Oral hygiene effects verbal and nonverbal displays of confidence

Although oral hygiene is known to impact self-confidence and self-esteem, little is known about how it influences our interpersonal behavior. Using a wearable, multi-sensor device, we examined differences in consumers' individual and interpersonal confidence after they had or had not brushed their teeth. Students (N = 140) completed nine one-to-one, 3-minute "speed dating" interactions while wearing a device that records verbal, nonverbal, and mimicry behavior. Half of the participants brushed their teeth using Close-Up toothpaste (Unilever) prior to the interactions, whilst the other half abstained from brushing that morning. Compared to those who had not brushed their teeth, participants who had brushed were more verbally confident (i.e., spoke louder, over-talked more), showed less nonverbal nervousness (i.e., fidgeted less), and were more often perceived as being "someone similar to me." These effects were moderated by attractiveness but not by self-esteem or self-monitoring.

Treatment Options for Fear of Blushing

PURPOSE OF REVIEW

To review mechanisms of blushing and fear of blushing from physiological, neuropharmacological and psychological viewpoints, and to evaluate current forms of treatment for blushing-related fear.

RECENT FINDINGS

Blushing appears to be driven primarily by sympathetic adrenomedullary and neural vasodilator discharge, possibly in association with secondary neurovascular inflammation. Psychological risk factors for fear of blushing include social anxiety, coupled with heightened self-focused attention and inflated beliefs about the likelihood and social costs of blushing. In addition, schemas of emotional inhibition, social isolation and alienation may underlie blushing-related fears. Established psychological treatments for fear of blushing include task concentration training, exposure, cognitive therapy, social skills training, psychoeducation and applied relaxation. More novel approaches include mindfulness and mindful self-compassion, video feedback and imagery rescripting. There are no established pharmacological treatments specifically for fear of blushing. However, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are effective treatments for social anxiety disorder and may thus help some patients manage their fear of blushing. A reactive sympathetic nervous system may interact with psychological predispositions to intensify fear of blushing. These physiological and psychological risk factors could be promising targets for treatment.

Bumping heart and sweaty palms: physiological hyperarousal as a risk factor for child social anxiety

BACKGROUND

Physiological hyperarousal in social situations is a characteristic of individuals with social anxiety disorder (SAD), but so far it has been rarely studied as a biological risk for SAD. Here, we investigate whether children at high risk for SAD (because of their parents' SAD) display physiological hyperarousal while interacting with a stranger. Also, we examine whether early physiological hyperarousal is related to later child social anxiety.

METHOD

One hundred and seventeen children took part in the stranger-approach task when they were 2.5 and 4.5 years old. Heart rate (HR), heart rate variability (HRV), and electrodermal activity (EDA) were measured before, during, and after the conversation with a stranger. Both parents' lifetime SAD status and SAD severity were assessed before the birth of the child. Both parents and children reported on children's social anxiety symptoms when children were 7.5.

RESULTS

Children of parents with the lifetime SAD diagnosis did not differ in their physiological activity from children of parents without lifetime SAD. However, children of parents with more severe SAD displayed heightened EDA throughout the task procedure. Increased HR and reduced HRV during the stranger-approach and elevated EDA throughout the task phases were linked to later child social anxiety.

CONCLUSIONS

Parents' severity of SAD is related to child physiological hyperarousal early in their childhood. In addition, physiological hyperarousal in early childhood predicts later child social anxiety. Together, these findings suggest that early physiological hyperarousal in social situations may pose a risk for later child social anxiety and that physiological hyperarousal, and EDA in particular, may be a biological mechanism in the intergenerational transmission of SAD.

Role of surgical thoracic sympathetic interruption in treatment of facial blushing: a systematic review

OBJECTIVES

This paper aims to review the evidence to support the effectiveness of sympathectomy as a treatment for facial blushing in terms of relief of facial blushing, patient satisfaction, recurrence of blushing, patients regretting treatment and its associated complications.

METHODS

A systematic search strategy was performed in Ovid-Medline, Embase, Cochrane library and NICE. Studies reporting outcomes of sympathetic interruption in the treatment of facial blushing were retrieved.

RESULTS

Nine studies met the inclusion criteria with 1369 patients included in the final analysis. The age range of patients was 8 to 74 years (from 7 studies) with 56% females. Mean follow up was 21 months in 8 studies (range 6 to 30 months). The pooled proportion of patients who had good relief of facial blushing was 78.30% (95% C.I. 58.20% - 98.39%). Complete satisfaction was reported in 84.02% (95% C.I. 71.71% - 96.33%). Compensatory sweating and gustatory sweating were the commonest complications occurring in 74.18% (95% C.I. 58.10% - 90.26%) and 24.42% (95% C.I. 12.22% - 36.61%) respectively. The estimated proportion of patients regretting surgery was 6.79% (C.I 2.08% 11.50%).

CONCLUSION

Sympathetic interruption at T2 or T2-3 ganglia appears to be an effective treatment for facial blushing. However, lack of randomized trials comparing sympathetic interruption with non-surgical methods of treatment and heterogeneity of included studies with respect to assessment of outcome measures preclude strong evidence and definitive recommendations.

Determinants of Perceived Stress in Individuals with Obesity: Exploring the Relationship of Potentially Obesity-Related Factors and Perceived Stress

OBJECTIVE

Associations of specific types of stress with increased food intake and subsequent weight gain have been demonstrated in animal models as well as in experimental and epidemiological studies on humans. This study explores the research question of to what extent potentially obesity-related factors determine perceived stress in individuals with obesity.

METHODS

N = 547 individuals with obesity participated in a cross-sectional study assessing perceived stress as the outcome variable and potential determinants of stress related to obesity. Based on the available evidence, a five factorial model of 'obesity-related obesogenic stressors' was hypothesized, including the dimensions, 'drive for thinness', 'impulse regulation', 'ineffectiveness', 'social insecurity', and 'body dissatisfaction'. The model was tested using multiple linear regression analyses.

RESULTS

The five factorial model of 'potentially obesity-related stressors' resulted in a total variance explanation of adjusted R² = 0.616 for males and adjusted R² = 0.595 for females for perceived stress. The relative variance contribution of the five included factors differed substantially for the two sexes.

CONCLUSION

The findings of this cross-sectional study support the hypothesized, potentially obesity-related factors: 'drive for thinness', 'impulse regulation', 'ineffectiveness', 'social insecurity', and 'body dissatisfaction' as relevant determinants of perceived stress in individuals with obesity.

Through rose-coloured glasses: An empirical test of narcissistic overestimation

BACKGROUND

Grandiosity is designated as a hallmark trait of narcissism. The current study tested whether narcissistic traits are related to overestimation of a range of agentic performances.

METHOD

Eighty-five non-patients executed six objective tasks to assess their level of (emotional) intelligence, first impression, attractiveness, social skills and learning performance. They were also asked to estimate their level of functioning in these six areas. This estimation was given on two moments: before and after performing the objective tasks. Our main variable of interest was the degree to which subjective estimation exceeds objective scores.

RESULTS

Narcissistic traits were related to overestimation of (emotional) intelligence, attractiveness and social skills, particularly at a global level before performing the tasks.

LIMITATIONS

The use of a homogenous student sample; Mainly agentic performances, were studied.

CONCLUSION

Overall, the findings provide a theoretical validation of unwarranted feelings of grandiosity as a core narcissistic criterion. Copyright © 2016 John Wiley & Sons, Ltd.

Social blushing: a neuropsychiatric disorder?

Until recently, social blushing was rarely discussed in the medical literature. It was usually considered only a normal and occasional physiological reaction associated with emotions such as embarrassment brought on by social situations. This has changed in recent years with attention increasingly being paid to blushing, either in the context of social anxiety disorder or in its own right. Some argue that blushing has adaptive value, so it may not make sense to treat people for blushing, a view we do not agree with since the blushing experience is not the same for everyone and those who seek medical help do so because their blushing impairs their quality of life. Furthermore, the fact that a symptom is adaptive does not place it beyond the scope of medical treatment. Quite the contrary: physicians treat many symptoms that cause discomfort, e.g. pain and vomiting, which may be regarded as adaptive, yet few doubt the value of treating such problems. The same is true for blushing. Recognizing its potential adaptive value does not mean that it should not be treated. The distress of those who blush easily and seek help justifies attempts to find ways to help them. This article underlines the need to distinguish between normal social blushing and pathological social blushing and, at the same time, reviews current available treatments for individuals who seek help for this condition.

Recent Insight Into the Subtypes of Social Anxiety Disorder

Systems for subtyping individuals with social anxiety disorder have been the focus of much research attention as a means to improve assessment and treatment of the disorder. This article highlights recent revisions to social anxiety disorder (SAD) subtypes from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to DSM-V, reviewing empirical evidence that served as the impetus for the revisions. Recent research examining the validity of the DSM-V system and alternative subtyping systems is reviewed. Overall, there appears to be greater empirical support for a dimensional subtyping system. Concerns therefore remain with the DSM-V system, which retained a categorical system but replaced the previous subtypes with a subtype of individuals fearing only performance situations. Recommendations for future research are discussed, as well as alternate options for capturing the variability in SAD presentations, including the possibility of eliminating subtyping altogether.

Psychodynamic psychotherapy versus cognitive behavior therapy for social anxiety disorder: an efficacy and partial effectiveness trial

OBJECTIVES

Comparing the overall and differential effects of psychodynamic psychotherapy (PDT) versus cognitive behavior therapy (CBT) for social anxiety disorder (SAD).

DESIGN

Patients with a primary SAD (N = 47) were randomly assigned to PDT (N = 22) or CBT (N = 27). Both PDT and CBT consisted of up to 36 sessions (average PDT 31.4 and CBT 19.8 sessions). Assessments took place at waitlist: pretest, after 12 and 24 weeks for those who received longer treatment: posttest, 3-month and 1-year follow-up.

METHODS

Changes in the main outcome measure self-reported social anxiety composite, as well as in other psychopathology, social skills, negative social beliefs, public self-consciousness, defense mechanisms, personal goals, independent rater's judgments of SAD and general improvement, and approach behavior during an objective test, were analyzed using multilevel analysis.

RESULTS

No improvement occurred during waitlist. Treatments were highly efficacious, with large within-subject effect sizes for social anxiety, but no differences between PDT and CBT on general and treatment-specific measures occurred. Remission rates were over 50% and similar for PDT and CBT. Personality disorders did not influence the effects of PDT or CBT.

CONCLUSIONS

PDT and CBT are both effective approaches for SAD. Further research is needed on the cost-effectiveness of PDT versus CBT, on different lengths PDT, and on patient preferences and their relationship to outcome of PDT versus CBT.

The effect of facial blood flow on ratings of blushing and negative affect during an embarrassing task: preliminary findings

Expecting to blush is a common source of social anxiety, and is associated with heightened perceptions of blushing and embarrassment. To assess whether sensory cues associated with heightened facial blood flow are an additional source of anxiety, the vasodilator niacin (100mg) or placebo was administered double-blind to 33 participants, and facial blood flow was investigated when they sang a children's song. Vasodilatation during singing was greater in the niacin than placebo condition, and niacin-evoked flushing and increases in pulse rate were greater in participants with high than low fear of negative evaluation. Nevertheless, ratings of embarrassment, anxiety, blushing and facial heat were similar in both drug conditions. This dissociation implies that cognitive appraisals or negative affect overrode more subtle physiological cues of blushing during embarrassment. Clarifying how judgments about blushing are made could be crucial for correcting faulty assumptions about blushing in people who are frightened of this response.

Dealing with fear of blushing: a psychoeducational group intervention for fear of blushing

The clinical impression is that people who fear blushing do not easily seek psychological help for their complaints. Therefore, we designed a low-threshold psychoeducational group intervention to reduce fear of blushing. The intervention followed a cognitive-behavioural approach, but in a course setting, e.g., with 'participants' and 'teachers' instead of 'patients' and 'therapists'. The effectiveness of the course in reducing fear of blushing and social anxiety was tested in a group of blushing-fearful individuals (n = 47) by using an uncontrolled study design. The course consisted of six weekly sessions and one booster session 3 months after the last regular session. Assessments took place upon application, immediately before the intervention, after the sixth session, before the booster session, and at 1-year follow-up. Results showed that the course was effective in reducing fear of blushing as well as symptoms of social anxiety. The positive effect of the course on anxiety measures suggests that it might be a promising approach for treating fear of blushing.

KEY PRACTITIONER MESSAGE

The course 'dealing with fear of blushing' is a cognitive-behavioural group intervention in a course setting, e.g., with 'participants' and 'teachers' instead of 'patients' and 'therapists'. The course was effective in reducing anxiety complaints. An effect size of 1.4 and a reduction of approximately 30 points on this Blushing, Trembling and Sweating Questionnaire are comparable with what was reported for individual cognitive-behavioural treatments. Participants evaluated the course positively.

What determines observer-rated social performance in individuals with social anxiety disorder?

Clark and Wells (1995) proposed that cognitive variables and safety behaviors are related to social performance in social anxiety disorder (SAD). Here, we tested this relationship by concurrent assessment of cognitive, behavioral, and physiological variables and social performance in a prototypical social interaction situation. 103 participants with SAD and 23 healthy controls interacted with a confederate. Anxiety, self-focused attention, cognitions, and safety behaviors were assessed by self-report and by confederate ratings. Social performance was evaluated by independent observers using a behavioral coding system. Social performance was predicted using two regression models for self-report and confederate ratings. Between-group differences in social performance disappeared when talking time was taken into account. Talking time emerged as the most powerful predictor of social performance (54% and 58% accounted variance). Positive cognitions, self-focused attention and safety behaviors accounted for an additional, but marginal amount of variance. Reduced talking time might represent a safety behavior and may be considered an easy to measure final common behavioral outcome of cognitive processes underlying social anxiety.

Social anxiety disorder: questions and answers for the DSM-V

BACKGROUND

This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues.

METHOD

A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V.

RESULTS/CONCLUSIONS

Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a "predominantly performance" variety of SAD. A specifier based on "fear of showing anxiety symptoms" (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options.