Anxious Participants Research Articles

How Adolescents Use Social Media to Cope with Feelings of Loneliness and Anxiety During COVID-19 Lockdown.

Next to physical health problems and economic damage, the coronavirus disease 2019 (COVID-19) pandemic and associated lockdown measures taken by governments of many countries are expected to cause mental health problems. Especially for adolescents, who highly rely on social contacts with peers, the prolonged period of social isolation may have detrimental effects on their mental health. Based on the mood management theory, the current study examines if social media are beneficial for adolescents to cope with feelings of anxiety and loneliness during the quarantine. A survey study among 2,165 (Belgian) adolescents (13-19 years old) tested how feelings of anxiety and loneliness contributed to their happiness level, and whether different social media coping strategies (active, social relations, and humor) mediated these relations. Structural equation modeling revealed that feelings of loneliness had a higher negative impact on adolescents' happiness than feelings of anxiety. However, anxious participants indicated to use social media more often to actively seek for a manner to adapt to the current situation, and to a lesser extent as a way to keep in touch with friends and family. The indirect effect of anxiety on happiness through active coping was significantly positive. Participants who were feeling lonely were more inclined to use social media to cope with lacking social contact. However, this coping strategy was not significantly related to their happiness feelings. Humorous coping was positively related with feelings of happiness, but not influenced by loneliness or anxiety. To conclude, social media can be used as a constructive coping strategy for adolescents to deal with anxious feelings during the COVID-19 quarantine.

Differences in cortical thinning across development among individuals with and without anxiety disorders.

Anxiety is associated with aberrant patterns of cortical thickness in regions implicated in emotion regulation. However, few studies have examined cortical thickness differences between individuals with anxiety and healthy controls (HCs) across development, particularly during childhood when cortical thinning begins and anxiety risk increases. A better understanding of age-related changes in cortical thickness patterns among anxious individuals is essential to develop plausible targets for early identification. The current study examined how age impacted differences in cortical thickness patterns between HCs and anxious individuals. Participants included 233 individuals (ages 7-35) with a current anxiety disorder (n = 149) or no lifetime history of psychopathology (n = 84). Cortical thickness of regions that are implicated in emotion regulation (ventromedial prefrontal cortex [vmPFC], rostral anterior cingulate [rACC], and insula) were assessed. All regions showed significant thinning with age, except left rACC and right insula. However, rates of thinning differed among anxious and HC participants, with anxious participants demonstrating slower rates of right vmPFC thinning. Regions of significance analyses indicated that anxious, relative to HC, participants exhibited thinner right vmPFC before age 11, but thicker right vmPFC after age 24. Current findings suggest that anxious individuals do not demonstrate normative right vmPFC cortical thinning, which may lead them to exhibit both thinner vmPFC in middle childhood and thicker vmPFC in adulthood compared with HCs. These findings may provide plausible targets for identification of anxiety risk that differ based on developmental stage.

Anxiety is a potential effect modifier of the association between red and processed meat consumption and cancer risk: findings from the NutriNet-Santé cohort.

Red and processed meats are recognized by the International Agency for Research on Cancer as probably carcinogenic and carcinogenic to humans, respectively. Heme iron has been proposed as a central factor responsible for this effect. Furthermore, anxiety affects the intestinal barrier function by increasing intestinal permeability. The objective of this work was to assess how anxiety modifies the association between red and processed meat consumption and cancer risk in the NutriNet-Santé prospective cohort (2009-2019). Using multi-adjusted Cox models in a sample of 101,269 subjects, we studied the associations between the consumption of red and processed meat, the amount of heme iron coming from these meats and overall, colorectal, prostate, and breast cancer risks, overall and separately among participants with and without anxiety. An increase in red and processed meat consumption was associated with an increased risk of developing colorectal cancer in the total population (HR for an increase of 50g/day = 1.18 (1.01-1.37), p = 0.03). After stratification on anxiety, the HR 50g/day was 1.42 (1.03-1.94, p = 0.03) in anxious participants and 1.12 (0.94-1.33, p = 0.20) in other participants. Similar trends were observed for overall cancer risk. Analyses conducted with heme iron also provided similar results. Our results strengthen the existing body of evidence supporting that red and processed meat consumption and heme iron intake are associated with an increased risk of overall and more specifically colorectal cancer, and suggest that anxiety modifies these associations, with an increased risk in anxious participants.

Predicting Subjective Measures of Social Anxiety from Sparsely Collected Mobile Sensor Data

Exploiting the capabilities of smartphones for monitoring social anxiety shows promise for advancing our ability to both identify indicators of and treat social anxiety in natural settings. Smart devices allow researchers to collect passive data unobtrusively through built-in sensors and active data using subjective, self-report measures with Ecological Momentary Assessment (EMA) studies. Prior work has established the potential to predict subjective measures from passive data. However, the majority of the past work on social anxiety has focused on a limited subset of self-reported measures. Furthermore, the data collected in real-world studies often results in numerous missing values in one or more data streams, which ultimately reduces the usable data for analysis and limits the potential of machine learning algorithms. We explore several approaches for addressing these problems in a smartphone based monitoring and intervention study of eighty socially anxious participants over a five week period. Our work complements and extends prior work in two directions: (i) we show the predictability of seven different self-reported dimensions of social anxiety, and (ii) we explore four imputation methods to handle missing data and evaluate their effectiveness in the prediction of subjective measures from the passive data. Our evaluation shows imputation of missing data reduces prediction error by as much as 22%. We discuss the implications of these results for future research.

Conscious Movement Processing, Fall-Related Anxiety, and the Visuomotor Control of Locomotion in Older Adults.

ObjectivesOlder adults anxious about falling will often consciously process walking movements in an attempt to avoid falling. They also fixate their gaze on the present step rather than looking ahead to plan future actions. The present work examined whether conscious movement strategies result in such restricted visual planning.MethodsA total of 18 community-dwelling older adults (agemean = 71.22; SD = 5.75) walked along a path and stepped into two raised targets. Repeated-measures analyses of variance were used to compare gaze behavior and movement kinematics when participants walked: (a) at baseline (ground level); (b) under conditions designed to induce fall-related anxiety (walkway elevated 0.6 m); and (c) in the absence of anxiety (ground level), but with explicit instructions to consciously process movements.ResultsParticipants reported increased conscious movement processing when walking both on the elevated walkway (fall-related anxiety condition) and at ground level when instructed to consciously process gait. During both conditions, participants altered their gaze behavior, visually prioritizing the immediate walkway 1–2 steps ahead (areas needed for the on-line visual control of individual steps) at the expense of previewing distal areas of the walking path required to plan future steps. These alterations were accompanied by significantly slower gait and increased stance durations prior to target steps.ConclusionsConsciously processing movement (in the relative absence of anxiety) resulted in gaze behavior comparable to that observed during conditions of fall-related anxiety. As anxious participants also self-reported directing greater attention toward movement, this suggests that fall-related anxiety may disrupt the visual control of gait through increased conscious movement processing.

Visual attention patterns during online video-mediated interaction in socially anxious individuals

Background and objectivesThese days, a growing number of social interactions occur through video-mediated communication (VMC). However, little is known about how socially anxious individuals use this technology. Here, we examined the visual attention patterns of high and low socially anxious individuals during a live interaction with a study confederate using a typical online VMC setup. MethodsHigh (n = 30) and low (n = 30) socially anxious participants completed a VMC-based social interaction task comprised of two parts: A one-on-one acquaintance interview followed by a one-on-one short presentation assignment. State anxiety was measured before and after the task, and gaze data was collected throughout. ResultsHigh socially anxious participants experienced elevated anxiety following the interaction task, whereas no elevation was observed for low socially anxious participants. Gaze data revealed that high socially anxious participants dwelled longer on the confederate's image during the acquaintance interview compared with the presentation task, and dwelled longer on non-face areas during the presentation relative to during the acquaintance interview. This task-related gaze pattern was not observed among low socially anxious participants. LimitationsAn analog sample was used in this study and future research should replicate its findings in a clinical sample. Future studies may also wish to counterbalance confederate's gender and task order across participants. ConclusionsThe results suggest that during VMC, socially anxious individuals observe their environment differently than non-socially anxious individuals, depending on the context of the interaction. This context-dependency might help explain mixed findings in previous studies. Further theoretical implications of these findings are discussed.

The neurophysiological relationship between number anxiety and the EEG gamma-band

ABSTRACT The development of math anxiety is thought to originate at a young age, as a form of number anxiety, but has not been investigated extensively. Research has shown greater levels of EEG gamma-band activity are experienced during threat perception and attentional bias. This has been identified in high math anxious individuals when confronted with math-based tasks, but has not yet been explored for number anxiety specifically. Single-digit numbers and letters were presented to 15 high and 15 low math anxious participants, who were required to observe the stimuli. High math anxious participants displayed significantly greater levels of gamma activity during number observation compared to letter observation. Findings suggest high math anxious individuals may have a threat-related response to observation of simple numerical stimuli. Further behavioural investigations are needed, but high math anxious individuals may display avoidance towards number and math due to a threat response associated with increased gamma activity.

Reducing Amygdala Activity and Phobic Fear through Cognitive Top-Down Regulation.

The amygdala is critically involved in emotional processing, including fear responses, and shows hyperactivity in anxiety disorders. Previous research in healthy participants has indicated that amygdala activity is down-regulated by cognitively demanding tasks that engage the PFC. It is unknown, however, if such an acute down-regulation of amygdala activity might correlate with reduced fear in anxious participants. In an fMRI study of 43 participants (11 men) with fear of snakes, we found reduced amygdala activity when visual stimuli were processed under high cognitive load, irrespective of whether the stimuli were of neutral or phobic content. Furthermore, dynamic causal modeling revealed that this general reduction in amygdala activity was partially mediated by a load-dependent increase in dorsolateral PFC activity. Importantly, high cognitive load also resulted in an acute decrease in perceived phobic fear while viewing the fearful stimuli. In conclusion, our data indicate that a cognitively demanding task results in a top-down regulation of amygdala activity and an acute reduction of fear in phobic participants. These findings may inspire the development of novel psychological intervention approaches aimed at reducing fear in anxiety disorders.

0938 Sleep, Perfectionism and Cognitive Anxiety in Sports: An Exploratory Study

Abstract Introduction Perfectionism has been related to cognitive anxiety in sports. The bidirectional association between sleep and anxiety has also been well studied. However, the relationship between sleep habits, anxiety and perfectionism in physically active young individuals hasn’t been documented yet. This was the objective of the present study. Methods 150 young, physically active participants (10 to 18 years old; 47% boys, 51% girls) completed an online survey comprised of questions extracted from the Sport Multidimensional Perfectionism Scale-2, the Competitive State Anxiety Inventory-2R and the Adolescent Sleep Habits Survey. First, independent t-tests were conducted to compare sleep habits, personal standards (PS), perceived parental pressure (PPP) and perceived coach pressure (PCP) of more anxious (ANX) to less anxious (NOANX) participants. Then, stepwise multiple linear regression analyses were computed to examine the significant sleep habits and perfectionism variables associations with competitive cognitive anxiety. Results Results show that ANX participants have higher PS (t(148)=3.19, p=0.002), less total sleep time on weekend (TST; t(148)=-2.94, p=0.004), longer sleep onset latency (SOL) on weeknights (t(128.09)=2.28, p=0.03) and report more daytime sleepiness (t(148)=3.06, p=0.003) compared to NOANX participants. The significant sleep variables and PS collectively explained 17.7% of competitive cognitive anxiety variance (p=0.00). PS was the largest predictor (β=0.27, p=0.00), followed by daytime sleepiness (β=0.21, p=0.007), weekend TST (β=-0.17, p=0.023) and weeknight SOL (β=0.16, p=.038). Conclusion These results suggest that, even though PS is associated with cognitive anxiety, sleep seem to be an important factor to consider. Specifically, increased daytime sleepiness accompanied by difficulties falling asleep during school nights and no recovery sleep during weekends significantly contribute to competitive cognitive anxiety. These results could have important implications when addressing competitive anxiety issues in young athletes. Support N/A

Prevalence and predictors of music performance anxiety in adolescent learners: Contributions of individual, task-related and environmental factors

Currently, no formal music performance anxiety (MPA) prevalence rates exist for children and adolescent musicians. Factors contributing to distinct MPA experiences (maladaptive versus adaptive) are also not clear and there is a lack of research investigating cultural variability in MPA experiences. The study aimed to investigate the prevalence of MPA and factors affecting MPA levels in adolescent musicians. Comparisons between sexes (boys, girls), age groups (12–15, 16–19 years) and nationalities (Cypriot, British) were conducted to elucidate the association between sex and MPA, explore the developmental trajectory of MPA and investigate cultural variability in its prevalence and manifestation. Profiles of musicians experiencing high, moderate and low MPA were examined to investigate discriminating characteristics. A sample of 410 musicians in Cyprus and the United Kingdom completed the Young Musicians’ Performance Questionnaire, including the Adolescent Musicians’ Performance Anxiety Scale (AMPAS). Overall, 11% of participants experienced high levels of MPA. Anxiety was affected by the cultural context as group differences and different developmental trajectories were observed in the two nationalities. Girls experienced higher MPA levels than boys, although when sex was included in a hierarchical regression with other variables, it was not a significant predictor. Approximately 60% of the variance in MPA was explained by variables that related to individual characteristics affecting susceptibility to anxiety, task-efficacy, and the performance environment. Highly anxious participants were more likely to experience maladaptive MPA. The findings support the development of personalized and culturally responsive interventions addressing individual needs on the basis of distinct musician profiles.

Behavior when socially anxious individuals expect to be (dis)liked: The role of self-disclosure and mimicry in actual likeability

Background and objectivesThis study aimed to unravel the relationship between socially anxious individuals’ expectation of being (dis)liked and actual likeability by looking at the mediating role of both strategic and automatic social behavior: Self-disclosure as well as mimicry were examined. MethodFemale participants (N = 91) with various levels of social anxiety participated in a social task with a confederate. Before the task, participants indicated their expectation of being liked by the confederate. Afterwards, objective video-observers rated the likeability of the participants before and after the social task as well as their level of self-disclosure and mimicry. ResultsSocial anxiety correlated negatively with the expectation to be liked but was not related to observer ratings of likeability, self-disclosure or mimicry. However, degree of social anxiety moderated the relation between expectations and self-disclosure. As expected, participants with low levels of social anxiety disclosed more if they expected to be liked. A reversed pattern was found for the high socially anxious participants: Here, higher expectations of being liked were related to less self-disclosure. LimitationsThe study used an analogue female sample. Our social interaction task was highly structured and does not reflect informal day-to-day conversations. ConclusionSocially anxious individuals function rather well in highly structured social tasks. No support was found for declined likeability or disrupted mimicry. Nevertheless, high socially anxious individuals did have a cognitive bias and show a self-protective strategy: when expecting a neutral judgment they reduce their level of self-disclosure. This pattern probably adds to their feelings of social disconnectedness.

Exploring the impact of safety behaviour use on cognitive, psychophysiological, emotional and behavioural responses during a speech task.

There is a debate among researchers and clinicians regarding whether the judicious use of safety behaviours (SBs) during exposure therapy is helpful or detrimental. Central to this debate is the premise that SBs may interfere with one's ability to gather disconfirmatory evidence. No study to date has assessed how SB use may impact cognitive mechanisms implicated during an exposure-like task. We investigated multiple cognitive, emotional, psychophysiological and behavioural underpinnings of exposure with and without SBs. Speech anxious participants (n = 111) were randomly assigned to deliver an evaluated speech with or without SBs. Self-reported anxiety ratings and psychophysiological arousal measures were recorded at baseline, in anticipation of the speech, and following the speech. Measures of working memory, ability to gather disconfirmatory evidence, speech duration, objective and subjective speech performance, and speech task acceptability were administered. There were no differences between conditions on working memory, self-reported anxiety, psychophysiological arousal, ability to gather disconfirmatory evidence, speech duration, or objective and subjective speech performance. All participants were able to gather disconfirmatory evidence. However, condition did influence willingness to deliver future speeches. Our sample was largely female undergraduate students, and we offered only a small number of specific safety behaviours. Judicious SB use may not necessarily be detrimental, but clients may believe them to be more helpful than they actually are.

Motivated action: Pupil diameter during active coping

Pupil diameter is dynamically modulated by a number of factors, including emotion, motor activity, and attention. Here, pupil modulation was examined as it varies with locus of control during aversive processing. Participants could control aversive exposure either by escape (terminating the event) or avoidance (blocking the event entirely), or they had no control. Highly anxious (n = 19), moderately anxious (n = 23), and less anxious (n = 23) participants saw cues that signaled whether a fast button press would terminate, prevent, or not affect subsequent presentation of an aversive picture. Pupil diameter was measured throughout the cuing interval. Pupil diameter was larger when preparing to escape or avoid compared to anticipating uncontrollable exposure. All participants, regardless of reported anxiety, showed increased pupil diameter in coping, relative to uncontrollable, contexts. Results support hypotheses that pupil diameter reflects action preparation and that differences in trait anxiety do not modulate this aspect of coping behavior in healthy subjects.

Pessimistically biased perception in panic disorder during risk learning.

Despite the well-known association between anxiety and risk-avoidant decision making, it is unclear how pathological anxiety biases risk learning. We propose a Bayesian inference model with bias parameters of prior, learning, and perception during risk learning in individuals with pathological anxiety. Patients with panic disorder (PD, n = 40) and healthy control subjects (n = 84) completed the balloon analog risk task (BART). By fitting our computational model of three bias parameters (prior belief, learning rate, and perceptual bias) to the participants' behavior, we estimated the degree of bias in risk learning and its relationship with anxiety symptoms. Relative to the healthy control subjects, the pathologically anxious participants exhibited a biased underestimation of perceptual evidence rather than differences in priors and learning rates. The degree of perceptual bias was correlated with the anxiety and depression symptom severity in the patients with PD. Furthermore, our proposed model was the winning model for BART data in an external data set from different patient groups. Our results showed that individuals with pathological anxiety demonstrate perceptual bias in evidence accumulation, which may explain why patients with anxiety overestimate risk in their daily lives. This clarification highlights the importance of interventions focusing on perceptual bias, such as enhancing the clarity of favorable outcome probabilities.

Aberrant salience and reward processing: a comparison of measures in schizophrenia and anxiety.

Aberrant salience may contribute to the development of schizophrenia symptoms via alterations in reward processing and motivation. However, tests of this hypothesis have yielded inconsistent results. These inconsistencies may reflect problems with the validity and specificity of measures of aberrant salience in schizophrenia. Therefore, we investigated relationships among measures of aberrant salience, reward, and motivation in schizophrenia and anxiety. Individuals with schizophrenia (n = 30), anxiety (n = 33) or unaffected by mental disorder (n = 30) completed measures of aberrant salience [Aberrant Salience Inventory (ASI), Salience Attribution Test (SAT)], motivation (Effort Expenditure for Reward Task), and reinforcer sensitivity (Stimulus Chase Task). Schizophrenia participants scored higher than anxiety (d = 0.71) and unaffected (d = 1.54) groups on the ASI and exhibited greater aberrant salience (d = 0.60) and lower adaptive salience (d = 0.98) than anxious participants on the SAT. There was no evidence of a correlation between measures of aberrant salience. Schizophrenia was associated with related deficits in motivated behaviour and maladaptive reward processing. However, these differences in reward processing did not correlate with aberrant salience measures. The results suggest that key measures of aberrant salience have limited specificity and validity. These problems may account for inconsistent findings reported in the literature.

The influence of fear on risk taking: a meta-analysis

ABSTRACT A common finding in the study of emotion and decision making is the tendency for fear and anxiety to decrease risk taking. The current meta-analysis summarises the strength and variability of this effect in the extant empirical literature. Our analysis of 136 effect sizes, derived from 68 independent samples and 9,544 participants, included studies that experimentally manipulated fear or measured naturally varying levels of fear or anxiety in both clinical and non-clinical samples, and studies measuring risky decision making and risk estimation. A multilevel random effects model estimated a small to moderate average effect size (r = 0.22), such that fear was related to decreased risky decision making and increased risk estimation. There was also high heterogeneity in the effect sizes. Moderator analyses showed that effect sizes were greater when risk tasks used tangible (e.g. monetary) outcomes and when studies used clinically anxious participants. However, there also remained considerable variability in effect sizes, the sources of which remain unknown. We posit several potential factors that may contribute to observed variability in this effect for future study, including factors concerning both the nature of fear experience and the risk taking context.

Social anxiety elicits an approach mere exposure effect for angry faces.

Zajonc (2001) called the mere exposure effect (MEE) a gateway into the subliminal - specifically, the affective unconscious discrimination of stimuli. Zajonc proposed that the MEE occurs because repeated unconscious presentation of a stimulus automatically elicits approach toward it, and thus, positive affect. We present the first test of Zajonc's hypothesis of what we term an approach mere exposure effect. We did so by using an implicit measure that identifies preferred stimuli by assessing automatic approach reactions. A total of 42 highly socially anxious and 39 nonanxious control participants were administered masked exposures to either angry or neutral faces. Then they reacted to visible pictures of angry or neutral faces that were either previously presented (old) or new in one of two ways. They either (a) pulled a joystick toward themselves, which created the visual effect of approaching these stimuli (stimulus preference), or (b) pushed a joystick away from themselves, which created the effect of avoiding the stimuli. Mere exposure to angry faces caused socially anxious participants to pull - approach - old angry faces more quickly than new angry faces, that is, an approach MEE. Nonanxious participants nearly approached old neutral faces more quickly than new neutral faces. Mere exposure to angry faces also caused socially anxious participants to approach visible angry faces generally, and counterintuitively, to approach angry faces faster than they avoided them, whether they were old or new. These results suggest that the approach MEE generalized to have fear-reducing effects in socially anxious persons.

Increased Basolateral Amygdala Functional Connectivity With Subgenual Anterior Cingulate Cortex and Fear-Related Memory Encoding in High Anxious Participants: A Premorbid Feature?

Increased Basolateral Amygdala Functional Connectivity With Subgenual Anterior Cingulate Cortex and Fear-Related Memory Encoding in High Anxious Participants: A Premorbid Feature?

Social anxiety compared to depression better accounts for enhanced acquisition of self-reported anxiety toward faces paired with negative evaluation in a conditioning task

Previous studies have shown that social anxiety was associated with enhanced acquisition of anxiety as measured by subjective ratings in conditioning tasks using faces as the conditioned stimulus and negative evaluation as the unconditioned stimulus. However, a recent study failed to replicate the effect. The current study re-examined the enhanced acquisition effect with a larger sample, explored whether differences in expectancy of negative evaluation was a potential mechanism, and compared the contribution of social anxiety to that of depression on enhanced acquisition. Two hundred and sixty-three unselected participants took part in a differential conditioning task in which three faces each were paired with hostile, neutral, and friendly reaction during acquisition, and all three were paired with neutral reaction during extinction. Results replicated earlier findings that participant social anxiety was associated with enhanced acquisition of anxiety. Socially anxious participants did not show higher expectancy of hostile reaction during acquisition, which suggested the need to consider alternative mechanisms underlying enhanced acquisition. Depression was also associated with enhanced acquisition; however, that association was accounted for by social anxiety. The effect of social anxiety was significant over and above depression, which supported its diagnostic validity.

Using connectivity-based real-time fMRI neurofeedback to modulate attentional and resting state networks in people with high trait anxiety.

High levels of trait anxiety are associated with impaired attentional control, changes in brain activity during attentional control tasks and altered network resting state functional connectivity (RSFC). Specifically, dorsolateral prefrontal cortex to anterior cingulate cortex (DLPFC - ACC) functional connectivity, thought to be crucial for effective and efficient attentional control, is reduced in high trait anxious individuals. The current study examined the potential of connectivity-based real-time functional magnetic imaging neurofeedback (rt-fMRI-nf) for enhancing DLPFC - ACC functional connectivity in trait anxious individuals. We specifically tested if changes in DLPFC - ACC connectivity were associated with reduced anxiety levels and improved attentional control. Thirty-two high trait anxious participants were assigned to either an experimental group (EG), undergoing veridical rt-fMRI-nf, or a control group (CG) that received sham (yoked) feedback. RSFC (using resting state fMRI), anxiety levels and Stroop task performance were assessed pre- and post-rt-fMRI-nf training. Post-rt-fMRI-nf training, relative to the CG, the EG showed reduced anxiety levels and increased DLPFC-ACC functional connectivity as well as increased RSFC in the posterior default mode network. Moreover, in the EG, changes in DLPFC - ACC functional connectivity during rt-fMRI-nf training were associated with reduced anxiety levels. However, there were no group differences in Stroop task performance. We conclude that rt-fMRI-nf targeting DLPFC - ACC functional connectivity can alter network connectivity and interactions and is a feasible method for reducing trait anxiety.