Social anxiety is characterized by biased learning about performance and the self

How the discrepancy between expectation and outcome influences expectation change in relation to depressive symptoms - Results from four experimental studies

BACKGROUND

Traditional associative learning models and their clinical applications suggest that the greater the discrepancy between expectations and outcome, the greater the adjustment of expectations. Other frameworks, however, propose a "tipping point", above which the discrepancy is so large that the source of information is considered unreliable, resulting in reduced expectation change.

METHODS

To test these competing predictions, we performed four experiments in which participants were provided with five levels of positivity/negativity in two different contexts: social interactions and performance feedback. We also examined how depressive symptoms were related to changes in expectations in response to different levels of positive/negative information.

RESULTS

The results regarding the processing of unexpectedly positive information (Study 1, N = 212; Study 2, N = 158) did not allow unanimous conclusions, but were more consistent with the tipping point hypothesis, as there was strong expectation change when information was moderately positive and a decline in expectation change when information was even more positive. For negative information (Study 3, N = 252; Study 4, N = 286), the results were more consistent with the linearity hypothesis, indicating that the more negative the information, the greater the change in expectations. Depressive symptoms interacted with the level of positive information in affecting expectation change: Depressive symptoms were associated with lower expectation change in response to mildly positive information, but not in response to highly positive information, particularly in Study 2.

CONCLUSIONS

The results suggest that the relationship between the magnitude of an expectation violation and expectation change may depend on the valence of the expectation violation.

It's the content of the feedback that matters, not the person giving it: An experimental study on change of negative performance expectations

Previous research on biased expectation change has mainly focused on the mechanisms underlying the deficient processing of novel positive information at the individual level. Yet, it is less clear whether also characteristics of the person who provides new learning experiences influence the modification of negative expectations. To approach this question, we tested whether the perceived warmth and competence of a person who provides positive performance feedback influences the extent to which performance expectations change. Participants from a non-clinical sample (N = 146) were randomly assigned to one of three experimental conditions which manipulated the experimenter's interpersonal behaviour in terms of warmth and competence: augmented, limited, control group (minimal physical contact). All participants received the same positive feedback for their performance in an emotion recognition test. Warmth and competence were successfully manipulated, with large effects, but this did not lead to differences in expectation change. Instead, positive post-feedback expectations were associated with low cognitive immunisation and high perceived cognitive value of the feedback across groups. The findings suggest that changing negative performance expectations through positive feedback is possible and mainly depends on the perception of the content of the feedback, while characteristics of the feedback-providing person are less relevant.

Biased information-seeking and information-integration in social anxiety

Social anxiety is associated with an intense fear of social evaluation and rejection, often leading to avoidance behaviors and distress. In this review, we summarize the current understanding of how various cognitive biases may lead to the development and maintenance of social anxiety. While early models of social anxiety have focused on negative biases in perception, attention, memory and emotion regulation, more recent literature has started to characterize biases in information-seeking and information-integration, especially in the context of self-referential information and social feedback. We also highlight directions for future work, including characterizing how different biases in social anxiety relate to each other, and how they may help dissociate social anxiety symptoms from co-occurring conditions such as generalized anxiety and depression.

How positive and negative feedback following real interactions changes subsequent sender ratings

Social evaluative feedback informs us about how others perceive us, constantly updates our expectations of what to receive, and simultaneously changes our view of the sender. However, little is known about the neuronal and behavioral responses when receiving incongruent positive or negative social evaluative feedback. This study (N = 40) investigated how receiving feedback from peers after a real-life interaction modulates behavioral responses and Event-Related Potentials (ERPs). Specifically, ERP modulations by feedback being incongruent with the self-view and incongruent with the feedback expectation were examined along the whole processing stream. Feedback was manipulated such that one peer provided overly positive feedback and the other overly negative feedback, with random computer feedback as a control condition. Behaviorally, participants updated their feedback expectations according to the feedback received from the 'negative' and 'positive' peers and rapidly changed ratings of the sender towards their positive or negative behavior. Concerning ERPs, separate effects of feedback incongruence based on the feedback expectation or self-view were found during the mid-latency processing stages. Subsequently, both types of incongruence increased late ERP amplitudes, which were also increased when participants substantially changed the ratings of the peer senders. This is the first study that combined neuronal and behavioral measures of evaluative feedback processing, emphasizing that incongruent feedback elicits mid-latency modulations and subsequent updating processes associated with increased late amplitudes. In addition, we find rapid behavioral changes in the ratings for the senders based on their feedback behavior.

Computational modeling of social evaluative decision-making elucidates individual differences in adolescent anxiety

Adolescents experience significant developmental changes during a time of heightened sensitivity to social cues, particularly rejection by peers, which can be especially overwhelming for those with elevated levels of social anxiety. Social evaluative decision-making tasks have been useful in uncovering the neural correlates of information processing biases; however, linking youths' task-based performance to individual differences in psychopathology (e.g., anxiety symptoms) has proven more elusive. Here, we address this weakness with drift diffusion modeling to decompose youths' performance on the social judgment paradigm (SJP) to determine if this approach is useful in discovering individual differences in anxiety symptoms, as well as puberty, age, and sex. A sample of 103 adolescents (55 males, Mage = 14.49, SD = 1.69) completed the SJP and self-report measures of anxiety, as well as self- and parent-reported measures of puberty. The decision threshold parameter, reflecting the amount of evidence needed to make a social evaluative decision, predicted youth self-reported anxiety, above and beyond typical metrics of SJP performance. Our results highlight the potential advantage of parsing task performance according to the underlying cognitive processes. Future research would likely benefit from applying computational modeling approaches to social judgment tasks when attempting to uncover performance-based individual differences in psychopathology.

Negative Affect Following Dating Application Use is Predicted by Social Anxiety Symptoms and Match Rate

Social rejection is a common and unavoidable experience for users of dating apps. Research suggests that socially anxious individuals may be particularly likely to use dating apps to establish intimate relationships, given their preference for online (vs. face-to-face) communication. However, social anxiety (SA) symptoms are associated with heightened negative affect and decreased prosocial behavior following social rejection, suggesting that exposure to dating app rejection has deleterious consequences in this population. This study examined whether SA symptoms and social rejection (vs. acceptance) feedback interact to predict participants' negative and positive affect and social engagement with dating app matches. Participants (N = 128) evaluated for SA symptoms were randomly assigned to receive high or low match rate feedback on a simulated dating application task. SA symptoms were negatively associated with positive affect following high match rate feedback and positively associated with negative affect following low match rate feedback. SA symptoms were negatively associated with self-reported likelihood of contact initiation with matches. Results suggest that high socially anxious individuals are more susceptible to negative repercussions of social rejection on dating applications.

Adapting to uncertainty: The role of anxiety and fear of negative evaluation in learning in social and non-social contexts

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.

Lack of optimistic bias during social evaluation learning reflects reduced positive self-beliefs in depression and social anxiety, but via distinct mechanisms

Processing social feedback optimistically may maintain positive self-beliefs and stable social relationships. Conversely, a lack of this optimistic bias in depression and social anxiety may perpetuate negative self-beliefs and maintain symptoms. Research investigating this mechanism is scarce, however, and the mechanisms by which depressed and socially anxious individuals respond to social evaluation may also differ. Using a range of computational approaches in two large datasets (mega-analysis of previous studies, n = 450; pre-registered replication study, n = 807), we investigated how depression (PHQ-9) and social anxiety (BFNE) symptoms related to social evaluation learning in a computerized task. Optimistic bias (better learning of positive relative to negative evaluations) was found to be negatively associated with depression and social anxiety. Structural equation models suggested this reflected a heightened sensitivity to negative social feedback in social anxiety, whereas in depression it co-existed with a blunted response to positive social feedback. Computational belief-based learning models further suggested that reduced optimism was driven by less positive trait-like self-beliefs in both depression and social anxiety, with some evidence for a general blunting in belief updating in depression. Recognizing such transdiagnostic similarities and differences in social evaluation learning across disorders may inform approaches to personalizing treatment.

Hooking the Self Onto the Past: How Positive Autobiographical Memory Retrieval Benefits People With Social Anxiety

Do people with social anxiety (SA) benefit from positive memory retrieval that heightens self-relevant meaning? In this preregistered study, an analog sample of 255 participants with self-reported clinically significant symptoms of SA were randomly assigned to retrieve and process a positive social-autobiographical memory by focusing on either its self-relevant meaning (deep processing) or its perceptual features (superficial processing). Participants were then socially excluded and instructed to reimagine their positive memory. Analyses revealed that participants assigned to the deep processing condition experienced significantly greater improvements than participants in the superficial processing condition in positive affect, social safeness, and positive beliefs about others during initial memory retrieval and in negative and positive beliefs about the self following memory reactivation during recovery from exclusion. These novel findings highlight the potential utility of memory-based interventions for SA that work by "hooking" self-meaning onto recollections of positive interpersonal experiences that elicit feelings of social acceptance.

Prevalence of social anxiety disorder and its associated factors among foreign-born undergraduate students in Türkiye: A cross-sectional study

Social anxiety disorder (SAD) is prevalent among university students, yet data on its severity among foreign-born international undergraduate students in Türkiye remains limited. This study aims to determine the prevalence of SAD and its associated factors within this population. A cross-sectional study was conducted using a Google Form survey distributed across various universities from September 17, 2023, to February 1, 2024. The survey comprised two sections: sociodemographic information and 17 items of the Social Phobia Inventory (SPIN), which measures the frequency and intensity of social anxiety symptoms. Data analysis included descriptive statistics and inferential analysis, multiple regression, and binomial logistic regression. Out of 506 participants, 455 were included in the study. Results revealed that 39.1% exhibited no or very mild symptoms of SAD, while 23.7% experienced mild symptoms, 21.3% faced moderate symptoms, and 11.6% and 4.2% presented with severe to very severe symptoms, respectively. Factors such as gender (p < 0.0001), previous academic failures (p = 0.013), family history of mental health issues (p = 0.009), exercise frequency (p < 0.0001), and perceptions of relationships with classmates (p < 0.0001) were significantly associated with SAD. Females showed a higher probability of SAD compared to males (OR = 1.976). Individuals engaging in over 90 minutes of exercise per week were less likely to have SAD (OR = 0.383), and occasional smokers had a lower risk of SAD compared to non-smokers (OR = 0.422). Our study uncovered a notably elevated prevalence of Social Anxiety Disorder (SAD) among foreign-born undergraduate students in Türkiye. Factors such as being female, having a family history of mental illnesses, studying in a stressful environment, experiencing academic failure, and engaging in less frequent exercise were associated with noticeable symptoms of SAD. These findings emphasize the urgent need for heightened efforts in recognizing and addressing SAD within this population.

A Bayesian model of the jumping-to-conclusions bias and its relationship to psychopathology

The mechanisms by which delusion and anxiety affect the tendency to make hasty decisions (Jumping-to-Conclusions bias) remain unclear. This paper proposes a Bayesian computational model that explores the assignment of evidence weights as a potential explanation of the Jumping-to-Conclusions bias using the Beads Task. We also investigate the Beads Task as a repeated measure by varying the key aspects of the paradigm. The Bayesian model estimations from two online studies showed that higher delusional ideation promoted reduced belief updating but the impact of general and social anxiety on evidence weighting was inconsistent. The altered evidence weighting as a result of a psychopathological trait appeared insufficient in contributing to the Jumping-to-Conclusions bias. Variations in Beads Task aspects significantly affected subjective certainty at the point of decisions but not the number of draws to decisions. Repetitions of the Beads Task are feasible if one assesses the Jumping-to-Conclusions bias using number of draws to decisions.

Exploring Asymmetries in Self-Concept Change After Discrepant Feedback

Receiving self-relevant feedback that is discrepant from one's self-concept can lead to self-concept change. However, it is currently unclear whether positive or negative feedback has a larger effect on self-concept change. Across four studies (total N = 1,438), we demonstrate that intentions for self-concept change (Study 1) as well as actual self-concept change (Studies 2, 3, and 4) are larger (a) for larger discrepancies between self-concept and feedback and (b) for negative compared to positive discrepancies. Exploring these effects further in Study 4, we find no evidence that the opportunity for improvement influences whether self-concept change is positively or negatively biased. In sum, the present research provides consistent evidence for a negativity bias in self-concept change, investigates a theoretical explanation, and discusses alternative explanatory approaches.

Negative mood and optimism bias: An experimental investigation of sadness and belief updating

BACKGROUND AND OBJECTIVES

Understanding how individuals integrate new information to form beliefs under changing emotional conditions is crucial to describing decision-making processes. Previous research suggests that although most people demonstrate bias toward optimistic appraisals of new information when updating beliefs, individuals with dysphoric psychiatric conditions (e.g., major depression) do not demonstrate this same bias. Despite these findings, limited research has investigated the relationship between affective states and belief updating processes.

METHODS

We induced neutral and sad moods in participants and had them complete a belief-updating paradigm by estimating the likelihood of negative future events happening to them, viewing the actual likelihood, and then re-estimating their perceived likelihood.

RESULTS

We observed that individuals updated their beliefs more after receiving desirable information relative to undesirable information under neutral conditions. Further, we found that individuals did not demonstrate unrealistic optimism under negative affective conditions.

LIMITATIONS

This study incorporated a population of university students under laboratory conditions and would benefit from replication and extension in clinical populations and naturalistic settings.

CONCLUSIONS

These findings suggest that momentary fluctuations in mood affect how individuals integrate information to form beliefs.

Although I know it: Social anxiety is associated with a deficit in positive updating even when the cost of avoidance is Obvious

Social anxiety (SA) is associated with difficulties in positively updating negative social information when new information and feedback about chosen options (actual decisions) are received. However, it is unclear whether this difficulty persists when hidden information regarding unchosen options is explicitly presented. The aim of the current study was to address this gap. Participants (Mturk; n = 191) completed a two-phases novel task. In the task, participants chose to approach or avoid people, represented by images of faces. During the initial (learning) phase, participants learned, in a probabilistic context, which people are associated with negative outcomes and should be avoided, and which are associated with positive outcomes and should be approached. During the subsequent updating phase, people previously associated with negative outcomes became associated with positive outcomes and vice versa. Importantly, participants received feedback not only on their approach (actual) decisions, but also on their avoidance (counter-factual) decisions (e.g., approaching this person would have been beneficial). The results revealed that even when the consequences of avoidance were explicitly presented, SA was associated with difficulty in positive updating of social information. The findings support the view that biased updating of social information is a change-resistant mechanism that may underlie the maintenance of SA.

Neurocognitive Model of Schema-Congruent and -Incongruent Learning in Clinical Disorders: Application to Social Anxiety and Beyond

Negative schemas lie at the core of many common and debilitating mental disorders. Thus, intervention scientists and clinicians have long recognized the importance of designing effective interventions that target schema change. Here, we suggest that the optimal development and administration of such interventions can benefit from a framework outlining how schema change occurs in the brain. Guided by basic neuroscientific findings, we provide a memory-based neurocognitive framework for conceptualizing how schemas emerge and change over time and how they can be modified during psychological treatment of clinical disorders. We highlight the critical roles of the hippocampus, ventromedial prefrontal cortex, amygdala, and posterior neocortex in directing schema-congruent and -incongruent learning (SCIL) in the interactive neural network that comprises the autobiographical memory system. We then use this framework, which we call the SCIL model, to derive new insights about the optimal design features of clinical interventions that aim to strengthen or weaken schema-based knowledge through the core processes of episodic mental simulation and prediction error. Finally, we examine clinical applications of the SCIL model to schema-change interventions in psychotherapy and provide cognitive-behavior therapy for social anxiety disorder as an illustrative example.

Brain mediators of biased social learning of self-perception in social anxiety disorder

Social anxiety disorder (SAD) is characterized by an excessive fear of social evaluation and a persistently negative view of the self. Here we test the hypothesis that negative biases in brain responses and in social learning of self-related information contribute to the negative self-image and low self-esteem characteristic of SAD. Adult participants diagnosed with social anxiety (N = 21) and matched controls (N = 23) rated their performance and received social feedback following a stressful public speaking task. We investigated how positive versus negative social feedback altered self-evaluation and state self-esteem and used functional Magnetic Resonance Imaging (fMRI) to characterize brain responses to positive versus negative feedback. Compared to controls, participants with SAD updated their self-evaluation and state self-esteem significantly more based on negative compared to positive social feedback. Responses in the frontoparietal network correlated with and mirrored these behavioral effects, with greater responses to positive than negative feedback in non-anxious controls but not in participants with SAD. Responses to social feedback in the anterior insula and other areas mediated the effects of negative versus positive feedback on changes in self-evaluation. In non-anxious participants, frontoparietal brain areas may contribute to a positive social learning bias. In SAD, frontoparietal areas are less recruited overall and less attuned to positive feedback, possibly reflecting differences in attention allocation and cognitive regulation. More negatively biased brain responses and social learning could contribute to maintaining a negative self-image in SAD and other internalizing disorders, thereby offering important new targets for interventions.

Changes in Learning From Social Feedback After Web-Based Interpretation Bias Modification: Secondary Analysis of a Digital Mental Health Intervention Among Individuals With High Social Anxiety Symptoms

BACKGROUND

Biases in social reinforcement learning, or the process of learning to predict and optimize behavior based on rewards and punishments in the social environment, may underlie and maintain some negative cognitive biases that are characteristic of social anxiety. However, little is known about how cognitive and behavioral interventions may change social reinforcement learning in individuals who are anxious.

OBJECTIVE

This study assessed whether a scalable, web-based cognitive bias modification for interpretations (CBM-I) intervention changed social reinforcement learning biases in participants with high social anxiety symptoms. This study focused on 2 types of social reinforcement learning relevant to social anxiety: learning about other people and learning about one's own social performance.

METHODS

Participants (N=106) completed 2 laboratory sessions, separated by 5 weeks of ecological momentary assessment tracking emotion regulation strategy use and affect. Approximately half (n=51, 48.1%) of the participants completed up to 6 brief daily sessions of CBM-I in week 3. Participants completed a task that assessed social reinforcement learning about other people in both laboratory sessions and a task that assessed social reinforcement learning about one's own social performance in the second session. Behavioral data from these tasks were computationally modeled using Q-learning and analyzed using mixed effects models.

RESULTS

After the CBM-I intervention, participants updated their beliefs about others more slowly (P=.04; Cohen d=-0.29) but used what they learned to make more accurate decisions (P=.005; Cohen d=0.20), choosing rewarding faces more frequently. These effects were not observed among participants who did not complete the CBM-I intervention. Participants who completed the CBM-I intervention also showed less-biased updating about their social performance than participants who did not complete the CBM-I intervention, learning similarly from positive and negative feedback and from feedback on items related to poor versus good social performance. Regardless of the intervention condition, participants at session 2 versus session 1 updated their expectancies about others more from rewarding (P=.003; Cohen d=0.43) and less from punishing outcomes (P=.001; Cohen d=-0.47), and they became more accurate at learning to avoid punishing faces (P=.001; Cohen d=0.20).

CONCLUSIONS

Taken together, our results provide initial evidence that there may be some beneficial effects of both the CBM-I intervention and self-tracking of emotion regulation on social reinforcement learning in individuals who are socially anxious, although replication will be important.

Invasive Computational Psychiatry

Computational psychiatry, a relatively new yet prolific field that aims to understand psychiatric disorders with formal theories about the brain, has seen tremendous growth in the past decade. Despite initial excitement, actual progress made by computational psychiatry seems stagnant. Meanwhile, understanding of the human brain has benefited tremendously from recent progress in intracranial neuroscience. Specifically, invasive techniques such as stereotactic electroencephalography, electrocorticography, and deep brain stimulation have provided a unique opportunity to precisely measure and causally modulate neurophysiological activity in the living human brain. In this review, we summarize progress and drawbacks in both computational psychiatry and invasive electrophysiology and propose that their combination presents a highly promising new direction-invasive computational psychiatry. The value of this approach is at least twofold. First, it advances our mechanistic understanding of the neural computations of mental states by providing a spatiotemporally precise depiction of neural activity that is traditionally unattainable using noninvasive techniques with human subjects. Second, it offers a direct and immediate way to modulate brain states through stimulation of algorithmically defined neural regions and circuits (i.e., algorithmic targeting), thus providing both causal and therapeutic insights. We then present depression as a use case where the combination of computational and invasive approaches has already shown initial success. We conclude by outlining future directions as a road map for this exciting new field as well as presenting cautions about issues such as ethical concerns and generalizability of findings.

Social memory characteristics of non-clinical college students with social anxiety

According to the cognitive theory of social anxiety, the cognitive schema of people with social anxiety makes them easily attracted by threatening information and memory processing. Two experiments explored the social memory characteristics of college students with social anxiety. In Experiment 1, the study investigated the social memory bias of college students with social anxiety. In Experiment 2, cue word technology was used to investigate the social autobiographical memory amount and generalization degree of college students with social anxiety using cue words. The results showed that: (1) Compared with low social anxiety college students, college students with high social anxiety had a memory bias for negative social information, but did not have a negative memory bias for irrelevant social information; (2) Compared with low social anxiety college students, college students with high social anxiety had more negative social autobiographical memory; (3) Compared with low social anxiety college students, college students with high social anxiety have a higher degree of social autobiographical memory generalization. This study revealed that college students with high social anxiety had a negative memory bias toward social information, the amount of negative social autobiographical memory was larger and the degree of social autobiographical memory generalization was higher, providing new perspectives for future interventions in this population.

Computational Modeling of Self-Referential Processing Reveals Domain General Associations with Adolescent Anxiety Symptoms

What an adolescent thinks about themselves, commonly termed self-referential processing, has significant implications for youth long-term psychological well-being. Self-referential processing plays an important role in anticipatory and reactive processing in social contexts and contributes to symptoms of social anxiety. Previous work examining self-referential processing largely focuses on child and adolescent depression, relying on endorsement and reaction time for positive and negative self-describing adjectives in a self-referential encoding task (SRET). Here, we employ computational methods to interrogate the latent processes underlying choice reaction times to evaluate the fit of several drift-diffusion models of youth SRET performance. A sample of 106 adolescent, aged 12-17 (53% male; M_age = 14.49, SD = 1.70) completed the SRET and self-report measures of anxiety and depression. Our results support the utility of modeling the SRET, where the rate of evidence accumulation (i.e., drift rate) during negative self-referential processing was related to social anxiety above-and-beyond mean task performance. Our regression analyses indicated that youth efficiency in processing of self-referential views was domain general to anxiety, highlighting the importance of assessing both social and physiological anxiety symptoms when predicting SRET performance. The computational modeling results revealed that self-referential views are not uniquely related to depression-related constructs but also facets of anxiety.

Social anxiety inhibits needs repair following exclusion in both relational and non-relational reward contexts: The mediating role of positive affect

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.

Therapeutic touch and therapeutic alliance in pediatric care and neonatology: An active inference framework

Therapeutic affective touch has been recognized as essential for survival, nurturing supportive interpersonal interactions, accelerating recovery-including reducing hospitalisations, and promoting overall health and building robust therapeutic alliances. Through the lens of active inference, we present an integrative model, combining therapeutic touch and communication, to achieve biobehavioural synchrony. This model speaks to how the brain develops a generative model required for recovery, developing successful therapeutic alliances, and regulating allostasis within paediatric manual therapy. We apply active inference to explain the neurophysiological and behavioural mechanisms that underwrite the development and maintenance of synchronous relationships through touch. This paper foregrounds the crucial role of therapeutic touch in developing a solid therapeutic alliance, the clinical effectiveness of paediatric care, and triadic synchrony between health care practitioner, caregiver, and infant in a variety of clinical situations. We start by providing a brief overview of the significance and clinical role of touch in the development of social interactions in infants; facilitating a positive therapeutic alliance and restoring homeostasis through touch to allow a more efficient process of allostatic regulation. Moreover, we explain the role of CT tactile afferents in achieving positive clinical outcomes and updating prior beliefs. We then discuss how touch is implemented in treatment sessions to promote cooperative interactions in the clinic and facilitate theory of mind. This underwrites biobehavioural synchrony, epistemic trust, empathy, and the resolution of uncertainty. The ensuing framework is underpinned by a critical application of the active inference framework to the fields of pediatrics and neonatology.

Affective and cognitive impact of social overinclusion: a meta-analytic review of cyberball studies

Belongingness is a central biopsychosocial system. Challenges to belongingness (i.e. exclusion/ostracism) engender robust negative effects on affect and cognitions. Whether overinclusion - getting more than one's fair share of social attention - favourably impacts affect and cognitions remains an open question. This pre-registered meta-analysis includes twenty-two studies (N = 2757) examining overinclusion in the context of the Cyberball task. We found that the estimated overall effect size of overinclusion on positive affect was small but robust, and the effect on fundamental needs cognitions (belongingness, self-esteem, meaningful existence and control) was moderate in size and positive in direction. Notably, the effect sizes of overinclusion were smaller than the corresponding effects of exclusion. Finally, the effects of overinclusion on positive affect were greater for high, as compared to low, socially anxious individuals. Exploring the sequelae of the full range of inclusion experiences - from exclusion to overinclusion - may enrich our understanding of the functioning of the belongingness system as well as its interaction with another central biosocial system - the social status system.

Individual differences in naturalistic learning link negative emotionality to the development of anxiety

Organisms learn from prediction errors (PEs) to predict the future. Laboratory studies using small financial outcomes find that humans use PEs to update expectations and link individual differences in PE-based learning to internalizing disorders. Because of the low-stakes outcomes in most tasks, it is unclear whether PE learning emerges in naturalistic, high-stakes contexts and whether individual differences in PE learning predict psychopathology risk. Using experience sampling to assess 625 college students' expected exam grades, we found evidence of PE-based learning and a general tendency to discount negative PEs, an "optimism bias." However, individuals with elevated negative emotionality, a personality trait linked to the development of anxiety disorders, displayed a global pessimism and learning differences that impeded accurate expectations and predicted future anxiety symptoms. A sensitivity to PEs combined with an aversion to negative PEs may result in a pessimistic and inaccurate model of the world, leading to anxiety.

The (un)learning of social functions and its significance for mental health

Social interactions are dynamic, context-dependent, and reciprocal events that influence prospective strategies and require constant practice and adaptation. This complexity of social interactions creates several research challenges. We propose a new framework encouraging future research to investigate not only individual differences in capacities relevant for social functioning and their underlying mechanisms, but also the flexibility to adapt or update one's social abilities. We suggest three key capacities relevant for social functioning: (1) social perception, (2) sharing emotions or empathizing, and (3) mentalizing. We elaborate on how adaptations in these capacities may be investigated on behavioral and neural levels. Research on these flexible adaptations of one's social behavior is needed to specify how humans actually "learn to be social". Learning to adapt implies plasticity of the relevant brain networks involved in the underlying social processes, indicating that social abilities are malleable for different contexts. To quantify such measures, researchers need to find ways to investigate learning through dynamic changes in adaptable social paradigms and examine several factors influencing social functioning within the three aformentioned social key capacities. This framework furthers insight concerning individual differences, provides a holistic approach to social functioning, and may improve interventions for ameliorating social abilities in patients.

Neurocomputational mechanisms of affected beliefs

The feedback people receive on their behavior shapes the process of belief formation and self-efficacy in mastering a particular task. However, the neural and computational mechanisms of how the subjective value of self-efficacy beliefs, and the corresponding affect, influence the learning process remain unclear. We investigated these mechanisms during self-efficacy belief formation using fMRI, pupillometry, and computational modeling, and by analyzing individual differences in affective experience. Biases in the formation of self-efficacy beliefs were associated with affect, pupil dilation, and neural activity within the anterior insula, amygdala, ventral tegmental area/ substantia nigra, and mPFC. Specifically, neural and pupil responses mapped the valence of the prediction errors in correspondence with individuals’ experienced affective states and learning biases during self-efficacy belief formation. Together with the functional connectivity dynamics of the anterior insula within this network, our results provide evidence for neural and computational mechanisms of how we arrive at affected beliefs.

Adaptive behavior and psychiatric symptoms in university students with ASD: One-year longitudinal study

In recent years, more young adults with ASD are attending post-secondary education, and several support programs have been proposed for this population. However, research regarding the long-term effects of university enrollment on outcomes among students with ASD is scarce. This study examined adaptive behavior and psychiatric symptoms during the first semester of two consecutive academic years (T1, T2) among 39 students with ASD, 29 students without ASD and high levels of social anxiety symptoms (High SA), and 32 students without ASD and low levels of SA symptoms (Low SA). Students with ASD participated in a university support program and resided with a peer mentor student without ASD, which encouraged social interaction. At T1, students with ASD reported lower levels of adaptive behavior and higher levels of social anxiety and obsessive-compulsive symptoms compared to the other groups. However, at follow-up (T2), significantly higher conceptual adaptive skill levels (specifically communication skills) and significantly lower depression symptom levels from T1 were reported only among students with ASD. The levels of social anxiety and obsessive-compulsive symptoms at T1 were negatively associated with adaptive functioning a year later (T2). Implications regarding adults with ASD attending university are discussed.

Low self-esteem and the formation of global self-performance estimates in emerging adulthood

High self-esteem, an overall positive evaluation of self-worth, is a cornerstone of mental health. Previously we showed that people with low self-esteem differentially construct beliefs about momentary self-worth derived from social feedback. However, it remains unknown whether these anomalies extend to constructing beliefs about self-performance in a non-social context, in the absence of external feedback. Here, we examined this question using a novel behavioral paradigm probing subjects' self-performance estimates with or without external feedback. We analyzed data from young adults (N = 57) who were selected from a larger community sample (N = 2402) on the basis of occupying the bottom or top 10% of a reported self-esteem distribution. Participants performed a series of short blocks involving two perceptual decision-making tasks with varying degrees of difficulty, with or without feedback. At the end of each block, they had to decide on which task they thought they performed best, and gave subjective task ratings, providing two measures of self-performance estimates. We found no robust evidence of differences in objective performance between high and low self-esteem participants. Nevertheless, low self-esteem participants consistently underestimated their performance as expressed in lower subjective task ratings relative to high self-esteem participants. These results provide an initial window onto how cognitive processes underpinning the construction of self-performance estimates across different contexts map on to global dispositions relevant to mental health such as self-esteem.

A corticostriatal pathway mediating self-efficacy enhancement

Forming positive beliefs about one's ability to perform challenging tasks, often termed self-efficacy, is fundamental to motivation and emotional well-being. Self-efficacy crucially depends on positive social feedback, yet people differ in the degree to which they integrate such feedback into self-beliefs (i.e., positive bias). While diminished positive bias of this sort is linked to mood and anxiety, the neural processes by which positive feedback on public performance enhances self-efficacy remain unclear. To address this, we conducted a behavioral and fMRI study wherein participants delivered a public speech and received fictitious positive and neutral feedback on their performance in the MRI scanner. Before and after receiving feedback, participants evaluated their actual and expected performance. We found that reduced positive bias in updating self-efficacy based on positive social feedback associated with a psychopathological dimension reflecting symptoms of anxiety, depression, and low self-esteem. Analysis of brain encoding of social feedback showed that a positive self-efficacy update bias associated with a stronger reward-related response in the ventral striatum (VS) and stronger coupling of the VS with a temporoparietal region involved in self-processing. Together, our findings demarcate a corticostriatal circuit that promotes positive bias in self-efficacy updating based on social feedback, and highlight the centrality of such bias to emotional well-being.

Blend in or stand out: social anxiety levels shape information-sharing strategies

Although living in social groups provides many benefits for group members, such groups also serve as a setting for social competition over rank and influence. Evolutionary accounts suggest that social anxiety plays a role in regulating in-group conflict, as individuals who are concerned about social threat may choose to defer to others to maintain the hierarchical status quo. Here, we examine how social anxiety levels are related to the advice-giving style an individual adopts: a competitive influence-seeking strategy or a defensive blend-in strategy. We begin by demonstrating that similarity to others drives activity in the brain's valuation system, even during a competitive advice-taking task. Then, in three behavioural experiments, we show that social anxiety levels are related to the tendency to give advice resembling the advice given by rival advisers and to refrain from status-seeking behaviour. Social anxiety was also associated with negative social comparisons with rival advisers. Our findings highlight the role of competing social goals in shaping information sharing.

Neural effects of a short-term virtual reality self-training program to reduce social anxiety

BACKGROUND

Social anxiety disorder (SAD) is characterized by anxiety regarding social situations, avoidance of external social stimuli, and negative self-beliefs. Virtual reality self-training (VRS) at home may be a good interim modality for reducing social fears before formal treatment. This study aimed to find neurobiological evidence for the therapeutic effect of VRS.

METHODS

Fifty-two patients with SAD were randomly assigned to a VRS or waiting list (WL) group. The VRS group received an eight-session VRS program for 2 weeks, whereas the WL group received no intervention. Clinical assessments and functional magnetic resonance imaging scanning with the distress and speech evaluation tasks were repeatedly performed at baseline and after 3 weeks.

RESULTS

The post-VRS assessment showed significantly decreased anxiety and avoidance scores, distress index, and negative evaluation index for 'self', but no change in the negative evaluation index for 'other'. Patients showed significant responses to the distress task in various regions, including both sides of the prefrontal regions, occipital regions, insula, and thalamus, and to the speech evaluation task in the bilateral anterior cingulate cortex. Among these, significant neuronal changes after VRS were observed only in the right lingual gyrus and left thalamus.

CONCLUSIONS

VRS-induced improvements in the ability to pay attention to social stimuli without avoidance and even positively modulate emotional cues are based on functional changes in the visual cortices and thalamus. Based on these short-term neuronal changes, VRS can be a first intervention option for individuals with SAD who avoid society or are reluctant to receive formal treatment.

Self-esteem depends on beliefs about the rate of change of social approval

A major challenge in understanding the neurobiological basis of psychiatric disorders is rigorously quantifying subjective metrics that lie at the core of mental illness, such as low self-esteem. Self-esteem can be conceptualized as a 'gauge of social approval' that increases in response to approval and decreases in response to disapproval. Computational studies have shown that learning signals that represent the difference between received and expected social approval drive changes in self-esteem. However, it is unclear whether self-esteem based on social approval should be understood as a value updated through associative learning, or as a belief about approval, updated by new evidence depending on how strongly it is held. Our results show that belief-based models explain self-esteem dynamics in response to social evaluation better than associative learning models. Importantly, they suggest that in the short term, self-esteem signals the direction and rate of change of one's beliefs about approval within a group, rather than one's social position.

Learning About the Self: Motives for Coherence and Positivity Constrain Learning From Self-Relevant Social Feedback

People learn about themselves from social feedback, but desires for coherence and positivity constrain how feedback is incorporated into the self-concept. We developed a network-based model of the self-concept and embedded it in a reinforcement-learning framework to provide a computational account of how motivations shape self-learning from feedback. Participants (N = 46 adult university students) received feedback while evaluating themselves on traits drawn from a causal network of trait semantics. Network-defined communities were assigned different likelihoods of positive feedback. Participants learned from positive feedback but dismissed negative feedback, as reflected by asymmetries in computational parameters that represent the incorporation of positive versus negative outcomes. Furthermore, participants were constrained in how they incorporated feedback: Self-evaluations changed less for traits that have more implications and are thus more important to the coherence of the network. We provide a computational explanation of how motives for coherence and positivity jointly constrain learning about the self from feedback, an explanation that makes testable predictions for future clinical research.

Social Context and Rejection Expectations Modulate Neural and Behavioral Responses to Social Feedback

When meeting other people, some are optimistic and expect to be accepted by others, whereas others are pessimistic and expect mostly rejections. How social feedback is evaluated in situations that meet or do not meet these biases and how people differ in their response to rejection and acceptance depending on the social situation are unknown. In this study, participants experienced rejection and acceptance by peers in two different social contexts, one with high (negative context) and the other with low probability of rejection (positive context). We examined how the neural and behavioral responses to rejection are altered by this context and whether it depends on the individual's sensitivity to rejection. Behavioral results show that, on average, people maintain an optimistic bias even when mostly experiencing rejection. Importantly, personality differences in rejection sensitivity affected both prior expectations to be rejected in the paradigm and the extent to which expectations changed during the paradigm. The context also strongly modulated ERPs and theta responses to rejection and acceptance feedback. Specifically, valence effects on neural responses were enhanced in the negative context, suggesting a greater relevance to monitor social feedback in such a situation. Moreover, midfrontal theta predicted how expectations were changed in response to prediction errors, stressing a role for theta in learning from social feedback. Surprisingly, interindividual differences in rejection sensitivity did not affect neural responses to feedback. Our results stress the importance of considering the interaction between subjective expectations and the social context for behavioral and neural responses to social rejection.

Testing the adolescent social reorientation model during self and other evaluation using hierarchical growth curve modeling with parcellated fMRI data

Adolescence is characterized as a period when relationships and experiences shift toward peers. The social reorientation model of adolescence posits this shift is driven by neurobiological changes that increase the salience of social information related to peer integration and acceptance. Although influential, this model has rarely been subjected to tests that could falsify it, or studied in longitudinal samples assessing within-person development. We focused on two phenomena that are highly salient and dynamic during adolescence—social status and self-perception—and examined longitudinal changes in neural responses during a self/other evaluation task. We expected status-related social information to uniquely increase across adolescence in social brain regions. Despite using hierarchical growth curve modeling with parcellated whole-brain data to increase power to detect developmental effects, we didn’t find evidence in support of this hypothesis. Social brain regions showed increased responsivity across adolescence, but this trajectory was not unique to status-related information. Additionally, brain regions associated with self-focused cognition showed heightened responses during self-evaluation in the transition to mid-adolescence, especially for status-related information. These results qualify existing models of adolescent social reorientation and highlight the multifaceted changes in self and social development that could be leveraged in novel ways to support adolescent health and well-being.

Targeted Memory Reactivation During REM Sleep in Patients With Social Anxiety Disorder

BACKGROUND

Social anxiety disorder (SAD) is characterized by a significant amount of fear when confronted to social situations. Exposure therapy, which is based on fear extinction, does not often lead to full remission. Here, based on evidence showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR) during REM sleep to enhance extinction learning in SAD.

METHODS

Forty-eight subjects with SAD were randomly assigned to two groups: control or TMR group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk in front of a virtual jury. At the end of each session, and only in the TMR group (N = 24), a sound was paired to the positive feedback phase of therapy (i.e., approval of their performance), which represented the memory to be strengthened during REM sleep. All participants slept at home with a wearable headband device which automatically identified sleep stages and administered the sound during REM sleep. Participants' anxiety level was assessed using measures of parasympathetic (root mean square of successive differences between normal heartbeats, RMSSD) and sympathetic (non-specific skin conductance responses, ns-SCRs) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation phase of their talks before (T1) and after (T2) one full-night's sleep and after 1 week at home (T3). Participants also filled in a dream diary.

RESULTS

We observed an effect of time on subjective measures of anxiety (SUDS). We did not find any difference in the anxiety levels of the two groups after 1 week of TMR at home. Importantly, the longer the total duration of REM sleep and the more stimulations the TMR group had at home, the less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with ns-SCRs and SUDS at T3 in the TMR group.

CONCLUSION

TMR during REM sleep did not significantly modulate the beneficial effect of therapy on subjective anxiety. Yet, our results support that REM sleep can contribute to extinction processes and substantiate strong links between emotions in dreams and waking stress levels in these patients.

No Evidence for the Involvement of Cognitive Immunisation in Updating Beliefs About the Self in Three Non-Clinical Samples

BACKGROUND

Cognitive immunisation against disconfirmatory evidence (i.e., devaluing expectation-disconfirming information through cognitive mechanisms) has recently been discussed as an obstacle to the revision of dysfunctional beliefs in mental disorders such as depression. Yet, it is unclear whether cognitive immunisation is also involved in belief updating in non-clinical samples.

METHODS

Using a three-group modulation protocol (promotion vs. inhibition of cognitive immunisation vs. control group), we examined how cognitive immunisation influences belief updating in response to performance feedback in three non-clinical samples. In Experiments 1 (N = 99) and 2 (N = 93), participants received unexpectedly negative feedback, whereas participants from Experiment 3 (N = 118) received unexpectedly positive feedback. Depressive symptoms and dispositional optimism were examined as additional predictors of belief updating.

RESULTS

In all experiments, participants adjusted their expectations in line with the feedback received, but this effect was not influenced by the cognitive immunisation manipulation. In Experiment 3, expectation change remained stable over 2 weeks. Depressive symptoms were associated with a reduced integration of positive feedback, but not with an increased sensitivity to negative feedback.

CONCLUSIONS

Whereas previous research has shown that cognitive immunisation contributes to persistent beliefs in clinical populations, the present findings suggest that it does not affect belief updating in non-clinical samples.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10608-021-10256-y.

Self-beneficial belief updating as a coping mechanism for stress-induced negative affect

Being confronted with social-evaluative stress elicits a physiological and a psychological stress response. This calls for regulatory processes to manage negative affect and maintain self-related optimistic beliefs. The aim of the current study was to investigate the affect-regulating potential of self-related updating of ability beliefs after exposure to social-evaluative stress, in comparison to non-social physical stress or no stress. We assessed self-related belief updating using trial-by-trial performance feedback and described the updating behavior in a mechanistic way using computational modeling. We found that social-evaluative stress was accompanied by an increase in cortisol and negative affect which was related to a positive shift in self-related belief updating. This self-beneficial belief updating, which was absent after physical stress or control, was associated with a better recovery from stress-induced negative affect. This indicates that enhanced integration of positive self-related feedback can act as a coping strategy to deal with social-evaluative stress.

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

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.

Frontoparietal and Default Mode Network Contributions to Self-Referential Processing in Social Anxiety Disorder

Social anxiety disorder (SAD) is characterized by negative self-referential processing, which triggers excessive emotional reactivity. In healthy individuals, positive self-views typically predominate and are supported by regions of the default mode network (DMN) that represent self-related information and regions of the frontoparietal control network (FPCN) that contribute to metacognitive awareness and emotion regulation. The current study used functional magnetic resonance imaging (fMRI) to examine patterns of DMN and FPCN activation during positive and negative self-referential judgments in SAD patients (N = 97) and controls (N = 34). As expected, SAD patients demonstrated a striking difference in self-beliefs compared with non-anxious healthy controls, endorsing fewer positive traits and more negative traits. However, SAD patients and controls demonstrated largely similar patterns of DMN and FPCN recruitment during self-referential judgements. No significant group differences were observed. However, equivalence testing identified numerous regions demonstrating effect sizes that were not small enough to conclude that they were practically equivalent to zero, despite the nonsignificant null hypothesis test. These regions may be key targets to investigate in future studies using larger samples.

An Investigation Into the Influence of Positive Peer Feedback on Self-Relevant Cognitions in Social Anxiety

This study investigated whether positive feedback from same-age peers can modify self-relevant cognitive processes of high socially anxious youth in a positive direction. Thirty-three high socially anxious and 32 non-socially anxious undergraduate students (17–22 years) gave an impromptu speech and received either positive or neutral feedback post-speech. Anticipatory processing (AP) was rated prior to the speech via self-report. One week later participants returned to the laboratory and completed questionnaires assessing post-event processing (PEP) thoughts related to the impromptu speech and AP about a future speech. For high socially anxious youth receiving positive feedback, AP about their speech performance significantly improved over time. In addition, high socially anxious participants who received positive feedback reported a higher frequency of positive PEP thoughts about their speech in the intervening week. These improvements did not occur in the neutral peer feedback condition. Non-socially anxious participants’ AP improved in both feedback conditions, whereas their frequency of PEP was unaffected by feedback. These findings suggest that, in high socially anxious youth, positive feedback from same-age peers can modify self-relevant cognitive processes in a positive direction. We discuss how methodological improvements could more thoroughly investigate the potential of positive peer feedback for changing cognitions.

The self in context: brain systems linking mental and physical health

Increasing evidence suggests that mental health and physical health are linked by neural systems that jointly regulate somatic physiology and high-level cognition. Key systems include the ventromedial prefrontal cortex and the related default-mode network. These systems help to construct models of the 'self-in-context', compressing information across time and sensory modalities into conceptions of the underlying causes of experience. Self-in-context models endow events with personal meaning and allow predictive control over behaviour and peripheral physiology, including autonomic, neuroendocrine and immune function. They guide learning from experience and the formation of narratives about the self and one's world. Disorders of mental and physical health, especially those with high co-occurrence and convergent alterations in the functionality of the ventromedial prefrontal cortex and the default-mode network, could benefit from interventions focused on understanding and shaping mindsets and beliefs about the self, illness and treatment.

A Reduced Self-Positive Belief Underpins Greater Sensitivity to Negative Evaluation in Socially Anxious Individuals

Positive self-beliefs are important for well-being, and are influenced by how others evaluate us during social interactions. Mechanistic accounts of self-beliefs have mostly relied on associative learning models. These account for choice behaviour but not for the explicit beliefs that trouble socially anxious patients. Neither do they speak to self-schemas, which underpin vulnerability according to psychological research. Here, we compared belief-based and associative computational models of social-evaluation, in individuals that varied in fear of negative evaluation (FNE), a core symptom of social anxiety. We used a novel analytic approach, 'clinically informed model-fitting', to determine the influence of FNE symptom scores on model parameters. We found that high-FNE participants learn more easily from negative feedback about themselves, manifesting in greater self-negative learning rates. Crucially, we provide evidence that this bias is underpinned by an overall reduced belief about self-positive attributes. The study population could be characterized equally well by belief-based or associative models, however large individual differences in model likelihood indicated that some individuals relied more on an associative (model-free), while others more on a belief-guided strategy. Our findings have therapeutic importance, as positive belief activation may be used to specifically modulate learning.

AUTHOR SUMMARY

Understanding how we form and maintain positive self-beliefs is crucial to understanding how things go awry in disorders such as social anxiety. The loss of positive self-belief in social anxiety, especially in inter-personal contexts, is thought to be related to how we integrate evaluative information that we receive from others. We frame this social information integration as a learning problem and ask how people learn whether someone approves of them or not. We thus elucidate why the decrease in positive evaluations manifests only for the self, but not for an unknown other, given the same information. We investigated the mechanics of this learning using a novel computational modelling approach, comparing models that treat the learning process as series of stimulusresponse associations with models that treat learning as updating of beliefs about the self (or another). We show that both models characterise the process well and that individuals higher in symptoms of social anxiety learn more from negative information specifically about the self. Crucially, we provide evidence that this originates from a reduction in the amount of positive attributes that are activated when the individual is placed in a social evaluative context.

Factors associated with perceived social support of patients with multiple sclerosis

Background: Multiple sclerosis (MS) is an inflammatory chronic disease of the central nervous system (CNS) which is related with unpredictable course and increasing disability. Social support as an available interpersonal resource may help patients with MS. The purpose of the present study was to evaluate perceived social support in patients with MS as well as the associated factors. Methods: The sample of this cross-sectional study included 200 patients with MS. Data collection was performed by the completion of the Multidimensional Scale of Perceived Social Support (MSPSS) and a questionnaire which included patients' characteristics. Results: Patients reported to perceive high support from significant others and their family (median: 24.0 and 23.5, respectively) and less from their friends (median: 20). Moreover, a statistically significant association was found between social support from significant others and marital status (P = 0.010), modification of daily activities (P = 0.018), difficulties with social and family environment (P ≤ 0.001 and P ≤ 0.001, respectively), frequent urination (P = 0.015), and whether they easily forgot (P = 0.049), characterized themselves as anxious (P = 0.049), and believed in God (P = 0.002). Also, a statistically significant association was fond between social support from family and relation with health professionals (P = 0.041), difficulties with social and family environment (P = 0.003 and P ≤ 0.001, respectively), and whether they considered themselves as anxious (P = 0.050), and they believed in God (P ≤ 0.001). Furthermore, a statistically significant association was found between support from friends and modification of daily activities (P = 0.010), help in daily activities (P = 0.016), need for movement assistance (P = 0.001), difficulties with social and family environment (P ≤ 0.001 and P = 0.005, respectively), and whether they considered themselves anxious (P = 0.046). Conclusion: Factors associated with perceived social support should be evaluated when planning holistic care to patients with MS.