Implementing clinically feasible psychophysiological measures in evidence-based assessments of adolescent social anxiety.

Abstract

How clinicians should assess adolescent patients distressed by physiological experiences of social anxiety is often unclear. Clinicians might hypothesize that this component of social anxiety will resolve with treatment of other components (e.g., negative thoughts or behavioral avoidance) and thus focus assessments on these other components. However, research has indicated that expressions of the different components of social anxiety often do not operate in synchrony. Evidence-based assessment and treatment of social anxiety in adolescence is critical because of its potential impact on psychosocial functioning; if left untreated, social anxiety places an adolescent at greater risk for developing substance use problems in adulthood. Practitioners rarely assess adolescents’ physiological experiences, but when they do, they tend to rely on subjective measures (e.g., paper and pencil) rather than on a multimethod approach including objective psychophysiological measures. It is possible that practitioners infrequently utilize objective psychophysiological assessments because they assume that subjective measures comprehensively assess this physiological component of social anxiety. Additionally, practitioners may believe that the use of objective psychophysiological methods is cost-prohibitive. Yet, recent technological innovations have resulted in low-cost, portable instruments to objectively assess psychophysiology in research and practice. In this review, we discuss objective psychophysiological measures of social anxiety in adolescents and provide recommendations for their use in research and practice. We argue that neither subjective nor objective measures alone yield a comprehensive understanding of psychophysiology. Rather, joint use of these measures may greatly improve both the assessment and treatment of adolescent social anxiety.