Cognitive-Behavioral Treatment of Social Phobia

Social phobia can be a chronic disorder, capable of restricting a client's social and occupational functioning. Cognitive-behavioral therapy can help many clients learn to overcome their social inhibitions, and make lasting changes in their interpersonal style. Cognitive-behavioral therapy for social phobia includes four general components for helping clients learn to manage their social anxiety. First, therapy begins with the establishment of a sound therapeutic alliance, a focus on assessment, diagnostic interviewing, and education regarding anxiety symptoms and their treatment. Second, the therapist helps clients to develop competence in social skills, relaxation training, and cognitive restructuring. Third, therapy uses exposure to social situations in order to help clients confront their fears and refine their coping skills. Fourth, relapse prevention strategies are used to help clients learn to tolerate feelings of discomfort and confront challenging social interactions. This treatment framework can be adapted to the specific needs of different clients.     

Dysfunctional Cognitions in Children with Social Phobia, Separation Anxiety Disorder, and Generalized Anxiety Disorder

According to cognitive theories of anxiety, anxious adults interpret ambiguous situations in a negative way: They overestimate danger and underestimate their abilities to cope with danger. The present study investigated whether children with social phobia, separation anxiety disorder, and generalized anxiety disorder have such a bias, compared to a clinical and a normal control group. Children were exposed to stories in which ambiguous situations were described, and asked to give their interpretations, using open and closed responses. Results showed that anxious children reported more negative cognitions than control children. However, anxious children did not overestimate danger on the free responses, but they did judge the situations as more dangerous on the closed responses. Anxious children had lower estimations of their own competency to cope with danger than the control groups on both open and closed responses. The results indicate that children with anxiety disorders have dysfunctional cognitions about ambiguous situations.     

Coping skills training for children: effects on distress before, during, and after hospitalization for surgery

Thirty-three parent-child dyads (children's mean age = 7.2 years, SD = 1.2) were randomly assigned to information, anxiety reduction, or coping skills presurgical preparatory interventions. All groups received the "information" procedure that described typical hospitalization and surgery experiences via a puppetry film viewed 1 week prior to hospital admission. In the anxiety reduction group, parents also learned procedures (e.g., relaxation) to help them reduce their own distress. Parents in the coping skills group learned how to help their children use coping self-talk and related techniques. The coping skills intervention was expected to assist children most effectively, although the anxiety reduction procedure was also expected to improve adaptation relative to the information condition. These hypotheses were generally supported. Anxiety reduction and coping skills groups, compared to the information group, reduced children's self-reported fearfulness and parents' reported distress. Furthermore, only the coping skills group, compared to the information group, exhibited fewer maladaptive behaviors during hospitalization (ratings by observers) and less problematic behavior in the preadmission week and second postdischarge week (daily parental diaries). Theoretical explanations for these results are discussed in light of the similar findings obtained by Peterson and Shigetomi (1981).     

The effect of Benson's relaxation response on the anxiety levels of Lebanese children under stress

The effect of Benson's relaxation techinque on the stress of fifth-grade Lebanese elementary students was investigated. The sample consisted of 62 students 10–12 years of age blocked by sex and randomly assigned to either the treatment group or a reading-activity control group. Subjects in the treatment group practiced relaxation each morning for 10 min over a 6-week period while the control group was taken to a separate room for a reading activity. Results indicated that the subjects in the treatment group scored lower on a general anxiety scale and also on a test anxiety scale than did the control group. Girls were also found to score higher on the general anxiety measure than did boys. Follow-up, 3 weeks after the treatment had been discontinued, revealed that the treatment effects had disappeared but not those related to sex differences for the general anxiety measure.     

Gender Differences in Coping Styles of Chinese Military Officers Undergoing Intensive Training

This study investigated gender differences in anxiety and coping styles under the stress of intense military training. We surveyed Chinese female (n = 470) and male (n = 379) military officers who were surveyed during the third month of a 10-month intensive training program. Results indicated that state and trait anxiety were highly correlated in both women and men. In general, female officers had higher levels of anxiety, greater negative coping tendencies, and less perceived self-efficacy than their male counterparts. When compared with the norm, both women and men had significantly more positive coping strategies. A hierarchical multiple regression analysis showed factors that influenced male and female state anxiety. Avoidance, which was chosen by women more often than men, in general was less useful for female officers. The most common positive coping style for female officers was problem solving, whereas for men it was help seeking. We suggested that even female officers with lower mental health levels than their male counterparts made active cognitive changes to their coping styles when undergoing intense military training.     

Social competence is reduced in socially deprived rhesus monkeys (Macaca mulatta)

Rhesus monkeys deprived for some period from their mother have often served as a model for the effect of adverse rearing conditions on social competence in humans. Social competence is the capacity to react in a species-specific way to social interactions. The current study assesses whether early deprivation from peers also affects the rates of behavior and social competence in rhesus monkeys. This was studied in groups of rhesus monkeys with different rearing conditions: subadult females that were mother-only reared during their first year of life and subsequently housed with peers were compared with subadult females from five naturalistic social groups. Socially deprived monkeys showed higher rates of submission and stereotypic behaviors than socially reared individuals. In addition, they show socially incompetent behavior, since they react with agonistic behavior to nonthreatening social situations. The results suggest that this socially incompetent behavior is rooted in a general feeling of anxiety toward group companions. The authors hypothesize that anxiety negatively affects social information processing, which results in socially incompetent behavior.     

Dialectical Thinking and Coping Flexibility: A Multimethod Approach

ABSTRACT Coping flexibility refers to the formulation of flexible coping strategies that meet distinct demands under changing circumstances. Dialectical thinking was proposed to be related to flexible coping across situations. The hypothesized link between dialectical thinking and coping flexibility was explored by a multimethod approach. In Study 1 , the association between dialectical thinking and coping flexibility was examined using a cross-sectional design. In Study 2 , the hypothesized link was tested using an experimental paradigm in which dialectical thinking was manipulated by priming procedures. Participants' responses to different hypothetical stressful situations were assessed after priming. Study 3 adopted a prospective design in which dialectical thinking assessed at an initial phase was a predictor of changes in coping flexibility and state anxiety over a 12-month period. Results from the three studies consistently revealed a positive relationship between dialectical thinking and coping flexibility.     

Effects of communication skills on stress responses while speaking Japanese and English

The present study was conducted to examine the effects of communication skills on stress responses, such as physiological (blink and heart rate), emotional (state of anxiety and mood), and behavioral responses (smiling and expressing an opinion) in stressful communication situations, specifically answering questions and giving a speech in Japanese and English. Participants were 32 students (16 men and 16 women; Mage = 19.5 yr., SD = 1.3) attending a Japanese university. A high communication skills group was selected from the upper tertile scores of the Social Skills Inventory, and a low communication skills group was selected from the lower tertile scores. Analysis indicated that individuals who had high communication skills performed without heart-rate increase and with more positive attitude during stressful communication tasks. Individuals who had low communication skills displayed higher anxiety prior to the experiment than those who had high communication skills.     

PARTNER LOSS IN LATER LIFE: GENDER DIFFERENCES IN COPING SHORTLY AFTER BEREAVEMENT

This longitudinal study aimed to explain coping responses of older women (n = 60)and men (n = 43) at about 1 year following partner loss using a general theory of coping. The theory of mental incongruity predicts that behavioral and mental coping are responses to experienced loneliness and that they are facilitated by actual and perceived opportunities or resources. Results show that the availability of social relationships and better general health encourage coping responses among the bereaved, as well as, unexpectedly, higher social anxiety and financial stress. Results reveal opposite effects for women and men. As time elapses since the death of the partner, men more often share their emotions with others than women. Also, the results suggest that resources play different roles in coping responses of recently bereaved women and men. Among widowers financial stress may impede emotional coping responses, while among widows higher education and having a best female friend seem to function as riskfactors in coping with loss. Relative health, or the feeling one is better off than comparable others, may protect against the negative effects of partner death, particularly among recently bereaved women. It is concluded that the proposed theory offers useful concepts in understanding how recently bereaved individuals cope with partner death; however,it is not helpful in explaining the gender differences found in the present study. Further, the findings question the supposed less favorable health position of older widows and the more favorable social position of older widows and socioeconomic position of older widowers.     

Long-term psychological sequelae of smoking cessation and relapse.

The authors examined whether smoking cessation and relapse were associated with changes in stress, negative affect, and smoking-related beliefs. Quitters showed decreasing stress, increasing negative health beliefs about smoking, and decreasing beliefs in smoking's psychological benefits. Quitters became indistinguishable from stable nonsmokers in stress and personalized health beliefs, but quitters maintained stronger beliefs in the psychological benefits of smoking than stable nonsmokers. Relapse was not associated with increases in stress or negative affect However, relapsers increased their positive beliefs about smoking and became indistinguishable from smokers in their beliefs. For quitters, decreased stress and negative beliefs about smoking may help maintain successful cessation. However, for relapsers, declining health risk perceptions may undermine future quit attempts.     

Anxiety,coping and academic performance

Anxiety is a frequent response to stressful evaluation situations and may be correlated with the performance being evaluated. The present study investigated individual differences in social evaluation trait anxiety and coping dimensions as predictors of state anxiety and performance on a university examination. Separate multiple regressions were computed for coping assessed as a style, an individual difference measure, and as situational specific responses. Emotion-oriented coping predicted state anxiety in the evaluation situation. Social evaluation trait anxiety and task-oriented and emotionoriented coping responses predicted exam performance. The regression models predicted approximately a quarter of the variance in course grades. When coping was measured as a response, task-oriented coping response was a significant predictor of course grade. When coping was measured as a style or individual difference, avoidance-oriented coping style predicted aggregated course grade. It was suggested that different coping dimensions predict different outcomes and that coping be assessed over time to better understand its relation to performance.     

Applicant Anxiety: Examining the sex‐linked anxiety coping theory in job interview contexts

The Sex‐linked Anxiety Coping Theory (SCT) suggests that anxiety should relate to performance more strongly for males than females. In Study 1, we examined how the theory applied to five interview anxiety dimensions (appearance anxiety, behavioral anxiety, communication anxiety, performance anxiety, and social anxiety) using actual job applicants. In general, females reported higher levels of each type of interview anxiety than did males. However, consistent with SCT, Overall Interview Anxiety, Appearance Anxiety, and Social Anxiety demonstrated stronger negative relations with interview performance for males than for females. Consistent with the SCT, in Study 2 we found that females had more effective coping orientations for job interviews than did males.     

Use of relaxation skills in differentially skilled athletes

ObjectivesTo examine the use of relaxation skills by differentially skilled athletes in relation to the deliberate practice framework.DesignDifferentially skilled athletes completed a survey about their use of relaxation skills.Method150 athletes representing three skill levels (recreational, college, and professional) completed the deliberate relaxation for sport survey, which assessed relaxation on three deliberate practice dimensions (relevancy, concentration, and enjoyment); time spent in different relaxation skills in a recent typical week; and functions of relaxation.ResultsAthletes perceived relaxation as relevant to performance, requiring concentration, and enjoyable, and the relationships between these dimensions were positive. Professional and college athletes perceived relaxation as more relevant to effective competition than recreational athletes. Professional athletes engaged in more relaxation in a typical week than college and recreational athletes. In a typical week, autogenic, eastern, and muscle relaxation types were used least, deep breathing, meditation, and imagery relaxation types moderately, and stretching most. Athletes reported the primary functions of relaxation were to cope with competitive anxiety and promote recovery but relaxation was also reported to be used to cope with “everyday” anxieties associated with being an athlete. More physical (e.g., muscle relaxation) than mental relaxation types were used in relation to coping with competitive anxiety, whereas more mental (e.g., meditation) than physical relaxation types were used in relation to coping with everyday anxiety.ConclusionsThe study provides support for the sport-specific framework of deliberate practice in relation to use of relaxation skills and informs the current understanding of self-regulation by athletes.     

Prediction of psychological reactions to bone density screening for osteoporosis using a cognitive-behavioral model of health anxiety

Pre-screening measures derived from a cognitive-behavioral theory of health anxiety were significant predictors of individual differences in post-screening reactions to a health screening procedure, bone densitometry. Predictors included specific illness beliefs (vulnerability, severity/consequences, coping and treatment) and general health anxiety measures. Three months after a low bone mineral density (BMD) result, women with high levels of pre-existing general health anxiety gave higher ratings of anxiety about osteoporosis and perceived likelihood of developing osteoporosis than women with low levels of preexisting health anxiety, even though the two groups' initial ratings had not differed significantly. Women with a low BMD result generally showed "minimization" of the seriousness of low BMD but women with very high levels of pre-existing health anxiety did not. After a high BMD result, highly health anxious women were only temporarily reassured. The results were consistent with the cognitive-behavioral analysis of health anxiety.     

Psychological responses to outbreak of severe acute respiratory syndrome: a prospective, multiple time-point study

This study examined anxiety and coping responses to the outbreak of severe acute respiratory syndrome (SARS) in Hong Kong. Trait anxiety, situation-specific coping strategies, and coping flexibility were proposed as predictors of state anxiety during the early phase of the SARS epidemic. Seventy-two Hong Kong undergraduates (31 men, 41 women) participated in a prospective, multiple time-point study. Participants' trait anxiety and coping flexibility had been assessed in an earlier study. Five months later, they reported their anxiety and coping at each of the four time points during the outbreak. Results revealed fluctuations in state anxiety across time points. Results from hierarchical linear modeling showed that trait anxiety as well as the situation-appropriate coping strategies of avoidance and personal hygiene practice accounted for changes in state anxiety.     

Prevention of anxiety symptoms in children: results from a universal school-based trial

The present study evaluated the effectiveness of a universal school-based cognitive behavior prevention program (the FRIENDS program) for childhood anxiety. Participants were 638 children, ages 9 to 12 years, from 14 schools in North Rhine-Westphalia, Germany. All the children completed standardized measures of anxiety and depression, social and adaptive functioning, coping strategies, social skills, and perfectionism before and after the 10-week FRIENDS program and at two follow-up assessments (6 and 12 months) or wait period. Children who participated in the FRIENDS program exhibited significantly fewer anxiety and depressive symptoms, and lower perfectionism scores than children in the control group at 12-month follow-up. Younger children (9-10-year-olds) displayed treatment gains immediately after the intervention, whereas older children (11-12-year-olds) showed anxiety reduction only at 6- and 12-month follow-up. Perfectionism and avoidant coping acted as mediators of pre- to postintervention changes in anxiety scores. This study provides empirical evidence for the utility of the FRIENDS program in reducing anxiety and depressive symptoms among German children.     

Trajectories of Social Anxiety during Adolescence and Relations with Cognition, Social Competence, and Temperament

This cohort-sequential study examined developmental trajectories of social anxiety in a nonclinical sample (N?=?331, 161 girls) aged 9 to 17 years at initial and 12 to 21 years at final assessment. We tested whether variables assessing cognition, social competence, and temperament discriminated between the trajectories. Variables were collected from different sources: participants, independent observers, parents, and teachers. Using Latent Class Growth Modeling (LCGM) we identified three distinct social anxiety trajectory groups: i) high and changing; ii) moderate and decreasing; and iii) low and decreasing. Multinomial regression analyses showed that the cognition variables, negative interpretations of ambiguous social situations and self-focused attention, differentiated between all three trajectories. A lack of social skills and having social problems at school were specifically related to the chance of following the high trajectory versus the moderate trajectory. Neuroticism differentiated between the low and moderate trajectories. Findings indicate that adolescents at risk of belonging to a high social anxiety trajectory can be discriminated from peers belonging to a less anxious trajectory using both cognition and social competence variables.     

Intrinsic motivation among regular, special, and alternative education high school students.

This study examined motivationally related variables among three types of high school students. In particular, students' perceptions of competence, control, parental autonomy support, teacher autonomy support, peer autonomy support, and academic coping were investigated. Two hundred fifty-one juniors and seniors (104 regular education, 93 alternative education, and 54 special education) from a large Southern California school district participated. Significant group differences were found on measures of perceived competence, academic coping, and parental autonomy support. Specifically, regular education students had a higher level of self-reported academic competence than did special education students. Further, regular education and special education students reported that their parents were more involved in their lives as compared with alternative education students. Finally, regular education students reported a higher level of academic anxiety than did special education and alternative education students; however, regular education students had the highest level of positive coping. The implications of these findings are discussed.     

The Broader Autism Phenotype,Social Interaction Anxiety,and Loneliness: Implications for Social Functioning

Recent research has begun to focus on the subclinical presentation of autistic-like traits in individuals, a construct termed the broader autism phenotype (BAP). The presence of the BAP has been established in both first-degree relatives of individuals with autism as well as in the general population. The current study aimed to examine how self-reported BAP characteristics, social interaction anxiety, and fear of negative evaluation relate to social functioning (specifically, loneliness) in a sample of college students. Results showed that for all subjects, BAP, social interaction anxiety, and fear of negative evaluation did not predict loneliness in a regression model. However, for males these predictors accounted for approximately 48 % of the variance in loneliness scores. Among males, individuals rating themselves as having lower social skills, lower imagination, and higher social interaction anxiety were more likely to also report feeling lonely. These results indicate that the predictors used may function differently among males and females. Although BAP characteristics and social interaction anxiety may not be important correlates of social functioning for females in this sample, they appear to be very important for males’ subjective feelings of loneliness.     

Stuttering and social anxiety

The aim of the present study was to investigate the presence of social anxiety in adults who stutter. This was done by administering the Inventory of Interpersonal Situations (IIS) (Van Dam-Baggen & Kraaimaat, 1999), a social anxiety inventory, to a group of 89 people who stuttered and 131 people who did not stutter. Two components of social anxiety were measured by the ISS, the extent to which emotional tension or discomfort is perceived in social situations and the frequency with which social responses are executed. The people who stuttered displayed significantly higher levels of emotional tension or discomfort in social situations. They also reported a significantly lower frequency of social responses compared to their nonstuttering peers. In addition, about 50% of the scores of the people who stuttered fell within the range of a group of highly socially anxious psychiatric patients. The results of the study suggest that the measurement of social anxiety is an important element in the assessment of adults who stutter. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to describe (1) the IIS as an assessment procedure for evaluating social anxiety, (2) the level of discomfort expressed by adult stutterers in social situations, and (3) the effect of social anxiety on stutterers' responsiveness in social situations.