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Topel S, Ma I, van Duijvenvoorde ACK, van Steenbergen H, de Bruijn ERA. Adapting to uncertainty: The role of anxiety and fear of negative evaluation in learning in social and non-social contexts. J Affect Disord 2024; 363:310-319. [PMID: 39043306 DOI: 10.1016/j.jad.2024.07.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 06/24/2024] [Accepted: 07/14/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Navigating social situations can be challenging due to uncertainty surrounding the intentions and strategies of others, which remain hidden and subject to change. Prior research suggests that individuals with anxiety-related symptoms struggle to adapt their learning in uncertain, non-social environments. Anxiety-prone individuals encounter challenges in social functioning, yet research on learning under uncertainty in social contexts is limited. In this preregistered study, we investigated whether individuals with higher levels of trait anxiety and fear of negative evaluation encounter difficulties in adjusting their learning rates in social contexts with stable or volatile outcome contingencies. METHODS We implemented a modified trust game (N = 190), where participants either retained or lost their investments based on their interactions with two players in volatile or stable environments. Participants also completed a matching non-social control task involving interactions with slot machines. RESULTS Results from computational modeling revealed significantly higher learning rates in social compared to non-social settings. Trait anxiety did not affect the adaptability of learning rates. Individuals with heightened fear of negative evaluation were more sensitive to social compared to non-social outcomes, as reflected in their stay/switch behavior and, though less conclusive, in their learning rates. LIMITATIONS While transdiagnostic and dimensional approaches are important for investigating disturbed social functioning, the inclusion of clinical samples in future studies may contribute to a broader generalization of these findings regarding behavioral variances in uncertain social environments. CONCLUSIONS Individuals with increased fear of negative evaluation may demonstrate heightened sensitivity to learning in uncertain social contexts. This leads to heightened responsiveness to recent outcomes in their interactions with others, potentially contributing to their problems in social functioning.
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Affiliation(s)
- Selin Topel
- Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
| | - Ili Ma
- Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Anna C K van Duijvenvoorde
- Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Henk van Steenbergen
- Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Ellen R A de Bruijn
- Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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2
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Rum R, Birg JA, Silva G, Rottenberg J, Clayson PE, Goodman FR. Social Motivation Differentiates Social Anxiety and Depression: A Daily Diary Study. Behav Ther 2024; 55:698-711. [PMID: 38937044 DOI: 10.1016/j.beth.2023.11.004] [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: 07/04/2023] [Revised: 10/28/2023] [Accepted: 11/30/2023] [Indexed: 06/29/2024]
Abstract
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.
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3
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Sequeira SL, Silk JS, Jones NP, Forbes EE, Hanson JL, Hallion LS, Ladouceur CD. Pathways to adolescent social anxiety: Testing interactions between neural social reward function and perceived social threat in daily life. Dev Psychopathol 2024:1-16. [PMID: 38801123 DOI: 10.1017/s0954579424001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Recent theories suggest that for youth highly sensitive to incentives, perceiving more social threat may contribute to social anxiety (SA) symptoms. In 129 girls (ages 11-13) oversampled for shy/fearful temperament, we thus examined how interactions between neural responses to social reward (vs. neutral) cues (measured during anticipation of peer feedback) and perceived social threat in daily peer interactions (measured using ecological momentary assessment) predict SA symptoms two years later. No significant interactions emerged when neural reward function was modeled as a latent factor. Secondary analyses showed that higher perceived social threat was associated with more severe SA symptoms two years later only for girls with higher basolateral amygdala (BLA) activation to social reward cues at baseline. Interaction effects were specific to BLA activation to social reward (not threat) cues, though a main effect of BLA activation to social threat (vs. neutral) cues on SA emerged. Unexpectedly, interactions between social threat and BLA activation to social reward cues also predicted generalized anxiety and depression symptoms two years later, suggesting possible transdiagnostic risk pathways. Perceiving high social threat may be particularly detrimental for youth highly sensitive to reward incentives, potentially due to mediating reward learning processes, though this remains to be tested.
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Affiliation(s)
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Neil P Jones
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jamie L Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lauren S Hallion
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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4
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Grammer J, Valles R, Bowles A, Zelikowsky M. SAUSI: a novel assay for measuring social anxiety and motivation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.13.594023. [PMID: 38798428 PMCID: PMC11118329 DOI: 10.1101/2024.05.13.594023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Social anxiety is one of the most prevalent mental health disorders, though the underlying neurobiology is poorly understood. Progress in understanding the etiology of social anxiety has been hindered by the lack of comprehensive tools to assess social anxiety in model systems. Here, we created a new behavioral task - Selective Access to Unrestricted Social Interaction (SAUSI), which combines elements of social motivation, hesitancy, decision-making, and free interaction to enable the wholistic assessment of social anxiety-like behaviors in mice. Using this novel assay, we found that social isolation-induced social anxiety-like behaviors in female mice are largely driven by increases in social fear, social hesitancy, and altered ultrasonic vocalizations. Deep learning analyses were able to computationally identify a unique behavioral footprint underlying the state produced by social isolation, demonstrating the compatibility of modern computational approaches with SAUSI. Finally, we compared the results of SAUSI to traditionally social assays including the 3-chamber sociability assay and the resident intruder task. This revealed that behavioral changes induced by isolation were highly context dependent, and that while fragments of social anxiety measured in SAUSI were replicable across other tasks, a wholistic assessment was not obtainable from these alternative assays. Our findings debut a novel task for the behavioral toolbox - one which overcomes limitations of previous assays, allowing for both social choice as well as free interaction, and offers a new approach for assessing social anxiety in rodents.
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Affiliation(s)
- Jordan Grammer
- Department of Neurobiology, University of Utah, United States
| | - Rene Valles
- Department of Neurobiology, University of Utah, United States
| | - Alexis Bowles
- Department of Neurobiology, University of Utah, United States
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5
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Ginat-Frolich R, Gilboa-Schechtman E, Huppert JD, Aderka IM, Alden LE, Bar-Haim Y, Becker ES, Bernstein A, Geva R, Heimberg RG, Hofmann SG, Kashdan TB, Koster EHW, Lipsitz J, Maner JK, Moscovitch DA, Philippot P, Rapee RM, Roelofs K, Rodebaugh TL, Schneier FR, Schultheiss OC, Shahar B, Stangier U, Stein MB, Stopa L, Taylor CT, Weeks JW, Wieser MJ. Vulnerabilities in social anxiety: Integrating intra- and interpersonal perspectives. Clin Psychol Rev 2024; 109:102415. [PMID: 38493675 DOI: 10.1016/j.cpr.2024.102415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
What are the major vulnerabilities in people with social anxiety? What are the most promising directions for translational research pertaining to this condition? The present paper provides an integrative summary of basic and applied translational research on social anxiety, emphasizing vulnerability factors. It is divided into two subsections: intrapersonal and interpersonal. The intrapersonal section synthesizes research relating to (a) self-representations and self-referential processes; (b) emotions and their regulation; and (c) cognitive biases: attention, interpretation and judgment, and memory. The interpersonal section summarizes findings regarding the systems of (a) approach and avoidance, (b) affiliation and social rank, and their implications for interpersonal impairments. Our review suggests that the science of social anxiety and, more generally, psychopathology may be advanced by examining processes and their underlying content within broad psychological systems. Increased interaction between basic and applied researchers to diversify and elaborate different perspectives on social anxiety is necessary for progress.
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Affiliation(s)
| | | | | | - Idan M Aderka
- School of Psychological Sciences, University of Haifa, Israel
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Canada
| | - Yair Bar-Haim
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Eni S Becker
- Behavioural Science Institute, Radboud University Nijmegen, Netherlands
| | - Amit Bernstein
- School of Psychological Sciences, University of Haifa, Israel
| | - Ronny Geva
- Department of Psychology, Bar Ilan University, Israel
| | - Richard G Heimberg
- Department of Psychology, Temple University, Philadelphia, United States of America
| | - Stefan G Hofmann
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany; Department of Psychological and Brain Sciences, Boston University, Boston, United States of America
| | - Todd B Kashdan
- Department of Psychology, George Mason University, Virginia, United States of America
| | - Ernst H W Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | | | - Jon K Maner
- Department of Psychology, Florida State University, Florida, United States of America
| | - David A Moscovitch
- Department of Psychology and Centre for Mental Health Research & Treatment, University of Waterloo, Canada
| | - Pierre Philippot
- Department of Psychology, Université Catholique de Louvain, Belgium
| | - Ronald M Rapee
- Centre for Emotional Health and School of Psychological Sciences, Macquarie University, Australia
| | - Karin Roelofs
- Behavioural Science Institute, Radboud University Nijmegen, Netherlands; Donders Institute, Radboud University Nijmegen, Netherlands
| | - Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St. Louis, Missouri, United States of America
| | - Franklin R Schneier
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, United States of America
| | | | - Ben Shahar
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University, Jerusalem, Israel
| | - Ulrich Stangier
- Department of Psychology, Goethe University Frankfurt, Germany
| | - Murray B Stein
- Department of Psychiatry and School of Public Health, University of California San Diego, United States of America
| | - Lusia Stopa
- Department of Psychology, University of Southampton, United Kingdom
| | - Charles T Taylor
- Department of Psychiatry and School of Public Health, University of California San Diego, United States of America
| | - Justin W Weeks
- Department of Psychology, Nebraska Medicine, Omaha, Nebraska, United States of America; Department of Psychiatry, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Matthias J Wieser
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Netherlands
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6
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Zhang J, Li X, Tang Z, Xiang S, Tang Y, Hu W, Tan C, Wang X. Effects of stress on sleep quality: multiple mediating effects of rumination and social anxiety. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:10. [PMID: 38498281 PMCID: PMC10948653 DOI: 10.1186/s41155-024-00294-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/07/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND In contemporary society, with the accelerated pace of work and life, more and more people feel different degrees of stress. Long-term stress may not only lead to insomnia, but also to mental health problems (e.g., anxiety and depression), which has a significant impact on people's quality of life and mental health. OBJECTIVE This study primarily investigates the mechanism through which stress affects sleep quality among college students. METHODS We conducted research on 1653 Chinese college students using four scales with high reliability and validity: stress, the Pittsburgh Sleep Quality Index, social anxiety, and rumination. RESULTS The study found: (1) Stress can significantly and positively predict sleep quality and rumination; (2) Rumination can positively predict social anxiety; (3) Social anxiety can positively predict sleep quality; (4) Stress can affect sleep quality through social anxiety and rumination separately, and stress can also affect sleep quality through the chained mediation of rumination and social anxiety. CONCLUSION This study reveals the relationship and mechanisms between stress and sleep quality. It not only deepens the research on the impact of stress on sleep quality but also provides theoretical support and new methods for mental health professionals to help clients improve their sleep quality. In practice, in addition to using some common psychological intervention methods to help individuals reduce stress, we should pay more attention to how to help clients reduce rumination and social anxiety, This is significant in improving the quality of an individual's sleep.
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Affiliation(s)
- Jun Zhang
- Sehan University, College of Education, Jeollanam-Do, 1113 Green Road Samho Eup, Yeongam County, 650106, Republic of Korea.
- Zhejiang Tourism College, Hangzhou, 310000, China.
| | - Xiaowen Li
- Sehan University, College of Education, Jeollanam-Do, 1113 Green Road Samho Eup, Yeongam County, 650106, Republic of Korea
| | | | | | - Yin Tang
- Zhejiang Tourism College, Hangzhou, 310000, China
| | - Wenxin Hu
- School of Educational Sciences, Huangshan University, Huangshan, 245021, China
| | - Chenchen Tan
- Zhejiang Tourism College, Hangzhou, 310000, China
| | - Xin Wang
- Zhejiang Tourism College, Hangzhou, 310000, China
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7
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Taylor CT, Stein MB, Simmons AN, He F, Oveis C, Shakya HB, Sieber WJ, Fowler JH, Jain S. Amplification of Positivity Treatment for Anxiety and Depression: A Randomized Experimental Therapeutics Trial Targeting Social Reward Sensitivity to Enhance Social Connectedness. Biol Psychiatry 2024; 95:434-443. [PMID: 37607657 DOI: 10.1016/j.biopsych.2023.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/04/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Social disconnection is common and causes significant impairment in anxiety and depressive disorders, and it does not respond sufficiently to available treatments. The positive valence system supports social bond formation and maintenance but is often hyporesponsive in people with anxiety or depression. We conducted an experimental therapeutics trial to test the hypothesis that targeting positive valence processes through cognitive and behavioral strategies would enhance responsivity to social rewards, a core mechanism underlying social connectedness. METHODS Sixty-eight adults who endorsed clinically elevated anxiety and/or depression with social impairment were randomized 1:1:1 to 5 (n = 23) or 10 (n = 22) sessions of amplification of positivity (AMP) treatment or waitlist (n = 23). Pre- to posttreatment change in striatal activity (primary outcome) during social reward anticipation was measured using functional magnetic resonance imaging, and reactivity to a social affiliation task (secondary) and self-reported social connectedness (exploratory) were examined. Primary analyses compared AMP (doses combined) versus waitlist. A second aim was to compare the effects of different doses. RESULTS AMP engaged the hypothesized treatment target, leading to greater striatal activation during anticipation of social rewards versus waitlist (d = 1.01 [95% CI = 0.42-1.61]; largest striatal volume). AMP yielded larger improvements in positive affect and approach behavior during the affiliation task (but not other outcomes) and social connectedness. Larger striatal and social connectedness increases were observed for 5-session versus 10-session AMP (d range = 0.08-1.03). CONCLUSIONS Teaching people with anxiety or depression strategies to increase positive thoughts, behaviors, and emotions enhances activity in brain regions that govern social reward processing and promotes social connectedness. Social reward sensitivity may be a transdiagnostic target for remediating social disconnection.
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Affiliation(s)
- Charles T Taylor
- Department of Psychiatry, University of California San Diego, San Diego, California.
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, San Diego, California; VA San Diego Healthcare System, San Diego, California
| | - Alan N Simmons
- Department of Psychiatry, University of California San Diego, San Diego, California; VA San Diego Healthcare System, San Diego, California
| | - Feng He
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, San Diego, California
| | - Christopher Oveis
- Rady School of Management, University of California San Diego, San Diego, California
| | - Holly B Shakya
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, San Diego, California
| | - William J Sieber
- Department of Family Medicine, University of California San Diego, San Diego, California
| | - James H Fowler
- Department of Political Science, University of California San Diego, San Diego, California
| | - Sonia Jain
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, San Diego, California
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8
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Schacter HL, Ehrhardt AD, Hoffman AJ. Daily Fluctuations in Adolescents' Perceived Friend Dominance and Friendship Clout: Associations with Mood and the Moderating Role of Anxiety. J Youth Adolesc 2024; 53:537-549. [PMID: 38055132 DOI: 10.1007/s10964-023-01906-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023]
Abstract
Emerging evidence suggests that whereas occupying high peer status promotes adolescents' well-being, feeling dominated by friends confers psychological costs. However, little is known about day-to-day power dynamics of adolescents' friendships or their acute affective consequences. This 14-day intensive longitudinal study introduced novel daily assessments of friend dominance and friendship clout, examined their associations with mood, and tested anxiety as a moderator. Participants were 195 11th-graders (Mage = 16.48, SDage = 0.35; 66% female). Multilevel models revealed that adolescents experienced worse mood on days they felt dominated by friends and better mood on days they felt powerful and influential among friends. Associations with negative mood were strongest for adolescents higher in anxiety. The findings underscore the dynamic nature of power in adolescents' friendships.
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Affiliation(s)
| | | | - Adam J Hoffman
- Department of Psychology, Cornell University, Ithaca, NY, USA
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9
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Villalongo Andino M, Garcia KM, Richey JA. Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review. Front Psychol 2024; 14:1331200. [PMID: 38259541 PMCID: PMC10800915 DOI: 10.3389/fpsyg.2023.1331200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/04/2023] [Indexed: 01/24/2024] Open
Abstract
The purposes of this brief integrative review are to identify and critically evaluate recent work in the area of Dialectical Behavior Therapy-Skills Group (DBT-SG) for Social Anxiety Disorder (SAD) with suicidal ideation (SI) and to suggest further how DBT-based skills may be applied to cognitive maintenance factors of SAD. Accordingly, we first evaluate the relevance of DBT in treating SI in other disorders. Second, we evaluate the relationship between SI and SAD, providing considerations for the complexity of comorbid disorders and presentations. Finally, we extend this knowledge to discuss considerations for the use of DBT-SG skills to target specific etiological and maintenance elements of SAD, with a focus on four themes (interpersonal effectiveness, mindfulness, emotion regulation, and distress tolerance). Overall, we conclude that DBT-SG may prove beneficial in reducing SI and symptoms in SAD that impact social and emotional functioning.
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10
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Snyder HR, Silton RL, Hankin BL, Smolker HR, Kaiser RH, Banich MT, Miller GA, Heller W. The dimensional structure of internalizing psychopathology: Relation to diagnostic categories. Clin Psychol Sci 2023; 11:1044-1063. [PMID: 37982000 PMCID: PMC10655959 DOI: 10.1177/21677026221119483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Recent approaches aim to represent the dimensional structure of psychopathology, but relatively little research has rigorously tested sub-dimensions within internalizing psychopathology. This study tests pre-registered models of the dimensional structure of internalizing psychopathology, and their relations with current and lifetime depressive and anxiety disorders diagnostic data, in adult samples harmonized across three sites (n=427). Across S-1 bifactor and hierarchical models, we found converging evidence for both general and specific internalizing dimensions. Depression, generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic attacks were all associated with a general internalizing factor that we posit primarily represents motivational anhedonia. GAD was also associated with a specific anxious apprehension factor, and SAD with specific anxious apprehension and low positive affect factors. We suggest that dimensional approaches capturing shared and specific internalizing symptom facets more accurately describe the structure of internalizing psychopathology and provide useful alternatives to categorical diagnoses to advance clinical science.
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Affiliation(s)
| | | | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Harry R Smolker
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Roselinde H Kaiser
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Marie T Banich
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute of Cognitive Science, University of Colorado Boulder
| | - Gregory A Miller
- Department of Psychology, University of Illinois at Urbana-Champaign
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, UCLA
| | - Wendy Heller
- Department of Psychology, University of Illinois at Urbana-Champaign
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11
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Potsch L, Rief W. Transdiagnostic considerations of the relationship between reward sensitivity and psychopathological symptoms - a cross-lagged panel analysis. BMC Psychiatry 2023; 23:650. [PMID: 37667190 PMCID: PMC10478275 DOI: 10.1186/s12888-023-05139-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/25/2023] [Indexed: 09/06/2023] Open
Abstract
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 ).
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Affiliation(s)
- L Potsch
- Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, D-35032, Marburg, Germany.
| | - W Rief
- Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, D-35032, Marburg, Germany
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12
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Silk JS, Sequeira SS, Jones NP, Lee KH, Dahl RE, Forbes EE, Ryan ND, Ladouceur CD. Subgenual Anterior Cingulate Cortex Reactivity to Rejection Vs. Acceptance Predicts Depressive Symptoms among Adolescents with an Anxiety History. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:659-674. [PMID: 35072560 PMCID: PMC9308833 DOI: 10.1080/15374416.2021.2019048] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The goal of this study was to examine whether neural sensitivity to negative peer evaluation conveys risk for depression among youth with a history of anxiety. We hypothesized that brain activation in regions that process affective salience in response to rejection, relative to acceptance, from virtual peers would predict depressive symptoms 1 year later and would be associated with ecological momentary assessment (EMA) reports of peer connectedness. METHOD Participants were 38 adolescents ages 11-16 (50% female) with a history of anxiety, recruited from a previous clinical trial. The study was a prospective naturalistic follow-up of depressive symptoms assessed 2 years (Wave 2) and 3 years (Wave 3) following treatment. At Wave 2, participants completed the Chatroom Interact Task during neuroimaging and 16 days of EMA. RESULTS Controlling for depressive and anxiety symptoms at Wave 2, subgenual anterior cingulate (sgACC; β = .39, p = .010) activation to peer rejection (vs. acceptance) predicted depressive symptoms at Wave 3. SgACC activation to rejection (vs. acceptance) was highly negatively correlated with EMA reports of connectedness with peers in daily life (r = - .71, p < .001). CONCLUSION Findings suggest that elevated sgACC activation to negative, relative to positive, peer evaluation may serve as a risk factor for depressive symptoms among youth with a history of anxiety, perhaps by promoting vigilance or reactivity to social evaluative threats. SgACC activation to simulated peer evaluation appears to have implications for understanding how adolescents experience their daily social environments in ways that could contribute to depressive symptoms.
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Affiliation(s)
| | | | - Neil P Jones
- Department of Psychology, University of Pittsburgh
| | - Kyung Hwa Lee
- Department of Psychiatry, Seoul National University College of Medicine
| | - Ronald E Dahl
- School of Public Health, University of California at Berkeley
| | | | - Neal D Ryan
- Department of Psychology, University of Pittsburgh
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13
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Beltzer ML, Daniel KE, Daros AR, Teachman BA. Examining social reinforcement learning in social anxiety. J Behav Ther Exp Psychiatry 2023; 80:101810. [PMID: 37247976 PMCID: PMC10227359 DOI: 10.1016/j.jbtep.2022.101810] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Reinforcement learning biases have been empirically linked to anhedonia in depression and theoretically linked to social anhedonia in social anxiety disorder, but little work has directly assessed how socially anxious individuals learn from social reward and punishment. METHODS N = 157 individuals high and low in social anxiety symptoms completed a social probabilistic selection task that involved selecting between pairs of neutral faces with varying probabilities of changing to a happy or angry face. Computational modeling was performed to estimate learning rates. Accuracy in choosing the more rewarding face was also analyzed. RESULTS No significant group differences were found for learning rates. Contrary to hypotheses, participants high in social anxiety showed impaired punishment learning accuracy; they were more accurate at choosing the most rewarding face than they were at avoiding the most punishing face, and their punishment learning accuracy was lower than that of participants low in social anxiety. Secondary analyses found that high (vs. low) social anxiety participants were less accurate at selecting the more rewarding face on more (vs. less) punishing face pairs. LIMITATIONS Stimuli were static, White, facial images, which lack important social cues (e.g., movement, sound) and diversity, and participants were largely non-Hispanic, White undergraduates, whose social reinforcement learning may differ from individuals at different developmental stages and those holding more marginalized identities. CONCLUSIONS Socially anxious individuals may be less accurate at learning to avoid social punishment, which may maintain negative beliefs through an interpersonal stress generation process.
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Affiliation(s)
- Miranda L Beltzer
- Department of Psychology, University of Virginia, USA; Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, USA.
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14
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Lear MK, Smith SM, Pilecki B, Stauffer CS, Luoma JB. Social anxiety and MDMA-assisted therapy investigation: a novel clinical trial protocol. Front Psychiatry 2023; 14:1083354. [PMID: 37520237 PMCID: PMC10379654 DOI: 10.3389/fpsyt.2023.1083354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Background Social anxiety disorder (SAD) is a serious and prevalent psychiatric condition that heavily impacts social functioning and quality of life. Though efficacious treatments exist for SAD, remission rates remain elevated and a significant portion of those affected do not access effective treatment, suggesting the need for additional evidence-based treatment options. This paper presents a protocol for an open-label pilot study of MDMA-assisted therapy (MDMA-AT) for social anxiety disorder. The study aims to assess preliminary treatment outcomes, feasibility and safety, and psychological and physiological processes of change in the treatment of SAD with MDMA-AT. A secondary aim includes the development of a treatment manual for MDMA-AT for SAD. Method The outlined protocol is a randomized, open-label delayed treatment study. We will recruit 20 participants who meet criteria with moderate-to-severe social anxiety disorder (SAD) of the generalized subtype. Participants will be randomly assigned to an immediate treatment (n = 10) or delayed treatment condition (n = 10). Those in the immediate treatment condition will proceed immediately to active MDMA-AT consisting of three preparation sessions, two medicine sessions in which they receive oral doses of MDMA, and six integration sessions over approximately a 16-week period. The delayed treatment condition will receive the same intervention after a 16-week delay. Our primary outcome is SAD symptom reduction as measured by the Liebowitz Social Anxiety Scale administered by blinded raters at post-treatment and 6 month follow up. Secondary outcomes include changes in functional impairment, feasibility and safety measures, and novel therapeutic processes of change including shame and shame-related coping, belongingness, self-concealment, and self-compassion at post-treatment. Exploratory outcomes are also discussed. Discussion The results of this pilot trial advance the field's understanding of the acceptability and potential effectiveness of MDMA-AT for social anxiety disorder and provide an overview of relevant therapeutic mechanisms unique to SAD. We hope findings from this protocol will inform the design of subsequent larger-scale randomized controlled trials (RCT) examining the efficacy of MDMA-AT for SAD. Clinical trial registration https://clinicaltrials.gov/, NCT05138068.
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Affiliation(s)
- M. Kati Lear
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
| | - Sarah M. Smith
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
| | - Brian Pilecki
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
| | - Chris S. Stauffer
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Jason B. Luoma
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
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15
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Förstner BR, Böttger SJ, Moldavski A, Bajbouj M, Pfennig A, Manook A, Ising M, Pittig A, Heinig I, Heinz A, Mathiak K, Schulze TG, Schneider F, Kamp-Becker I, Meyer-Lindenberg A, Padberg F, Banaschewski T, Bauer M, Rupprecht R, Wittchen HU, Rapp MA, Tschorn M. The associations of Positive and Negative Valence Systems, Cognitive Systems and Social Processes on disease severity in anxiety and depressive disorders. Front Psychiatry 2023; 14:1161097. [PMID: 37398596 PMCID: PMC10313476 DOI: 10.3389/fpsyt.2023.1161097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/19/2023] [Indexed: 07/04/2023] Open
Abstract
Background Anxiety and depressive disorders share common features of mood dysfunctions. This has stimulated interest in transdiagnostic dimensional research as proposed by the Research Domain Criteria (RDoC) approach by the National Institute of Mental Health (NIMH) aiming to improve the understanding of underlying disease mechanisms. The purpose of this study was to investigate the processing of RDoC domains in relation to disease severity in order to identify latent disorder-specific as well as transdiagnostic indicators of disease severity in patients with anxiety and depressive disorders. Methods Within the German research network for mental disorders, 895 participants (n = 476 female, n = 602 anxiety disorder, n = 257 depressive disorder) were recruited for the Phenotypic, Diagnostic and Clinical Domain Assessment Network Germany (PD-CAN) and included in this cross-sectional study. We performed incremental regression models to investigate the association of four RDoC domains on disease severity in patients with affective disorders: Positive (PVS) and Negative Valance System (NVS), Cognitive Systems (CS) and Social Processes (SP). Results The results confirmed a transdiagnostic relationship for all four domains, as we found significant main effects on disease severity within domain-specific models (PVS: β = -0.35; NVS: β = 0.39; CS: β = -0.12; SP: β = -0.32). We also found three significant interaction effects with main diagnosis showing a disease-specific association. Limitations The cross-sectional study design prevents causal conclusions. Further limitations include possible outliers and heteroskedasticity in all regression models which we appropriately controlled for. Conclusion Our key results show that symptom burden in anxiety and depressive disorders is associated with latent RDoC indicators in transdiagnostic and disease-specific ways.
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Affiliation(s)
- Bernd R. Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Sarah Jane Böttger
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Alexander Moldavski
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Malek Bajbouj
- Charité–Universitätsmedizin Berlin, Department of Psychiatry, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - André Manook
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Andre Pittig
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
- Translational Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany
| | - Ingmar Heinig
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-Brain, Research Center Jülich, Jülich, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, United States
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- University Hospital Düsseldorf, Medical School, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Michael A. Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
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16
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Carlton CN, Antezana L, Richey JA. Associations between resting-state neural connectivity and positive affect in social anxiety disorder. Brain Behav 2023; 13:e3006. [PMID: 37062915 PMCID: PMC10275543 DOI: 10.1002/brb3.3006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 04/18/2023] Open
Abstract
INTRODUCTION Social anxiety disorder (SAD) has been characterized by deficits in social motivation and lack of reactivity to pleasurable stimuli (i.e., positive affect; [PA]). Recent neuroimaging work has shifted toward examining positively valenced motivational systems in SAD focused on reward responses. However, little is known about the associations of reward connectivity and PA in individuals with SAD. As such, the purpose of the current study was to determine whether connectivity among key units of reward neurocircuitry meaningfully relate to PA and whether these key units are more heterogeneous in SAD as compared to controls. METHODS Thirty-one participants who met diagnostic criteria for SAD and 33 control participants were included (Mage = 24.8, SD = 6.9; 55% cisgender man). Seed-based timeseries correlations were conducted in NiTime to extract region of interest (ROI) coupling correlation strength values. ANOVAs were carried out to assess whether individuals with SAD differed in ROI-to-ROI connectivity strength as compared to controls. Correlations and variance analyses were also conducted to examine the relationship between ROI-to-ROI connectivity strength and PA, as well as heterogeneity in connectivity strength and PA expression. RESULTS Weaker connectivity between the left and right orbital frontal cortex was observed when comparing the SAD to the control group. Within the SAD group, PA was associated with several reward-related ROI couplings; however, these links were not observed among controls. Results further demonstrated that individuals with SAD had significantly more variability in reward connectivity strength as compared to controls. CONCLUSION Overall, these results provide emergent evidence for the association between reward regions and PA in individuals with SAD. Additionally, these findings show that individuals with SAD demonstrate greater heterogeneity in reward connectivity.
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Affiliation(s)
| | | | - John A. Richey
- Department of PsychologyVirginia TechBlacksburgVirginia
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
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17
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Hudd T, Moscovitch DA. Social anxiety inhibits needs repair following exclusion in both relational and non-relational reward contexts: The mediating role of positive affect. Behav Res Ther 2023; 162:104270. [PMID: 36746058 DOI: 10.1016/j.brat.2023.104270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/19/2023] [Accepted: 01/27/2023] [Indexed: 01/30/2023]
Abstract
The pain of social exclusion can motivate people to capitalize on opportunities to reconnect with others and repair their self-esteem and feelings of belongingness. This effect is often diminished for those with high social anxiety (HSA). Prior research suggests this may be due to their diminished capacity for recognizing and emotionally responding to relational reward cues. We investigated whether non-relational success experiences in the aftermath of exclusion may be an alternative means of repairing threatened self-esteem and belongingness in HSA individuals. In a preregistered, online study, we threatened belongingness and self-esteem in 422 participants by excluding them in a Cyberball game and then assigned them to one of three conditions: Relational Repair, Non-Relational Repair, or a No-Repair control condition. Results showed that both repair contexts facilitated needs repair relative to the no-repair control condition, and mediation analyses suggested this effect was driven by increased positive affect (PA). HSA individuals were less likely to restore needs regardless of condition and this effect appeared to be driven by low PA. Findings emphasize the critical role of PA for restoring threatened needs in the aftermath of exclusion and suggest that HSA inhibits needs repair processes across both relational and non-relational reward contexts.
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18
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Validation of a novel method of ultraviolet-induced cutaneous inflammation and its associations with anhedonia. Sci Rep 2022; 12:20237. [PMID: 36424456 PMCID: PMC9691739 DOI: 10.1038/s41598-022-24598-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022] Open
Abstract
Affective immunology of the skin is a growing area; however, established protocols for measuring individual differences in cutaneous inflammation are lacking. To address this, we present a preliminary validation of Precision Implementation of Minimal Erythema Dose (PI-MED) testing as a method for measuring cutaneous inflammation. PI-MED is a recently adapted protocol, optimized for reproducibility and individual differences research, that uses ultraviolet (UV) light to evoke cutaneous erythema, or inflammatory skin reddening. PI-MED's novel UV dosage schedule produces standardized erythema responses across different skin pigmentation types and shows strong internal consistency within person and good test-retest reliability across 8-10 weeks. In line with predictions, increased PI-MED erythema was associated with heightened anhedonia, across several measures, beyond influences of non-affective covariates. While future work should further refine the dosage schedule for the lightest and darkest skin types, overall, evidence supports PI-MED as a protocol for inducing and measuring individual differences in cutaneous inflammation. Further, PI-MED-induced erythema can expand psychoneuroimmunology research by offering a complementary assessment for general inflammatory tone. This work adds to a growing body of evidence demonstrating a distinct relationship between inflammation and anhedonia.
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19
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Rahamim O, Azoulay R, Keshet H, Shahar G, Gilboa-Schechtman E. Apprehensions and Aspirations in Social Anxiety and Depression. Int J Cogn Ther 2022. [DOI: 10.1007/s41811-022-00150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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20
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Now I Always have to Perform Well! Effects of CBT for Social Anxiety Disorder on Negative Interpretations of Positive Social Events. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10322-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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21
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Positive valence systems in youth anxiety development: A scoping review. J Anxiety Disord 2022; 89:102588. [PMID: 35691120 DOI: 10.1016/j.janxdis.2022.102588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
Research on pathophysiological mechanisms supporting anxiety development in youth has traditionally focused on the role of threat systems. However, emerging research suggests that the positive valence system (PVS) may also play a strong and unique role in the development and maintenance of anxiety during childhood and adolescence. To better understand the connection between the PVS and anxiety, this scoping review describes current research spanning multiple units of analysis (i.e., self-report, behavior, neural circuits) linking child and adolescent anxiety and risk for anxiety to various PVS constructs (i.e., positive affect, reward responsiveness, reward learning and decision-making). After screening, 78 peer-reviewed articles and dissertations published between 1998 and May 2021 were included in a qualitative review. Though some consistencies in the literature were found, such as high neural reactivity to incentive anticipation in youth at temperamental risk for social anxiety and blunted positive affect in youth with social anxiety disorder, the literature is largely inconsistent. Inconsistencies could be related to the small number of similar studies, small and homogenous study samples, and variability in methodologies employed in this research. It cannot be confirmed whether findings linking PVS constructs to anxiety are unique to anxiety symptoms or better accounted for by co-occurring depressive symptoms. This review concludes with recommendations for robust future research in this area.
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22
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Francis DA, Hudson JL, Robidoux S, McArthur GM. Are different reading problems associated with different anxiety types? APPLIED COGNITIVE PSYCHOLOGY 2022. [DOI: 10.1002/acp.3970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Serje Robidoux
- Macquarie University Centre for Reading, Macquarie University
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23
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Young KS, Ward C, Vinograd M, Chen K, Bookheimer SY, Nusslock R, Zinbarg RE, Craske MG. Individual differences in threat and reward neural circuitry activation: Testing dimensional models of early adversity, anxiety and depression. Eur J Neurosci 2022; 55:2739-2753. [PMID: 34989038 PMCID: PMC9149108 DOI: 10.1111/ejn.15592] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/13/2021] [Accepted: 12/28/2021] [Indexed: 01/31/2023]
Abstract
Altered functioning of the brain's threat and reward circuitry has been linked to early life adversity and to symptoms of anxiety and depression. To date, however, these relationships have been studied largely in isolation and in categorical-based approaches. It is unclear to what extent early life adversity and psychopathology have unique effects on brain functioning during threat and reward processing. We examined functional brain activity during a face processing task in threat (amygdala and ventromedial prefrontal cortex) and reward (ventral striatum and orbitofrontal cortex) regions of interest among a sample (N = 103) of young adults (aged 18-19 years) in relation to dimensional measures of early life adversity and symptoms of anxiety and depression. Results demonstrated a significant association between higher scores on the deprivation adversity dimension and greater activation of reward neural circuitry during viewing of happy faces, with the largest effect sizes observed in the orbitofrontal cortex. We found no significant associations between the threat adversity dimension, or symptom dimensions of anxiety and depression, and neural activation in threat or reward circuitries. These results lend partial support to theories of adversity-related alterations in neural activation and highlight the importance of testing dimensional models of adversity and psychopathology in large sample sizes to further our understanding of the biological processes implicated.
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Affiliation(s)
- Katherine S. Young
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychology, Psychiatry and NeuroscienceKing's College LondonLondonUK,NIHR Maudsley Biomedical Research CentreKing's College LondonLondonUK
| | - Camilla Ward
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychology, Psychiatry and NeuroscienceKing's College LondonLondonUK
| | - Meghan Vinograd
- Center of Excellence for Stress and Mental HealthVeterans Affairs San Diego Healthcare SystemSan DiegoCaliforniaUSA,Department of PsychiatryUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Kelly Chen
- Department of PsychologyUniversity of ArizonaTucsonArizonaUSA
| | - Susan Y. Bookheimer
- Department of Psychiatry and Biobehavioral SciencesUniversity of California, Los Angeles (UCLA)Los AngelesCaliforniaUnited States
| | - Robin Nusslock
- Department of PsychologyNorthwestern UniversityEvanstonIllinoisUSA
| | - Richard E. Zinbarg
- Department of PsychologyNorthwestern UniversityEvanstonIllinoisUSA,The Family InstituteNorthwestern UniversityEvanstonIllinoisUSA
| | - Michelle G. Craske
- Department of Psychiatry and Biobehavioral SciencesUniversity of California, Los Angeles (UCLA)Los AngelesCaliforniaUnited States,Department of PsychologyUniversity of California, Los Angeles (UCLA)Los AngelesCaliforniaUSA
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Nishikawa Y, Fracalanza K, Rector NA, Laposa JM. Social anxiety and negative interpretations of positive social events: What role does intolerance of uncertainty play? J Clin Psychol 2022; 78:2513-2524. [PMID: 35435997 DOI: 10.1002/jclp.23363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/17/2022] [Accepted: 03/29/2022] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Yasunori Nishikawa
- Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Katie Fracalanza
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Neil A Rector
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Judith M Laposa
- Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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25
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Auerbach RP, Pagliaccio D, Hubbard NA, Frosch I, Kremens R, Cosby E, Jones R, Siless V, Lo N, Henin A, Hofmann SG, Gabrieli JDE, Yendiki A, Whitfield-Gabrieli S, Pizzagalli DA. Reward-Related Neural Circuitry in Depressed and Anxious Adolescents: A Human Connectome Project. J Am Acad Child Adolesc Psychiatry 2022; 61:308-320. [PMID: 33965516 PMCID: PMC8643367 DOI: 10.1016/j.jaac.2021.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/17/2021] [Accepted: 04/26/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although depression and anxiety often have distinct etiologies, they frequently co-occur in adolescence. Recent initiatives have underscored the importance of developing new ways of classifying mental illness based on underlying neural dimensions that cut across traditional diagnostic boundaries. Accordingly, the aim of the study was to clarify reward-related neural circuitry that may characterize depressed-anxious youth. METHOD The Boston Adolescent Neuroimaging of Depression and Anxiety Human Connectome Project tested group differences regarding subcortical volume and nucleus accumbens activation during an incentive processing task among 14- to 17-year-old adolescents presenting with a primary depressive and/or anxiety disorder (n = 129) or no lifetime history of mental disorders (n = 64). In addition, multimodal modeling examined predictors of depression and anxiety symptom change over a 6-month follow-up period. RESULTS Our findings highlighted considerable convergence. Relative to healthy youth, depressed-anxious adolescents exhibited reduced nucleus accumbens volume and activation following reward receipt. These findings remained when removing all medicated participants (∼59% of depressed-anxious youth). Subgroup analyses comparing anxious-only, depressed-anxious, and healthy youth also were largely consistent. Multimodal modeling showed that only structural alterations predicted depressive symptoms over time. CONCLUSION Multimodal findings highlight alterations within nucleus accumbens structure and function that characterize depressed-anxious adolescents. In the current hypothesis-driven analyses, however, only reduced nucleus accumbens volume predicted depressive symptoms over time. An important next step will be to clarify why structural alterations have an impact on reward-related processes and associated symptoms.
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Abstract
Humans, like other animals, are fundamentally motivated to pursue rewarding outcomes and avoid aversive ones. Anxiety disorders are conceptualized, defined, and treated based on heightened sensitivity to perceived aversive outcomes, including imminent threats as well as those that are uncertain yet could occur in the future. Avoidance is the central strategy used to mitigate anticipated aversive outcomes - often at the cost of sacrificing potential rewards and hindering people from obtaining desired outcomes. It is for these reasons that people are often motivated to seek treatment. In this chapter, we consider whether and how anhedonia - the loss of interest in pursuing and/or reduced responsiveness to rewarding outcomes - may serve as a barrier to recovering from clinically impairing anxiety. Increasingly recognized as a prominent symptom in many individuals with elevated anxiety, anhedonia is not explicitly considered within prevailing theoretical models or treatment approaches of anxiety. Our goal, therefore, is to review what is known about anhedonia within the anxiety disorders and then integrate this knowledge into a functional perspective to consider how anhedonia could maintain anxiety and limit treatment response. Our overarching thesis is that anhedonia disrupts the key processes that are central to supporting anxiety recovery. We end this chapter by considering how explicitly targeting anhedonia in treatment can optimize outcomes for anxiety disorders.
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Affiliation(s)
- Charles T Taylor
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Samantha N Hoffman
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Amanda J Khan
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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27
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Carlton CN, Garcia KM, Sullivan-Toole H, Stanton K, McDonnell CG, Richey JA. From childhood maltreatment to adult inflammation: Evidence for the mediational status of social anxiety and low positive affect. Brain Behav Immun Health 2021; 18:100366. [PMID: 34704081 PMCID: PMC8526764 DOI: 10.1016/j.bbih.2021.100366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 01/02/2023] Open
Abstract
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.
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Affiliation(s)
| | | | - Holly Sullivan-Toole
- Virginia Tech, Department of Psychology, USA
- Temple University, Department of Psychology, USA
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Goodman FR, Rum R, Silva G, Kashdan TB. Are people with social anxiety disorder happier alone? J Anxiety Disord 2021; 84:102474. [PMID: 34509949 PMCID: PMC9199593 DOI: 10.1016/j.janxdis.2021.102474] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/23/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Fallon R. Goodman
- University of South Florida, Department of Psychology, Tampa, FL, USA
| | - Ruba Rum
- University of South Florida, Department of Psychology, Tampa, FL, USA
| | - Gabriella Silva
- University of South Florida, Department of Psychology, Tampa, FL, USA
| | - Todd B. Kashdan
- George Mason University, Department of Psychology, Fairfax, VA, USA
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Carlton CN, Antezana L, Garcia KM, Sullivan-Toole H, Richey JA. Mindfulness-Based Stress Reduction Specifically Improves Social Anhedonia Among Adults with Chronic Stress. AFFECTIVE SCIENCE 2021; 3:145-159. [PMID: 36046096 PMCID: PMC9382999 DOI: 10.1007/s42761-021-00085-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 10/02/2021] [Indexed: 10/19/2022]
Abstract
This randomized controlled trial examined the effects of mindfulness on anhedonic symptoms in a sample of adults reporting high levels of chronic stress. Meditation-naïve adults (N = 68, Mage = 32, 62% female) were randomized to either an 8-week group-based MBSR intervention (N = 35), or a waitlist control group (N = 33). We hypothesized that changes in mindfulness would mediate the relationship between condition and changes in anhedonic symptoms. Additionally, the present study aimed to determine if other theoretically linked mechanisms (i.e., stress, negative affect [NA], depression) were involved in producing changes in anhedonic symptoms. Results provided evidence for full mediation of the effect of MBSR on social anhedonia through its essential mechanism of ΔMindfulness. These results highlight specificity of anhedonic symptoms targeted by MBSR, with social anhedonia symptoms being modified by changes in mindfulness whereas other anhedonic domains were not. The specificity of effects to the social anhedonia domain may be in part due to the group-based nature of MBSR. Additionally, although associative relationships were present for stress, depression, NA, and anhedonic symptoms, no mediational relationships emerged. Results presented here should be evaluated in light of study limitations, such as the reliance on self-report measures as well as a lack of information regarding cultural or geographic diversity.
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Affiliation(s)
- Corinne N. Carlton
- grid.438526.e0000 0001 0694 4940Department of Psychology, Virginia Tech, 109 Williams Hall, Blacksburg, VA 24061 USA
| | - Ligia Antezana
- grid.438526.e0000 0001 0694 4940Department of Psychology, Virginia Tech, 109 Williams Hall, Blacksburg, VA 24061 USA
| | - Katelyn M. Garcia
- grid.438526.e0000 0001 0694 4940Department of Psychology, Virginia Tech, 109 Williams Hall, Blacksburg, VA 24061 USA
| | - Holly Sullivan-Toole
- grid.438526.e0000 0001 0694 4940Department of Psychology, Virginia Tech, 109 Williams Hall, Blacksburg, VA 24061 USA ,grid.264727.20000 0001 2248 3398Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA 191221 USA
| | - John A. Richey
- grid.438526.e0000 0001 0694 4940Department of Psychology, Virginia Tech, 109 Williams Hall, Blacksburg, VA 24061 USA
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Blöte AW, Miers AC, Westenberg PM. Concurrent and Prospective Associations Between Social Anxiety and Responses to Stress in Adolescence. Res Child Adolesc Psychopathol 2021; 50:659-668. [PMID: 34661781 PMCID: PMC9054901 DOI: 10.1007/s10802-021-00880-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 11/28/2022]
Abstract
Several studies have investigated the relationship between adolescents' responses to stress and general anxiety and depression, but only few studies addressed the relationship between responses to stress and social anxiety. The current three-wave longitudinal study, that covered a period of 5 years with a time interval of on average two years between waves, examined concurrent as well as prospective relations between adolescents' self-reported stress responses, including coping responses, and self-perceived social anxiety. Both the predictive power of social anxiety for different stress responses and, reversely, of stress responses for social anxiety were evaluated. Participants were 331 youth (170 boys) aged 9 to 17 years old at Wave 1. Self-report questionnaires were used to measure social anxiety, responses to social stress, and depressive symptoms. Results showed significant concurrent relations between social anxiety and maladaptive stress responses. Moreover, the study yielded evidence for social anxiety predicting stress responses across time as well as stress responses predicting social anxiety, although evidence for the former link is stronger. The findings suggest that a relative lack of adaptive stress responses may heighten social anxiety and social anxiety in turn may trigger maladaptive as well as adaptive responses to social problems. The relevance of these findings for social anxiety prevention and intervention purposes are discussed.
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Affiliation(s)
- Anke W Blöte
- Institute of Psychology, Unit of Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
| | - Anne C Miers
- Institute of Psychology, Unit of Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - P Michiel Westenberg
- Institute of Psychology, Unit of Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
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Luoma J, Lear MK. MDMA-Assisted Therapy as a Means to Alter Affective, Cognitive, Behavioral, and Neurological Systems Underlying Social Dysfunction in Social Anxiety Disorder. Front Psychiatry 2021; 12:733893. [PMID: 34646176 PMCID: PMC8502812 DOI: 10.3389/fpsyt.2021.733893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Jason Luoma
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
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Hudd T, Moscovitch DA. Reconnecting in the Face of Exclusion: Individuals with High Social Anxiety May Feel the Push of Social Pain, but not the Pull of Social Rewards. COGNITIVE THERAPY AND RESEARCH 2021; 46:420-435. [PMID: 34421156 PMCID: PMC8369445 DOI: 10.1007/s10608-021-10263-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
Background Previous research has shown that high levels of trait social anxiety (SA) disrupt the social repair processes following a painful social exclusion, but the cognitive mechanisms involved in these processes and how trait SA may disrupt them remain unknown. Methods We conducted a preregistered study on Prolific participants (N = 452) who were assigned to experience either social exclusion or inclusion and were then exposed to follow-up opportunities for social reconnection. Results Moderated mediation analyses revealed that irrespective of levels of SA, participants responded to social pain with heightened approach motivation and greater downstream positive affect. Exploratory analyses revealed that heightened desire to affiliate was driven by increased curiosity and attention to social rewards. Moreover, higher SA was associated with lower overall desire to affiliate and this relationship between SA and affiliation was mediated by diminished reward responsiveness. Conclusions Findings highlight the roles of goal pursuit and social reward responsiveness in social repair and how high levels of trait SA may disrupt these processes. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-021-10263-z.
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Affiliation(s)
- Taylor Hudd
- Department of Psychology and Centre for Mental Health Research and Treatment, University of Waterloo, Waterloo, ON N2L-3G1 Canada
| | - David A Moscovitch
- Department of Psychology and Centre for Mental Health Research and Treatment, University of Waterloo, Waterloo, ON N2L-3G1 Canada
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Carlton CN, Dike JE, Brown MFD, Stanton K, Richey JA. Motivationally-relevant domains of positive affectivity are differentially related to social anxiety symptoms. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02165-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Abstract
Purpose of Review
Anhedonia is a transdiagnostic symptom comprising reduced subjective reward or pleasure. Anhedonia influences subjective anticipation and in-the-moment experiences. This review draws together affective learning and engagement evidence for anhedonia affecting subjective experiences of social environments.
Recent Findings
While social engagement is diminished consistently, subjective appraisals of social contexts vary across different mental health disorders. Low positive affect during social experiences or stimuli is reported in PTSD, mood, schizophrenia, and anxiety disorders. Diminished neural reward networks underpin the anticipation of social experiences in ADHD, schizophrenia spectrum, and autistic spectrum disorders. Multiple theories exist to explain how anhedonia might interfere with social environments.
Summary
Anhedonia is a barrier to engagement, motivation, and enjoyment of social contexts. While many studies characterize experiences during social contexts, learning theories provide the most promise for developing targeted interventions.
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Crane NA, Chang F, Kinney KL, Klumpp H. Individual differences in striatal and amygdala response to emotional faces are related to symptom severity in social anxiety disorder. NEUROIMAGE-CLINICAL 2021; 30:102615. [PMID: 33735785 PMCID: PMC7985697 DOI: 10.1016/j.nicl.2021.102615] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 08/21/2020] [Accepted: 02/25/2021] [Indexed: 11/05/2022]
Abstract
Amygdala & striatal neural activity may underlie Social Anxiety Disorder (SAD). 80 individuals with SAD completed an emotion processing task during fMRI. Dorsal striatal & amygdala response to angry > happy related to illness severity. Activity in these regions may contribute to individual differences in SAD.
Social anxiety disorder (SAD) is a common heterogeneous disorder characterized by excessive fear and deficient positive experiences. Case-control emotion processing studies indicate that altered amygdala and striatum function may underlie SAD; however, links between these regions and symptomatology have yet to be established. Therefore, in the current study, 80 individuals diagnosed with SAD completed a validated emotion processing task during functional magnetic resonance imaging. Anatomy-based regions of interest were amygdala, caudate, putamen, and nucleus accumbens. Neural activity in response to angry > happy faces and fearful > happy faces in these regions were submitted to multiple linear regression analysis with bootstrapping. Additionally, multiple linear regression analysis was performed to explore clinical features of SAD. Results showed greater putamen activity and less amygdala activity in response to angry > happy faces were related to greater social anxiety severity. In the model consisting of caudate and amygdala activity in response to angry > happy faces, results were marginally related to social anxiety severity and the pattern of activity was similar to the regression model comprising putamen and amygdala. Nucleus accumbens activity was not related to social anxiety severity. There was no correspondence between brain activity in response to fearful > happy faces and social anxiety severity. Clinical variables revealed greater levels of anhedonia and general anxiety were related to social anxiety severity, however, neural activity was not related to these features of SAD. Neuroimaging findings suggest that variance in dorsal striatal and amygdala activity in response to certain social signals of threat contrasted with an approach/rewarding social signal may contribute to individual differences in SAD. Clinical findings indicate variance in anhedonia and general anxiety symptoms may contribute to individual differences in social anxiety severity.
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Affiliation(s)
- Natania A Crane
- Department of Psychiatry (NAC, FC, KLK, HK), University of Illinois at Chicago, 1601 W. Taylor St (M/C 912), Chicago, IL 60612, United States.
| | - Fini Chang
- Department of Psychiatry (NAC, FC, KLK, HK), University of Illinois at Chicago, 1601 W. Taylor St (M/C 912), Chicago, IL 60612, United States; Department of Psychology (FC, KLK, HK), University of Illinois at Chicago, 1007 W. Harrison St (M/C 285), Chicago, IL 60607, United States
| | - Kerry L Kinney
- Department of Psychiatry (NAC, FC, KLK, HK), University of Illinois at Chicago, 1601 W. Taylor St (M/C 912), Chicago, IL 60612, United States; Department of Psychology (FC, KLK, HK), University of Illinois at Chicago, 1007 W. Harrison St (M/C 285), Chicago, IL 60607, United States
| | - Heide Klumpp
- Department of Psychiatry (NAC, FC, KLK, HK), University of Illinois at Chicago, 1601 W. Taylor St (M/C 912), Chicago, IL 60612, United States; Department of Psychology (FC, KLK, HK), University of Illinois at Chicago, 1007 W. Harrison St (M/C 285), Chicago, IL 60607, United States
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36
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Interpersonal motivations in social anxiety: Weakened approach and intensified avoidance motivations for affiliation and social-rank. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reilly EE, Whitton AE, Pizzagalli DA, Rutherford AV, Stein MB, Paulus MP, Taylor CT. Diagnostic and dimensional evaluation of implicit reward learning in social anxiety disorder and major depression. Depress Anxiety 2020; 37:1221-1230. [PMID: 32906219 DOI: 10.1002/da.23081] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/24/2020] [Accepted: 07/08/2020] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Erin E Reilly
- Department of Psychology, Hofstra University, Hempstead, New York.,Department of Psychiatry, University of California, La Jolla, California
| | - Alexis E Whitton
- Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts.,School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts
| | - Ashleigh V Rutherford
- Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts.,Department of Psychology, Yale University, New Haven, Connecticut
| | - Murray B Stein
- Department of Psychiatry, University of California, La Jolla, California
| | - Martin P Paulus
- Department of Psychiatry, University of California, La Jolla, California.,Laureate Institute for Brain Research, Tulsa, Oklahoma
| | - Charles T Taylor
- Department of Psychiatry, University of California, La Jolla, California
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Hedger N, Dubey I, Chakrabarti B. Social orienting and social seeking behaviors in ASD. A meta analytic investigation. Neurosci Biobehav Rev 2020; 119:376-395. [PMID: 33069686 DOI: 10.1016/j.neubiorev.2020.10.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 12/29/2022]
Abstract
Social motivation accounts of autism spectrum disorder (ASD) posit that individuals with ASD find social stimuli less rewarding than neurotypical (NT) individuals. Behaviorally, this is proposed to manifest in reduced social orienting (individuals with ASD direct less attention towards social stimuli) and reduced social seeking (individuals with ASD invest less effort to receive social stimuli). In two meta-analyses, involving data from over 6000 participants, we review the available behavioral studies that assess social orienting and social seeking behaviors in ASD. We found robust evidence for reduced social orienting in ASD, across a range of paradigms, demographic variables and stimulus contexts. The most robust predictor of this effect was interactive content - effects were larger when the stimulus involved an interaction between people. By contrast, the evidence for reduced social seeking indicated weaker evidence for group differences, observed only under specific experimental conditions. The insights gained from this meta-analysis can inform design of relevant task measures for social reward responsivity and promote directions for further study on the ASD phenotype.
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Affiliation(s)
- Nicholas Hedger
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK.
| | - Indu Dubey
- School of Applied Social Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
| | - Bhismadev Chakrabarti
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK
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Carlton CN, Sullivan-Toole H, Strege MV, Ollendick TH, Richey JA. Mindfulness-Based Interventions for Adolescent Social Anxiety: A Unique Convergence of Factors. Front Psychol 2020; 11:1783. [PMID: 32774320 PMCID: PMC7387717 DOI: 10.3389/fpsyg.2020.01783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Social anxiety disorder (SAD) is a debilitating and often chronic psychiatric disorder that typically onsets during early adolescence. Cognitive behavior therapy (CBT), the current "gold-standard" treatment for SAD, tends to focus on threat- and fear-based systems hypothesized to maintain the disorder. Despite this targeted approach, SAD ranks among the least responsive anxiety disorders to CBT in adolescent samples, with a considerable proportion of individuals still reporting clinically significant symptoms following treatment, suggesting that the CBT-family of interventions may not fully target precipitating or maintaining factors of the disorder. This gap in efficacy highlights the need to consider new therapeutic modalities. Accordingly, this brief review critically evaluates the emergent literature supporting the use of mindfulness-based interventions (MBIs) for treating adolescent SAD. MBIs may be particularly relevant for addressing maintaining factors within this diagnosis, as they may target and interrupt cycles of avoidance and de-motivation. Despite limitations in the relative lack of randomized controlled trials (RCTs) on this topic, a unique convergence of factors emerge from the extant literature that support the notion that MBIs may hold particular promise for attenuating symptoms of SAD in adolescents. These factors include: (1) MBIs demonstrate the ability to directly engage symptoms of SAD; (2) MBIs also show consistent reduction of anxiety, including symptoms of social anxiety in adolescent populations; and (3) MBIs demonstrate high rates of feasibility and acceptability in anxious adolescent samples. We briefly review each topic and conclude that MBIs are an encouraging treatment approach for reducing symptoms of social anxiety in adolescents. However, given the lack of research within MBIs for adolescent SAD in particular, more research is needed to determine if MBIs are more advantageous than other current treatment approaches.
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Affiliation(s)
- Corinne N. Carlton
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Holly Sullivan-Toole
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, United States
| | - Marlene V. Strege
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Thomas H. Ollendick
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - John A. Richey
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
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40
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Carlton CN, Sullivan-Toole H, Ghane M, Richey JA. Reward Circuitry and Motivational Deficits in Social Anxiety Disorder: What Can Be Learned From Mouse Models? Front Neurosci 2020; 14:154. [PMID: 32174811 PMCID: PMC7054462 DOI: 10.3389/fnins.2020.00154] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 02/10/2020] [Indexed: 01/09/2023] Open
Abstract
Social anxiety disorder (SAD) is a common and serious psychiatric condition that typically emerges during adolescence and persists into adulthood if left untreated. Prevailing interventions focus on modulating threat and arousal systems but produce only modest rates of remission. This gap in efficacy suggests that most mainstream treatment concepts do not sufficiently target core processes involved in the onset and maintenance of SAD. This idea has further driven the development of new theoretical models that target dopamine (DA)-driven reward circuitry and motivational deficits that appear to be systematically altered in SAD. Most of the available data linking systemic alterations in DA neurobiology to SAD in humans, although abundant, remains at the level of correlational evidence. Accordingly, the purpose of this brief review is to critically evaluate the relevance of experimental work in rodent models that link details of DA function to symptoms of social anxiety. We conclude that, despite certain systematic limitations inherent in animal models, these approaches provide useful insights into human biomarkers of social anxiety including that (1) adolescence may serve as a critical period for the convergence of neurobiological and environmental factors that modify future expectations about social reward through experience dependent changes in DA-ergic circuitry, (2) females may show unique susceptibility to social anxiety symptoms when encountering relational instability that influences DA-related neural processes, and (3) separate from fear and arousal systems, the functional neurobiology of central DA systems contribute uniquely to susceptibility and maintenance of anhedonic factors relevant to human models of SAD.
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Affiliation(s)
- Corinne N Carlton
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Holly Sullivan-Toole
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, United States
| | - Merage Ghane
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - John A Richey
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
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41
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Goodman FR, Kashdan TB. The most important life goals of people with and without social anxiety disorder: Focusing on emotional interference and uncovering meaning in life. THE JOURNAL OF POSITIVE PSYCHOLOGY 2019; 16:272-281. [PMID: 34239597 PMCID: PMC8259167 DOI: 10.1080/17439760.2019.1689423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/08/2019] [Indexed: 06/13/2023]
Abstract
People with social anxiety disorder (SAD) display maladaptive attitudes towards emotions. In this experience-sampling study, we explored the extent to which people with SAD viewed anxiety and pain as an impediment to pursuing personal strivings and deriving meaning in life. Participants were adults diagnosed with SAD and a control comparison group who completed baseline questionnaires and daily surveys for 14 consecutive days. People with SAD perceived anxiety and pain as interfering with progress towards their strivings to a greater degree than healthy controls. Perception of emotion-related goal interference was inversely associated with daily meaning. This relationship was moderated by diagnostic group such that there was a strong, inverse association with daily meaning in life for people with SAD; for controls, no association was found. Results suggest that negative beliefs about the value of anxiety and pain are pronounced in people with SAD and may impede derivation of meaning in life.
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