Enduring without avoiding: Pauses and verbal dysfluencies in public speaking fear

Direct measures of overt behavior have been underutilized in speech and other social fear, anxiety, and phobia research. This study demonstrates the usefulness of such variables in the evaluation of public speaking fear. A molecular behavioral assessment methodology was used to examine pauses and verbal dysfluencies of individuals with circumscribed speech fear (n=8) or general social anxiety (n=8), as well as nonanxious control participants (n=16), during an impromptu speech behavior test. Speech fear and generally social anxious individuals paused more often and for a longer duration than the nonanxious group. Results also indicated greater increases in state anxiety during the speech in the circumscribed speech fear sample, relative to the generalized social anxiety and control groups. Taken together with other research, these findings provide evidence that circumscribed speech fear is a meaningful subtype and can be independent of generalized social anxiety. The utility of measuring pausing and verbal dysfluencies in the behavioral assessment of speech fear and other social anxiety and phobia is discussed.     

The Social Phobia Inventory: screening and cross-cultural validation in Spanish adolescents

Availability of brief, self-report measures to be used as screening instruments is crucial to detect correctly youth with social anxiety disorder and therefore, reach those otherwise under-detected and under-treated. A previous study revealed that the Social Phobia Inventory (SPIN) was potentially an appropriate measure for screening social anxiety among US adolescents. However, there is a lack of information concerning its properties as a screening test in other cultures and languages. This is the main objective of this study, although further validity of the scale is provided as well. The sample consisted of 192 adolescents (a sample composed of 114 subjects with a principal diagnosis of social anxiety disorder; and a group consisting of 78 subjects with no diagnosis of social phobia). Results suggest that the Social Phobia Inventory has demonstrated good psychometric properties and indeed may be used as a screening tool in Spanish-speaking adolescents.     

Trait social anxiety and physiological activation: cardiovascular threat during social interaction

Physiological activation is thought to be a part of the constellation of responses that accompany social anxiety, but evidence regarding the nature of such activation is mixed. In two studies, the relationship between trait social anxiety and responses during social interaction was explored using on-line cardiovascular indexes of threat. Across Studies 1 and 2, women higher in trait social anxiety exhibited cardiovascular responses consistent with greater threat during the social interaction than those lower in social anxiety. Retrospective self-reports (Studies 1 and 2), as well as partner ratings and interaction behavior (Study 2), also revealed consistent differences as a function of trait social anxiety. Study 2 added male participants, among whom a divergence emerged between results for physiological measures and other responses. These findings have implications for understanding physiological as well as psychological processes among people with social anxiety during social interaction.     

Understanding pregnant women's decision making concerning prenatal screening

OBJECTIVE: This study is aimed at enhancing understanding prenatal screening decision making through testing a hypothesized decision model based on decision theory and health behavior theory. DESIGN: We obtained questionnaires from 1,666 pregnant women who were offered prenatal screening for Down's syndrome. Path analysis (using LISREL) resulted in a final model with reasonable model fit, which was verified by split-sample cross-validation. MAIN OUTCOME MEASURES: These included perceived probability, perceived severity, attitude toward termination, response efficacy, attitude toward prenatal screening, subjective norm, child-related anxiety, and intention to undergo prenatal screening. RESULTS: Attitude toward termination of pregnancy, perceived test efficacy, and subjective norm regarding the desirability of having prenatal screening determined a woman's attitude toward having a prenatal test. Anxiety was influenced by perceived risk and perceived severity of having a child with Down's syndrome, and by subjective norm, but this appeared to be a weak predictor of intention to test. Pregnant women with a positive attitude toward prenatal screening, and who perceived a subjective norm in favor of undergoing prenatal screening, showed a greater intention to have prenatal screening done. CONCLUSION: These findings suggest that more attention should be paid toward the values and social context of pregnant women during the counseling process.     

Stereotypic and nonstereotypic sex role trait and behavior orientations, gender identity, and psychological adjustment

This study examines the relations among sex role trait and behavior orientations, gender identity, and psychological adjustment in order to test traditional and contemporary perspectives regarding the adjustment implications of stereotypic and nonstereotypic sex role trait and behavior orientations. Measures of sex role personality traits and behaviors and scales assessing depression, anxiety, and social maladjustment were administered to 235 college men and women. In addition, subjects completed measures of gender identity and gender adequacy. Contrary to traditional perspectives, androgynous men and women and cross-sex-typed women were no less well adjusted than sex-typed individuals. However, consistent with traditional perspectives, men who were low in masculine characteristics (and men and women low in both masculine and feminine characteristics) did appear less well adjusted on measures of depression, anxiety, and social maladjustment. Furthermore, low masculinity men had less secure gender identities. No such gender identity disturbances were found in women.     

Implicit self-esteem and social anxiety: differential self-favouring effects in high and low anxious individuals

This study was designed to investigate the role of negative self-image in social phobia. Participants were 19 high and 19 low socially anxious women. Because self-report measures of self-esteem are sensitive to self-presentation and impression management strategies, an implicit association test (IAT) was used to assess participants' self-esteem as well as their general evaluation of others ('other-esteem'). Socially anxious women displayed relatively low levels of self-esteem on self-report measures. However, at the implicit level, low and high anxious women were characterised by a similar, highly positive self-image. Both groups displayed a relatively low 'other-esteem'. Yet, this self-favouring effect was considerably weaker in high than in low anxious participants. The results provide no unequivocal support for the idea that low self-esteem plays an important role in social anxiety. Yet, rather than by low self-esteem per se, socially anxious people are characterised by a small discrepancy between esteem of self and others, and it may be this reduced tendency to self-favouring that is pivotal to social anxiety.     

The incremental role of trait emotional intelligence on perceived cervical screening barriers

Researchers have become increasingly interested in investigating the role of the psychological aspects related to the perception of cervical screening barriers. This study investigates the influence of trait EI on perceived cervical screening barriers. Furthermore, this study investigates the incremental validity of trait EI beyond the Big Five, as well as emotion regulation in the perceived barrier towards the Pap test as revealed in a sample of 206 Italian women that were undergoing cervical screening. Results have shown that trait EI is negatively related to cervical screening barriers. Furthermore, trait EI can be considered as a strong incremental predictor of a woman’s perception of screening over and above the Big Five, emotion regulation, age, sexual intercourse experience and past Pap test. Detailed information on the study findings and future research directions are discussed.     

When the heat is on: romantic partner responses influence distress in socially anxious women

This study provided a preliminary test of whether socially anxious women and their partners would show more negative social support behavior, especially among those with low relationship satisfaction, and whether this would increase the distress of the socially anxious women. Women with (n=22) and without (n=23) heightened social anxiety were observed interacting with their partners under a social-evaluative threat and support behaviors were coded. Unexpectedly, no differences were found between socially and non-socially anxious women and their partners. Although relationship satisfaction influenced this process, it was the more satisfied women who showed more negative behavior. Additionally, the more positive behaviors the partner exhibited, the greater was the distress reported by socially anxious women, particularly among women whose partners reported high relationship satisfaction. Implications for how these findings might expand theories on interpersonal processes in social anxiety are discussed.     

Prüfungsangst bewältigen

Test anxiety or exam anxiety is a prevalent problem among students. Therefore, a high proportion of students seek help in university counseling centers. Based on a theoretical review of psychological theories and models of test anxiety, a cognitive-behavioral training program for coping with test anxiety as well as the evaluation of the program is presented. The program includes elements of behavior training with video-supported role playing and simulation of (oral) test situations, enhancement of learning and preparation strategies including time management as well as cognitive intervention strategies and relaxation training. Evaluation of the workshop program shows significant reduction of test anxiety and the strengthening of self-efficacy. The group program also lends itself for application with other groups, such as school students or for the preparation of job interviews.     

Virtual social interactions in social anxiety--the impact of sex, gaze, and interpersonal distance

In social interactions, interpersonal distance between interaction partners plays an important role in determining the status of the relationship. Interpersonal distance is an important nonverbal behavior, and is used to regulate personal space in a complex interplay with other nonverbal behaviors such as eye gaze. In social anxiety, studies regarding the impact of interpersonal distance on within-situation avoidance behavior are so far rare. Thus the present study aimed to scrutinize the relationship between gaze direction, sex, interpersonal distance, and social anxiety in social interactions. Social interactions were modeled in a virtual-reality (VR) environment, where 20 low and 19 high socially anxious women were confronted with approaching male and female characters, who stopped in front of the participant, either some distance away or close to them, and displayed either a direct or an averted gaze. Gaze and head movements, as well as heart rate, were measured as indices of avoidance behavior and fear reactions. High socially anxious participants showed a complex pattern of avoidance behavior: when the avatar was standing farther away, high socially anxious women avoided gaze contact with male avatars showing a direct gaze. Furthermore, they showed avoidance behavior (backward head movements) in response to male avatars showing a direct gaze, regardless of the interpersonal distance. Overall, the current study proved that VR social interactions might be a very useful tool for investigating avoidance behavior of socially anxious individuals in highly controlled situations. This might also be the first step in using VR social interactions in clinical protocols for the therapy of social anxiety disorder.     

Defense mechanisms, behavior, and affect in young adulthood

The relationship between defense mechanism use, observed behavior, and affect was investigated in a sample of 91 young adults. Defense mechanisms were assessed using Cramer's (1991a) Defense Mechanism Manual for TAT stories; behavior was based on observer Q-sort ratings (Block, 1978). The findings show that men and women who rely on the immature defense of denial at age 23 show multiple signs of behavioral immaturity, as well as anxiety. In contrast, extensive use of projection was related to a suspicious, hyperalert personality style, including anxiety and depression, in men, but to a sociable, nonwary, nondepressed style in women. The use of the mature defense of identification, by women, was related to behavior characterized by maturity, social competence, and the absence of depressive symptoms.     

Modelling relationships between cognitive variables during and following public speaking in participants with social phobia

Cognitive models of social phobia predict that several cognitive processes will mediate the relationship between trait levels of social anxiety and the extent of anxiety experienced in a specific social-evaluative situation. The current study aimed to provide a test of these relationships. Over 200 clinical participants with social phobia completed measures of their general social anxiety and a week later performed a brief impromptu speech. They completed a measure of state anxiety in response to the speech as well as questionnaires assessing several cognitive constructs including focus of perceived attention, perceived performance, and probability and cost of negative evaluation. A week later, they completed measures of negative rumination experienced over the week, as well as a measure of the recollection of their perceived performance. Path analysis provided support for a model in which the cognitive factors mediated between general social anxiety and the degree of anxiety experienced in response to the speech. A second model supported the theory that negative rumination mediated between characteristic social anxiety and negative bias in the recollection of performance.     

Parental Stress and Children’s Social and Behavioral Outcomes: The Role of Abuse Potential over Time

Parental stress is a well-established risk factor for adverse child outcomes, including the development of aggression, externalizing behavior problems, and anxiety, as well as compromised emotional coping, impaired social cognition, and diminished treatment response. Abuse potential represents a mechanism by which parental stress may impact child social competence and behavior; evidence links parental stress to abuse potential, and abuse potential to a range of negative child social competence and behavioral outcomes. The current study assessed relationships between parental stress, abuse potential, and child social and behavioral outcomes over time. Parents of children ages 2–6 years (N?=?610, 44% girls) reported on perceived parental stress and attitudes towards abuse and neglect, as well as child social competence and behavior problems, before and after a caregiver-directed, community-based intervention. Changes in parental stress, abuse potential, and child social and behavioral outcomes were examined using panel analyses, while controlling for intervention effects and demographic variables. Parental stress predicted child social competence, anxiety/withdrawal, and anger/aggression over time; while the links between stress and anxiety/withdrawal, and stress and social competence, were mediated by child abuse potential, the link between stress and anger/aggression was not mediated by child abuse potential. Findings suggest that abuse potential represents a mechanism by which parental stress and child social and behavioral outcomes are linked. Further, screening for child social competence deficits may identify children at risk for abuse, as well as parents in need of services to reduce stress.     

Does Father Know Best? A Formal Model of the Paternal Influence on Childhood Social Anxiety

We explore paternal social anxiety as a specific risk factor for childhood social anxiety in a rational optimization model. In the course of human evolution, fathers specialized in external protection (e.g., confronting the external world) while mothers specialized in internal protection (e.g., providing comfort and food). Thus, children may instinctively be more influenced by the information signaled by paternal versus maternal behavior with respect to potential external threats. As a result, if fathers exhibit social anxiety, children interpret it as a strong negative signal about the external social world and rationally adjust their beliefs, thus becoming stressed. Under the assumption that paternal signals on social threats are more influential, a rational cognitive inference leads children of socially anxious fathers to develop social anxiety, unlike children of socially anxious mothers. We show in the model that mothers cannot easily compensate for anxious paternal behavior, but choose to increase maternal care to maintain the child’s wellbeing. We discuss research directions to test the proposed model as well as implications for the prevention and treatment of child social anxiety.     

Development of an abbreviated Social Phobia and Anxiety Inventory (SPAI) using item response theory: the SPAI-23

An abbreviated version of the Social Phobia and Anxiety Inventory (SPAI) was developed using methods based in nonparametric item response theory. Participants included a nonclinical sample of 1,482 undergraduates (52% female, mean age = 19.4 years) as well as a clinical sample of 105 individuals (56% female, mean age = 36.4 years) diagnosed with either generalized (73%) or specific social phobia (27%). Twenty-three of the 45 SPAI items demonstrated good discrimination along the social anxiety continuum. In addition, option characteristic curves (OCCs) indicated that the SPAI's 7-point scale may generate errors in ranking individuals. Thus, options were collapsed to improve item performance. No gender differences emerged between any of the items' OCCs, suggesting that items function similarly among men and women. The abbreviated version also correlated highly with the original 45-item SPAI and exhibited similar patterns of correlations with measures of social anxiety. The SPAI-23 has considerable practical benefits, including a screening of both social and agoraphobic anxiety as well as decreased assessment and scoring time.     

Receipt of a False Positive Test Result During Routine Screening for Ovarian Cancer: A Teachable Moment?

The term "teachable moment" (TM) has been used to describe a life transition or event which motivates an individual to change a behavior or presents an opportunity to intervene to prompt behavior change. We examined whether receipt of a false positive ovarian cancer (OC) screening result may represent a TM. 403 women participating in an OC screening program completed questionnaires assessing demographic, clinical, behavioral, and psychosocial information. The TM was operationalized as expressed interest in receiving health-related information. We hypothesized that among women receiving a false positive screening test result, those women who had experienced greater personal perceived risk for OC as well as distress would be more interested in receiving health-related information than women receiving a normal result. Analyses revealed that women receiving a false positive screening result were less interested in receiving health-related information than women receiving a normal screening result. For women receiving a false positive result, expressed interest in receipt of health-related information was only modestly related to distress and related even less to perceptions of OC risk. Our data do not support viewing a false positive OC screening result as a TM. Potential explanations for the current findings as well as recommendations for future research investigating the TM are discussed.     

Relationships between psychoevolutionary fear of evaluation,cognitive distortions,and social anxiety symptoms: A preliminary structural equation model

Social anxiety disorder is a mental health condition that affects 4.7% of Australians each year. The complex interplay between psychoevolutionary and cognitive models has become the focus of research in recent years, particularly with the development of the bivalent fear of evaluation model (i.e., negative and positive evaluation fears). The present study aimed to test a model of social anxiety symptoms using structural equation modelling, integrating previously fragmented evidence. A sample of 255 participants (75.3% female; M_age = 31.9, SD = 10.3) undertook an online survey, including Social Phobia Scale, Brief Fear of Negative Evaluation—Straightforward, Fear of Positive Evaluation, Concerns of Social Reprisal, and Disqualifications of Positive Social Outcomes measures. The hypothesised model for social anxiety symptoms described the data reasonably well (χ²(1) = 4.917, p = .027, CFI = .995, GFI = .992, SRMR = .017), explaining 57.1% of social anxiety variance. Study hypotheses were supported with bivalent fear of evaluation accounting for unique variance in cognitive distortions, which in turn accounted for unique variation in social anxiety symptoms. Effect sizes indicate bivalent fears of evaluation and disqualification of positive social outcomes as important predictors of social anxiety symptoms. Although replication in a clinical cohort and experimental confirmation are needed, the findings suggest a focus on disqualification of positive social outcomes to alleviate social anxiety symptoms.     

Do socially anxious individuals fear embarrassment by close others? Development of the Fear of Embarrassment by Others Scale

Social anxiety disorder is characterized by an intense fear of social or performance situations, and a fear of acting in a way that will be humiliating or embarrassing. However, the extent to which socially anxious individuals fear embarrassment due to the behavior of close others remains unknown. The Fear of Embarrassment by Others Scale (FEOS) was developed to assess the extent to which individuals with social anxiety fear being embarrassed by others. To assess the psychometric properties of this measure, 162 undergraduate students low or high in social anxiety completed the FEOS, along with additional questionnaires. An exploratory factor analysis suggested a single factor. The measure demonstrates high internal consistency, and is correlated with measures of social anxiety, fear of negative evaluation, and anxiety sensitivity. Fear of embarrassment by others was not found to be a significant predictor of social anxiety, as compared to anxiety sensitivity and fear of negative evaluation. The FEOS discriminated among participants high and low in social anxiety, as those high in social anxiety scored significantly higher on the measure than did participants low in social anxiety. The utility of this scale for research and clinical practice is discussed.     

Adolescent Self-Reports of Social Anxiety: Can They Disagree with Objective Psychophysiological Measures and Still Be Valid?

We examined self-reported and parent-reported adolescent social anxiety symptoms and objective baseline measures of psychophysiological flexibility in 62 families. Measures completed by 31 adolescents referred for a clinical screening evaluation for social anxiety were compared to an age- and gender-matched community control sample of 31 adolescents (total sample: age range 14 to 17?years; 22 boys and 40 girls; M?=?15.32?years; SD?=?1.1). Clinic referred adolescents reported significantly fewer social anxiety symptoms than parents reported about adolescents. Further, for all adolescents, self-reported social anxiety symptoms exhibited low correspondence with objective psychophysiological measures. Yet, both measures uniquely discriminated between adolescents on whether they were clinic referred for a social anxiety screening. Further, adolescent self-reported social anxiety symptoms exhibited high levels of internal consistency and convergent validity. Findings indicate that researchers and practitioners should refrain from using disagreements between adolescent self-reports and other measures (e.g., parent report, objective measures) as indicators of the veracity of adolescent self-reports.