Social Surrogacy and Adjustment: Exploring the Correlates of Having a “Social Helper” for Shy and Non-Shy Young Adolescents

A social surrogate is an individual who offers help and comfort in social situations or makes social events more exciting. In this study of 157 young adolescents (55% female; M_age = 13.84 years, SD = 0.75 years), the authors examined whether the linear and curvilinear associations between self-reported social surrogate use and adjustment outcomes (social problems, loneliness, anxiety symptoms, depressive symptoms) varied as a function of shyness and gender, after accounting for the effects of positive friendship quality. Regression analyses revealed that low and high levels of social surrogate use were related to greater social problems for all adolescents. In addition, shyness emerged as a moderator for several curvilinear effects. Specifically, results indicated that (a) high levels of social surrogate use were associated with greater anxiety for adolescents high in shyness; and (b) low levels of social surrogate use were associated with greater depressive symptoms for adolescents low in shyness. Findings highlight the developmental importance of specific types of relationship experiences during early adolescence and point to different implications of social surrogate use for shy and non-shy young adolescents.     

Test Anxiety,Coping Strategies,and Perceived Health in a Group of High School Students: A Turkish Sample

A group of high school juniors and a group of high school seniors in Izmir, Turkey completed measures of test anxiety, coping skills, and perceived health status both before and after a major exam period. Students with high test anxiety used less effective coping mechanisms and tended to have poorer perceptions of their health. Prior to the exams, juniors displayed higher test anxiety and used less effective coping mechanisms than seniors. After the exam periods, improvements were seen for both age groups on perceived health, but scores of younger students remained significantly higher than scores of seniors on one of the key measures of test anxiety. Results of the study lend support to those of previous studies done in other cultural contexts, and findings have implications for the development of interventions designed to help students cope with stress.     

Reactivity to Exclusion Prospectively Predicts Social Anxiety Symptoms in Young Adults

Peer victimization leads to negative outcomes such as increased anxiety and depression. The prospective relationship between peer victimization and social anxiety in children and adolescents is well established, and adults with social anxiety disorder (SAD) are more likely than individuals with other anxiety disorders to report a history of teasing. However, a crucial bridge between these findings (peer victimization in young adults) is missing. We manipulated perceptions of peer exclusion in a young adult sample (N = 108) using the Cyberball Ostracism Task. Reactivity to exclusion prospectively predicted social anxiety symptoms at a 2-month follow-up, whereas self-reported teasing during high school and current relational victimization did not. This research suggests that reactions to peer victimization may be a worthwhile target for clinical interventions in young adults. Targeting how young adults react to stressful social interactions such as exclusion may help prevent the development of SAD. Future research should test if reactivity to exclusion plays a role in the relationship between other disorders (e.g., depression) and peer victimization.     

Experiential Avoidance as a Moderator of the Relationship Between Anxiety Sensitivity and Perceived Stress

Given the significant deleterious effects of stress on psychological and physical well-being, the present two-part study sought to clarify relations among putative vulnerability factors (i.e., anxiety sensitivity, experiential avoidance) for perceived stress. Relations among anxiety sensitivity, experiential avoidance, and perceived stress were examined using a large college student sample (N = 400) in Study 1 and were replicated using a large community sample (N = 838) in Study 2. As predicted, experiential avoidance moderated the relationship between anxiety sensitivity and perceived stress. Contrary to expectations, simple effects in both studies revealed that anxiety sensitivity shared a significant positive association with perceived stress at low, but not high, levels of experiential avoidance. The moderating role of experiential avoidance was found to be robust to the effects of general distress. Moreover, anxiety sensitivity and experiential avoidance evidenced a differential pattern of relations with perceived stress than was evidenced with related negative affective states (i.e., anxiety and depression). The present results suggest that experiential avoidance appears to be a vulnerability factor of particular importance for understanding the phenomenology of perceived stress. Conceptual and clinical implications are discussed.     

Predictors of outcome in Internet-based cognitive behavior therapy for severe health anxiety

Internet-based cognitive behavior therapy (CBT) for severe health anxiety can be effective, but not all patients achieve full remission. Under these circumstances, knowledge about predictors is essential for the clinician in order to make reliable treatment recommendations. The primary aim of this study was to investigate clinical, demographic, and therapy process-related predictors of Internet-based CBT for severe health anxiety. We performed three types of analyses on data from a sample comprising participants (N = 81) who had received Internet-based CBT in a randomized controlled trial. Outcomes were a) end state health anxiety, b) improvement in health anxiety (continuous change scores), and c) clinically significant improvement. Outcomes were assessed at six-month follow-up. The results showed that the most stable predictors of both end state health anxiety and improvement were baseline health anxiety and depressive symptoms. Treatment adherence, i.e. the number of completed treatment modules, also significantly predicted outcome. Notably, health anxiety at baseline was positively associated with symptom improvement while depressive symptoms was negatively related to improvement. Demographic factors were largely without significant impact on end state symptoms or improvement. We conclude that baseline symptom burden and adherence to treatment have strong predictive effects in Internet-based CBT for severe health anxiety.     

Integrated Behavior Therapy for Selective Mutism: A randomized controlled pilot study

Objective

To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech.

Method

A total of 21 children ages 4 to 8 with primary selective mutism were randomized to 24 weeks of Integrated Behavior Therapy for Selective Mutism (IBTSM) or a 12-week Waitlist control. Clinical outcomes were assessed using blind independent evaluators, parent-, and teacher-report, and an objective behavioral measure. Treatment recipients completed a three-month follow-up to assess durability of treatment gains.

Results

Data indicated increased functional speaking behavior post-treatment as rated by parents and teachers, with a high rate of treatment responders as rated by blind independent evaluators (75%). Conversely, children in the Waitlist comparison group did not experience significant improvements in speaking behaviors. Children who received IBTSM also demonstrated significant improvements in number of words spoken at school compared to baseline, however, significant group differences did not emerge. Treatment recipients also experienced significant reductions in social anxiety per parent, but not teacher, report. Clinical gains were maintained over 3 month follow-up.

Conclusion

IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers.     

Thought Suppression in Spider-Fearful and Nonfearful Individuals

The authors examined the suppression of spider-related thoughts in spiderfearful (n = 23) and nonfearful (n = 22) individuals. Participants were primed with vivid pictures of spiders and a story about spiders. Next, they were randomly assigned to 1 of 2 conditions: (a) suppression of thoughts associated with the previously presented spiderrelated stimuli or (b) free expression of any thoughts, including those related to the spider-related stimuli. All participants completed a subsequent free-expression exercise. Results indicated that spider-fearful individuals expressed thoughts about the spider-related stimuli for a longer length of time than did nonfearful individuals, particularly in the suppression condition. Participants in both groups demonstrated a rebound of thoughts associated with the spider-related stimuli following suppression. The authors propose that the priming of feared stimuli makes suppression of fear-related thoughts particularly difficult for fearful individuals, perhaps by activating a state of heightened arousal.     

Anxiety and Repression in Attention and Retention

High- and low-anxious college students (as determined by scores on the Taylor Manifest Anxiety Scale; A. W. Bendig, 1956) and repressors (low anxiety and high scores on the Marlowe–Crowne Social Desirability Scale; D. P. Crowne & D. Marlowe, 1964) were compared on 3 cognitive tasks. High-anxious participants more often spelled the negative emotional meaning of ambiguous homophones (e.g., pane/pain) and forgot more of their free associations to emotional cue words than did the low-anxious participants. The repressors also detected the emotional meaning of the homophones but unlike the anxious, the repressors did recall their associations to the emotional words. In a working memory task using nonemotional items, the moderately anxious participants recalled fewer words than did the low- and high-anxious participants. The results confirm that both trait anxiety and repression affect information processing at a variety of stages but not in the same way. Repressors were sensitive to, and retentive of, negative emotional stimuli.     

Health care utilisation in patients with non-cardiac chest pain: A longitudinal analysis of chest pain,anxiety and interoceptive fear

Chest pain can be a frightening experience that leads many to seek medical evaluation. The symptom results in costly health care utilisation. Over half of patients referred for cardiac evaluations of chest pain do not obtain definitive medical explanations for their symptoms; these cases are described as non-cardiac chest pain (NCCP). Some patients with NCCP are not reassured after being informed their chest pain is non-cardiac in origin and seek repeated medical evaluation. Co-morbid anxiety and mood disorders often coexist with NCCP and are associated with health care utilisation. The current study examined chest pain, general anxiety, interoceptive fear and health care utilisation in a sample of 196 chest pain patients near the time of cardiac evaluation (Time 1), and 70 of these patients one year later (Time 2). Results indicate that anxiety and interoceptive fear were significantly associated with health care utilisation at Time 1, and only interoceptive fear (at Time 1) predicted health care utilisation at Time 2. This study develops research in this area by examining the relation of anxiety and health care utilisation longitudinally in patients with NCCP.     

“Test-Tube Baby” procedures: Stress and judgements under uncertainty

Patients participating in an in vim fertilisation with embryo transfer (IVF and ET) programme face uncertainty at each stage of the procedure. Research on heuristics and on stress lead to predictions about behaviour in situations of uncertainty. It was predicted that IVF and ET participants would overestimate the likelihood of success, due to publicity the process has received, and would underestimate the likelihood of an earlier, less publicised. stage in the procedure. Both predictions were confirmed in a total of 70 participants (26 women at out-patient clines, 23 of their partners and 21 surgical in-patients). All the men and all but one woman overestimated the likelihood of becoming pregnant and having a baby. and most of the surgical patients underestimated the likelihood of egg recovery. Estimates were not related to patients' confidence about their information, confirming previous evidence about confidence in inaccurate judgements based on heuristics. Data on patients' distress as indicated by mood rating show high anxiety at points of uncertainty and Pailure, as found in other studies of stress. While the couples shared their inaccurate judgements. they did not necessarily share their distress. The results are discussed in terms of patients' decision making. coping strategies and the implications for doctor-patient communication.