Criteria For Social Anxiety Disorder Research Articles

Anger in social anxiety disorder

ABSTRACT The present study focused on the emotional experience of anger among individuals with and without social anxiety disorder (SAD). Eighty-eight participants took part in the study, half (n = 44) met diagnostic criteria for SAD and half (n = 44) did not meet criteria for SAD. Participants completed a 21-day experience sampling measurement (ESM) in which they reported on daily social interactions and emotions. Using multilevel linear modeling we found that individuals with SAD experienced more anger compared to individuals without SAD. We also found a Diagnosis × Social Context interaction such that interactions with distant others were associated with elevated anger compared to interactions with close others for individuals with SAD but not for individuals without SAD. Finally, we found that for individuals with SAD (but not those without SAD) anger on a given day (day t) was associated with elevated anxiety on the following day (day t + 1), above and beyond previous anxiety, sadness and guilt (i.e. anxiety, sadness and guilt reported on day t). This suggests that anger may play a unique role in maintaining or exacerbating anxiety among individuals with SAD. Additional implications of our findings for models of psychopathology and for treatment of SAD are discussed.

Behind the mask: Stuttering, anxiety, and communication dynamics in the era of COVID-19.

While wearing masks during the pandemic poses communication and social challenges for people in everyday life, those with social anxiety might find them plausible, aligning with contemporary cognitive theories. Social anxiety involves fearing negative assessments and holding a negative self-image. Concealing anxiety symptoms during mask use may contribute to a more positive self-perception. Given that up to 60% of adults seeking stuttering treatment also meet criteria for social anxiety disorder, this study aims to investigate the complex relationship between communication freedom, self-perceived stuttering and anxiety in adults who stutter (AWS). The unique context of mandatory mask-wearing during the pandemic provides an opportunity to explore these dynamics and understand the conflicting relationships between stuttering, anxiety-related safety behaviours and the need for open communication in AWS. Twenty AWS participated in interviews, responding to open-ended questions to elucidate their affective, cognitive and behavioural experiences while wearing masks during the COVID-19 pandemic. Thematic analysis was used to identify the emerging themes and subthemes based on information-rich quotes, employing a six-phase recursive process. Various speech and anxiety-related measures were used to describe the characteristics of the study participants. Three main themes and sub-themes emerged. The first theme highlights communication challenges for AWS wearing masks, impacting verbal and nonverbal interactions. The second theme reveals AWS wearing masks to conceal stuttering cues, experiencing reduced stress. The third theme indicates that, despite the comfort in concealment, most AWS prefer speaking freely without a face mask. The conflict between the desire for authentic, fluent communication and the ease of hiding stuttering symptoms poses a major dilemma for AWS. According to the results of this study, most adults who stutter prioritize open communication. However, there were some individual differences. A major factor influencing their decision was their fear of negative evaluation. What is already known on the subject The prevalence of social anxiety is higher among adults who stutter (AWS), possibly stemming from their prior negative experiences with stuttering. In response, AWS may adopt adaptive or maladaptive coping behaviours to manage stuttering and mitigate fears of negative evaluation. Maladaptive strategies, like avoiding certain communication situations, can diminish their satisfaction with everyday speaking situations. What this study adds This study leveraged the mask-wearing mandate during the pandemic to explore the intricate relationship between anxiety-related symptoms and communication. While some participants saw masks as a plausible means to conceal stuttering and anxiety, most preferred open communication without the challenges posed by masks. Our findings offer additional support for the varied emotional, cognitive and behavioural responses that AWS may display in response to changes in daily life, emphasizing the individual differences within this population and highlighting that stuttering goes beyond observable speech dysfluencies. What are the clinical implications of this work? Our study underscores the need for comprehensive therapeutic interventions addressing both the physical and cognitive-emotional aspects of stuttering in AWS. Recognizing the role of safety behaviours and self-focused attention emphasizes the importance of an integrated approach, enhancing communication efficacy and social well-being for AWS. Addressing speech fluency alone, without considering pertinent cognitive-emotional factors, falls short in providing adequate stuttering treatment.

Pride in social anxiety disorder

The present study examined differences in the experience of pride between individuals with and without social anxiety disorder (SAD), and is the first to examine both the effects of context on pride and the temporal relationship between pride and anxiety in participants’ daily lives. Eighty-eight participants took part in the study, half (n = 44) met diagnostic criteria for SAD and half (n = 44) did not. Both groups completed an experience sampling measurement (ESM) to assess the levels of pride and anxiety and the nature of interpersonal contexts in which these emotions were experienced every day for 21 consecutive days. Using multilevel linear modeling, our findings suggest that pride is diminished among individuals with SAD, that situations percieved as highly neagative and positive, or as highly meaningful and positive are associated with the highest levels of pride, and that the experience of pride is associated with subsequent reductions in anxiety among individuals with SAD. These findings point to the role of pride in the disorder and can be used to inform and enhance therapeutic interventions for SAD.

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.

Is There any Difference Between DSM-5 performance-only Specifier and Social Anxiety Disorder? Results from the Young-HUNT3 Study

With the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA, 2013), the diagnostic criteria for social anxiety disorder (SAD) changed; the generalized SAD specifier was removed, and a performance-only specifier was introduced. Despite growing awareness and understanding of the DSM-5 performance-only type specifier, information about its key aspects is lacking. Exploring a large, population-based adolescent sample (N = 8,216), we identified three SAD classes: full spectrum SAD, subclinical SAD, and the performance-only specifier. The three groups were compared across a broad range of parameters. The results indicate that adolescents with the performance-only specifier differed significantly from both the full spectrum and subclinical groups on most clinical indexes. By contrast, the subclinical and full spectrum groups differed less from each other on most parameters. Thus, there were specific aspects of the performance-only specifier group that differentiate this condition from subclinical and clinical SAD in our sample of adolescents. These data indicate that the specifier in the new version of the DSM may be valid in adolescents, and that policymakers and clinicians should not disregard adolescents who show subclinical SAD levels with performance-related challenges. Furthermore, researchers and clinicians should consider the extent to which adolescents with the SAD performance-only specifier may need a different treatment approach.

Associations between resting-state neural connectivity and positive affect in social anxiety disorder.

Social anxiety disorder (SAD) has been characterized by deficits in social motivation and lack of reactivity to pleasurable stimuli (i.e., positive affect; [PA]). Recent neuroimaging work has shifted toward examining positively valenced motivational systems in SAD focused on reward responses. However, little is known about the associations of reward connectivity and PA in individuals with SAD. As such, the purpose of the current study was to determine whether connectivity among key units of reward neurocircuitry meaningfully relate to PA and whether these key units are more heterogeneous in SAD as compared to controls. Thirty-one participants who met diagnostic criteria for SAD and 33 control participants were included (Mage = 24.8, SD = 6.9; 55% cisgender man). Seed-based timeseries correlations were conducted in NiTime to extract region of interest (ROI) coupling correlation strength values. ANOVAs were carried out to assess whether individuals with SAD differed in ROI-to-ROI connectivity strength as compared to controls. Correlations and variance analyses were also conducted to examine the relationship between ROI-to-ROI connectivity strength and PA, as well as heterogeneity in connectivity strength and PA expression. Weaker connectivity between the left and right orbital frontal cortex was observed when comparing the SAD to the control group. Within the SAD group, PA was associated with several reward-related ROI couplings; however, these links were not observed among controls. Results further demonstrated that individuals with SAD had significantly more variability in reward connectivity strength as compared to controls. Overall, these results provide emergent evidence for the association between reward regions and PA in individuals with SAD. Additionally, these findings show that individuals with SAD demonstrate greater heterogeneity in reward connectivity.

Examining the Relations Between Children's Vagal Flexibility Across Social Stressor Tasks and Parent- and Clinician-Rated Anxiety Using Baseline Data from an Early Intervention for Inhibited Preschoolers.

Early behavioral inhibition (BI) is a known risk factor for later anxiety disorder. Variability in children's parasympathetic nervous system (PNS) functioning may provide insight into the substantial heterogeneity in anxiety outcomes for children high in BI. However, gaps persist due to an over-reliance on static measures of functioning, which limits our ability to leverage PNS functioning to identify risk for anxiety. We address these gaps using baseline data from an early intervention study of inhibited preschoolers by characterizing vagal flexibility (VF), an index of non-linear change in PNS functioning, across social stressor tasks and by examining the associations between VF and anxiety. One hundred and fifty-one parents and their 3.5- to 5-year-old children were selected on the basis of BI to participate in an early intervention program (ClinicalTrials.gov registration: NCT02308826). A structural equation modeling framework was used to model children's VF across tasks designed to mimic exposure to novel social interactions and to test the predictive links between VF and anxiety. Children who showed less VF, characterized by less suppression and flatter recovery, were rated by both parents and clinicians as more anxious. Moreover, a multiple group model showed that children meeting diagnostic criteria for social anxiety disorder demonstrated significantly less VF across social stressor tasks. Among inhibited youth, reduced VF is a risk factor for anxiety and may reflect an individual's reduced capacity to actively cope with external demands. Study results contribute to our understanding of the regulatory processes underlying risk for anxiety in early childhood.

Social anxiety disorder in adolescents who stutter: A risk for school refusal.

Stuttering is a childhood-onset fluency disorder. Part of the counseling for middle and high school students with persistent stuttering is related to school refusal. Anxiety disorders are known to contribute to school refusal. However, it is not known whether social anxiety disorder (SAD) is a factor in school refusal among adolescents who stutter. In our first study, we examined the relationship between school refusal and SAD in 84 middle and high school students who stutter; 26% of the 84 students were in the school refusal group and the remaining 74% were in the school attendance group. The second study examined whether SAD was associated with 10 factors related to speech and stuttering frequency using the Japanese version of the Liebowitz Social Anxiety Scale for Children and Adolescents to determine the presence of SAD. Of the 84 students in the first study, 40 participated in the second study. The school refusal group of adolescents who stutter had significantly higher rates of SAD than the school attendance group. Fifty percent of adolescents who stutter met the criteria for SAD. Moreover, adolescents who stutter with SAD had significantly higher scores on the items "When speaking in public, do you experience tremors in your limbs?" and "After you stutter, do you have negative thoughts about yourself?" than the adolescents who stutter without SAD. When examining adolescents who stutter, checking for comorbid SAD may lead to better support. Moreover, noticing their repetitive negative thinking, nervousness, and trembling during speech may help to resolve SAD.

Influence of comorbid social anxiety disorder in PTSD treatment outcomes for Prolonged Exposure in female military sexual trauma survivors with PTSD.

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that frequently presents alongside other comorbid diagnoses. Although several evidence-based psychotherapies have been well-studied for PTSD, limited research has focused on the influence of diagnostic comorbidity on their outcomes. The present study sought to investigate the influence of comorbid social anxiety disorder on treatment outcomes in patients with PTSD. One hundred and twelve treatment-seeking female veteran participants with PTSD completed baseline assessments and received 12-15 sessions of Prolonged Exposure. Symptom measures were completed biweekly as well as at immediate posttreatment, 3-month, and 6-month follow-ups. Thirty (26.8%) participants seeking PTSD treatment also met diagnostic criteria for social anxiety disorder. Multilevel modeling was used to examine effects of social anxiety disorder diagnosis on post-intervention symptoms and revealed significantly worse outcomes for symptoms of PTSD and depression in participants with comorbid PTSD and social anxiety disorder. Consistent with previous studies of co-occurring PTSD and depression, present findings suggest that comorbid diagnoses may adversely affect disorder-specific treatment outcomes. As such, the presence of diagnostic comorbidity may merit further consideration and potential adaptions to the traditional, disorder-specific assessment and treatment practices for PTSD.

Social anxiety in adolescents and young adults from the general population: an epidemiological characterization of fear and avoidance in different social situations

Social Anxiety Disorder (SAD) and, more generally, social fears are common in young people. Although avoidance behaviors are known to be an important maintaining factor of social anxiety, little is known about the severity and occurrence of avoidance behaviors in young people from the general population, hampering approaches for early identification and intervention. Symptoms, syndromes, and diagnoses of DSM-5 mental disorders including SAD were assessed in a random population-based sample of 14-21-year-olds (n = 1,180) from Dresden, Germany, in 2015/2016 using a standardized diagnostic interview (DIA-X-5/D-CIDI). An adapted version of the Liebowitz Social Anxiety Scale was used to ascertain the extent of social fears and avoidance. Diagnostic criteria for lifetime SAD were met by n = 82 participants, resulting in a weighted lifetime prevalence of 6.6%. Social anxiety was predominantly reported for test situations and when speaking or performing in front of others. Avoidance was most prevalent in the latter situations. On average, anxiety and avoidance first occurred at ages 11 and 12, respectively, with avoidance occurring in most cases either at about the same age as anxiety or slightly later. In the total sample, lifetime prevalence for most DSM-5 disorders increased with the severity of social anxiety and avoidance. Results underline the need for preventive or early intervention efforts especially regarding test anxiety and fear and avoidance of speaking in front of others. These situations are particularly relevant in youth. Avoidance behaviors may also be discussed as diagnostic marker for early case identification.

‘It’s Nothing Serious I Suppose’ Family Help-Seeking for Adolescent Social Anxiety

This article investigates how families seek professional supports for adolescent social anxiety. Many adolescents meet diagnostic criteria for social anxiety disorder but do not access professional mental health supports. Access to timely interventions is important because social anxiety has a range of developmental implications and typically persists into adulthood when untreated. Twelve adolescents (aged 14 to 18) who had attended mental health services for support with social anxiety and 13 mothers of such adolescents participated in semi-structured interviews which were analysed thematically. Findings indicated that mothers play an important role in noticing difficulties and initiating help-seeking for their children, although adolescents and their mothers can initially view anxiety as ‘just shyness’ and often seek help for a range of difficulties, including unhappiness, rather than anxiety specifically. Furthermore, many adolescents described experiencing help-seeking as embarrassing or shameful. Implications for facilitating families to access professional supports for adolescents are discussed.

An Interpersonal Approach to the Treatment of Social Anxiety Disorder (Social Phobia): A Component Analysis.

Most treatments of social anxiety disorder aim at anxiety reduction. To what extent this leads to improved social functioning remains unclear. An effective alternative aiming primarily at social functioning- the Interpersonal Approach- is available. The present study sought to identify its active ingredients. This is a randomized controlled study; 102 social anxiety disorder individuals were randomly assigned to 3 versions of the Interpersonal Approach. A total of 76 patients completed treatment and 67, a 1-year follow-up. The patients met Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for social anxiety disorder. The study was carried out in an experimental clinic for the treatment of social anxiety disorder at the Research Center of Louis-H. Lafontaine Hospital in Montreal, Canada. No clinically meaningful change occurred during the waiting list. A significant and equivalent improvement was obtained in all treatment conditions in social functioning, anxiousness, and general psychopathology, maintaining over a 12-month follow-up. Remission rates improved progressively with 54% remission at 1-year follow-up. All variants of the Interpersonal Approach resulted in similar improvements. The Interpersonal Approach in all its versions has proved to be effective in reducing anxiety complaints and improving social functioning. The combined improvement in these 2 outcomes accounts for the significant remission rates seen at 1-year follow-up. Two active features were common to all: (1) targeting and ultimately dissolving long-standing habits of self-protection across various spheres of life and (2) fostering participatory interpersonal patterns of behavior, enacted by patients systematically and repeatedly between sessions.

Social anxiety disorder in adolescents: Prevalence and subtypes in the Young-HUNT3 study

BackgroundFew studies have examined the prevalence of social anxiety disorder (SAD) among adolescents and the associated sex-specific fears. No previous studies have reported variance in SAD prevalence among adolescents based on a stepwise diagnostic approach. MethodsUsing various diagnostic thresholds from the Anxiety Disorders Interview Schedule child version, and the diagnostic criteria from both the 4th and 5th editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), we explored the point prevalence of SAD among a population-based sample of 8216 adolescents aged 13–19 years. ResultsOverall, 2.6% of adolescents met the SAD diagnostic criteria. The prevalence varied from 2.0% to 5.7% depending on the criteria-set. Twice as many females met the overall SAD criteria. The DSM-IV generalized SAD subtype was assigned to 86.5% of the sample, while 3.5% met the DSM-5 performance-only subtype. Compared with males aged 16–19 years, significantly more of those aged 13–15 years met the SAD criteria; no significant age group differences were found among females. ConclusionsThis is the first study to demonstrate variance in SAD prevalence among adolescents based on the diagnostic threshold method. Depending on the threshold applied, SAD prevalence among adolescents varied from 2.0% to 5.7%. Age and sex differences in social fear experiences highlight the importance of considering developmental heterogeneity in SAD, especially for adapting prevention and treatment interventions.

GAD: Over-reactive and unstable mood

• Generalized Anxiety Disorder (GAD) consists of an over-reactive and/or unstable mood that could be mistaken with mood swings and affective instability of bipolar disorder and borderline personality disorder. • Recognition of the over-reactive and/or unstable mood in GAD has significant clinical implication not to be misdiagnosed as bipolar disorder or borderline personality disorder that occurred in our research sample. • Inclusion of over-reactive and/or unstable mood in the next DSM edition as cardinal diagnostic criteria symptoms is a step towards a more comprehensive understanding of this very common psychiatric condition. We sought to clarify if over-reactive mood in Generalized Anxiety Disorder (GAD) could be misdiagnosed as mood swings of Bipolar Disorder, or with affective instability in Borderline Personality Disorder. We re-assessed 32 subjects who were referred to our clinic in 2020 and had been previously diagnosed with Bipolar and Borderline Personality Disorders, as they seem to fit more the diagnostic criteria of Generalized Anxiety Disorder (GAD), based on the structured clinical interview for DSM5 (SCID-DSM5) and our previously published general definition of this disorder. All the subjects met the DSM5 criteria of GAD and presented with excessive anxiety and worry lasting more than 6 months in different situations or spontaneous with no triggers, leading to dysfunctions in social, occupational, or any other important areas of the individual's life. The subjects also met our general definition of GAD and met the DSM5 diagnostic criteria for Social Anxiety Disorder, Panic Disorder and Major Depressive Disorder. Moreover some of these subjects had an over-reactive mood that was subjectively labeled by themselves as “mood swings”, but without any discreet hypomanic or manic episodes. Some of the subjects also described their mood as "unstable" that had led their previous clinicians with mislableing them with "affective instability" leading to the misdiagnosis of Borderline Personality Disorder. The result of the study showed that the over-reactive mood in GAD could simply by the patients be interpreted as mood swings and when reported to the physicians, diagnosed as Bipolar Disorder. In the same token the unstable mood in GAD could be taken as affective instability by the patients and the physicians, leading to the misdiagnosis of Borderline Personality Disorder. Other than mood over-reactivity and unstable mood in this sample that led their previous misdiagnoses with Bipolar and Borderline Personality Disorders, they were all presented with the symptoms of GAD like others without over-reactive and unstable mood. The findings of our present adds a new symptom of over-reactive mood in GAD that could be easily misinterpreted as mood swings and affective instability and misdiagnosed as Bipolar and Borderline Personality Disorders.

50.1 Additional, Alternative Avoidant Cluster Symptoms for the Diagnosis of PTSD in Children

This study sought to explore developmentally sensitive avoidant cluster symptoms for children. Abused children (N = 119; mean age = 9.96 years; SD = 1.67) were recruited in a southern state; 65.5% were female, 68.9% were White, and 31.1% were Black. Data were collected in an NIMH study (5-RO1MH49784-04). Informed consent and assent were completed by parents and children. The Abuse Dimensions Inventory (ADI) measures severity of physical and sexual abuse. Data collection for this NIMH study began prior to the release of the DSM-IV, so the Diagnostic Interview for Children and Adolescents—Revised (DICA-R) was utilized for the assessment of PTSD and social anxiety disorder (SAD). The Child Dissociative Checklist (CDC) is a screening measure to access dissociative symptoms based on ratings by caregivers. The CDC mean was 6.93 (SD = 6.54). For the creation of developmentally sensitive, avoidant symptoms, using the DICA-R, if a parent endorsed symptoms that met the criteria for SAD, then the diagnosis of SAD was counted as one avoidant symptom. For dissociation, the CDC was used with a cutoff greater than 12 to establish an alternative avoidant symptom. Of the 119 children, the percentage meeting the threshold set by DSM-III-R was identified for each cluster based on child and parent interviews: Reexperiencing (child: 84.9%; parent: 67.2%); Arousal (child: 84.9%; parent: 66.3%); Avoidance (child: 76.5%; parent: 58.1%); and Positive Diagnosis (child: 62.2%; parent: 31.1%). The percentage of children meeting the threshold of 3, but using the 2 additional symptoms (SAD and CDC) as developmental equivalents for avoidance, was identified based on child and parent interviews: Child PTSD (child: 66.7%; parent: 43.9%); Child PTSD + SAD (child: 78.2%; parent: 53.6%); Child PTSD + CDC (child: 78.0%; parent: 56.0%); Child PTSD + SAD + CDC (child: 89.5%; parent: 75.7%). The developmentally sensitive avoidant criteria resulted in higher rates of PTSD. It is plausible that clinging to a safe parent served the function of reducing distress (reexperiencing and arousal). Similarly, dissociative symptoms may reduce distress. The study limitations included: 1) it was a retrospective analysis of study data that used DSM-III-R criteria; 2) it was conducted in one southern state; and 3) variables used for alternative SAD and dissociative symptoms were available in a subset (N = 66) of the sample.

Do stigma and level of social anxiety predict adolescents' help-seeking intentions for social anxiety disorder?

Many adolescents meeting diagnostic criteria for social anxiety disorder (SAD) do not seek help or access timely professional supports. The current study investigated two hypothesized barriers to adolescents' seeking help for SAD: stigma and SAD symptoms. Three hundred fifteen adolescents (52% female; mean age=14.85 years) read a vignette describing a hypothetical peer with symptoms of SAD and completed measures of their own help-seeking intentions, SAD symptoms, stigma awareness and agreement. The majority of adolescents reported that the vignette character needed help. Adolescents with more SAD symptoms, and those with greater stigma awareness, were less likely to indicate they would seek help from an adult they know (e.g., parent or teacher) for similar symptoms. Both SAD symptoms and perceptions of societal stigma may act as barriers to help-seeking for young people indicating the importance of intervention with young people, and the adults with whom they interact regularly.

Subjective distress and physiological reactivity during anxiety-evoking imagery in social anxiety

Anxiety disorders differ in the association between subjective distress and physiological reactivity towards threat. For some anxiety disorders, like Social Anxiety Disorder (SAD), the relationship among emotion responses remains unclear. The current study examines how different components of subjective distress relate to autonomic arousal (Heart Rate, Skin Conductance Levels) and behavioural expressions (startle reflex, corrugator activity) in individuals with SAD symptoms and healthy controls. Thirty-one participants fitting clinical criteria for SAD and 48 healthy controls imagined four types of anxiety-evoking situations (panic, GAD, SAD and animal phobia), while we measured their physiological reactivity. Participants rated the unpleasantness, arousal and fear they experienced during each script. Results showed that the groups did not differ substantially in physiological or subjective responding to anxious imagery, although the SAD group tended to report more fear across scripts. For socially anxious individuals higher Skin Conductance Levels were associated with higher perceived arousal across scripts, but not for controls. Current findings indicate a positive association between perceived and autonomic arousal in individuals with SAD, when imagining anxious situations. This may reflect better perception of bodily signals in social anxiety under certain conditions.

Treating Childhood Social Anxiety Disorder With Virtual Environments and Serious Games: A Randomized Trial

Disseminating efficacious psychological treatments remains a challenge for researchers and clinicians. In the case of social anxiety disorder (SAD), Social Effectiveness Therapy for Children (SET-C) has been demonstrated as an efficacious intervention, but elements of the protocol, such as peer generalization sessions, remain challenging to conduct in typical clinical settings. To address this need, we developed an artificially intelligent, web-based application, Pegasys-VR™, designed to replace peer generalization sessions and enhance homework compliance. The feasibility of Pegasys-VR™ was tested in a randomized controlled trial in comparison to SET-C. The results indicated that both programs were equally efficacious in decreasing anxiety and improving social skill in social encounters. Sixty-three percent (63%) of children treated with SET-C and 60% treated with Pegasys-VR™ did not meet diagnostic criteria for SAD at posttreatment. Pegasys-VR™ is a feasible, efficacious, and dissemination-friendly element of a comprehensive treatment program for social anxiety disorder in children.

Screening for Adolescent Social Anxiety: Psychometric Properties of the Severity Measure for Social Anxiety Disorder.

Social anxiety disorder (SAD) is a debilitating disorder that emerges during adolescence and confers a significant burden on interpersonal functioning. Currently available diagnostic interviews are lengthy and generally require clinically-trained experts to administer. Consequently, the identification of clinically valid self-report measures of social anxiety is necessary for streamlining assessment processes and routine outcome monitoring of adolescent social anxiety symptoms. Accordingly, the present study establishes the psychometric properties and predictive utility of the Severity Measure for Social Anxiety Disorder (SMSAD). Participants included 58 adolescents between 12 and 16years of age who met diagnostic criteria for SAD. In addition to the SMSADand other self-report measures, clinician and parent reports were obtained. Findings support the reliability and validity of the SMSAD, and highlight the clinical utility of this measure in comparison to previously validated measures of social anxiety. Overall, results indicate that the SMSAD is a valid and reliable measure for assessing and routinely tracking social anxiety symptoms in adolescents.

Aspectos neuropsicológicos de universitários com ansiedade social

O Transtorno de Ansiedade Social (TAS) é definido por um padrão acentuado de alarme, medo e desconforto desencadeado pela exposição a situações nas quais o indivíduo deve interagir, realizar tarefas sob a avaliação de outras pessoas ou engajar-se em atividades sociais. O presente estudo teve como objetivo caracterizar o perfil clínico e neuropsicológico de universitários com sintomas de ansiedade social. Trata-se de uma pesquisa do tipo caso-controle realizada em três etapas: 1) utilizou-se a Escala de Ansiedade Social de Liebowitz (LSAS) como instrumento de rastreio da prevalência dos sintomas na amostra estudada; 2) os participantes responderam a Entrevista Clínica Estruturada para os Transtornos do DSM-5 (SCID-5), a fim de coletar dados que corroborassem os critérios diagnósticos para o TAS; 3) os grupos caso e controle foram avaliados em termos de desempenho cognitivo por meio de uma bateria de testes neuropsicológicos computadorizados. Observou-se que o grupo caso obteve um escore total médio de 72,91 na LSAS, ao passo que o grupo controle obteve uma média de 49,42 pontos na escala. No que se refere ao desempenho cognitivo, foi possível corroborar os achados da literatura científica que apontam para prejuízos decorrentes do Transtorno de Ansiedade Social em funções neuropsicológicas específicas, como a atenção seletiva, habilidades visuoespaciais e de resolução de problemas complexos.