Interpretation bias and social anxiety: does interpretation bias mediate the relationship between trait social anxiety and state anxiety responses?

Two studies aimed to examine whether high socially anxious individuals are more likely to negatively interpret ambiguous social scenarios and facial expressions compared to low socially anxious individuals. We also examined whether interpretation bias serves as a mediator of the relationship between trait social anxiety and state anxiety responses, in particular current state anxiety, bodily sensations, and perceived probability and cost of negative evaluation pertaining to a speech task. Study 1 used ambiguous social scenarios and Study 2 used ambiguous facial expressions as stimuli to objectively assess interpretation bias. Undergraduate students with high and low social anxiety completed measures of state anxiety responses at three time points: baseline, after the interpretation bias task, and after the preparation for an impromptu speech. Results showed that high socially anxious individuals were more likely to endorse threat interpretations for ambiguous social scenarios and to interpret ambiguous faces as negative than low socially anxious individuals. Furthermore, negative interpretations mediated the relationship between trait social anxiety and perceived probability of negative evaluation pertaining to the speech task in Study 1 but not Study 2. The present studies provide new insight into the role of interpretation bias in social anxiety.     

Social anxiety and cognitive expectancy of aversive outcome in avoidance conditioning

Fear conditioning studies have shown that social anxiety is associated with enhanced expectancy of aversive outcome. However, the relation between cognitive expectancy and social anxiety has never been tested in avoidance conditioning paradigms. We compared 48 low (LSA) and high socially anxious individuals (HSA) on subjective expectancy of aversive outcome during an avoidance conditioning task. Displays of neutral faces were coupled with an aversive outcome (US): a shout and a shock. Participants could avoid the US by pressing a correct button from a button box. First, HSA showed higher US expectancy than LSA during the initial phase of avoidance conditioning, supporting the view that socially anxious individuals have an expectancy bias when social situations are ambiguous. Second, when the avoidance response became unavailable, LSA showed lower US expectancy than HSA, suggesting that low socially anxious individuals are prone to a positive bias when perceived threat is high. A lack of such positive bias in socially anxious individuals may lead to higher susceptibility to safety behavior interpretations. Together, these findings support the role of cognitive processes in avoidance conditioning and underscore the relevance to encounter avoidance learning when studying social anxiety.     

Affective primes suppress attention bias to threat in socially anxious individuals

Anxious individuals show an attention bias towards threatening information. However, under conditions of sustained environmental threat this otherwise-present attention bias disappears. It remains unclear whether this suppression of attention bias can be caused by a transient activation of the fear system. In the present experiment, high socially anxious and low socially anxious individuals (HSA group, n=12; LSA group, n=12) performed a modified dot-probe task in which they were shown either a neutral or socially threatening prime word prior to each trial. EEG was collected and ERP components to the prime and faces displays were computed. HSA individuals showed an attention bias to threat after a neutral prime, but no attention bias after a threatening prime, demonstrating that suppression of attention bias can occur after a transient activation of the fear system. LSA individuals showed an opposite pattern: no evidence of a bias to threat with neutral primes but induction of an attention bias to threat following threatening primes. ERP results suggested differential processing of the prime and faces displays by HSA and LSA individuals. However, no group by prime interaction was found for any of ERP components.     

Intolerance for approach of ambiguity in social anxiety disorder

Previous research has utilised the approach–avoidance task (AAT) to measure approach and avoidance action tendencies in socially anxious individuals. “Neutral” social stimuli may be perceived as ambiguous and hence threatening to socially anxious individuals, however it is unclear whether this results in difficulty approaching ambiguous (“neutral”) versus unambiguous threat (e.g. disgust) faces (i.e. intolerance of ambiguity). Thirty participants with social anxiety disorder (SADs) and 29 non-anxious controls completed an implicit AAT in which they were instructed to approach or avoid neutral and disgust faces (i.e. pull or push a joystick) based on colour of the picture border. Results indicated that SADs demonstrated greater difficulty approaching neutral relative to disgust faces. Moreover, intolerance for approach of ambiguity predicted social anxiety severity while controlling for the effects of trait anxiety and depression. Our results provide further support for the role of intolerance of ambiguity in SAD.     

Attention to Positive and Negative Social-Evaluative Words: Investigating the Effects of Social Anxiety,Trait Anxiety and Social Threat

The study investigated how attention to negative (threatening) and positive social-evaluative words is affected by social anxiety, trait anxiety and the expectation of social threat. High and low socially anxious individuals carried out a modified dot-probe task either while expecting to give a speech or under non-threatening conditions. High socially anxious individuals showed no significant attentional bias towards or away from social-evaluative words. This result significantly contrasted with an identical design that showed avoidance of emotional faces in high socially anxious participants drawn from the same population (Mansell et al ., 1999). Participants who expected to give a speech showed less attentional avoidance of negative and positive social-evaluative words. High trait anxiety was associated with selective attention to negative relative to positive social-evaluative words, consistent with earlier findings of attention to threat cues in high trait-anxious individuals. Implications for designing attention tasks and attentional bias across different dimensions of anxiety are discussed.     

Facilitating a benign interpretation bias in a high socially anxious population

Previous research has shown that high socially anxious individuals lack the benign interpretation bias present in people without social anxiety. The tendency of high socially anxious people to generate more negative interpretations may lead to anticipated anxiety about future social situations. If so, developing a more benign interpretation bias could lead to a reduction in this anxiety. The current study showed that a benign interpretation bias could be facilitated (or 'trained') in a high socially anxious population. Participants in the benign training groups had repeated practice in accessing benign (positive or non-negative) interpretations of potentially threatening social scenarios. Participants in the control condition were presented with the same social scenarios but without their outcomes being specified. In a later recognition task, participants who received benign interpretation training generated more benign, and less negative, interpretations of new ambiguous social situations compared to the control group. Participants who received benign training also predicted that they would be significantly less anxious in a future social situation than those in the control group. Possible implications of the findings for therapeutic interventions in social phobia are discussed.     

A multi-session interpretation modification program: changes in interpretation and social anxiety symptoms

Previous research suggests that socially anxious individuals interpret ambiguous social information in a more threatening manner compared to non-anxious individuals. Recently, studies have experimentally modified interpretation and shown that this subsequently affected anxiety in non-anxious individuals. If similar procedures can modify interpretation biases in socially anxious individuals, they may lead to a reduction in social anxiety symptoms. In the current study, we examined the effect of a computerized Interpretation Modification Program (IMP) on interpretation bias and social anxiety symptoms. Twenty-seven socially anxious individuals were randomly assigned to the IMP or a control condition. Participants completed eight computer sessions over four weeks. The IMP modified interpretation by providing positive feedback when participants made benign interpretations and negative feedback in response to threat interpretations. The IMP successfully decreased threat interpretations, increased benign interpretations, and decreased social anxiety symptoms compared to the control condition. Moreover, changes in benign interpretation mediated IMP's effect on social anxiety. This initial trial suggests that interpretation modification may have clinical utility when applied as a multi-session intervention.     

Attentional biases to internal and external sources of potential threat in social anxiety

D. M. Clark and A. Wells (1995) proposed that a shift of attention inward toward interoceptive information is a central feature of social phobia. However, few studies have examined attentional biases toward internal physiological cues in social phobia. The current experiment assessed whether socially anxious individuals exhibit an attentional bias (a) toward cues for an internal source of potential threat (heart-rate information), (b) toward cues for an external source of potential threat (threatening faces) or (c) both. Ninety-one participants who were selected to form extreme groups based on a social anxiety screening measure performed a dot-probe task to assess location of attention. Results showed that socially anxious participants exhibited an attentional bias toward cues of internal, but not external, sources of potential threat.     

Terror mismanagement: evidence that mortality salience exacerbates attentional bias in social anxiety

Death anxiety is a basic fear underlying a range of psychological conditions, and has been found to increase avoidance in social anxiety. Given that attentional bias is a core feature of social anxiety, the aim of the present study was to examine the impact of mortality salience (MS) on attentional bias in social anxiety. Participants were 36 socially anxious and 37 non-socially anxious individuals, randomly allocated to a MS or control condition. An eye-tracking procedure assessed initial bias towards, and late-stage avoidance of, socially threatening facial expressions. As predicted, socially anxious participants in the MS condition demonstrated significantly more initial bias to social threat than non-socially anxious participants in the MS condition and socially anxious participants in the control condition. However, this effect was not found for late-stage avoidance of social threat. These findings suggest that reminders of death may heighten initial vigilance towards social threat.     

The effects of self-focus on attentional biases in social anxiety:An ERP study

Cognitive theories of social anxiety disorder suggest that biased attention plays a key role in maintaining symptoms. These biases include self-focus and attention to socially threatening stimuli in the environment. The goal of this study was to utilize ERPs that are elicited by a change detection task to examine biases in selective attention (i.e., N2pc) and working memory maintenance (i.e., contralateral delay activity; CDA). Additionally, the effect of self-focus was examined using false heart rate feedback. In support of the manipulation, self-focus cues resulted in greater self-reported self-consciousness and task interference, enhanced anterior P2 amplitude and reduced SPN amplitude. Moreover, P2 amplitude for self-focus cues was correlated with reduced task performance for socially anxious subjects only. The difference in P2 amplitude between self-focus and standard cues was correlated with social anxiety independent of depression. As hypothesized, socially anxious participants (n = 20) showed early selection and maintenance of disgust faces relative to neutral faces as indicated by the N2pc and CDA components. Nonanxious controls (n = 22) did not show these biases. During self-focus cues, controls showed marginal evidence of biased selection for disgust faces, whereas socially anxious subjects showed no bias in this condition. Controls showed an ipsilateral delay activity after being cued to attend to one hemifield. Overall, this study supports early and persistent attentional bias for social threat in socially anxious individuals. Furthermore, self-focus may disrupt these biases. These findings and supplementary data are discussed in light of cognitive models of social anxiety disorder, recent empirical findings, and treatment.     

Attentional bias towards angry faces is moderated by the activation of a social processing mode in the general population

ABSTRACT

Dot-probe studies usually find an attentional bias towards threatening stimuli only in anxious participants, but not in non-anxious participants. In the present study, we conducted two experiments to investigate whether attentional bias towards angry faces in unselected samples is moderated by the extent to which the current task requires social processing. In Experiment 1, participants performed a dot-probe task involving classification of either socially meaningful targets (schematic faces) or meaningless targets (scrambled schematic faces). Targets were preceded by two photographic face cues, one angry and one neutral. Angry face cues only produced significant cueing scores (i.e. faster target responses if the target replaced the angry face compared to the neutral face) with socially meaningful targets, not with meaningless targets. In Experiment 2, participants classified only meaningful targets, which were either socially meaningful (schematic faces) or not (schematic houses). Again, mean cueing scores were significantly moderated by the social character of the targets. However, cueing scores in this experiment were non-significant in the social target condition and significantly negative in the non-social target condition. These results suggest that attentional bias towards angry faces in the dot-probe task is moderated by the activation of a social processing mode in unselected samples.     

Impaired positive inferential bias in social phobia

People with social phobia report anticipatory and retrospective judgments about social situations that appear consistent with a negative interpretative bias. However, it is not at all clear that biased interpretative inferences are made "on-line;" that is, at the time that ambiguous information is first encountered. In a previous study, volunteers who were anxious about interviews were found to lack the positive on-line inferential bias that was characteristic of nonanxious controls but also failed to show a bias favoring threatening inferences (C. R. Hirsch & A. Mathews, 1997). This finding was confirmed in the present study, in which social phobic patients showed no evidence of making on-line emotional inferences, in contrast with socially nonanxious controls who were again clearly biased in favor of positive inferences. The authors concluded that nonanxious individuals are characterized by a benign on-line inferential bias, but that this is impaired in people with social phobia.     

Experimental modification of interpretation bias in socially anxious children: Changes in interpretation, anticipated interpersonal anxiety, and social anxiety symptoms

We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10–11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test–retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.     

社交焦虑个体对正性面孔刺激的解释偏差

本研究分别在短时（60ms）和长时（无时间限制）条件下呈现匹配的正性和中性面孔,要求高、低社交焦虑被试选择更具威胁性的面孔,以验证两者对正性刺激是否存在主观解释偏差,并考察该偏差产生于认知加工的哪一阶段。结果发现,长时条件下,高焦虑组选择正性面孔的比例显著高于低焦虑组;短时条件下无显著差异。提示高社交焦虑个体对正性刺激存在主观、外显的解释偏差,他们更倾向于对正性刺激做出消极解释,并且这种偏差产生于认知加工的后期。     

Fear-relevant selective associations and social anxiety: absence of a positive bias

An illusory correlation paradigm was used to compare high and low socially anxious individuals' initial, on-line and a posteriori covariation estimates between emotional faces and aversive, pleasant and neutral outcomes. Overall, participants demonstrated an initial expectancy bias for aversive outcomes following angry faces, and pleasant outcomes following happy faces. On-line expectancy biases indicated that initial biases were extinguished during the task, with the exception of low socially anxious individuals who continued to over-associate positive social cues with pleasant outcomes. In addition to lacking this protective positive on-line bias, the high social anxiety group reported retrospectively more negative social cues than the low socially anxious group. Findings are discussed in relation to similar evidence from recent interpretive and memory paradigms.     

Social Anxiety and Attention away from Emotional Faces

A substantial literature indicates that anxiety is often associated with selective attention to threat cues. Socially anxious individuals are excessively concerned about negative evaluation by others. One might therefore predict that high social anxiety would be associated with selective attention to negative facial expressions. On the other hand, some recent models have suggested that social anxiety may be associated with reduced processing of external social cues. A modified dot-probe task was used to investigate face attention. High and low socially anxious individuals were presented with pairs of pictures, consisting of a face (positive, neutral, or negative) and a household object, under conditions of social-evaluative threat or no threat. The results indicated that, compared to low socially anxious individuals, high socially anxious individuals show an attentional bias away from emotional (positive and negative) faces but this effect is only observed under conditions of social-evaluative threat. Theoretical and clinical implications of the results are discussed.     

Social phobics do not misinterpret facial expression of emotion

Attentional biases in the processing of threatening facial expressions in social anxiety are well documented. It is generally assumed that these attentional biases originate in an evaluative bias: socially threatening information would be evaluated more negatively by socially anxious individuals. However, three studies have failed to evidence a negative evaluative bias in the processing of emotional facial expression (EFE) in socially anxious individuals. These studies however suffer from several methodological limitations that the present study has attempted to overcome. Twenty-one out-patients diagnosed with generalized social phobia have been compared to 20 out-patients diagnosed with another anxiety disorder and with 39 normal controls matched for gender, age and level of education. They had to decode on seven emotion intensity scales a set of 40 EFE whose intensity and emotional nature were manipulated. Although sufficient statistical power was ensured, no differences among groups could be found in terms of decoding accuracy, attributed emotion intensity, or reported difficulty of the task. Based on these findings as well as on other evidences, we propose that, if they exist, evaluative biases in social anxiety should be implicit and automatic and that they might be determined by the relevance of the stimulus to the person's concern rather than by the stimulus valence. The implications of these findings for the interpersonal processes involved in social phobia are discussed.     

Mental Imagery and Post-Event Processing in Anticipation of a Speech Performance Among Socially Anxious Individuals

The present study investigated whether post-event processing (PEP) involving mental imagery about a past speech is particularly detrimental for socially anxious individuals who are currently anticipating giving a speech. One hundred fourteen high and low socially anxious participants were told they would give a 5 min impromptu speech at the end of the experimental session. They were randomly assigned to one of three manipulation conditions: post-event processing about a past speech incorporating imagery (PEP-Imagery), semantic post-event processing about a past speech (PEP-Semantic), or a control condition, (n = 19 per experimental group, per condition [high vs low socially anxious]). After the condition inductions, individuals’ anxiety, their predictions of performance in the anticipated speech, and their interpretations of other ambiguous social events were measured. Consistent with predictions, high socially anxious individuals in the PEP-Imagery condition displayed greater anxiety than individuals in the other conditions immediately following the induction and before the anticipated speech task. They also interpreted ambiguous social scenarios in a more socially anxious manner than socially anxious individuals in the control condition. High socially anxious individuals made more negative predictions about their upcoming speech performance than low anxious participants in all conditions. The impact of imagery during post-event processing in social anxiety and its implications are discussed.     

Evidence from the eyes: Threatening postures hold attention

Efficient detection of threat provides obvious survival advantages and has resulted in a fast and accurate threat-detection system. Although beneficial under normal circumstances, this system may become hypersensitive and cause threat-processing abnormalities. Past research has shown that anxious individuals have difficulty disengaging attention from threatening faces, but it is unknown whether other forms of threatening social stimuli also influence attentional orienting. Much like faces, human body postures are salient social stimuli, because they are informative of one’s emotional state and next likely action. Additionally, postures can convey such information in situations in which another’s facial expression is not easily visible. Here we investigated whether there is a threat-specific effect for high-anxious individuals, by measuring the time that it takes the eyes to leave the attended stimulus, a task-irrelevant body posture. The results showed that relative to nonthreating postures, threat-related postures hold attention in anxious individuals, providing further evidence of an anxiety-related attentional bias for threatening information. This is the first study to demonstrate that attentional disengagement from threatening postures is affected by emotional valence in those reporting anxiety.     

Competition effects of threatening faces in social anxiety

Threatening faces involuntarily grab attention in socially anxious individuals. It is unclear, however, whether attention capture is at the expense of concurrent visual processing. The current study examined the perceptual cost effects of viewing fear-relevant stimuli (threatening faces) relative to a concurrent change-detection task. Steady-state visual evoked potentials (ssVEPs) were used to separate the neural response to 2 fully overlapping types of stimuli flickering at different frequencies: Task-irrelevant facial expressions (angry, neutral, happy) were overlaid with a task-relevant Gabor patch stream, which required a response to rare phase reversals. Groups of 17 high and 17 low socially anxious observers were recruited through online prescreening of 849 students. A prominent competition effect of threatening faces was observed solely in elevated social anxiety: When an angry face, relative to a neutral or happy face, served as a distractor, heightened ssVEP amplitudes were seen at the tagging frequency of that facial expression. Simultaneously, the ssVEP evoked by the task-relevant Gabor grating was reliably diminished compared with conditions with neutral or happy distractor faces. Thus, threatening faces capture and hold low-level perceptual resources in viewers symptomatic for social anxiety at the cost of a concurrent primary task. It is important to note that this competition in lower tier visual cortex was maintained throughout the viewing period and was unaccompanied by competition effects on behavioral performance. (PsycINFO Database Record (c) 2012 APA, all rights reserved).