Anxiety Cues Research Articles

Physician’s prosodic behavior and the regulation of patient anxiety: A quantitative study within the communication accommodation theory framework

ObjectivesPatients commonly experience anxiety when visiting a medical provider. While regulating its level, the physician may adjust their own prosodic behavior to express different levels of affective empathy and shape the emotional outcome. The primary aim was to examine the impact of convergence and divergence with the patient’s prosodic emotional cues on the patient-perceived physician’s affective empathy and the emotion regulation process. MethodsAnalog patients (n = 132) made assessments after the exposure to an audio vignette of a physician – patient conversation in the prosodic convergence or divergence condition. ResultsConvergence with the prosodic cues of anxiety was associated with the physician experiencing the same as or a similar emotional state to the patient. The former type of emotional reaction was related to lower odds of anxiety alleviation. Prosodic convergence had a negative effect on anxiety alleviation through the mediation of experiencing the same emotional state as the patient. ConclusionsDivergence from the prosodic cues of anxiety and, therefore, a low patient-perceived level of this emotion may facilitate the anxiety regulation process. Practice implicationsA careful use of convergence and divergence with prosodic emotional cues and adequate control of prosody in general are strongly recommended for practitioners.

InsightStream: A Real-Time Perspective on Classroom Environment

Abstract: Traditionally, understanding classroom environment relies on subjective observations and post-hoc surveys. "Insight Stream" proposes a paradigm shift, offering a real-time, data-driven perspective through machine learning-powered facial emotion detection. This project leverages AI to analyse student facial expressions during class, capturing the emotional undercurrents in real-time. By delving beyond spoken words, "Insight Stream" aims to: Quantify classroom engagement: Detect emotions like boredom, confusion, and excitement to gauge real-time student engagement and adapt teaching methods accordingly. Identify hidden anxieties: Uncover subtle cues of anxiety or discomfort that may go unnoticed, allowing for proactive support and personalized interventions. Optimize teaching delivery: Track shifts in emotional response to different teaching styles and materials, enabling instructors to fine-tune their methods for maximal impact. Foster well-being: Monitor overall emotional climate to ensure a positive and supportive learning environment, contributing to student well-being and academic success. "Insight Stream" goes beyond just observing the classroom - it delves into the hearts and minds of students, offering a real-time window into their emotional tapestry. This project holds immense potential to revolutionize teaching and learning, creating a dynamic and data-driven environment that caters to the holistic needs of every student.

Modifying Cognitive-Behavioral Therapy for Fear of Sleeping Alone in a Child With Autism Spectrum Disorder

This case study demonstrates the use of a modified evidence-based treatment protocol for “Maya,” a 13-year-old girl who presented with a fear of sleeping alone, Autism Spectrum Disorder (ASD), and separation anxiety disorder (SAD). The treatment, which spanned across 36 sessions, consisted of skills acquisition and exposure, with modifications made to address Maya’s ASD symptoms and cognitive limitations. Modifications for treating comorbid anxiety and ASD are described, including the use of: forced-choice list for emotions and somatic cues of anxiety, concrete props for teaching skills, and a higher level of parent involvement than typical for adolescent clients being treated for anxiety. Based on in-office observations and parental reports of at-home behavior, Maya’s avoidance of sleeping alone decreased over time, and she was able to sleep alone by the end of treatment. This case demonstrates successful treatment of fear of sleeping alone in a child with co-occurring anxiety and ASD.

Reduced use of anticipatory cues in anxiety

Reduced use of anticipatory cues in anxiety

Nonverbal cues of anxiety in English class presentation: From self- and other-perspectives

Nonverbal cues of anxiety in English class presentation: From self- and other-perspectives

Can You Feel It?

Virtual reality exposure therapy (VRET) has been widely acknowledged as an effective alternative for in vivo exposure therapy (iVET). So far, previous research focused on long- and short-term effectiveness and comparisons to iVET, whereas the impact of design choices is understudied. Hence, the present study focuses on the effectiveness of several types of anxiety cues for the manipulation of anxiety. More specifically, five interoceptive cues (i.e., “fake” bodily sensations for tunnel vision, light flickering, heartbeat audio, blurred vision, and dizziness) and a physical cue (i.e., heat stimulation) are implemented in the VRET design of a within-subjects experiment with people who have claustrophobic and panic tendencies (N = 24). Results show that adding interoceptive cues significantly increased reported levels of anxiety, independent of the type of interoceptive cue. However, introducing a physical cue in VRET can also be effective but has no real added value when combined. Studies focusing on the design of anxiety cues can be valuable in understanding the effectiveness of VRET.

How am I going to tell you this? The relations between social anxiety and narrative coherence

ABSTRACT Recently, evidence has been increasing that individuals who are able to narrate coherently about their autobiographical memories, receive more positive social feedback, have higher-quality social relationships and are overall less likely to suffer from internalising psychopathology, like depression and anxiety. However, the relation between narrative coherence and social anxiety, in particular, has not been topic of research until now. This is remarkable, since the concern about negative evaluations by others in social situations is at the core of social anxiety. In the present experimental study (N = 68), we investigated in a two-by-two design how trait and state social anxiety are related to narrative coherence, as well as possible underlying mechanisms. In our study, neither trait nor state social anxiety, nor their interaction had the expected detrimental effect on narrative coherence. However, trait differences in the proposed mechanisms of social anxiety were in line with the literature. Results showed that trait social anxiety and thematic narrative coherence were indirectly negatively related, via the intervening effects of an increased internal focus on anxiety cues, an excessive external focus on negative social evaluation, larger working memory load, more rumination and more depressive symptoms. Limitations and recommendations for future research are addressed.

Observing Anxiety in the Foreign Language Classroom: Student Silence and Nonverbal Cues

This study looked at multiple forms of silence and nonverbal cues of language anxiety in the foreign language classroom to explore their functions from the perspectives of students. Using the Classroom Oral Participation Scheme (COPS) developed by King (2013), 18 hours of observation produced data on learners’ verbal and non-verbal participation behaviours in Japanese university EFL classes. The data was analysed using the COPS participatory categories. Three recurring forms of silent L2 behaviour were identified: short responses, use of L1, and non-talk. Semi-structured follow-up interviews were carried out with 14 studentswhose silent behaviour was observed and transcribed into a corpus of 43,711 words. In addition to facilitative functions of silence such as cognitive processing, interviewees reported using silence to navigate interpersonal interactions with their classmates and fear of negative evaluation by peers. Findings illustrate how anxious learners may limit social exchanges in the target language for image protection purposes. For example, some students used short responses to avoid revealing a different opinion to their partner that might lead to an awkward interaction. The results suggest that awareness of nonverbal cues and silent behaviour - with multiple forms and functions, should be explored further as an approach to detecting language anxiety in EFL contexts.

Recognition of aggressive and anxious behaviors in canines by a group of Chilean veterinarians

The aim of this study was to evaluate the ability of veterinarians to recognize and interpret cues of aggression and anxiety in domestic dogs. Clinical veterinary ethology is defined as the science of diagnosing and treating primary behavioral disorders, including those caused by clinical disease and suboptimal performance (Luescher et al., 1989). This field of study is relevant given the expansion of human-animal relationships, which consequently increases the chances of animal behavioral issues (Chávez and Ubilla, 2014). A study conducted by Raffo (2015) determined that most people can correctly interpret canine body postures. However, no quantitative evidence supports the notion that veterinarians can recognize canine cues better than the general populace. This investigation focused on the recognition of canine aggression and anxiety by experienced veterinarians. A total of 139 veterinarians were surveyed. Highly experienced veterinarians excelled at recognizing canine behavior, but those with little to moderate experience performed poorly. Differences by sex were found, but results were inconclusive. While 66.18% (N = 93) of veterinarians recognized cues of aggression and anxiety, only 49.39% (N = 69) provided correct interpretations. This finding means that nearly 40% of veterinarians are at a greater risk for canine bites due to inadequately recognizing anticipatory cues of aggression. Finally, more than half of the surveyed veterinarians believed themselves able to recognize and interpret nonverbal cues in canines, but their actual abilities were considerably lower. In terms of job safety, this overconfidence would place veterinarians at a greater risk for being bitten.

Perceived interviewee anxiety and performance in telephone interviews

Purpose The purpose of this paper is to focus on the role of interviewee anxiety as a predictor of perceived hireability (Study 1, n=82) and job suitability (Study 2, n=74). Design/methodology/approach Using an experimental design, participants were randomly allocated to one of two conditions (an audio recording of either a confident or anxious job candidate with identical scripts) and asked to take the role of an interviewer. Findings The anxious interviewee (played by an actor) was consistently rated as less hireable (in a combined sample based on Studies and 2), less suitable to the job and received less favorable hiring recommendations (as assessed in Study 2) than the confident interviewee (played by the same actor). Research limitations/implications The study was conducted with students who may have less interview experience than experienced interviewers. Practical implications The results suggest that anxiety has a negative biasing effect on perceived hireability and job suitability ratings. In other words, the behavioral manipulation of anxiety affects hireability ratings, independent of any subjective assessment of anxiety. Originality/value The findings provide evidence of an anxiety bias in telephone interview settings. The results highlight the importance of considering anxiety cues when training employment interviewers.

Attentional biases in patients with alcohol dependence: influence of coexisting psychopathology.

The effects of coexisting psychopathology on disorder-specific attentional biases in patients with alcohol dependence are uncertain. We undertook a cross-sectional study assessing attentional biases to alcohol-, depression-, and anxiety- related stimuli using the visual probe task in patients with alcohol dependence, attending a community alcohol service. Using the visual probe task, we presented disorder-specific words (relating to alcohol, anxiety, and depression) for 500ms and measured reaction times. Participants demonstrated a significant attentional bias towards alcohol-related cues (mean 8.5, p=0.03) but significant avoidance of depression-related cues (mean-8.4, p=0.01). The subgroup of participants who were recently abstinent (n=70) showed greatest avoidance of depression-related cues (t(69)=2.68, p<0.01) but no significant vigilance towards alcohol or anxiety cues, whereas those still drinking (n=43) showed attentional biases towards alcohol-related (t(42)=2.70, p=0.01) and social anxiety-related cues (t(42)=2.84, p<0.01). In the whole sample, the magnitude of attentional bias to alcohol was not correlated with length of drinking history, number of comorbid conditions, or severity of anxiety/depression. In a clinical sample of alcohol-dependent patients, further investigation is required to explore whether these attentional biases reflect current drinking status or factors indicating prognosis.

Chemosensory anxiety cues enhance the perception of fearful faces – An fMRI study

Recent evidence suggests that humans can communicate emotion via chemosensory signals. Olfactory cues signaling anxiety can bias the perception of ambiguous stimuli, but the underlying neurobiological mechanisms of this effect are currently unknown. Here, we investigated the brain responses to subtle changes in facial expressions in response to anxiety chemosensory cues. Ten healthy individuals donated their sweat in two situations: while anticipating an important oral examination (anxiety condition) and during physical exercise (control condition). Subsequently, 24 participants completed a parametrically morphed (neutral to fearful) emotion recognition task under exposure to the olfactory cues of anxiety and sports, in the fMRI scanner. Behaviorally, the participants rated more discernible fearful faces as more fearful and neutral faces as more neutral under exposure to the anxiety cues. For brain response, under exposure to the anxiety cues, increased fearfulness of the face corresponded to increased activity in the left insula and the left middle occipital gyrus extending into fusiform gyrus. Moreover, with higher subjective ratings of facial fearfulness, participants additionally showed increased activity in the left hippocampus. These results suggest that chemosensory anxiety cues facilitate processing of socially relevant fearful stimuli and boost memory retrieval due to enhanced emotional context.

Chemosensory anxiety cues moderate the experience of social exclusion - an fMRI investigation with Cyberball.

Recent evidence suggests that the experience of stress can be communicated between individuals via chemosensory cues. Little is known, however, about the impact of these cues on neurophysiological responses during a socially threatening situation. In the current investigation we implemented a widely used paradigm to study social exclusion—Cyberball—to examine whether chemosensory cues signaling anxiety modulate the neuronal effects of ostracism. In a double-blind, within-subjects design, 24 healthy, normosmic participants were presented with chemosensory cues of anxiety (or control samples) and completed the Cyberball task while in a 3T fMRI scanner. Axillary sweat collected from male students awaiting an oral examination served as the anxiety cues while the chemosensory control stimuli consisted of sweat collected from the same individuals participating in an ergometer training session. The neuroimaging data revealed that under the control chemosensory condition, exclusion from Cyberball was associated with significantly higher orbitofrontal cortex and anterior cingulate cortex activity, which is consistent with previous studies in the field. However, when participants were primed with the anxiety sweat, the activity in these regions was not observed. Further, under exposure to anxiety cues during ostracism the participants showed deactivations in brain regions involved in memory (hippocampus), social cognition (middle temporal gyrus, superior temporal gyrus) and processing of salience (inferior frontal gyrus). These results suggest that successful communication of anxiety via the chemosensory domain may moderate the experience of social exclusion. It is possible that the anxiety signals make it easier for the individuals to detach from the group, pointing to the communicative role of chemosensory anxiety cues in enhancing adjustment mechanisms in light of a distressing situation.

Attentional bias to respiratory- and anxiety-related threat in children with asthma

This study investigated attentional biases in children with asthma. The study aimed at testing whether children with asthma are vigilant to asthma and/or anxiety cues. Thirty-six children (18 with asthma and 18 healthy controls) aged 9–12 completed a computerised dot probe task designed to measure attentional bias to three different categories of words: asthma, anxiety symptom and general negative emotion. Main caregiver anxiety was also assessed, as was frequency of inhaler use for those with asthma. Children with asthma showed an attentional bias towards asthma words but not anxiety or general negative emotion words. Children without asthma showed no significant attentional biases to any word categories. Caregiver anxiety was correlated with asthma word attentional bias in the asthma group. The findings indicate that attentional bias is present in children with asthma. Further research is required to ascertain if this exacerbates or maintains health-related problems.

Revisiting attentional processing of non-emotional cues in social anxiety: A specific impairment for the orienting network of attention

People with social anxiety disorder (SAD) exhibit an attentional bias for threat (AB). Nevertheless, the focus on AB for emotional stimuli has led to neglect the exploration of basic attention deficits for non-emotional material among SAD patients. This study aimed to investigate the integrity of the attentional system in SAD. The Attention Network Test was used to precisely explore attentional deficits, and centrally the differential deficit across the three attentional networks, namely alerting (allowing to achieve and maintain a state of alertness), orienting (allowing to select information from sensory input by engaging or disengaging attention to one stimulus among others and/or shifting the attentional resources from one stimulation to another), and executive control (involving the top-down control of attention and allowing to resolve response conflicts). Twenty-five patients with SAD were compared to 25 matched controls. SAD patients exhibited a specific impairment for the orienting network (p<0.001) but preserved performance for the alerting and executive networks. Complementary analyses revealed that this impairment may result from a faster attentional engagement to task-irrelevant material. The orienting impairment was highly correlated with the intensity of the social anxiety symptoms, but did not correlate either with trait-anxiety, state-anxiety, or depressive symptoms.

Social rejection following neonatal inflammation is mediated by olfactory scent cues.

Early-life exposure to inflammation has been associated with several behavioral and cognitive deficits detected in adulthood. However, early behavioral changes have not been well described in rodent models of infection, specifically with respect to social behavior. In the present work we show that lipopolysaccharide (LPS) challenge at 3 and 5days of age reduced overall social contact time in male juvenile rats, primarily mediated by the amount of contact they received from a novel conspecific. Given that there are important sensory, motor, and motivational components that underlie social interaction we sought to uncover the mechanism(s) responsible for the reduced social contact directed towards neonatal (n)LPS treated animals. Using an intranasal perfusion procedure, we induced a ZnSO4 lesion in a subset of novel conspecifics, effectively disrupting their olfactory processing via olfactory neuroepithelium degeneration. Overall, this procedure equalized the amount of social contact directed towards nLPS animals compared to nsaline rats. To determine whether nLPS disrupted auditory communication we evaluated ultrasonic vocalizations (USVs) for the total number and duration of calls, and the average duration and frequency from each vocalization recording. There were no differences in USVs across treatment groups. Treating nLPS rats with diazepam maintained the level of social contact they initiated, compared to the stress-induced decrease observed in their saline treated counterparts. However, diazepam did not stabilize the amount of contact directed towards them. Together, this indicates that neither vocalized motor pathways nor anxiety cues, mediated by auditory/motor communication, are involved in the social deficits following nLPS. Instead, our data suggest that olfactory indicators, likely mediated through microbiota/immunomodulatory scent signals underlie the reductions in social contact that follow neonatal inflammation.

Neural systems and hormones mediating attraction to infant and child faces.

We find infant faces highly attractive as a result of specific features which Konrad Lorenz termed “Kindchenschema” or “baby schema,” and this is considered to be an important adaptive trait for promoting protective and caregiving behaviors in adults, thereby increasing the chances of infant survival. This review first examines the behavioral support for this effect and physical and behavioral factors which can influence it. It then provides details of the increasing number of neuroimaging and electrophysiological studies investigating the neural circuitry underlying this baby schema effect in parents and non-parents of both sexes. Next it considers potential hormonal contributions to the baby schema effect in both sexes and the neural effects associated with reduced responses to infant cues in post-partum depression, anxiety and drug taking. Overall the findings reviewed reveal a very extensive neural circuitry involved in our perception of cuteness in infant faces, with enhanced activation compared to adult faces being found in brain regions involved in face perception, attention, emotion, empathy, memory, reward and attachment, theory of mind and also control of motor responses. Both mothers and fathers also show evidence for enhanced responses in these same neural systems when viewing their own as opposed to another child. Furthermore, responses to infant cues in many of these neural systems are reduced in mothers with post-partum depression or anxiety or have taken addictive drugs throughout pregnancy. In general reproductively active women tend to rate infant faces as cuter than men, which may reflect both heightened attention to relevant cues and a stronger activation in their brain reward circuitry. Perception of infant cuteness may also be influenced by reproductive hormones with the hypothalamic neuropeptide oxytocin being most strongly associated to date with increased attention and attraction to infant cues in both sexes.

Reduced Processing of Facial and Postural Cues in Social Anxiety: Insights from Electrophysiology

Social anxiety is characterized by fear of evaluative interpersonal situations. Many studies have investigated the perception of emotional faces in socially anxious individuals and have reported biases in the processing of threatening faces. However, faces are not the only stimuli carrying an interpersonal evaluative load. The present study investigated the processing of emotional body postures in social anxiety. Participants with high and low social anxiety completed an attention-shifting paradigm using neutral, angry and happy faces and postures as cues. We investigated early visual processes through the P100 component, attentional fixation on the P2, structural encoding mirrored by the N170, and attentional orientation towards stimuli to detect with the P100 locked on target occurrence. Results showed a global reduction of P100 and P200 responses to faces and postures in socially anxious participants as compared to non-anxious participants, with a direct correlation between self-reported social anxiety levels and P100 and P200 amplitudes. Structural encoding of cues and target processing were not modulated by social anxiety, but socially anxious participants were slower to detect the targets. These results suggest a reduced processing of social postural and facial cues in social anxiety.

Generalized Anxiety Disorder Is Associated With Overgeneralization of Classically Conditioned Fear

Meta-analytic results of fear-conditioning studies in the anxiety disorders implicate generalization of conditioned fear to stimuli resembling the conditioned danger cue as one of the more robust conditioning markers of anxiety pathology. Due to the absence of conditioning studies assessing generalization in generalized anxiety disorder (GAD), results of this meta-analysis do not reveal whether such generalization abnormalities also apply to GAD. The current study fills this gap by behaviorally and psychophysiologically assessing levels of conditioned fear generalization across adults with and without GAD. Twenty-two patients with a DSM-IV-Text Revision diagnosis of GAD and 26 healthy comparison subjects were recruited and tested. The employed generalization paradigm consisted of quasi-randomly presented rings of gradually increasing size, with extreme sizes serving as conditioned danger cues (CS+) and conditioned safety cues. The rings of intermediary size served as generalization stimuli, creating a continuum of similarity between CS+ and conditioned safety cues across which to assess response slopes, referred to as generalization gradients. Primary outcome variables included slopes for fear-potentiated startle (electromyography) and self-reported risk ratings. Behavioral and psychophysiological findings demonstrated overgeneralization of conditioned fear among patients with GAD. Specifically, generalization gradients were abnormally shallow among GAD patients, reflecting less degradation of the conditioned fear response as the presented stimulus differentiated from the CS+. Overgeneralization of conditioned fear to safe encounters resembling feared situations may contribute importantly to the psychopathology of GAD by proliferating anxiety cues in the individual's environment that are then capable of evoking and maintaining anxiety and worry associated with GAD.

Attention biases in female survivors of chronic interpersonal violence: relationship to trauma-related symptoms and physiology

BackgroundExposure to chronic interpersonal violence (IPV) has been associated with psychiatric impairment; however, few studies have investigated attention processes and psychophysiology in this population.ObjectiveWe investigated self-report and physiological correlates of attention biases in 27 IPV-exposed women.MethodParticipants completed self-report measures of trauma history, posttraumatic stress disorder (PTSD) symptoms, and dissociation; were monitored physiologically during baseline; and responded to an emotional dot probe task.ResultsParticipants showed bias away from positive and anxiety words, and toward IPV words. Lower baseline respiratory sinus arrhythmia (RSA) and higher skin conductance levels were associated with bias away from anxiety cues. Greater total PTSD symptoms were associated with bias toward IPV cues, and greater PTSD intrusion and avoidance symptoms were associated with lower RSA. Individuals exposed to more types of trauma had lower heart rates.ConclusionsThese data extend the research on emotion–cognition interactions in PTSD and other anxiety disorders to chronic IPV survivors, in part confirming avoidance and intrusion symptom and attention bias relations found in studies. The present work also draws attention to a group that tends to experience a range of severe symptoms associated with apparent blunting in autonomic activity, and suggests that self-report may not be sensitive to physiological and attention alterations in chronic IPV samples.