Linear and curvilinear association of pain tolerance and social anxiety symptoms among youth with different subgroups of childhood trauma

BACKGROUND

Social anxiety is a common symptom that occurs after exposure to childhood trauma (CT), and pain tolerance is a protective factor against social anxiety in generic populations with CT. However, few studies have investigated whether and how this association varies across different CT subgroups. Thus, this study aimed to investigate (1) the effects of pain tolerance on social anxiety symptoms among youth with different subgroups of CT; (2) the nonlinear relationship between pain tolerance and social anxiety symptoms among different CT categories.

METHODS

In this study, 15,682 college or university students with experiences of CT were identified in a large sample and divided into five CT subgroups. Linear and quadratic regression models were conducted to explore the association between pain tolerance and social anxiety symptoms among youth with different CT subgroups.

RESULTS

The results of model revealed a linear relationship between pain tolerance and social anxiety symptoms among youth with most CT subgroups. Notably, an inverted U-shaped curve was found between pain tolerance and social anxiety symptoms in youth with emotional abuse. Social anxiety symptoms increased gradually with pain tolerance scores between 0 and 16, and then sharply decreased when scores reached above 16.

LIMITATIONS

Limited by self-report measurements, the results of this study focused only on perceived pain tolerance and ignored behavioral pain tolerance.

CONCLUSION

These findings highlight the importance of assessing pain tolerance thresholds in youth with emotional abuse and improving pain tolerance to prevent social anxiety symptoms in youth with different subgroups of CT.

Childhood psychological maltreatment and adolescent depressive symptoms: Exploring the role of social anxiety and maladaptive emotion regulation strategies

BACKGROUND

Despite emerging evidence for the effect of childhood psychological maltreatment on adolescent depressive symptoms, the underlying processes for this effect are largely under-investigated. This study examined a conceptual framework for the effect of childhood psychological maltreatment on adolescent depressive symptoms through social anxiety disorder (SAD) and maladaptive emotion regulation strategies.

METHODS

The participants were 1649 Chinese middle school students (751 girls and 898 boys) with a mean age of 16.29 ± 1.04 years old. A moderation-mediation model hypothesized that childhood psychological maltreatment predicts adolescent depressive symptoms, with SAD as a mediator and maladaptive emotion regulation strategies as a moderator.

RESULTS

Childhood psychological maltreatment significantly positively predicted adolescent depressive symptoms, while SAD mediated the relation. Maladaptive emotion regulation strategies moderated the pathways from psychological maltreatment to depressive symptoms (but not from psychological maltreatment to SAD) and from SAD to adolescent depressive symptoms.

LIMITATIONS

Subjective measures, and the cross-sectional design are the main limitations.

CONCLUSIONS

SAD plays a mediating role in the relation between childhood psychological maltreatment and depressive symptoms. Maladaptive emotion regulation strategies exacerbate the relation between childhood psychological maltreatment and depressive symptoms, as well as the relation between SAD and depressive symptoms. These results highlight the importance of addressing social anxiety in reducing adolescent depressive symptoms by improving their cognitive emotion regulation strategies.

Pathways from Trait Emotional Intelligence to factors of distress in Rosacea: The mediating role of Social Phobia and Self-Esteem

BACKGROUND

Rosacea is a skin disease characterized by facial erythema and inflammatory pustules that may result in emotional distress. Social Phobia and Self-Esteem appear to be linked to the development of higher levels of distress in dermatological conditions, while Trait Emotional Intelligence (Trait EI) has been consistently associated with greater levels of adaptation to one's chronic condition. Hence, it seems extremely relevant to observe the interplay between these dimensions in the context of Rosacea. The goal of the current study is to test the hypothesis that an association between Trait EI and General Distress, in individuals with Rosacea would be mediated by Self-Esteem and Social Phobia.

METHODS

Questionnaires were administered to 224 individuals suffering from Rosacea to assess Trait EI, Social Phobia, Self-Esteem, and General Distress.

RESULTS

Results highlighted that Trait EI was positively related to Self-Esteem and negatively related to Social Phobia and General Distress. In addition, both Self-Esteem and Social Phobia showed a mediating role in the relationship between Trait EI and General Distress.

LIMITATIONS

The main limitations of this work consist in the cross-sectional nature of the data, the small number of participants, also it was not possible to differentiate the participants according to the type of rosacea.

DISCUSSION

These results emphasize how individuals with Rosacea may be vulnerable to internalizing states and how high levels of Trait EI may constitute a protective factor for the onset of distressing states and it would be useful to create programs aimed at fostering Trait EI in Rosacea sufferers.

Emotions in social anxiety disorder: A review

Extant cognitive behavioral models of social anxiety disorder (SAD) have primarily focused on cognitions and behaviors that maintain the disorder. Emotional aspects of SAD have been investigated but have not been sufficiently integrated into current models. To facilitate such integration, we reviewed the literature on emotional constructs (emotional intelligence, emotional knowledge, emotional clarity, emotion differentiation, and emotion regulation), and discrete emotions (anger, shame, embarrassment, loneliness, guilt, pride, and envy) in SAD and social anxiety. We present the studies conducted on these constructs, summarize the main findings, suggest areas for future research, discuss the findings in the context of existing models of SAD and attempt to integrate the findings into these existing models of the disorder. Clinical implications of our findings are also discussed.

Examining the Latent Dimensions of Social Anxiety Disorder

While the body of literature has investigated the latent dimensions of Social Anxiety Disorder (SAD), only few have directly anchored in the DSM-5 SAD symptoms. Similarly, a continuing issue on measuring mental health disorders pertains to whether a symptom's frequency, intensity, or both, are appropriate and sufficient indicators of severity. To address this gap, the present study developed and validated a DSM-5-based measurement tool, the Social Anxiety Symptom Severity Inventory (SASSI), which assesses both the intensity (intensity of disturbance) and frequency (frequency of occurrence) of SAD symptoms. In study 1 (n = 6458, college students), the results revealed a two-factor structure using exploratory structural equation modeling. In study 2 (n = 425, left-behind emerging adults), confirmatory factor analysis, measurement invariance testing, and latent class analysis were used. Findings demonstrated the importance of using both frequency and intensity of symptoms in assessing SAD severity. Moreover, a five-class solution best fitted the sample. Studies 1 and 2 demonstrated the good psychometric properties of SASSI and filled an important gap among available measures in assessing SAD severity through symptom frequency and intensity.

Loneliness Versus Distress: A Comparison of Emotion Regulation Profiles

Loneliness, a negative emotion stemming from the perception of unmet social needs, is a major public health concern. Current interventions often target social domains but produce small effects and are not as effective as established emotion regulation (ER)-based interventions for general psychological distress (i.e., depression/anxiety). Given that loneliness and distress are types of negative affect, we aimed to compare them within an ER framework by examining the amount of variance ER strategies accounted for in loneliness versus distress, and comparing the ER strategy profiles characterising them. Participants (N = 582, Mage = 22.31, 77.66% female) completed self-report measures of loneliness, distress, and use of 12 cognitive (e.g., cognitive reappraisal) or behavioural (e.g., expressive suppression) ER strategies. Regression analyses revealed that ER explained comparable variance in these constructs. Latent profile analysis identified seven profiles differing in ER patterns, with no distinct loneliness or distress profile identified. Rather, similar patterns of ER characterised these two constructs, involving the greater use of generally maladaptive strategies and the lesser use of generally adaptive strategies. However, loneliness was additionally characterised by less use of strategies involving social connection/expression. Overall, our study supports the utility of ER for understanding loneliness. Established ER-based frameworks/interventions for distress may have transdiagnostic utility in targeting loneliness.

Risk Factors Associated With Social Media Addiction: An Exploratory Study

The use of social media is becoming a necessary daily activity in today’s society. Excessive and compulsive use of social media may lead to social media addiction (SMA). The main aim of this study was to investigate whether demographic factors (including age and gender), impulsivity, self-esteem, emotions, and attentional bias were risk factors associated with SMA. The study was conducted in a non-clinical sample of college students (N = 520), ranging in age from 16 to 23 years, including 277 females (53%) and 243 males (47%). All participants completed a survey measuring impulsivity, self-esteem, anxiety, depression, social anxiety, loneliness, and attentional bias. The final hierarchical regression model indicated significant risk factors for SMA with an accuracy of 38%. The identified set of associated risk factors included female gender (β = −0.21, t = −4.88, p < 0.001), impulsivity (β = 0.34, t = 8.50, p < 0.001), self-esteem (β = −0.20, t = −4.38, p < 0.001), anxiety (β = 0.24, t = 4.43, p < 0.001), social anxiety (β = 0.25, t = 5.79, p < 0.001), and negative attentional biases (β = 0.31, t = 8.01, p < 0.001). Finally, a discussion of the results is presented, followed by corresponding recommendations for future studies.

Family Function, Loneliness, Emotion Regulation, and Hope in Secondary Vocational School Students: A Moderated Mediation Model

This study explored family function as a key factor of loneliness, hope, and emotion related to secondary vocational school students during the novel coronavirus pandemic. Chinese versions of the Olson Family Function Scale, Russell Loneliness Scale, Snyder Hope Scale, and Gross Emotion Regulation Scale were completed by 5,138 participants. Guardian type significantly predicted family function and loneliness. Family function significantly and positively correlated with loneliness. The relationship between family function and loneliness was mediated by hope, and expressive suppression concurrently moderated the relationship between hope and loneliness. Our study offers meaningful insights into the family function of Chinese secondary vocational school students. The findings supported a moderated mediation model that exemplifies the relationship between family function, loneliness, expressive suppression, and hope. Although the results showed that high hope mediated lower family functioning and loneliness, low expressive suppression led to intense loneliness immediately. This study confirms that emotional strategy is important and associated with mental health. It also suggests that schools should pay more attention to students' emotion regulation and help them rebuild hope or appropriate cognition to relieve loneliness during crisis events.

Examining the Link Between Multidimensional Perfectionism and Depression: A Longitudinal Study of the Intervening Effects of Social Disconnection

Introduction: The Perfectionism Social Disconnection Model (PSDM) posits that perfectionism confers risk for depression by promoting social disconnection. However, the specific indirect effect of social disconnection on the prospective relation of perfectionism dimensions with depression severity is not well understood. The aim of the current study was to provide the first comprehensive examination of the PSDM. Methods: A diverse community sample of 447 completed measures of trait perfectionism, perfectionistic self-presentation styles, and depressive symptoms at baseline. Six months later, participants completed measures of perfectionistic self-presentation styles, social disconnection, and depressive symptoms. Indirect effects models were analyzed to examine the impact of each facet of perfectionism on social disconnection and subsequent depression severity. Results: Consistent with the PSDM, all perfectionism traits and self-presentation styles resulted in greater depression severity via one or more facets of social disconnection, with social hopelessness and loneliness demonstrating the most widespread effects. Furthermore, perfectionistic self-presentation styles and social disconnection demonstrated sequential indirect effects on the relation of self-oriented and socially prescribed perfectionism with depressive symptoms at follow-up. Discussion: This study is the first to demonstrate the depressogenic effects of all perfectionism dimensions. Findings delineate the interpersonal mechanisms underlying the perfectionism-depression link.

The link between social anxiety and intimate loneliness is stronger for older adults than for younger adults

OBJECTIVES

The current study focuses on the association between social anxiety (e.g. fear of social interactions or negative judgment by others) and intimate loneliness (lacking meaningful relationships, i.e. having low quantity/quality of intimate companionship) in older and younger adults. We assessed whether social anxiety, a factor which hampers intimacy, may be associated with intimate loneliness to a greater extent in older adults versus younger adults.

METHOD

Measures of loneliness (Revised UCLA loneliness scale) and social anxiety (Leibowitz social anxiety scale) were obtained from 342 participants (220 younger adults, age = 19-40, and 122 older adults, age = 61-89).

RESULTS

Age differences were evident for non-intimate types of loneliness but not for intimate loneliness. Further, older adults were less socially anxious. Critically, the strength of the social anxiety-intimate loneliness link was more robust among older adults. Effects remained significant after controlling for demographic and computer/social media variables.

CONCLUSIONS

Older adults with high levels of social anxiety displayed greater intimate loneliness relative to younger adults. On a theoretical level, the results reveal that the pruning mechanism of investing more in closer and more rewarding relationships among older adults may be challenged under high social anxiety. The results suggest that older adults with higher intimate loneliness may benefit from interventions aimed at decreasing their social anxiety.

Awakening to recognize the detrimental effects of social avoidance and the possibility of healing through reconnection

BACKGROUND

Loneliness and social avoidance are widespread and serious mental health problems. People experiencing loneliness or social avoidance have difficulties maintaining ordinary life activities and often experience profound suffering. How do we as clinicians deal with or help people out of loneliness and social avoidance?

AIMS

In this paper, we introduce the issue on loneliness and social avoidance. We do so by first defining loneliness and social avoidance and outlining the impact on mental health issues of these phenomena. Next, we introduce the six papers central to the special issue along with some thoughts on how to understand therapy and treatment of social avoidance.

DISCUSSION

We discuss new directions and how to move beyond more conventional therapeutic approaches to these problems.