anhedonia

Anhedonia, a loss of interest or pleasure in activities, is a transdiagnostic symptom that characterizes many individuals suffering from depression and anxiety. Most psychological interventions are designed to decrease negative affect rather than increase positive affect, and are largely ineffective for reducing anhedonia. More recently, affective neuroscience has been leveraged to inform treatments for anhedonia by targeting aspects of the Positive Valence Systems, including impairments in reward anticipation, reward responsiveness, and reward learning. In this chapter, we review the efficacy of treatments and, when possible, highlight links to reward constructs. Augmented behavioral approaches and targeted cognitive interventions designed to target reward anticipation, responsiveness, and learning show preliminary efficacy in reducing anhedonia, while there is a relative lack of treatments that target positive emotion regulation and reward devaluation. In addition to developing treatments that address these targets, the field will benefit from establishing standardized measurement of anhedonia across units of analysis, mapping mechanisms of change onto aspects of reward processing, and examining anhedonia outcomes in the long-term.

Early and late signals of unexpected reward contribute to low extraversion and high disinhibition, respectively

Like socio-economic status and cognitive abilities, personality traits predict important life outcomes. Traits that reflect unusually low or high approach motivations, such as low extraversion and high disinhibition, are linked to various forms of mental disorder. Similarly, the dopamine system is theoretically linked to approach motivation traits and to various forms of mental disorder. Identifying neural contributions to extremes of such traits should map to neural sources of psychopathology, with dopamine a prime candidate. Notably, dopamine cells fire in response to unexpected reward, which suggests that the size of non-invasive, scalp-recorded potentials evoked by unexpected reward could reflect sensitivity in approach motivation traits. Here, we evaluated the validity of evoked electroencephalography (EEG) responses to unexpected reward in a monetary gain/loss task to assess approach motivation traits in 137 participants, oversampled for externalizing psychopathology symptoms. We demonstrated that over the 0–400 ms period in which feedback on the outcome was presented, responses evoked by unexpected reward contributed to all theoretically relevant approach motivation trait domains (disinhibition, extraversion and the behavioural activation system); and did so only at times when dopamine responses normally peak and reportedly code salience (70–100 ms) and valuation (200–300 ms). In particular, we linked “dopaminergic” salience and valuation to the psychopathology-related constructs of low extraversion (social anxiety) and high disinhibition (impulsivity) respectively, making the evoked potential components biomarker candidates for indexing aberrant processing of unexpected reward.

From childhood maltreatment to adult inflammation: Evidence for the mediational status of social anxiety and low positive affect

Prior work has established a robust association between childhood maltreatment and systemic inflammatory activation later in life; however, the mechanisms involved in this process remain incompletely understood. The purpose of this investigation was to examine potential mechanistic roles for social anxiety (SA) symptoms and low positive affect (PA) in the path from childhood maltreatment to elevations in circulating interleukin (IL)-6, a common biomarker of inflammatory activation. In addition, building on prior work establishing linkages between mindful awareness and reductions in systemic inflammation, we examined the potential role of trait mindfulness as a moderator of the relationships among childhood maltreatment, SA, low PA, and IL-6. A serial mediation model utilizing a large epidemiologic dataset (final N ​= ​527) supported our central hypothesis that the direct effect of childhood maltreatment on IL-6 was fully serially statistically mediated by SA symptoms and low PA (but not high negative affect). Additionally, results indicated that individuals falling in the upper versus lower quartiles of SA symptoms demonstrated significantly elevated concentrations of IL-6, a finding that has not been previously reported. Trait mindfulness moderated the association between low PA and IL-6, to the exclusion of any paths related to negative affect. Additionally, results indicated that the effect of child maltreatment on IL-6 bypasses SA to indirectly impact IL-6 via negative affect. Overall, we conclude that childhood maltreatment and SA symptoms have a significant influence on IL-6, albeit indirectly via low PA, and the influence of PA on IL-6 may be uniquely susceptible to influence by individual differences in mindfulness.

Are people with social anxiety disorder happier alone?

Quality contact with other people serves as a reliable mood enhancement strategy. We wondered if the emotional benefits of socializing are present even for those with a psychological disorder defined by social distress and avoidance: social anxiety disorder (SAD). We conducted two ecological momentary assessment (EMA) studies and analyzed 7243 total surveys. In both studies, community adults diagnosed with SAD and healthy controls received five surveys each day for 2 weeks. Consistent with research on positivity deficits in SAD, between-person analyses in both studies suggest that, on average, participants with SAD reported lower positive and higher negative affect in social and non-social situations than healthy controls. Within-person analyses, however, revealed that in both studies participants with SAD and healthy controls reported higher positive affect when with others than when alone; no differences were found for negative affect for those with SAD. The difference in positive affect between social and nonsocial situations was smaller for participants with SAD in Study 1, suggesting that people with SAD may experience diminished reward responding when socializing. Our results suggest that even those with a mental illness defined by interpersonal distress can and do derive positive emotions from social interactions.

MDMA-Assisted Therapy as a Means to Alter Affective, Cognitive, Behavioral, and Neurological Systems Underlying Social Dysfunction in Social Anxiety Disorder

Social anxiety disorder (SAD) is a prevalent and often debilitating psychiatric disorder that can assume a chronic course even when treated. Despite the identification of evidence-based pharmacological and behavioral treatments for SAD, much room for improved outcomes exists and 3,4-methylenedioxymethamphetamine (MDMA) has been proposed as a promising adjunctive treatment to psychological interventions for disorders characterized by social dysfunction. A small randomized, placebo-controlled trial of MDMA-assisted therapy (MDMA-AT) for social anxiety in autistic adults offered encouraging results, but more research is sorely needed to explore the potential for MDMA-AT in treating SAD. This review aims to stimulate future study by summarizing research on disruptions in neurological, perceptual, receptive, and expressive systems regulating social behavior in SAD and proposing how MDMA-AT may alter these systems across four domains. First, we review research highlighting the roles of social anhedonia and reduced social reward sensitivity in maintaining SAD, with specific attention to the reduction in positive affect in social situations, infrequent social approach behaviors, and related social skills deficits. We posit that MDMA-AT may enhance motivation to connect with others and alter perceptions of social reward for an extended period following administration, thereby potentiating extinction processes, and increasing the reinforcement value of social interactions. Second, we review evidence for the central role of heightened social evaluative threat perception in the development and maintenance of SAD and consider how MDMA-AT may enhance experiences of affiliation and safety when interacting with others. Third, we consider the influence of shame and the rigid application of shame regulation strategies as important intrapersonal processes maintaining SAD and propose the generation of self-transcendent emotions during MDMA sessions as a mechanism of shame reduction that may result in corrective emotional experiences and boost memory reconsolidation. Finally, we review research on the role of dysfunctional interpersonal behaviors in SAD that interfere with social functioning and, in particular, the development and maintenance of close and secure relationships. We discuss the hypothesized role of MDMA-AT in improving social skills to elicit positive interpersonal responses from others, creating a greater sense of belonging, acceptance, and social efficacy.

The moderating effects of reported pre-pandemic social anxiety, symptom impairment, and current stressors on mental health and affiliative adjustment during the first wave of the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

Individuals with social anxiety (SA) have well-established fears of being negatively evaluated and exposing self-perceived flaws to others. However, the unique impacts of pre-existing SA on well-being and interpersonal outcomes within the stressful context of the pandemic are currently unknown.

DESIGN

In a study that took place in May 2020, we surveyed 488 North American community participants online.

METHODS

We used multiple linear regression to analyze whether retrospective reports of pre-pandemic SA symptoms predicted current coronavirus anxiety, loneliness, fears of negative evaluation, use of preventive measures, and affiliative outcomes, and whether pre-pandemic functional impairment and recent COVID-related stressors moderated these relations.

RESULTS

Results highlighted the negative effects of pre-pandemic SA on current mental health functioning, especially for participants with higher pre-pandemic functional impairment and greater exposure to COVID-related stressors. Although participants with higher pre-pandemic SA reported currently feeling lonelier and more fearful of negative evaluation, they also endorsed greater efforts to affiliate with others.

CONCLUSIONS

High SA individuals may have heightened desire for social support within the isolating context of the pandemic, in which COVID-related social restrictions enable greater avoidance of social evaluation but may also mask the enduring impairment associated with pre-pandemic SA.

An Investigation Into the Influence of Positive Peer Feedback on Self-Relevant Cognitions in Social Anxiety

This study investigated whether positive feedback from same-age peers can modify self-relevant cognitive processes of high socially anxious youth in a positive direction. Thirty-three high socially anxious and 32 non-socially anxious undergraduate students (17–22 years) gave an impromptu speech and received either positive or neutral feedback post-speech. Anticipatory processing (AP) was rated prior to the speech via self-report. One week later participants returned to the laboratory and completed questionnaires assessing post-event processing (PEP) thoughts related to the impromptu speech and AP about a future speech. For high socially anxious youth receiving positive feedback, AP about their speech performance significantly improved over time. In addition, high socially anxious participants who received positive feedback reported a higher frequency of positive PEP thoughts about their speech in the intervening week. These improvements did not occur in the neutral peer feedback condition. Non-socially anxious participants’ AP improved in both feedback conditions, whereas their frequency of PEP was unaffected by feedback. These findings suggest that, in high socially anxious youth, positive feedback from same-age peers can modify self-relevant cognitive processes in a positive direction. We discuss how methodological improvements could more thoroughly investigate the potential of positive peer feedback for changing cognitions.

Changes in neural reward processing following Amplification of Positivity treatment for depression and anxiety: Preliminary findings from a randomized waitlist controlled trial

Positive valence system (PVS) deficits are increasingly recognized as important treatment targets for depression and anxiety. Emerging behavioral treatments designed to upregulate the PVS show initial promise; however, neural mechanisms underlying these approaches remain unknown. This study investigated neural reward-processing-related changes following Amplification of Positivity (AMP)-a treatment designed to enhance positive thinking, emotions and behaviors through positive activity interventions (Clinicaltrials.gov: NCT02330627). Individuals with depression and/or anxiety (N = 29) were randomized to 10 sessions of AMP (n = 16) or waitlist (WL; n = 13). Participants completed a monetary incentive delay task during fMRI at baseline and post-assessment. Hypothesis-driven region of interest (ventral striatum, insula, anterior cingulate) and exploratory whole-brain activation and connectivity analyses evaluated pre-to-post changes for AMP vs. WL when anticipating potential monetary gain or loss. No between-group brain activation changes emerged in regions of interest or whole-brain analyses. Increased neural connectivity from pre-to-post-treatment was observed in AMP vs. WL, including ventral striatum, anterior insula, and anterior cingulate connectivity with prefrontal, limbic, occipital and parietal regions-predominantly during loss anticipation. This preliminary study is the first to examine neural mechanisms of positive activity interventions in depression and anxiety and suggests that AMP may strengthen brain connectivity in reward processing, attention, and emotion regulation networks.

What is the lived experience of anxiety for people with Parkinson's? A phenomenological study

PURPOSE

Anxiety is a common non-motor symptom of Parkinson's and there is no specific pharmacological intervention for people with Parkinson's who experience anxiety. Yet there is little specific research documenting how individuals with this condition experience anxiety. It is important to explore the experiences of people with Parkinson's to identify potential issues in developing future non-pharmacological interventions. This study explored the lived experience of anxiety for people with Parkinson's.

MATERIALS AND METHODS

Six participants were recruited into a descriptive phenomenological study, through the charity Parkinson's UK, using a maximum variation sampling strategy. Face to face interviews were conducted. Data analysis employed thematic analysis.

RESULTS

Three key themes encapsulated the data: Finding ways to cope to "Try not to let it rule your life", Amplifies symptoms "It's emotionally draining it it's also physically draining" and "Anxiety is a funny thing" experienced in myriad ways. A model of the experience of PWP experience of anxiety is proposed.

CONCLUSIONS

Anxiety is a complex experience constructed of interlinked parts affecting people with Parkinson's in myriad ways. Researchers and healthcare professionals should take these findings into account when designing future studies and interventions.

Emotion Malleability Beliefs and Emotion Experience and Regulation in the Daily Lives of People with High Trait Social Anxiety

BACKGROUND

The extent to which a person believes they can change or control their own emotions is associated with trait-level symptoms of mood and anxiety-related psychopathology. Method: The present study examined how this belief relates to momentary and daily self-reports of affect, emotion regulation tendencies, and perceived effectiveness of emotion regulation attempts throughout a five-week experience sampling study conducted in N = 113 high socially anxious people (https://osf.io/eprwt/).

RESULTS

Results suggest that people with relatively stronger beliefs that their emotions are malleable experienced more momentary and daily positive affect (relative to negative affect), even after controlling for social anxiety symptom severity (although only daily positive affect, and not momentary positive affect, remained significant after correcting for false discovery rate). However, emotion malleability beliefs were not uniquely associated with other emotion regulation-related outcomes in daily life, despite theory suggesting malleability beliefs influence motivation to engage in emotion regulation.

CONCLUSION

The paucity of significant associations observed between trait malleability beliefs and momentary and daily self-reports of emotion regulation (despite consistent findings of such relationships at trait levels) calls for additional research to better understand the complex dynamics of emotion beliefs in daily life.

Within-person networks of clinical features of social anxiety disorder during cognitive and interpersonal therapy

Analysis of longitudinal within-person networks over the course of therapy allows an identification of possible targets of treatment. This study examined within-person networks of clinical features in social anxiety disorder (SAD) patients during cognitive (CT) and interpersonal (IPT) therapy. Patients (n = 80) were randomized to either CT or IPT in a 10 week residential program. They completed a measure of clinical features two times a week. The 60 (75 %) patients who had completed at least 18 measurements were included in the analyses. The multilevel vector autoregressive (mlVAR) model was used to analyze the data, producing a temporal, contemporaneous, and between-person network. In the temporal network and as expected, more homework compliance in a half-week predicted less social anxiety and less social avoidance the subsequent half-week. Also better social function predicted less social avoidance, whereas more social anxiety predicted more self-focus. Unexpectedly, less social avoidance predicted more self-focus and less self-focus predicted less social function and social joy. In the contemporaneous network, self-focus, anxiety and avoidance displayed a conditional independence structure. The estimated temporal network suggests that homework compliance and social function are promising targets of treatment.

Diagnostic and dimensional evaluation of implicit reward learning in social anxiety disorder and major depression

OBJECTIVE

Increasing evidence supports the presence of an anhedonic endophenotype in major depressive disorder (MDD), characterized by impairments in various components of reward processing, particularly incentive motivation, effort-based decision making, and reward learning. In addition to its prominent role in MDD, reward processing dysregulation has been proposed as a transdiagnostic risk and/or maintenance factor for a range of other forms of psychopathology. Individuals with social anxiety disorder (SAD)-a condition that frequently co-occurs with MDD-demonstrate low trait positive affectivity and altered processing of rewards and positively valenced information. However, no studies to date have directly tested reward learning-the ability to modulate behavior in response to rewards-in this population.

MATERIALS AND METHODS

The current study evaluated reward learning in MDD, SAD, and healthy control subjects (N = 90) using a well-validated signal detection task. Given increasing data supporting transdiagnostic features of psychopathology, we also evaluated associations between anhedonia and task performance transdiagnostically in the patient sample.

RESULTS

Contrary to expectations, results indicated no significant group differences in response bias in the full sample, suggesting no diagnostic differences in reward learning. However, dimensional analyses revealed that higher self-reported anhedonia (but not general distress or anxious arousal) was associated with worse reward learning in both the MDD and SAD groups explaining about 11% of the variance.

CONCLUSION

Deficits in implicit reward learning are associated with anhedonia but not necessarily with major depressive disorder as a diagnosis, which supports the use of transdiagnostic approaches to understanding psychopathology.

Social context and the real-world consequences of social anxiety

BACKGROUND

Social anxiety lies on a continuum, and young adults with elevated symptoms are at risk for developing a range of psychiatric disorders. Yet relatively little is known about the factors that govern the hour-by-hour experience and expression of social anxiety in the real world.

METHODS

Here we used smartphone-based ecological momentary assessment (EMA) to intensively sample emotional experience across different social contexts in the daily lives of 228 young adults selectively recruited to represent a broad spectrum of social anxiety symptoms.

RESULTS

Leveraging data from over 11 000 real-world assessments, our results highlight the central role of close friends, family members, and romantic partners. The presence of such close companions was associated with enhanced mood, yet socially anxious individuals had fewer confidants and spent less time with the close companions that they do have. Although higher levels of social anxiety were associated with a general worsening of mood, socially anxious individuals appear to derive larger benefits - lower levels of negative affect, anxiety, and depression - from their close companions. In contrast, variation in social anxiety was unrelated to the amount of time spent with strangers, co-workers, and acquaintances; and we uncovered no evidence of emotional hypersensitivity to these less-familiar individuals.

CONCLUSIONS

These findings provide a framework for understanding the deleterious consequences of social anxiety in emerging adulthood and set the stage for developing improved intervention strategies.

Cognitive reactivity to low positive and high negative affect

Cognitive Reactivity (CR), an established diathesis for depression, has been defined as the within-person strength of association between sad affect and dysfunctional attitudes. Watson and Tellegen (1985) proposed that sad affect is a combination of high negative affect (NA) and low positive affect (PA). The current study integrated the CR and the affect literatures by examining the differential and conjoint roles of cognitive reactivity to high negative affect (CR-highNA) and cognitive reactivity to low positive affect (CR-lowPA). In the current study, college student participants completed daily diary measures of CR-highNA, CR-lowPA, and CR to sadness (CR-Sad). Results showed that naturally occurring NA and PA accounted for the relation of sadness to dysfunctional cognitions. Further, the relation of depressive symptoms to CR-Sad was explained by high levels of CR-highNA and CR-lowPA. Born out of the integration of research on CR and affective structures, the current results have implications for both theory and treatment of depression.

Examining the link between positive affectivity and anxiety reactivity to social stress in individuals with and without social anxiety disorder

BACKGROUND

Positive affect (PA) attenuates negative reactivity to stress; however, this adaptive function of PA is seldom studied in psychiatric conditions characterized by more extreme forms of affective responding. We tested distinct associations of PA and negative affect (NA) with anxiety reactivity in participants with social anxiety disorder (SAD)-a condition characterized by heightened NA and diminished PA-and non-SAD control subjects.

METHOD

Adults with a principal diagnosis of SAD (n = 71) and those without a psychiatric history (n = 36) rated their PA and NA during the past week, and were exposed to a laboratory stressor wherein they delivered a video-recorded speech on a controversial topic. Anxiety reactivity was assessed in terms of anticipatory anxiety prior to the speech, and observer-rated anxiety-related behavior during the speech.

RESULTS

Across all participants, higher PA significantly predicted lower anticipatory anxiety and less anxiety-related behavior, beyond level of NA; lower NA significantly predicted attenuated anticipatory anxiety, but not anxiety-related behavior, beyond level of PA. The association between PA and stress reactivity was diminished for individuals with especially elevated NA, as well as for individuals with SAD compared to those without.

CONCLUSIONS

PA may be protective against negative reactivity to social stress; however, theoretical models and clinical applications should consider possible interactive effects of PA and NA in modulating stress reactivity.

The effects of positive interpretation bias on cognitive reappraisal and social performance: Implications for social anxiety disorder

People with social anxiety disorder (SAD) lack non-socially anxious individuals' tendency to interpret ambiguous social information in a positively biased manner. To gain a better understanding of the specific in-vivo social consequences of positive interpretation bias, we recruited 38 individuals with SAD and 31 healthy controls (HC) to participate in an in-vivo social task. We tested whether a positive interpretation bias, measured using a sentence completion task, might confer benefits for the adaptive emotion regulation strategy of cognitive reappraisal, and whether such benefits depended on participants' emotional states. We also examined whether positive interpretation bias might confer additional benefits such as improved self-perceived and observer-rated social performance. In support of prior research, HC participants exhibited a positive interpretation bias on the sentence completion task, whereas participants with SAD did not. Regression analyses revealed that positive interpretation bias predicted greater cognitive reappraisal during social stress, particularly when state positive affect was low. Moreover, positive interpretation bias predicted more positive self-perception of social performance and reduced underestimations of performance relative to observer ratings. These results suggest that positive interpretations of ambiguous social information may be related to increased use of cognitive reappraisal and more positive self-perceptions of social performance.

Fear of positive evaluation and social anxiety: A systematic review of trait-based findings

BACKGROUND

Although fear of negative evaluation (FNE) has long been recognized as a core cognitive bias in social anxiety, fear of positive evaluation (FPE) has received considerable attention over the past several years. The literature would benefit from a synthesis of the current state of the research in order to contribute to our understanding of FPE.

METHODS

A systematic review of the literature was conducted in order to address several questions: (a) Is self-reported FPE distinct from self-reported FNE? (b) Is self-reported FPE related to social anxiety symptomatology? and (c) Is self-reported FPE uniquely related to social anxiety symptomatology when accounting for self-reported FNE? Inclusion criteria included studies published in English, testing FPE and FNE with trait-based measures, and testing social anxiety with either self-report or diagnostic interviews.

RESULTS

There were 33 studies identified in this review that provided convincing empirical support for each of these questions across community and clinical samples of adolescents, undergraduates, and adults.

LIMITATIONS

The systematic review did not have access to null results, present meta-analytic results, or include studies that evaluated FPE or social anxiety with experimental designs.

CONCLUSIONS

The findings from the systematic review support updated theoritical models of social anxiety and highlight the importance of assessing and treating FPE in clinical interventions.

Testing the specificity of interpretation biases in women with eating disorder symptoms: An online experimental assessment

OBJECTIVE

Cognitive biases, such as memory, attention, and interpretation bias, are thought to play a central role in the development and maintenance of eating disorders (EDs). The aim of the present study was to investigate whether the interpretation bias is ED-specific or can be generalized to comorbid disorder-related threats in women with high levels of ED symptoms.

METHOD

In an online study, we measured interpretation bias using the modified Sentence Word Association Paradigm (SWAP), comparing women with (n = 39) and without (sub)threshold eating disorders (n = 56). We assessed endorsement and rejection rates as well as reaction times in response to a positive/neutral or a negative ED-specific, social anxiety-specific (SAD), or generalized anxiety-specific (GAD) interpretive word following an ambiguous sentence.

RESULTS

In ambiguous situations, women with high ED symptoms selected more negative (p < .001) and fewer positive/neutral ED-related interpretations (p < .001). Negative interpretations were endorsed significantly faster (p < .001), while positive interpretations were rejected faster in this group (p < .001). These women also manifested negative SAD-specific interpretation bias patterns in reaction time measures. Nevertheless, ED severity was best predicted by the endorsement of negative ED-specific stimuli, whereas ED and SAD reaction time measures seemed to have a negligible effect.

DISCUSSION

The results indicate that the interpretation bias might be ED-specific. The SWAP can be a useful tool for the further investigation of the etiological relevance of the interpretation bias as well as for the development of modification training interventions.

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).