1
|
Krömer L, Jarczok TA, Althen H, Mühlherr AM, Howland V, Jungmann SM, Freitag CM. Implicit assumptions and interpretation bias in youth with severe, chronic social phobia. Eur Child Adolesc Psychiatry 2023; 32:501-512. [PMID: 34596762 PMCID: PMC10038968 DOI: 10.1007/s00787-021-01879-3] [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: 07/01/2020] [Accepted: 09/16/2021] [Indexed: 11/28/2022]
Abstract
Interpretation bias and dysfunctional social assumptions are proposed to play a pivotal role in the development and maintenance of social phobia (SP), especially in youth. In this study, we aimed to investigate disorder-specific implicit assumptions of rejection and implicit interpretation bias in youth with severe, chronic SP and healthy controls (CG). Twenty-seven youth with SP in inpatient/day-care treatment (M age = 15.6 years, 74% female) and 24 healthy controls (M age = 15.7 years, 54% female) were included. The Implicit Association Test (IAT) and the Affect Misattribution Procedure (AMP) were completed to assess implicit assumptions and interpretation bias related to the processing of social and affective stimuli. No group differences were observed for the IAT controlling for depressive symptoms in the analyses. However, group differences were found regarding interpretation bias (p = .017, η2p = .137). Correlations between implicit scores and explicit questionnaire results were medium to large in the SP group (r =|.28| to |.54|, pall ≤ .05), but lower in the control group (r =|.04| to |.46|, pall ≤ .05). Our results confirm the finding of an interpretation bias in youth SP, especially regarding the implicit processing of faces, whereas implicit dysfunctional social assumptions of being rejected do not seem to be specific for SP. Future research should investigate the causal relationship of assumptions/interpretation bias and SP.
Collapse
Affiliation(s)
- Lisa Krömer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany.
| | - Tomasz A Jarczok
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
| | - Heike Althen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
| | - Andreas M Mühlherr
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
| | - Vanessa Howland
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
- Department of Neonatology and Pediatric Intensive Care, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Stefanie M Jungmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University Mainz, 55122, Mainz, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
| |
Collapse
|
2
|
Loscalzo Y, Giannini M. Studyholism and Study Engagement in Adolescence: The Role of Social Anxiety and Interpretation Bias as Antecedents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095261. [PMID: 35564654 PMCID: PMC9103961 DOI: 10.3390/ijerph19095261] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/15/2022] [Accepted: 04/22/2022] [Indexed: 01/27/2023]
Abstract
Studyholism (or obsession toward study) is a new potential clinical condition that, in contrast with Study Engagement, is associated with negative outcomes. However, previous studies showed that both Studyholism and Study Engagement predict social impairment due to study. Therefore, we analyzed the role of social anxiety and interpretation bias as predictors of Studyholism and Study Engagement in 541 adolescents (Mage = 16.30 ± 1.59; 66% girls). We performed a path analysis model, MANOVAs, and Mann–Whitney tests. Among the main findings, social anxiety is a positive predictor of both Studyholism and Study Engagement. Hence, this provides further support to the conceptualization of Studyholism as an OCD-related disorder (or as an internalizing disorder) and suggests the need of screening socially anxious adolescents for the presence of Studyholism and engaged students for the presence of high social anxiety. Moreover, Studyholism is predicted by a negative interpretation style in non-social situations, while a positive interpretation style predicts Study Engagement in social and non-social situations. Hence, Studyholism and social anxiety are two different diagnoses, even if social anxiety might fuel Studyholism. Moreover, interventions to reduce Studyholism should decrease the tendency to interpret non-social situations negatively or neutrally.
Collapse
|
3
|
Subar AR, Rozenman M. Like parent, like child: Is parent interpretation bias associated with their child's interpretation bias and anxiety? A systematic review and meta-analysis. J Affect Disord 2021; 291:307-314. [PMID: 34077820 DOI: 10.1016/j.jad.2021.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/09/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Anxiety disorders are the most prevalent psychiatric problem across the lifespan, with typical onset during the pediatric period. Prior literature has examined cognitive mechanisms associated with youth anxiety and identified interpretation bias, the threatening appraisal of ambiguity, as a ubiquitous correlate and likely mechanism. A small set of studies have examined interpretation bias and anxiety in parent-child dyads, although results about this potential relationship are conflicted. This systematic review and meta-analysis investigates the association between parent interpretation bias with child interpretation bias and child anxiety. METHODS Eight studies met the rigorous inclusion criteria, which required direct assessment of interpretation bias in both youth and parent. RESULTS Meta-analysis with a random effects model indicated a small and significant correlation between parent and child interpretation biases (r = 0.14, p < .01), as well as a small and significant correlation between parent interpretation bias and child anxiety (r = = 0.20, p = .01). LIMITATIONS As only eight studies were included in this meta-analysis, reflecting the state of the extant literature, it is possible that, as data accumulate and this work continues in the future, results may or may not be replicated. CONCLUSIONS Despite variability in findings across the included empirical studies, the current meta-analysis suggests that a correlational relationship between parent interpretation bias and child bias/anxiety exists. This work has implications for conceptualizing parent interpretation bias as a possible explanatory mechanism underlying youth interpretation bias and anxiety.
Collapse
Affiliation(s)
- Anni R Subar
- University of Denver, Department of Psychology, United States.
| | | |
Collapse
|
4
|
Zhang F, Zhang X, Mao X, Chen A, Yin Q, Deng G. Interpretation bias of high trait anxiety Chinese military servicemen in ambiguous military scenarios. Medicine (Baltimore) 2020; 99:e18746. [PMID: 32011456 PMCID: PMC7220039 DOI: 10.1097/md.0000000000018746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Converging evidence reveals the negative interpretation bias in anxiety. Given that anxiety is a severe psychological problem among Chinese military personnel, the present study examined whether high trait anxiety military personnel showed negative interpretation bias in real-world situations and whether their interpretations were influenced by self-relevance.The sample included 24 high trait anxiety (H-TA) and 22 low trait anxiety (L-TA) Chinese military servicemen. Participants completed 20 open-ended ambiguous scenarios by deciding how much they believed in the positive and negative ending of each sentence. The 20 scenarios were designed according to real life in military and half of them were self-relevant and the others were non-self-relevant.A 2(group) ×2(self-relevance) ANOVA of positive and negative endings revealed that compared to L-TA, H-TA believed more in negative continuations and less in positive continuations. Moderate correlations were found between samples' believes in positive and negative endings and their trait anxiety scores. Military personnel showed more positive interpretation biases in non-self-relevant scenarios than in self-relevant scenarios.These findings are the first to show interpretation bias in military situations, and interventional strategies to modify servicemen's interpretation bias could be designed according to military situations.
Collapse
|
5
|
Stuijfzand S, Creswell C, Field AP, Pearcey S, Dodd H. Research Review: Is anxiety associated with negative interpretations of ambiguity in children and adolescents? A systematic review and meta-analysis. J Child Psychol Psychiatry 2018; 59:1127-1142. [PMID: 29052865 PMCID: PMC6849625 DOI: 10.1111/jcpp.12822] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The tendency to interpret ambiguity as threat (negative interpretation) has been implicated in cognitive models of anxiety. A significant body of research has examined the association between anxiety and negative interpretation, and reviews suggest there is a robust positive association in adults. However, evidence with children and adolescents has been inconsistent. This study aimed to provide a systematic quantitative assessment of the association between anxiety and negative interpretation in children and adolescents. METHOD Following systematic searches and screening for eligibility, 345 effects sizes from 77 studies were meta-analysed. RESULTS Overall a medium positive association was found between anxiety and negative interpretation in children and adolescents ( d ^ = .62). Two variables significantly moderated this effect. Specifically, the association increased in strength with increasing age and when the content of ambiguous scenarios matched the anxiety subtype under investigation. CONCLUSIONS Results extend findings from adult literature by demonstrating an association in children and adolescents with evidence for content specificity in the association. Age effects imply a role for development. Results raise considerations for when and for whom clinical treatments for anxiety focusing on interpretation bias are appropriate. The vast majority of studies included in the review have used correlational designs and there are a limited number of studies with young children. The results should be considered with these limitations in mind.
Collapse
Affiliation(s)
- Suzannah Stuijfzand
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Cathy Creswell
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | | | - Samantha Pearcey
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Helen Dodd
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| |
Collapse
|
6
|
Loscalzo Y, Giannini M, Miers AC. Social anxiety and interpretation bias: examining clinical and subclinical components in adolescents. Child Adolesc Ment Health 2018; 23:169-176. [PMID: 32677297 DOI: 10.1111/camh.12221] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to examine whether different components of interpretation bias are clinical or dimensional features of adolescent social anxiety. The study analyzed the components of this bias at a subclinical level of Social Anxiety Disorder (SAD) and compared these with a clinical sample of adolescents with SAD. METHOD Adolescents in the age range 13-17 years participated. A group with SAD (n = 30) was compared with a group with subclinical SAD (n = 60), and a non-socially anxious group (n = 95). RESULTS Negative interpretation bias for social situations was found to be a dimensional aspect of social anxiety. In contrast, belief in negative interpretations of social situations appears to be a clinical feature. Contrary to expectations, endorsement of positive interpretations did not differ between the three groups. CONCLUSIONS The results suggest that a screening instrument based on negative interpretations of social situations could be useful to detect adolescents at-risk of developing SAD. In a clinical setting, the belief in negative interpretations and the presence of the bias in nonsocial situations should also be considered.
Collapse
Affiliation(s)
- Yura Loscalzo
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Marco Giannini
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Anne C Miers
- Leiden University, Faculty of Social and Behavioral Sciences, Institute of Psychology, Unit Developmental and Educational Psychology, The Netherlands
| |
Collapse
|
7
|
Ainsworth B, Bolderston H, Garner M. Testing the differential effects of acceptance and attention-based psychological interventions on intrusive thoughts and worry. Behav Res Ther 2017; 91:72-77. [PMID: 28160721 PMCID: PMC5338649 DOI: 10.1016/j.brat.2017.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/19/2017] [Accepted: 01/23/2017] [Indexed: 12/13/2022]
Abstract
Background Worry is a key component of anxiety and may be an effective target for therapeutic intervention. We compared two psychological processes (attention and acceptance) on the frequency of intrusive worrying thoughts in an experimental worry task. Method 77 participants were randomised across three groups and completed either a 10 min attention or acceptance-based psychological exercise, or progressive muscle relaxation control. We subsequently measured anxiety, and the content and frequency of intrusive thoughts before and after a ‘worry induction task’. Results Groups did not differ in baseline worry, anxiety or thought intrusions. Both attention and acceptance-based groups experienced fewer negative thought intrusions (post-worry) compared to the relaxation control group. The acceptance exercise had the largest effect, preventing ‘worry induction’. Increases in negative intrusive thoughts predicted subjective anxiety. Discussion We provide evidence that acceptance and attention psychological exercises may reduce anxiety by reducing the negative thought intrusions that characterise worry. We used an experimental worry task to see how psychological interventions can target worry. We compared 10-min attention and acceptance-based exercises to progressive muscle relaxation. Both acceptance and attention were better than relaxation, and acceptance had the largest effect. Increases in negative intrusive thoughts predicted subjective anxiety across all groups. Acceptance and attention psychological exercises may help anxiety by reducing worry.
Collapse
Affiliation(s)
- B Ainsworth
- Psychology. Faculty of Social, Human & Mathematical Sciences, University of Southampton, UK; Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, UK.
| | - H Bolderston
- Research Centre for Behaviour Change, Department of Psychology, Bournemouth University, UK
| | - M Garner
- Psychology. Faculty of Social, Human & Mathematical Sciences, University of Southampton, UK; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK
| |
Collapse
|
8
|
Biased interpretations of ambiguous bodily threat information in adolescents with chronic pain. Pain 2017; 158:471-478. [DOI: 10.1097/j.pain.0000000000000781] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Giannini M, Loscalzo Y. Social anxiety and adolescence: Interpretation bias in an Italian Sample. Scand J Psychol 2016. [DOI: 10.1111/sjop.12263] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marco Giannini
- University of Florence; School of Psychology, Department of Health Sciences; Florence Italy
| | - Yura Loscalzo
- University of Florence; School of Psychology, Department of Health Sciences; Florence Italy
| |
Collapse
|
10
|
Valadão Dias F, Oliveira RV, Leal I, Maroco J. Positive and Negative Thoughts in Ambiguous Anxiety-Related Stories: The Child’s Perspective. PSYCHOLOGY, COMMUNITY & HEALTH 2015. [DOI: 10.5964/pch.v4i1.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim To evaluate the presence/absence, frequency of cognitive products (positive, negative and neutral thoughts) in a Portuguese community sample of children aged 10 and 11 years. Method A total of 274 children participated in this study, 151 girls and 123 boys, from the 5th and 6th grades, aged 10 and 11 years. Cognitive products were accessed through children’s cognitive responses to the Nine Ambiguous Stories. Results The answers to the nine stories produced 6,633 thoughts (positive - 2,570, negative - 4,063, neutral - 32). The number of positive and negative thoughts varied according to the stories. The absence of either positive or negative thoughts was observed in a very small number of children. The simultaneous presence of positive and negative thoughts per child occurred in all stories. More than half of the children showed more negative thoughts in all stories except for stories 2 and 6. Conclusion The results of this study contribute to the understanding of cognitive development of children, based on what is known and observed in the child and calls attention to the importance of the research of positive and negative content of thoughts shown by children and their impact on childhood anxiety.
Collapse
|