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Zabag R, Kivity Y, Gilboa-Schechtman E, Levy-Gigi E. Better social reversal learning is associated with a more social approach across time. Sci Rep 2024; 14:8443. [PMID: 38600127 PMCID: PMC11006889 DOI: 10.1038/s41598-024-58348-5] [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: 11/13/2023] [Accepted: 03/27/2024] [Indexed: 04/12/2024] Open
Abstract
Flexibly updating behaviors towards others is crucial for adaptive social functioning. Previous studies have found that difficulties in flexibly updating behaviors are associated with social anxiety (SA). However, it is unclear whether such difficulties relate to actual social behaviors. The current study investigated the relationships between negative-to-positive social reversal learning, social approach behavior, and SA across time. Participants (MTurk, Time 1 = 275, Time 2 = 126, 16 weeks later) completed a performance-based social reversal-learning task. In the initial phase, participants learned that interactions with certain individuals are associated with negative outcomes, whereas interactions with other individuals are associated with positive outcomes. In the reversal phase, these associations were reversed, requiring participants to update their behaviors. The relationships between the performance in the task, SA severity, and social approach behavior reported by participants were assessed cross-sectionally and longitudinally. We found that negative-to-positive updating was negatively associated with SA severity. Furthermore, negative-to-positive updating was positively correlated with social approach behavior, both cross-sectionally and prospectively. Hence, individuals with better negative-to-positive updating at Time 1 reported significantly more social approach behaviors across time. The results support the role of negative-to-positive updating as a mechanism associated with SA and social approach, advancing and refining interpersonal and cognitive theories of SA.
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Affiliation(s)
- Reut Zabag
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.
- Department of Psychology, Yale University, New Haven, CT, USA.
| | - Yogev Kivity
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
| | - Einat Levy-Gigi
- Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
- Faculty of Education, Bar-Ilan University, Ramat Gan, Israel
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2
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Vardi N, Gilboa-Schechtman E, Daches S. Unpacking affect maintenance and its association with depressive symptoms: integrating positive and negative affects. Cogn Emot 2024:1-7. [PMID: 38564187 DOI: 10.1080/02699931.2024.2334843] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024]
Abstract
ABSTRACTDepression is associated with increased maintenance of negative affect (NA) and reduced - blunted and short-lived - maintenance of positive affect (PA). Studies have focused on factors associated with the maintenance of NA, specifically, the emotion regulation strategy of brooding and the capacity to hold negative affective experiences in working memory (WM). Despite its theoretical importance, less attention has been given to factors associated with the maintenance of PA in depression. This study aims to synthesise factors playing a role in the maintenance of both NA and PA. Specifically, we used self-reported assessment of PA and NA regulation and performance-based measures of NA and PA processing in WM to predict depressive symptoms severity. Participants (N = 219) completed the Affective Maintenance Task (AMT, Mikels et al., 2008), which provided performance-based measures of PA and NA maintenance, and filled out questionnaires assessing brooding, positive rumination and depressive severity. Brooding, positive rumination and AMT-based measures of positive (but not negative) affective information processing were independently associated with depressive symptoms. We highlight the unique contributions of PA processing, as well as of self-reported emotion regulation strategies in understanding depression maintenance.
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Affiliation(s)
- Noa Vardi
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
| | - Shimrit Daches
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
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3
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Ginat-Frolich R, Gilboa-Schechtman E, Huppert JD, Aderka IM, Alden LE, Bar-Haim Y, Becker ES, Bernstein A, Geva R, Heimberg RG, Hofmann SG, Kashdan TB, Koster EHW, Lipsitz J, Maner JK, Moscovitch DA, Philippot P, Rapee RM, Roelofs K, Rodebaugh TL, Schneier FR, Schultheiss OC, Shahar B, Stangier U, Stein MB, Stopa L, Taylor CT, Weeks JW, Wieser MJ. Vulnerabilities in social anxiety: Integrating intra- and interpersonal perspectives. Clin Psychol Rev 2024; 109:102415. [PMID: 38493675 DOI: 10.1016/j.cpr.2024.102415] [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: 06/10/2022] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
What are the major vulnerabilities in people with social anxiety? What are the most promising directions for translational research pertaining to this condition? The present paper provides an integrative summary of basic and applied translational research on social anxiety, emphasizing vulnerability factors. It is divided into two subsections: intrapersonal and interpersonal. The intrapersonal section synthesizes research relating to (a) self-representations and self-referential processes; (b) emotions and their regulation; and (c) cognitive biases: attention, interpretation and judgment, and memory. The interpersonal section summarizes findings regarding the systems of (a) approach and avoidance, (b) affiliation and social rank, and their implications for interpersonal impairments. Our review suggests that the science of social anxiety and, more generally, psychopathology may be advanced by examining processes and their underlying content within broad psychological systems. Increased interaction between basic and applied researchers to diversify and elaborate different perspectives on social anxiety is necessary for progress.
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Affiliation(s)
| | | | | | - Idan M Aderka
- School of Psychological Sciences, University of Haifa, Israel
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Canada
| | - Yair Bar-Haim
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Eni S Becker
- Behavioural Science Institute, Radboud University Nijmegen, Netherlands
| | - Amit Bernstein
- School of Psychological Sciences, University of Haifa, Israel
| | - Ronny Geva
- Department of Psychology, Bar Ilan University, Israel
| | - Richard G Heimberg
- Department of Psychology, Temple University, Philadelphia, United States of America
| | - Stefan G Hofmann
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany; Department of Psychological and Brain Sciences, Boston University, Boston, United States of America
| | - Todd B Kashdan
- Department of Psychology, George Mason University, Virginia, United States of America
| | - Ernst H W Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | | | - Jon K Maner
- Department of Psychology, Florida State University, Florida, United States of America
| | - David A Moscovitch
- Department of Psychology and Centre for Mental Health Research & Treatment, University of Waterloo, Canada
| | - Pierre Philippot
- Department of Psychology, Université Catholique de Louvain, Belgium
| | - Ronald M Rapee
- Centre for Emotional Health and School of Psychological Sciences, Macquarie University, Australia
| | - Karin Roelofs
- Behavioural Science Institute, Radboud University Nijmegen, Netherlands; Donders Institute, Radboud University Nijmegen, Netherlands
| | - Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St. Louis, Missouri, United States of America
| | - Franklin R Schneier
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, United States of America
| | | | - Ben Shahar
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University, Jerusalem, Israel
| | - Ulrich Stangier
- Department of Psychology, Goethe University Frankfurt, Germany
| | - Murray B Stein
- Department of Psychiatry and School of Public Health, University of California San Diego, United States of America
| | - Lusia Stopa
- Department of Psychology, University of Southampton, United Kingdom
| | - Charles T Taylor
- Department of Psychiatry and School of Public Health, University of California San Diego, United States of America
| | - Justin W Weeks
- Department of Psychology, Nebraska Medicine, Omaha, Nebraska, United States of America; Department of Psychiatry, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Matthias J Wieser
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Netherlands
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Azoulay R, Gilboa-Schechtman E. CyberStatus: Responses to status manipulation and fears of positive and negative evaluations. J Anxiety Disord 2024; 103:102845. [PMID: 38447231 DOI: 10.1016/j.janxdis.2024.102845] [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: 07/10/2023] [Revised: 12/22/2023] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
Fear of positive evaluation (FPE) and fear of negative evaluation (FNE), which play distinct and central roles in social anxiety (SA), are postulated to reflect conflicting forces in hierarchal group contexts. Yet, experimental studies testing these assumptions are scarce. We examined the impact of status positions on FPE, FNE, and SA using a novel manipulation, CyberStatus. Participants (N = 557) provided self-descriptive statements before being randomly assigned to high, intermediate, or low-status conditions. Next, they reported their emotions, status, and belongingness-related cognitions and adjusted their self-presentation. FPE was more strongly linked to self-presentation modifications in the high- compared to intermediate-status conditions and positively associated with perceived status in the low vs. intermediate conditions. Furthermore, FPE and SA were more linked to belongingness in low vs. intermediate status conditions while FNE demonstrated the reversed pattern. These findings support and expand the evolutionary perspective on evaluation fears and emphasize the importance of assessing the linkage between status and belongingness systems in SA.
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Affiliation(s)
- Roy Azoulay
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Israel.
| | - Eva Gilboa-Schechtman
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Israel
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de Haan A, Meiser-Stedman R, Landolt MA, Kuhn I, Black MJ, Klaus K, Patel SD, Fisher DJ, Haag C, Ukoumunne OC, Jones BG, Flaiyah AM, Catani C, Dawson K, Bryant RA, de Roos C, Ertl V, Foa EB, Ford JD, Gilboa-Schechtman E, Tutus D, Hermenau K, Hecker T, Hultmann O, Axberg U, Jaberghaderi N, Jensen TK, Ormhaug SM, Kenardy J, Lindauer RJL, Diehle J, Murray LK, Kane JC, Peltonen K, Kangaslampi S, Robjant K, Koebach A, Rosner R, Rossouw J, Smith P, Tonge BJ, Hitchcock C, Dalgleish T. Efficacy and moderators of efficacy of cognitive behavioural therapies with a trauma focus in children and adolescents: an individual participant data meta-analysis of randomised trials. Lancet Child Adolesc Health 2024; 8:28-39. [PMID: 37980918 DOI: 10.1016/s2352-4642(23)00253-5] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Existing clinical trials of cognitive behavioural therapies with a trauma focus (CBTs-TF) are underpowered to examine key variables that might moderate treatment effects. We aimed to determine the efficacy of CBTs-TF for young people, relative to passive and active control conditions, and elucidate putative individual-level and treatment-level moderators. METHODS This was an individual participant data meta-analysis of published and unpublished randomised studies in young people aged 6-18 years exposed to trauma. We included studies identified by the latest UK National Institute of Health and Care Excellence guidelines (completed on Jan 29, 2018) and updated their search. The search strategy included database searches restricted to publications between Jan 1, 2018, and Nov 12, 2019; grey literature search of trial registries ClinicalTrials.gov and ISRCTN; preprint archives PsyArXiv and bioRxiv; and use of social media and emails to key authors to identify any unpublished datasets. The primary outcome was post-traumatic stress symptoms after treatment (<1 month after the final session). Predominantly, one-stage random-effects models were fitted. This study is registered with PROSPERO, CRD42019151954. FINDINGS We identified 38 studies; 25 studies provided individual participant data, comprising 1686 young people (mean age 13·65 years [SD 3·01]), with 802 receiving CBTs-TF and 884 a control condition. The risk-of-bias assessment indicated five studies as low risk and 20 studies with some concerns. Participants who received CBTs-TF had lower mean post-traumatic stress symptoms after treatment than those who received the control conditions, after adjusting for post-traumatic stress symptoms before treatment (b=-13·17, 95% CI -17·84 to -8·50, p<0·001, τ2=103·72). Moderation analysis indicated that this effect of CBTs-TF on post-traumatic stress symptoms post-treatment increased by 0·15 units (b=-0·15, 95% CI -0·29 to -0·01, p=0·041, τ2=0·03) for each unit increase in pre-treatment post-traumatic stress symptoms. INTERPRETATION This is the first individual participant data meta-analysis of young people exposed to trauma. Our findings support CBTs-TF as the first-line treatment, irrespective of age, gender, trauma characteristics, or carer involvement in treatment, with particular benefits for those with higher initial distress. FUNDING Swiss National Science Foundation.
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Affiliation(s)
- Anke de Haan
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK; Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland; Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Markus A Landolt
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland; Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
| | - Isla Kuhn
- Medical Library, University of Cambridge, Cambridge, UK
| | - Melissa J Black
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Kristel Klaus
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Shivam D Patel
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - David J Fisher
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Christina Haag
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland; Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Obioha C Ukoumunne
- National Institute for Health and Care Research Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK
| | - Benjamin G Jones
- National Institute for Health and Care Research Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK; Exploristics, Belfast, UK
| | | | - Claudia Catani
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Katie Dawson
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Carlijn de Roos
- Academic Centre for Child and Adolescent Psychiatry, Amsterdam University Medical Center (location AMC), Amsterdam, Netherlands; Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Verena Ertl
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Edna B Foa
- Department of Psychiatry, University of Pennsylvania Medical School, Philadelphia, PA, USA
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Eva Gilboa-Schechtman
- Emotional Processing Laboratory, Department of Psychology and the Gonda Brain Science Center, Bar-Ilan University, Ramat Gan, Israel
| | - Dunja Tutus
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Katharin Hermenau
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, University Medical Centre EWL, Bielefeld University, Bielefeld, Germany
| | - Tobias Hecker
- Division of Clinical Developmental Psychopathology, Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Ole Hultmann
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Ulf Axberg
- Faculty of Social Studies, VID Specialized University, Oslo, Norway
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Tine K Jensen
- Department of Psychology, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Silje M Ormhaug
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Justin Kenardy
- School of Psychology, University of Queensland, Brisbane, QLD, Australia; Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Ramon J L Lindauer
- Academic Centre for Child and Adolescent Psychiatry, Amsterdam University Medical Center (location AMC), Amsterdam, Netherlands; Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry, Public Mental Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Julia Diehle
- WODC-Research and Documentation Centre, Ministry of Justice and Security, The Hague, Netherlands
| | - Laura K Murray
- Department of Mental Health and International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Jeremy C Kane
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
| | - Kirsi Peltonen
- INVEST Research Flagship Centre, University of Turku, Turku, Finland
| | - Samuli Kangaslampi
- Faculty of Social Sciences, Psychology, Tampere University, Tampere, Finland
| | - Katy Robjant
- Clinical and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany; Vivo International, Konstanz, Germany
| | - Anke Koebach
- Clinical and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany; Development Research Group, Department of Politics and Administration, University of Konstanz, Konstanz, Germany; Vivo International, Konstanz, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Jaco Rossouw
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa; Centre for Cognitive-Behavioural Therapy, Cape Town, South Africa
| | - Patrick Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bruce J Tonge
- Centre for Developmental Psychology and Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
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Zabag R, Rinck M, Becker E, Gilboa-Schechtman E, Levy-Gigi E. Although I know it: Social anxiety is associated with a deficit in positive updating even when the cost of avoidance is Obvious. J Psychiatr Res 2024; 169:279-283. [PMID: 38065052 DOI: 10.1016/j.jpsychires.2023.11.041] [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: 02/26/2023] [Revised: 09/13/2023] [Accepted: 11/22/2023] [Indexed: 01/15/2024]
Abstract
Social anxiety (SA) is associated with difficulties in positively updating negative social information when new information and feedback about chosen options (actual decisions) are received. However, it is unclear whether this difficulty persists when hidden information regarding unchosen options is explicitly presented. The aim of the current study was to address this gap. Participants (Mturk; n = 191) completed a two-phases novel task. In the task, participants chose to approach or avoid people, represented by images of faces. During the initial (learning) phase, participants learned, in a probabilistic context, which people are associated with negative outcomes and should be avoided, and which are associated with positive outcomes and should be approached. During the subsequent updating phase, people previously associated with negative outcomes became associated with positive outcomes and vice versa. Importantly, participants received feedback not only on their approach (actual) decisions, but also on their avoidance (counter-factual) decisions (e.g., approaching this person would have been beneficial). The results revealed that even when the consequences of avoidance were explicitly presented, SA was associated with difficulty in positive updating of social information. The findings support the view that biased updating of social information is a change-resistant mechanism that may underlie the maintenance of SA.
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Affiliation(s)
- Reut Zabag
- Department of Psychology, Yale University, New Haven, Connecticut, United States; Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Eni Becker
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Eva Gilboa-Schechtman
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel; Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Einat Levy-Gigi
- Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat-Gan, Israel; Faculty of Education, Bar-Ilan University, Ramat-Gan, Israel
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7
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Lavi-Rotenberg A, Frishman N, Igra L, Gilboa-Schechtman E, Hasson-Ohayon I. Beyond One's Attitude Toward the Self: The Role of Social Anxiety in Self-Stigma Among Individuals With Schizophrenia. J Nerv Ment Dis 2024; 212:28-32. [PMID: 37846987 DOI: 10.1097/nmd.0000000000001724] [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: 10/18/2023]
Abstract
ABSTRACT Self-stigma is associated with a variety of negative self-perceptions among people coping with schizophrenia, as well as with different aspects of social behaviors. We explored the associations between self-compassion, self-esteem, social anxiety, and self-stigma among people coping with schizophrenia. The baseline data of 56 adults with schizophrenia who were enrolled in a Metacognitive Reflection and Insight Therapy trial were used. Participants filled out self-report questionnaires measuring self-compassion, self-esteem, social anxiety, and self-stigma. Self-esteem and self-compassion were negatively correlated with self-stigma and social anxiety. Self-compassion was not found to contribute beyond self-esteem to the prediction of self-stigma. Importantly, self-esteem and social anxiety were found to mediate the effects of self-compassion on self-stigma. Thus, it seems that social variables, in addition to self-variables, may lead to the formation of self-stigma among people with schizophrenia. Therefore, alongside addressing self-esteem and self-compassion, integrating therapeutic elements related to coping with social anxiety into interventions would seem to be an important factor in reducing self-stigma among people with serious mental illness.
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8
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Slonim DA, Yehezkel I, Paz A, Bar-Kalifa E, Wolff M, Dar A, Gilboa-Schechtman E. Facing Change: Using Automated Facial Expression Analysis to Examine Emotional Flexibility in the Treatment of Depression. Adm Policy Ment Health 2023:10.1007/s10488-023-01310-w. [PMID: 37880472 DOI: 10.1007/s10488-023-01310-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE Depression involves deficits in emotional flexibility. To date, the varied and dynamic nature of emotional processes during therapy has mostly been measured at discrete time intervals using clients' subjective reports. Because emotions tend to fluctuate and change from moment to moment, the understanding of emotional processes in the treatment of depression depends to a great extent on the existence of sensitive, continuous, and objectively codified measures of emotional expression. In this observational study, we used computerized measures to analyze high-resolution time-series facial expression data as well as self-reports to examine the association between emotional flexibility and depressive symptoms at the client as well as at the session levels. METHOD Video recordings from 283 therapy sessions of 58 clients who underwent 16 sessions of manualized psychodynamic psychotherapy for depression were analyzed. Data was collected as part of routine practice in a university clinic that provides treatments to the community. Emotional flexibility was measured in each session using an automated facial expression emotion recognition system. The clients' depression level was assessed at the beginning of each session using the Beck Depression Inventory-II (Beck et al., 1996). RESULTS Higher emotional flexibility was associated with lower depressive symptoms at the treatment as well as at the session levels. CONCLUSION These findings highlight the centrality of emotional flexibility both as a trait-like as well as a state-like characteristic of depression. The results also demonstrate the usefulness of computerized measures to capture key emotional processes in the treatment of depression at a high scale and specificity.
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Affiliation(s)
| | - Ido Yehezkel
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Adar Paz
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Eran Bar-Kalifa
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Maya Wolff
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Avinoam Dar
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
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9
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Shany O, Dunsky N, Gilam G, Greental A, Gilboa-Schechtman E, Hendler T. Self-evaluation of social-rank in socially anxious individuals associates with enhanced striatal reward function. Psychol Med 2023; 53:4569-4579. [PMID: 35698849 PMCID: PMC10388315 DOI: 10.1017/s0033291722001453] [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: 08/19/2021] [Revised: 04/21/2022] [Accepted: 05/04/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Negative self-views, especially in the domain of power (i.e. social-rank), characterize social anxiety (SA). Neuroimaging studies on self-evaluations in SA have mainly focused on subcortical threat processing systems. Yet, self-evaluation may concurrently invoke diverse affective processing, as motivational systems related to desired self-views may also be activated. To investigate the conflictual nature that may accompany self-evaluation of certain social domains in SA, we examined brain activity related to both threat and reward processing. METHODS Participants (N = 74) differing in self-reported SA-severity underwent fMRI while completing a self-evaluation task, wherein they judged the self-descriptiveness of high- v. low-intensity traits in the domains of power and affiliation (i.e. social connectedness). Participants also completed two auxiliary fMRI tasks designated to evoke reward- and threat-related activations in the ventral striatum (VS) and amygdala, respectively. We hypothesized that self-evaluations in SA, particularly in the domain of power, involve aberrant brain activity related to both threat and reward processing. RESULTS SA-severity was more negatively associated with power than with affiliation self-evaluations. During self-evaluative judgment of high-power (e.g. dominant), SA-severity associated with increased activity in the VS and ventromedial prefrontal cortex. Moreover, SA-severity correlated with higher similarity between brain activity patterns activated by high-power traits and patterns activated by incentive salience (i.e. reward anticipation) in the VS during the reward task. CONCLUSIONS Our findings indicate that self-evaluation of high-power in SA involves excessive striatal reward-related activation, and pinpoint the downregulation of VS-VMPFC activity within such self-evaluative context as a potential neural outcome for therapeutic interventions.
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Affiliation(s)
- Ofir Shany
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Netta Dunsky
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Gadi Gilam
- Faculty of Dental Medicine, The Institute of Biomedical and Oral Research, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ayam Greental
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology and the Gonda Brain Science Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Talma Hendler
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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10
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Bilu Y, Kalkstein N, Gilboa-Schechtman E, Akiva P, Zalsman G, Itzhaky L, Atzil-Slonim D. Predicting future onset of depression among middle-aged adults with no psychiatric history. BJPsych Open 2023; 9:e85. [PMID: 37218301 DOI: 10.1192/bjo.2023.62] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Depression is a major cause of disability worldwide. Recent data suggest that, in industrialised countries, the prevalence of depression peaks in middle age. Identifying factors predictive of future depressive episodes is crucial for developing prevention strategies for this age group. AIMS We aimed to identify future depression in middle-aged adults with no previous psychiatric history. METHOD To predict a diagnosis of depression 1 year or more following a comprehensive baseline assessment, we used a data-driven, machine-learning methodology. Our data-set was the UK Biobank of middle-aged participants (N = 245 036) with no psychiatric history. RESULTS Overall, 2.18% of the study population developed a depressive episode at least 1 year following baseline. Basing predictions on a single mental health questionnaire led to an area under the curve of the receiver operating characteristic of 0.66, and a predictive model leveraging the combined results of 100 UK Biobank questionnaires and measurements improved this to 0.79. Our findings were robust to demographic variations (place of birth, gender) and variations in methods of depression assessment. Thus, machine-learning-based models best predict diagnoses of depression when allowing the inclusion of multiple features. CONCLUSIONS Machine-learning approaches show potential for being beneficial for the identification of clinically relevant predictors of depression. Specifically, we can identify, with moderate success, people with no recorded psychiatric history as at risk for depression by using a relatively small number of features. More work is required to improve these models and evaluate their cost-effectiveness before integrating them into the clinical workflow.
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Affiliation(s)
| | | | | | | | - Gil Zalsman
- Psychiatry School of Continuing Medical Education, Tel-Aviv University, Israel
| | - Liat Itzhaky
- Department of Psychiatry, Columbia University Medical Center, New York, USA
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11
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Bar-Kalifa E, Goren O, Gilboa-Schechtman E, Wolff M, Rafael D, Heimann S, Yehezkel I, Scheniuk A, Ruth F, Atzil-Slonim D. Clients' emotional experience as a dynamic context for client-therapist physiological synchrony. J Consult Clin Psychol 2023; 91:367-380. [PMID: 37104801 DOI: 10.1037/ccp0000811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Client-therapist physiological synchrony has recently attracted significant empirical attention. Recent theoretical accounts propose that physiological linkages should not be considered a stable dyadic virtue but rather a dynamic process that depends on the situational context in which they transpire. The present study adopted a "momentary" (vs. "global") approach that focuses on therapist-client physiological synchrony over relatively short periods of time. These temporal data served to examine the interplay between patterns of synchrony (in-phase vs. antiphase) and clients' momentary emotional experiences (inhibited/unproductive, productive, and positive). Synchrony was assessed by measuring respiratory sinus arrhythmia (RSA), an autonomic index that is known to be associated with interpersonal emotion regulation. METHOD Data were drawn from 28 clients undergoing a 16-session supportive-expressive dynamic therapy for depression. Clients' and therapists' electrocardiography were recorded in five sessions; clients' emotional experiences were coded at the speech-turn level. After each session, the clients also completed the session evaluation scale. RESULTS Client-therapist dyads had greater momentary RSA synchrony than would be predicted by chance. Compared to moments of unproductive emotional experience, greater antiphase synchrony was observed during moments of productive emotional experiences. In addition, compared to moments of unproductive emotional experience, greater in-phase and antiphase synchrony were observed during moments of positive emotional experiences. These patterns of synchrony were associated with clients' favorable evaluations of the session. CONCLUSION By considering the dynamic nature of synchrony, these findings provide a fine-grained picture of physiological synchrony and its potential effects on therapy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Eran Bar-Kalifa
- Department of Psychology, Ben-Gurion University of the Negev
| | - Omer Goren
- Department of Psychology, Bar-Ilan University
| | | | - Maya Wolff
- Department of Psychology, Bar-Ilan University
| | - Dana Rafael
- Department of Psychology, Bar-Ilan University
| | | | | | - Amit Scheniuk
- Department of Psychology, Ben-Gurion University of the Negev
| | - Feldman Ruth
- Department of Psychology, Reichman University (IDC Herzliya)
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12
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Zabag R, Azoulay R, Rinck M, Becker E, Levy-Gigi E, Gilboa-Schechtman E. You never get a chance to undo a negative first impression: Social anxiety is associated with impaired positive updating of social information. Personality and Individual Differences 2023. [DOI: 10.1016/j.paid.2022.111993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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13
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Azoulay R, Avigadol L, Gilboa-Schechtman E. Social anxiety and accumulation of status loss events: The role of adulthood experiences. Br J Clin Psychol 2023; 62:518-524. [PMID: 36808121 DOI: 10.1111/bjc.12417] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/04/2023] [Accepted: 02/08/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVES The association between social anxiety (SA) and early-life status loss events (SLEs) is well documented. However, such an association in adulthood is yet to be examined. METHODS Two studies (N = 166 and N = 431) were conducted to address this question. Adult participants filled out questionnaires regarding SLEs accumulation during childhood, adolescence, and adulthood, along with depression and SA severity measures. RESULTS SA was associated with SLEs in adulthood over and above SLEs in childhood and adolescence, and depression. CONCLUSION The adaptive role of SA in adulthood in the face of concrete and relevant status threats is discussed.
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Affiliation(s)
- Roy Azoulay
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
| | - Liat Avigadol
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
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14
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Hay DE, Bleicher S, Azoulay R, Kivity Y, Gilboa-Schechtman E. Affective and cognitive impact of social overinclusion: a meta-analytic review of cyberball studies. Cogn Emot 2023:1-18. [PMID: 36622872 DOI: 10.1080/02699931.2022.2163619] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Belongingness is a central biopsychosocial system. Challenges to belongingness (i.e. exclusion/ostracism) engender robust negative effects on affect and cognitions. Whether overinclusion - getting more than one's fair share of social attention - favourably impacts affect and cognitions remains an open question. This pre-registered meta-analysis includes twenty-two studies (N = 2757) examining overinclusion in the context of the Cyberball task. We found that the estimated overall effect size of overinclusion on positive affect was small but robust, and the effect on fundamental needs cognitions (belongingness, self-esteem, meaningful existence and control) was moderate in size and positive in direction. Notably, the effect sizes of overinclusion were smaller than the corresponding effects of exclusion. Finally, the effects of overinclusion on positive affect were greater for high, as compared to low, socially anxious individuals. Exploring the sequelae of the full range of inclusion experiences - from exclusion to overinclusion - may enrich our understanding of the functioning of the belongingness system as well as its interaction with another central biosocial system - the social status system.
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Affiliation(s)
- Dan E Hay
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.,Gonda Brain Science Center, Bar-Ilan University, Ramat Gan, Israel
| | - Sun Bleicher
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.,Gonda Brain Science Center, Bar-Ilan University, Ramat Gan, Israel
| | - Roy Azoulay
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.,Gonda Brain Science Center, Bar-Ilan University, Ramat Gan, Israel
| | - Yogev Kivity
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.,Gonda Brain Science Center, Bar-Ilan University, Ramat Gan, Israel
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15
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Rahamim O, Azoulay R, Keshet H, Shahar G, Gilboa-Schechtman E. Apprehensions and Aspirations in Social Anxiety and Depression. Int J Cogn Ther 2022. [DOI: 10.1007/s41811-022-00150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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16
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Azoulay R, Gilboa-Schechtman E. The scarring impact of status loss in social anxiety: An evolutionary perspective. J Anxiety Disord 2022; 90:102600. [PMID: 35841783 DOI: 10.1016/j.janxdis.2022.102600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 12/01/2022]
Abstract
Evolutionary models suggest that social anxiety (SA) is associated with sensitivity to status loss. These models make several additional predictions concerning the strength as well as the specificity of the association between post-event distress (PED) following status losses and SA. First, the strength of this association is postulated to be enhanced in men, especially following status losses inflicted by other men (intra-male status losses). Second, given the evolutionary postulated relationship between social status and physical fitness, sensitivity to status loss in SA is expected to extend to physically threatening events. We examined these predictions in four online samples (total N = 1123; 59% females, 27% above the cutoff for clinically elevated SA). In all studies, participants recalled social status-loss events and rated the emotional and distressing impact of these experiences. In two samples, participants also identified and recalled physically threatening events. Our findings were consistent with evolutionary predictions. SA was associated with PED following social status-loss events (β = 0.27). This association was stronger in men than in women (β = 0.40, β = 0.16, respectively). Moreover, the SA-PED association was especially enhanced following intra-male, compared to intra-female and inter-gender, status losses (β = 0.47, β = 0.26, and β = 0.17, respectively). Furthermore, SA was uniquely associated with PED following physically threatening events, over and above PED following social status-loss events (β = 0.21). Our data highlights the significant impact of socially and physically threatening events and delineates the scarring signature of such events in SA.
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Affiliation(s)
- Roy Azoulay
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Israel.
| | - Eva Gilboa-Schechtman
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Israel
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17
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Azoulay R, Wilner-Sakal M, Zabag R, Gilboa-Schechtman E. Evolutionary Perspective on Self-Concept: The Effects of Interpersonal Motivations and Inclusionary Status on Spontaneous Self-Descriptions of Communion and Agency. Evol Psychol 2022; 20:14747049221120095. [PMID: 36066014 PMCID: PMC10358400 DOI: 10.1177/14747049221120095] [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: 03/09/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/16/2022] Open
Abstract
Evolutionary models suggest that self-concept is a dynamic structure shaped jointly by interpersonal motivations and social challenges. Yet, empirical data assessing this claim are sparse. We examined this question in two studies. In study 1, participants (N = 386) generated spontaneous self-descriptions and filled out questionnaires assessing dominance and affiliation motivations. We found that self-descriptions categorized as communion or agency were associated with affiliation and dominance motivations, respectively. In study 2, participants (N = 360) underwent an inclusionary manipulation (exclusion, inclusion, popularity) and completed self-description and motivation measures. We found that exclusion (compared to inclusion/popularity) enhanced the salience of communion self-descriptions such that participants described themselves using more communion traits. Finally, in the popularity condition (compared to exclusion/inclusion), an enhanced positive association between salience of agency self-descriptions and dominance motivation was found. Our results support evolutionary models suggesting that self-concept organization shapes and is being shaped by social motivations to enhance interpersonal functioning.
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Affiliation(s)
- Roy Azoulay
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Moran Wilner-Sakal
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Reut Zabag
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat-Gan, Israel
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18
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Azoulay R, Gilboa-Schechtman E. Social Construction and Evolutionary Perspectives on Gender Differences in Post-traumatic Distress: The Case of Status Loss Events. Front Psychiatry 2022; 13:858304. [PMID: 35651822 PMCID: PMC9148972 DOI: 10.3389/fpsyt.2022.858304] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Women report greater post-traumatic distress (PTD) than men following physically threatening events. However, gender differences in PTD following social stressors such as status losses are understudied. Whereas the social construction account points to a general sensitivity in women following any type of stressor, the evolutionary account suggests enhanced sensitivity to status losses in men, especially following inter-males aggressions. These propositions were examined in two studies (Study 1, N = 211; Study 2, N = 436). Participants were asked to recall a status loss and to fill out measures assessing PTD and depression severity. In line with the evolutionary account, men, as compared to women, displayed enhanced PTD following status loss. Status losses conducted by men against men were associated with greater PTD than were instances involving other target-aggressor pairings. Finally, age was negatively associated with PTD in men but not in women. The examination of evolutionary challenges modifies the standard view linking the female gender to enhanced sensitivity to trauma. Thus, the pattern of enhanced sensitivity to stressful events appears to be affected by gender- and development-specific adaptive challenges.
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Affiliation(s)
- Roy Azoulay
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
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19
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Dapprich AL, Gilboa-Schechtman E, Becker ES, Rinck M. Evaluations of three different types of smiles in relation to social anxiety and psychopathic traits. Cogn Emot 2022; 36:535-545. [PMID: 34951819 DOI: 10.1080/02699931.2021.2016638] [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] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 11/28/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
Research has identified three different types of smiles - the reward, affiliation and dominance smile - which serve expressions of happiness, connectedness, and superiority, respectively. Examining their explicit and implicit evaluations by considering a perceivers' level of social anxiety and psychopathy may enhance our understanding of these smiles' theorised meanings, and their role in problematic social behaviour. Female participants (N=122) filled in questionnaires on social anxiety, psychopathic tendencies (i.e. the affective-interpersonal deficit and antisocial lifestyle) and callous-unemotional (CU) traits. In order to measure explicit and implicit evaluations of the three smiles, angry and neutral facial expressions, an Explicit Valence Rating Task and an Approach-Avoidance Task were administered. Results indicated that all smiles were explicitly evaluated as positive. No differences in implicit evaluations between the smile types were found. Social anxiety was not associated with either explicit or implicit smile evaluations. In contrast, CU-traits were negatively associated with explicit evaluations of reward and dominance smiles. These findings support the assumptions of non-biased explicit information processing in social anxiety, and flattened emotional sensitivity in CU-traits. The importance of a multimethod approach to enhance the understanding of the effects of smile types on perceivers is discussed.
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Affiliation(s)
- Anna L Dapprich
- Experimental Psychopathology & Treatment, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Eva Gilboa-Schechtman
- Department of Psychology, Gonda Brain Science Center, Bar-Ilan University, Ramat Gan, Israel
| | - Eni S Becker
- Experimental Psychopathology & Treatment, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Mike Rinck
- Experimental Psychopathology & Treatment, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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20
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Atzil-Slonim D, Stolowicz-Melman D, Bar-Kalifa E, Gilboa-Schechtman E, Paz A, Wolff M, Rotter I, Zagoory O, Feldman R. Oxytocin reactivity to the therapeutic encounter as a biomarker of change in the treatment of depression. J Couns Psychol 2022; 69:755-760. [PMID: 35482667 DOI: 10.1037/cou0000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Depression affects millions worldwide, thus underscoring the urgent need to optimize health care practices. To better understand the processes involved in psychotherapy gains, studies have emphasized the need to complement subjective reports with objective measures, in particular biological markers. Oxytocin (OT) has been proposed as a potential biomarker in the treatment of depression given its involvement in depression-related psychological and physiological functions and the formation of close relationships. Here, we assessed whether OT reactivity to therapeutic encounters (absolute and/or directional reactivity) is linked to improvements in depressive symptoms from session to session during psychotherapy. A total of 284 saliva samples were collected from 30 adult clients who underwent 16 sessions of manualized psychodynamic psychotherapy for depression in a university setting. Salivary OT was measured before and after five preselected sessions distributed evenly throughout the therapy. The Beck Depression Inventory-II (BDI-II) was administered at the beginning of each session. Multilevel growth models indicated that clients exhibiting greater absolute OT reactivity showed greater improvement in depressive symptoms throughout treatment. Directional reactivity was not associated with depressive symptom change. In addition, clients with higher baseline OT levels displayed less change in depressive symptoms. These findings highlight reactivity of the OT system, in either direction, as an important feature of the treatment response. Consistent with recent models of the neurobiology of resilience, OT reactivity appears to serve as an important biomarker of psychotherapy gain in the treatment of depression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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21
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Elliott JGC, Gilboa-Schechtman E, Grigorenko EL, Heathcote A, Purdie-Greenaway VJ, Uddin LQ, van der Maas HLJ, Waldmann MR. Editorial. Psychol Rev 2022; 129:1-3. [PMID: 35266788 DOI: 10.1037/rev0000359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
During its 128 years of operation, Psychological Review has exerted a powerful and consistent influence on the field under its long-term sponsor, the American Psychological Association (APA). Notwithstanding changes in ownership, it has always been what it is now-the flagship of the Association and the field. Since its inception, the journal has focused on theoretical analyses (e.g., systematic evaluations of alternative theories) and/or developments (e.g., the generation of novel theories) in the psychological sciences. Thus, the objectives of any incoming editor and editorial board remain steadfast: (a) to maintain and enhance the standing of Psychological Review in the field and (b) to correspondingly align its scope, content, and operations with any changes in the Association, the field of psychology in particular, and science and society in general. The journal's new senior editorial team is excited to navigate Psychological Review through the ever-changing landscape of psychology at this time of multiple challenges, referred to by the United Nations Secretary General António Guterres as "the greatest cascade of crises in our lifetime." Although we are initiating a number of changes, we will do our best to maintain Psychological Review's excellence. This will involve our capacity to reflect on and disseminate new theoretical developments, enriched and inspired by current trends in science in general and in psychological science in particular, while maintaining an overarching commitment to advancing the field through the incorporation of diverse perspectives. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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22
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Rozen N, Gilboa-Schechtman E, Marom S, Hermesh H, Aderka IM. Comorbid major depressive disorder in cognitive-behavior group treatment for social anxiety disorder: An examination of processes of symptom change. Psychotherapy (Chic) 2022; 59:48-56. [PMID: 35025567 DOI: 10.1037/pst0000413] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Individuals with social anxiety disorder (SAD) typically have elevated depressive symptoms and approximately 50% also meet criteria for major depressive disorder (MDD; Beesdo et al., 2007). In the present study, we examined the relationship between social anxiety and depressive symptoms during cognitive-behavior group treatment (CBGT) for SAD. Specifically, we compared individuals with SAD and comorbid MDD and individuals with SAD without MDD to examine the role of MDD as a moderator of social anxiety-depression relationship. Participants were 90 individuals seeking treatment for SAD (36% were diagnosed with MDD), who completed self-report measures of social anxiety and depression every 2 weeks during CBGT. Lower level mediational modeling indicated that for individuals without MDD, a reciprocal relationship was observed in which changes in both social anxiety and depressive symptoms mediated changes in each other. However, changes in social anxiety explained all subsequent changes in depression, whereas changes in depression explained 11.26% of subsequent changes in social anxiety. For individuals with both SAD and MDD, neither social anxiety nor depression significantly mediated changes in each other. Our findings suggest that different processes of change occur for individuals with and without MDD and clinical implications of these findings are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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23
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Cohen-Chazani Y, Lavidor M, Gilboa-Schechtman E, Roe D, Hasson-Ohayon I. Meta-Analysis of the Effect of Psychotherapy in an Inpatient Setting: Examining the Moderating Role of Diagnosis and Therapeutic Approach. Psychiatry 2022; 85:399-417. [PMID: 35442174 DOI: 10.1080/00332747.2022.2062660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The current meta-analysis investigates the efficacy of psychotherapy during psychiatric hospitalization and examines the moderating role of diagnosis and therapeutic approach. METHODS We conducted systematic searches in literature databases, including PubMed, PsycInfo, and Google Scholar. In total, 37 samples were included for the meta-analysis with a total of 4,443 patients. The primary outcome was the standardized mean differences in clinical status measured by symptomatic and functional measures. RESULTS The meta-analysis of 22 samples without a control group resulted in the upper end of the medium effect size for the overall effect of treatment during psychiatric hospitalization that included psychotherapy (k = 22, Cohen's d = 0.70, and 95% Cl 0.36 to 1.04). The meta-analysis of 15 samples with a control group resulted in the upper end of the low effect size for the contribution of psychotherapy to the improvement of patients' clinical status measured by symptomatic and functional measures (k = 15, Cohen's d = 0.43, and 95% CI 0.06 to 0.81). No significant effects were uncovered for psychotherapy orientation. Diagnosis was found to moderate the contribution of psychotherapy in an inpatient setting to the improvement of patients' clinical condition. CONCLUSION Psychotherapy during psychiatric hospitalization may be an effective treatment. Across the various samples, psychotherapy has a moderate effect on the reduction of psychiatric symptoms beyond the overall effect of ward treatment.
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24
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Atzil-Slonim D, Juravski D, Bar-Kalifa E, Gilboa-Schechtman E, Tuval-Mashiach R, Shapira N, Goldberg Y. Using topic models to identify clients' functioning levels and alliance ruptures in psychotherapy. ACTA ACUST UNITED AC 2021; 58:324-339. [PMID: 33734743 DOI: 10.1037/pst0000362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Computerized natural language processing techniques can analyze psychotherapy sessions as texts, thus generating information about the therapy process and outcome and supporting the scaling-up of psychotherapy research. We used topic modeling to identify topics discussed in psychotherapy sessions and explored (a) which topics best identified clients' functioning and alliance ruptures and (b) whether changes in these topics were associated with changes in outcome. Transcripts of 873 sessions from 58 clients treated by 52 therapists were analyzed. Before each session, clients self-reported functioning and symptom level. After each session, therapists reported the extent of alliance rupture. Latent Dirichlet allocation was used to extract latent topics from psychotherapy textual data. Then a sparse multinomial logistic regression model was used to predict which topics best identified clients' functioning levels and the occurrence of alliance ruptures in psychotherapy sessions. Finally, we used multilevel growth models to explore the associations between changes in topics and changes in outcome. Session-based processing yielded a list of semantic topics. The model identified the labels above chance (65% to 75% accuracy). Change trajectories in topics were associated with change trajectories in outcome. The results suggest that topic models can exploit rich linguistic data within sessions to identify psychotherapy process and outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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25
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Martin JD, Wood A, Cox WTL, Sievert S, Nowak R, Gilboa-Schechtman E, Zhao F, Witkower Z, Langbehn AT, Niedenthal PM. Correction to: Evidence for Distinct Facial Signals of Reward, Affiliation, and Dominance from Both Perception and Production Tasks. Affect Sci 2021; 2:31. [PMID: 36042916 PMCID: PMC9383027 DOI: 10.1007/s42761-021-00042-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
[This corrects the article DOI: 10.1007/s42761-020-00024-8.].
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Affiliation(s)
- Jared D. Martin
- Department of Psychology, New York University, 6 Washington Pl., New York, NY 10003 USA
| | - Adrienne Wood
- Department of Psychology, University of Virginia, Charlottesville, VA USA
| | - William T. L. Cox
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Scott Sievert
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, WI USA
| | - Robert Nowak
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, WI USA
| | | | - Fangyun Zhao
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Zachary Witkower
- Department of Psychology, University of British Columbia, Vancouver, BC Canada
| | - Andrew T. Langbehn
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
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Shapira N, Lazarus G, Goldberg Y, Gilboa-Schechtman E, Tuval-Mashiach R, Juravski D, Atzil-Slonim D. Using computerized text analysis to examine associations between linguistic features and clients' distress during psychotherapy. J Couns Psychol 2020; 68:77-87. [PMID: 32352823 DOI: 10.1037/cou0000440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Raw linguistic data within psychotherapy sessions may provide important information about clients' progress and well-being. In the current study, computerized text analytic techniques were applied to examine whether linguistic features were associated with clients' experiences of distress within and between clients and whether changes in linguistic features were associated with changes in treatment outcome. Transcripts of 729 psychotherapy sessions from 58 clients treated by 52 therapists were analyzed. Prior to each session, clients reported their distress level. Linguistic features were extracted automatically by using natural language parser for first-person singular identification and using positive and negative emotion words lexicon. The association between linguistic features and levels of distress was examined using multilevel models. At the within-client level, fewer first-person singular words, fewer negative emotional words and more positive emotional words were associated with lower distress in the same session; and fewer negative emotion words were associated with lower next session distress (rather small f2 effect sizes = 0.011 < f2 < 0.022). At the between-client level, only first session use of positive emotion words was associated with first session distress (ηp2 effect size = 0.08). A drop in the use of first-person singular words was associated with improved outcome from pre- to posttreatment (small ηp2 effect size = 0.05). The findings provide preliminary support for the association between clients' linguistic features and their fluctuating experience of distress. They point to the potential value of computerized linguistic measures to track therapeutic outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Azoulay R, Berger U, Keshet H, Niedenthal PM, Gilboa-Schechtman E. Social anxiety and the interpretation of morphed facial expressions following exclusion and inclusion. J Behav Ther Exp Psychiatry 2020; 66:101511. [PMID: 31614264 DOI: 10.1016/j.jbtep.2019.101511] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 06/27/2019] [Accepted: 08/31/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Negative interpretation biases are postulated to play etiological and maintaining roles in social anxiety (SA). However, empirical support for interpretation biases of facial expression in SA is inconsistent. Given the importance of signals of (dis)approval in SA, our objective was to examine whether SA is associated with enhanced sensitivity to such signals especially following exclusion. METHODS In Study 1, participants (N = 139) underwent an exclusion/inclusion manipulation and were then presented with video clips of smiles gradually changing into disgust expressions (smile-to-disgust). In Study 2 (N = 203), participants saw smile-to-disgust as well as disgust-to-smile clips following an exclusion/inclusion manipulation. Participants' task in both studies was to detect the offset of the initial expression. RESULTS Results of Study 1 show that detection latency of smiles' disappearance is negatively associated with SA severity. The results of Study 2 suggest that this association is stronger following exclusion, and specific to the smile-to-disgust as opposed to the disgust-to-smile, transitions. LIMITATIONS Our studies did not examine whether the observed interpretation bias was specific to SA. CONCLUSIONS Our findings support and refine cognitive theories of SA, suggesting that interpretation biases for facial information in SA may be especially pronounced following exclusion.
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Affiliation(s)
- Roy Azoulay
- Department of Psychology and the Gonda Brain Science Center, Bar-Ilan University, Israel.
| | - Uri Berger
- Department of Psychiatry, Yale University, USA
| | - Hadar Keshet
- Department of Psychology and the Gonda Brain Science Center, Bar-Ilan University, Israel
| | | | - Eva Gilboa-Schechtman
- Department of Psychology and the Gonda Brain Science Center, Bar-Ilan University, Israel
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Abstract
Previous studies have found that PTSD is associated with hippocampal-related impairment in cognitive flexibility. However, little is known about this impairment following nature adventure interventions. The current ex post facto study aimed to examine the relationship between cognitive flexibility, sailing-based intervention and PTSD symptoms. Thirty-nine individuals with PTSD diagnosis (17 who engaged in sailing and 22 who did not engage in sailing) and 38 healthy control (18 who engaged in sailing and 20 who did not engage in sailing) completed a performance-based reversal learning paradigm to assess cognitive flexibility and were evaluated for PTSD, depressive and anxiety symptoms. The results revealed significantly lower levels of PTSD and trait anxiety symptoms in the PTSD-sailing group, compared to the PTSD-no-sailing group. In addition, both PTSD groups showed selective, though different, impairments in reversal learning. Specifically, PTSD-no-sailing individuals showed a selective impairment in reversing the outcome of a negative stimulus- they struggled to learn that a previously negative stimulus was later associated with a positive outcome. PTSD-sailing individuals, on the other hand, displayed a selective impairment in reversing the outcome of a positive stimulus- they had difficulty learning that a previously positive stimulus was later associated with a negative outcome. The results may suggest that although individuals who participated in a sailing-based intervention had lower clinical symptoms, their hippocampal related cognitive flexibility was mot improved, and the impairment exists in a different domain.
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Affiliation(s)
- Reut Zabag
- School of Education, Bar-Ilan University, Ramat-Gan, Israel
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Orly Deri
- Integrated Brain and Behavior Research Center, University of Haifa, Israel
- Sagol Department of Neurobiology, University of Haifa, Haifa, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
- Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat-Gan, Israel
| | - Gal Richter-Levin
- Integrated Brain and Behavior Research Center, University of Haifa, Israel
- Sagol Department of Neurobiology, University of Haifa, Haifa, Israel
- Department of Psychology, University of Haifa, Israel
| | - Einat Levy-Gigi
- School of Education, Bar-Ilan University, Ramat-Gan, Israel
- Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat-Gan, Israel
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Erdman A, Abend R, Jalon I, Artzi M, Gazit T, Avirame K, Ais ED, Levokovitz H, Gilboa-Schechtman E, Hendler T, Harel EV. Ruminative Tendency Relates to Ventral Striatum Functionality: Evidence From Task and Resting-State fMRI. Front Psychiatry 2020; 11:67. [PMID: 32153443 PMCID: PMC7044182 DOI: 10.3389/fpsyt.2020.00067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ruminative responding involves repetitive and passive thinking about one's negative affect. This tendency interferes with initiation of goal-directed rewarding strategies, which could alleviate depressive states. Such reward-directed response selection has been shown to be mediated by ventral striatum/nucleus accumbens (VS/NAcc) function. However, to date, no study has examined whether trait rumination relates to VS/NAcc functionality. Here, we tested whether rumination moderates VS/NAcc function both in response to reward and during a ruminative state. METHODS Trait rumination was considered dimensionally using Rumination Response Scale (RRS) scores. Our sample (N = 80) consisted of individuals from a community sample and from patients diagnosed with major depressive disorder, providing a broad range of RRS scores. Participants underwent fMRI to assess two modes of VS/NAcc functionality: 1) in response to reward, and 2) during resting-state, as a proxy for ruminative state. We then tested for associations between RRS scores and VS/NAcc functional profiles, statistically controlling for overall depressive symptom severity. RESULTS RRS scores correlated positively with VS/NAcc response to reward. Furthermore, we noted that higher RRS scores were associated with increased ruminative-dependent resting-state functional connectivity of the VS/NAcc with the left orbitofrontal cortex. CONCLUSIONS These findings suggest that ruminative tendencies manifest in VS/NAcc reward- and rumination-related functions, providing support for a theoretical-clinical perspective of rumination as a habitual impairment in selection of rewarding, adaptive coping strategies.
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Affiliation(s)
- Alon Erdman
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Psychology Department, Bar-Ilan University, Ramat Gan, Israel
| | - Rany Abend
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, United States
| | - Itamar Jalon
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
| | - Moran Artzi
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Gazit
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren Avirame
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Beer Yaakov Mental Health Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ezequiel Diego Ais
- Beer Yaakov Mental Health Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hilik Levokovitz
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Beer Yaakov Mental Health Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Talma Hendler
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,School of Psychological Science, Tel Aviv University, Tel Aviv, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Eiran Vadim Harel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Beer Yaakov Mental Health Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Becker G, Orbach I, Mikulincer M, Iohan M, Gilboa-Schechtman E, Grossman-Giron A. Reexamining the Mental Pain-Suicidality Link in Adolescence: The Role of Tolerance for Mental Pain. Suicide Life Threat Behav 2019; 49:1072-1084. [PMID: 30125385 DOI: 10.1111/sltb.12506] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/13/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE In this study, we reexamine the mental pain-suicidality link in adolescence, by focusing on mental pain tolerance as a critical factor in explaining youth suicidal behavior. METHOD In a series of three studies, participants completed measures of mental pain (tolerance and intensity), emotional regulation, depression, and suicidality. Study 1 included a nonclinical sample of 183 Israeli adolescents. Study 2 included a nonclinical sample of 139 Israeli adolescents, who completed additional measures of self-esteem, optimism, mindfulness, meaning in life, positive affectivity, and life satisfaction. Study 3 included suicidal psychiatric inpatients (N = 24), nonsuicidal psychiatric inpatients (N = 24), and nonclinical adolescents (N = 24). RESULTS In Study 1, mental pain tolerance was significantly associated with depression, suicidality, and emotion-regulation skills. In Study 2, mental pain tolerance was significantly associated with measures of psychological resources. In Study 3, we found that suicidal psychiatric inpatients reported significantly lower levels of mental pain tolerance than nonsuicidal psychiatric inpatients and nonclinical adolescents. No significant group difference was found in the reported intensity of mental pain. CONCLUSIONS Findings imply that mental pain tolerance may be a better indicator for suicidal behavior during adolescence than reported pain intensity.
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Affiliation(s)
- Gideon Becker
- The Academic Center for Studies, Or Yehuda, Israel.,Hanotrim Mental Health Clinic, Shalvata Mental Health Center, Raanana, Israel
| | - Israel Orbach
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel.,Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Mario Mikulincer
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Maya Iohan
- The Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Eva Gilboa-Schechtman
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Ariella Grossman-Giron
- Hanotrim Mental Health Clinic, Shalvata Mental Health Center, Raanana, Israel.,Department of Behavioral Sciences, Ariel University, Ariel, Israel
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Keshet H, Gilboa-Schechtman E. The Focality of Sexual Trauma and Its Effects on Women’s Symptoms and Self-Perceptions. Psychology of Women Quarterly 2019. [DOI: 10.1177/0361684319861100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sexual trauma is associated with particularly harmful consequences in comparison to other types of trauma. Studies investigating differences between trauma-types usually focus on the most distressing (i.e., main) trauma of each participant and do not consider the cumulative effects of multiple traumas, which many individuals experience. We sought to fill this gap by examining the effects of trauma-type (sexual vs. nonsexual), as well as the focality assigned to the sexual trauma (whether it was perceived as a main vs. background trauma), on symptoms and self-perceptions. Our sample comprised 231 Jewish-Israeli women: 96 with a single trauma-type and 135 with multiple (two to three) trauma-types. Women completed online measures of trauma history, symptoms, and self-perceptions. Women who were exposed to sexual trauma reported greater symptom severity and self-perception impairments than women with a history of nonsexual trauma-type(s). Among women with multiple trauma-types, those with a main sexual trauma reported greater symptom severity and self-perception impairments than women with a background sexual trauma. When controlling for levels of posttraumatic symptoms, differences in self-perceptions ceased to be significant. Our findings highlight the importance of collecting a detailed trauma history, with attention to trauma-centrality, and of addressing various symptoms and self-perceptions among sexual trauma survivors.
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Affiliation(s)
- Hadar Keshet
- Department of Psychology, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel
- Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel
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Keshet H, Foa EB, Gilboa-Schechtman E. Women’s self-perceptions in the aftermath of trauma: The role of trauma-centrality and trauma-type. ACTA ACUST UNITED AC 2019; 11:542-550. [DOI: 10.1037/tra0000393] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Peschard V, Ben-Moshe S, Keshet H, Restle H, Dollberg D, Gilboa-Schechtman E. Social anxiety and sensitivity to social-rank features in male faces. J Behav Ther Exp Psychiatry 2019; 63:79-84. [PMID: 30446163 DOI: 10.1016/j.jbtep.2018.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Evolutionary theories propose that socially anxious individuals are especially sensitive to social-rank signals, presumably at the expense of the attunement to signals of affiliation. Despite this theoretical claim, few empirical attempts examined the association between social anxiety (SA) and sensitivity to specific features of social-rank and affiliation. This study aims to fill this gap. METHOD Participants (N = 67) completed two tasks in which two emotionally neutral computer-generated male faces of the same character were presented side-by-side. In the Social-Rank-Sensitivity Task, the faces within each pair differed in their level of dominance and, in the Affiliation-Sensitivity Task, the faces differed in their level of trustworthiness. The participants' task was to decide which of the two faces looked more dominant or friendly. RESULTS There were no differences in accuracy between high- and low-SA participants in the Affiliation-Sensitivity Task. In contrast, high-SA participants were more accurate than low-SA participants in the Social-Rank-Sensitivity Task. No group differences were found in decision latencies in either task. LIMITATIONS Limitations of the study are that a non-clinical sample was used and that only computer-generated male faces were considered. CONCLUSIONS Our findings suggest that SA is related to an enhanced ability to discriminate faces based on social-rank features. Examining sensitivity to facial cues signaling social-rank and affiliation may help to specify the nature of social threat sensitivity in SA.
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Affiliation(s)
| | | | - Hadar Keshet
- Psychology Department, Bar Ilan University, Israel
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Shalom JG, Gilboa-Schechtman E, Atzil-Slonim D, Bar-Kalifa E, Hasson-Ohayon I, van Oppen P, van Balkom AJLM, Aderka IM. Intraindividual variability in symptoms consistently predicts sudden gains: An examination of three independent datasets. J Consult Clin Psychol 2018; 86:892-902. [DOI: 10.1037/ccp0000344] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Zabag R, Bar-Kalifa E, Mor N, Gilboa-Schechtman E. Social Anxiety, Depression and Close Relationship: Intra and Inter-Personal Perceptions of Social-Rank and Affiliation. Journal of Social and Clinical Psychology 2018. [DOI: 10.1521/jscp.2018.37.8.582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The present study investigated the associations between social anxiety (SA) and depression on the one hand, and intra- and interpersonal perceptions within a friendship relationship on the other. Evolutionary theories suggest that SA is associated with impairment in the social-rank system. Recent studies suggest that depression is associated with impairment in the affiliation system. We examined whether these impairments are manifested in the positivity and accuracy of (a) self-perception; (b) meta-perception (beliefs about how the other perceives the self); and (c) other-perception (evaluations of the friend). Pairs of same-sex friends (n = 50) completed rankings pertaining to these perceptions on general, social-rank, and affiliation traits. Higher levels of SA were associated with lower self-perception positivity, lower meta-perception positivity, and lower accuracy in the social-rank domain. Moreover, higher levels of SA were associated with perceiving the friend as higher on social-rank, regardless of the friend's self-rated traits. Higher levels of depression were associated with lower affiliation and social-rank self-perception positivity, and with lower accuracy in the domain of affiliation. Our findings broaden current conceptualizations of SA and depression and highlight the importance of understanding these disorders through the lens of interpersonal relationships.
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Affiliation(s)
- Reut Zabag
- Hebrew University of Jerusalem
- Bar-Ilan University
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Chen R, Rafaeli E, Bar-Kalifa E, Gilboa-Schechtman E, Lutz W, Atzil-Slonim D. Moderators of congruent alliance between therapists and clients: A realistic accuracy model. J Couns Psychol 2018; 65:703-714. [PMID: 30024193 DOI: 10.1037/cou0000285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Congruence between therapists' and their clients' alliance ratings was found to be beneficial to therapeutic processes and outcomes. To date, however, less is known about the possible moderators of such congruence. The current study adapted Funder's (1995) realistic accuracy model to identify a judge characteristic (therapists' affiliative tendencies), a target characteristic (clients' affiliative tendencies), information (time elapsed in therapy), and traits (bond vs. task/goal aspects of the alliance) that may moderate this congruence. These were examined using the innovative truth-and-bias model (West & Kenny, 2011), which allows the simultaneous estimation of two different congruence indices within repeatedly measured data: therapist/client temporal congruence (i.e., the correlation over time between therapists' and their clients' alliance ratings) and directional discrepancy (i.e., the average difference between therapists' and their clients' alliance ratings across sessions). Clients (n = 109) and therapists (n = 62) at a university-based clinic rated their affiliation tendencies at the beginning of treatment and rated their alliance perception after each session. Time elapsed in therapy, as well as therapists' (but not clients') affiliative tendencies were linked to higher therapist/client temporal congruence and to lower therapist directional discrepancy. In addition, congruence was higher for the bond aspect of the therapeutic alliance than for goals/tasks. Consistent with Funder's model, multiple factors (including judge, information, and trait) were associated with therapist/client congruence in alliance. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Gilboa-Schechtman E, Keshet H, Livne T, Berger U, Zabag R, Hermesh H, Marom S. Explicit and implicit self-evaluations in social anxiety disorder. Journal of Abnormal Psychology 2017; 126:285-290. [DOI: 10.1037/abn0000261] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Social-rank cues communicate social status or social power within and between groups. Information about social-rank is fluently processed in both visual and auditory modalities. So far, the investigation on the processing of social-rank cues has been limited to studies in which information from a single modality was assessed or manipulated. Yet, in everyday communication, multiple information channels are used to express and understand social-rank. We sought to examine the (in)voluntary nature of processing of facial and vocal signals of social-rank using a cross-modal Stroop task. In two experiments, participants were presented with face-voice pairs that were either congruent or incongruent in social-rank (i.e. social dominance). Participants' task was to label face social dominance while ignoring the voice, or label voice social dominance while ignoring the face. In both experiments, we found that face-voice incongruent stimuli were processed more slowly and less accurately than were the congruent stimuli in the face-attend and the voice-attend tasks, exhibiting classical Stroop-like effects. These findings are consistent with the functioning of a social-rank bio-behavioural system which consistently and automatically monitors one's social standing in relation to others and uses that information to guide behaviour.
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Affiliation(s)
- Virginie Peschard
- a Psychology Department and the Gonda Brain Science Center , Bar Ilan University , Ramat Gan , Israel.,b Laboratory for Experimental Psychopathology , Psychological Sciences Research Institute, Université Catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Pierre Philippot
- b Laboratory for Experimental Psychopathology , Psychological Sciences Research Institute, Université Catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Eva Gilboa-Schechtman
- a Psychology Department and the Gonda Brain Science Center , Bar Ilan University , Ramat Gan , Israel
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Helpman L, Penso J, Zagoory-Sharon O, Feldman R, Gilboa-Schechtman E. Endocrine and emotional response to exclusion among women and men; cortisol, salivary alpha amylase, and mood. Anxiety Stress Coping 2016; 30:253-263. [PMID: 27925794 DOI: 10.1080/10615806.2016.1269323] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Social exclusion is ubiquitous and painful. Evolutionary models indicate sex differences in coping with social stress. Recent empirical data suggest different sex patterns in hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) reactivity. The present study sought to test this hypothesis. DESIGN We examined differences in endocrine and emotional response to exclusion by using a virtual ball tossing paradigm (Cyberball). Saliva samples and mood ratings were collected to reflect levels before, and repeatedly following, exclusion. METHODS The sample included 21 women and 23 men. Cortisol and salivary alpha amylase (sAA), biomarkers of the HPA and SAM systems, respectively, were used as indices of two arms of stress response. RESULTS Following exclusion, all participants experienced mood worsening followed by mood improvement, with men reporting less distress than women. Women evinced decline in cortisol following the Cyberball task, whereas men's cortisol levels showed a non-significant rise, and then decline, following exclusion. CONCLUSIONS Our results concur with previous findings showing SAM reactivity to be gender-neutral and HPA reactivity to be gender-divergent. Additional studies are needed to examine sex-specific response to social exclusion. Implications for individual differences in recovery from stress are discussed.
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Affiliation(s)
- Liat Helpman
- a Columbia University Psychiatry , New York , NY , USA.,b New York State Psychiatric Institute , New York , NY , USA
| | - Julia Penso
- c Bar Ilan University , Ramat Gan , Israel.,d Sami Shamoon College of Engineering , Ashdod , Israel
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Abstract
The majority of evidence on social anxiety (SA)-linked attentional biases to threat comes from research using facial expressions. Emotions are, however, communicated through other channels, such as voice. Despite its importance in the interpretation of social cues, emotional prosody processing in SA has been barely explored. This study investigated whether SA is associated with enhanced processing of task-irrelevant angry prosody. Fifty-three participants with high and low SA performed a dichotic listening task in which pairs of male/female voices were presented, one to each ear, with either the same or different prosody (neutral or angry). Participants were instructed to focus on either the left or right ear and to identify the speaker's gender in the attended side. Our main results show that, once attended, task-irrelevant angry prosody elicits greater interference than does neutral prosody. Surprisingly, high socially anxious participants were less prone to distraction from attended-angry (compared to attended-neutral) prosody than were low socially anxious individuals. These findings emphasise the importance of examining SA-related biases across modalities.
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Affiliation(s)
- Virginie Peschard
- a Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute , Université Catholique de Louvain , Louvain-la-Neuve , Belgium.,b Laboratory of Emotion Processing, Psychology Department and the Gonda Brain Science Center , Bar Ilan University , Ramat-Gan , Israel
| | - Eva Gilboa-Schechtman
- b Laboratory of Emotion Processing, Psychology Department and the Gonda Brain Science Center , Bar Ilan University , Ramat-Gan , Israel
| | - Pierre Philippot
- a Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute , Université Catholique de Louvain , Louvain-la-Neuve , Belgium
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Abstract
OBJECTIVE The unique characteristics of sexual assault (SA)-a toxic mix of an interpersonal harm, a violent exploitation of one's body, and a transformation of an act of connectedness into an act of submission-are postulated to negatively affect the self-concept. We sought to deepen the understanding of self-concept impairments among sexually assaulted women with varying levels of posttraumatic distress. To this end, we compared women with a main trauma of SA to women with a main trauma of motor-vehicle accident (MVA) and to nontraumatized (NT) women on several self-concept aspects. Our main hypotheses were (a) sexually assaulted women without PTSD exhibit impaired self-concept as compared with NT women and (b) SA is related to greater self-concept impairments as compared with MVA, even when posttraumatic distress is statistically controlled. METHOD Women (N = 235: NT = 69, MVA = 87, SA = 79) completed a web-based survey including measures designed to assess the global and domain-specific contents and structure of the self-concept as well as background and clinical questionnaires. RESULTS Sexually assaulted women without PTSD reported impaired self-concept as compared with NT women. Furthermore, SA was related to greater self-concept impairments as compared with MVA, even when considering participants' levels of posttraumatic distress. CONCLUSIONS SA is related to unique self-concept impairments that extend beyond symptoms, emphasizing the need to assess and address self-concept impairments in sexually assaulted women. The importance of adopting a multifaceted conceptualization of the self to gain a deeper understanding of the aftermath of trauma is highlighted. (PsycINFO Database Record
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Granat A, Gadassi R, Gilboa-Schechtman E, Feldman R. Maternal depression and anxiety, social synchrony, and infant regulation of negative and positive emotions. ACTA ACUST UNITED AC 2016; 17:11-27. [PMID: 27441576 DOI: 10.1037/emo0000204] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Maternal postpartum depression (PPD) exerts long-term negative effects on infants; yet the mechanisms by which PPD disrupts emotional development are not fully clear. Utilizing an extreme-case design, 971 women reported symptoms of depression and anxiety following childbirth and 215 high and low on depressive symptomatology reported again at 6 months. Of these, mothers diagnosed with major depressive disorder (n = 22), anxiety disorders (n = 19), and controls (n = 59) were visited at 9 months. Mother-infant interaction was microcoded for maternal and infant's social behavior and synchrony. Infant negative and positive emotional expression and self-regulation were tested in 4 emotion-eliciting paradigms: anger with mother, anger with stranger, joy with mother, and joy with stranger. Infants of depressed mothers displayed less social gaze and more gaze aversion. Gaze and touch synchrony were lowest for depressed mothers, highest for anxious mothers, and midlevel among controls. Infants of control and anxious mothers expressed less negative affect with mother compared with stranger; however, maternal presence failed to buffer negative affect in the depressed group. Maternal depression chronicity predicted increased self-regulatory behavior during joy episodes, and touch synchrony moderated the effects of PPD on infant self-regulation. Findings describe subtle microlevel processes by which maternal depression across the postpartum year disrupts the development of infant emotion regulation and suggest that diminished social synchrony, low differentiation of attachment and nonattachment contexts, and increased self-regulation during positive moments may chart pathways for the cross-generational transfer of emotional maladjustment from depressed mothers to their infants. (PsycINFO Database Record
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Affiliation(s)
- Adi Granat
- Department of Psychology, Bar-Ilan University
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Arviv O, Goldstein A, Weeting JC, Becker ES, Lange WG, Gilboa-Schechtman E. Brain response during the M170 time interval is sensitive to socially relevant information. Neuropsychologia 2015; 78:18-28. [DOI: 10.1016/j.neuropsychologia.2015.09.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 09/21/2015] [Accepted: 09/24/2015] [Indexed: 11/16/2022]
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Gilboa-Schechtman E. Treating individuals with multiple problems: On roads not taken. Journal of Psychotherapy Integration 2015. [DOI: 10.1037/a0039555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Riwkes S, Goldstein A, Gilboa-Schechtman E. The temporal unfolding of face processing in social anxiety disorder--a MEG study. Neuroimage Clin 2014; 7:678-87. [PMID: 25844308 PMCID: PMC4377840 DOI: 10.1016/j.nicl.2014.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 10/10/2014] [Accepted: 11/01/2014] [Indexed: 11/04/2022]
Abstract
The current study is the first to use magnetoencephalography (MEG) to examine how individuals with social anxiety disorder (SAD) process emotional facial expressions (EFEs). We expected that, compared to healthy controls (HCs), participants with SAD will show an early (<200 ms post-stimulus) over-activation in the insula and the fusiform gyrus (FG, associated with the N170/M170 component), and later (>200 ms post-stimulus) over-activation in the dorsolateral prefrontal cortex (DLPFC). Individuals with SAD (n = 12) and healthy controls (HCs, n = 12) were presented with photographs of facial displays during MEG recording. As compared to the HC group, the SAD group showed a reduced M170 (right FG under-activation around 130–200 ms); early reduced activation in the right insula, and lower insular sensitivity to the type of EFE displayed. In addition, the SAD group showed a late over-activation in the right DLPFC. This unique EFE processing pattern in SAD suggests an early under-activation of cortical areas, possibly related to reduced emphasis on high spatial frequency information and greater early emphasis on low spatial frequency information. The late DLPFC over-activation in the SAD group may correlate to failures of cognitive control in this disorder. The importance of a temporal perspective for the understanding of facial processing in psychopathology is underlined. This study is the first to use MEG to study social anxiety disorder (SAD). SADs and controls viewed emotional facial expressions during MEG. Compared to controls, SADs showed reduced M170 (early fusiform gyrus activity). SADs presented a late over-activation in the right dorsolateral prefrontal cortex. The late frontal over-activity may correlate to failures of cognitive control in SAD.
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Key Words
- AFNI, analysis of functional neuroimages
- BDI, Beck Depression Inventory
- Cognitive control
- DLPFC, dorsolateral prefrontal cortex
- EEG, electroencephalography
- EFE, emotional facial expressions
- FG, fusiform gyrus
- FMRI, functional magnetic resonance imaging
- FNE, fear of negative evaluation
- Facial processing
- HC, healthy control
- HSF, high spatial frequency
- LSAS, Liebowitz Social Anxiety Scale
- LSF, low spatial frequency
- MEG, magnetoencephalography
- Magnetoenchephalography
- Regulation
- SA, social anxiety
- SAD, social anxiety disorder
- SAM, synthetic aperture modeling
- Social anxiety
- TMS, transcranial magnetic stimulation
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Affiliation(s)
- Sharon Riwkes
- Department of Psychology, Bar Ilan University, Ramat Gan 52900, Israel
| | - Abraham Goldstein
- Department of Psychology, Bar Ilan University, Ramat Gan 52900, Israel
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Brand-Gothelf A, Yoeli-Bligh N, Gilboa-Schechtman E, Benaroya-Milshtein N, Apter A. Perceptions of self, mother and family and behavior of prepubertal depressed children. Eur Psychiatry 2014; 30:69-74. [PMID: 24969104 DOI: 10.1016/j.eurpsy.2014.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 05/09/2014] [Accepted: 05/20/2014] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To characterize the perceptions of self, mother and family of prepubertal children and to determine if the perceptions of children with depression and their behavior towards their mothers are different from children with anxiety disorders and nonpsychiatric controls. METHODS Children (aged 7-13 years) with major depressive disorder (n=30), anxiety disorders (n=37) and nonpsychiatric controls (n=32) underwent structured psychiatric evaluations and completed questionnaires on their perceptions of themselves and their relations with their mothers and families. The child-mother dyad was observed during structured interactions. RESULTS Self-perceptions of depressed children were significantly more negative than those of children with anxiety and controls. Depression severity negatively correlated with the child's self-perception and positively correlated with perceptions of the mother as being more rejecting, controlling, less accepting and less allowing autonomy, and of the family as being less cohesive. Depression severity was also positively associated with the child's hostile attitude towards the mother during the interactions. CONCLUSION Our findings of greater negative perceptions of self, mother and family in depressed children compared to children with anxiety disorders and nonpsychiatric children suggest that approaches specifically addressing negative perceptions and targeting familial relationships could be especially effective for treating young children with depression.
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Affiliation(s)
- A Brand-Gothelf
- The Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - N Yoeli-Bligh
- The Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel; Department of Psychology and the Gonda Brain Science Center, Bar-Ilan University, Ramat-Gan, Israel
| | - E Gilboa-Schechtman
- Department of Psychology and the Gonda Brain Science Center, Bar-Ilan University, Ramat-Gan, Israel
| | - N Benaroya-Milshtein
- The Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Apter
- The Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Gilboa-Schechtman E, Galili L, Sahar Y, Amir O. Being "in" or "out" of the game: subjective and acoustic reactions to exclusion and popularity in social anxiety. Front Hum Neurosci 2014; 8:147. [PMID: 24672463 PMCID: PMC3957023 DOI: 10.3389/fnhum.2014.00147] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 02/27/2014] [Indexed: 11/18/2022] Open
Abstract
Social Anxiety (SA) has been shown to be associated with compensatory deficits in pro-social behavior following exclusion and with failure to capitalize on social success. We assessed the subjective and expressive responses of high (n = 48) and low (n = 56) socially anxious individuals to exclusion, acceptance, and popularity induced by a participation in an online ball-tossing game. Before the manipulation, participants read aloud neutral and command utterances. Following the manipulation, participants rated their mood and cognitions and re-read the utterances. Acoustic properties (fundamental frequency-mF0, vocal intensity) of these utterances were analyzed. We found greater differences in self-esteem between high and low socially anxious individuals following the exclusion condition, as compared to the acceptance condition. Among low socially anxious individuals, exclusion promoted increased vocal confidence, as indicated by decreased mF0 and increased vocal intensity in uttering commands; High socially anxious individuals exhibited an opposite reaction, responding to exclusion by decreased vocal confidence. Following popularity, high SA was associated with decreased enhancement in mood and self-esteem in women but not in men. Consistent with evolutionary and interpersonal accounts of SA, we highlight the importance of examining the effects of SA and gender on events indicating unambiguous and unanimous social acceptance. Examining reactivity to changes in belongingness may have important implications for understanding the core mechanisms of SA.
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Affiliation(s)
- Eva Gilboa-Schechtman
- Department of Psychology and the Gonda Multidisciplinary Brain Research Center, Bar-Ilan UniversityRamat Gan, Israel
| | - Lior Galili
- Department of Psychology and the Gonda Multidisciplinary Brain Research Center, Bar-Ilan UniversityRamat Gan, Israel
| | - Yair Sahar
- Department of Psychology and the Gonda Multidisciplinary Brain Research Center, Bar-Ilan UniversityRamat Gan, Israel
| | - Ofer Amir
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv UniversityTel Aviv, Israel
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Helpman L, Rachamim L, Aderka IM, Gabai-Daie A, Schindel-Allon I, Gilboa-Schechtman E. Posttraumatic symptom structure across age groups. J Clin Child Adolesc Psychol 2014; 44:630-9. [PMID: 24635582 DOI: 10.1080/15374416.2014.883928] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The applicability of diagnostic criteria of Posttraumatic Stress Disorder to the pediatric population has been a focus of much debate (e.g., Carrion, Weems, Ray, & Reiss, 2002 ), informing changes in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). The current study examined the factor structure of posttraumatic distress among adult versus pediatric samples using confirmatory factor analysis. The analysis was performed on the DSM-IV-adherent Posttraumatic Diagnostic Scale (Foa, Cashman, Jaycox, & Perry, 1997 ) and Child Posttraumatic Symptom Scale (Foa, Johnson, Feeny, & Treadwell, 2001 ). The sample included 378 adult and 204 child and adolescent victims of diverse single-event traumas. A series of models based on previous findings and DSM-IV specification were evaluated. A 4-factor model (Intrusions, Avoidance, Dysphoria, and Hyperarousal), similar to the DSM-5 model, best fit the data among adults, and a different 4-factor model (Intrusion, Avodiance, Numbing, and Hyperarousal) best fit the data among children and adolescents. Despite some similarity, the posttraumatic symptom profiles of pediatric and adult samples may differ. These differences are not fully incorporated into the DSM-5, and warrant further examination.
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Affiliation(s)
- Liat Helpman
- a Psychology Department and Gonda Brain Research Center , Bar-Ilan University
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Haker A, Aderka IM, Marom S, Hermesh H, Gilboa-Schechtman E. Impression formation and revision in social anxiety disorder. J Anxiety Disord 2014; 28:133-9. [PMID: 23774009 DOI: 10.1016/j.janxdis.2013.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 04/22/2013] [Accepted: 05/06/2013] [Indexed: 11/29/2022]
Abstract
Interpersonal relations are markedly impaired in social anxiety. Yet, little is known about the ways social anxiety affects social cognition. We examined impression formation and impression revision among individuals with social anxiety disorder (SAD, n = 26) and non-anxious individuals (n = 29). Participants read initial descriptions of protagonists depicted as dominant, neutral or submissive and rated them on social rank and affiliation dimensions. Next, participants were presented with behavioral acts that were either congruent, incongruent or irrelevant to the initial descriptions, and re-rated the protagonists. Individuals with SAD (a) rated others as more extreme on social rank dimension, (b) rated others as lower on the affiliation dimension, and (c) revised their impressions of others to a greater extent than did the non-anxious individuals. Understanding the ways social anxiety affects the formation and revision of perceptions of others can improve our understanding of maintaining processes in SAD.
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Affiliation(s)
- Ayala Haker
- Psychology Department and the Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Idan M Aderka
- Psychology Department and the Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel; Psychology Department, Boston University, Boston, MA, USA
| | - Sofi Marom
- Anxiety Disorders and Behavior Therapy Unit, Outpatient Department, Geha Mental Health Center, Petach-Tikva, Israel
| | - Haggai Hermesh
- Anxiety Disorders and Behavior Therapy Unit, Outpatient Department, Geha Mental Health Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eva Gilboa-Schechtman
- Psychology Department and the Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel.
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Gilboa-Schechtman E, Shachar-Lavie I. More than a face: a unified theoretical perspective on nonverbal social cue processing in social anxiety. Front Hum Neurosci 2013; 7:904. [PMID: 24427129 PMCID: PMC3876460 DOI: 10.3389/fnhum.2013.00904] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 12/10/2013] [Indexed: 01/31/2023] Open
Abstract
Processing of nonverbal social cues (NVSCs) is essential to interpersonal functioning and is particularly relevant to models of social anxiety. This article provides a review of the literature on NVSC processing from the perspective of social rank and affiliation biobehavioral systems (ABSs), based on functional analysis of human sociality. We examine the potential of this framework for integrating cognitive, interpersonal, and evolutionary accounts of social anxiety. We argue that NVSCs are uniquely suited to rapid and effective conveyance of emotional, motivational, and trait information and that various channels are differentially effective in transmitting such information. First, we review studies on perception of NVSCs through face, voice, and body. We begin with studies that utilized information processing or imaging paradigms to assess NVSC perception. This research demonstrated that social anxiety is associated with biased attention to, and interpretation of, emotional facial expressions (EFEs) and emotional prosody. Findings regarding body and posture remain scarce. Next, we review studies on NVSC expression, which pinpointed links between social anxiety and disturbances in eye gaze, facial expressivity, and vocal properties of spontaneous and planned speech. Again, links between social anxiety and posture were understudied. Although cognitive, interpersonal, and evolutionary theories have described different pathways to social anxiety, all three models focus on interrelations among cognition, subjective experience, and social behavior. NVSC processing and production comprise the juncture where these theories intersect. In light of the conceptualizations emerging from the review, we highlight several directions for future research including focus on NVSCs as indexing reactions to changes in belongingness and social rank, the moderating role of gender, and the therapeutic opportunities offered by embodied cognition to treat social anxiety.
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Affiliation(s)
- Eva Gilboa-Schechtman
- Department of Psychology, The Gonda Brain Science Center, Bar-Ilan University Ramat Gan, Israel
| | - Iris Shachar-Lavie
- Department of Psychology, The Gonda Brain Science Center, Bar-Ilan University Ramat Gan, Israel
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