Performance and interaction anxiety: specific relationships with other- and self-evaluation concerns

Interventions That Target or Affect Voice or Speech Production During Public Speaking: A Scoping Review

OBJECTIVES

Public speaking (PS) is frequently necessary in many professional, educational, and personal settings. Mastering this communication skill is particularly important in today's society. Training techniques for PS have been described in the literature. Given that PS anxiety affects performance, especially voice characteristics and speech fluency, the purpose of this scoping review is to examine, map, and narratively summarize the available evidence on PS interventions that target or affect voice or speech.

METHODS

An extensive literature search was conducted in three bibliographic databases: Medline ALL/Ovid, PsycINFO/Ovid, and Eric/Ovid. Of the 850 studies identified, 22 met the eligibility criteria, and one was added from the reference lists of the included studies.

RESULTS

A total of 23 studies were included. The interventions identified aim to improve speaking skills either by explicitly targeting the voice or speech (direct intervention, n = 15) or by targeting the cognitive, behavioral, psychological, or physical environment impacting the speaker's production (indirect intervention, n = 8).

CONCLUSIONS

This scoping review provides the first published methodological summary of the characteristics of existing PS interventions that target or affect voice and speech. Heterogeneous characteristics were observed. Further studies are needed to determine which interventions are most effective.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Childhood abuse and social anxiety symptoms among young adults: Moderating role of respiratory sinus arrhythmia suppression to social stress

BACKGROUND

Childhood abuse (CA) has been considered as an environmental risk factor for the development of social anxiety symptoms. Respiratory sinus arrhythmia (RSA) is a biomarker that has been found to interact with environmental stressors to affect psychopathological symptoms. However, little is known whether RSA moderates the relationship between CA and social anxiety symptoms.

OBJECTIVE

The current study aimed to examine the relationships between CA and two forms of social anxiety symptoms including social performance anxiety symptoms (SPAS) and social interaction anxiety symptoms (SIAS), and the moderating role of baseline RSA and/or RSA suppression to a social-evaluative stress in these links.

PARTICIPANTS AND SETTING

A total of 157 Chinese undergraduate students (Mage = 18.96, SD = 0.85, 85 % females) participated in this study.

METHOD

Participants completed the short form of Childhood Trauma Questionnaire, Social Phobia Scale and Social Interaction Anxiety Scale to assess CA, SPAS and SIAS, and then underwent a social stress protocol (a public speech task) during which their baseline RSA and stress induced RSA were obtained.

RESULTS

CA was positively correlated with SPAS but was not correlated with SIAS. RSA suppression to social stress moderated the associations between CA and two forms of social anxiety symptoms, such that CA was positively associated with SPAS and SIAS among individuals with blunted RSA suppression, but not among those with greater RSA suppression.

CONCLUSIONS

Greater social stress RSA suppression as a better physiological regulation marker might ameliorate the negative effect of CA on social anxiety symptoms.

Evaluation of the social phobia scale and social interaction anxiety scale as assessments of performance and interaction anxiety

The DSM-5 classification of performance anxiety as distinct from social anxiety underlines the need for specific measurement instruments. The Social Phobia Scale (SPS) and Social Interaction Anxiety Scale (SIAS) are widely used assessments of performance and general interaction anxiety, yet few studies have examined their criterion validity using actual performance and interaction stressors. The current study is the first to assess the scales' convergent and discriminant validity using multimodal anxiety indices including psychophysiological reactivity, which is a key characterizing feature of performance anxiety. Ninety-three individuals completed the SPS and SIAS and participated in performance and interaction challenges. Anxiety response was assessed with criterion measures of self-reported anxiety, observer-rated anxiety, heart rate and skin conductance. Both scales were moderately correlated with self-report and observer-rated anxiety (r's = 0.21-0.62) and weakly correlated with physiological measures (r's = 0.07-0.35), generally supporting convergent criterion validity. Discriminant criterion validity was not supported, however, with the SIAS and SPS showing similar correlations with each criterion measure for both social challenges. These findings suggest the SIAS and SPS are valid instruments for the assessment of social anxiety but may not be suitable for the specific measurement of performance and interaction anxiety.

The latent structure of social anxiety disorder and the performance only specifier: a taxometric analysis

Social anxiety disorder (SAD) is often treated as a discrete diagnostic entity that represents a naturally occurring class, though empirical evidence largely supports a dimensional conceptualization of social fears. Further, the inclusion of a "performance only" specifier in the DSM-5 implies that individuals who experience intense social anxiety exclusively in performance situations are distinct from those with broader social fears. The purpose of the present research was to examine the latent structure of SAD and the DSM-5 "performance only" specifier in a large nonclinical sample (n = 2019). Three taxometric procedures (MAXCOV, MAMBAC, and L-Mode) were applied to indicators derived from two commonly used measures of social anxiety. Results yielded convergent evidence indicating that social anxiety exhibits a dimensional latent structure. Further, social performance anxiety demonstrates continuous relationships with milder social fears, suggesting that the "performance only" specifier may not represent a discrete entity. The implications of these findings for the assessment, diagnosis, classification, and treatment of social anxiety are discussed.

Subtyping social anxiety in youth

Few empirical studies have examined subtypes of social anxiety disorder (SAD) in youth, and limited consensus resides on the nature of potential subtypes. Identifying subtypes, based on both fear and avoidance patterns, can help improve assessment and treatment of SAD. Subtypes of fear and avoidance were examined in a sample comprising 131 youth (age 8-15 years) diagnosed with SAD using the Anxiety Disorders Interview Schedule for children and parents (ADIS-C/P). Exploratory factor analysis of fear responses revealed three factors, defining fear subtypes linked to: (1) performance, (2) observation, and (3) interaction situations, respectively. Exploratory factor analysis of avoidance responses showed these were best represented by one avoidance factor. Few youth qualified exclusively for either of the fear subtypes, thus calling into question the clinical utility of these subtypes. Nevertheless, the findings indicate distinct contributions of fear and avoidance in SAD presentation. This finding might help clinicians target and improve treatment of the disorder.

Focus-of-attention behavioral experiment: an examination of a therapeutic procedure to reduce social anxiety

A clinical protocol based on contemporary cognitive behavioral treatment for social anxiety was developed and examined. Previously published instructions for conducting a focus-of-attention behavioral experiment targeting self-focused attention and safety behaviors during exposure were used to create a structured protocol. Individuals (n = 45) with high levels of social anxiety and public-speaking anxiety were randomly assigned to either a focus-of-attention behavioral experiment (FABE) or an Exposure-Only Control (EOC) condition. During four exposure trials, those in the FABE condition (n = 24) were alternately instructed to engage in self-focused attention vs. externally focused attention and to eliminate safety behaviors. Those in the EOC condition (n = 21) were not so instructed. At post-intervention, individuals in the FABE condition showed significantly less self-focused attention and anxiety, and better observed performance as rated by audience members. Focus-of-attention statistically mediated the effect of condition on anxiety. For those in the FABE condition, the degree of association between focus-of-attention and anxiety during the intervention predicted less self-focused attention post-intervention. The FABE appears to be a useful procedure for implementing part of the contemporary cognitive behavioral treatment model.

An investigation into the jumping-to-conclusions bias in social anxiety

'Jumping-to-Conclusions' (JTC) is a data-gathering bias characterised by hasty decision-making, and is typically seen in individuals with high levels of delusions or paranoia. JTC has also been found in people with high trait and state anxiety. The present study aimed to explore the relationship between JTC and trait social anxiety and state anxiety, given paranoia is common in both social anxiety and psychotic disorders. One-hundred-and-eighty-six undergraduate students were allocated to a manipulation or control condition, and classified as high or low socially anxious. All participants completed the 'beads task' to assess JTC, and the State-Trait Anxiety Inventory (state subscale) to assess state anxiety. Participants in the manipulation condition were given an anxiety-inducing situation. Although the manipulation was effective in inducing state anxiety, there was no significant correlation between JTC and trait or state social anxiety. High socially anxious individuals showed more conservative decision-making than controls over time, which was posited to be caused by inhibited working memory resulting from increased state anxiety.

Self-Focused Attention and Post-Event Processing: Relevance to Social Performance Anxiety and Social Interaction Anxiety

This study examined the roles of self-focused attention and post-event processing in social performance anxiety and social interaction anxiety. College students (N = 101) completed measures of social performance anxiety, social interaction anxiety, self-focused attention, post-event processing, and beliefs related to social anxiety. Interoceptive self-focused attention and post-event processing predicted social performance anxiety after controlling for social interaction anxiety. The associations with social interaction anxiety were not significant after controlling for social performance anxiety. Associations of behavioral self-focused attention with social performance anxiety and social interaction anxiety were not significant after controlling for interoceptive self-focused attention. No evidence of an interaction between self-focused attention and post-event processing in the prediction of social anxiety was found. This study found no evidence that the associations of interoceptive self-focused attention and post-event processing with social performance anxiety were statistically mediated by high standards, conditional beliefs about self, and unconditional beliefs about self. These results and their theoretical implications are discussed.

Pre-treatment shyness mindset predicts less reduction of social anxiety during exposure therapy

This study examined the moderating role of shyness mindset on the reduction of social anxiety during exposure-based treatment. Participants (N=60) in an intensive outpatient program for anxiety disorders were assessed at pre- and post-treatment. Social performance anxiety decreased dramatically during treatment, but the amount of decrease differed as a function of pre-treatment shyness mindset. At one standard deviation above the mean on both the social performance anxiety and shyness mindset measures, an average reduction of 15 points on the social performance anxiety measure was observed. At one standard deviation above the mean on the social performance anxiety measure and one standard deviation below the mean on the shyness mindset measure, an average reduction of 27 points on the social performance anxiety measure was observed. These results suggest that targeting shyness mindset during exposure-based treatments for social anxiety disorder might increase the effectiveness of treatment for individuals with a high shyness mindset.