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Nan Y, Mehta P, Liao J, Zheng Y, Han C, Wu Y. Testosterone administration decreases sensitivity to angry facial expressions in healthy males: A computational modeling approach. Psychoneuroendocrinology 2024; 161:106948. [PMID: 38211451 DOI: 10.1016/j.psyneuen.2023.106948] [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: 08/09/2023] [Revised: 11/10/2023] [Accepted: 12/23/2023] [Indexed: 01/13/2024]
Abstract
Previous research indicates that higher testosterone levels are related to increased aggressive and dominant behaviors, particularly in males. One possible mechanism for these hormone-behavior associations could involve threat perception. However, the causal influence of testosterone on men's recognition of threatening facial expressions remains unknown. Here, we tested the causal effect of exogenous testosterone on men's sensitivity to facial threat by combining a psychophysical task with computational modeling. We administered a single dose (150 mg) of testosterone or placebo gel to healthy young men (n = 120) in a double-blind, placebo-controlled, between-participant design. Participants were presented with morphed emotional faces mixing anger/fear and neutral expressions and made judgments about the emotional expression. Across typical regression analysis, signal detection analysis, and drift diffusion modeling, our results consistently showed that individuals who received testosterone (versus placebo) exhibited a lower perceived sensitivity to angry facial expressions. But we observed no significant effects of testosterone administration on fearful facial expressions. The findings indicate that testosterone attenuates sensitivity to facial threat, especially angry facial expressions, which could lead to a misestimation of others' dominance and an increase in one's own aggressive and dominant behaviors.
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Affiliation(s)
- Yu Nan
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China; School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Pranjal Mehta
- Department of Experimental Psychology, University College London, London, United Kingdom
| | - Jiajun Liao
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yueyuan Zheng
- Department of Psychology, University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Chengyang Han
- Department of Psychology, Hangzhou Normal University, Hangzhou, China
| | - Yin Wu
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China; Research Institute for Sports Science and Technology, Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China.
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Tönsing D, Schiller B, Vehlen A, Spenthof I, Domes G, Heinrichs M. No evidence that gaze anxiety predicts gaze avoidance behavior during face-to-face social interaction. Sci Rep 2022; 12:21332. [PMID: 36494411 PMCID: PMC9734162 DOI: 10.1038/s41598-022-25189-z] [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: 07/14/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
Eye contact is an indispensable social signal, yet for some individuals it is also a source of discomfort they fear and avoid. However, it is still unknown whether gaze anxiety actually produces avoidant gaze behavior in naturalistic, face-to-face interactions. Here, we relied on a novel dual eye-tracking setup that allows us to assess interactive gaze behavior. To investigate the effect of gaze anxiety on gaze behavior, we a priori created groups of participants reporting high or low levels of gaze anxiety. These participants (n = 51) then performed a semi-standardized interaction with a previously unknown individual reporting a medium level of gaze anxiety. The gaze behavior of both groups did not differ in either classical one-way, eye-tracking parameters (e.g. unilateral eye gaze), or interactive, two-way ones (e.g. mutual gaze). Furthermore, the subjective ratings of both participants' interaction did not differ between groups. Gaze anxious individuals seem to exhibit normal gaze behavior which does not hamper the perceived quality of interactions in a naturalistic face-to-face setup. Our findings point to the existence of cognitive distortions in gaze anxious individuals whose exterior behavior might be less affected than feared by their interior anxiety.
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Affiliation(s)
- Daniel Tönsing
- grid.5963.9Laboratory for Biological Psychology, Clinical Psychology and Psychotherapy, Department of Psychology, Albert-Ludwigs University of Freiburg, Stefan-Meier-Straße 8, 79104 Freiburg, Germany
| | - Bastian Schiller
- grid.5963.9Laboratory for Biological Psychology, Clinical Psychology and Psychotherapy, Department of Psychology, Albert-Ludwigs University of Freiburg, Stefan-Meier-Straße 8, 79104 Freiburg, Germany ,grid.5963.9Freiburg Brain Imaging Center, University Medical Center, Albert-Ludwigs University of Freiburg, Freiburg, Germany
| | - Antonia Vehlen
- grid.12391.380000 0001 2289 1527Department of Biological and Clinical Psychology, University of Trier, Trier, Germany
| | - Ines Spenthof
- grid.5963.9Laboratory for Biological Psychology, Clinical Psychology and Psychotherapy, Department of Psychology, Albert-Ludwigs University of Freiburg, Stefan-Meier-Straße 8, 79104 Freiburg, Germany
| | - Gregor Domes
- grid.12391.380000 0001 2289 1527Department of Biological and Clinical Psychology, University of Trier, Trier, Germany
| | - Markus Heinrichs
- grid.5963.9Laboratory for Biological Psychology, Clinical Psychology and Psychotherapy, Department of Psychology, Albert-Ludwigs University of Freiburg, Stefan-Meier-Straße 8, 79104 Freiburg, Germany ,grid.5963.9Freiburg Brain Imaging Center, University Medical Center, Albert-Ludwigs University of Freiburg, Freiburg, Germany
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Günther V, Kropidlowski A, Schmidt FM, Koelkebeck K, Kersting A, Suslow T. Attentional processes during emotional face perception in social anxiety disorder: A systematic review and meta-analysis of eye-tracking findings. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110353. [PMID: 34000291 DOI: 10.1016/j.pnpbp.2021.110353] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 01/04/2023]
Abstract
Background In recent years, a growing body of eye-tracking research has investigated gaze behavior in individuals with social anxiety during the visual perception of emotional stimuli. The aim of this article was to review and synthesize studies examining attention orientation in patients with clinical social anxiety by means of eye-tracking methodology. Methods Through a systematic search, 30 articles were identified, including 11 studies in which single emotional faces were used as stimuli and seven eligible studies in which threatening faces were paired with neutral stimuli. Meta-analyses were conducted to compare prolonged eye-contact behavior and early attentional biases to threats in individuals with social anxiety disorder (SAD) and healthy controls. Results Moderate group differences were revealed for single face viewing studies, with SAD patients showing significantly reduced eye contact with negative (Hedges' g = -0.67) and positive emotional faces (g = -0.49) compared to that of healthy participants. Type of task and duration of stimulus presentation were (marginally) significant moderators of between-study variance in effect size. Small but significant group differences were found for early attentional biases toward angry faces versus neutral stimuli (g = 0.21) but not toward happy faces versus neutral stimuli (g = 0.05). Preliminary evidence for a hyperscanning strategy in SAD patients relative to healthy controls emerged (g = 0.42). Limitations The number of included studies with face pairings was low, and two studies were excluded due to unavailable data. Conclusions Our results suggest that eye contact avoidance with emotional faces is a prominent feature in SAD patients. Patients might benefit from guidance to learn to make adequate eye contact during therapeutic interventions, such as exposure therapy. SAD patients demonstrated slightly heightened attention allocation toward angry faces relative to that of healthy participants during early processing stages. Threat biases can be potential targets for attention modification training as an adjuvant to other treatments. Future research on early attentional processes may benefit from improved arrangements of paired stimuli to increase the psychometric properties of initial attention indices.
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Affiliation(s)
- Vivien Günther
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Adam Kropidlowski
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Frank Martin Schmidt
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Katja Koelkebeck
- LVR-Hospital Essen, Institute and Hospital of the University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.
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Roitblat Y, Cohensedgh S, Frig-Levinson E, Cohen M, Dadbin K, Shohed C, Shvartsman D, Shterenshis M. Emotional expressions with minimal facial muscle actions. Report 2: Recognition of emotions. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00691-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Chen J, van den Bos E, Westenberg PM. A systematic review of visual avoidance of faces in socially anxious individuals: Influence of severity, type of social situation, and development. J Anxiety Disord 2020; 70:102193. [PMID: 32058889 DOI: 10.1016/j.janxdis.2020.102193] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/15/2020] [Indexed: 01/15/2023]
Abstract
Although visual avoidance of faces is a hallmark feature of social anxiety disorder (SAD) on clinical and theoretical grounds, empirical support is equivocal. This review aims to clarify under which conditions socially anxious individuals display visual avoidance of faces. Through a systematic search in Web of Science and PubMed up to March 2019 we identified 61 publications that met the inclusion criteria. We discuss the influence of three factors on the extent to which socially anxious individuals avoid looking at faces: (a) severity of social anxiety symptoms (diagnosed SAD versus High Social Anxiety levels in community samples [HSA] or related characteristics [Shyness, Fear of Negative Evaluation]), (b) three types of social situation (computer facial-viewing tasks, speaking tasks, social interactions), and (c) development (age-group). Adults with SAD exhibit visual avoidance across all three types of social situations, whereas adults with HSA exhibit visual avoidance in speaking and interaction tasks but not in facial-viewing tasks. The relatively few studies with children and adolescents suggest that visual avoidance emerges during adolescence. The findings are discussed in the context of cognitive-behavioral and skills-deficit models. Suggestions for future research include the need for developmental studies and more fine-grained analyses of specific areas of the face.
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Affiliation(s)
- Jiemiao Chen
- Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands.
| | - Esther van den Bos
- Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
| | - P Michiel Westenberg
- Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
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Banner A, Gabay S, Shamay-Tsoory S. Androstadienone, a putative chemosignal of dominance, increases gaze avoidance among men with high social anxiety. Psychoneuroendocrinology 2019; 102:9-15. [PMID: 30481725 DOI: 10.1016/j.psyneuen.2018.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Abstract
Socially anxious individuals show increased sensitivity toward social threat signals, including cues of dominance. This sensitivity may account for the hypervigilance and gaze avoidance commonly reported in individuals with social anxiety. This study examines visual scanning behavior in response to androstadienone (androsta-4,16,-dien-3-one), a putative chemosignal of dominance. We tested whether exposure to androstadienone would increase hypervigilance and gaze avoidance among individuals with high social anxiety. In a double-blind, placebo-controlled, within-subject design, 26 participants with high social anxiety and 26 with low social anxiety were exposed to androstadienone and a control solution on two separate days. On each day, an eye-tracker recorded their spontaneous scanning behavior while they viewed facial images of men depicting dominant and neutral poses. The results indicate that among participants with high social anxiety, androstadienone increased gaze avoidance by reducing the percentage of fixations made to the eye-region and the total amount of time spent gazing at the eye-region of the faces. Participants with low social anxiety did not show this effect. These findings indicate that androstadienone serves as a threatening chemosignal of dominance, further supporting the link between hypersensitivity toward social threat cues and the perpetuation of social anxiety.
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Affiliation(s)
- A Banner
- Department of Psychology, University of Haifa, Abba Khoushy Ave 199, Haifa, Israel.
| | - S Gabay
- Department of Psychology, University of Haifa, Abba Khoushy Ave 199, Haifa, Israel; The Institute of Information Processing and Decision Making, University of Haifa, Abba Khoushy Ave 199, Haifa, Israel
| | - S Shamay-Tsoory
- Department of Psychology, University of Haifa, Abba Khoushy Ave 199, Haifa, Israel
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Abstract
PURPOSE OF REVIEW A broad base of research has sought to identify the biases in selective attention which characterize social anxiety, with the emergent use of eye tracking-based methods. This article seeks to provide a review of eye tracking studies examining selective attention biases in social anxiety. RECENT FINDINGS Across a number of contexts, social anxiety may be associated with a mix of both vigilant and avoidant patterns of attention with respect to the processing of emotional social stimuli. Socially anxious individuals may additionally avoid maintaining eye contact and may exhibit a generalized vigilance via hyperscanning of their environment. The findings highlight the utility of eye tracking methods for increasing understanding of the gaze-based biases which characterize social anxiety disorder, with promising avenues for future research.
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Affiliation(s)
- Nigel T M Chen
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
- School of Psychology and Speech Pathology, Curtin University, Bentley, Perth, WA, Australia.
| | - Patrick J F Clarke
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
- School of Psychology and Speech Pathology, Curtin University, Bentley, Perth, WA, Australia
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Boll S, Bartholomaeus M, Peter U, Lupke U, Gamer M. Attentional mechanisms of social perception are biased in social phobia. J Anxiety Disord 2016; 40:83-93. [PMID: 27131909 PMCID: PMC4877390 DOI: 10.1016/j.janxdis.2016.04.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 02/11/2016] [Accepted: 04/04/2016] [Indexed: 11/15/2022]
Abstract
Previous studies of social phobia have reported an increased vigilance to social threat cues but also an avoidance of socially relevant stimuli such as eye gaze. The primary aim of this study was to examine attentional mechanisms relevant for perceiving social cues by means of abnormalities in scanning of facial features in patients with social phobia. In two novel experimental paradigms, patients with social phobia and healthy controls matched on age, gender and education were compared regarding their gazing behavior towards facial cues. The first experiment was an emotion classification paradigm which allowed for differentiating reflexive attentional shifts from sustained attention towards diagnostically relevant facial features. In the second experiment, attentional orienting by gaze direction was assessed in a gaze-cueing paradigm in which non-predictive gaze cues shifted attention towards or away from subsequently presented targets. We found that patients as compared to controls reflexively oriented their attention more frequently towards the eyes of emotional faces in the emotion classification paradigm. This initial hypervigilance for the eye region was observed at very early attentional stages when faces were presented for 150ms, and persisted when facial stimuli were shown for 3s. Moreover, a delayed attentional orienting into the direction of eye gaze was observed in individuals with social phobia suggesting a differential time course of eye gaze processing in patients and controls. Our findings suggest that basic mechanisms of early attentional exploration of social cues are biased in social phobia and might contribute to the development and maintenance of the disorder.
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Affiliation(s)
- Sabrina Boll
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany; Department of General Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Germany.
| | - Marie Bartholomaeus
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | | | | | - Matthias Gamer
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany,Department of Psychology, University of Würzburg, Germany
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The German Version of the Gaze Anxiety Rating Scale (GARS): Reliability and Validity. PLoS One 2016; 11:e0150807. [PMID: 26937638 PMCID: PMC4777438 DOI: 10.1371/journal.pone.0150807] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 02/02/2016] [Indexed: 11/25/2022] Open
Abstract
Objective Fear of eye gaze and avoidance of eye contact are core features of social anxiety disorders (SAD). To measure self-reported fear and avoidance of eye gaze, the Gaze Anxiety Rating Scale (GARS) has been developed and validated in recent years in its English version. The main objectives of the present study were to psychometrically evaluate the German translation of the GARS concerning its reliability, factorial structure, and validity. Methods Three samples of participants were enrolled in the study. (1) A non-patient sample (n = 353) completed the GARS and a set of trait questionnaires to assess internal consistency, test-retest reliability, factorial structure, and concurrent and divergent validity. (2) A sample of patients with SAD (n = 33) was compared to a healthy control group (n = 30) regarding their scores on the GARS and the trait measures. Results The German GARS fear and avoidance scales exhibited excellent internal consistency and high stability over 2 and 4 months, as did the original version. The English version’s factorial structure was replicated, yielding two categories of situations: (1) everyday situations and (2) situations involving high evaluative threat. GARS fear and avoidance displayed convergent validity with trait measures of social anxiety and were markedly higher in patients with GSAD than in healthy controls. Fear and avoidance of eye contact in situations involving high levels of evaluative threat related more closely to social anxiety than to gaze anxiety in everyday situations. Conclusions The German version of the GARS has demonstrated reliability and validity similar to the original version, and is thus well suited to capture fear and avoidance of eye contact in different social situations as a valid self-report measure of social anxiety and related disorders in the social domain for use in both clinical practice and research.
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Enter D, Terburg D, Harrewijn A, Spinhoven P, Roelofs K. Single dose testosterone administration alleviates gaze avoidance in women with Social Anxiety Disorder. Psychoneuroendocrinology 2016; 63:26-33. [PMID: 26402923 DOI: 10.1016/j.psyneuen.2015.09.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 08/28/2015] [Accepted: 09/08/2015] [Indexed: 12/18/2022]
Abstract
Gaze avoidance is one of the most characteristic and persistent social features in people with Social Anxiety Disorder (SAD). It signals social submissiveness and hampers adequate social interactions. Patients with SAD typically show reduced testosterone levels, a hormone that facilitates socially dominant gaze behavior. Therefore we tested as a proof of principle whether single dose testosterone administration can reduce gaze avoidance in SAD. In a double-blind, within-subject design, 18 medication-free female participants with SAD and 19 female healthy control participants received a single dose of 0.5mg testosterone and a matched placebo, at two separate days. On each day, their spontaneous gaze behavior was recorded using eye-tracking, while they looked at angry, happy, and neutral facial expressions. Testosterone enhanced the percentage of first fixations to the eye-region in participants with SAD compared to healthy controls. In addition, SAD patients' initial gaze avoidance in the placebo condition was associated with more severe social anxiety symptoms and this relation was no longer present after testosterone administration. These findings indicate that single dose testosterone administration can alleviate gaze avoidance in SAD. They support theories on the dominance enhancing effects of testosterone and extend those by showing that effects are particularly strong in individuals featured by socially submissive behavior. The finding that this core characteristic of SAD can be directly influenced by single dose testosterone administration calls for future inquiry into the clinical utility of testosterone in the treatment of SAD.
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Affiliation(s)
- Dorien Enter
- Radboud University Nijmegen, Behavioural Science Institute (BSI), 6500 HE, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, 6525 EN, Nijmegen, The Netherlands; Leiden University, Institute of Psychology, 2300 RB, Leiden, The Netherlands.
| | - David Terburg
- Utrecht University, Department of Psychology, 3584 CS, Utrecht, The Netherlands; University of Cape Town, Department of Psychiatry & Mental Health, Cape Town 7925, South Africa
| | - Anita Harrewijn
- Leiden University, Institute of Psychology, 2300 RB, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, 2300 RC, Leiden, The Netherlands
| | - Philip Spinhoven
- Leiden University, Institute of Psychology, 2300 RB, Leiden, The Netherlands; Leiden University Medical Center, Department of Psychiatry, 2300 RC, Leiden, The Netherlands
| | - Karin Roelofs
- Radboud University Nijmegen, Behavioural Science Institute (BSI), 6500 HE, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, 6525 EN, Nijmegen, The Netherlands
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Buchanan H, Markson L, Bertrand E, Greaves S, Parmar R, Paterson KB. Effects of social gaze on visual-spatial imagination. Front Psychol 2014; 5:671. [PMID: 25071645 PMCID: PMC4082314 DOI: 10.3389/fpsyg.2014.00671] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 06/10/2014] [Indexed: 11/13/2022] Open
Abstract
Previous research suggests that closing one’s eyes or averting one’s gaze from another person can benefit visual-spatial imagination by interrupting cognitive demands associated with face-to-face interaction (Markson and Paterson, 2009). The present study further investigated this influence of social gaze on adults’ visual-spatial imagination, using the matrix task (Kerr, 1987, 1993). Participants mentally kept track of a pathway through an imaginary 2-dimensional (2D) or 3-dimensional (3D) matrix. Concurrent with this task, participants either kept their eyes closed or maintained eye contact with another person, mutual gaze with a person whose eyes were obscured (by wearing dark glasses), or unreciprocated gaze toward the face of a person whose own gaze was averted or whose face was occluded (by placing a paper bag over her head). Performance on the 2D task was poorest in the eye contact condition, and did not differ between the other gaze conditions, which produced ceiling performance. However, the more difficult 3D task revealed clear effects of social gaze. Performance on the 3D task was poorest for eye contact, better for mutual gaze, and equally better still for the unreciprocated gaze and eye-closure conditions. The findings reveal the especially disruptive influence of eye contact on concurrent visual-spatial imagination and a benefit for cognitively demanding tasks of disengaging eye contact during face-to-face interaction.
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Affiliation(s)
| | - Lucy Markson
- Department of Psychology, University of Cambridge Cambridge, UK ; Institute of Criminology, University of Cambridge Cambridge, UK
| | - Emma Bertrand
- School of Psychology, University of Leicester Leicester, UK
| | - Sian Greaves
- School of Psychology, University of Leicester Leicester, UK
| | - Reena Parmar
- School of Psychology, University of Leicester Leicester, UK
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Muschalla B. Fähigkeitsorientierte Verhaltenstherapie bei psychischen Erkrankungen. VERHALTENSTHERAPIE 2014. [DOI: 10.1159/000358737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Gilboa-Schechtman E, Shachar-Lavie I. More than a face: a unified theoretical perspective on nonverbal social cue processing in social anxiety. Front Hum Neurosci 2013; 7:904. [PMID: 24427129 PMCID: PMC3876460 DOI: 10.3389/fnhum.2013.00904] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 12/10/2013] [Indexed: 01/31/2023] Open
Abstract
Processing of nonverbal social cues (NVSCs) is essential to interpersonal functioning and is particularly relevant to models of social anxiety. This article provides a review of the literature on NVSC processing from the perspective of social rank and affiliation biobehavioral systems (ABSs), based on functional analysis of human sociality. We examine the potential of this framework for integrating cognitive, interpersonal, and evolutionary accounts of social anxiety. We argue that NVSCs are uniquely suited to rapid and effective conveyance of emotional, motivational, and trait information and that various channels are differentially effective in transmitting such information. First, we review studies on perception of NVSCs through face, voice, and body. We begin with studies that utilized information processing or imaging paradigms to assess NVSC perception. This research demonstrated that social anxiety is associated with biased attention to, and interpretation of, emotional facial expressions (EFEs) and emotional prosody. Findings regarding body and posture remain scarce. Next, we review studies on NVSC expression, which pinpointed links between social anxiety and disturbances in eye gaze, facial expressivity, and vocal properties of spontaneous and planned speech. Again, links between social anxiety and posture were understudied. Although cognitive, interpersonal, and evolutionary theories have described different pathways to social anxiety, all three models focus on interrelations among cognition, subjective experience, and social behavior. NVSC processing and production comprise the juncture where these theories intersect. In light of the conceptualizations emerging from the review, we highlight several directions for future research including focus on NVSCs as indexing reactions to changes in belongingness and social rank, the moderating role of gender, and the therapeutic opportunities offered by embodied cognition to treat social anxiety.
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Affiliation(s)
- Eva Gilboa-Schechtman
- Department of Psychology, The Gonda Brain Science Center, Bar-Ilan University Ramat Gan, Israel
| | - Iris Shachar-Lavie
- Department of Psychology, The Gonda Brain Science Center, Bar-Ilan University Ramat Gan, Israel
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Open-label treatment with escitalopram in patients with social anxiety disorder and fear of blushing. J Clin Psychopharmacol 2013; 33:695-8. [PMID: 23948787 DOI: 10.1097/jcp.0b013e31829a878b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Fear of blushing (FB) is a form of social anxiety disorder (SAD) characterized by an intense and obsessive threat of blushing in front of other people. No data are available on the specific efficacy of antidepressants on FB. This open-label pilot study investigated whether the selective serotonin reuptake inhibitor escitalopram specifically improves symptoms of FB in SAD patients. Thirty-nine patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for SAD and presenting a significant FB according to the Salpêtrière Erythrophobia Questionnaire (SEQ) were administered open-label escitalopram (10-30 mg/d) for 12 weeks. A systematic assessment, at baseline and at week 12, included the SEQ, the Liebowitz Social Anxiety Scale, and the Hospital Anxiety and Depression scale. From the 39 patients included, 31 attended the week 4 visit, and 28 the week 12 visit. Significant reductions of FB were observed after 4 weeks of treatment and were more pronounced at the end of the 12-week treatment since patients experienced a 60% decrease in their FB symptoms (P < 0.001). Nineteen subjects (67.8%) reported a 50% decrease or more of their SEQ score, and 14 (50%) met criteria for remission of FB (SEQ score <7). The effect sizes of changes on SEQ, Liebowitz Social Anxiety Scale, and Hospital Anxiety and Depression scale scores were high, with η² ranging between 0.53 and 0.86. Results of this open-label study suggest that escitalopram can be a useful treatment for FB associated with SAD, even if large controlled trials are now needed to further evaluate this result.
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