Social anxiety and depressive symptoms mediate instrumentality and maladaptive interpersonal styles

This study sought to examine the relationships between stereotypically masculine (instrumentality) and feminine (expressiveness) personality traits, social anxiety and depressive symptoms, and three interpersonal styles of relating: destructive overdependence (DO), dysfunctional detachment (DD), and healthy dependence (HD). Based on theories of social anxiety and recent research on social anxiety and close relationships, it is argued that individuals with higher levels of social anxiety would display greater detachment and overdependence in their interpersonal relationships. Students at an Australian university (n = 524) completed a battery of online self-report measures. The findings suggest that low levels of instrumentality are related to social anxiety and depressive symptoms, which both mediate the relationship between instrumentality and the two maladaptive interpersonal styles of relating: DO and DD.     

Gender Role Orientation and Anxiety Symptoms Among African American Adolescents

The present study evaluated gender role theory as an explanation for the observed gender differences in anxiety symptoms among adolescents. Specifically, the relation between gender, gender role orientation (i.e., masculinity and femininity), self-esteem, and anxiety symptoms was examined in a community sample of 114 African Americans aged 14 to 19 (mean age 15.77; 57 girls). Results revealed that masculinity was negatively associated with anxiety symptoms whereas femininity was positively associated with anxiety symptoms. Gender role orientation accounted for unique variance in anxiety scores above biological gender and self-esteem, and self-esteem moderated the relation between femininity (but not masculinity) and overall anxiety symptoms. Consistent with research on children and Caucasians, findings supported gender role theory as a partial explanation for the observed gender disparity in anxiety symptoms among African American adolescents.     

Examining the Panic Attack Specifier in Social Anxiety Disorder

Panic attacks (PAs) are characterized by overwhelming surges of fear and discomfort and are one of the most frequently occurring symptoms in psychiatric populations. The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (i.e. DSM-5) allows for a panic attack (PA) specifier for all disorders, including social anxiety disorder (SAD). However, there is little research examining differences between individuals diagnosed with SAD with the PA specifier versus individuals diagnosed with SAD without the PA specifier. The current study examined social anxiety, mood, anxiety, and anxiety sensitivity social concerns, a risk factor for social anxiety in SAD-diagnosed individuals without (N = 52) and with (N = 14) the PA specifier. The groups differed only in somatic symptoms of anxiety. Result of the current study provides preliminary evidence that the presence of the PA specifier in social anxiety does not result in elevated levels of comorbidity or a more severe presentation of social anxiety.     

The Role of Anger in Generalized Anxiety Disorder

Little is known about the role of anger in the context of anxiety disorders, particularly with generalized anxiety disorder (GAD). The aim of study was to examine the relationship between specific dimensions of anger and GAD. Participants (N = 381) completed a series of questionnaires, including the Generalized Anxiety Disorder Questionnaire (GAD-Q-IV; Newman et al., 2002, Behavior Therapy, 33, 215–233), the State-Trait Anger Expression Inventory (STAXI-2; Spielberger 1999, State-Trait Anger Expression Inventory-2: STAXI-2 professional manual, Odessa, FL: Psychological Assessment Resources) and the Aggression Questionnaire (AQ; Buss & Perry 1992, Journal of Personality and Social Psychology, 63, 452–459). The GAD-Q-IV identifies individuals who meet diagnostic criteria for GAD (i.e. GAD analogues) and those who do not (non-GAD). The STAXI-2 includes subscales for trait anger, externalized anger expression, internalized anger expression, externalized anger control and internalized anger control. The AQ includes subscales for physical aggression, verbal aggression, anger and hostility. The GAD-Q-IV significantly correlated with all STAXI-2 and AQ subscales (r's ranging from .10 to .46). Multivariate analyses of variance revealed that GAD analogues significantly differed from non-GAD participants on the combined STAXI-2 subscales (η² = .098); high levels of trait anger and internalized anger expression contributed the most to GAD group membership. GAD analogue participants also significantly differed from non-GAD participants on the combined AQ subscales (η² = .156); high levels of anger (affective component of aggression) and hostility contributed the most to GAD group membership. Within the GAD analogue group, the STAXI-2 and AQ subscales significantly predicted GAD symptom severity (R ² = .124 and .198, respectively). Elevated levels of multiple dimensions of anger characterize individuals who meet diagnostic criteria for GAD.     

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.     

Social Anxiety in Children with Anxiety Disorders: Relation with Social and Emotional Functioning

Investigated the psychometric properties of the Social Anxiety Scale for children-Revised (SASC-R) as well as relations between social anxiety and children's social and emotional functioning. Participants were a clinic sample of children, ages 6–11 with anxiety disorders (N = 154) who completed the SASC-R. For a subset of these children, parent ratings of social skills, and self-ratings of perceived competence and peer interactions were also obtained. Factor analysis of the SASC-R supported the original three-factor solution and internal consistencies were in the acceptable range. Among children with simple phobia, scores on the SASC-R differentiated those with and without a comorbid social-based anxiety disorder. Social anxiety was also associated with impairments in social and emotional functioning. Specifically, highly socially anxious children reported low levels of social acceptance and global self-esteem and more negative peer interactions. Girls with high levels of social anxiety were also rated by parents as having poor social skills, particularly in the areas of assertive and responsible social behavior.     

Change in gaze-based attention bias in adolescents with Social Anxiety Disorder

ABSTRACT

Although attention bias (AB) toward threat has been associated with Social Anxiety Disorder (SAD), concerns regarding the ability of current measures to detect change in AB following treatment exist. We sought to examine change in bias, as measured via eye-tracking, in adolescents with SAD receiving either attention-bias modification training (ABMT) or attention-control training (ACT). Gaze-based AB was associated (r?=??0.361) with symptoms of social anxiety prior to treatment, whereas there was no association between bias as measured via dot probe and social anxiety. Moreover, gaze-based bias to same-age face stimuli showed change following treatment. Large effects are seen for condition (ABMT or ACT) and for time, independent of treatment condition, in gaze-based AB to same-age stimuli. Findings suggest that further research on gaze-based bias, to assess stability over time outside of treatment and sensitivity to change following intervention, is warranted.     

Combining Exposure and Pharmacotherapy in the Treatment of Social Anxiety Disorder: A Preliminary Study of State Dependent Learning

State dependent learning (SDL) occurs when learning acquired in one context is not retrievable in a different context. Although traditionally SDL is thought of in the context of substance use, the role of SDL should be considered during combined medication and exposure treatment for anxiety disorders. Data are presented from a within-subjects, case-series design of four participants with social anxiety disorder. Participants engaged in a series of situational exposures while taking either alprazolam (0.75 mg), propranolol (40 mg), placebo or no medication. They returned 48 h later and engaged in the same situational exposure in an unmedicated state to determine retention of learning following the shift in drug context. Results suggest that SDL effects are possible when combining pharmacotherapy (alprazolam) with exposure therapy. Future research is needed determine the conditions under which SDL is most likely to occur and ways to facilitate transfer of learning across different contexts.     

The Relationship between Social Dominance Orientation and Gender: The Mediating Role of Social Values

Invariance hypothesis posits that, across cultures and contexts, men are higher in SDO than women. Social Dominance Theory (SDT) suggests that this difference is biologically determined and resulting from the differences in reproductive strategies between sexes. In this study we tested the hypothesis that values can explain gender–SDO differences. SDT suggests that SDO mediates gender differences in values. The contrasting hypothesis suggests that gender–SDO differences are mediated by values. Using SEM with a sample of Italian University students (N = 162, 80 men), the results provided strong support for the hypothesis of a mediation effect of values. Indeed, when controlling for values, gender difference in SDO disappear. Very similar findings were obtained for both GBD and OEQ. Results are discussed.     

Psychometric Properties of the Generalized Anxiety Disorder Questionnaire for DSM-IV Among Four Racial Groups

The Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV) is a self-report diagnostic measure of generalized anxiety disorder. Previous studies have established the psychometric properties of the GAD-Q-IV, revealing excellent diagnostic specificity and sensitivity as well as good test–retest reliability and convergent and discriminant validity (Newman et al., 2002). Recent analyses with other measures of anxiety symptoms have revealed differences across racial or national groups. Given that the GAD-Q-IV was tested primarily on Caucasians (78%), the purpose of this study was to demonstrate the psychometric properties of the GAD-Q-IV across four racial groups: African American, Caucasian, Hispanic/Latino, and Asian. A student sample of 585 undergraduate psychology students completed the GAD-Q-IV as well as other measures of anxiety symptoms. A clinical replication sample included 188 participants who completed the GAD-Q-IV as part of a larger psychotherapy study. Results indicated excellent and very similar factor structures in the student sample and similar psychometric properties in both samples across the racial groups. Implications for the use of the GAD-Q-IV across racial groups are discussed.     

Direct and Mediating Effects of an Anxiety Sensitivity Intervention on Posttraumatic Stress Disorder Symptoms in Trauma-Exposed Individuals

Anxiety sensitivity (AS), or fear of anxious arousal, is a higher-order cognitive risk-factor for posttraumatic stress disorder (PTSD) composed of lower-order physical, cognitive, and social concerns regarding anxiety symptoms. Brief and effective interventions have been developed targeting AS and its constituent components. However, there is limited evidence as to whether an intervention aimed at targeting AS would result in reductions in PTS symptoms and whether the effects on PTS symptoms would be mediated by reductions in AS. Furthermore, there is no evidence whether these mediation effects would be because of the global or more specific components of AS. The direct and indirect effects of an AS intervention on PTS symptoms were examined in a sample of 82 trauma-exposed individuals (M age = 18.84 years, SD = 1.50) selected based on elevated AS levels (i.e., 1 SD above the mean) and assigned to either a treatment (n = 40) or an active control (n = 42) condition. Results indicated that the intervention led to reductions in Month 1 PTS symptoms, controlling for baseline PTS symptoms. Furthermore, this effect was mediated by changes in global AS and AS social concerns, occurring from intervention to Week 1. These findings provide an initial support for an AS intervention in amelioration of PTS symptoms and demonstrate that it is primarily reductions in the higher-order component of AS contributing to PTS symptom reduction.     

Social Anxiety Among Adolescents: Linkages with Peer Relations and Friendships

This study examined the utility of modifying the Social Anxiety Scale for Children—Revised (SASC-R) for use with adolescents, and examined associations between adolescents' social anxiety (SA) and their peer relations, friendships, and social functioning. Boys (n = 101) and girls (n = 149) in the 10th through 12th grades completed the Social Anxiety Scale for Adolescents (SAS-A) and measures of social support, perceived competence, and number and quality of their best friendships. Factor analysis of the SAS-A confirmed a three-factor structure: Fear of Negative Evaluation, Social Avoidance and Distress in General, and Social Avoidance Specific to New Situations or Unfamiliar Peers. Girls reported more SA than boys, and SA was more strongly linked to girls' social functioning than boys'. Specifically, adolescents with higher levels of SA reported poorer social functioning (less support from classmates, less social acceptance), and girls with higher levels of SA reported fewer friendships, and less intimacy, companionship, and support in their close friendships. These findings extend work on the SASC-R to adolescents, and suggest the importance of SA for understanding the social functioning and close friendships of adolescents, especially girls.     

Attention Bias Modification Treatment for Adolescents With Social Anxiety Disorder

Social anxiety disorder (SAD) tends to emerge during the early teenage years and is particularly refractory to change even when standard evidence-based CBT treatments are delivered. Efforts have been made to develop novel, mechanistic-driven interventions for this disorder. In the present study, we examined Attention Bias Modification Treatment (ABMT) for youth with SAD. Participants were 58 adolescents (mean age = 14.29 years) who met diagnostic criteria for SAD and who were randomized to ABMT or a placebo control condition, Attention Control Training (ACT). We predicted that ABMT would result in greater changes in both threat biases and social anxiety symptoms. We also explored potential moderators of change including the severity of social anxiety symptoms, the level of threat bias at pretreatment, and the degree of temperament-defined attention control. Contrary to our hypotheses, changes in attention bias were not observed in either condition, changes in social anxiety symptoms and diagnosis were small, and significant differences were not observed between the ABMT and ACT conditions. Little support for the proposed moderators was obtained. Reasons for our failure to find support for ABMT and its potential moderators are explored and recommendations for changes in the ABMT paradigm are suggested.     

社交焦虑障碍中的注意偏差三成分研究述评

社交焦虑障碍表现为对一种或多种社交情境存在显著并持续的害怕,并表现出对社交刺激具有注意偏差,即注意增强、注意固着和注意回避,这三个成分交互作用促使社交焦虑持续发展.目前主要采用视觉搜索任务、点探测任务、空间线索任务,并结合眼动技术对此进行研究,但三成分之间的关系仍然存在疑惑,三者是否具有时间进程,如何衔接转换,仍需进一步检验.     

Worry and Rumination in Generalized Anxiety Disorder and Obsessive Compulsive Disorder

Ample work has already been conducted on worry and rumination as negative thought processes involved in the etiology of most of the anxiety and mood related disorders. However, minimal effort has been exerted to investigate whether one type of negative thought process can make way for another type of negative thought process, and if so, how it subsequently results in experiencing a host of symptoms reflective of one or the other type of psychological distress. Therefore, the present study was taken up to investigate whether rumination mediates the relationship between worry and generalized anxiety disorder (GAD), and between worry and obsessive compulsive disorder (OCD) in two clinical groups. Self-report questionnaires tapping worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) were administered to a clinical sample of 60 patients aged 30–40. Worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) correlated substantially with each other, however, rumination did not mediate the relationship between worry and generalized anxiety disorder (GAD) and between worry and obsessive compulsive disorder (OCD). We also analyzed differences of outcome variables within two clinical groups. These results showed that worry and rumination were significantly different between GAD and OCD groups.     

大学生社交焦虑对躯体变形障碍的影响：外表拒绝敏感性的中介作用

躯体变形障碍在大学生群体中具有较高的发病率,在其发展过程中,社交焦虑是重要的预测因素;然而两者潜在的中介机制却未得到研究者关注。本研究采用问卷调查法,旨在大学生 (N = 875)中探究外表拒绝敏感性在社交焦虑与躯体变形障碍之间的中介作用。结果发现： (1) 社交焦虑显著正向预测外表拒绝敏感性与躯体变形障碍,且外表拒绝敏感性显著正向预测躯体变形障碍; (2) 外表拒绝敏感性在社交焦虑与躯体变形障碍之间具有显著的部分中介作用。本研究发现,个体的社交焦虑可直接影响躯体变形障碍,也可通过提高外表拒绝敏感性间接影响。     

Examining Safety Behavior Subtypes Across Distinct Social Contexts in Social Anxiety Disorder and Major Depression

People with social anxiety disorder (SAD) use different types of safety behaviors that have been classified as avoidance vs. impression management. The current study investigated differences in safety behavior subtype use in 132 individuals with principal diagnoses of social anxiety disorder (SAD, n = 69), major depressive disorder (MDD, n = 30), and nonpatient controls (n = 33) across two social contexts: an interpersonal relationship-building task (social affiliation) and a speech task (social performance). We examined whether diagnostic groups differed in safety behavior subtype use and whether group differences varied by social context. We also explored relationships between avoidance and impression management safety behaviors, respectively, and positive and negative valence affective and behavioral outcomes within the social affiliation and social performance contexts. Safety behavior use varied by diagnosis (SAD > MDD > nonpatient controls). The effect of diagnosis on impression management safety behavior use depended on social context: use was comparable for the principal SAD and MDD groups in the social performance context, whereas the SAD group used more impression management safety behaviors than the MDD group in the social affiliation context. Greater use of avoidance safety behaviors related to higher negative affect and anxious behaviors, and lower positive affect and approach behaviors across contexts. Impression management safety behaviors were most strongly associated with higher positive affect and approach behaviors within the social performance context. These findings underscore the potential value of assessing safety behavior subtypes across different contexts and within major depression, in addition to SAD.     

Development and Evaluation of the Anxiety Disorder Diagnostic Questionnaire

A model of anxiety that emphasizes a single common pathology across diagnostic categories is gaining support and influencing nosological and treatment approaches of anxiety disorders. As research in this area continues to grow, a need exists for an assessment tool of the theorized single anxiety pathology that is unbiased toward any particular anxiety diagnosis. The Anxiety Disorder Diagnostic Questionnaire (ADDQ) was developed as a screening tool for the presence of clinical fear and anxiety irrespective of diagnoses. It is a brief four-section index developed to assess fear, anxiety/worry, escape/avoidance behaviors, physiological symptoms, and associated distress and interference. The ADDQ was tested for reliability and validity in two samples: 146 undergraduate students who were given the ADDQ along with a variety of other commonly-used measures of anxiety and 94 outpatients representing a mix of diagnoses (28.2% panic disorder with or without agoraphobia, 44.6% social anxiety disorder, 20.7% generalized anxiety disorder, 3.3% anxiety disorder not otherwise specified, 2.1% obsessive–compulsive disorder, and 1.1% posttraumatic stress disorder). Internal consistency of the instrument was strong, and a one- or two-factor solution was found to be the best fit to the data. Convergent and discriminant validity was also demonstrated. Data from those clinical participants who completed a manualized cognitive–behavioral treatment program indicated a very strong concordance between change on the ADDQ and change in clinician severity ratings from a structured diagnostic interview. The findings offer support for the psychometric validity of the ADDQ in both clinical and nonclinical populations.     

Health Perceptions and Anxiety Sensitivity in Patients with Panic Disorder

Separate lines of research indicate that patients with panic disorder display negative perceptions of physical health and elevated fear of autonomic arousal. Because health perceptions and anxiety sensitivity may be related, the present study evaluated the degree to which these constructs can be distinguished in patients meeting DSM-IV criteria for panic disorder (N = 44). Perceived health, anxiety sensitivity, and the clinical features of panic disorder were assessed at pretreatment and following 12 sessions of cognitive–behavioral treatment. Findings consistently indicated that perceived health and anxiety sensitivity can be meaningfully differentiated. Perceived physical health was only moderately associated with anxiety sensitivity, and each was uniquely associated with pretreatment symptomatology and posttreatment end-state functioning. Perceived physical health appears to be a clinically useful index in the overall evaluation of panic disorder and is readily distinguishable from anxiety sensitivity.