Social anxiety and cardiovascular responses to an evaluative speaking task: The role of stressor anticipation

Trait and state self-compassion interactively predict cortisol recovery following an acute stressor in healthy males

This study examined the effect of self-compassion induction on cortisol stress recovery following an acute stressor. A total of 67 male university students completed the Maastricht Acute Stress Test and were then randomized to either a self-compassion (a guided self-compassion writing task) or control condition (a writing task just to review the stress test), followed by a 50-minute resting period. Subjective stress and cortisol levels were assessed at - 15, - 10, 0, 10, 20, 30, 40, and 50 min relative to the stress offset. Heart rate and respiratory sinus arrhythmia were monitored throughout the study. Multilevel modeling indicated that self-compassion induction had no significant effect on cortisol recovery. An exploratory analysis examining the moderating effect of trait self-compassion indicated that the effect of self-compassion induction was prominent when trait self-compassion was low but not when it was high. These findings suggest that self-compassion induction may help recovery from stressful experiences, particularly for those who are less self-compassionate.

Associations between general trait anxiety, trait social anxiety and cardiovascular responses to social and non-social stressors

OBJECTIVE

The present study sought to examine whether anxiety propensity dimensions (general trait anxiety vs. trait social anxiety) interact with stressor types (tasks with social vs. non-social challenges) to determine cardiovascular stress responses.

METHODS

A 2 × 3 mixed-factorial experimental design was employed. The State-Trait Anxiety Inventory, the Social Performance and Social Interaction Anxiety Scales were administered to 233 participants, who engaged in a stress task with either social or non-social challenges during which their cardiovascular data were continuously collected.

RESULTS

General trait anxiety negatively predicted heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) reactivity (β = -0.16, p = 0.001; β = -0.17, p = 0.001; β = -0.18, p < 0.001), and positively predicted HR, SBP, DBP recovery (β = 0.16, p = 0.012; β = 0.15, p = 0.014; β = 0.15, p = 0.011), regardless of stress types. Social performance anxiety (β = -0.23, p = 0.002; β = -0.25, p = 0.001; β = -0.24, p = 0.001) and social interaction anxiety (β = -0.22, p < 0.001; β = -0.25, p < 0.001; β = -0.22, p < 0.001) only negatively predicted HR, SBP, DBP reactivity to the stress task with social challenges. No associations were observed between trait social anxiety and cardiovascular recovery from the stress task with social or non-social challenges.

CONCLUSIONS

These findings suggest that different trait anxiety dimensions interact with stressor types in affecting cardiovascular stress responses, which have different health implications.

Reflecting on Existential Threats Elicits Self-Reported Negative Affect but No Physiological Arousal

There is mixed evidence whether reflecting on an existential threat increases negative affect and thereby elicits subjective arousal and physiological activation. Additionally, it is debated whether different existential and non-existential threats elicit different arousal responses, although systematic comparisons are lacking. The current study explored affective, subjective, and physiological arousal responses while comparing several existential threats with a non-existential threat and with a control condition. One-hundred-and-seventy-one undergraduate students were randomly allocated to one of four existential threat conditions: mortality salience (MS), freedom restriction, uncontrollability, and uncertainty; or to the non-existential threat condition: social-evaluative threat (SET); or to a control condition (TV salience). Self-reported positive/negative affect was measured before and after reflection, while subjective arousal and physiological activation (electrodermal, cardiovascular, and respiratory) were measured on a high time-scale during baseline and reflection. Results showed larger increases in self-reported negative affect, as compared to the control condition, for all existential threat conditions, while there were no differences between the control condition and threat conditions regarding positive affect, subjective arousal, skin conductance, respiratory rate, and respiratory sinus arrythmia. There were subtle differences between existential and non-existential threat conditions, most notably in affective responses. Correlations showed positive associations between negative affect and subjective arousal and between trait avoidance and subjective arousal. This study is the first to systematically compare affective, subjective, and physiological changes in arousal due to reflecting on different existential threats, as well as one non-existential threat. We showed that, as compared to a control condition, reflecting on threats has a large impact on negative affect, but no significant impact on positive affect, subjective arousal, and physiological activation.

Social-evaluative threat: Stress response stages and influences of biological sex and neuroticism

Social-evaluative threat (SET) - when the self could be negatively judged by others - can cause pronounced responses in the different stress systems: threat/challenge appraisal, the sympathetic (SNS) and parasympathetic (PNS) nervous systems, experienced motivation and affect, and the hypothalamus-pituitary-adrenal (HPA) axis. Here, we utilize a four-stage stress response model to shed light on the complex associations between different stress responses, where earlier stages are hypothesized to predict later stages. Additionally, we take into account important moderators, such as biological sex (controlling for menstrual cycle phase), personality traits (neuroticism and extraversion), and baseline stress levels. Thirty-seven men and 30 women in their luteal phase participated in an impromptu public speaking task to induce SET. Stress responses in four different stages were measured using: self-reported appraisal (threat or challenge, stage 1: S1), cardiovascular measures (pre-ejection period as SNS index, respiratory sinus arrhythmia as PNS index, S2), self-reported motivation and affect (state approach motivation, state anxiety, S3) and endocrine measures (cortisol as HPA index, S4). Stress reactivity was calculated by subtracting individual peaks from baseline. Results showed that SET induced pronounced stress reactivity in stages two to four. Against expectations, self-reported appraisal (S1) or motivation and affect (S3) did not predict later stress reactivity. As hypothesized, increased SNS (but not PNS) reactivity (S2) predicted increased HPA reactivity (S4). Bayesian model comparison confirmed the absence of sex differences in stress reactivity, likely due to controlling for menstrual cycle phase and sex differences in neuroticism levels. Higher trait neuroticism predicted blunted SNS (S2) and HPA (S4) reactivity, while higher baseline stress levels predicted blunted stages two and three reactivity overall. In conclusion, this rigorously controlled experiment partly supports and partly contradicts previous findings regarding associations between stress response stages, and offers new insight into the causes of blunted HPA responses in women.

Low estradiol is linked to increased skin conductance, but not subjective anxiety or affect, in response to an impromptu speech task

Low estradiol is associated with impaired extinction of conditioned physiological fear responses (e.g. skin conductance) in females. As fear extinction is the laboratory basis of exposure therapy for anxiety disorders, it has been speculated that estradiol may be related to the effectiveness of treatment for anxiety. The present study extended past research by examining whether estradiol is related to physiological and subjective fear responses during the impromptu speech task, where participants perform a surprise speech to camera. This task elicits psychosocial fear, and thus has relevance for social anxiety disorder (SAD). We used a quasi-experimental design with two groups of women: 39 naturally cycling women, and 19 women taking hormonal contraceptives. Based on the measured serum levels, naturally cycling women were further divided into women with higher- vs. lower estradiol levels. Compared to those with higher estradiol, women with lower estradiol, and those using hormonal contraceptives (chronically suppressed estradiol) displayed higher speech-elicited skin conductance yet reported no differences in subjective anxiety or affect. Conversely, irrespective of estradiol status, compared to those with low self-reported social anxiety, participants with higher social anxiety exhibited greater subjective anxiety and affect, yet no differences in skin conductance. These results demonstrate that the relationship between estradiol and physiological fear responses extends to psychosocial tasks. However, the dissociations between physiological and subjective measures highlight the need to consider the relevance of different response outputs so that the potential impact of estradiol on the treatment of anxiety disorders can be better understood.

Heart rate variability as candidate endophenotype of social anxiety: A two-generation family study

BACKGROUND

Social anxiety disorder (SAD) is the extreme fear and avoidance of one or more social situations. The goal of the current study was to investigate whether heart rate variability (HRV) during resting state and a social performance task (SPT) is a candidate endophenotype of SAD.

METHODS

In this two-generation family study, patients with SAD with their partner and children, and their siblings with partner and children took part in a SPT (total n = 121, 9 families, 3-30 persons per family, age range: 8-61 years, 17 patients with SAD). In this task, participants had to watch and evaluate the speech of a female peer, and had to give a similar speech. HRV was measured during two resting state phases, and during anticipation, speech and recovery phases of the SPT. We tested two criteria for endophenotypes: co-segregation with SAD within families and heritability.

RESULTS

HRV did not co-segregate with SAD within families. Root mean square of successive differences during the first resting phase and recovery, and high frequency power during all phases of the task were heritable.

LIMITATIONS

It should be noted that few participants were diagnosed with SAD. Results during the speech should be interpreted with caution, because the duration was short and there was a lot of movement.

CONCLUSIONS

HRV during resting state and the SPT is a possible endophenotype, but not of SAD. As other studies have shown that HRV is related to different internalizing disorders, HRV might reflect a transdiagnostic genetic vulnerability for internalizing disorders. Future research should investigate which factors influence the development of psychopathology in persons with decreased HRV.

Assessing Performance on an Evaluated Speaking Task

Abstract. Coping with social stress involves cognitive perceptions and the activation of several physiological mechanisms. Our main purpose was to examine how psychological factors such as cognitive appraisal, and particularly self-efficacy, may affect psychophysiological reactivity to social stress and young people’s performance on an evaluated speaking task. Thirty-five university students (18 men and 17 women) were exposed to the Trier Social Stress Test (TSST) and a control condition in a counterbalanced order. Self-efficacy, several dimensions of trait anxiety related to social evaluation, and changes in state anxiety were assessed. Additionally, heart rate and heart rate variability (HRV) were analyzed by means of R-R and r-MSSD parameters, respectively. The results indicate that a positive self-assessment of their own ability to overcome a social threat was related to the predominance of vagal tone and better performance. However, cardiac reactivity was not related to the quality of the performance displayed. In addition, some dimensions of trait anxiety, such as cognitive anxiety and test evaluation anxiety, were negatively associated with self-efficacy and performance. These findings emphasize the relevance of self-efficacy, a key component of cognitive appraisal, in explaining psychophysiological reactivity to social stress. Furthermore, they highlight the importance of some personality characteristics, such as social evaluation anxiety, in explaining performance in specifically related stressful situations, regardless of autonomic activation.

DJINNI: A Novel Technology Supported Exposure Therapy Paradigm for SAD Combining Virtual Reality and Augmented Reality

The present paper explores the benefits and the capabilities of various emerging state-of-the-art interactive 3D and Internet of Things technologies and investigates how these technologies can be exploited to develop a more effective technology supported exposure therapy solution for social anxiety disorder. "DJINNI" is a conceptual design of an in vivo augmented reality (AR) exposure therapy mobile support system that exploits several capturing technologies and integrates the patient's state and situation by vision-based, audio-based, and physiology-based analysis as well as by indoor/outdoor localization techniques. DJINNI also comprises an innovative virtual reality exposure therapy system that is adaptive and customizable to the demands of the in vivo experience and therapeutic progress. DJINNI follows a gamification approach where rewards and achievements are utilized to motivate the patient to progress in her/his treatment. The current paper reviews the state of the art of technologies needed for such a solution and recommends how these technologies could be integrated in the development of an individually tailored and yet feasible and effective AR/virtual reality-based exposure therapy. Finally, the paper outlines how DJINNI could be part of classical cognitive behavioral treatment and how to validate such a setup.

The interactive effect of change in perceived stress and trait anxiety on vagal recovery from cognitive challenge

The present study tested the hypothesis that the change in state negative affect (measured as perceived stress) after cognitive challenge moderates the relationship of trait anxiety and anger to vagal recovery from that challenge. Cardiac vagal control (assessed using heart rate variability) and respiratory rate were measured in a sample of 905 participants from the Midlife in the United States Study. Cognitive challenges consisted of computerized mental arithmetic and Stroop color-word matching tasks. Multiple regression analyses controlling for the effects of the demographic, lifestyle, and medical factors influencing cardiac vagal control showed a significant moderating effect of change in perceived stress on the relationship of trait anxiety to vagal recovery from cognitive challenges (Beta=.253, p=.013). After adjustment for respiratory rate, this effect became marginally significant (Beta=.177, p=.037). In contrast, for the relationship of trait anger to vagal recovery, this effect was not significant either before (Beta=.141, p=.257) or after (Beta=.186, p=.072) adjusting for respiratory rate. Secondary analyses revealed that among the individuals with higher levels of trait anxiety, greater reductions in perceived stress were associated with greater increases in cardiac vagal control after the challenge. In contrast, among the individuals with lower levels of trait anxiety, changes in perceived stress had no impact on vagal recovery. Therefore, change in perceived stress moderates the relationship of trait anxiety, but not trait anger, to vagal recovery from cognitive challenge.