Attention training toward and away from threat in social phobia: effects on subjective, behavioral, and physiological measures of anxiety

Social phobics exhibit an attentional bias for threat in probe detection and probe discrimination paradigms. Attention training programs, in which probes always replace nonthreatening cues, reduce attentional bias for threat and self-reported social anxiety. However, researchers have seldom included behavioral measures of anxiety reduction, and have never taken physiological measures of anxiety reduction. In the present study, we trained individuals with generalized social phobia (n = 57) to attend to threat cues (attend to threat), to attend to positive cues (attend to positive), or to alternately attend to both (control condition). We assessed not only self-reported social anxiety, but also behavioral and physiological measures of social anxiety. Participants trained to attend to nonthreatening cues demonstrated significantly greater reductions in self-reported, behavioral, and physiological measures of anxiety than did participants from the attend to threat and control conditions.     

Avoidance of emotional facial expressions in social anxiety: The Approach-Avoidance Task

The Approach–Avoidance Task (AAT) was employed to indirectly investigate avoidance reactions to stimuli of potential social threat. Forty-three highly socially anxious individuals (HSAs) and 43 non-anxious controls (NACs) reacted to pictures of emotional facial expressions (angry, neutral, or smiling) or to control pictures (puzzles) by pulling a joystick towards themselves (approach) versus pushing it away from themselves (avoidance). HSAs showed stronger avoidance tendencies than NACs for smiling as well as angry faces, whereas no group differences were found for neutral faces and puzzles. In contrast, valence ratings of the emotional facial expressions did not differ between groups. A critical discrepancy between direct and indirect measures was observed for smiling faces: HSAs evaluated them positively, but reacted to them with avoidance.     

Intolerance for approach of ambiguity in social anxiety disorder

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

Gaze direction differentially affects avoidance tendencies to happy and angry faces in socially anxious individuals

Increasing evidence indicates that eye gaze direction affects the processing of emotional faces in anxious individuals. However, the effects of eye gaze direction on the behavioral responses elicited by emotional faces, such as avoidance behavior, remain largely unexplored. We administered an Approach-Avoidance Task (AAT) in high (HSA) and low socially anxious (LSA) individuals. All participants responded to photographs of angry, happy and neutral faces (presented with direct and averted gaze), by either pushing a joystick away from them (avoidance) or pulling it towards them (approach). Compared to LSA, HSA were faster in avoiding than approaching angry faces. Most crucially, this avoidance tendency was only present when the perceived anger was directed towards the subject (direct gaze) and not when the gaze of the face-stimulus was averted. In contrast, HSA individuals tended to avoid happy faces irrespectively of gaze direction. Neutral faces elicited no approach-avoidance tendencies. Thus avoidance of angry faces in social anxiety as measured by AA-tasks reflects avoidance of subject-directed anger and not of negative stimuli in general. In addition, although both anger and joy are considered to reflect approach-related emotions, gaze direction did not affect HSA's avoidance of happy faces, suggesting differential mechanisms affecting responses to happy and angry faces in social anxiety.     

To see ourselves as others see us: an experimental integration of the intra and interpersonal consequences of self-protection in social anxiety disorder

The current study investigated the mechanism through which safety behaviors perpetuate perceived and actual negative social outcomes hypothesized to maintain social anxiety disorder (SAD). Eighty individuals diagnosed with generalized SAD took part in a "getting acquainted" conversation with a trained experimental confederate. Participants were then randomly assigned to either a safety behavior reduction plus exposure condition (SB + EXP) or a graduated exposure (EXP) control condition and completed a 2nd conversation with the same interaction partner. Mediation analyses revealed that participants instructed to reduce their idiosyncratic safety behaviors displayed significantly greater increases in both perceived and actual positive interpersonal outcomes relative to the EXP group. However, whereas the safety behavior manipulation influenced participants' appraisals of their partner's reaction to them through reducing self-judgments about the visibility of anxiety-related behaviors, in reality, the SB + EXP group elicited more positive partner reactions because they displayed a greater increase in social approach behavior. Thus, although both parties recognized positive changes in the social exchange following the safety behavior manipulation, different sources of social information accounted for participant versus partner interpersonal judgments. The current findings point to the potential value of considering both the intra and interpersonal consequences of safety behaviors in SAD.     

Automatic avoidance tendencies in individuals with contamination-related obsessive-compulsive symptoms

We used an approach-avoidance task (AAT) to examine response to threatening stimuli in 20 individuals high in contamination-related obsessive-compulsive symptoms (HCs) and 21 individuals low in contamination-related obsessive-compulsive symptoms (LCs). Participants were instructed to respond to contamination-related and neutral pictures by pulling a joystick towards themselves or by pushing it away from themselves. Moving the joystick changed the size of the image to simulate approaching or distancing oneself from the object. Consistent with our hypothesis, the HC group was significantly slower in pulling contamination-related pictures than in pulling neutral pictures, whereas in the LC group there was no difference between speed of pulling contamination-related pictures and neutral pictures. Contrary to our hypothesis, we did not find support for faster pushing away of contamination-related pictures than neutral pictures by the HC group. Moreover, the degree of avoidance of contamination-related stimuli when pulling - but not when pushing - was significantly correlated with self-reported contamination-related obsessive-compulsive symptoms. These results suggest a biased behavioral response for threatening objects in individuals high in contamination fears only when inhibiting the prepotent response to avoid threatening stimuli and not when performing a practiced avoidance response. Thus, our results validate the use of the AAT as a measure of inhibited and uninhibited automatic avoidance reactions to emotional information in individuals with contamination-related obsessive-compulsive symptoms.     

Social anxiety and evaluation of social crowds: explicit and implicit measures

To investigate whether social anxiety disorder is indeed characterized by a biased negative evaluation of facial expressions, 25 highly socially anxious (SA) participants and 30 non-anxious controls (NACs) were asked to respond to different ratios of neutral-angry or happy-angry face combinations (crowds). In an indirect Approach-Avoidance Task (AAT), participants used a joystick to pull the crowds towards themselves (approach) or push them away (avoidance). SAs showed faster avoidance of neutral-angry crowds when the number of angry faces in the crowd increased. The happy-angry crowds were generally avoided, independent of the ratio of the two emotions. NACs did not show any specific response tendency. When directly rating the friendliness of the crowds, the two groups did not differ.     

Psychometric Evaluation of a Controlled Social Affiliation Paradigm: Findings From Anxiety,Depressive Disorder,and Healthy Samples

Social impairments are common across many psychiatric conditions. Standardized dyadic assessments intended to elicit social affiliation between unacquainted partners are used to elucidate mechanisms that disrupt relationship formation and inform possible treatment targets; however, the psychometric properties of such paradigms remain poorly understood. This study evaluated the psychometric properties of a controlled social affiliation paradigm intended to induce connectedness between a target participant and trained confederate. Individuals with an anxiety or depressive disorder diagnosis (clinical group; n = 132) and those without (control group; n = 35) interacted face-to-face with a trained confederate; partners took turns answering a series of increasingly intimate questions about themselves. Social connectedness, affect, and affiliative behavior measures were collected during the interaction. Participant symptom and social functioning measures were collected to examine validity. The paradigm elicited escalating social connectedness throughout the task for both participants and confederates. Parallel forms (i.e., different question sets) elicited similar affiliation outcomes. Self-reported (but not behavioral) affiliation differed across some demographic variables (e.g., participant gender, Hispanic ethnicity). Within-task affiliation measures were associated with one another and with global social connectedness and social anxiety symptom measures, but not with somatic anxiety measures. Clinical participants reported lower social affiliation and positive affect reactivity and higher negative affect reactivity than healthy participants. These findings provide initial psychometric support for a standardized and controlled dyadic affiliation paradigm that could be used to reliably probe social disconnection mechanisms across psychopathology.     

动物辅助治疗与特殊儿童的身心发展

动物辅助治疗是以动物为媒介,通过人与动物的接触,而使病弱或残疾个体身体状况得到改善或维持;或者使个体的心理状况通过有动物参与的活动,加强与外界环境的互动,进而能适应社会的、一种以目标为导向的干预方法。动物辅助治疗有助于缓解儿童的焦虑,促进儿童社会化过程。尤其是可减少情绪问题、注意缺陷和行为障碍、自闭症及脑瘫儿童的问题行为,并促进他们的发展。     

Avoidance of eye gaze by adults who stutter

PurposeAdults who stutter are at significant risk of developing social phobia. Cognitive theorists argue that a critical factor maintaining social anxiety is avoidance of social information. This avoidance may impair access to positive feedback from social encounters that could disconfirm fears and negative beliefs. Adults who stutter are known to engage in avoidance behaviours, and may neglect positive social information. This study investigated the gaze behaviour of adults who stutter whilst giving a speech.Method16 adults who stutter and 16 matched controls delivered a 3-min speech to a television display of a pre-recorded lecture theatre audience. Participants were told the audience was watching them live from another room. Audience members were trained to display positive, negative and neutral expressions. Participant eye movement was recorded with an eye-tracker.ResultsThere was a significant difference between the stuttering and control participants for fixation duration and fixation count towards an audience display. In particular, the stuttering participants, compared to controls, looked for shorter time at positive audience members than at negative and neutral audience members and the background.ConclusionsAdults who stutter may neglect positive social cues within social situations that could serve to disconfirm negative beliefs and fears.Educational objectives: The reader will be able to: (a) describe the nature of anxiety experienced by adults who stutter; (b) identify the most common anxiety condition among adults who stutter; (c) understand how information processing biases and the use of safety behaviours contribute to the maintenance of social anxiety; (d) describe how avoiding social information may contribute to the maintenance of social anxiety in people who stutter; and (e) describe the clinical implications of avoidance of social information in people who stutter.     

An anxiety-induced bias in the perception of a bistable point-light walker

Human sensitivity for social cues is exquisite, as illustrated by the ease with which simplified point-light movements invoke social and emotional responses. Compared to faces, these biological motion stimuli only recently started to be used to explore questions regarding social cognition and anxiety. We presented human point-light walkers that could be perceived as facing towards or facing away from the observer, and tested whether participants with high social anxiety would perceive these bistable stimuli differently, because this type of stimuli has particular relevance for them. The results showed that observers with high social anxiety tended to see walkers as facing away more frequently than those with low social anxiety. This may mean that high socially anxious observers are biased towards the more positive perceptual alternative because they are motivated to protect themselves against threatening social experiences, but we also explore alternative explanations. The findings are in line with the evidence for a positivity bias in perception, also called wishful seeing, but in contrast with the attentional negativity bias often found in social anxiety. We discuss reasons for this divergence and possible limitations of the current study.     

Safety behaviors and judgmental biases in social anxiety disorder

Two experiments were conducted to examine the link between safety behaviors and social judgments in social anxiety disorder (SAD). Safety behaviors were manipulated in the context of a controlled laboratory-based social interaction, and subsequent effects of the manipulation on the social judgments of socially anxious participants (N = 50, Study 1) and individuals meeting diagnostic criteria for generalized SAD (N = 80, Study 2) were examined. Participants were randomly assigned to either a safety behavior reduction plus exposure condition (SB + EXP) or a graduated exposure (EXP) control condition, and then took part in a conversation with a trained experimental confederate. Results revealed across both studies that participants in the SB + EXP group were less negative and more accurate in judgments of their performance following safety behavior reduction relative to EXP participants. Study 2 also demonstrated that participants in the SB + EXP group displayed lower judgments about the likelihood of negative outcomes in a subsequent social event compared to controls. Moreover, reduction in safety behaviors mediated change in participant self-judgments and future social predictions. The current findings are consistent with cognitive theories of anxiety, and support the causal role of safety behaviors in the persistence of negative social judgments in SAD.     

眼睛注视线索对经济领域风险决策的影响：基于框架效应范式

采用基金投资框架任务,结合眼动技术考察眼睛注视线索与框架类型对风险决策的影响。结果发现：（1）消极眼睛注视线索促进了被试在损失框架下的风险寻求行为,控制组与积极、中性、消极眼睛组的行为结果无显著差异;（2）以均字注视次数为指标的眼动结果表明,积极眼睛组和中性眼睛组对确定损益的关注差异大于对风险损益的关注差异;消极眼睛组和控制组被试对损失的关注大于对收益的关注,对确定项的关注大于对风险项的关注,但两者不存在交互作用。消极眼睛注视线索可能改变了个体对风险性和确定性的感知,并因此影响了人们的风险决策行为,规避消极情绪线索可能有助于减少经济决策中的风险寻求行为。     

过犹不及：情绪的效价-唤醒度冲突在动机倾向上的分离

本研究通过两个实验考察不同效价度和唤醒度的情绪刺激是否存在动机倾向上的分离模式。实验1要求被试对表情图片的动机倾向（趋近/回避）进行主观评分,发现被试对低唤醒表情或积极表情有更加趋近的倾向。实验2以运动的线索启动动机倾向（趋近/回避）,完成情绪词效价判断任务,从内隐的角度考察情绪刺激是否存在动机倾向上的分离模式,结果发现,被试对动机倾向一致的情绪刺激的反应时更快。趋近的消极情绪词比趋近的积极情绪词的N2波幅更大,远离的低唤醒情绪词比趋近的低唤醒情绪词的LPC波幅更大。结果说明积极或者低唤醒的情绪刺激引发趋近倾向,而消极或高唤醒的情绪刺激引发回避倾向。     

The contextual malleability of approach-avoidance training effects: approaching or avoiding fear conditioned stimuli modulates effects of approach-avoidance training

Previous research showed that the repeated approaching of one stimulus and avoiding of another stimulus typically leads to more positive evaluations of the former stimuli. In the current study, we examined whether approach and avoidance training (AAT) effects on evaluations of neutral stimuli can be modulated by introducing a regularity between the approach-avoidance actions and a positive or negative (feared) stimulus. In an AAT task, participants repeatedly approached one neutral non-word and avoided another neutral non-word. Half of the participants also approached a negative fear-conditioned stimulus (CS+) and avoided a conditioned safe stimulus (CS?). The other half of the participants avoided the CS+ and approached the CS?. Whereas participants in the avoid CS+ condition exhibited a typical AAT effect, participants in the approach CS+ condition exhibited a reversed AAT effect (i.e. they evaluated the approached neutral non-word as more negative than the avoided non-word). These findings provide evidence for the malleability of the AAT effect when strongly valenced stimuli are approached or avoided. We discuss the practical and theoretical implications of our findings.     

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.     

Malleability of attentional bias for positive emotional information and anxiety vulnerability

Recent research supports a causal link between attentional bias for negative emotional information and anxiety vulnerability. However, little is known about the role of positive emotional processing in modulating anxiety reactivity to stress. In the current study, we used an attentional training paradigm designed to experimentally manipulate the processing of positive emotional cues. Participants were randomly assigned to complete a computerized probe detection task designed to induce selective processing of positive stimuli or to a sham condition. Following training, participants were exposed to a laboratory stressor (i.e., videotaped speech), and state anxiety and positive affect in response to the stressor were assessed. Results revealed that individual variability in the capacity to develop an attentional bias for positive information following training predicted subsequent emotional responses to the stressor. Moreover, individual differences in social anxiety, but not depression, moderated the effects of the attentional manipulation, such that, higher levels of social anxiety were associated with diminished attentional allocation toward positive cues. The current findings point to the potential value of considering the role of positive emotional processing in anxiety vulnerability.     

社会排斥促进亲群体行为意向：权力感的调节作用

亲群体行为在个体的成长与发展中具有重要的适应价值。三个研究探讨了社会排斥对亲群体行为意向的影响以及权力感的调节作用。研究1采用问卷法考察社会排斥与亲群体行为意向的关系,发现社会排斥能够正向预测亲群体行为意向;研究2与研究3采用实验法操纵社会排斥,并分别通过回忆法启动个体状态权力感（研究2）、测量特质权力感（研究3）,发现在社会排斥下,相比于低权力感者,高权力感者的亲群体行为意向更高,结果证实了权力感能够调节社会排斥对亲群体行为意向的影响。     

The neural correlates of social attention: automatic orienting to social and nonsocial cues

Previous evidence suggests that directional social cues (e.g., eye gaze) cause automatic shifts in attention toward gaze direction. It has been proposed that automatic attentional orienting driven by social cues (social orienting) involves a different neural network from automatic orienting driven by nonsocial cues. However, previous neuroimaging studies on social orienting have only compared gaze cues to symbolic cues, which typically engage top-down mechanisms. Therefore, we directly compared the neural activity involved in social orienting to that involved in purely automatic nonsocial orienting. Twenty participants performed a spatial cueing task consisting of social (gaze) cues and automatic nonsocial (peripheral squares) cues presented at short and long stimulus (cue-to-target) onset asynchronies (SOA), while undergoing fMRI. Behaviorally, a facilitation effect was found for both cue types at the short SOA, while an inhibitory effect (inhibition of return: IOR) was found only for nonsocial cues at the long SOA. Imaging results demonstrated that social and nonsocial cues recruited a largely overlapping fronto-parietal network. In addition, social cueing evoked greater activity in occipito-temporal regions at both SOAs, while nonsocial cueing recruited greater subcortical activity, but only for the long SOA (when IOR was found). A control experiment, including central arrow cues, confirmed that the occipito-temporal activity was at least in part due to the social nature of the cue and not simply to the location of presentation (central vs. peripheral). These results suggest an evolutionary trajectory for automatic orienting, from predominantly subcortical mechanisms for nonsocial orienting to predominantly cortical mechanisms for social orienting.     

Images of the self and self-esteem: do positive self-images improve self-esteem in social anxiety?

Negative self-images play an important role in maintaining social anxiety disorder. We propose that these images represent the working self in a Self-Memory System that regulates retrieval of self-relevant information in particular situations. Self-esteem, one aspect of the working self, comprises explicit (conscious) and implicit (automatic) components. Implicit self-esteem reflects an automatic evaluative bias towards the self that is normally positive, but is reduced in socially anxious individuals. Forty-four high and 44 low socially anxious participants generated either a positive or a negative self-image and then completed measures of implicit and explicit self-esteem. Participants who held a negative self-image in mind reported lower implicit and explicit positive self-esteem, and higher explicit negative self-esteem than participants holding a positive image in mind, irrespective of social anxiety group. We then tested whether positive self-images protected high and low socially anxious individuals equally well against the threat to explicit self-esteem posed by social exclusion in a virtual ball toss game (Cyberball). We failed to find a predicted interaction between social anxiety and image condition. Instead, all participants holding positive self-images reported higher levels of explicit self-esteem after Cyberball than those holding negative self-images. Deliberate retrieval of positive self-images appears to facilitate access to a healthy positive implicit bias, as well as improving explicit self-esteem, whereas deliberate retrieval of negative self-images does the opposite. This is consistent with the idea that negative self-images may have a causal, as well as a maintaining, role in social anxiety disorder.