265. The intervention effect and follow-up of mindfulness cognitive therapy on college students' social anxiety

Secular Mindfulness-Based Interventions: Efficacy and Neurobiology.

The college environment significantly shapes students’ social development, yet many experience social anxiety that affects their mental health. Trait resilience has been identified as an important psychological resource that may influence how individuals regulate emotions and cope with stress, which could be relevant to understanding social anxiety. Focusing on college students, this study examines the extent to which trait resilience, emotion regulation, and coping strategies contribute to the mitigation of social anxiety, emphasizing their potential roles as mediators in this psychological process. This study surveyed 748 college students using questionnaires to assess their trait resilience, social anxiety, emotion regulation, and coping strategies. The data were obtained via an online questionnaire, employing random sampling of university students from different regions in China during the period from November 2024 to January 2025. The dataset was processed through SPSS, which was applied to carry out statistical descriptions, examine variable correlations, and explore mediating effects. The study found a significant negative correlation between trait resilience and social anxiety (r = − 0.486, p < 0.001). In the mediation analysis, the direct effect of trait resilience on social anxiety remained significant (β = − 0.173, 95% CI − 0.224, − 0.121). Additionally, cognitive reappraisal (β = 0.047, 95% CI 0.001,0.096), expressive suppression (β = − 0.019, 95% CI − 0.037, − 0.002), approach coping strategies (β = − 0.145, 95% CI − 0.185, − 0.107), and avoidance coping strategies (β = − 0.025, 95% CI − 0.045, − 0.006) all played mediating roles between trait resilience and social anxiety. This study shows that higher trait resilience has been linked to lower social anxiety, with emotion regulation and coping strategies playing key mediating roles. These findings provide a basis for designing interventions to reduce social anxiety in college students. Future research should focus on enhancing trait resilience and promoting positive emotion regulation.

BackgroundSocial anxiety has been a burning problem among contemporary college students in China. Increasing evidence suggests that individual circadian typology–chronotype may play an important role in the development of social anxiety. However, little research has focused directly on examining the association between chronotype and social anxiety, and less is known about the mediating and moderating mechanisms underlying this relationship. The aim of the present study was to investigate the link between chronotype and social anxiety among Chinese college students, and to explore the mediating effect of loneliness and the moderating effect of perceived social support in the association between chronotype and social anxiety.MethodsA cross-sectional design was conducted among 1616 college students (16–29 years old) from several public universities in Northern China, including 1172 females (72.52%) and 444 males (27.48%), with an average age of 19.68 years old (SD = 1.49). All participants completed the standardized self-report questionnaires including the Social Avoidance and Distress Scale, Morningness-Eveningness Questionnaire, UCLA Loneliness Scale, and the Perceived Social Support Scale. Common method bias was performed using Harman’s single-factor test. The mediation and moderation effects were analyzed using SPSS software and PROCESS macros.ResultsChronotype had a negative predictive effect on social anxiety in college students. Specifically, the greater the inclination of individuals' chronotypes toward evening preference, the more pronounced their symptoms of social anxiety would be. Loneliness served as a partial mediator in the relationship between chronotype and social anxiety, accounting for 30.0% of the total effect. In addition, perceived social support, particularly from friends and significant others, was found to play a moderating role in the process of loneliness affecting social anxiety among college students, while support from family did not. Interestingly, the perceived social support displayed a limited protective effect when college students suffered from higher levels of loneliness.ConclusionThese findings deepened our understanding of how and when (or for “whom”) chronotype is related to social anxiety, offering a theoretical foundation and practical insights for preventing and addressing social anxiety risk in young adult university students, particularly those with evening chronotypes.

Randomized controlled trials have demonstrated that mindfulness-based cognitive therapy (MBCT) is efficacious in reducing residual depressive symptoms and preventing future depressive episodes (Kuyken et al., 2016). One potential treatment effect of MBCT may be improvement of positive affect (PA), due to improved awareness of daily positive events (Geschwind et al., 2011). Considering social anxiety disorder (SAD) is characterized by diminished PA (Brown et al., 1998; Kashdan, 2007), we sought to determine whether MBCT would reduce social anxiety symptoms, and whether this reduction would be associated with improvement of PA deficits. Adults (N = 22) who met criteria for varied anxiety disorders participated in a small, open-label trial of an 8-week manualized MBCT intervention. Most participants presented with either a diagnosis (primary, secondary, or tertiary) of generalized anxiety disorder (GAD) (N = 15) and/or SAD (N = 14) prior to treatment, with eight individuals meeting diagnostic criteria for both GAD and SAD. We hypothesized participants would demonstrate improvements in social anxiety symptoms, which would be predicted by improvements in PA, not reductions in negative affect (NA). Results of several hierarchical linear regression analyses (completed in both full and disorder-specific samples) indicated that improvements in PA but not reductions in NA predicted social anxiety improvement. This effect was not observed for symptoms of worry, which were instead predicted by decreased NA for individuals diagnosed with GAD and both decreased NA and increased PA in the entire sample. Results suggest that MBCT may be efficacious in mitigating social anxiety symptoms, and this therapeutic effect may be linked to improvements in PA. However, further work is necessary considering the small, heterogeneous sample, uncontrolled study design, and exploratory nature of the study.

Socially anxious individuals typically select more avoidant emotion regulation (ER) strategies than non-anxious individuals, contributing to interpersonal difficulties. The present study utilized smartphone-delivered experience sampling over 14 days to assess how actual and desired social situations predicted reports of ER strategy use in 115 undergraduate students with varying levels of social anxiety symptoms. After controlling for multiple comparisons, results indicated that higher (vs. lower) baseline social anxiety symptoms predicted endorsing at least one of the available eight ER strategies relatively more often than reporting no strategy use, in the context of high negative affect. We did not find the hypothesized positive relationship between social anxiety symptoms and endorsements of avoidant- (e.g., expressive suppression) versus engagement-oriented (e.g., cognitive reappraisal) ER strategies in the context of high negative affect. However, state social desire interacted with trait social anxiety at high negative affect to predict the use of an ER strategy, although the simple effects analyses at high and low levels of social desire were not statistically reliable. Collectively, our results demonstrate the importance of considering both trait-level social anxiety symptoms and in-the-moment social context when studying ER strategy selection. The importance of assessing intrinsic motivational goals and beliefs in the context of ER strategy use is also discussed.

Alcohol use disorder and social anxiety disorder are interconnected disorders that commonly co-occur. We report the first trial to assess whether integrated treatment for social anxiety and alcohol use disorder comorbidity improves outcomes relative to standard alcohol-focussed treatment. Participants were recruited to a randomised controlled trial, and randomly allocated to one of two treatments, Integrated (n = 61) or Control (alcohol-focussed; n = 56). Assessment and treatment session were conducted at two sites in Sydney, Australia. Inclusion criteria were as follows: (1) clinical diagnosis of social anxiety disorder and (2) Diagnosis or sub-clinical symptoms of alcohol use disorder. Diagnoses were determined according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). All participants (n = 117) received 10 sessions of cognitive behavioural treatment and motivational enhancement. The Integrated treatment simultaneously targeted social anxiety disorder, alcohol use disorder and the connections between these disorders. The Control treatment focussed on alcohol use disorder only. Outcomes were assessed at 6-month follow-up, with interim assessments at post-treatment and 3 months. Primary outcomes were social anxiety disorder severity (composite Social Phobia Scale and Social Interaction Anxiety Scale), alcohol use disorder severity (standard drinks per day and Severity of Alcohol Dependence Questionnaire) and quality of life (Short-Form Health survey) was assessed to capture the combined impairment of social anxiety and alcohol use disorder comorbidity. At 6-month follow-up, both conditions showed significant reductions in social anxiety and alcohol use disorder symptoms, and improved quality of life. There was no evidence of between-condition differences for alcohol outcomes, with mean consumption reduced by 5.0 (0.8) and 5.8 (1.0) drinks per day following Alcohol and Integrated treatments, respectively. Integrated treatment achieved greater improvements in social anxiety symptoms (mean difference = -14.9, 95% confidence interval = [-28.1, -1.6], d = 0.60) and quality of life (mean difference = 7.6, 95% confidence interval = [1.2, 14.0], d = 0.80) relative to alcohol-focused treatment. These results suggest that integrated social anxiety and alcohol use disorder treatment enhances quality of life and social anxiety disorder symptom improvement, but not alcohol outcomes, compared to treatment focussed on alcohol use disorder alone.

Brief Form of the Social Phobia and Anxiety Inventory (SPAI-B) for Adolescents

Five-Factor Model of Personality, Social Anxiety, and Relational Aggression in College Students Daniel L. Deason (bio), Eric R. Dahlen (bio), Michael B. Madson (bio), and Emily Bullock-Yowell (bio) Relational aggression involves behaviors intended to harm others’ social relationships, reputation or status, and feelings of belonging (Linder, Crick, & Collins, 2002). Relationally aggressive behaviors (e.g., social exclusion, malicious gossip, ignoring someone) are likely to interfere with college students’ well-being and success. Examples of the adverse correlates of relational aggression include peer rejection, anxiety and depression, poor psychological adjustment, problematic alcohol use, and dysfunctional anger (Dahlen, Czar, Prather, & Dyess, 2013; Goldstein, 2011; Werner & Crick, 1999). Campus professionals regularly encounter the impact of relational aggression. University housing offices receive complaints about relationally aggressive living situations, resident assistants are asked to settle disputes involving relationally aggressive students, and counseling center staff encounter students experiencing emotional distress due to relational victimization. By improving our understanding of relational aggression, we will be better equipped to mitigate its impact on campus. We investigated the relationship of the Five-Factor Model (FFM; Goldberg, 1990) of personality and social anxiety to peer relational aggression among college students. The FFM conceptualizes personality as involving five latent domains: intellect/imagination (i.e., openness to experience), conscientiousness, extraversion, agreeableness, and emotional stability (i.e., the inverse of neuroticism). The FFM has been used to understand the role of personality in overt aggression where the strongest relationships involve low emotional stability, low agreeableness, and low conscientiousness (Hosie, Gilbert, Simpson, & Daffern, 2014; Miller, Zeichner, & Wilson, 2012). While less is known about the relationships of FFM traits to relational aggression, most of the traits should be relevant. Low emotional stability involves an increased tendency to experience unpleasant emotional states (e.g., anger), and low agreeableness involves antagonism and hostility. Students high in extraversion enjoy groups and social events, suggesting they may be more likely to participate in group activities where relational aggression occurs. The role of conscientiousness is less clear, but the inverse relationship between conscientiousness and impulse control suggests that it might be inversely related to at least some forms of relational aggression. Burton, Hafetz, and Henninger (2007) found that low emotional stability, low agreeableness, and low [End Page 110] conscientiousness were related to relational aggression. Similarly, Hines and Saudino (2008) found that low emotional stability was positively related to psychological aggression in students’ intimate partnerships, while conscientiousness and extraversion were positively related to psychological aggression, and agreeableness was inversely related to psychological aggression only among women. Learning more about the relationship of personality traits to relational aggression may be useful in improving our understanding of why some students are more relationally aggressive than others. A relationship between social anxiety and relational aggression has long been posited, but research investigating it has been sparse. Socially anxious students who fear negative evaluation may engage in relationally aggressive behaviors to deflect attention from themselves, removing from their peer group those from whom they anticipate negative evaluation (Loudin, Loukas, & Robinson, 2003). The limited research connecting social anxiety to relational aggression is generally supportive. For example, Storch, Bagner, Geffken, and Baumeister (2004) found that relational aggression was positively associated with social anxiety in a college student sample, and Loudin and colleagues (2003) found that students who feared negative evaluation were more likely to engage in relationally aggressive behaviors. Thus, there is reason to expect that social anxiety is relevant to understanding relational aggression. It remains unclear whether social anxiety has the potential to explain unique variance in relational aggression beyond the FFM. We explored the relationships among the broad domains of personality represented by the FFM, social anxiety, and relational aggression in a college student sample. We expected that emotional stability, agreeableness, and conscientiousness would be inversely related to relational aggression while extraversion would be positively related to relational aggression. In addition, we expected that social anxiety would be positively related to relational aggression, explaining additional variance over and above gender and the full FFM. METHOD Participants and Procedure Undergraduate volunteers (N = 342: 143 men and 199 women) of traditional college age were recruited from a midsized Southeastern university in the United States using the Department of Psychology’s web-based research system. Of the...

Social anxiety disorder (SAD) is 1 of the most prevalent psychological disorders, and among college students in particular, social anxiety has been associated with other problems such as substance use problems and increased vulnerability to other psychiatric disorders. The Social Phobia and Anxiety Inventory-23 (SPAI-23; Roberson-Nay, Strong, Nay, Beidel, & Turner, 2007) may be a useful, brief measure of problematic social anxiety in college students. Results from 4 studies (total n = 2,436) using the SPAI-23 with college student samples are presented. Scores on the SPAI-23 demonstrated strong convergent validity with other measures of social anxiety and discriminant validity as evidenced by lower correlations with measures of dissimilar constructs. Difference scores on the SPAI-23 also demonstrated adequate test-retest reliability over 5 ½ weeks (r = .72). Exploratory factor analysis suggested a two-factor structure: social anxiety and agoraphobia. Finally, differential item function analyses suggested that the items function similarly in men and women. In conclusion, the SPAI-23 demonstrated strong psychometric properties for use with college students.

Moderators of Improvement From Mindfulness-Based vs Traditional Cognitive Behavioral Therapy for the Treatment of Provoked Vestibulodynia

To explore the mechanism of physical exercise’s influence on college students’ social anxiety and to analyze the chain-mediated role of mindfulness and mental toughness. A questionnaire survey was conducted on 1071 Chinese college students using the Physical Exercise Rating Scale, Social Anxiety Self-Rating Scale, Positive Thoughts Scale, and Mental Toughness Scale. The direct effect value of physical exercise on college students’ social anxiety was − 0.042, the effect values of positive thoughts and mental toughness between physical exercise and college students’ social anxiety were − 0.078 and − 0.007, respectively, and the chain mediation effect of positive thoughts and mental toughness was significant, with an effect value of -0.040. (1) Physical exercise significantly positively predicts positive thoughts and mental toughness and significantly negatively predicts social anxiety; (2) physical exercise has a significant direct and indirect effect on social anxiety in college students. Physical exercise can significantly predict college students’ social anxiety through the independent mediation effect of mindfulness and mental toughness and the chain mediation effect of mindfulness and mental toughness.

BackgroundObsessive-compulsive disorder (OCD) is a very disabling condition with a chronic course, if left untreated. Though cognitive behavioral treatment (CBT) with or without selective serotonin reuptake inhibitors (SSRI) is the method of choice, up to one third of individuals with obsessive-compulsive disorder (OCD) do not respond to treatment in terms of at least 35% improvement of symptoms. Mindfulness based cognitive therapy (MBCT) is an 8-week group program that could help OCD patients with no or only partial response to CBT to reduce OC symptoms and develop a helpful attitude towards obsessions and compulsive urges.Methods/designThis study is a prospective, bicentric, assessor-blinded, randomized, actively-controlled clinical trial. 128 patients with primary diagnosis of OCD according to DSM-IV and no or only partial response to CBT will be recruited from in- and outpatient services as well as online forums and the media. Patients will be randomized to either an MBCT intervention group or to a psycho-educative coaching group (OCD-EP) as an active control condition. All participants will undergo eight weekly sessions with a length of 120 minutes each of a structured group program. We hypothesize that MBCT will be superior to OCD-EP in reducing obsessive-compulsive symptoms as measured by the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) following the intervention and at 6- and 12-months-follow-up. Secondary outcome measures include depressive symptoms, quality of life, metacognitive beliefs, self-compassion, mindful awareness and approach-avoidance tendencies as measured by an approach avoidance task.DiscussionThe results of this study will elucidate the benefits of MBCT for OCD patients who did not sufficiently benefit from CBT. To our knowledge, this is the first randomized controlled study assessing the effects of MBCT on symptom severity and associated parameters in OCD.Trial registrationGerman Clinical Trials Register DRKS00004525. Registered 19 March 2013.

Cognitive behavioral therapy for youth with social anxiety: Differential short and long-term treatment outcomes

The current study examined changes in social anxiety thoughts and beliefs following cognitive-behavioral treatment (CBT). Participants (N = 77) were adults with a principal diagnosis of SAD who received 12, 2-h sessions of group CBT at a hospital-based outpatient anxiety disorders clinic. There were significant decreases from pretreatment to posttreatment in social anxiety symptoms and in symptoms of depression, nonspecific anxiety and tension, as well as significant improvements in social anxiety beliefs, as assessed via the Social Thoughts and Beliefs Scale (STABS; Turner et al., Psychol Assess 15:384–391, 2003). Change in social anxiety beliefs made a significant contribution to the prediction of social anxiety symptoms at posttreatment over and above pretreatment social anxiety symptoms and changes in depression, nonspecific anxiety and tension. A positive change in the belief that others are more socially-competent emerged as a significant unique predictor of social anxiety symptoms at posttreatment. The findings demonstrate that the STABS is sensitive to cognitive-behavioral treatment. The findings also suggest that social comparison processes in particular are a key aspect of improvement in social anxiety symptoms. This is an important direction for future research.

Adolescence is characterized by an increased vulnerability for internalizing psychopathologies such as depression and anxiety. A positive association between anxiety and depression has consistently been found in research. However, the specific direction of this association is less clear. In this study, we investigated the temporal associations between (social) anxiety and depressive symptoms. Furthermore, the role of dependent interpersonal stress as a potential mediating factor in these temporal associations was examined. Data were part of a larger longitudinal study on the emotional development of adolescents, which was initiated in February 2013. The total sample consisted of 2011 adolescents between the ages of 11 and 19. Data were analyzed using cross-lagged models. Bidirectional positive associations were found between social anxiety symptoms and depressive symptoms. However, dependent interpersonal stress was not a mediator in the link between social anxiety and depression. Our results indicate that dependent interpersonal stress seems to be particularly related to depressive symptoms and not to social anxiety symptoms. Findings suggest that bidirectional associations between social anxiety and depressive symptoms exist. This implies that clinicians should be specifically vigilant for the development of depressive symptoms in socially anxious adolescents and the development of social anxiety symptoms in depressed adolescents. Our findings further highlight the importance of targeting dependent interpersonal stress in the context of depression.