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Dreyer-Oren SE, Das A, Geyer RB, Fite RE, Kiel EJ, Clerkin EM. Transitioning to college: Testing cognitive bias modification for interpretations as an inoculation tool for social anxiety in college first-years. J Behav Ther Exp Psychiatry 2024; 84:101961. [PMID: 38489952 DOI: 10.1016/j.jbtep.2024.101961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 01/09/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND AND OBJECTIVES Reducing social anxiety development among incoming college students may improve college adjustment and mental health outcomes. This study tested whether cognitive bias modification for interpretations (CBM-I) reduces social anxiety and increases adjustment during the transition to college, and whether changes in outcomes would be mediated by changes in interpretation biases. METHODS Participants (N = 73) were randomly assigned to a 3-session weekly CBM-I condition or symptom tracking (ST) control condition. Multilevel models were used to estimate within-person trajectories from baseline to one week post-intervention and to test whether trajectories differed by condition. RESULTS Those in the CBM-I condition (vs. ST) reported higher increases in social adjustment across time. There were not significant differences between conditions for changes in social anxiety, academic adjustment, and personal adjustment. CBM-I was indirectly linked to improvements in outcome variables via more adaptive interpretation biases. LIMITATIONS CBM-I was administered in a laboratory setting, requiring more resources than some computerized interventions. CONCLUSIONS Data tentatively support CBM-I for first-year students to increase social adjustment. Further, mediation findings provide support for targeting interpretation biases to improve social anxiety and adjustment outcomes. Yet, CBM-I did not outperform ST in improving social anxiety symptoms or other areas of college adjustment, and effect sizes were small, suggesting that more work is needed to amplify the potential of CBM-I as a therapeutic tool.
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Affiliation(s)
- Sarah E Dreyer-Oren
- Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA.
| | | | | | - Robert E Fite
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
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Lee D, Jung YH, Kim S, Lee YI, Ku J, Yoon U, Choi SH. Alterations in cortical thickness of frontoparietal regions in patients with social anxiety disorder. Psychiatry Res Neuroimaging 2024; 340:111804. [PMID: 38460394 DOI: 10.1016/j.pscychresns.2024.111804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/26/2023] [Accepted: 02/20/2024] [Indexed: 03/11/2024]
Abstract
Although functional changes of the frontal and (para)limbic area for emotional hyper-reactivity and emotional dysregulation are well documented in social anxiety disorder (SAD), prior studies on structural changes have shown mixed results. This study aimed to identify differences in cortical thickness between SAD and healthy controls (CON). Thirty-five patients with SAD and forty-two matched CON underwent structural magnetic resonance imaging. A vertex-based whole brain and regional analyses were conducted for between-group comparison. The whole-brain analysis revealed increased cortical thickness in the left insula, left superior parietal lobule, left superior temporal gyrus, and left frontopolar cortex in patients with SAD compared to CON, as well as decreased thickness in the left superior/middle frontal gyrus and left fusiform gyrus in patients (after multiple-correction). The results from the ROI analysis did not align with these findings at the statistically significant level after multiple corrections. Changes in cortical thickness were not correlated with social anxiety symptoms. While consistent results were not obtained from different analysis methods, the results from the whole-brain analysis suggest that patients with SAD exhibit distinct neural deficits in areas involved in salience, attention, and socioemotional processing.
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Affiliation(s)
- Dasom Lee
- Department of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ye-Ha Jung
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Suhyun Kim
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, Gyeongbuk, Republic of Korea
| | - Yoonji Irene Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeonghun Ku
- Department of Biomedical Engineering, Keimyung University, Gyeongsan-si, Gyeongbuk, Republic of Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, Gyeongbuk, Republic of Korea.
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
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Duque RH, Andrade CVC, Campos VR, Moulaz IR, Albertino LF, de Oliveira Gavi MBR. Cross-sectional study of psychiatric disorders in patients with chronic musculoskeletal pain and individuals without pain. Adv Rheumatol 2024; 64:40. [PMID: 38730423 DOI: 10.1186/s42358-024-00375-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Musculoskeletal chronic pain is a leading cause of global disability and laboral incapacity. However, there is a lack of population-based studies that investigate the relationship between chronic pain and mental disorders with a control group, particularly among low- and middle-income countries. Chronic pain is a serious public health problem in terms of human suffering, and in terms of socioeconomic implications. Frequent association with different mental disorders increases disability, decreases quality of life, and makes diagnosis and treatment challenging. The present study aimed to evaluate the presence of mental disorders in patients with chronic musculoskeletal pain and compare with a control group without pain. METHODS We selected 100 patients in a regular follow-up at the Musculoskeletal Pain Outpatient Clinic of the University Hospital and compared them with 100 painless individuals from the control group from June 2016 to June 2018. The instruments used were the Mini International Neuropsychiatric Interview (MINI-PLUS) and a structured questionnaire to collect sociodemographic data. Statistical analysis used t-test, chi-square, Fisher's exact test, Mann-Whitney, Kolmogorov-Smirnov tests, and multiple logistic regression. RESULTS In the sample evaluated, the majority of patients were women (83%), of brown color (54%), with lower-level education (51%), lower salary range (73%) and high absenteeism rate at work (60,7%). Patients with chronic pain had more psychiatric disorders (88% vs. 48% in the control group; p < 0.001). The most frequent diagnoses were anxiety disorders with panic attacks (44%), generalized anxiety (36%), mixed anxiety and depression disorder (33%), social phobia (30%), agoraphobia (29%), suicide risk (28%), and major depression (27%). CONCLUSION Positive correlations of mental disorders and chronic musculoskeletal pain have been documented. This suggests that psychiatric components must be taken into account in the management of chronic pain syndromes. The use of Mini Plus as a diagnostic tool for psychiatric disorders can contribute to optimizing the diagnosis and treatment of patients with chronic pain and encourage the creation of policies with strategies and criteria for quick access to Multi-professional Services.
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Affiliation(s)
- Ruben Horst Duque
- Rheumatology Department, University Hospital Cassiano Antonio Moraes, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Carla Vasconcelos Cáspar Andrade
- Neuromusculoskeletal Unit, University Hospital Cassiano Antonio Moraes, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Valdir Ribeiro Campos
- Psychiatry Service, Internal Medicine Department, University Hospital Cassiano Antonio Moraes, Federal University of Espirito Santo, Vitoria, ES, Brazil
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Kato TA, Sartorius N, Shinfuku N. Shifting the paradigm of social withdrawal: a new era of coexisting pathological and non-pathological hikikomori. Curr Opin Psychiatry 2024; 37:177-184. [PMID: 38415743 PMCID: PMC10990035 DOI: 10.1097/yco.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Social withdrawal syndrome, known as "hikikomori," has been highlighted since the late 1990 s in Japan. Hikikomori is more common in urban areas, and often comorbid with mental disorders, and now spreading throughout the world. In the post-COVID-19 era, not outing is no longer considered pathological in itself as the "new normal," and a novel concept of hikikomori is needed. This review summarizes the concept of hikikomori, and presents the latest methods for identification of hikikomori. RECENT FINDINGS The novel definition can distinguish between pathological and non-pathological hikikomori using the scale of "Hikikomori Diagnostic Evaluation (HiDE)," which has been developed in the hikikomori research lab at Kyushu University. An online survey among non-working adults has revealed that persons who have become pathological hikikomori for less than three months showed a particularly strong tendency toward gaming disorder and depression. SUMMARY Now, physical isolation itself is not pathological, but when dysfunction and distress are present, rapid mental health support should be provided. In the novel urban society, the establishment of a checkup system to assess whether persons who stay home are happy or suffering is important for prevention against mental disorders triggered by social isolation.
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Affiliation(s)
- Takahiro A. Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University
- Mood Disorder & Hikikomori Clinic, Kyushu University Hospital
- Hikikomori Research Lab, Kyushu University, Fukuoka, Japan
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programs, Geneva, Switzerland
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Mizzi S, Pedersen M, Rossell SL, Rendell P, Terrett G, Heinrichs M, Labuschagne I. Resting-state amygdala subregion and precuneus connectivity provide evidence for a dimensional approach to studying social anxiety disorder. Transl Psychiatry 2024; 14:147. [PMID: 38485930 PMCID: PMC10940725 DOI: 10.1038/s41398-024-02844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/12/2024] [Accepted: 02/20/2024] [Indexed: 03/18/2024] Open
Abstract
Social anxiety disorder (SAD) is a prevalent and disabling mental health condition, characterized by excessive fear and anxiety in social situations. Resting-state functional magnetic resonance imaging (fMRI) paradigms have been increasingly used to understand the neurobiological underpinnings of SAD in the absence of threat-related stimuli. Previous studies have primarily focused on the role of the amygdala in SAD. However, the amygdala consists of functionally and structurally distinct subregions, and recent studies have highlighted the importance of investigating the role of these subregions independently. Using multiband fMRI, we analyzed resting-state data from 135 participants (42 SAD, 93 healthy controls). By employing voxel-wise permutation testing, we examined group differences of fMRI connectivity and associations between fMRI connectivity and social anxiety symptoms to further investigate the classification of SAD as a categorical or dimensional construct. Seed-to-whole brain functional connectivity analysis using multiple 'seeds' including the amygdala and its subregions and the precuneus, revealed no statistically significant group differences. However, social anxiety severity was significantly negatively correlated with functional connectivity of the precuneus - perigenual anterior cingulate cortex and positively correlated with functional connectivity of the amygdala (specifically the superficial subregion) - parietal/cerebellar areas. Our findings demonstrate clear links between symptomatology and brain connectivity in the absence of diagnostic differences, with evidence of amygdala subregion-specific alterations. The observed brain-symptom associations did not include disturbances in the brain's fear circuitry (i.e., disturbances in connectivity between amygdala - prefrontal regions) likely due to the absence of threat-related stimuli.
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Affiliation(s)
- Simone Mizzi
- School of Health and Biomedical Science, RMIT University, Melbourne, VIC, Australia.
| | - Mangor Pedersen
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
- Psychiatry, St Vincent's Hospital, Fitzroy, Australia
| | - Peter Rendell
- Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Australian Catholic University, Fitzroy, Australia
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Gill Terrett
- Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Australian Catholic University, Fitzroy, Australia
| | - Markus Heinrichs
- Department of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center, University Medical Center, Albert-Ludwigs University of Freiburg, Freiburg, Germany
| | - Izelle Labuschagne
- Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Australian Catholic University, Fitzroy, Australia.
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
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Shatz H, Asher M, Aderka IM. Catching a (sine) wave: Temporal dynamics of nonverbal synchrony in social anxiety disorder. J Anxiety Disord 2024; 102:102828. [PMID: 38245962 DOI: 10.1016/j.janxdis.2024.102828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/24/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Individuals with social anxiety disorder (SAD) experience a range of interpersonal problems and studies have found that nonverbal synchrony (the coordination between interaction partners' movements) may be impaired in dyads in which one individual has SAD (Asher et al., 2020). In the present study, we examined the temporal dynamics of nonverbal synchrony during "getting aquatinted" conversations of individuals with and without SAD. Specifically, participants (n = 146) formed either SAD dyads (dyads in which one individual had SAD and the other did not; n = 37 dyads), or control dyads (dyads in which both individuals did not have SAD; n = 36 dyads). Dyads were randomized to either small talk or closeness-generating (i.e., intimate) conversations. We found that during conversations, nonverbal synchrony followed a repeating pattern of increases and decreases that was best modeled by a sinusoidal wave (explained variance = 63.74 %). We found significant Diagnosis × Social Context interactions in the temporal dynamics of nonverbal synchrony (i.e., in the parameters of sine waves). Specifically, we found that for SAD dyads (but not control dyads), the average sine wave amplitude which indicates increases and decreases in nonverbal synchrony was greater during small talk conversations compared to closeness-generating conversations. In addition, we found that among control dyads (but not SAD dyads), the average vertical offset of sine waves (i.e., the average level of nonverbal synchrony) during closeness-generating conversations was greater compared to small talk conversations. The findings are interpreted within the context of the social anxiety literature as capturing two distinct social-anxiety related processes, and suggest that when examined temporally (rather than averaged), nonverbal synchrony may be an important implicit biomarker of SAD.
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Affiliation(s)
- Hallel Shatz
- School of Psychological Sciences, University of Haifa, Israel
| | - Maya Asher
- School of Psychological Sciences, University of Haifa, Israel
| | - Idan M Aderka
- School of Psychological Sciences, University of Haifa, Israel.
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Hai R, Wong PWC. Emerging trends in Hikikomori behaviour among young people in China: Implications for research and policy. Asian J Psychiatr 2024; 93:103925. [PMID: 38232442 DOI: 10.1016/j.ajp.2024.103925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/19/2024]
Affiliation(s)
- Ri Hai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Paul Wai-Ching Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
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Adu P, Jurcik T, Demah E, Korang PT, Grigoryev D. Mental health literacy for social phobia in Ghana: Investigation of gender stereotypes and previous experience for recognition rates and prejudice. Int J Soc Psychiatry 2024; 70:271-281. [PMID: 37968913 PMCID: PMC10913351 DOI: 10.1177/00207640231206055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND Mental health literacy (MHL) research has been of substantial interest internationally. Nevertheless, the interplay between beliefs, attitudes, previous experience with mental disorders, and knowledge of Ghanaians on specific mental disorders remains to be understood. The present study explored the interconnectedness between gender stereotypes, prejudice, previous experience with social phobia, and MHL among the general population in Ghana. METHOD Six hundred and one Ghanaians were recruited for an online experimental study design using a survey approach for data gathering. Respondents were randomly assigned to one of the two conditions (i.e., male and female vignettes) depicting symptoms of social phobia for a hypothetical person. Participants further completed self-reported measures including gender stereotypes (based on Ambivalent Sexism Inventory) and prejudice. RESULTS Results revealed a 15.5% recognition rate for social phobia. Recognition rates of social phobia did not differ by the experimental condition or by the gender of participants. However, personal experience of social phobia was positively related to an increased likelihood of correctly labeling social phobia among men in the female vignette condition, whereas correct recognition of social phobia was negatively related to prejudice among women in the male vignette condition. In the male vignette condition, men with more hostile sexism attitudes toward men exhibited more prejudice toward their hypothetical male counterpart. In contrast, women with hostile sexism attitudes toward men exhibited less prejudice, but greater benevolent sexism attitudes toward men was associated with more prejudice toward the hypothetical male in the vignette. CONCLUSION Findings from the current study emphasize the role of the cultural milieu in shaping effective mental health interventions. The results also have implications for promoting MHL to reduce prejudice in Ghana and other developing countries in the region.
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Affiliation(s)
- Peter Adu
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
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Zainal NH, Jacobson NC. Reliability (or lack thereof) of smartphone ecological momentary assessment of visual dot probe attention bias toward threat indices. J Behav Ther Exp Psychiatry 2024; 82:101918. [PMID: 37907019 DOI: 10.1016/j.jbtep.2023.101918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/05/2023] [Accepted: 10/09/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Cognitive bias theories posit that generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are entwined with attention bias toward threats, commonly indexed by faster response time (RT) on threat-congruent (vs. threat-incongruent) trials on the visual dot probe. Moreover, although smartphone ecological momentary assessment (EMA) of the visual dot probe has been developed, their psychometric properties are understudied. This study thus aimed to assess the reliability of 8 smartphone-delivered visual dot probe attention bias and related indices in persons with and without GAD and SAD. METHODS Community-dwelling adults (n = 819; GAD: 64%; SAD: 49%; Mixed GAD and SAD: 37%; Non-GAD/SAD Controls: 24%) completed a five-trial smartphone-delivered visual dot probe for a median of 60 trials (12 sessions x 5 trials/session) and an average of 100 trials (20 sessions x 5 trials/session). RESULTS As hypothesized, Global Attention Bias Index, Disengagement Effect, and Facilitation Bias had low-reliability estimates. However, retest-reliability and internal reliability were good for Trial-Level Bias Scores (TLBS) (Bias Toward Treat: intra-class correlation coefficients (ICCs) = 0.626-0.644; split-half r = 0.640-0.670; Attention Bias Variability: ICCs = 0.507-0.567; split-half r = 0.520-0.580) and (In)congruent RTs. Poor retest-reliability and internal reliability estimates were consistently observed for all traditional attention bias and related indices but not TLBS. LIMITATIONS Our visual dot probe EMA should have administered ≥320 trials to match best-practice guidelines based on similar laboratory studies. CONCLUSIONS Future research should strive to examine attention bias paradigms beyond the dot-probe task that evidenced meaningful test-retest reliability properties in laboratory and real-world naturalistic settings.
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Affiliation(s)
- Nur Hani Zainal
- Harvard Medical School, Department of Health Care Policy, USA; National University of Singapore, Department of Psychology, Singapore.
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
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Correia Lopes F, Pinto da Costa M, Fernandez-Lazaro CI, Lara-Abelenda FJ, Pereira-Sanchez V, Teo AR, Alvarez-Mon MA. Analysis of the hikikomori phenomenon - an international infodemiology study of Twitter data in Portuguese. BMC Public Health 2024; 24:518. [PMID: 38373925 PMCID: PMC10875796 DOI: 10.1186/s12889-023-17617-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/29/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Hikikomori refers to the extreme isolation of individuals in their own homes, lasting at least six months. In recent years social isolation has become an important clinical, social, and public health problem, with increased awareness of hikikomori around the globe. Portuguese is one of the six most spoken languages in the world, but no studies have analysed the content regarding this phenomenon expressed in Portuguese. OBJECTIVE To explore the hikikomori phenomenon on Twitter in Portuguese, utilising a mixed-methods approach encompassing content analysis, emotional analysis, and correlation analysis. METHODS A mixed methods analysis of all publicly available tweets in the Portuguese language using a specific keyword (hikikomori) between 1st January 2008 and 19th October 2022. The content analysis involved categorising tweets based on tone, content, and user types, while correlation analysis was used to investigate user engagement and geographical distribution. Statistical analysis and artificial intelligence were employed to classify and interpret the tweet data. RESULTS Among the total of 13,915 tweets generated, in terms of tone 10,731 were classified as "negative", and 3184 as "positive". Regarding content, "curiosities" was the most posted, as well as the most retweeted and liked topic. Worldwide, most of the hikikomori related tweets in Portuguese were posted in Europe, while "individuals with hikikomori" were the users most active posting. Regarding emotion analysis, the majority of tweets were "neutral". CONCLUSIONS These findings show the global prevalence of the discourse on hikikomori phenomenon among Portuguese speakers. It also indicates an increase in the number of tweets on this topic in certain continents over the years. These findings can contribute to developing specific interventions, support networks, and awareness-raising campaigns for affected individuals.
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Affiliation(s)
| | - Mariana Pinto da Costa
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
- Institute of Psychiatry Psychology & Neuroscience, King´s College London, London, UK.
| | - Cesar I Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Francisco J Lara-Abelenda
- Department of Signal Theory and Communications and Telematic Systems and Computing, School of Telecommunications Engineering, Rey Juan Carlos University, 28942, Madrid, Spain
| | | | - Alan R Teo
- Health Services Research & Development Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, University Hospital Infanta Leonor, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Miou M, Fujimoto H, Yotsumoto K, Hirota M, Nishigaki S, Hashimoto T. Exploring Psychiatric Home-Visit Nursing Practices for Patients with Schizophrenia and Hikikomori with a Thematic Analysis. Int J Environ Res Public Health 2024; 21:181. [PMID: 38397672 PMCID: PMC10887901 DOI: 10.3390/ijerph21020181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
The phenomenon of some patients with schizophrenia withdrawing and becoming hikikomori needs to be resolved. In some countries, outreach methods are being employed. In Japan, psychiatric home-visit nursing for patients with schizophrenia and hikikomori is being implemented. However, it is not based on sufficient evidence and relies on the experience and intuition of individual nurses. This study explored the underlying themes in the nursing practices of psychiatric home-visit nurses via semi-structured interviews with 10 nurses and a thematic analysis. Nine key themes emerged. Four themes-(i) understanding the patient's world, (ii) supporting the patients as they are, (iii) providing a sense of relief, and (iv) having equal relationships-highlighted the nurses' commitment to respecting patients' individuality while building and sustaining relationships. Two themes-(v) exploring the right timing and (vi) waiting for the appropriate timing-illustrated the nurses' anticipation of proactive patient engagement. Finally, three themes-(vii) working together on things, (viii) continuing care for expanding the patient's world, and (ix) nursing care for the patient's future-underscored the nurses' gradual and methodical approach to working alongside patients. Nursing practices based on these nine themes cultivated meaningful relationships and secured a sense of relief for the patients. Additionally, they awaited patients' proactive engagement and delivered timely support to facilitate positive daily life changes. These findings contribute to the establishment of evidence-based nursing practices for patients with schizophrenia and hikikomori.
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Affiliation(s)
- Maki Miou
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan; (K.Y.); (M.H.); (T.H.)
- Faculty of Nursing, Osaka Shin-Ai Gakuin University, 6-2-28 Tsurumi, Tsurumi-ku, Osaka 5380053, Japan
| | - Hirokazu Fujimoto
- Faculty of Nursing, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe 6508530, Japan
| | - Kayano Yotsumoto
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan; (K.Y.); (M.H.); (T.H.)
| | - Misato Hirota
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan; (K.Y.); (M.H.); (T.H.)
| | - Satoshi Nishigaki
- School of Nursing, Takarazuka University, 1-13-16 Shibata, Kita-ku, Osaka 5300012, Japan;
| | - Takeshi Hashimoto
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan; (K.Y.); (M.H.); (T.H.)
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Lidle LR, Schmitz J. Assessing Visual Avoidance of Faces During Real-Life Social Stress in Children with Social Anxiety Disorder: A Mobile Eye-Tracking Study. Child Psychiatry Hum Dev 2024; 55:24-35. [PMID: 35708796 PMCID: PMC10796484 DOI: 10.1007/s10578-022-01383-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 12/01/2022]
Abstract
This study measured visual attention (fixation count, dwell time) during two real-life social stress tasks using mobile eye-tracking glasses in children (9-13 years) diagnosed with social anxiety disorder (SAD; n = 25) and a healthy control group (HC; n = 30). The influence of state anxiety on attention allocation and negative self-evaluation biases regarding gaze behavior were also examined. Compared to the HC group, children with SAD showed visual avoidance (i.e., fewer fixations) of the faces of interaction partners during the second social stress task. While visual avoidance in HC children decreased with declining state anxiety from the first to the second social stress task, no such effect was found in children with SAD. A negative self-evaluation bias regarding gaze behavior in children with SAD was not found. In sum, measuring visual attention during real-life social situations may help enhance our understanding of social attention in childhood SAD.
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Affiliation(s)
- Leonie Rabea Lidle
- Department for Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Neumarkt 9-19, 04109, Leipzig, Germany.
- Leipzig Research Centre for Early Child Development, Leipzig University, Leipzig, Germany.
| | - Julian Schmitz
- Department for Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Neumarkt 9-19, 04109, Leipzig, Germany
- Leipzig Research Centre for Early Child Development, Leipzig University, Leipzig, Germany
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13
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Diaz Heijtz R. Gut microbiota: A key susceptibility factor in social anxiety disorder. Proc Natl Acad Sci U S A 2024; 121:e2320425121. [PMID: 38252816 PMCID: PMC10835049 DOI: 10.1073/pnas.2320425121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
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14
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Ritz NL, Brocka M, Butler MI, Cowan CSM, Barrera-Bugueño C, Turkington CJR, Draper LA, Bastiaanssen TFS, Turpin V, Morales L, Campos D, Gheorghe CE, Ratsika A, Sharma V, Golubeva AV, Aburto MR, Shkoporov AN, Moloney GM, Hill C, Clarke G, Slattery DA, Dinan TG, Cryan JF. Social anxiety disorder-associated gut microbiota increases social fear. Proc Natl Acad Sci U S A 2024; 121:e2308706120. [PMID: 38147649 PMCID: PMC10769841 DOI: 10.1073/pnas.2308706120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/05/2023] [Indexed: 12/28/2023] Open
Abstract
Social anxiety disorder (SAD) is a crippling psychiatric disorder characterized by intense fear or anxiety in social situations and their avoidance. However, the underlying biology of SAD is unclear and better treatments are needed. Recently, the gut microbiota has emerged as a key regulator of both brain and behaviour, especially those related to social function. Moreover, increasing data supports a role for immune function and oxytocin signalling in social responses. To investigate whether the gut microbiota plays a causal role in modulating behaviours relevant to SAD, we transplanted the microbiota from SAD patients, which was identified by 16S rRNA sequencing to be of a differential composition compared to healthy controls, to mice. Although the mice that received the SAD microbiota had normal behaviours across a battery of tests designed to assess depression and general anxiety-like behaviours, they had a specific heightened sensitivity to social fear, a model of SAD. This distinct heightened social fear response was coupled with changes in central and peripheral immune function and oxytocin expression in the bed nucleus of the stria terminalis. This work demonstrates an interkingdom basis for social fear responses and posits the microbiome as a potential therapeutic target for SAD.
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Affiliation(s)
- Nathaniel L. Ritz
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Anatomy and Neuroscience, University College Cork, CorkT12YT20, Ireland
| | - Marta Brocka
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
| | - Mary I. Butler
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Psychiatry and Neurobehavioural Science, University College Cork, CorkT12YT20, Ireland
| | - Caitlin S. M. Cowan
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
| | - Camila Barrera-Bugueño
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
| | - Christopher J. R. Turkington
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- School of Microbiology, University College Cork, CorkT12K8AF, Ireland
| | - Lorraine A. Draper
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- School of Microbiology, University College Cork, CorkT12K8AF, Ireland
| | - Thomaz F. S. Bastiaanssen
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Anatomy and Neuroscience, University College Cork, CorkT12YT20, Ireland
| | - Valentine Turpin
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
| | - Lorena Morales
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
| | - David Campos
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
| | - Cassandra E. Gheorghe
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Anatomy and Neuroscience, University College Cork, CorkT12YT20, Ireland
- Department of Psychiatry and Neurobehavioural Science, University College Cork, CorkT12YT20, Ireland
| | - Anna Ratsika
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Anatomy and Neuroscience, University College Cork, CorkT12YT20, Ireland
| | - Virat Sharma
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- School of Microbiology, University College Cork, CorkT12K8AF, Ireland
| | - Anna V. Golubeva
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
| | - Maria R. Aburto
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Anatomy and Neuroscience, University College Cork, CorkT12YT20, Ireland
| | - Andrey N. Shkoporov
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- School of Microbiology, University College Cork, CorkT12K8AF, Ireland
| | - Gerard M. Moloney
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Anatomy and Neuroscience, University College Cork, CorkT12YT20, Ireland
| | - Colin Hill
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- School of Microbiology, University College Cork, CorkT12K8AF, Ireland
| | - Gerard Clarke
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Psychiatry and Neurobehavioural Science, University College Cork, CorkT12YT20, Ireland
| | - David A. Slattery
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt60528, Germany
| | - Timothy G. Dinan
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Psychiatry and Neurobehavioural Science, University College Cork, CorkT12YT20, Ireland
| | - John F. Cryan
- Alimentary Pharmabiotic Centre Microbiome Ireland, University College Cork, CorkT12YT20, Ireland
- Department of Anatomy and Neuroscience, University College Cork, CorkT12YT20, Ireland
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15
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Jin SV. "In the Metaverse We (Mis)trust?" Third-Level Digital (In)equality, Social Phobia, Neo-Luddism, and Blockchain/Cryptocurrency Transparency in the Artificial Intelligence-Powered Metaverse. Cyberpsychol Behav Soc Netw 2024; 27:64-75. [PMID: 38197840 PMCID: PMC10794821 DOI: 10.1089/cyber.2022.0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
The Metaverse, powered by a variety of key innovative technologies including 3D virtual reality (VR)/augmented reality (AR), artificial intelligence (AI), blockchain/cryptocurrency-based non-fungible tokens (NFTs), and the Internet of Things, has been proposed as the future of a virtual universe for education, work, business, and commerce. This research (∑ N = 954) presents the results of three cross-sectional surveys that examine the influence of third-level digital (in)equality and consumer (mis)trust on Metaverse adoption intention. Study 1, focusing on the Metaverse for hybrid education, reports the mediating effect of (mis)trust in the Metaverse on the relationship between the educational dimension of third-level digital (in)equality and behavioral intention to adopt the Metaverse for virtual learning as well as the moderating effect of social phobia. Study 2, focusing on the Metaverse for remote working, reports the mediating effect of (mis)trust in the Metaverse on the relationship between the economic labor dimension of third-level digital (in)equality and Metaverse adoption for virtual working as well as the moderating effect of neo-Luddism. Study 3, focusing on the Metaverse for business, reports the mediating effect of (mis)trust in the Metaverse on the relationship between the economic commerce dimension of third-level digital (in)equality and Metaverse adoption for virtual commerce as well as the moderating effect of blockchain/cryptocurrency transparency perception. This research can provide theoretical frameworks to examine people's hopes and fears about the Metaverse and consequential adoption versus non-adoption of the Metaverse for hybrid education, hybrid remote working, and omni-channel virtual commerce. Practical, managerial, and policy implications for the Metaverse and the NFT market are also discussed.
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Affiliation(s)
- Seunga Venus Jin
- NU-Q Communication Program, Northwestern University in Qatar, Education City, Doha, Qatar
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16
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Yamazaki S, Ura C, Inagaki H, Sugiyama M, Miyamae F, Edahiro A, Ito K, Iwasaki M, Sasai H, Okamura T, Hirano H, Awata S. Social isolation and well-being among families of middle-aged and older hikikomori people. Psychogeriatrics 2024; 24:145-147. [PMID: 37932240 DOI: 10.1111/psyg.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/26/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023]
Affiliation(s)
| | - Chiaki Ura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Mika Sugiyama
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kae Ito
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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17
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Kubo T, Horie K, Matsushima T, Tateno M, Kuroki T, Nakao T, Kato TA. Hikikomori and gaming disorder tendency: A case-control online survey for nonworking adults. Psychiatry Clin Neurosci 2024; 78:77-78. [PMID: 37904301 DOI: 10.1111/pcn.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/15/2023] [Accepted: 10/25/2023] [Indexed: 11/01/2023]
Affiliation(s)
- Taisei Kubo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazumasa Horie
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Clinical Psychology Practice, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Toshio Matsushima
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaru Tateno
- Tokiwa Child Development Center, Tokiwa Hospital, Sapporo, Japan
| | - Toshihide Kuroki
- Department of Clinical Psychology Practice, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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18
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Uvais NA, Moideen S. Shared or Induced Olfactory Reference Syndrome. Prim Care Companion CNS Disord 2023; 25:23cr03582. [PMID: 38134408 DOI: 10.4088/pcc.23cr03582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Affiliation(s)
- N A Uvais
- Department of Psychiatry, Iqraa International Hospital and Research Centre, Calicut, India
- Corresponding Author: N. A. Uvais, MBBS, DPM, Iqraa International Hospital and Research Centre, Calicut, Kerala, India
| | - Shamsudeen Moideen
- Department of Internal Medicine, Iqraa International Hospital and Research Centre, Calicut, Kerala, India
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19
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Shin J, Rodebaugh TL. The role of fear of evaluation in group perception. J Anxiety Disord 2023; 100:102791. [PMID: 37924612 DOI: 10.1016/j.janxdis.2023.102791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/08/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
Social anxiety disorder (SAD) is associated with interpersonal impairment. One possible reason for this dysfunction is that people with SAD evaluate others differently on dimensions of warmth and dominance compared to individuals without the disorder. In the current study, we examined whether two core constructs of SAD, fear of negative evaluation and fear of positive evaluation, affect the judgments that people make about groups based on warmth and dominance. We also investigated whether racial similarity (i.e., whether someone is the same race as those they're interacting with) and ethnic identity (i.e., one's sense of belonging to a particular social group) played a role in the types of evaluations people made. We created vignettes about groups varying in warmth and dominance, as well as photos varying in racial makeup. We presented photo-vignette pairs to participants and asked them to rate their desire to interact with the groups depicted in the photo-vignette. Participants in general reported greater desire to interact with warmer and less dominant groups. People with higher fear of negative evaluation reported higher desire for interaction with warmer groups, and those with higher fear of positive evaluation reported higher desire to interact with less dominant groups. We did not find any support for our hypothesis that people with stronger ethnic identity would show greater desire to interact with groups that were more similar to their race. Implications for treatment and directions for further research are discussed.
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Affiliation(s)
- Jin Shin
- Department of Psychological & Brain Sciences, Washington University in St. Louis, USA.
| | - Thomas L Rodebaugh
- University of North Carolina at Chapel Hill Department of Psychology and Neuroscience, USA
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20
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Shamai-Leshem D, Abend R, Arad G, Azriel O, Chong L, de Jong P, Dykan CDG, Hajcak G, Klawohn J, Meyer A, Neophytou K, Neria Y, Panayiotou G, Schneier F, Soleymani A, Yair N, Pine DS, Bar-Haim Y, Lazarov A. The free-viewing matrix task: A reliable measure of attention allocation in psychopathology. J Anxiety Disord 2023; 100:102789. [PMID: 37949029 DOI: 10.1016/j.janxdis.2023.102789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 09/25/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023]
Abstract
Aberrant attention allocation has been implicated in the etiology and maintenance of a range of psychopathologies. However, three decades of research, relying primarily on manual response-time tasks, have been challenged on the grounds of poor reliability of its attention bias indices. Here, in a large, multisite, international study we provide reliability information for a new eye-tracking-based measure of attention allocation and its relation to psychopathology and age. Data from 1567 participants, across a wide range of psychiatric diagnoses and ages, were aggregated from nine sites around the world. Of these, 213 participants also provided retest data. Acceptable overall internal consistency and test-retest reliability were observed among adult participants (Cronbach's alpha = 0.86 and r(213) = 0.89, respectively), as well as across all examined psychopathologies. Youth demonstrated lower internal consistency scores (Cronbach's alpha = 0.65). Finally, the percent dwell time index derived from the task statistically differentiated between healthy participants and participants diagnosed with social anxiety disorder, major depression, and post-traumatic stress disorder. These results potentially address a long-standing reliability crisis in this research field. Aberrant attention allocation patterns in a variety of psychiatric disorders may be targeted with the hope of affecting symptoms. The attention allocation index derived from the matrix task offers reliable means to measure such cognitive target engagement in clinical contexts.
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Affiliation(s)
- Dana Shamai-Leshem
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, USA
| | - Gal Arad
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Omer Azriel
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Lyndsey Chong
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Peter de Jong
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | | | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Julia Klawohn
- Department of Psychology, Florida State University, Tallahassee, FL, USA; Department of Medicine, MSB Medical School Berlin, Berlin, Germany
| | - Alexandria Meyer
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | | | - Yuval Neria
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | | | - Franklin Schneier
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Ali Soleymani
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Centre of Education and Learning, Technical University of Delft, Delft, the Netherlands
| | - Noga Yair
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, USA
| | - Yair Bar-Haim
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
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21
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Lin H, Yang Z, Huo S, Su C, Zhang Z, Rao Y, Yin H. Factors affecting social phobia among Chinese college students in the context of COVID-19 pandemic: a cross-sectional study. Sci Rep 2023; 13:20900. [PMID: 38017075 PMCID: PMC10684864 DOI: 10.1038/s41598-023-48225-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Abstract
Social phobia (SP) refers to excessive anxiety about social interactions. College students, with their exposure to academic, familial, and job-related pressures, are an ideal population for early screening and intervention of social phobia. Additionally, COVID-19 prevention measures including keeping social distance may further impact social phobia. This study aims to investigate the influencing factors of social phobia among Chinese college students and to tentatively explore the impact of COVID-19 prevention measures on social phobia. Respondents were recruited through Chinese Internet social platforms for an online survey. College students' social phobia scores in pre- and early-COVID-19 periods were measured using Peters' short form of the Social Interaction Anxiety Scale and Social Phobia Scale (SIAS-6/SPS-6). Demographic information, family information, social relations, self-evaluation, and subjective feelings regarding the impact of COVID-19 preventive measures on social phobia were collected. A multivariable logistic regression model was used to analyze the influencing factors. A total of 1859 valid questionnaires were collected, revealing that the social phobia scores increased from 12.3 ± 11.9 to 13.4 ± 11.9 between pre- and early-COVID-19 periods, with an increase of 1.0 ± 6.4 (p < 0.001). Low GPA rank, mobile phone dependence, distant family relationships, indulgent parents, childhood adversity, and childhood bullying were risk factors for social phobia among Chinese college students. Female gender, being a senior university student or postgraduate, satisfaction with physical appearance, self-reported good mental health and high level of interpersonal trust were protective factors for social phobia. Although most respondents believed that COVID-19 prevention measures (e.g., mask wearing and social distancing rules) reduced their social phobia, these measures were not significantly associated with social phobia levels in the multivariable analyses. In conclusion, Chinese college students' social phobia was widely influenced by diverse factors and warrants increased attention, with early intervention aimed at high-risk individuals being crucial for their mental health. Additional research is necessary to understand the impact of COVID-19 preventive measures on social phobia among college students.
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Affiliation(s)
- Hai Lin
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Ziming Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Shanshan Huo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191, China
| | - Caixia Su
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhongsong Zhang
- School of Public Health, Peking University, Beijing, 100191, China
| | - Yingting Rao
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Hui Yin
- School of Public Health, Peking University, Beijing, 100191, China.
- Institute of Global Health, Peking University, Beijing, 100191, China.
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22
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Uğurpala C, Tükel R, Ziylan EÇ, Ertekin E, Berberoğlu E. Social Cognition and Functioning in Patients With Social Anxiety Disorder and/or Attention-Deficit/Hyperactivity Disorder. J Nerv Ment Dis 2023; 211:828-834. [PMID: 37432028 DOI: 10.1097/nmd.0000000000001696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
ABSTRACT In recent years, social cognition and one of its dimensions, the theory of mind, have been more commonly investigated in patients with social anxiety disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD). In this study, SAD, ADHD, comorbid SAD-ADHD, and healthy control (HC) groups, each consisting of 30 participants, were included and compared in terms of social cognition and functionality. Mean global functioning assessment scores were found to be significantly higher in the HC group compared with the other three groups and in the ADHD group compared with the SAD and SAD-ADHD groups. Mean Dokuz Eylül Theory of Mind Index total scores were found to be significantly higher in the HC group compared with the other three groups and in the SAD and SAD-ADHD groups compared with the ADHD group. These findings suggest that SAD patients with or without ADHD show better social cognition but worse functioning compared with pure ADHD patients.
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Affiliation(s)
- Can Uğurpala
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ege Çağın Ziylan
- Physiology and Pharmacology Laboratory, Beykent University Faculty of Medicine, Beykent University, Büyükçekmece, Istanbul, Turkey
| | - Erhan Ertekin
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ertuğ Berberoğlu
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
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23
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Glück VM, Boschet-Lange JM, Pittig R, Pittig A. Persistence of extensively trained avoidance is not elevated in anxiety disorders in an outcome devaluation paradigm. Behav Res Ther 2023; 170:104417. [PMID: 37879245 DOI: 10.1016/j.brat.2023.104417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND A habitual avoidance component may enforce the persistence of maladaptive avoidance behavior in anxiety disorders. Whether habitual avoidance is acquired more strongly in anxiety disorders is unclear. METHODS Individuals with current social anxiety disorder, panic disorder and/or agoraphobia (n = 62) and healthy individuals (n = 62) completed a devaluation paradigm with extensive avoidance training, followed by the devaluation of the aversive outcome. In the subsequent test phase, habitual response tendencies were inferred from compatibility effects. Neutral control trials were added to assess general approach learning in the absence of previous extensive avoidance training. RESULTS The compatibility effects indicating habitual control did not differ between patients with anxiety disorders and healthy controls. Patients showed lower overall approach accuracy, but this effect was unrelated to the compatibility effects. CONCLUSIONS In this study, anxiety disorders were characterized by reduced approach but not stronger habitual avoidance. These results do not indicate a direct association between anxiety disorders and the acquisition of pervasive habitual avoidance in this devaluation paradigm.
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Affiliation(s)
- Valentina M Glück
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Juliane M Boschet-Lange
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Roxana Pittig
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Andre Pittig
- Translational Psychotherapy, Institute of Psychology, University of Goettingen, Göttingen, Germany.
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Wan Hussain WMH. Evolution and trends of hikikomori: a bibliometrics analysis. Int J Psychiatry Clin Pract 2023; 27:385-396. [PMID: 37452649 DOI: 10.1080/13651501.2023.2233580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
Hikikomori is the Japanese term for the phenomenon of young adults isolating themselves from society and becoming reclusive. This study aims to examine the evolution and distribution of hikikomori, as well as identify the major players and institutions involved in hikikomori research. The searches, which were conducted in Scopus database identified 286 academic research works pertaining to hikikomori research. The findings indicate that hikikomori has attracted the attention of academic researchers in both the East and the West, with a consistent increase in research output since the Internet revolution over the past decade. The study highlights the potential for additional research on hikikomori and provides a benchmark for new researchers entering the field.
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Wakuta M, Nishimura T, Osuka Y, Tsukui N, Takahashi M, Adachi M, Suwa T, Katayama T. Adverse childhood experiences: impacts on adult mental health and social withdrawal. Front Public Health 2023; 11:1277766. [PMID: 37954050 PMCID: PMC10639139 DOI: 10.3389/fpubh.2023.1277766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/10/2023] [Indexed: 11/14/2023] Open
Abstract
Background Adverse childhood experiences (ACEs) have been found to negatively impact adult mental health outcomes. Numerous studies have highlighted on ACEs in family and community settings. However, few have examined the impact of ACEs in school settings, despite the potential influence on social participation. Hikikomori, characterized by severe social withdrawal, was first studied in Japan and has gained recognition in recent years. The present study aims to present the concept of ACEs specific to schools and investigate the impact of both school ACEs and traditional ACEs on adult mental health and Hikikomori. Methods A total of 4,000 Japanese adults, aged 20-34, were recruited through an Internet survey form. All data were obtained in October 2021. Participants answered questions regarding their ACEs in the family (10 items), school ACEs (five teacher-related items and two bullying-related items), depressive/anxiety symptoms, and Hikikomori (remaining at home for more than 6 months). Results A significant association with depressive/anxiety symptoms was shown in both ACEs and school ACEs. An increase of one point in the ACE scores was associated with a 24% increase in the risk of depressive/anxiety symptoms. School ACE scores also demonstrated a significant association with depressive/anxiety symptoms, with an increase of one point associated with a 44% increase in the risk of these symptoms. As for Hikikomori, a significant association was shown in the school ACEs only: a 29% increased risk of Hikikomori for every one-point increase in school ACE scores. Both school ACE scores for teacher-related and bullying-related factors revealed a significant association with Hikikomori; the rates of increased risk were 23 and 37%, respectively. Conclusion These results suggest that school ACEs, rather than ACEs in the family, are associated with the risk of Hikikomori. School ACEs are important for social adaptation, and reducing traumatic experiences in school settings may have the potential to prevent problems in later life, specifically in terms of social participation.
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Affiliation(s)
- Manabu Wakuta
- Research Department, Institute of Child Developmental Science Research, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Suita, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoko Nishimura
- Research Department, Institute of Child Developmental Science Research, Hamamatsu, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuko Osuka
- Research Department, Institute of Child Developmental Science Research, Hamamatsu, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Nobuaki Tsukui
- Research Department, Institute of Child Developmental Science Research, Hamamatsu, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Michio Takahashi
- Research Department, Institute of Child Developmental Science Research, Hamamatsu, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | - Masaki Adachi
- Research Department, Institute of Child Developmental Science Research, Hamamatsu, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
- Department of Psychology, Meiji Gakuin University, Yokohama, Japan
| | - Toshiaki Suwa
- Research Department, Institute of Child Developmental Science Research, Hamamatsu, Japan
- Department of Health and Welfare, Kawasaki University of Medical Welfare, Okayama, Japan
| | - Taiichi Katayama
- Research Department, Institute of Child Developmental Science Research, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Suita, Japan
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Brookman R, Bird F, Harris CB, Grant KA. Social Anxiety Disorder: Associations with Peer-Liking, Discrimination, and Prejudicial Feelings in Early Adolescent Girls. Child Psychiatry Hum Dev 2023; 54:1231-1241. [PMID: 35195808 PMCID: PMC8863903 DOI: 10.1007/s10578-022-01336-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 01/01/2023]
Abstract
Social anxiety can have an adverse effect on social connections, educational achievement, and wellbeing. However, the extent to which students stigmatize their peers with social anxiety disorder (SAD) in female educational settings remains unknown. This study investigated the relationship between SAD, peer-liking and stigma in a cohort of early adolescent girls. The sample was 103 sixth and seventh graders attending three girls' schools in Australia. The students, aged between 10- and 13-years, were randomly allocated to either a control (n = 52) or experimental (n = 51) group. Participants completed an online survey while at school to examine their responses to one of two age-and-gender matched vignettes: a hypothetical peer with SAD (experimental condition), or without SAD (control condition). Contrary to expectations, group comparisons revealed that students with the SAD vignette liked their peer more than students with the non-SAD vignette. Also, students endorsed higher levels of pity, lower levels of fear, but similar levels of anger when considering their SAD (versus non-SAD) peer. In the SAD group, higher levels of pity were associated with greater peer-liking. The opposite pattern was evident in response to the non-SAD peer. Importantly, students discriminated less (preferred less social distance) in response to their peer with SAD. This points to the potential benefit of adolescent peer programs that aim to promote positive peer-relationships as a protective factor for students with SAD. Future research may examine gender and socio-economically diverse students to increase the confidence with which findings can be generalized to other educational settings.
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Affiliation(s)
- Ruth Brookman
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Fay Bird
- KYDS Youth Development Service, 265 Pacific Hwy, Lindfield, NSW, 2070, Australia
| | - Celia B Harris
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Kerry-Ann Grant
- Health Education and Training Institute, Locked Bag 7118, Parramatta BC, NSW, 2124, Australia
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Olry R. Hikikomori (きこもり): Ancient term, modern concept. J Hist Neurosci 2023; 32:499-505. [PMID: 37459241 DOI: 10.1080/0964704x.2023.2231794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Affiliation(s)
- Régis Olry
- Département d'Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
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28
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Cai H, Sha S, Zhang Q, Si TL, Liu YF, Zheng WY, Su Z, Cheung T, Ungvari GS, Teo AR, Kato TA, Ng CH, Xiang YT. Hikikomori: A perspective from bibliometric analysis. Psychiatry Clin Neurosci 2023; 77:541-549. [PMID: 37350640 DOI: 10.1111/pcn.13573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 06/08/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023]
Abstract
AIMS Hikikomori is a common phenomenon reported in Japan and many other countries. However, the broad trends of the research publications on hikikomori are unclear. Therefore, this study examined the patterns of research on hikikomori using bibliometric analysis. METHODS Relevant publications were searched in Web of Science. Bibliometric analyses were performed with CiteSpace, R and VOSviewer. RESULTS In total, 297 publications on hikikomori met the eligibility criteria. The International Journal of Social Psychiatry (IF = 10.461) published the most papers (K = 17, or 5.7%) on hikikomori. Takahiro A. Kato from Kyushu University (41; 13.8%; H-index = 18) was the most influential author, while Takahiro A. Kato (total link strength [TLS]: 235), Alan R. Teo (TLS: 157), and Masaru Tateno (TLS: 153) separately had the strongest research collaboration with other researchers. Of all countries that published on hikikomori, Japan had the highest number of publications (K = 91). The keywords "United States" and "psychiatric diagnosis" received the most attention between 2013 and 2015, whereas "health" and "autism spectrum disorder" received the most attention in 2021 and 2022. CONCLUSIONS Peer-reviewed research publications on hikikomori are growing rapidly and the research trends in this field are also changing.
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Affiliation(s)
- Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, China
| | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, China
| | - Wan-Ying Zheng
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, Australia
| | - Alan R Teo
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, China
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Stork M, Lemos M, Román-Calderón JP. Differences in anxiety sensitivity and experiential avoidance between subtypes of social anxiety disorder. PLoS One 2023; 18:e0290756. [PMID: 37713395 PMCID: PMC10503767 DOI: 10.1371/journal.pone.0290756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/15/2023] [Indexed: 09/17/2023] Open
Abstract
Both anxiety sensitivity (AS) and experiential avoidance (EA) have been linked to social anxiety disorder (SAD). However, previous studies did not consider their joint variance and the heterogeneity of SAD. In this mixed methods cross-sectional survey, we examined 121 online participants (age range: 16-70 years) who self-reported as socially anxious. We compared AS and EA levels in individuals with a primary fear of noticeable anxiety symptoms vs. behaving ineptly. AS and EA were highly prevalent across the sample. Surprisingly, the noticeable symptoms subtype showed slightly lower AS and EA levels than the inept behavior subtype. The noticeable symptoms subtype scored notably lower on social anxiety measures (mean = 69.8) than the inept behavior subtype (mean = 89.3). EA was uniquely associated with social anxiety in both subtypes, while AS was uniquely associated with social anxiety only in the inept behavior subtype. The joint variance explained substantially more of the noticeable symptoms subtype's social anxiety (32.5%) compared to the inept behavior subtype's (9.4%). Qualitative themes aligned with these findings, indicating a self-reinforcing dynamic between high AS, high EA, and social anxiety symptoms. Potential clinical implications are discussed. Future research should examine causality in the AS-EA-SAD dynamic, considering the heterogeneity of SAD.
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Affiliation(s)
- Martin Stork
- Department of Psychology, Faculty of Arts and Humanities, EAFIT University, Medellín, Antioquia, Colombia
| | - Mariantonia Lemos
- Department of Psychology, Faculty of Arts and Humanities, EAFIT University, Medellín, Antioquia, Colombia
| | - Juan Pablo Román-Calderón
- Department of Psychology, Faculty of Arts and Humanities, EAFIT University, Medellín, Antioquia, Colombia
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Wong QJJ, Hamrick HC, Clague CA, Judah MR. Understanding the Dimensions of Post-Event Processing: Applying a Bifactor Modeling Approach to the EPEPQ-15. Assessment 2023; 30:1836-1847. [PMID: 36176182 DOI: 10.1177/10731911221127911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social anxiety disorder is maintained in part by rumination about past social experiences, known as post-event processing. The Extended Post-Event Processing Questionnaire (EPEPQ-15) assesses post-event processing as three correlated factors. Competing against this structure is a bifactor model that has not yet been evaluated for the EPEPQ-15. These models were tested for the conventional state version of the EPEPQ-15 and a new trait version in two separate samples (Ns = 327 and 351). In both samples, the fit of the bifactor model was better than that of correlated factor models. Moreover, the results did not support the group factors, indicating that a unidimensional interpretation of the EPEPQ-15 is most appropriate. The general dimension of the EPEPQ-15 was highly correlated with social interaction anxiety, beliefs related to social anxiety, anticipatory processing, and safety behaviors. These results overall suggest post-event processing is best conceptualized as a unitary construct.
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Abstract
PURPOSE OF REVIEW This examines significant trends and developments in the utilization of virtual reality (VR) and augmented reality (AR) simulations in the field of mental health and education. The objective is to gain insights into the emerging applications of VR/AR in mental health interventions and their potential impact on patient outcomes. The review also includes personal observations on the effectiveness and challenges associated with VR/AR simulations and the rise of exciting, disruptive artificial intelligence large language models. The findings of this review contribute to the understanding of the current state of VR/AR technology in mental health and highlight potential future directions in this rapidly evolving field. RECENT FINDINGS Recent studies have shown that VR/AR simulation is an effective and promising approach for treating various anxiety disorders, including specific phobias, social anxiety disorder, and post-traumatic stress disorder (PTSD). Simulated environments can be tailored to induce provoking situations, allowing individuals to learn from and gradually confront and grow in controlled and safe environments. Recent findings in the field of virtual reality simulations in mental health indicate that VR/AR exposure therapy is effective for treating anxiety disorders, while interventions show promise in improving social skills in individuals working with patients. In a broader sense, the use of VR/AR as an educational tool shows enormous potential now that functional generative artificial intelligence (AI) is recently available.
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Affiliation(s)
- Clint G Carlson
- Fitzsimons Building, University of Colorado, School of Medicine, 13001 East 17Th Place, Room E1354, Campus Box C290, CO, 80045, Aurora, USA.
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Orsolini L, Longo G, Bellagamba S, Kato TA, Volpe U. Hikikomori-like social withdrawal: An Italian case report. Psychiatry Clin Neurosci 2023; 77:510. [PMID: 37254899 DOI: 10.1111/pcn.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/13/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023]
Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Giulio Longo
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Silvia Bellagamba
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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Roza TH, Paim Kessler FH, Passos IC. Hikikomori in Brazil: Context, clinical characteristics, and challenges. Int J Soc Psychiatry 2023; 69:1059-1061. [PMID: 36003018 DOI: 10.1177/00207640221120363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Thiago Henrique Roza
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Brazil
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felix Henrique Paim Kessler
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Brazil
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Künkül F, Bal F. The Relationship Between Social Anxiety Disorder and Psychological Symptoms in University Students. J Nerv Ment Dis 2023; 211:382-385. [PMID: 37040139 DOI: 10.1097/nmd.0000000000001638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
ABSTRACT The aim of this study was to examine the relationship between social anxiety disorder and psychological symptoms in university students. It was also aimed to reveal the relationship between the dependent variables of the research and sociodemographic variables. The research is of the relational type, and the survey method was used to collect the relevant data. The research data were obtained from a total of 300 university students, 150 women and 150 men. According to the findings of the study, a low-, medium-, and high-strength linear relationship was found between social anxiety disorder and the Symptom Checklist-90 (SCL-90) general and its subdimensions. Scores on SCL-90 general and its subdimension increased as social anxiety disorder increased in the university student participants. It is recommended to give awareness education under the name of "general awareness-raising" about the concepts of social anxiety disorder and psychological symptoms in university students.
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Affiliation(s)
| | - Fatih Bal
- Department of Psychology, Sakarya University, Sakarya, Turkey
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35
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Yilmaz G, Yildirim EA, Tabakcı AS. Comparison of Social-Evaluative Anxiety and Theory of Mind Functions in Social Anxiety Disorder, Schizophrenia, and Healthy Controls. Psychopathology 2023; 56:440-452. [PMID: 37062284 DOI: 10.1159/000529880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 02/20/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION Despite the similarities in poor social competence and clinical manifestations of poor social behavior, no study has compared the theory of mind performance between social anxiety disorder (SAD) and schizophrenia, considering the effect of social-evaluative anxiety and neurocognitive functions. In our study, we aimed to compare the theory of mind functions and social-evaluative anxiety between patients with SAD and schizophrenia and healthy controls and to examine the relationship between the theory of mind, neurocognitive skills, and social-evaluative anxiety. METHODS Thirty-four consecutive patients with schizophrenia, 29 patients with SAD, and 30 controls matched by age, education level, and sex were enrolled in the study. Structured Clinical Interview for DSM, Beck Depression Inventory, Liebowitz Social Anxiety Scale, Theory of Mind measures (Reading the Mind in the Eyes Test, Hinting Task, Faux Pas Test), Social Appearance Anxiety Scale, Fear of Positive Evaluation Scale, Fear of Negative Evaluation Scale-Short Form, and neuropsychological tests were administered to all participants. RESULTS A greater significant deterioration in theory of mind and neurocognitive functions was found in patients with schizophrenia compared to those with SAD and healthy controls. Social evaluation anxiety was highest in patients with SAD. Although social-evaluative anxiety was associated with the theory of mind function in schizophrenia, only fear of positive evaluation was associated with SAD. In all groups, neither theory of mind nor neurocognitive ability measures were correlated with social anxiety levels and related symptoms. CONCLUSIONS The impaired theory of mind functioning detected in our study is more prominent in the schizophrenia group and largely independent of anxiety in schizophrenia and SAD. Although social evaluation anxiety, as a transdiagnostic concept, seems to be independent of theory of mind function in general, fear of positive evaluation seems to be associated with hinting in both disorders.
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Affiliation(s)
- Gorkem Yilmaz
- Private Practice, Psychiatry Department, Istanbul, Turkey
| | - Ejder Akgun Yildirim
- Department of Psychiatry, Psychotherapy Outpatient Clinic, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Abdulkadir Sencer Tabakcı
- Department of Psychiatry, Psychotherapy Outpatient Clinic, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
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Groenewold NA, Bas-Hoogendam JM, Amod AR, Laansma MA, Van Velzen LS, Aghajani M, Hilbert K, Oh H, Salas R, Jackowski AP, Pan PM, Salum GA, Blair JR, Blair KS, Hirsch J, Pantazatos SP, Schneier FR, Talati A, Roelofs K, Volman I, Blanco-Hinojo L, Cardoner N, Pujol J, Beesdo-Baum K, Ching CRK, Thomopoulos SI, Jansen A, Kircher T, Krug A, Nenadić I, Stein F, Dannlowski U, Grotegerd D, Lemke H, Meinert S, Winter A, Erb M, Kreifelts B, Gong Q, Lui S, Zhu F, Mwangi B, Soares JC, Wu MJ, Bayram A, Canli M, Tükel R, Westenberg PM, Heeren A, Cremers HR, Hofmann D, Straube T, Doruyter AGG, Lochner C, Peterburs J, Van Tol MJ, Gur RE, Kaczkurkin AN, Larsen B, Satterthwaite TD, Filippi CA, Gold AL, Harrewijn A, Zugman A, Bülow R, Grabe HJ, Völzke H, Wittfeld K, Böhnlein J, Dohm K, Kugel H, Schrammen E, Zwanzger P, Leehr EJ, Sindermann L, Ball TM, Fonzo GA, Paulus MP, Simmons A, Stein MB, Klumpp H, Phan KL, Furmark T, Månsson KNT, Manzouri A, Avery SN, Blackford JU, Clauss JA, Feola B, Harper JC, Sylvester CM, Lueken U, Veltman DJ, Winkler AM, Jahanshad N, Pine DS, Thompson PM, Stein DJ, Van der Wee NJA. Volume of subcortical brain regions in social anxiety disorder: mega-analytic results from 37 samples in the ENIGMA-Anxiety Working Group. Mol Psychiatry 2023; 28:1079-1089. [PMID: 36653677 PMCID: PMC10804423 DOI: 10.1038/s41380-022-01933-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/31/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023]
Abstract
There is limited convergence in neuroimaging investigations into volumes of subcortical brain regions in social anxiety disorder (SAD). The inconsistent findings may arise from variations in methodological approaches across studies, including sample selection based on age and clinical characteristics. The ENIGMA-Anxiety Working Group initiated a global mega-analysis to determine whether differences in subcortical volumes can be detected in adults and adolescents with SAD relative to healthy controls. Volumetric data from 37 international samples with 1115 SAD patients and 2775 controls were obtained from ENIGMA-standardized protocols for image segmentation and quality assurance. Linear mixed-effects analyses were adjusted for comparisons across seven subcortical regions in each hemisphere using family-wise error (FWE)-correction. Mixed-effects d effect sizes were calculated. In the full sample, SAD patients showed smaller bilateral putamen volume than controls (left: d = -0.077, pFWE = 0.037; right: d = -0.104, pFWE = 0.001), and a significant interaction between SAD and age was found for the left putamen (r = -0.034, pFWE = 0.045). Smaller bilateral putamen volumes (left: d = -0.141, pFWE < 0.001; right: d = -0.158, pFWE < 0.001) and larger bilateral pallidum volumes (left: d = 0.129, pFWE = 0.006; right: d = 0.099, pFWE = 0.046) were detected in adult SAD patients relative to controls, but no volumetric differences were apparent in adolescent SAD patients relative to controls. Comorbid anxiety disorders and age of SAD onset were additional determinants of SAD-related volumetric differences in subcortical regions. To conclude, subtle volumetric alterations in subcortical regions in SAD were detected. Heterogeneity in age and clinical characteristics may partly explain inconsistencies in previous findings. The association between alterations in subcortical volumes and SAD illness progression deserves further investigation, especially from adolescence into adulthood.
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Affiliation(s)
- Nynke A Groenewold
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
- South African Medical Research Council (SA-MRC) Unit on Child and Adolescent Health, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
| | - Janna Marie Bas-Hoogendam
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
| | - Alyssa R Amod
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Max A Laansma
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Laura S Van Velzen
- Orygen & Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Moji Aghajani
- Leiden University, Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden, Netherlands
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hyuntaek Oh
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Michael E DeBakey VA Medical Center, Center for Translational Research on Inflammatory Diseases, Houston, TX, USA
| | - Andrea P Jackowski
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Pedro M Pan
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Giovanni A Salum
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Joy Hirsch
- Departments of Psychiatry & Neurobiology, Yale School of Medicine, New Haven, CT, USA
| | - Spiro P Pantazatos
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Franklin R Schneier
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Ardesheer Talati
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Karin Roelofs
- Donders Institute for Brain, Cognition and Behavior, Radboud University Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | - Inge Volman
- Wellcome Centre for Integrative Neuroimaging Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Narcís Cardoner
- Department of Mental Health, University Hospital Parc Taulí-I3PT, Barcelona, Spain, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psycholog and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christopher R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Andreas Jansen
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University Hospital of Bonn, Bonn, Germany
| | - Igor Nenadić
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Benjamin Kreifelts
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Fei Zhu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Benson Mwangi
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Mon-Ju Wu
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ali Bayram
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Mesut Canli
- Department of Physiology, Istanbul University, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul University, Istanbul, Turkey
| | - P Michiel Westenberg
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
| | - Alexandre Heeren
- Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Henk R Cremers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | | | - Christine Lochner
- SA-MRC Unit on Risk and Resilience in Mental Disorders, Stellenbosch University, Stellenbosch, South Africa
| | - Jutta Peterburs
- Institute of Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Marie-José Van Tol
- Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Bart Larsen
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Courtney A Filippi
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - André Zugman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Harald Kugel
- University Clinic for Radiology, University of Münster, Münster, Germany
| | - Elisabeth Schrammen
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Peter Zwanzger
- KBO-Inn-Salzach-Klinikum, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University of Munich, Munich, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lisa Sindermann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Tali M Ball
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Gregory A Fonzo
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | | | - Alan Simmons
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Murray B Stein
- Departments of Psychiatry & School of Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Heide Klumpp
- Departments of Psychology & Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K Luan Phan
- Department of Psychiatry & Behavioral Health, the Ohio State University, Columbus, OH, USA
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | | | - Suzanne N Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Brandee Feola
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Chad M Sylvester
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC location VUMC, Amsterdam, Netherlands
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Dan J Stein
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SA-MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Nic J A Van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
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Fong TCT, Cheng Q, Pai CY, Kwan I, Wong C, Cheung SH, Yip PSF. Uncovering sample heterogeneity in gaming and social withdrawal behaviors in adolescent and young adult gamers in Hong Kong. Soc Sci Med 2023; 321:115774. [PMID: 36796169 DOI: 10.1016/j.socscimed.2023.115774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 02/13/2023]
Abstract
OBJECTIVE The current study aimed to examine the latent heterogeneity of gaming and social withdrawal behaviors in internet gamers and their associations with help-seeking behaviors. METHOD The present study recruited 3430 young people (1874 adolescents and 1556 young adults) in Hong Kong in 2019. The participants completed the Internet Gaming Disorder (IGD) Scale, Hikikomori Questionnaire, and measures on gaming characteristics, depression, help-seeking, and suicidality. Factor mixture analysis was used to classify the participants into latent classes based on their latent factors of IGD and hikikomori in separate age groups. Latent class regressions examined the associations between help-seeking and suicidality. RESULTS Both adolescents and young adults supported a 4-class, 2-factor model on gaming and social withdrawal behaviors. Over two-third of the sample were classified as healthy or low-risk gamers with low IGD factor means and low prevalence of hikikomori. Around one-fourth was moderate-risk gamers with elevated prevalence of hikikomori, higher IGD symptoms and psychological distress. A minority of the sample (3.8%-5.8%) belonged to high-risk gamers with the highest IGD symptoms and prevalence of hikikomori and heightened suicidal risks. Help-seeking in low-risk and moderate-risk gamers was positively associated with depressive symptoms and negatively associated with suicidal ideation. Perceived usefulness of help-seeking was significantly linked with lower likelihoods of suicidal ideation in the moderate-risk gamers and suicide attempt in the high-risk gamers. CONCLUSIONS The present findings explicate the latent heterogeneity of gaming and social withdrawal behaviors and associated factors on help-seeking and suicidality among internet gamers in Hong Kong.
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Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China.
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China.
| | - C Y Pai
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China.
| | - Isabelle Kwan
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China.
| | - Clifford Wong
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China.
| | | | - Paul S F Yip
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China; Dept of Social Work & Social Administration, University of Hong Kong, Hong Kong, China.
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Pauley D, Cuijpers P, Papola D, Miguel C, Karyotaki E. Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness. Psychol Med 2023; 53:567-579. [PMID: 34047264 PMCID: PMC9899576 DOI: 10.1017/s0033291721001999] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder v. wait-list and care-as-usual controls. METHODS A systematic search of bibliographic databases identified 15 030 abstracts from inception to 1 January 2020. Forty-seven randomized controlled trials (53 comparisons; 4958 participants) contributed to the meta-analysis. Subgroup analyses were conducted by an anxiety disorder, risk of bias, treatment support, recruitment, location and treatment adherence. RESULTS A large, pooled effect size of g = 0.80 [95% Confidence Interval: 0.68-0.93] was found in favor of digital interventions. Moderate to large pooled effect sizes favoring digital interventions were found for generalized anxiety disorder (g = 0.62), mixed anxiety samples (g = 0.68), panic disorder with or without agoraphobia (g = 1.08) and social anxiety disorder (g = 0.76) subgroups. No subgroups were significantly different or related to the pooled effect size. Notably, the effects of guided interventions (g = 0.84) and unguided interventions (g = 0.64) were not significantly different. Supplemental analysis comparing digital and face-to-face interventions (9 comparisons; 683 participants) found no significant difference in effect [g = 0.14 favoring digital interventions; Confidence Interval: -0.01 to 0.30]. CONCLUSION The precise and powerful estimates found further justify the application of digital interventions for anxiety disorders in place of wait-list or usual care.
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Affiliation(s)
- Darin Pauley
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam, The Netherlands
| | - Davide Papola
- Department of Neuroscience, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam, The Netherlands
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Ünal D, Çelebi F. Is There a Difference in Parental Attitudes and Attachment for ADHD-Social Phobia Comorbidity? Turk Psikiyatri Derg 2023; 34:24-30. [PMID: 36970959 PMCID: PMC10552161 DOI: 10.5080/u26580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Social phobia (SP) is one the commonest of comorbid anxiety disorders seen with ADHD. It is also known that Social phobia and ADHD patients have some differences in parental attitudes and attachment styles. We aimed to investigate the effects attachment status and parental attitudes in ADHD-social phobia comorbidity. METHOD 66 children and adolescents with ADHD were included for the study. the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5 November 2016-Turkish Adaptation (KSADS-PL-DSM5-T) was used for evaluating diagnosis. Socioeconomic status (SES) was scored with Hollingshead Redlich Scale. Sosyodemografic and clinical data were recorded. Adult Attachment Scale (AAS) and Parental Attitudes Research Instrument (PARI) were completed by the parents. The patients filled Kerns Security Scale (KSS). We compared the ADHD patients with and without SAD comorbidity in terms of scales used and sociodemographic-clinical variables. RESULTS There were no differences between ADHD + SP group and ADHD without SP group in terms of age, gender, SES, family structure and family history of diagnosed psychiatric disease (p>0.05). Rate of inattentive subtype of ADHD (p=0.05) and comorbid psychiatric disease frequency (p=0.00) was higher in ADHD+SP group compared to ADHD without social phobia group. However, the groups did not differ according to their attachment styles, their parent's attachment styles and parental attitudes (p>0.05). CONCLUSION Parental attitudes and attachment styles may not play a role in the development of SP comorbidity in children and adolescents with ADHD. Other biological and environmental factors should be kept in mind when evaluating and treating children with ADHD who have SP. Biological treatments and individualized interventions such as CBT may be chosen as a first line treatment rather than psychotherapies targeting attachment and parenting styles in those children.
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Mobach L, Rinck M, Becker ES, Carl T, Klein AM, Rapee RM, Hudson JL. Facing Uncertainty: Interpretation of Ambiguous Emotional Faces in Childhood Social Anxiety Disorder. J Clin Child Adolesc Psychol 2022; 51:955-969. [PMID: 35617097 DOI: 10.1080/15374416.2022.2070850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The current study examined whether children with a social anxiety disorder (SAD) demonstrate divergent facial emotion processing and a disorder-specific negative interpretation bias in the processing of facial emotional expressions. This study aimed to overcome previous study limitations by including both a nonsocially anxious control group and a healthy control group to examine whether childhood SAD is characterized by a general emotion labeling deficit, and/or by a negative interpretation bias, indicated by systematic misclassifications, or a lower threshold for recognizing threatening emotions. METHOD Participants were 132 children aged 7-12 years (Mage = 9.15; 45.5% female). Children with SAD (n = 42) were compared to children with other, nonsocial, anxiety disorders (n = 40) and healthy control children (n = 50) on a novel facial emotion recognition task. Children judged ambiguous happy/neutral, angry/neutral and fear/neutral faces that were morphed at different intensities (10%, 30%, 50%, 70%). RESULTS Children with SAD did not differ from other groups in their accuracy of identifying emotions. They did not show systematic misclassifications or a heightened sensitivity to negative, threatening faces either. Rather, children with nonsocial anxiety disorders showed a generally heightened sensitivity to emotional faces. CONCLUSIONS The current study does not provide evidence for a general deficit in labeling of emotional faces in childhood SAD. Childhood SAD was not characterized by an interpretation bias in processing emotional faces. Children with nonsocial anxiety disorders may benefit from assistance in accurately interpreting the degree of emotionality in interpersonal situations.
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Affiliation(s)
- Lynn Mobach
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | - Mike Rinck
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University
| | - Eni S Becker
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University
| | - Talia Carl
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | - Anke M Klein
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University
- Developmental and Educational Psychology of the Institute of Psychology, Leiden University
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | - Jennifer L Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University
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Prieto-Fidalgo Á, Miers AC, Calvete E. Interpretation Biases in Social Scenarios and Social Anxiety: The Role of Safety Behaviors. Psicothema 2022; 34:489-497. [PMID: 36268953 DOI: 10.7334/psicothema2021.406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Interpretation bias (IB) and safety behaviors (SB) are maintenance mechanisms of social anxiety (SA). However, few studies have examined the role of IB and SB together in explaining SA. The objective of this study was to determine whether SB explains the association between IB and SA. To evaluate these variables, the Adolescents' Interpretation and Beliefs Questionnaire (AIBQ 2.0) and the Social Phobia Safety Behaviors Scale (SPSBS) needed to be adapted for Spanish adolescents and young people. METHOD 826 Spanish vocational training students (60% males, 14-28 years old) completed a measure of SA and the AIBQ 2.0 and SPSBS. RESULTS Path analysis showed that IB in offline scenarios was associated with SA through SB. IB in offline situations, but not in online situations, was directly associated with SA. As expected, the AIBQ 2.0 showed a two-dimensional structure and good internal consistency. The SPSBS demonstrated a unidimensional structure and good internal consistency. CONCLUSIONS In the absence of longitudinal studies, the data are compatible with the possible mediating role of SB in the association between IB and SA. Both instruments (AIBQ 2.0 and SPSBS) exhibited good psychometric properties for Spanish students.
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Boudjafad Z, Lguensat A, Elmardadi K, Dahi A, Bennis M, Ba-M'hamed S, Garcia R. The socially enriched environment test: a new approach to evaluate social behavior in a mouse model of social anxiety disorder. Learn Mem 2022; 29:390-400. [PMID: 36253006 PMCID: PMC9578375 DOI: 10.1101/lm.053627.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/19/2022] [Indexed: 11/24/2022]
Abstract
Social anxiety disorder (SAD) is a common anxiety disorder characterized by a marked fear of social situations. Treatments for SAD, including exposure therapy and medication, are not satisfactory for all patients. This has led to the development of several paradigms to study social fear in rodents. However, there are still some social impairments observed in SAD patients that have never been examined in rodent models. Indeed, social situations avoided by SAD patients include not only social interactions but also public performances and being observed by others. Nevertheless, tests used to assess sociability in rodents evaluate mostly social interaction in pairs. Thus, we developed a new test-a socially enriched environment test-that evaluates sociability within a group of three unfamiliar conspecifics in an enriched environment. In this study, we induced a SAD-like behavior (i.e., social fear) in male mice using social fear conditioning (SFC) and then tested social fear using the socially enriched environment test and the three-chamber test. Finally, we tested the effects of fear extinction and acute diazepam treatment in reversing social fear. Results revealed, in conditioned mice, decreased object exploration in proximity to conspecifics, social interaction, and mouse-like object exploration. Extinction training, but not acute diazepam treatment, reversed SFC-induced behavioral changes. These findings demonstrate that the socially enriched environment test provides an appropriate behavioral approach to better understand the etiology of SAD. This test may also have important implications in the exploration of new treatments.
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Affiliation(s)
- Zineb Boudjafad
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie, et Environnement, Université Cadi Ayyad, Marrakech 40000, Marocco
| | - Asmae Lguensat
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie, et Environnement, Université Cadi Ayyad, Marrakech 40000, Marocco
| | - Kenza Elmardadi
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie, et Environnement, Université Cadi Ayyad, Marrakech 40000, Marocco
| | - Asma Dahi
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie, et Environnement, Université Cadi Ayyad, Marrakech 40000, Marocco
| | - Mohamed Bennis
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie, et Environnement, Université Cadi Ayyad, Marrakech 40000, Marocco
| | - Saadia Ba-M'hamed
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie, et Environnement, Université Cadi Ayyad, Marrakech 40000, Marocco
| | - René Garcia
- Laboratoire Interdisciplinaire Récits Cultures et Sociétés, Université Côte d'Azur, 06204 Nice, France
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Amendola S, Presaghi F, Teo AR, Cerutti R. Psychometric Properties of the Italian Version of the 25-Item Hikikomori Questionnaire. Int J Environ Res Public Health 2022; 19:ijerph192013552. [PMID: 36294128 PMCID: PMC9603413 DOI: 10.3390/ijerph192013552] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 05/27/2023]
Abstract
A serious form of social withdrawal, initially described within Japan as hikikomori, has received increasing attention from the international scientific community during the last decade. The 25-item Hikikomori Questionnaire (HQ-25) was initially developed and validated in Japan. To date, data on its psychometric properties in other populations where cases of hikikomori have been described are still scarce. Thus, the aims of this study were to (1) translate, adapt, and validate the Italian version of the HQ-25 analyzing its psychometric properties; and (2) verify the association between hikikomori and personality functioning, social support, and problematic Internet use. A sample of 372 Italian adults aged 18 to 50 years completed the HQ-25 and measures of psychoticism, personality dysfunction, social support, and problematic Internet use were employed to test the convergent validity of the HQ-25. The data showed a satisfactory fit for a three-factor model, significantly better than a one-factor model. The three factors (socialization, isolation, and emotional support, as in the original study on the HQ-25) correlated positively with psychoticism, personality dysfunction, and problematic Internet use, and correlated negatively with social support. A lifetime history of hikikomori was present in 1.1% of the sample (n = 4). This is the first study to use the Italian validated version of the HQ-25 with an adult population. The findings from this study provide evidence of the satisfactory psychometric properties of the Italian version of the HQ-25 and support further investigation of the HQ-25 as an instrument to help screen for and investigate the presence of hikikomori.
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Affiliation(s)
- Simone Amendola
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabio Presaghi
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, 00185 Rome, Italy
| | - Alan R. Teo
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR 97239, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rita Cerutti
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
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Amendola S, Presaghi F, Teo AR, Cerutti R. Psychometric Properties of the Italian Version of the 25-Item Hikikomori Questionnaire for Adolescents. Int J Environ Res Public Health 2022; 19:ijerph191610408. [PMID: 36012042 PMCID: PMC9408307 DOI: 10.3390/ijerph191610408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/13/2022] [Accepted: 08/18/2022] [Indexed: 05/27/2023]
Abstract
Hikikomori is a form of social withdrawal that is commonly described as having an onset during adolescence, a life stage when other psychiatric problems can also emerge. This study aimed to adapt the 25-item Hikikomori Questionnaire (HQ-25) for the Italian adolescent population, examining its psychometric properties; associations between hikikomori and psychoticism, depression, anxiety, problematic internet use (PIU), psychotic-like experiences (PLEs), to confirm convergent validity of the HQ-25; and the interaction effect between symptoms of hikikomori and PIU in predicting PLEs. Two-hundred and twenty-one adolescents participated in the study. Measures included the HQ-25, the Psychoticism subscale of the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, the Depression and Anxiety subscales of the Brief Symptom Inventory, the Internet Disorder Scale, and the Brief Prodromal Questionnaire. Data showed a satisfactory fit for a three-factor model for the HQ-25 that is consistent with the original study on the HQ-25. Three factors (socialization, isolation, and emotional support) were associated with psychopathology measures. Six participants reported lifetime history of hikikomori. Symptoms of hikikomori and PIU did not interact in predicting PLEs. This is the first study to validate the HQ-25 in a population of adolescents. Findings provide initial evidence of the adequate psychometric properties of the Italian version of the HQ-25 for adolescents.
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Affiliation(s)
- Simone Amendola
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabio Presaghi
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, 00185 Rome, Italy
| | - Alan Robert Teo
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR 97239, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rita Cerutti
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
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Rozen N, Aderka IM. Swipe right, swipe left: Initial interactions in social anxiety disorder. J Psychopathol Clin Sci 2022; 131:435-446. [PMID: 35653757 DOI: 10.1037/abn0000761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Individuals with SAD have difficulties initiating and maintaining relationships. However, little is known about the preinteraction behavior of individuals with SAD. Individuals with (n = 40) and without SAD (n = 40) who reported being attracted to individuals of the opposite sex participated in a preregistered lab-based experiment using a novel task similar to existing initial interaction/dating applications. Specifically, participants viewed 112 profiles of individuals from the opposite sex that included pictures (either happy/smiling or neutral) and descriptive texts and were requested to choose partners for a future interaction. Participants could swipe right to indicate their willingness to meet an individual, swipe left to indicate their lack of willingness to meet the individual, or press a button to receive more information before making their decision. Participants were also requested to provide a photo of themselves and write a short description of themselves ostensibly for inclusion in the database. We found that individuals with SAD were less likely to swipe right compared to individuals without SAD, and their likelihood to swipe right did not increase in response to happy/smiling pictures. Individuals with SAD also sought less information about others before making their swiping decisions compared to individuals without SAD. Finally, individuals with SAD provided shorter self-descriptions and more neutral pictures compared to individuals without SAD. These findings could not be accounted for by depression and remained above and beyond depressive symptoms. Our findings suggest that significant SAD-related biases may exist even in preinteraction stages of relationship development (i.e., before initial interactions occur) and research and clinical implications are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Elsaid S, Rubin-Kahana DS, Kloiber S, Kennedy SH, Chavez S, Le Foll B. Neurochemical Alterations in Social Anxiety Disorder (SAD): A Systematic Review of Proton Magnetic Resonance Spectroscopic Studies. Int J Mol Sci 2022; 23:ijms23094754. [PMID: 35563145 PMCID: PMC9105768 DOI: 10.3390/ijms23094754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Objective: Considering that current knowledge of mechanisms involved in the molecular pathogenesis of Social Anxiety Disorder (SAD) is limited, we conducted a systematic review to evaluate cumulative data obtained by Proton Magnetic Resonance Spectroscopic (1H MRS) studies. (2) Methods: A computer-based literature search of Medline, EMBASE, PsycInfo, and ProQuest was performed. Only cross-sectional studies using 1H MRS techniques in participants with SAD and healthy controls (HCs) were selected. (3) Results: The search generated eight studies. The results indicated regional abnormalities in the ‘fear neurocircuitry’ in patients with SAD. The implicated regions included the anterior cingulate cortex (ACC), dorsomedial prefrontal cortex (dmPFC), dorsolateral prefrontal cortex (dlPFC), insula, occipital cortex (OC), as well as the subcortical regions, including the thalamus, caudate, and the putamen. (4) Conclusions: The evidence derived from eight studies suggests that possible pathophysiological mechanisms of SAD include impairments in the integrity and function of neurons and glial cells, including disturbances in energy metabolism, maintenance of phospholipid membranes, dysregulations of second messenger systems, and excitatory/inhibitory neurocircuitry. Conducting more cross-sectional studies with larger sample sizes is warranted given the limited evidence in this area of research.
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Affiliation(s)
- Sonja Elsaid
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada; (S.E.); (D.S.R.-K.)
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (S.K.); (S.H.K.); (S.C.)
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
| | - Dafna S. Rubin-Kahana
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada; (S.E.); (D.S.R.-K.)
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Stefan Kloiber
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (S.K.); (S.H.K.); (S.C.)
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Sidney H. Kennedy
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (S.K.); (S.H.K.); (S.C.)
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON M5B 1M4, Canada
- Li Ka Shing Knowledge Institute, Toronto, ON M5B 1T8, Canada
- Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada
- Homewood Research Institute, Guelph, ON N1E 6K9, Canada
| | - Sofia Chavez
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (S.K.); (S.H.K.); (S.C.)
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada; (S.E.); (D.S.R.-K.)
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (S.K.); (S.H.K.); (S.C.)
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Departments of Family and Community Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON M6J 1H3, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON L9M 1G3, Canada
- Correspondence: ; Tel.: +1-416-535-8501 (ext. 33111)
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Hunt C, Fleig R, Almy B, Lissek S. Heightened false alarms of conditioned threat predict longitudinal increases in GAD and SAD symptoms over the first year of college. J Anxiety Disord 2022; 87:102539. [PMID: 35134626 DOI: 10.1016/j.janxdis.2022.102539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/14/2021] [Accepted: 01/24/2022] [Indexed: 11/19/2022]
Abstract
Lab-based fear-conditioning studies have repeatedly implicated exaggerated threat reactivity to benign (unreinforced) stimuli as concurrent markers of clinical anxiety, but little work has examined the strength of false alarms as a longitudinal predictor of anxiety problems. As such, we tested whether heightened false alarms of conditioned threat assessed in participants' first semester of college predicted second-semester symptoms of generalized anxiety disorder (GAD) and social anxiety disorder (SAD) - two anxiety conditions that are common in college students, have been associated with excessive false alarms, and have yet to be assessed with longitudinal conditioning designs. Here, we focused on the predictive effects of behavioral threat responses (threat expectancy, subjective anxiety, avoidance) given their greater potential for translation to the clinic. Results implicate conditioning-related increases in anxiety to safe stimuli resembling the danger-cue as prospective predictors of GAD. In contrast, SAD was predicted by non-specific elevations in anxiety to a broad set of safe stimuli, as well as by increased threat expectancy toward cues least resembling the conditioned danger cue. These findings suggest that risk for GAD and SAD are captured by distinct, behavioral indicators of false-alarms that may be more feasibly collected in clinical settings compared to alternative experimental anxiety measures like psychophysiological responses.
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Affiliation(s)
- Christopher Hunt
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota-Twin City Campus, USA.
| | - Ryan Fleig
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota-Twin City Campus, USA
| | - Brandon Almy
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota-Twin City Campus, USA
| | - Shmuel Lissek
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota-Twin City Campus, USA
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Mueller NE, Duffy ME, Stewart RA, Joiner TE, Cougle JR. Quality over quantity? The role of social contact frequency and closeness in suicidal ideation and attempt. J Affect Disord 2022; 298:248-255. [PMID: 34728279 DOI: 10.1016/j.jad.2021.10.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/23/2021] [Accepted: 10/23/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Social support has been identified as a protective factor against suicidal thoughts and behaviors. Research has not conclusively identified the component of social support most implicated in suicidal thoughts and behaviors: (1) frequency of social contact or (2) closeness of relationships. This study examined the relationships between these facets of social support and suicidal thoughts and behaviors in two nationally representative samples, as well as subsamples with social anxiety disorder (SAD). METHODS Study 1 variables for lifetime and past-year suicide ideation and attempt, social contact frequency, and closeness were calculated and examined within the National Comorbidity Survey-Replication (NCS-R). Study 2 examined the independent contributions of social contact frequency and closeness to only lifetime suicide attempt in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). RESULTS In the NCS-R, lower social closeness but not contact frequency was uniquely associated with suicidal ideation and attempt in the general sample and those with SAD. In the NESARC-III, both components of social support were associated with lifetime suicide attempt in the general sample, while only social closeness was uniquely associated with suicide attempt in the SAD subsample. LIMITATIONS This study utilized cross-sectional data and was limited in the validity and specificity of the variables assessed. DISCUSSION Lower social closeness was more strongly associated with suicidality than social contact frequency and merits attention as a potential target for suicide-related interventions. Social closeness may be especially relevant in populations experiencing high rates of suicidal thoughts and behaviors and decreased social support.
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Affiliation(s)
- Nora E Mueller
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA
| | - Mary E Duffy
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA
| | - Rochelle A Stewart
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA.
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Panto F, Saito T, Morita N, Ogai Y. The Correlation between Enjoying Fictional Narratives and Empathy in Japanese Hikikomori. F1000Res 2022; 10:776. [PMID: 35342623 PMCID: PMC8921688 DOI: 10.12688/f1000research.55398.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Hikikomori is a Japanese social withdrawal phenomenon which, in recent years, is spreading in western developed countries as well. Spending a lot of time secluded indoors, watching and playing with fictional narratives may be relatively common for Hikikomori people and may represent a protective factor for their psychological well-being. Method: We evaluated the role of enjoying fictional narratives on empathy, relaxation, depression, and anxiety in people with Hikikomori experience, in relation to their daily consumption of fictional narratives and their emotional transportation toward fictional narratives. Hikikomori from one psychiatric clinic and three different support facilities were enrolled in this study. Multidimensional empathy scale, CES-D, STAI questionnaire, and relaxation inventory self-report scale were used as outcome measures. Results: We found a significant correlation between empathy and emotional transportation toward fictional narratives and between relaxation during watching and reading fictional narratives and consumption frequency of fictional narratives. We failed, however, to find any significant correlation with depression and anxiety. Conclusions: These findings suggest a possible correlation between fiction and empathy/relaxation response; however, any causal relationship is not proven, consequently we deem that further investigations with a larger sample size are required for a better understanding.
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Affiliation(s)
- Francesco Panto
- Social Psychiatry and Mental Health, University of Tsukuba , Faculty of Medicine, Tsukuba, Japan, 3058577, Japan
| | - Tamaki Saito
- Social Psychiatry and Mental Health, University of Tsukuba , Faculty of Medicine, Tsukuba, Japan, 3058577, Japan
| | - Nobuaki Morita
- Social Psychiatry and Mental Health, University of Tsukuba , Faculty of Medicine, Tsukuba, Japan, 3058577, Japan
| | - Yasukazu Ogai
- Social Psychiatry and Mental Health, University of Tsukuba , Faculty of Medicine, Tsukuba, Japan, 3058577, Japan
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Pereira-Sanchez V, Alvarez-Mon MA, Horinouchi T, Kawagishi R, Tan MPJ, Hooker ER, Alvarez-Mon M, Teo AR. Examining Tweet Content and Engagement of Users With Tweets About Hikikomori in Japanese: Mixed Methods Study of Social Withdrawal. J Med Internet Res 2022; 24:e31175. [PMID: 35014971 PMCID: PMC8925292 DOI: 10.2196/31175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/22/2021] [Accepted: 10/29/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Hikikomori is a form of severe social withdrawal that is particularly prevalent in Japan. Social media posts offer insight into public perceptions of mental health conditions and may also inform strategies to identify, engage, and support hard-to-reach patient populations such as individuals affected by hikikomori. OBJECTIVE In this study, we seek to identify the types of content on Twitter related to hikikomori in the Japanese language and to assess Twitter users' engagement with that content. METHODS We conducted a mixed methods analysis of a random sample of 4940 Japanese tweets from February to August 2018 using a hashtag (#hikikomori). Qualitative content analysis included examination of the text of each tweet, development of a codebook, and categorization of tweets into relevant codes. For quantitative analysis (n=4859 tweets), we used bivariate and multivariate logistic regression models, adjusted for multiple comparisons, and estimated the predicted probabilities of tweets receiving engagement (likes or retweets). RESULTS Our content analysis identified 9 codes relevant to tweets about hikikomori: personal anecdotes, social support, marketing, advice, stigma, educational opportunities, refuge (ibasho), employment opportunities, and medicine and science. Tweets about personal anecdotes were the most common (present in 2747/4859, 56.53% of the tweets), followed by social support (902/4859, 18.56%) and marketing (624/4859, 12.84%). In the adjusted models, tweets coded as stigma had a lower predicted probability of likes (-33 percentage points, 95% CI -42 to -23 percentage points; P<.001) and retweets (-11 percentage points, 95% CI -18 to -4 percentage points; P<.001), personal anecdotes had a lower predicted probability of retweets (-8 percentage points, 95% CI -14 to -3 percentage points; P=.002), marketing had a lower predicted probability of likes (-13 percentage points, 95% CI -21 to -6 percentage points; P<.001), and social support had a higher predicted probability of retweets (+15 percentage points, 95% CI 6-24 percentage points; P=.001), compared with all tweets without each of these codes. CONCLUSIONS Japanese tweets about hikikomori reflect a unique array of topics, many of which have not been identified in prior research and vary in their likelihood of receiving engagement. Tweets often contain personal stories of hikikomori, suggesting the potential to identify individuals with hikikomori through Twitter.
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Affiliation(s)
- Victor Pereira-Sanchez
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
- Department of Psychiatry, Columbia University, New York, NY, United States
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States
- Department of Psychiatry and Clinical Psychology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, Hospital Infanta Leonor, Madrid, Spain
| | - Toru Horinouchi
- Department of Psychiatry and Neurology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Ryo Kawagishi
- Department of Psychiatry, Chiba Psychiatric Medical Center, Chiba, Japan
| | - Marcus P J Tan
- Department of Child and Adolescent Psychiatry, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Elizabeth R Hooker
- VA Portland Health Care System, Health Services Research & Development Center to Improve Veteran Involvement in Care, Portland, OR, United States
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Immune System Diseases-Rheumatology, Oncology Service and Internal Medicine, Hospital Universitario Principe de Asturias, Alcalá de Henares, Spain
| | - Alan R Teo
- VA Portland Health Care System, Health Services Research & Development Center to Improve Veteran Involvement in Care, Portland, OR, United States
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
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