Expectations and Attributions in Social Anxiety Disorder: Diagnostic Distinctions and Relationship to General Anxiety and Depression

Contemporary cognitive models suggest that social anxiety disorder arises from a number of cognitive factors, including tendencies to form pessimistic (rather than optimistic) attributions and expectations for socially-related events. These models also assume that the strengths of such attributions and expectations are more closely linked with social anxiety than with general anxiety or depression. To test these assumptions, a battery of self-report measures was completed by participants with a primary diagnosis of generalized social anxiety disorder (n?=?75), panic disorder with agoraphobia (n?=?44), or post-traumatic stress disorder (n?=?59). To examine differences on these cognitive variables, group comparisons were performed controlling for general anxiety, depression and medication status. Social anxiety disorder, compared with panic disorder with agoraphobia and post-traumatic stress disorder, was characterized by lower expectations for positive social events and higher expectations for negative social events. There was no difference among the groups on expectations for non-social positive or negative events. Stable and global attributions for social negative events were more closely associated with social anxiety disorder than with panic disorder with agoraphobia and post-traumatic stress disorder. Correlational analyses also revealed specific relationships among social-cognitive measures and social anxiety, even after controlling for general anxiety and depression. The results are consistent with cognitive models of social anxiety disorder.     

Body Dysmorphic Symptoms,Functional Impairment,and Depression: The Role of Appearance-Based Teasing

Body dysmorphic disorder is associated with elevated social and occupational impairment and comorbid depression, but research on risk factors for body dysmorphic symptoms and associated outcomes is limited. Appearance-based teasing may be a potential risk factor. To examine the specificity of this factor, the authors assessed self-reported appearance-based teasing, body dysmorphic, and obsessive-compulsive symptom severity, functional impairment (i.e., social, occupational, family impairment), and depression in a nonclinical sample of undergraduates. As hypothesized, appearance-based teasing was positively correlated with body dysmorphic symptoms. The correlation between teasing and body dysmorphic symptoms was stronger than that between teasing and obsessive-compulsive symptom severity. Last, body dysmorphic symptom severity and appearance-based teasing interacted in predicting functional impairment and depression. Specifically, appearance-based teasing was positively associated with depression and functional impairment only in those with elevated body dysmorphic symptoms. When a similar moderation was tested with obsessive-compulsive, in place of body dysmorphic, symptom severity, the interaction was nonsignificant. Findings support theory that appearance-based teasing is a specific risk factor for body dysmorphic symptoms and associated functional impairment.     

Anticipatory Processing and Post‐Event Processing in Social Anxiety Disorder: An Update on the Literature

Two repetitive thinking processes that have been proposed in prominent maintenance models of social anxiety disorder (SAD) are anticipatory processing and post‐event processing. Research into these two processes has steadily increased over the last 20 years. This review highlights the main lines of existing research on anticipatory processing and post‐event processing, including studies on the nature of these processes, their association with social anxiety, the predictors, and consequences of these processes, as well as how these processes respond to treatments for SAD. The review also highlights some of the conceptual and methodological issues that have prevented the literature on anticipatory processing and post‐event processing from being more integrated and focused. Finally, the review draws together some new directions in terms of theory and research to further advance the field.     

An Examination of the Relationship Between Parent Language and Child Anxiety

Research suggests that parents of anxious children behave differently when interacting with their children than do parents of nonanxious children. However, the relationship between parent language use in this context and child anxiety remains unclear. The present study investigates how parent language use relates to child anxiety during parent–child interactions using a community sample recruited to participate in a study of familial anxiety. Results indicate that parent language use varies in relation to child anxiety. Further, this idiosyncratic pattern of parent linguistic activity uniquely predicts child anxiety diagnostic status. Implications of this study and future directions for research are discussed.     

反刍思维与社交焦虑的关系:来自元分析的证据

反刍思维与社交焦虑的关系一直存在争议,为探究这些研究结论不一致的原因,本研究采用元分析技术研究反刍思维与社交焦虑的关系.综合国内国外研究42篇,中文文献8篇,英文文献34篇,共53个独立样本,总样本23032人.研究结果显示,反刍思维与社交焦虑呈高度正相关(r=0.42),反刍思维与社交焦虑的关系受到年龄段、反刍思维使...     

初中生依恋风格与欺凌保护行为的关系：社会支持和欺凌应对效能的链式中介作用

为考察初中生依恋风格与欺凌保护行为的关系,同时探讨社会支持和欺凌应对效能的链式中介作用,采用问卷法对565名初中生进行调查。结果发现：（1）依恋焦虑与欺凌保护行为呈显著正相关,依恋回避与欺凌保护行为呈显著负相关;（2）社会支持和欺凌应对效能在依恋回避与欺凌保护行为之间起链式中介作用。若要增加依恋回避初中生的欺凌保护行为,应注重为其提供社会支持,提升欺凌应对效能。     

Cognitive Factors that Maintain Social Anxiety Disorder: a Comprehensive Model and its Treatment Implications

Social anxiety disorder (SAD) is a common, distressing and persistent mental illness. Recent studies have identified a number of psychological factors that could explain the maintenance of the disorder. These factors are presented here as part of a comprehensive psychological maintenance model of SAD. This model assumes that social apprehension is associated with unrealistic social standards and a deficiency in selecting attainable social goals. When confronted with challenging social situations, individuals with SAD shift their attention toward their anxiety, view themselves negatively as a social object, overestimate the negative consequences of a social encounter, believe that they have little control over their emotional response, and view their social skills as inadequate to effectively cope with the social situation. In order to avoid social mishaps, individuals with SAD revert to maladaptive coping strategies, including avoidance and safety behaviors, followed by post‐event rumination, which leads to further social apprehension in the future. Possible disorder‐specific intervention strategies are discussed.     

Clinical Experiences in Conducting Cognitive-Behavioral Therapy for Social Phobia

Several authors have identified a disconnect between psychotherapy research, including research on cognitive behavioral therapy (CBT), and real-world psychotherapy practice. This disconnect has several negative consequences, potentially including less-than-optimal practice standards as well as a lack of input from practicing psychotherapists on how research can be improved and made more relevant in their day-to-day clinical work. As part of an ongoing effort to engage practicing psychotherapists in a feedback loop with psychotherapy researchers, this study reports the results of a survey of CBT therapists who have used CBT in the treatment of social phobia (SP). The survey was designed primarily to document how often certain potential problems, identified by expert researchers and CBT manuals, actually act as barriers to successful treatment when CBT is employed in nonresearch environments. The participants were 276 psychotherapists responding to email, online, and print advertisements completing the online survey. Participants varied considerably in psychotherapy experience, work environment, experience in using CBT for SP, and in some ways varied in their usual CBT techniques when treating SP. Among the most prominent barriers identified by many of the participants were patient motivation, comorbidity, logistical problems (especially with exposures), patient resistance, and severity and chronicity of SP symptoms. These findings may be useful for psychotherapy researchers as areas for potential study. The results may also suggest topics requiring clinical guidelines, innovations within CBT, and dissemination of successful techniques to address the barriers identified here.     

Theory of Mind Impairments in Social Anxiety Disorder

Social anxiety disorder (SAD) is a common psychiatric disorder characterized by a persistent, excessive fear and avoidance of social and performance situations. Research on cognitive biases indicates individuals with SAD may lack an accurate view of how they are perceived by others, especially in social situations when they allocate important attentional resources to monitoring their own actions as well as external threat. In the present study, we explored whether socially anxious individuals also have impairments in theory of mind (ToM), or the ability to comprehend others’ mental states, including emotions, beliefs, and intentions. Forty socially anxious and 40 non-socially-anxious comparison participants completed two ToM tasks: the Reading the Mind in the Eyes and the Movie for the Assessment of Social Cognition. Participants with SAD performed worse on ToM tasks than did non-socially-anxious participants. Relative to comparison participants, those with SAD were more likely to attribute more intense emotions and greater meaning to what others were thinking and feeling. These group differences were not due to interpretation bias. The ToM impairments in people with SAD are in the opposite direction of those in people with autism spectrum conditions whose inferences about the mental states of other people are absent or very limited. This association between SAD and ToM may have important implications for our understanding of both the maintenance and treatment of social anxiety disorder.     

Selective Mutism in Children: Comparison to Youths With and Without Anxiety Disorders

Fifteen children with selective mutism (SM), 15 children with anxiety disorders (AD) without selective mutism, and 15 children without anxiety disorders or selective mutism (CN) were compared to examine the relationship between selective mutism and anxiety. Data were collected from children (age 4–10 years), parents, teachers, and clinicians. Results indicated that children with SM closely resemble children with AD. All children with SM received a diagnosis of social anxiety disorder and 53% received a diagnosis for an additional anxiety disorder. In addition, the SM and AD groups differed substantially from controls with respect to parent- and teacher-rated internalizing behavior problems. No differences among the groups were found with respect to parent-and teacher-reported externalizing behavior problems. The results are consistent with prior research emphasizing the association between selective mutism and anxiety disorders, and suggest that selective mutism may be conceptualized, assessed, and treated as an anxiety-related problem.     

Heightened sensitivity to emotional expressions in generalised anxiety disorder,compared to social anxiety disorder,and controls

Few studies have examined potential differences between social anxiety disorder (SAD) and generalised anxiety disorder (GAD) in the sensitivity to detect emotional expressions. The present study aims to compare the detection of emotional expressions in SAD and GAD. Participants with a primary diagnosis of GAD (n?=?46), SAD (n?=?70), and controls (n?=?118) completed a morph movies task. The task presented faces expressing increasing degrees of emotional intensity, slowly changing from a neutral to a full-intensity happy, sad, or angry expressions. Participants used a slide bar to view the movie frames from left to right, and to stop at the first frame where they perceived an emotion. The frame selected thus indicated the intensity of emotion required to identify the facial expression. Participants with GAD detected the onset of facial emotions at lower intensity of emotion than participants with SAD (p?=?0.002) and controls (p?=?0.039). In a multiple regression analysis controlling for age, race, and depressive symptom severity, lower frame at which the emotion was detected was independently associated and GAD diagnosis (B?=?–5.73, SE?=?1.74, p?相似文献   

Social Anxiety Disorder in Childhood and Adolescence: Current Status and Future Directions

This paper reviews the current status of research on the phenomenology, etiology, maintenance, assessment, and treatment of childhood and adolescent social anxiety disorder (SAD). Despite being one of the most prevalent disorders of childhood and adolescence, SAD paradoxically stands as one of the least recognized, researched, and treated pediatric disorders. The small treatment outcome literature provides preliminary support to the effectiveness of various forms of cognitive behavior therapy. The majority of studies to date, however, are limited by inadequate control conditions. Other findings include some support for the utility of parental involvement in treatment, significant advancements in outcome measures (e.g., normative comparisons, indices of naturalistic social functioning), and impressive durability of gains for the majority of treatments. Future directions are suggested, including experimental and naturalistic studies of developmental pathways and maintenance factors, the incorporation of positive psychology constructs (e.g., positive emotions, hope, self-control) in treatment and prevention, and the continued delineation of differences between child, adolescent, and adult manifestations of SAD.     

Recognizing Anxiety Disorders in the Aftermath of the World Trade Center Crisis

This article seeks to educate the reader on how to recognize the presence of anxiety disorders as they occur in the church community. The author uses medical information, Scriptural wisdom and a case illustration to help concerned Christians to assist sufferers in getting appropriate care. Anxiety disorders in the aftermath of the World Trade Center trajedy will be on the rise and the paper addresses this matter particularly for clergy, caregivers and professional counselors.     

The social phobia and social interaction anxiety scales: An exploration of the dimensions of social anxiety and sex differences in structure and relations with pathology

This study sought to provide information on the Social Phobia Scale (SPS) and Social Interaction Anxiety Scale (SIAS) of Mattick and Clarke (1989) with respect to factor structure, relations with psychopathology, and sex differences. A sample of 200 university students completed the SPS and SIAS and various measures of anxiety symptoms and depression. The results from the factor analyses for the sample as a whole suggest the presence of three factors corresponding to scrutiny fears, social interaction anxiety, and a general level of discomfort in social interactions. The results for men replicated this structure. For women, the three-factor solution demonstrated a blurring between the types of anxiety-provoking situations, and a general discomfort in situations involving differences in social power. In general, the discomfort factor was not correlated with measures of pathology, raising the possibility that uneasiness in these situations represents a process that is not part of social anxiety. The distinction between scrutiny fears and social interaction anxiety was also supported by the pattern of partial correlations that suggests that the presence of scrutiny fears is a stronger predictor of psychopathology than is social interaction anxiety, especially for men.     

Anxiety and Depression in Children: A Preliminary Examination of the Utility of the PANAS-C

Recent research has questioned the validity of identifying depression and anxiety as separate constructs in children. The current investigation examined the usefulness of the Positive and Negative Affect Schedule for Children (PANAS-C) in differentiating between anxiety and depression in children while also providing needed reliability and validity data on the PANAS-C. In addition, the relationship between positive and negative affect and coping was examined. Subjects included 110 third through fifth graders from a semirural public school setting. Children completed the PANAS-C, as well as self-report measures of depression, anxiety, and coping strategies. Moderate item–total correlations and high internal consistency indicated that the PANAS-C has good reliability. Validity results were mixed: a two-factor solution resembled previous studies, and negative affect was associated with avoidance coping strategies whereas positive affect was associated with approach coping strategies, as expected. However, correlations of positive and negative affect, anxiety, and depression scales suggest that positive and negative affectivity are negatively related in children as opposed to separate and independent constructs. Results of the present investigation question the validity of the use of the PANAS-C for differentiating anxiety and depression with this age group and lend support to the possibility that high overlap between anxiety and depression in this age group may be specific for childhood depression.     

自闭症谱系障碍个体的焦虑：发生机制、评估与治疗

自闭症谱系障碍是一种神经发育性障碍, 主要表现为社会交往互动障碍和重复刻板性行为。焦虑或焦虑障碍常被认为是自闭症个体最普遍的共病之一。焦虑与自闭症之间的关系尚不明确, 自闭症个体的焦虑与无法忍受不确定性、杏仁核功能和体积、情绪调节策略、消极思维存在一定关联; 目前已经开发出专门用于自闭症个体焦虑的评估工具; 修订版认知行为疗法对自闭症个体焦虑的治疗取得了良好效果。未来的研究应着重探索自闭症个体焦虑的认知与神经机制, 检验专用评估工具的有效性, 继续关注现代技术(如虚拟现实技术)对自闭症个体焦虑的治疗效果。     

A Transdiagnostic Examination of Intolerance of Uncertainty Across Anxiety and Depressive Disorders

Intolerance of uncertainty (IU) has been identified as a potential maintaining factor for generalised anxiety disorder; however, there is a growing evidence to suggest that IU may contribute to other anxiety and depressive disorders. Moreover, certain components of IU (namely prospective and inhibitory IU) have been shown to be differentially associated with symptoms of emotional disorders. The aim of this study was to determine the extent to which individuals with various anxiety and depressive disorders endorsed IU, firstly as a trait variable (with prospective and inhibitory components) and secondly in reference to regularly occurring, diagnostically relevant situations (situation-specific IU). The degree to which diagnosis predicted IU was examined in a highly comorbid clinical sample (N = 218). Regardless of specific diagnoses, the degree of comorbidity emerged as a significant predictor of prospective IU and situation-specific IU. Conversely, specific diagnoses of social phobia, generalised anxiety disorder, depression, and obsessive compulsive disorder were uniquely related to inhibitory IU. These findings suggest that IU is a transdiagnostic construct and have implications for current diagnosis-specific and transdiagnostic theory and clinical practice.     

Predictive Relationship Between Parental Beliefs and Accommodation of Pediatric Anxiety

Behavior performed by parents to assist a youth in avoiding or alleviating anxiety, known as accommodation, is ubiquitous among pediatric anxiety disorders and strongly related to poor treatment outcome. According to cognitive-behavioral theory, the beliefs parents hold regarding accommodation should predict parental accommodating behavior. Unfortunately, little is known about the beliefs parents hold regarding accommodation, as there exists no validated measure of this construct. First, the psychometric properties were examined for the Parental Accommodation Scale (PAS), a novel measure of parental accommodating behavior frequency (PAS-Behavior scale) and parental beliefs about accommodation (PAS-Belief scale). Second, the relationship between parental beliefs about accommodation and accommodation frequency was examined. Results provide preliminary evidence of the internal consistency and convergent validity of the PAS. Stronger positive beliefs about accommodation significantly predicted accommodation frequency, even after controlling for youth anxiety severity. Specifically, beliefs that accommodation prevents youth from losing behavioral and emotional control significantly predicted accommodation frequency. Therefore, efforts to decrease accommodation in clinical settings should involve correcting maladaptive parental beliefs about accommodation, with a particular emphasis on beliefs regarding the necessity of accommodation in preventing a youth from losing behavioral and emotional control.     

Empathic Skills and Cyberbullying: Relationship of Different Measures of Empathy to Cyberbullying in Comparison to Offline Bullying Among Young Adults

ABSTRACT

Empathy, as the ability to understand and feel the emotions of others, is related to less bullying behavior. However, the link of bullying behavior with self-reports of empathy seems to be stronger than with behavioral measures of empathy (e.g., empathic accuracy). Few studies have analyzed the relationship of affective and cognitive empathy to cyberbullying behavior, especially among young adults. In a quasiexperimental dyadic interaction paradigm with 72 young adults, empathic accuracy was operationalized as the match of other- and self-reported emotions for the target, and emotional congruence as the match of the target's and the perceiver's self-reported emotions. Affective and cognitive empathy, offline bullying behavior, and cyberbullying behavior were measured using self-reports. Empathic accuracy and cognitive empathy were found to be negatively linked. Emotional congruence, self-reported affective and cognitive empathy did not correlate with offline bullying behavior or cyberbullying behavior. Only empathic accuracy was significantly negatively linked to offline bullying behavior. In group tests, higher empathic accuracy (but not emotional congruence) was connected to less offline bullying behavior. In a multiple regression analysis only emotional congruence was a predictor of cyberbullying behavior. Thus, while empathic accuracy might diminish offline bullying behavior, emotional congruence might diminish cyberbullying behavior.     

A Preliminary Examination of the Acceptability,Feasibility, and Effectiveness of a Telehealth Cognitive-Behavioral Therapy Group for Social Anxiety Disorder

In light of the growing interest in, and need for, the telehealth delivery of health care, additional research is needed on the acceptability and effectiveness of these types of interventions. This study examined the acceptability, feasibility, and preliminary effectiveness of an adapted telehealth-delivered group cognitive-behavioral therapy (CBT) intervention for adults with social anxiety disorder (SAD). This report describes the adaptation and subsequent implementation of an 8-week telehealth-delivered group treatment designed to reduce symptoms of SAD. Specific adaptations for delivering treatment during the COVID-19 pandemic and the subsequent enactment of social distancing measures are discussed. Posttreatment data indicated that the intervention was feasible to implement in an outpatient mental health clinic, acceptable to participants, and associated with reduction in symptoms of social anxiety, general anxiety, depression, and stress.