Avoidance of all feedback? Attention allocation during and after public speech in social anxiety

Gaze behavior is associated with the cortisol response to acute psychosocial stress in the virtual TSST

BACKGROUND

The Trier Social Stress Test (TSST) is a reliable tool for psychobiological stress induction. Because of its socio-evaluative nature, it has been useful for investigating gaze behavior. It has been shown that healthy people avoid looking toward faces when under stress, a finding that corroborates studies demonstrating avoidance of eye contact in social anxiety disorder. Yet, little is known about the relationship between gaze behavior and the biological stress response.

METHODS

In a final sample of 74 healthy males, a virtual reality version of the Trier Social Stress Test (TSST-VR) with an integrated eye tracker was implemented to investigate gaze behavior during acute stress induction. Stress response measures were collected via saliva samples and subjective stress ratings. Additional questionnaires were administered for examining the influence of social anxiety traits.

RESULTS

The TSST-VR elicited a significant psychobiological stress response. Overall, higher gaze times on judges compared to surroundings were found in the speech task while this pattern was reversed in the arithmetic task. Critically, there was a significant negative association between gaze time on judges and cortisol output in cortisol responders.

CONCLUSIONS

In a non-clinical sample, avoidance of gaze is associated with a stronger cortisol response to acute stress. This study demonstrates the potential of eye tracking to disentangle the effects of acute stress on social interaction, warranting further investigation in clinical populations characterized by high levels of anxiety in social situations, such as social anxiety and autism spectrum disorder.

Self-focused attention vs. negative attentional bias during public speech task in socially anxious individuals

Enhanced self-focused attention (SFA) and negative attentional bias (NAB) towards social cues are characteristic hallmarks of social anxiety. It is essential to investigate these two attentional phenomena under socially relevant situations using comparable stimuli. In the present study, individuals with high social anxiety (HSA, n = 32) and low social anxiety (LSA, n = 29) were compared according to their attention toward self-related stimuli and toward positive, neutral, and negative feedback related stimuli. Video stimuli of moving indicators of self-anxiety-status and positive, neutral, and negative feedback from an audience were presented during an impromptu speech task (high anxiety condition) and a re-watching phase (low anxiety condition). Eye movements in response to the different stimuli served as readouts for attentional preference. An interaction effect suggested that the HSA group directed more attention to self-related stimuli relative to other stimuli and the LSA group only during the high anxiety condition. The LSA group exhibited a general attentional preference toward positive feedback, especially during the low anxiety condition. Meanwhile, only the total duration of fixation on positive feedback negatively correlated with subjective anxiety rating. Our results point to increased SFA rather than NAB in HSA individuals under social threats.

Biased distance estimation in social anxiety disorder: A new avenue for understanding avoidance behavior

OBJECTIVES

People regulate their interpersonal space appropriately to obtain a comfortable distance for interacting with others. Socially anxious individuals are especially prone to discomfort from and fear of physical closeness, leading them to prefer a greater interpersonal distance from others. Previous studies also indicate that fear can enhance the threat-related elements of a threatening stimulus. For example, spider phobia is associated with estimating spiders as bigger and faster than they actually are. Nonetheless, it is still unclear whether the preference of those with social anxiety disorder (SAD) to maintain greater distance from others is associated with biased estimations of interpersonal distance.

MATERIALS AND METHODS

A total of 87 participants (44 clinically diagnosed with SAD and 43 control) performed validated computerized and ecological tasks in a real-life setting while social space estimations and preferences were measured.

RESULTS

Participants with SAD felt comfortable when maintaining a greater distance from unfamiliar others compared to the control group and estimated unfamiliar others to be closer to them than they actually were. Moreover, the estimation bias predicted their preferred distance from strangers, indicating a strong association between estimation bias severity and actual approach-avoidance behavior.

CONCLUSION

Our findings indicate that distance estimation bias underlies avoidance behavior in SAD, suggesting the involvement of a new cognitive mechanism in personal space regulation.