Social Anxiety Scale for Adolescents (SAS-A) Short Form: Longitudinal Measurement Invariance in Two Community Samples of Youth

A longitudinal examination of the measurement properties and invariance of the Sleep Condition Indicator in Chinese healthcare students

BACKGROUND

The Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population.

METHODS

Healthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU_SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test-retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI.

RESULTS

We identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953-0.989, Tucker-Lewis index = 0.931-0.984, root means square error of approximation = 0.040-0.092, standardized root mean square residual = 0.039-0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU_SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach's alpha = 0.811-0.835, McDonald's omega = 0.805-0.832), and test-retest reliability (intraclass correlation coefficient = 0.829).

CONCLUSION

The SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students.

Why So Lonely? The Direct and Indirect Associations between Developmental Trajectories of Fear of Negative Evaluation, Prosocial Behavior and Loneliness in Adolescence

Fear of negative evaluation and prosocial behavior have been identified as predictive factors influencing the development of loneliness in adolescence, representing typical factors in the cognitive and behavioral processes of re-affiliation. The elucidation of plausible direct and indirect pathways linking these pivotal factors to adolescents' loneliness need further exploration. This study aimed to investigate the direct and indirect relationships between the fear of negative evaluation, prosocial behavior, and adolescents' loneliness through the lens of developmental changes. A total of 533 adolescents (49.0% girls, Mage = 15.18 years, SD = 0.71) participated in this longitudinal study, assessed at three timepoints over a span of two years with 12-month intervals. Latent growth modeling uncovered direct associations between the developmental trajectories of both fear of negative evaluation and prosocial behavior with the developmental trajectory of adolescents' loneliness. The developmental trajectory of fear of negative evaluation exhibited an indirect association with the developmental trajectory of loneliness through the mediating role of prosocial behavior. These findings highlighted the roles of cognitive and behavioral re-affiliation processes, both independently and as mediators, in influencing adolescent loneliness, suggesting that interventions aimed at reducing fear of negative evaluation and promoting prosocial behavior could effectively mitigate adolescents' loneliness.

Factor structure and measurement invariance of the Depression anxiety stress scale (DASS-21) in Chinese left-behind and non-left-behind children: an exploratory structural equation modeling approach

BACKGROUND

Comprehensive data has shown that adolescents often suffer from depression, anxiety, and low self-esteem, and are in a particularly fragile stage of psychological, physiological, and social development. Left-behind children in particular tend to have significantly higher, state anxiety and depression compared to non-left-behind children. The Depression, Anxiety, and Stress Scale (DASS-21) is an effective tool for evaluating depression, anxiety, and stress, and is used to measure levels of depression, anxiety, and stress in groups from a variety of backgrounds. The purpose of this study was to determine the effectiveness, reliability, and measurement invariance of the DASS-21 in Chinese left-behind children.

METHOD

The test and re-test method was used (N = 676), and the exploratory structural equation model (Mplus v.8.3) used to verify basic measurement models. For measurement invariance, the configural, weak, strong, and strict models were tested. The reliability of the DASS-21 was also tested using the collected data.

RESULTS

Analysis results showed that the DASS-21 had a stable three-factor structure in the sample of left-behind children in China. The measurement invariance test showed that gender and time not only had strong invariance, but also strict invariance. The results of cross left and non-left invariance indicated a lack of strict invariance. Finally, the McDonald's omega coefficient of the DASS-21 total scale was 0.864, and the internal consistency of each subscale was also good.

CONCLUSIONS

The DASS-21 is shown to be an effective and reliable tool for measuring depression, anxiety and stress in Chinese left-behind children.

Social anxiety mediates between victimization experiences and internet addiction among adolescents: results from propensity score matching

Background

Previous research has indicated that Victimization Experiences (VE) may be linked to a heightened likelihood of developing psychological symptoms and Internet Addiction (IA) among adolescents. However, the precise mechanism through which VE contributes to IA in adolescents remains uncertain. This study aimed to investigate whether Social Anxiety (SA) serves as a mediation between VE and IA, utilizing the framework of General Strain Theory.

Methods

A cross-sectional survey among 11 middle schools or high schools in Macao was conducted from October to December 2022. Respondents in the victimized group and non-victimized group were 1:1 paired using Propensity Score Matching (PSM) to control the potential confounding factors.

Results

A total of 1,089 questionnaires were valid for analysis and 311 pairs were generated through PSM. Respondents in the victimized group reported significantly higher IA than those in non-victimized group (23.5% vs. 12.5%, p < 0.001) after PSM treatment. Multivariate logistic regression analysis showed that VE (p = 0.015, OR = 1.750, 95% CI = 1.115 to 2.746, E-value = 2.90) and SA (p < 0.001, OR = 1.052, 95% CI = 1.030 to 1.074, E-value = 1.29) were the predictors of IA. The model successfully classified 81.7% of cases overall (R 2 N = 0.133). Further analysis indicated that SA mediates between VE and IA (Z = 3.644, p < 0.001).

Conclusion

This study revealed the potential mediation effect of SA on the link between VE and IA. By acknowledging the mediating influence of SA, researchers and practitioners can develop more accurate and effective strategies to mitigate Internet Addiction among adolescents.

Social Anxiety and Peer Victimization and Aggression: Examining Reciprocal Trait-State Effects among Early Adolescents

As peer relationships become paramount during early adolescence, there's a normative rise in social anxiety, coinciding with a peak in peer victimization and aggression. Although previous studies have suggested reciprocal associations between changes in social anxiety and adolescent peer victimization and aggression, the mechanics of these associations at the personal trait and time-varying state levels remains unclear. This study examined the longitudinal relations between social anxiety and adolescent peer victimization and aggression by disentangling between-person trait differences from within-person state processes. A total of 4731 Chinese early adolescents (44.9% girls; M age = 10.91 years, SD = 0.72) participated in a four-wave longitudinal study with 6-month intervals. Random-intercept cross-lagged panel model (RI-CLPM) was applied. The results revealed higher levels of social anxiety are associated with more peer victimization and aggression at the between-person trait level. At the within-person state level, adolescent social anxiety, and adolescent physical victimization and physical aggression, reciprocally predicted each other. Relational victimization significantly predicted an increase of social anxiety, but not vice versa. Social anxiety positively predicted relational aggression over time, whereas the effect of relational aggression on social anxiety was only observed at the initial stage of early adolescence. These findings highlight that various types of victimization and aggression might exhibit unique reciprocal associations with social anxiety. Distinguishing between the within-person state and between-person trait effects is crucial in research that informs the co-development of adolescent peer victimization, aggression, and social anxiety.

Association Between Social Media Use and Substance Use Among Middle and High School-Aged Youth

Purpose: The purpose of our study was to identify whether different aspects of social media use were associated with substance use among middle- and high school-aged youth. Methods: Participants were recruited from four Northeast U.S. middle schools and invited to complete an online survey in Fall 2019 and Fall 2020. We conducted separate adjusted logistic mixed effects models the substance use outcomes: ever use of alcohol, cannabis, e-cigarettes, tobacco cigarettes, prescription drugs, and multiple substances. Our sample included N = 586 participants (52.7% female, 58% White). Results: Seeing a social media post about drugs/alcohol in the past-12-months was significantly associated with higher odds of ever using alcohol, cannabis, e-cigarettes, and multiple substance use. Total number of social media sites ever used was significantly associated with higher odds of ever using cannabis, cigarettes, e-cigarettes, and multiple substances. Checking social media every hour or more was significantly associated with higher odds of ever using alcohol. Higher problematic internet use score was significantly associated with higher odds of ever using cannabis, e-cigarettes, and multiple substances. Online social support seeking score was not associated substance use. Conclusions: Our findings support the need for substance use prevention and social media literacy education and screening to begin early, ideally in elementary school before youth are using social media and substances.

Longitudinal Associations Between Pet Relationship Quality and Socio-Emotional Functioning in Early Adolescence

Adolescence is a key developmental period for socio-emotional skills, and companion animal relationships may be one potential source of emotional support and resilience during this time. This study used longitudinal data from 940 pet-owning adolescents, collected over four time points, from youth in the Northeastern United States. We assessed whether pet relationship quality (indexed by relationship satisfaction, companionship, and emotional disclosure) predicted trajectories of loneliness, social anxiety, and depression. Results indicated that high satisfaction with a pet relationship was associated with more favorable trajectories, but companionship (i.e., regarding frequency of interacting with the pet) was not related significantly to socio-emotional functioning. High levels of disclosure to a pet were linked with less favorable trajectories for loneliness and depression, but not related to social anxiety. These results suggest that a pet relationship can, in some cases, be associated positively with socio-emotional development, but that there is significant complexity in these associations. Families, educators, and practitioners should take a nuanced approach to understanding individual adolescent-pet relationships as a contextual asset for specific youth.

Prospective Associations Between Fears of Negative Evaluation, Fears of Positive Evaluation, and Social Anxiety Symptoms in Adolescence

Fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are independently associated with social anxiety symptoms in adolescence, though no study has tested these relations longitudinally. The current study examined longitudinal relations between FNE, FPE, and social anxiety symptoms using a multi-informant design, in addition to testing adolescent gender as a moderator. Adolescents (N = 113; Mage = 12.39; Girls = 44.2%) and parents completed measures of FNE, FPE, and two ratings of social anxiety approximately 6 months apart. FNE and FPE demonstrated significant stability over time, but neither predicted change in the other construct. Adolescent and parent-reported FNE, but not FPE, predicted increased social anxiety symptoms. Adolescent report of social anxiety symptoms predicted increased FPE over time, whereas parent report of social anxiety symptoms predicted increased FNE. Contrary to hypothesis, gender did not moderate any of the pathways in the model. Findings provide the first evidence that FNE may function as a risk factor for increased social anxiety in adolescence.

Prevalence and predictors of social anxiety disorders among Malaysian secondary school students during the COVID-19 pandemic: Exploring the influence of internet gaming disorder and impulsivity

This study aimed to investigate the prevalence of social anxiety disorder (SAD) among Malaysian secondary school students during the COVID-19 pandemic and to explore its correlations with demographic variables, impulsivity behavior, and internet gaming disorder (IGD). A total of 1574 participants from 12 government secondary schools across five Malaysian states, comprising 569 males and 1005 females, completed an online questionnaire containing validated Malay versions of the Social Interaction Anxiety Scale, Barratt Impulsiveness Scale, and Internet Gaming Disorder Scale - Short Form. The findings revealed a notable SAD prevalence rate of 40.53% among Malaysian adolescents. Logistic regression analysis unveiled significant associations between SAD and factors such as attention impulsiveness (OR = 2.58, p < .001), motor impulsiveness (OR = 1.47, p = .03), female gender (OR = 2, p < .001), Malay ethnicity, and IGD (OR = 1.08, p < .001). In conclusion, this study provides valuable insights into the extent of social anxiety experienced by Malaysian secondary school students during the pandemic, shedding light on the demographic and psychosocial factors linked to its emergence. Furthermore, the research underscores a robust link between IGD and SAD, emphasizing the need for comprehensive interventions addressing both issues concurrently. By recognizing the multifaceted nature of these associations, future interventions can be tailored to provide holistic support for adolescents' mental well-being.

Social interpretation inflexibility moderates emotional reactions to social situations in children and adolescents

Interpretation biases and inflexibility (i.e., difficulties revising interpretations) have been linked to increased internalizing symptoms. Although adolescence is a developmental period characterized by novel social situations and increased vulnerability to internalizing disorders, no studies have examined interpretation inflexibility in adolescents. Additionally, no studies (on adolescents or adults) have examined interpretation flexibility as a protective factor against adverse outcomes of interpersonal events. Using a novel task and a 28-day diary we examined relations among interpretation bias and inflexibility, internalizing symptoms, and negative interpersonal events in a sample of children and adolescents (N = 159, ages 9-18). At baseline, negative interpretation bias was positively correlated with social anxiety symptoms, and positive interpretation bias negatively correlated with social anxiety and depressive symptoms. Inflexible positive interpretations were correlated with higher social anxiety and depressive symptoms, while inflexible negative interpretations were correlated with higher social anxiety. Finally, interpretation inflexibility moderated daily associations between negative interpersonal events and depressive symptoms in daily life, such that higher inflexibility was associated with stronger associations between interpersonal events and subsequent depressive symptoms, potentially increasing depressive symptom instability. These results suggest that interpretation biases and inflexibility may act as both risk and protective factors for adolescent anxiety and depression.

Potential risk and protective factors related to problematic social media use among adolescents in Iran: A latent profile analysis

This study aimed to assess Problematic Social Media Use (PSMU) among Iranian adolescents and explore potential risk and protective factors. In the present cross-sectional study, 3375 Iranian adolescents were recruited online and completed questionnaires. Latent profile analysis (LPA) was performed to identify groups with various levels of PSMU. Indicator variables included standardized factor scores for PSMU, attention-deficit/hyperactivity disorder, sensation-seeking, internet addiction, loneliness, social anxiety, internalizing symptoms, social support and self-esteem. Five groups were identified relating to severities of PSMU and other factors: low-risk: n = 823 (24.4 %); low-to-moderate-risk: n = 835 (24.7 %); moderate-risk: n = 630 (18.7 %); moderate-to-high-risk: n = 584 (17.3 %); high-risk: n = 503 (14.9 %). Multiple factors, including sensation-seeking, internalizing symptoms, social anxiety, loneliness, internet addiction, attention-deficit/hyperactivity disorder, low self-esteem and low perceived social support, statistically predicted PSMU. The current findings may help identify Iranian adolescents who are particularly vulnerable to PSMU and assist in intervention development.

Validation of the Chinese version of the Rosenberg Self-Esteem Scale: evidence from a three-wave longitudinal study

BACKGROUND

The 10-item Rosenberg Self-Esteem Scale (RSES) is a widely used tool for individuals to self-report their self-esteem; however, the factorial structures of translated versions of the RSES vary across different languages. This study aimed to validate the Chinese version of the RSES in the Chinese mainland using a longitudinal design.

METHODS

A group of healthcare university students completed the RSES across three waves: baseline, 1-week follow-up, and 15-week follow-up. A total of 481 valid responses were collected through the three-wave data collection process. Exploratory factor analysis (EFA) was performed on the baseline data to explore the potential factorial structure, while confirmatory factor analysis (CFA) was performed on the follow-up data to determine the best-fit model. Additionally, the cross-sectional and longitudinal measurement invariances were tested to assess the measurement properties of the RSES for different groups, such as gender and age, as well as across different time points. Convergent validity was assessed against the Self-Rated Health Questionnaire (SRHQ) using Spearman's correlation. Internal consistency was examined using Cronbach's alpha and McDonald's omega coefficients, while test-retest reliability was assessed using intraclass correlation coefficient.

RESULTS

The results of EFA revealed that Items 5, 8, and 9 had inadequate or cross-factor loadings, leading to their removal from further analysis. Analysis of the remaining seven items using EFA suggested a two-factor solution. A comparison of several potential models for the 10-item and 7-item RSES using CFA showed a preference for the 7-item form (RSES-7) with two factors. Furthermore, the RSES-7 exhibited strict invariance across different groups and time points, indicating its stability and consistency. The RSES-7 also demonstrated adequate convergent validity, internal consistency, and test-retest reliability, which further supported its robustness as a measure of self-esteem.

CONCLUSIONS

The findings suggest that the RSES-7 is a psychometrically sound and brief self-report scale for measuring self-esteem in the Chinese context. More studies are warranted to further verify its usability.

The RU_SATED as a measure of sleep health: cross-cultural adaptation and validation in Chinese healthcare students

BACKGROUND

The RU_SATED scale is a multidimensional instrument measuring sleep health, consisting of Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration dimensions. We adapted and validated the Chinese RU_SATED (RU_SATED-C) scale.

METHODS

The RU_SATED-C scale was developed through a formal linguistic validation process and was validated in an observational longitudinal survey design. Healthcare students completed the RU_SATED scale, Sleep Quality Questionnaire, and Patient Health Questionnaire-4 among two sites of Hangzhou and Ningbo, China. Psychometric assessments included structural validity, longitudinal measurement invariance, convergent and divergent validity, internal consistency, and test-retest reliability.

RESULTS

A total of 911 healthcare students completed the RU_SATED-C scale at baseline (Time 1, T1) and follow-up (Time 2, T2) with an average time interval of 7 days + 5.37 h. Confirmatory factor analysis (CFA) confirmed a single-factor model and resulted in an acceptable model fit. The two-factor model previously found in the Japanese version fit better than the one-factor model, whereas the one-factor model fit had a better fit than the two-factor model found in the English version. Longitudinal CFA resulted in negligible changes in fit indices for four forms of increasingly restrictive models and supported that a single-factor model was equivalent over time. The data also endorsed longitudinal measurement invariance among the two-factor models found in the English and Japanese samples. The RU_SATED-C scale total score displayed a moderately strong negative correlation with sleep quality; however, negligible associations were observed with anxiety and depression. Ordinal Cronbach's alpha and Ordinal McDonald's omega at T1 and T2 ranged from suboptimal to acceptable. The RU_SATED-C scale and all items were significantly correlated across time intervals.

CONCLUSION

The RU_SATED-C scale is an easy-to-use instrument with potentially valid data for the measurement of multidimensional sleep health. Use of the RU_SATED-C scale can help raise awareness of sleep health and could pave the way for important efforts to promote healthy sleep.

Context and domain matter: the error-related negativity in peer presence predicts fear of negative evaluation, not global social anxiety, in adolescents

BACKGROUND

Social anxiety symptoms are most likely to emerge during adolescence, a developmental window marked by heightened concern over peer evaluation. However, the neurocognitive mechanism(s) underlying adolescent social anxiety remain unclear. Emerging work points to the error-related negativity (ERN) as a potential neural marker of exaggerated self/error-monitoring in social anxiety, particularly for errors committed in front of peers. However, social anxiety symptoms are marked by heterogeneity and it remains unclear exactly what domain(s) of social anxiety symptoms are associated with ERN variation in peer presence, particularly within the adolescent period.

METHODS

To advance and deepen the mechanistic understanding of the ERN's putative role as a neural marker for social anxiety in adolescence, we leveraged a social manipulation procedure and assessed a developmentally salient domain of social anxiety during adolescence - fear of negative evaluation (FNE). Adolescents residing in Hanzhong, a small city in the southwestern region of mainland China, had EEG recorded while performing a flanker task, twice (peer presence/absence); FNE, as well as global social anxiety symptoms, was assessed.

RESULTS

Overall ERN increases in peer presence. FNE specifically, but not global levels of social anxiety symptoms, predicted ERN in peer presence.

CONCLUSIONS

These data are the first demonstration that the ERN relates to a specific domain of social anxiety in adolescents, as well as the first evidence of such relations within a non-WEIRD (Western, Educated, Industrialized, Rich and Democratic) sample. Results have important implications for theory and research into adolescent social anxiety.

Bidirectional relationships between interpretation biases, safety behaviors, and social anxiety

Theoretical models of social anxiety (SA) propose bidirectional relationships between SA, interpretation biases, and safety behaviors (Safe-B). However, longitudinal studies evaluating these bidirectional relationships are scarce. The main objective of this study was to analyze the bidirectional relationships between interpretation biases (from ambiguous situations and ambiguous faces), Safe-B, and SA. A two-time longitudinal study was carried out with the participation of 575 vocational training students (M = 19.49, SD = 2.41). Both the interpretation biases measured through ambiguous situations and ambiguous faces and the Safe-B predicted higher levels of SA in the second time. In turn, a bidirectional relationship was found between SA and Safe-B. However, no bidirectional relationships were found between interpretation biases and Safe-B and between biases and SA. Among others, the limitations of the study include the high attrition rate (30.4%) and the high proportion of male students (62.1%). The findings highlight the role of interpretation bias and Safe-B in SA. In turn, as a new initiative, the study supports the bidirectional relationship between Safe-B and SA. Implications are discussed throughout the manuscript.

Do youth anxiety measures assess the same construct consistently throughout treatment? Results are...complicated

Interventionists interpret changes in symptoms as reflecting response to treatment. However, changes in symptom functioning and the measurement of the underlying constructs may be reflected in reported change. Longitudinal measurement invariance (LMI) is a statistical approach that assesses the degree to which measures consistently capture the same construct over time. We examined LMI in measures of anxiety severity/symptoms [i.e., Pediatric Anxiety Rating Scale (PARS), Multidimensional Anxiety Scale for Children (MASC), Screen for Child Anxiety and Related Disorders (SCARED)] in anxious youth at baseline and posttreatment. Initial fit was inadequate for 27 of 38 baseline and posttreatment models, but model modifications resulted in acceptable fit. Tests of LMI supported scalar invariance for the PARS and many, but not all, MASC and SCARED subscales. Findings suggest that the PARS, and many MASC and SCARED subscales can accurately be used to measure change over time, however, others may reflect changes in measurement properties.

Adaptation and validation of the Chinese version of the Sleep Quality Questionnaire

STUDY OBJECTIVES

Sleep quality is essential to health. The current study aimed to adapt and validate the Sleep Quality Questionnaire (SQQ) into Chinese language.

METHODS

The Chinese version of the SQQ (SQQ-C) was created following the guidelines for cross-cultural adaptation. Compliant with the COSMIN methodology, baseline data (N = 13,325) examined three validity domains and internal consistency, including content validity using the content validity index (CVI) and the cognitive debriefing and focus group (relevance, comprehensiveness and comprehensibility), construct validity using structural validity and cross‑sectional measurement invariance, and criterion validity using concurrent/convergent validity. Follow-up data (N = 3410) gathered within a mean of 168 (167-207) h interval were used to additionally assess longitudinal measurement invariance and test-retest reliability using intraclass correlation coefficient (ICC).

RESULTS

Scale-level CVI/Average was equal to 0.922; Item-level CVIs ranged from 0.889 to 1.000 (excellent), except for item 2 (0.556-fair). A panel of local experts and local participants during cognitive debriefing and focus group stated that it had sufficient relevance and comprehensibility but a slight deficiency in comprehensiveness. Confirmatory factor analysis indicated a stable two-factor structure encompassing Daytime Sleepiness Subscale and Sleep Difficulty Subscale from baseline to follow-up data. The SQQ-C-9 (without item 2) outperformed the SQQ-C-10 (full form). The SQQ-C-9 provided evidence of measurement invariance (strict) across subgroups (cohorts, gender, and age) and across time. The SQQ-C was negatively correlated with the Chinese Nonrestorative Sleep Scale and the Chinese Sleep Condition Indicator. Cronbach's alpha (α), McDonald's Omega (ω), and ICC, respectively, ranged from 0.712 to 0.838, 0.723 to 0.840, and 0.738 to 0.764 for total scale and each subscale.

CONCLUSION

The SQQ-C exhibits adequate psychometric properties and a stable two-factor structure, and should enable valuable assessments of sleep quality in clinical and research settings.

Psychological suzhi moderates state anxiety and heart rate responses to acute stress in male adolescents

Psychological suzhi has increasingly been recognized to buffer chronic stress and improve mental health. However, few studies have examined the role of psychological suzhi in the response to acute stress. The current study aimed to investigate whether psychological suzhi can buffer state anxiety and heart rate responses to acute stress in adolescents. Healthy male adolescents (N = 63) were classified into high (N = 30) or low (N = 33) psychological suzhi groups based on the Chinese norm of adolescent psychological suzhi scale-simplified version. They completed both the modified Trier Social Stress Test for Groups and a specific control condition, with heart rate and state anxiety assessed. Data were analysed with mixed-design repeated measures analysis of variance. The results showed that the modified Trier Social Stress Test for Groups condition effectively induced an increase in state anxiety and heart rate. Furthermore, individuals with higher levels of psychological suzhi showed lower state anxiety and heart rate stress responses. The present study indicated that psychological suzhi is an important internal resource against acute stress, which may inform interventions for male adolescents exposed to acute stress.

Evidence on Problematic Online Gaming and Social Anxiety over the Past Ten Years: a Systematic Literature Review

Purpose of Review

The present study aimed to review the literature concerning the relationship between problematic online gaming (POG) and social anxiety, taking into account the variables implicated in this relationship. This review included studies published between 2010 and 2020 that were indexed in major databases with the following keywords: Internet gaming, disorder, addiction, problematic, social phobia, and social anxiety.

Recent Findings

In recent years, scientific interest in POG has grown dramatically. Within this prolific research field, difficulties associated with social anxiety have been increasingly explored in relation to POG. Indeed, evidence showed that individuals who experience social anxiety are more exposed to the risk of developing an excessive or addictive gaming behavior.

Summary

A total of 30 studies satisfied the initial inclusion criteria and were included in the present literature review. Several reviewed studies found a strong association between social anxiety and online gaming disorder. Furthermore, the relationships among social anxiety, POG, age, and psychosocial and comorbid factors were largely explored. Overall, the present review showed that socially anxious individuals might perceive online video games as safer social environments than face-to-face interactions, predisposing individuals to the POG. However, in a mutually reinforcing relationship, individuals with higher POG seem to show higher social anxiety. Therefore, despite online gaming might represent an activity able to alleviate psychopathological symptoms and/or negative emotional states, people might use online gaming to counterbalance distress or negative situations in everyday life, carrying out a maladaptive coping strategy.

The Positive Loop at Work: A Longitudinal Long-Term Study of Transformational Leadership, Group Passion, and Employee Results

Positive psychology and positive organizational behavior studies recognize that leadership is extremely important for generating positive well-being. Despite the frequently reported significant positive correlations, the causal long-term relationship between leadership, positive high intense affect, and employee results remains unclear. The main objective of this study was to analyze the long-term (longitudinal) relation of transformational leadership and positive high-intensity emotions with employee group satisfaction, commitment, and proactive behavior. We built a longitudinal structural equation model to test a mediation model with two time points; 2,480 workers from 166 work units completed questionnaires at both time points. Our results reveal that positive high-intensity emotions mediate the relation between transformational leadership and proactive behavior of workers, the bidirectional relations between the variables were also analyzed. The present study is, to our knowledge, the first analyzing the long-term effect of TFL and collective high-intensity emotions on worker’s results longitudinally. Our findings reflect the great complexity of affect and affect-related results in organizations and highlight the need for more longitudinal research to clarify emotional processes at work.

The psychometric properties of Social Anxiety Scale for Adolescents (SAS-A) short form-Bangla

There is a lack of available valid assessment tools (published) for assessing social anxiety symptoms among Bangladeshi people. Therefore, this study was aimed to examine the psychometric properties of the Social Anxiety Scale for Adolescents (Short Form) to assess the social anxiety symptoms among Bangladeshi young adults. In this study, the data (N = 683) from the ‘Social Media Addiction among University Students’ project were utilized. Results regarding item-level information using classical test theory and item response theory demonstrated that all items of the scale had a higher discrimination index and acceptable infit and outfit mean squares. The confirmatory factor analysis supported a three-factor structure for the scale and strict invariance between males and females. Scale level results showed that this translated scale had good internal consistency reliabilities, composite reliability, as well as acceptable average variance extracted values, standard error of measurement, and discrimination power. Regarding validity, this scale had moderate to low correlations with loneliness and the big five personality traits. To sum up, the SAS-A-SF Bangla is a psychometrically sound measure that would be helpful for practitioners and researchers to assess the social anxiety symptoms among Bangladesh young adults.

Longitudinal and Gender Measurement Invariance of the Gratitude Questionnaire in Chinese Adolescents

The 5-item Gratitude Questionnaire (GQ-5) is one of the most commonly used instruments to measure dispositional gratitude in adolescents. The purpose of this study was to verify the longitudinal measurement invariance (LMI) and gender measurement invariance (GMI) of the GQ-5 that was administered to an adolescent sample twice over the course of 18 months (N = 669). Single-group confirmatory factor analysis (CFA) was adopted to examine the LMI and multiple-group CFA was conducted to assess the GMI. The results showed that the GQ-5 had strong invariance (i.e., equality of factor patterns, loadings, and intercepts) across time and gender. Validation of latent factor mean differences showed that females had higher gratitude scores than males. In addition, the GQ-5 exhibited good internal consistency indices across time and a moderate stability coefficient was also found across an 18-month time interval in adolescents. In summary, our study showed that LMI and GMI of the GQ-5 are satisfactory and the GQ-5 is a reliable instrument for measuring gratitude in adolescents.

Early Adolescent Social Media-Related Body Dissatisfaction: Associations with Depressive Symptoms, Social Anxiety, Peers, and Celebrities

OBJECTIVE

It is critical to examine the powerful socializing effects of networked media on early adolescents when social media use, body self-consciousness, and social comparisons are at their peak.

METHOD

Using 2 subsamples (N = 374 and N = 396) of those aged 11 to 14 years from a larger survey sample of 700 middle school participants in the Northeast United States, we conducted a cross-sectional pilot survey using brief, descriptive body dissatisfaction measures directly related to social media use.

RESULTS

Within our body dissatisfaction subsample, 19% reported dissatisfaction to body image issues. Participants' most common concerns around body image included not being thin enough, not attractive enough, and feeling dissatisfaction with body shape, hair, and face. The results from analysis of covariance analyses showed that those reporting social media-related body dissatisfaction checked their social media more frequently. When compared with those who did not feel negatively about their body image because of social media, those who did had higher rates of depressive symptoms, had online social anxiety, had found it harder to make new friends, and were more socially isolated. Those who followed celebrities checked social media more frequently and were more likely to have depressive symptoms and online social anxiety.

CONCLUSION

There may be negative socioemotional health consequences of early adolescent social media users with exposure to particular sources of social media content, such as photographs of celebrities.

Prospective associations between social status and social anxiety in early adolescence

This study examined the transactional longitudinal association between social status (likeability and popularity) and social anxiety symptoms (fear of negative evaluation and social avoidance and distress), and explored gender differences in this association. Participants included 274 adolescents (136 boys, M_age = 12.55). Data were collected at two waves with a 6‐month interval. Likeability and popularity were measured with peer nominations and social anxiety symptoms with self‐reports. Autoregressive cross‐lagged path models showed relative stability of social status and social anxiety. Girls who were seen as less popular by their classmates avoided social situations more frequently and experienced more distress during such situations over time. These results highlight the importance of distinguishing between different social status components and social anxiety symptoms and to take gender into account. Early support for less popular girls seems important to prevent more severe consequences of avoidance and distress, such as social exclusion and victimization.

The pattern of hospital-community-home (HCH) nursing in tracheostomy patients with severe traumatic brain injury: Is it feasible?

BACKGROUND

Tracheostomy is very common in patients with severe traumatic brain injury (TBI), long-term nursing care are needed for those patients. We aimed to evaluate the effects of hospital-community-home (HCH) nursing in those patients.

METHODS

This study was a before-after study design. Patients were divided into control groups (traditional nursing care) and HCH group(HCH nursing care). Tracheostomy patients with severe TBI needing long-term care were included. All patients underwent a two-month long follow-up. Glasgow coma score (GCS), Karnofsky, Self-Anxiety Scale (SAS) from caregiver and Barthel assessment at the discharge and two months after discharge were evaluated. The tracheostomy-related complications were recorded and compared.

RESULTS

A total of 60 patients were included. There were no significant differences between the two groups in the GCS, Karnofsky, SAS from caregiver and Barthel index at discharge((all P > .05); the GCS, Karnofsky and Barthel index were all significantly increased after two-month follow-up for the two groups (all P < .05), and the GCS, Karnofsky and Barthel index at two-month follow-up in HCH group were significantly higher than that of the control group(all P < .05), but the SAS from caregiver at two-month follow-up in HCH group was significantly less than that of the control group(P = .009). The incidence of block of artificial tracheal cannula and readmission in HCH group were significant less than that of control group (all P < .05).

CONCLUSION

HCH nursing care is feasible in tracheostomy patients with severe TBI, future studies are needed to further evaluate the role of HCH nursing care.

The Relationship between Social Anxiety, Smartphone Use, Dispositional Trust, and Problematic Smartphone Use: A Moderated Mediation Model

BACKGROUND

The pervasiveness of smartphones has raised concerns about an increase in the prevalence of problematic smartphone use (PSU), which depends on a set of psychological and behavioral risk factors. Previous research has yielded mixed results on factors predicting PSU, including social anxiety and trust. In particular, the role of trust remained largely unexplored. In the present study, we aimed to investigate the relationship between social anxiety and PSU, via the mediating role of time spent on the phone, and to explore the moderating role of dispositional trust toward others, by using a moderated mediation model with PSU as the outcome.

METHODS

A total of 240 young adults (M_age = 23.33, SD = 3.90, 50% male) answered an online questionnaire, which included the 12-item Social Anxiety Scale, a question on the daily duration of smartphone use, a single-item measure of dispositional trust, and the 10-item Smartphone Addiction Scale Short Version. Gender and occupational status were included as covariates.

RESULTS

Social anxiety was significantly and positively related to PSU; however, smartphone use did not mediate this relationship. Although the relationship between smartphone use and PSU was significant and positive, the link between social anxiety and smartphone use was not. Dispositional trust moderated and strengthened the direct relationships between social anxiety and PSU as well as smartphone use and PSU.

CONCLUSIONS

Heavy smartphone users as well as socially anxious individuals, with the tendency of trusting others, are more at risk of PSU, which can be explained by their preference and search for online connections.

A Multi-Method, Multi-Informant Test of Maternal Emotion Socialization in Relation to Adolescent Fears of Social Evaluation

Fears of negative and positive social evaluation are considered potential transdiagnostic mechanisms underpinning multiple internalizing disorders and impairments in adolescence. Although emotion socialization processes have been associated with adolescents' internalizing symptoms, the socialization of distinct fears of social evaluation has not been studied. Thus, the goal of the current study was to test whether mother's emotion expression, direct messages, responses to emotions, and parenting behaviors interact with adolescents' gender and temperamental shyness in relation to fears of negative and positive evaluation. A community sample of 107 adolescents ages 11 to 14 (M = 12.39; Girls = 45.8%) and their mothers completed survey measures of emotion socialization, temperament, and fears of social evaluation, in addition to participating in a speech preparation task used to code observed behaviors. For shy adolescents, adolescent-reported maternal cautious messages about social evaluation were associated with greater fears of positive evaluation, while encouraging messages were linked to less fears of positive evaluation. Further, maternal self-reported warmth was associated with fewer fears of negative and positive for shy adolescents, while supportive responses to emotions were linked to higher fears of positive evaluation for boys. Among girls, maternal ratings of encouraging messages were associated with higher fears of social evaluation, while cautious messages were linked to lower fears of negative evaluation. These findings are the first to consider several features of emotion socialization in relation to two distinct valences of adolescents' socio-evaluative fear, and highlight the importance of assessing emotion socialization behaviors via multiple informants and methods.

Internalizing Problems in Adolescence: Linking Loneliness, Social Anxiety Symptoms, and Depressive Symptoms Over Time

Adolescents are particularly vulnerable to experiencing loneliness, social anxiety symptoms, and depressive symptoms. These internalizing problems often co-occur but, until now, it remains unclear how they are associated over time. Insight in these temporal sequences is important to enhance our understanding of how internalizing problems arise and may reinforce each other over time. To examine these temporal sequences, three samples of adolescents were used: Sample 1 consisted of 1,116 adolescents (48.97% girls, M_age = 13.59), Sample 2 of 1,423 adolescents (52.42% girls, M_age = 13.79), and Sample 3 of 549 adolescents (62.66% girls, M_age = 14.82). Adolescents filled out well-established self-report measures of loneliness, social anxiety symptoms, and depressive symptoms during regular school hours at three measurement occasions with a 1-year interval. Meta-analytic techniques were used to estimate the average true effects across three-variable autoregressive cross-lagged models in the three samples. In addition, indirect effects and gender differences in the temporal associations were explored in all three samples. The results suggest that social anxiety symptoms play a crucial role as potential antecedent of emerging feelings of loneliness and depression in adolescence. In addition, in line with theoretical expectations, our results suggest the presence of a vicious cycle between adolescents' feelings of loneliness and social anxiety symptoms. The indirect effects were inconsistent across samples and no gender differences were found. These findings shed more light on the unique temporal relationships among different internalizing problems. Clinical interventions should target social anxiety symptoms to prevent feelings of loneliness and vice versa.

Changes in adolescent loneliness and concomitant changes in fear of negative evaluation and self-esteem

Current theories of loneliness posit that biases in social information processing play a key role in the development and maintenance of loneliness. However, this assumption has rarely been tested in longitudinal research in adolescence. The current study concentrated on two constructs associated with such biases, that is, fear of negative evaluation and self-esteem. More specifically, we examined whether changes in loneliness were associated with simultaneous changes in fear of negative evaluation and self-esteem. A sample of Dutch adolescents ( N = 1,174; 50% female) in Grades 7 to 10 completed well-established measures of loneliness, fear of negative evaluation, and self-esteem on four measurement occasions with yearly intervals. Correlations among both initial levels and rates of change for these three variables were examined using a Parallel Process Model (PPM). Adolescents scoring high on loneliness scored high on fear of negative evaluation, but low on self-esteem. Changes in loneliness were accompanied by changes in the same direction for fear of negative evaluation and in the opposite direction for self-esteem. These findings indicate that fear of negative evaluation and low self-esteem could indeed play a role in the development and maintenance of loneliness. Future research will need to clarify how exactly these variables can hamper re-affiliation efforts and lead to sustained loneliness over time.

Loneliness, Social Anxiety Symptoms, and Depressive Symptoms in Adolescence: Longitudinal Distinctiveness and Correlated Change

Loneliness, social anxiety symptoms, and depressive symptoms are internalizing problems that are highly intertwined and often co-occur during adolescence. This overlap and co-occurrence raises the question whether three different labels are used for the same underlying phenomenon. The present study adopts a comprehensive approach to this issue by investigating the development of the three phenomena simultaneously. Specifically, this study aimed to investigate (1) the developmental trend for all three internalizing problems separately, (2) whether they are best described by a single developmental trend, (3) how they co-develop across adolescence, and (4) gender differences in this co-development. The analyses were run in three three-wave longitudinal samples of adolescents with one-year intervals in order to verify the robustness of the findings. Sample 1 (roughly ages 15, 16, and 17) comprised 549 adolescents (63% girls), and Samples 2 and 3 (roughly ages 13, 14, and 15) comprised 811 adolescents (46% girls) and 1101 adolescents (52% girls), respectively. Latent growth curve modeling for the three phenomena separately showed either small increases or stable patterns. A comparison of a Multiple Indicator Latent Growth Model (MILGM) with a Parallel Process Latent Growth Curve Modeling (PPLGCM) showed that the three internalizing problems followed unique, but related, developmental trends across adolescence. The intercepts of the three phenomena were positively correlated with one another in all samples and increases in loneliness were associated consistently with increases in social anxiety symptoms. Only in Sample 3 evidence was found for a similar association between loneliness and depressive symptoms and between social anxiety symptoms and depressive symptoms. Except for differences in initial levels, gender differences in the development of the three problems were limited. Overall, the results of the present study clearly indicate that the three internalizing problems are longitudinally distinct from one another, but co-develop across adolescence.

Parenting Interacts with Oxytocin Polymorphisms to Predict Adolescent Social Anxiety Symptom Development: A Novel Polygenic Approach

Guided by a developmental psychopathology framework, research has increasingly focused on the interplay of genetics and environment as a predictor of different forms of psychopathology, including social anxiety. In these efforts, the polygenic nature of complex phenotypes such as social anxiety is increasingly recognized, but studies applying polygenic approaches are still scarce. In this study, we applied Principal Covariates Regression as a novel approach to creating polygenic components for the oxytocin system, which has recently been put forward as particularly relevant to social anxiety. Participants were 978 adolescents (49.4% girls; M_age T₁ = 13.8 years). Across 3 years, questionnaires were used to assess adolescent social anxiety symptoms and multi-informant reports of parental psychological control and autonomy support. All adolescents were genotyped for 223 oxytocin single nucleotide polymorphisms (SNPs) in 14 genes. Using Principal Covariates Regression, these SNPs could be reduced to five polygenic components. Four components reflected the underlying linkage disequilibrium and ancestry structure, whereas the fifth component, which consisted of small contributions of many SNPs across multiple genes, was strongly positively associated with adolescent social anxiety symptoms, pointing to an index of genetic risk. Moreover, significant interactions were found with this polygenic component and the environmental variables of interest. Specifically, adolescents who scored high on this polygenic component and experienced less adequate parenting (i.e., high psychological control or low autonomy support) showed the highest levels of social anxiety. Implications of these findings are discussed in the context of individual-by-environment models.

Gene-environment interaction: New insights into perceived parenting and social anxiety among adolescents

Background.

Social anxiety symptoms (SAS) are among the most common mental health problems during adolescence, and it has been shown that parenting influences the adolescent’s level of social anxiety. In addition, it is now widely assumed that most mental health problems, including social anxiety, originate from a complex interplay between genes and environment. However, to date, gene–environment (G × E) interactions studies in the field of social anxiety remain limited. In this study, we have examined how 274 genes involved in different neurotransmission pathways interact with five aspects of perceived parenting as environmental exposure (i.e., support, proactive control, psychological control, punitive control, and harsh punitive control) to affect SAS during adolescence.

Methods.

We have applied an analytical technique that allows studying genetic information at the gene level, by aggregating data from multiple single-nucleotide-polymorphisms within the same gene and by taking into account the linkage disequilibrium structure of the gene. All participants were part of the STRATEGIES cohort of 948 Flemish adolescents (mean age = 13.7), a population-based study on the development of problem behaviors in adolescence. Relevant genes were preselected based on prior findings and neurotransmitter-related functional protein networks.

Results.

The results suggest that genes involved in glutamate (SLC1A1), glutathione neurotransmission (GSTZ1), and oxidative stress (CALCRL), in association with harsh punitive parenting, may contribute to social anxiety in adolescence. Isolated polymorphisms in these genes have been related to anxiety and related disorders in earlier work.Conclusions: Taken together, these findings provide new insights into possible biological pathways and environmental risk factors involved in the etiology of social anxiety symptoms’ development.

Conclusions.

Taken together, these findings provide new insights into possible biological pathways and environmental risk factors involved in the etiology of social anxiety symptoms’ development.

“Who Am I” and “How Should I Be”: a Systematic Review on Self-Concept and Avatar Identification in Gaming Disorder

Purpose of Review

Gaming disorder (GD) appears to be associated with self-concept deficits and increased identification with one’s avatar. The goal of this literature review is to highlight study findings assessing psychological and neurobiological correlates of self-concept-related characteristics and avatar identification in GD.

Recent Findings

The review was based on three literature researches on GD: (1) self-esteem, (2) emotional, social, and academic self-concept domains and avatar identification, and (3) neurobiological correlates of self-concept and avatar identification. The results indicate that GD is associated with decreased self-esteem as well as deficits in physical, social, and emotional self-concept domains. A relatively stable relationship between higher avatar identification and GD was reported in addicted gamers. Furthermore, addicted gamers showed increased activation of brain regions associated with Theory-of-Mind processing while contemplating their own avatar.

Summary

The results point towards impairments in self-concept and increased identification with the virtual gaming character in addicted gamers. This virtual compensation fosters the formation of an idealized self-concept, which grows increasingly distant from their own self-image. Thus, additional empirically based psychological interventions should focus on the development of a realistic self-image by reducing the dysfunctional discrepancy between the ideal self and the real self.

Transactional Links Between Social Anxiety Symptoms and Parenting Across Adolescence: Between- and Within-Person Associations

This 4-year longitudinal multi-informant study examined between- and within-person associations between adolescent social anxiety symptoms and parenting (parental psychological control and autonomy support). A community sample of 819 adolescents (46.1% girls; Mage T1  = 13.4 years) reported annually on social anxiety symptoms and both adolescents and mothers reported on parenting. Between-person associations suggested that adolescent social anxiety symptoms were associated with higher adolescent- and mother-reported psychological control and lower mother-reported autonomy support. At the within-person level, however, mothers reported lower psychological control and higher autonomy support after periods with higher adolescent social anxiety symptoms. Our findings illustrate the importance of distinguishing among between-person and within-person associations and including perceptions of both dyad members in longitudinal research concerning parenting and adolescent mental health.

Temporal associations between social anxiety and depressive symptoms and the role of interpersonal stress in adolescents

BACKGROUND

Adolescence is characterized by an increased vulnerability for internalizing psychopathologies such as depression and anxiety. A positive association between anxiety and depression has consistently been found in research. However, the specific direction of this association is less clear. In this study, we investigated the temporal associations between (social) anxiety and depressive symptoms. Furthermore, the role of dependent interpersonal stress as a potential mediating factor in these temporal associations was examined.

METHODS

Data were part of a larger longitudinal study on the emotional development of adolescents, which was initiated in February 2013. The total sample consisted of 2011 adolescents between the ages of 11 and 19. Data were analyzed using cross-lagged models.

RESULTS

Bidirectional positive associations were found between social anxiety symptoms and depressive symptoms. However, dependent interpersonal stress was not a mediator in the link between social anxiety and depression. Our results indicate that dependent interpersonal stress seems to be particularly related to depressive symptoms and not to social anxiety symptoms.

CONCLUSIONS

Findings suggest that bidirectional associations between social anxiety and depressive symptoms exist. This implies that clinicians should be specifically vigilant for the development of depressive symptoms in socially anxious adolescents and the development of social anxiety symptoms in depressed adolescents. Our findings further highlight the importance of targeting dependent interpersonal stress in the context of depression.

Psychopathological Consequences Related to Problematic Instagram Use Among Adolescents: The Mediating Role of Body Image Dissatisfaction and Moderating Role of Gender

In a minority of cases, problematic use of technology can negatively impact on adolescents and impair some aspects of their social, emotional, and psychological development. The purpose of the present study was to examine the direct and indirect effects of problematic Instagram use (PIU) on different psychopathological outcomes including loneliness, depression, anxiety, and social anxiety via body image dissatisfaction (BID). Additionally, moderating role of gender on the relationships among variables was investigated. A total of 491 adolescents (Mage = 15.92 years, SDage = 1.07; range = 14 to 19 years) were recruited for the study to complete a questionnaire that included the relevant assessment tools for the aforementioned variables. Mediation and moderation analyses showed that among male adolescents, PIU was directly associated with loneliness, depression, general anxiety, and social anxiety and BID partially mediated these associations. Among females, PIU was directly associated with depression and indirectly with general anxiety and social anxiety via BID. Gender significantly moderated the direct relationships of PIU with loneliness, general anxiety, and social anxiety. PIU was directly associated with loneliness, general anxiety, and social anxiety among males only, whereas among females, PIU was indirectly associated with general and social anxiety via BID but was not related to loneliness. Results of this study indicate that PIU has different negative psychological effects on male and female adolescents and that BID appears to be one explanatory factor for these impairments especially among females.

Psychosocial factors mediating the relationship between childhood emotional trauma and internet gaming disorder: a pilot study

Internet gaming disorder (IGD) has been related to a wide range of detrimental psychological and health consequences. The purpose of the present pilot study was to test the direct and indirect relationships between IGD and emotional trauma, body image dissatisfaction, social anxiety, loneliness, depression, and self-esteem. A total of 242 online gamers completed a survey comprising a comprehensive battery of psychometric self-report scales concerning aforementioned variables. Results indicated that IGD was significantly correlated with all the variables except for body image dissatisfaction. Path analysis indicated an indirect relationship between childhood emotional trauma and IGD through depressive symptoms, while adjusting for gender, age, and number of hours gaming. The findings of the present study indicate that online gamers with a history of emotional abuse and/or neglect have higher levels of depressive symptoms, and that depressive symptoms are important risk factors of IGD.