Changes In Social Anxiety Research Articles

Evaluation of the Effect of Surgery on Psychosocial Function and Quality of Life in Children with Simple Congenital Ptosis and Their Parents.

Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery. Materials and. A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and parents answered the Spence Children's Anxiety Scale (SCAS) - Social Anxiety Domain, and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and three months after ptosis surgery. This study involved 45 children. Females comprised 57.8% (n=26). At enrolment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean MRD1 and mean inter-eye MRD1 difference of 4.070.62 mm and 0.290.46 mm respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p<0.001). A decrease in inter-eye MRD1 difference post-operatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p<0.001). Together with the presence of amblyopia (p<0.001), the inter-eye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p=0.021). Age, gender and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p<0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p<0.001). Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

The Efficacy of Web-Based Cognitive Behavioral Therapy With a Shame-Specific Intervention for Social Anxiety Disorder: Randomized Controlled Trial.

Social anxiety disorder (SAD) is one of the most prevalent psychological disorders and generally co-occurs with elevated shame levels. Previous shame-specific interventions could significantly improve outcomes in social anxiety treatments. Recent review suggests that integrating a more direct shame intervention could potentially increase the effectiveness of cognitive behavioral therapy. Web-based cognitive behavioral therapy (WCBT) has proven efficacy, sustaining benefits for 6 months to 4 years. Previous evidence indicated that shame predicted the reduction of social anxiety and mediated between engagements in exposure and changes in social anxiety during WCBT. This study aimed to design a shame intervention component through a longitudinal study and conduct a randomized controlled trial to investigate the effectiveness of a shame intervention component in reducing social anxiety symptoms and shame experience in a clinical sample of people with SAD. The development of a shame intervention component was informed by cognitive behavioral principles and insights from longitudinal data that measured the Experience of Shame Scale (ESS), the Coping Styles Questionnaire, and the Social Interaction Anxiety Scale (SIAS) in 153 participants. The psychoeducation, cognitive construct, and exposure sections were tailored to focus more on shame-related problem-solving and self-blame. A total of 1220 participants were recruited to complete questionnaires, including the ESS, the SIAS, the Social Phobia Scale (SPS), and diagnostic interviews. Following a 2-round screening process, 201 participants with SAD were randomly assigned into a shame WCBT group, a normal WCBT group, and a waiting group. After the 8-week WCBT intervention, the participants were asked to complete posttest evaluations, including the ESS, SIAS and SPS. Participants in the shame WCBT group experienced significant reductions in shame levels after the intervention (ESS: P<.001; ηp2=0.22), and the reduction was greater in the shame intervention group compared to normal WCBT (P<.001; mean deviation -12.50). Participants in both the shame WCBT and normal WCBT groups experienced significant reductions in social anxiety symptoms (SIAS: P<.001; ηp2=0.32; SPS: P<.001; ηp2=0.19) compared to the waiting group after intervention. Furthermore, in the experience of social interaction anxiety (SIAS), the shame WCBT group showed a higher reduction compared to the normal WCBT group (P<.001; mean deviation -9.58). Problem-solving (SE 0.049, 95% CI 0.025-0.217) and self-blame (SE 0.082, 95% CI 0.024-0.339) mediated the effect between ESS and SIAS. This is the first study to design and incorporate a shame intervention component in WCBT and to validate its efficacy via a randomized controlled trial. The shame WCBT group showed a significant reduction in both shame and social anxiety after treatment compared to the normal WCBT and waiting groups. Problem-solving and self-blame mediated the effect of shame on social anxiety. In conclusion, this study supports previous findings that a direct shame-specific intervention component could enhance the efficacy of WCBT.

Work-Related Cognitive Behavioral Therapy for racially and economically diverse unemployed persons with social anxiety: A randomized clinical trial

Individuals with Social Anxiety Disorder (SAD) are at risk for employment problems. This multi-site trial examined the efficacy of Work-Related Cognitive Behavioral Therapy provided alongside vocational services as usual (WCBT+VSAU), a group-based treatment designed to improve mental health and employment outcomes for individuals with SAD. Vocational service-seeking participants with SAD (N = 250) were randomized to either WCBT+VSAU or VSAU-alone. Hypotheses were that participants randomized to WCBT+VSAU would report less social anxiety, less depression, and more hours worked than participants randomized to VSAU-alone. WCBT+VSAU participants had significantly greater improvements on the Liebowitz Social Anxiety Scale (LSAS; d=−.25, CI=−0.49 to −0.02, p = .03) at post-assessment compared to VSAU-alone. The conditions did not differ on any variable at later time points or on secondary outcomes. Unexpectedly, participants randomized to VSAU-alone experienced LSAS improvements, similar to WCBT+VASU at later timepoints. Baseline psychological flexibility (beta=−.098 [−0.19–0.008]) and depression (beta=−0.18 [−0.34–0.009]) moderated change in social anxiety. Participants with lower psychological flexibility and higher depression responded more strongly to WCBT+VSAU than VSAU-alone over the duration of the study, suggesting that WCBT+VSAU may particularly benefit those with greater psychopathology. Results indicate that vocational centers are promising settings for treating SAD and employment-focused refinements are likely needed to improve work outcomes.

Trajectories and influencing factors of social anxiety in postoperative breast cancer patients

BackgroundSocial anxiety among postoperative breast cancer patients is a prevalent concern, with its intensity fluctuating throughout the course of treatment. The study aims to describe the trajectory of social anxiety in postoperative breast cancer patients, explore the influencing factors, and provide theoretical support for the construction of future intervention programs.MethodsThis study was conducted from June 2022 to January 2023, encompassing 213 breast cancer patients from three first-class hospitals in China. Data collection occurred at four distinct time points. A growth mixture model was employed to identify latent categories representing the trajectories of social anxiety changes among patients. A multiple regression analysis was utilized to explore predictive factors associated with different latent trajectory categories.ResultsThe trajectory of social anxiety changes in postoperative breast cancer patients includes five potential categories: maintaining mild social anxiety group, changing from mild to moderate social anxiety group, maintaining moderate social anxiety group, changing from moderate to severe social anxiety group, and maintaining severe social anxiety group. Cluster analysis results indicated three types: positive, negative, and low. Logistic regression analysis revealed that younger age, spouses concerned about postoperative appearance, chemotherapy with taxol-based drugs, opting for modified radical surgery or radical mastectomy surgical approaches, and breast cancer patients with negative rumination were factors that influenced patients’ social anxiety (P < 0.05).ConclusionThe trajectory of social anxiety in postoperative breast cancer patients comprises five potential categories. In clinical practice, it is essential to strengthen the management of high-risk populations susceptible to experiencing social anxiety emotions, including younger age, spouses concerned about postoperative appearance, chemotherapy with taxol-based drugs, opting for modified radical surgery or radical mastectomy surgical approaches, and breast cancer patients with negative rumination.

The impact of long-term online learning on social anxiety and problematic smartphone use symptoms among secondary school students with different levels of fear of missing out: Evidence from a symptom network and longitudinal panel network analysis.

The advancement of communication technology and the impact of the COVID-19 pandemic have led to an increased reliance on online education. However, the effects of the long-term use of smart devices for online learning on students' social anxiety and problematic smartphone use (PSU) and the role of fear of missing out (FoMO) in this process have yet to be fully explored. This study analysed longitudinal data from 2,356 high school students (female = 1,137 (48.26%), meanage = 13.84, SD age = 1.37) in China, divided into high- and low-FoMO groups based on their scores on the FoMO scale, to examine the impact of four months of online learning on social anxiety and PSU. The Social Anxiety Scale (SAS) and Mobile Phone Addiction Index (MPAI) were used to assess socialanxiety and PSU symptoms. The undirected symptom networks revealed more bridge symptoms among the students in the high-FoMO group, although their overall symptom scores decreased. The results of the directed cross-lagged panel networks showed that "productivity loss" predicted other symptoms in the low-FoMO group but that "afraid of negative evaluation" was the predictor in the high-FoMO group. Meanwhile, "withdrawal/escape" and "productivity loss" were thesymptoms that were most affected by other symptoms in the high-FoMO and low-FoMO groups, respectively. The current study therefore sheds light on the changes in social anxiety and PSU symptoms among secondary school students during long-term online learning, as well as the moderating role of FoMO.

Mediation of social anxiety and depression during internet-delivered treatment for social anxiety disorder

ABSTRACT Many individuals with social anxiety disorder (SAD) have depressive symptoms that meet criteria for major depressive disorder (MDD). In our study, we examined the temporal relationship between symptoms of social anxiety and symptoms of depression during the course of an 11-week internet-delivered cognitive behavioral treatment (ICBT) for SAD (n = 170). Specifically, we investigated whether weekly changes in social anxiety mediated changes in depression, changes in depression mediated changes in anxiety, both or neither. In addition, we compared individuals with SAD and MDD (n = 50) and individuals with SAD and no MDD (n = 120) to examine the role of MDD as a moderator of the social anxiety—depression relationship. Lower-level mediational modeling revealed that changes in social anxiety symptoms mediated changes in depression symptoms to a greater extent than vice versa. In addition, mediation among individuals with SAD and MDD was significantly greater compared to individuals with SAD and no MDD. Our findings suggest that ICBT is effective in treating individuals with SAD regardless of comorbid depression, and that focusing ICBT interventions on social anxiety can lead to significant reductions in depression among individuals with SAD.

Transitioning to college: Testing cognitive bias modification for interpretations as an inoculation tool for social anxiety in college first-years

Background and objectivesReducing social anxiety development among incoming college students may improve college adjustment and mental health outcomes. This study tested whether cognitive bias modification for interpretations (CBM-I) reduces social anxiety and increases adjustment during the transition to college, and whether changes in outcomes would be mediated by changes in interpretation biases. MethodsParticipants (N = 73) were randomly assigned to a 3-session weekly CBM-I condition or symptom tracking (ST) control condition. Multilevel models were used to estimate within-person trajectories from baseline to one week post-intervention and to test whether trajectories differed by condition. ResultsThose in the CBM-I condition (vs. ST) reported higher increases in social adjustment across time. There were not significant differences between conditions for changes in social anxiety, academic adjustment, and personal adjustment. CBM-I was indirectly linked to improvements in outcome variables via more adaptive interpretation biases. LimitationsCBM-I was administered in a laboratory setting, requiring more resources than some computerized interventions. ConclusionsData tentatively support CBM-I for first-year students to increase social adjustment. Further, mediation findings provide support for targeting interpretation biases to improve social anxiety and adjustment outcomes. Yet, CBM-I did not outperform ST in improving social anxiety symptoms or other areas of college adjustment, and effect sizes were small, suggesting that more work is needed to amplify the potential of CBM-I as a therapeutic tool.

Brief imaginal exposure exercises for social anxiety disorder: A randomized controlled trial of a self-help momentary intervention app

IntroductionEmerging technological interventions for psychological disorders are being developed continually. Offering imaginal exposure exercises as a self-help intervention presents the opportunity to acquire foundational skills to address social anxiety. The current study evaluates the feasibility and effectiveness of a novel smartphone application for social interaction anxiety. MethodsParticipants (n = 82) were adults meeting criteria for social anxiety disorder. They were randomly assigned to imaginal exposure (IE; n = 39) or self-monitoring (n = 43) delivered multiple times daily via a smartphone application for a one-week trial. It was expected that participants using the IE exercises would demonstrate significantly greater declines in social anxiety in addition to increases in self-efficacy and that compliance would serve as a predictor of outcome. Mixed-effects models were utilized. ResultsParticipants using IE (vs. self-monitoring) evidenced significantly greater reductions in social anxiety from pre- to post-treatment and at 1-month follow-up. Similarly, IE (vs. self-monitoring) led to significantly greater increases in self-efficacy from pre- to post-treatment and 1-month follow-up. Further, more completed IE exercises predicted significantly greater changes in social anxiety and self-efficacy at subsequent timepoints compared with self-monitoring. ConclusionsFindings suggest that a brief IE self-help intervention was effective in targeting social interaction anxiety.

Reducing social anxiety and intolerance of uncertainty in adolescents with improvisational theater

Intolerance of uncertainty has been implicated in the development and maintenance of depression and anxiety (McEvoy & Mahoney, 2012). Given that, promoting positive experiences of uncertainty through improvisational theater training (Napier, 2004) may have psychological benefits such as reductions in anxiety and depression (Krueger, Murphy, & Bink, 2017; Felsman, Seifert, & Himle, 2019). This study tests whether intolerance of uncertainty changes with participation in improvisational theater class for adolescents, and whether that change can explain changes in social anxiety. Surveys were collected on weeks one (n = 350) and ten (n = 339) of an improvisational theater program across 14 urban public schools, grades 8–12, measuring social anxiety (the Mini-SPIN; Connor, Kobak, Churchill, Katzelnick, & Davidson, 2001) and intolerance of uncertainty (Brief-IUS; Fialko, Bolton, & Perrin, 2012). Participating in the program was associated with significant reductions in social anxiety and intolerance of uncertainty. In our linear mixed model, change in intolerance of uncertainty was associated with greater reductions in social anxiety. This study provides the first evidence that participating in improvisational theater is associated with reductions in intolerance of uncertainty and adds to the argument that improvisational theater training may indirectly provide a low stigma, accessible mental health intervention (Felsman et al., 2019).

Positive Interpretation Bias Predicts Longitudinal Decreases in Social Anxiety

Theoretical models of social anxiety suggest that distorted interpretation processes contribute to its development and maintenance, although the pathways through which this occurs are not well understood. Therefore, the present longitudinal study sought to determine whether negative interpretation bias, positive interpretation bias, and interpretation inflexibility (the degree to which participants correctly revise initial interpretations) predict changes in social anxiety over time. In an important advance over prior studies, individual differences in working memory capacity (WMC) were accounted for, as WMC is thought to play a crucial role in the generation and maintenance of interpretation biases. Following a baseline assessment of social anxiety, interpretation biases, and WMC, participants completed follow-up assessments of social anxiety both 2 weeks (n = 106) and 4 weeks (n = 96) later. After controlling for baseline social anxiety and WMC, greater positive interpretation bias was found to predict lower social anxiety at both follow-ups. Neither negative interpretation bias nor interpretation inflexibility was significantly associated with follow-up social anxiety. These results provide support for greater positive interpretation bias as a facilitator of decreases in social anxiety and a potential target for clinical intervention.

Is it safe? Exploring positive and negative outcome changes following a web-based intervention for adolescents distressed by a visible difference (YP Face IT)

Despite the importance of making sure that psychological interventions are safe, research including both positive and negative effects of novel internet-delivered support is scarce. The aim of our study was to explore whether, and in what way, a new intervention for adolescents distressed by a visible difference (YP Face IT; YPF, Norwegian version) led to positive and/or negative outcome changes. Participants were 79 adolescents (62.00% girls; Mage = 13.84, SD = 1.73), with a visible difference. All had access to the YPF programme and answered questionnaires assessing social anxiety and body esteem pre- and post-intervention. Analyses included calculations of statistical as well as clinically significant and reliable changes. Results showed that fewer participants reported clinical levels of social anxiety and low body esteem after access to YPF. Results also indicated that participants who had a positive pre- to post-intervention change had lower levels of perceived self-worth pre-intervention, and spent more time on the intervention than those with a negative pre- to post change. Three participants showed a clinically significant negative and reliable change in social anxiety or body esteem from pre- to post-intervention. However, based on an examination of these participants’ characteristics, preliminary findings support the safety of YPF.

Comorbid major depressive disorder in cognitive-behavior group treatment for social anxiety disorder: An examination of processes of symptom change.

Individuals with social anxiety disorder (SAD) typically have elevated depressive symptoms and approximately 50% also meet criteria for major depressive disorder (MDD; Beesdo et al., 2007). In the present study, we examined the relationship between social anxiety and depressive symptoms during cognitive-behavior group treatment (CBGT) for SAD. Specifically, we compared individuals with SAD and comorbid MDD and individuals with SAD without MDD to examine the role of MDD as a moderator of social anxiety-depression relationship. Participants were 90 individuals seeking treatment for SAD (36% were diagnosed with MDD), who completed self-report measures of social anxiety and depression every 2 weeks during CBGT. Lower level mediational modeling indicated that for individuals without MDD, a reciprocal relationship was observed in which changes in both social anxiety and depressive symptoms mediated changes in each other. However, changes in social anxiety explained all subsequent changes in depression, whereas changes in depression explained 11.26% of subsequent changes in social anxiety. For individuals with both SAD and MDD, neither social anxiety nor depression significantly mediated changes in each other. Our findings suggest that different processes of change occur for individuals with and without MDD and clinical implications of these findings are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Improving Social Anxiety and Social Responsiveness in Autism Spectrum Disorder through PEERS®

ABSTRACT Autistic individuals often experience anxiety at higher rates than typically developing individuals, which could worsen social impairment. While anxiety is highly linked to social skills, social anxiety symptoms have not often been investigated within the context of social skills interventions. The present study compared changes in social anxiety and social responsiveness in 154 adolescents and young adults on the autism spectrum participating in the Program for the Education and Enrichment of Relational Skills (PEERS®) social skills intervention. Results indicate that social anxiety symptoms significantly improved following treatment for both adolescents and young adults. Although young adults reported higher levels of anxiety overall, age group did not moderate social anxiety outcome, with both groups demonstrating comparable social anxiety improvements following treatment. Further, greater improvements in social responsiveness following PEERS® were associated with greater reductions in social anxiety symptoms. We also examined reporter agreement (e.g., self- and caregiver-reports), which indicated these reports were largely consistent, though correlations between adolescent and caregiver-report increased from pre- to post-treatment. Findings suggest that social skills interventions may play a critical role in the reduction of mental health symptoms, such as anxiety symptoms, for autistic adolescents and young adults.

Identifying mediators of cognitive behaviour therapy and exposure therapy for social anxiety disorder (SAD) using repeated measures

• Process research aiming to identify mediators of therapy can aid in making therapy more efficient and optimal. • Repeated measurement, at the start of each session of potential mediators of CBT and Exposure Therapy for social anxiety was carried out. • Both CBT and Exposure Therapy were found to have common mediational pathways and were equally effective in the treatment of SAD. • Perceived social self-efficacy and estimated social cost was found to be mediators of CBT and Exposure Therapy. Process research aims to identify mediators of therapy which can help increase the efficacy and optimization of therapy. The present study examined the role of estimated social cost, perceived social self-efficacy and perceived emotional control as potential mediators in Cognitive Behaviour Therapy (CBT) and Exposure Therapy (EXP) in individuals with social anxiety disorder. Fifty adults with a primary diagnosis of social anxiety disorder (SAD) were recruited from a tertiary treatment center and randomly assigned to receive either CBT (N=25) or EXP (N=25).Levels of social anxiety, estimated social cost, perceived social self-efficacy, and perceived emotional control were assessed at the beginning of each session. Multilevel modeling was used to estimate the effects of the above variables on social anxiety and examine differences between the two groups. Changes in perceived social self-efficacy and estimated social cost predicted changes in social anxiety. Perceived emotional control was not a significant predictor of changes in social anxiety. There were no significant differences between the two groups. The study has a small sample size, and there is a lack of adequate follow-up data. A single therapist delivered both interventions, which could limit external validity. Perceived social self-efficacy and estimated social cost emerged as mediators of both CBT and EXP. The two interventions had common meditational pathways, and there was an interactive bi-directional relationship between social anxiety and the studied mediators.

The Predictive Role of Spiritual Wellbeing in Social Anxiety of Al-Zahra University Students, Iran, 2019

Background and Objectives: Social anxiety disorder is one of the most common anxiety disorders. It presents with a persistent fear of one or more social or functional situations and is highly prevalent. This study aimed to investigate the predictive role of spiritual wellbeing in social anxiety. Methods: The method of research was descriptive correlational. The study population included all students of Al-Zahra University in the 2018-2019 academic year. The cluster random sampling method was used to recruit 290 samples. Data collection tools included social phobia inventory and spiritual wellbeing. A correlation and multivariate regression test was used to analyze the data. Results: The results showed that the dimensions of spiritual wellbeing have a negative relationship with social anxiety. Based on these results, the correlation coefficient (r=0.157) between the total score of spiritual wellbeing and social anxiety is significant (P&lt;0.01). Also, the results showed that the spiritual wellbeing variable explains 10% of the changes in social anxiety. Conclusion: According to these findings, planning, and teaching to promote students’ spiritual wellbeing are essential in reducing their social anxiety.

Understanding the Dynamic Interaction of Maladaptive Social-Evaluative Beliefs and Social Anxiety: A Latent Change Score Model Approach

There is a paucity of research that has examined the dynamic relationship between maladaptive social-evaluative beliefs and social anxiety. Thus, this study aimed to use latent change score models to examine changes in three theory-driven maladaptive social-evaluative belief types (i.e., conditional, unconditional, and high standard beliefs) and their relationship with social anxiety changes in the real-world, day-to-day life contexts of a community sample of individuals with elevated social anxiety (N = 73). Individuals completed one daily assessment of the three belief types and social anxiety symptoms over 4 days. Only the measures of social anxiety, unconditional beliefs, and high standard beliefs were found to have invariant measurement properties across time. As such, latent change score models were only examined for these measures. These models ultimately showed that greater increases in high standard beliefs predicted greater increases in social anxiety the subsequent day. Additionally, greater increases in social anxiety predicted smaller increases or declines in high standard beliefs the next day. Changes in unconditional beliefs were unrelated to social anxiety changes the next day, and changes in social anxiety were unrelated to next day changes in unconditional beliefs. These findings suggest high standard beliefs play a prominent role in the dynamics involving social anxiety and provide a basis for future research to further understand the interaction between these constructs.

Interpersonal Patterns in Social Anxiety Disorder: Predictors and Outcomes of Cognitive-Behavioral Therapy

Given the strong associations of social anxiety disorder (SAD) with interpersonal problems and insecure attachment, this study sought to examine specific interpersonal problem domains in relation to the outcome of cognitive-behavioral therapy (CBT) for SAD. Ninety-five adults with SAD received individual CBT and completed a measure of attachment style at pretreatment, as well as measures of interpersonal problems and social anxiety at pre- and posttreatment. At baseline, social anxiety was significantly associated with overall interpersonal problems, multiple specific interpersonal problems, as well as insecure attachment. Interpersonal problems decreased significantly over the course of treatment but did not predict a reduction in social anxiety. No specific interpersonal problem predicted changes in social anxiety. The greatest changes from pre- to posttreatment were observed across avoidance-related interpersonal problems. Higher levels of secure attachment predicted lower social anxiety, but individuals with less secure attachment experienced a greater reduction in social anxiety from pre- to posttreatment. However, this interaction was significant for only one of three measures of social anxiety. Our findings suggest that although higher levels of interpersonal problems and lower levels of secure attachment predict greater social anxiety, interpersonal problems and insecure attachment do not predict poorer treatment outcome.

The Relationship between Symptoms and Social Functioning over the Course of Cognitive Behavioral Therapy for Social Anxiety Disorder.

Background The present study is aimed at investigating the relationship between changes in symptoms and changes in social functioning during cognitive behavioral therapy (CBT) for social anxiety disorder (SAD). Methods Ninety-six patients with SAD were treated with manualized group CBT. Measures of social anxiety symptoms, depression symptoms, cognition, and social functioning were administered at baseline and endpoint. Using multiple regression analysis, we examined the associations between the changes in four aspects (work, home management, social leisure activities, and private leisure activities) of social functioning as dependent variables and the changes in four factors (social interaction, public speaking, observation by others, and eating and drinking in public) in social anxiety symptoms, depression symptoms, and cognition as independent variables. Results The changes in work functioning were predicted by the changes in the public speaking factor in social anxiety symptoms. The changes in depression symptoms predicted the changes in home management. The significant predictors of changes in social leisure activities were the changes in the social interaction factor and depression symptoms. The changes in private leisure activities were predicted by the changes in the observation by others factor. The changes in cognition predicted nothing. Conclusion The present study suggested that the changes in social anxiety or depression symptoms may predict several aspects of social functioning changes in patients with SAD over the course of CBT. In order to improve social functioning, our results may be useful for selecting the fear or feared situation in CBT for SAD. Trial Registration. The clinical study registration number in the Japanese trials registry is UMIN CTR 000031147.

Impact of changes in social anxiety on social functioning and quality of life in outpatients with schizophrenia: A naturalistic longitudinal study

The prevalence of comorbid social anxiety disorder among patients with schizophrenia is currently attracting attention, and symptoms of social anxiety are reportedly associated with various clinical features. However, the contribution of social anxiety to social functioning and quality of life (QOL) over time remains obscure. The aim of this study was to examine the impact of changes in social anxiety symptoms on social functioning and QOL among outpatients with schizophrenia. Of the 207 outpatients who were eligible at baseline, 118 patients agreed with and completed a follow-up investigation at least 1 year (695.8 days on average) after the baseline study. Stepwise multiple regressions examining the change in social functioning using demographic data and changes in clinical variables as explanatory variables demonstrated that the changes in social anxiety and general psychopathology contributed to the change in the Social Functioning Scale, while the changes in clinical severity and negative symptoms contributed to the change in the Global Assessment of Functioning scale. Stepwise multiple regressions for the change in QOL demonstrated that the changes in social anxiety and depression contributed to the change in the World Health Organization QOL scale, Brief version, and the changes in social anxiety and positive symptoms contributed to the Subjective Well-being Under Neuroleptic Drug Treatment, Short Form. The results revealed that the changes in social anxiety symptoms were significantly associated with the change in functional outcome among patients with schizophrenia. Treatments targeting social anxiety seem to be key to achieving a full recovery in patients with schizophrenia.

Prospective associations between social anxiety and depression in youth: The moderating role of maternal major depressive disorder

IntroductionAlthough social anxiety symptoms and exposure to maternal major depressive disorder (MDD) have each been conceptualized as key contributors to the development of depression symptoms in youth, these risk factors have not been integrated into a single model of risk. The current study evaluated a two-hit model of risk to determine whether the impact of social anxiety on prospective changes in youth depressive symptoms is stronger among youth exposed to maternal MDD than among those of never-depressed mothers. MethodsParticipants were youth (aged 8–14 at baseline, 50.4% girls, 80.9% Caucasian) and their biological mothers recruited from the community in the United States. Of the mothers, 129 had a history of MDD during their youth's lifetime and 117 had no lifetime history of MDD. At the initial assessment, mothers completed diagnostic interviews and youth completed self-report measures of social anxiety and depressive symptoms. Participants were reassessed every 6 months for 2 years during which youth again completed the symptom measures. ResultsResults of hierarchical linear modeling revealed that levels of social anxiety predicted prospective increases in depressive symptoms among offspring of mothers with a history of MDD, but not among those of never-depressed mothers. Depressive symptoms did not predict prospective changes in social anxiety (alone or in interaction with maternal MDD). ConclusionsThese results provide preliminary evidence for an integrated model of risk such that social anxiety symptoms may be a particularly strong risk factor for the subsequent development of depression symptoms among youth with exposure to maternal MDD.