Interpersonal Fear Research Articles

Reducción del miedo al entorno sanitario en niños usando espacios simulados: un ensayo controlado aleatorizado

PurposeThis study aimed to evaluate the effectiveness of an intervention that involved interactions within a simulated health care space to reduce medical fear among children in infant classes. MethodsAn experimental study involving 86 children divided into an intervention group and a control group with pre- and postintervention measurements was undertaken. The intervention, known as the Health-Friendly Program, consisted of showing children various scenarios that simulated different medical contexts so that they could interact in them, experiment with the materials and ask questions. Medical fear was evaluated using the Spanish version of the revised «Child Medical Fear Scale», which provides a score of the medical fear level ranging between 0 and 34 points. The pretest and posttest levels of medical fear in the intervention and control groups were compared with Student's t test. ResultsThe children in the intervention group experienced a significant reduction in fear by 3.21 points (SD: 6.50) compared to the children in the control group. This reduction in fear was shown in all four dimensions of the scale: intrapersonal fears, procedural fears, environmental fears and interpersonal fears. ConclusionThe Health-Friendly Program provides an innovative intervention to reduce medical fear among children based on information, confrontation strategies and simulation scenarios. This study suggests the potential benefit of incorporating educational interventions in schools in collaboration with university and health care simulation centers.

Does social empathy moderate fear-induced minority blaming during the COVID-19 pandemic?

This study investigated the minority-blaming phenomenon in South Korea during the COVID-19 pandemic. The pandemic amplified fear, discrimination, and structural inequalities among minoritized groups during the COVID-19 pandemic. This study identified who was blamed for the spread of COVID-19 and the sociodemographic characteristics associated with this blame. Additionally, it examines the roles of individual and interpersonal fear and social empathy in minority blaming. We measured the fear of COVID-19 at both individual and interpersonal levels. Individual fear was assessed through personal health concerns, while the fear of transmitting the virus to others was measured as interpersonal fear. Social empathy was defined by macro perspective-taking, cognitive empathy, self-other awareness, and affective responses. The study was conducted through an online survey involving a quota sample of 1,500 South Korean participants aged 19–69 years, based on age, gender, and residential area. The response was collected in December 2020, when mass infections in specific communities received attention from mass and social media before the national spread of the COVID-19 pandemic. Analytical strategies, including OLS and hierarchical regression models, were employed to examine the roles of socioeconomic factors, individual and interpersonal fear, and social empathy in minority blaming. This study found varying correlations between sociodemographic factors and attitudes toward ethnic, religious, sexual, economic, and age-minority groups. Individual fear of contracting COVID-19 was associated with increased blame across all minority groups. In contrast, interpersonal fear was associated with increased blame only for ethnic and religious minority groups. Similarly, social empathy presented mixed associations, as it displayed a buffering role on blaming ethnic, religious, and sexual minorities when considered alongside interpersonal fear, yet mildly intensified blame for economic and age minorities. These findings provide an understanding on fear-induced minority blaming during the pandemic and the potential role of social empathy in mitigating blame.

Interpersonally-Based Fears and Problematic Social Networking Site Use: The Moderating Role of Online Social Support

Within the Compensatory Internet Use Theory (CIUT) framework, online activities may compensate for psychosocial problems. However, those who attempt to satisfy their needs or mitigate their fears via Social Networking Sites (SNSs) may be at heightened risk for problematic use of SNSs (PSNSU), especially in cases when these fears have an interpersonal basis, and the individual effectively finds online social support. The current study hypothesizes that interpersonally-based fears (i.e., fear of no mattering, fear of intimacy, and fear of negative evaluation) predict PSNSU, and online social support moderates these associations. Four hundred and fifty Italian participants (Mage = 27.42 ± 7.54; F = 73.5%) take part in the study. As examined by path analysis, the three interpersonal fears were positively associated with PSNSU, and online social support significantly moderates the relationship between fear of negative evaluation and PSNSU. The model accounted for 19% of the variance of PSNSU and showed good fit indices. The associations' strengths decrease as age increases. Overall, the current study finds further support for the theory that motivations need to be taken into account when it comes to internet uses (i.e., CIUT) and extends our understanding by highlighting that online social support might reinforce the link between the fear of being negatively evaluated and PSNSU.

Preference of online friends over face-to-face friends: Effect of interpersonal fears on online relationship building preference

The emergence of online social networking has increased development of exclusively online friendships. Individuals in online environments are willing to invest considerable time and effort to develop and maintain relationships as they would in other gathering spaces. In some cases, individuals find it preferable to make friends via the internet over more traditional means of relationship formation. The current study examines preference for online friends over face-to-face friends. Initially, we developed a brief, one-dimensional, 11-item questionnaire assessing online friendship preference based on semi-structured interviews. Confirmatory factor analysis showed support for a one-factor model. Internal consistency was established using inter-item correlation, corrected item-total correlation, and Cronbach’s α. Subsequently, we examined the psychological determinants and consequences of preference for online friendship formation. Participants who reported higher fear of intimacy and perceived relationship vulnerability reported greater preference for online friends over face-to-face friends. Preference for online friendship was related to increased risk of problematic internet use. The findings suggest that interpersonal fears, combined with attributes of online communication (e.g., reduced social cues and more personal control) motivate some individuals to prefer online intimacies over face-to-face friendships, thereby increasing time spent online.

Fear of Cancer Recurrence: Lived Experiences of Cancer Survivors’ Spouses

Fear of cancer recurrence is the most prevalent and burdensome emotional concern among cancer survivors’ spouses after treatment. This qualitative study aimed to disclose, what are cancer survivors’ spouses lived experiences of fear of cancer recurrence. Seven adult spouses were explored. Data were obtained using a semi-structured interview and analyzed by inductive thematic analysis. Analysis revealed that fear of cancer recurrence is interpersonal experience and fear transmits in a couple. The spouses associate cancer recurrence with death and risk of losing their spouse. The threat of cancer recurrence triggers not only the feelings of insecurity, uncertainty about the future and loss of control, but also appreciation of life. Planning and control, religiosity, avoidance and awareness of fear helped spouses to reduce concerns about relapse. Interventions for spouses should focus on promotion of emotional expression of cancer recurrence concerns, also learning to accept and tolerate uncertainty.

STAI-Anxiety and STAI-Depression Revisited

Abstract. The State-Trait Anxiety Inventory (STAI) is widely used to measure anxiety in academic, psychiatric, and medical settings. However, it has been proposed that the trait scale does not measure pure anxiety but contains subscales that measure either anxiety or depression. As this may have implications for the interpretation of research, we investigated the differential correlates of these two subscales. Participants ( N = 171; Mage = 23.6 years) completed measures of attentional control (attentional focusing; attentional shifting), behavioral approach sensitivity (BAS), trait anger, and interpersonal fear. STAI-anxiety was predicted by interpersonal fear, and trait anger when STAI-depression was held constant. By contrast, STAI-depression was predicted by BAS and attentional shifting when STAI-anxiety was held constant. To further illustrate the functional significance of these results, we reanalyzed a published study that originally showed that total STAI scores predicted affective cognitive control in the emotional face Stroop task. Results showed that STAI-anxiety and STAI-depression differentially predicted the cognitive control of distraction. The significance of our results is discussed in relation to interpreting the STAI in academic and neuropsychiatric/clinical settings.

A longitudinal examination of the interpersonal fear avoidance model of pain: the role of intolerance of uncertainty.

Youth with chronic pain and their parents face uncertainty regarding their diagnosis, treatment, and prognosis. Given the uncertain nature of chronic pain and high comorbidity of anxiety among youth, intolerance of uncertainty (IU) may be critical to the experience of pediatric chronic pain. This study longitudinally examined major tenets of the Interpersonal Fear Avoidance Model of Pain and included parent and youth IU as key factors in the model. Participants included 152 youth with chronic pain (Mage = 14.23 years; 72% female) and their parents (93% female). At baseline, parents and youth reported on their IU and catastrophic thinking about youth pain; youth reported on their fear of pain, pain intensity, and pain interference; and parents reported on their protective responses to child pain. Youth reported on their pain interference 3 months later. Cross-lagged panel models, controlling for baseline pain interference, showed that greater parent IU predicted greater parent pain catastrophizing, which, in turn, predicted greater parent protectiveness, greater youth fear of pain, and subsequently greater youth 3-month pain interference. Youth IU had a significant indirect effect on 3-month pain interference through youth pain catastrophizing and fear of pain. The results suggest that parent and youth IU contribute to increases in youth pain interference over time through increased pain catastrophizing, parent protectiveness, and youth fear of pain. Thus, parent and youth IU play important roles as risk factors in the maintenance of pediatric chronic pain over time and may be important targets for intervention.

Parent physical and mental health contributions to interpersonal fear avoidance processes in pediatric chronic pain.

Theoretical models and evidence increasingly identify chronic pain as a family issue. To date, much of this work has focused on risk conferred by parental chronic pain status despite evidence suggesting parent mental illness and non-pain-related chronic illness may also contribute to poorer chronic pain outcomes in children. This study is the first to test interpersonal fear avoidance processes as possible mechanisms through which parent health (mental and physical) influences pediatric chronic pain functioning. We used structural equation models to test such an integrative model using cross-sectional data from a large clinical registry of 448 dyads of patients aged between 8 and 18 years (M = 14.57 years; SD = 2.38; 327 females) with mixed chronic pain and their parents (403 mothers). As expected, poorer parent global health was indirectly related to greater child pain interference through higher parent pain catastrophizing, and then through greater parent protective behaviors and child pain catastrophizing. The model demonstrated excellent fit to the data (χ[5] = 5.04, ns; χ/df = 1.01; comparative fit index = 1.00, root mean square error of approximation = 0.004 [90% confidence interval = 0.000 to 0.066]). Exploratory multiple-group comparison structural equation model revealed moderation of specific model paths based on child age group (8- to 12-year-olds vs 13- to 18-year-olds) and parent pain status (present vs absent). This study integrates family models of pain with the interpersonal fear avoidance model to extend our mechanistic understanding of parental physical and mental health contributors to pediatric chronic pain.

Influence of the self-evaluation of social skills and affinity motivation against interpersonal fear

Influence of the self-evaluation of social skills and affinity motivation against interpersonal fear

Do interpersonal fears mediate the association between childhood maltreatment and interpersonal skills deficits? A matched cross-sectional analysis

Objective: Childhood maltreatment, interpersonal fear and a specific kind of interpersonal skills deficit (preoperational thinking) have all been associated with persistent depressive disorder (PDD). We hypothesize that interpersonal fears mediate the association between childhood maltreatment and preoperational thinking.Method: A total of 108 matched participants have been examined cross-sectionally (31 healthy controls, 30 patients with episodic depression and 47 patients with PDD) with the following instruments: the Childhood Trauma Questionnaire (CTQ-SF), a measure of interpersonal fear (CBASP Interpersonal Questionnaire) and the Lübeck Questionnaire of Preoperational Thinking.Results: Patients with PDD reported significantly more childhood maltreatment than patients with episodic depression (d = 0.65) and healthy controls (d = 1.29). They also had more interpersonal fears (d = 0.71 and d = 2.11 respectively) and higher levels of preoperational thinking (d = 0.90 and d = 2.78 respectively). The association between childhood maltreatment and preoperational thinking was mediated through interpersonal fears.Conclusions: Our findings might have important implications for psychotherapy of PDD because they demonstrate how specific problems in social interactions can be associated with interpersonal fears that arise secondary to childhood maltreatment.

Investigation and Education Practice on Nurse Mental Health

Mental health is a dynamic balance. Generalized mental health is a kind of status that is efficient and satisfactory to the environment with the rapid development of science and technology and the continuous improvement of social material living standard, mental health is getting more and more attentions extensively. The characteristics of the nursing work causes high intensity stress state, not only induce to fatigue but also affects mental health. Objective: To understand the clinical nurses’mental health condition, and perform different forms of mental health education practice accordingly. Method: The symptom self-assessment scale (SCL-90) was used to investigate among 704 clinical nurses. Results: Except interpersonal sensitivity factor, the somatization, force, depression, anxiety, fear, hostility, paranoid, psychotic factor, and total average score of SCL-90 of nurse were higher than that of domestic norm and the female norm (P＜0. 01). The positive statistical indicators of force, interpersonal sensitivity and depression factor were relatively high. Conclusion: The high strength work pressure have serious impact on the clinical nurses’ mental health, managers must attach great importance to it and actively take countermeasures. Nurses also need to strengthen self-consciousness of mental health and learn self-management methods. The overall mental health level in nurse group is very important in hospital. To receive this target, hospitals should establish an external operating mechanism to allow nurses to accept continuous psychology health education and counseling.

Effects analysis of risks grading nursing on emotion and BRS score influencing factors in patients with acute upper gastrointestinal bleeding

Objective To analyze the effects of risks grading nursing on emotion and Blatchford risk score system (BRS) influencing factors in patients with acute upper gastrointestinal bleeding. Methods A total of 93 patients with acute upper gastrointestinal bleeding in the Wuxi No.2 People′s Hospital from March 2013 to July 2015 were randomly admitted to either observation group (n=45 ) or control group (n=48). The patients of control group adopted routine nursing and the patients of observation group received risk grading nursing. The two groups were given positively nursing intervention. Before and after intervention, the scores of symptom checklist and BRS were compared between the two groups. Results After the interventions, there were significant differences in interpersonal relationship, somatic, depression, anxiety, fear, nervousness and total average score between the two groups (all scores of observation group<all scores of the control group) (P<0.05). The percentage of patients with BRS<6 in the observation group (73.33%, 33/45) was more than that in the control group (52.08%, 25/48) (χ2=4.469, P<0.05). Conclusions Taking risks grading nursing has important significance for alleviating the negative emotions of patients with upper gastrointestinal bleeding and reducing the patient BRS score. Key words: Acute upper gastrointestinal bleeding; Grading nursing; Emotion; Blatchford risk score system

Fear conditioning induced by interpersonal conflicts in healthy individuals.

Psychophysiological markers have been focused to investigate the psychopathology of psychiatric disorders and personality subtypes. In order to understand neurobiological mechanisms underlying these conditions, fear-conditioning model has been widely used. However, simple aversive stimuli are too simplistic to understand mechanisms because most patients with psychiatric disorders are affected by social stressors. The objective of this study was to test the feasibility of a newly-designed conditioning experiment using a stimulus to cause interpersonal conflicts and examine associations between personality traits and response to that stimulus. Twenty-nine healthy individuals underwent the fear conditioning and extinction experiments in response to three types of stimuli: a simple aversive sound, disgusting pictures, and pictures of an actors’ face with unpleasant verbal messages that were designed to cause interpersonal conflicts. Conditioned response was quantified by the skin conductance response (SCR). Correlations between the SCR changes, and personality traits measured by the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) and Revised NEO Personality Inventory were explored. The interpersonal conflict stimulus resulted in successful conditioning, which was subsequently extinguished, in a similar manner as the other two stimuli. Moreover, a greater degree of conditioned response to the interpersonal conflict stimulus correlated with a higher ZAN-BPD total score. Fear conditioning and extinction can be successfully achieved, using interpersonal conflicts as a stimulus. Given that conditioned fear caused by the interpersonal conflicts is likely associated with borderline personality traits, this paradigm could contribute to further understanding of underlying mechanisms of interpersonal fear implicated in borderline personality disorder.

Fears of school-age children and parental perceptions of nursing support during hospitalization in a selected pediatric hospital, Mangalore

Background: A child's hospitalization is usually an unpleasant and difficult experience, both for the child and parents. Unfamiliarity of the environment, uncertainty regarding outcomes, and painful procedures are just a few stressors during hospitalization that can create overwhelming anxiety for children and their parents. Objectives: The objectives of the study were to assess the fears of school-age children during their hospitalization, assess parental perceptions of nursing support during their child's hospitalization, and to find association between children's fear and selected variables. Materials and Methods: To accomplish the objectives of the problem under study, nonexperimental typical descriptive design was adopted. The study was conducted in Regional Advanced Pediatric Care Center, Mangalore with the sample size of 60 hospitalized school-age children and their parents. Non-probability purposive sampling technique was used to select the sample. The researcher used background proforma for children and parents, Modified Child Medical Fear Scale and Modified Nurse Parent Support Tool to collect data from hospitalized school-age children and their parents, respectively. The tools were assessed for their reliability with the similar sample and found reliable. Informed consent was obtained from the study subjects. Results: Majority of the school-age children (91.67%) had moderate fear and 8.33% had high fear of hospitalization. Majority (70%) of parents have perceived fully satisfactory nursing support and 30% were satisfied with nursing support provided during their child's hospitalization. There was no significant association between the fears and selected demographic variables such as age of the child, gender, number of days of hospitalization, and previous experience of hospitalization. There was no significant difference between the fears in different age-groups of hospitalized school-age children to the different areas of fear in the hospital, i.e., environmental, procedural, interpersonal, and intrapersonal fears. Conclusion: Nurses should encourage children to express their fears and discuss their coping strategies. Nurses can promote the quality of family-centered care and should be aware of the importance of the several types of nursing support in meeting the requests of parents.

Taijin Kyofusho and Social Anxiety and Their Clinical Relevance in Indonesia and Switzerland

Background: Taijin Kyofusho Scale (TKS) is an interpersonal fear to offend others and is defined by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a culturally bound syndrome that occurs in Japan and Korea. Recently, cases with TKS have also been recognized in other cultures. The present questionnaire study investigated self-report TKS symptoms and social anxiety symptoms, and their clinical relevance in an Indonesian and Swiss sample. It also investigated whether self-construal is associated with TKS and social anxiety, and if self-construal is a mediator of the expected association between cultural background and social anxiety and TKS symptoms.Method: 311 Indonesian and 349 Swiss university students filled out the Liebowitz Social Anxiety Scale, the Taijin Kyofusho Scale, the Self-Construal Scale, self-report social phobia DSM-IV criteria, and rated their wish for professional help to deal with social fears.Results: TKS and social anxiety symptoms were higher in the Indonesian than the Swiss sample. TKS symptoms were associated with clinical relevance in Indonesia, whereas in Switzerland only social anxiety symptoms were associated with clinical relevance. Independent self-construal was negatively associated and interdependent self-construal was positively associated with TKS and social anxiety symptoms. Interdependent self-construal mediated the association between cultural background and these symptoms.Discussion: TKS might be a clinically relevant syndrome in all individuals or cultures with an interdependent self-construal or less independent self-construal. The proposal to include the fear of offending others in the DSM-V criteria of social phobia is supported by the present findings.

Le cinéphile : réflexions sur le traitement d’un trouble de personnalité schizoïde

While treatment of personality disorders in general is often described as difficult and filled with many obstacles, knowledge is still limited regarding the specific treatment challenges for DSM's Cluster A individuals. The purpose of this paper is to explore these challenges, as illustrated by the case study of a schizoid patient who underwent psychodynamic therapy for over a year. Deep and unconscious interpersonal fears that complicated treatment, and how these fears had to be taken into account in therapeutic interventions, will be explored. Strong countertransference reactions, especially those evoked by long silences and constant management of optimal therapeutic distance, will also be discussed. This paper also proposes some reflections on the limitations of DSM's conceptualization of the schizoid personality disorder, and how a dynamic understanding of relational fears and ambivalence in these patients may be crucial to treatment.

Adolescents’ impulse buying: Susceptibility to interpersonal influence and fear of negative evaluation

We examined the effects of susceptibility to interpersonal influence and fear of negative evaluation on adolescents’ impulse buying tendency. A survey of 453 adolescents was carried out and we found the greater the susceptibility to interpersonal influence, the greater the tendency to buy on impulse. Likewise, the greater the fear of negative evaluation, the greater the impulse buying tendency.

Posttraumatic stress and social anxiety: the interaction of traumatic events and interpersonal fears

Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) are frequently comorbid among veteran and community samples. Several studies have demonstrated significant comorbidity between trauma, PTSD, and social anxiety (SA), and a growing number of studies have explored the nature of this association. Although a diagnosis of either PTSD or SAD alone can result in significant impairment in social and occupational functioning, these difficulties are often magnified in persons suffering from both disorders. This review describes the current state-of-the-art regarding the co-occurrence of trauma, PTSD, and SA. First, we provide an overview of empirical data on the prevalence of co-occurring trauma, PTSD, and SAD. Second, we describe possible explanatory models of the co-occurrence, with a specific focus on the shared vulnerability model. Third, we review the available empirical data addressing the postulates of this model, including both genetic and psychological vulnerabilities. Fourth, we describe additional factors-guilt, shame, and depressive symptoms-that may help to explain the co-occurrence of PTSD and SA. A better understanding of this complex relationship will improve the efficacy of treatment for individuals suffering from both disorders. We conclude with key areas for future research.

Interpretation of positive social events in social phobia: An examination of cognitive correlates and diagnostic distinction

Research suggests that individuals with social phobia fear positive social events and interpret them in a negative fashion that serves to maintain anxiety. To better elucidate the nature and role of interpretation of positive events in social phobia, two studies were conducted. Study 1 examined symptom and cognitive correlates of negative interpretation of positive social events. Participants with DSM-IV diagnosed generalized social phobia (GSP) completed a measure of interpretation of positive social events (IPES) in relation to a range of symptom and cognition measures of social anxiety. Results indicated that perfectionism and a measure tapping interpersonal fears associated with social anxiety were significantly predictive of IPES scores. Study 2 examined IPES scores in clinical participants with GSP, obsessive compulsive disorder (OCD), panic disorder with or without agoraphobia (PD/A), generalized anxiety disorder (GAD), and non-anxious controls. Results indicated that individuals with GSP scored higher on the IPES than those with PD/A, GAD and controls, but did not differ from OCD. These findings suggest that negative interpretation of positive events is a distinct and characteristic feature of social phobia with significant associations with other cognitive risk factors for the disorder.

EEG, biochemical and psychometric concomitants of individual differences in selective attention to masked emotional faces

Previous psychometric studies using a visual search task suggested that interpersonal fear in individuals with social anxiety disorder (SAD) may be processed by unconscious preattentive mechanisms. However, little is known about relationships between social anxiety and preattentive emotional responses. We explored whether social anxiety is associated with preattentive emotional responses to facial expression. Groups with high and low social anxiety were selected from 125 healthy volunteers according to scores on the Social Phobia Inventory. Fearful and happy faces were presented subliminally using backward masking, with skin conductance responses (SCRs) being measured as an autonomic index of emotional responses. SCRs to these two facial expressions were compared between groups. The group with high social anxiety showed significantly greater differences in SCRs between masked fearful and happy faces than the group with low social anxiety. Social anxiety was associated with unconscious autonomic responses to fearful faces. A preattentive interpersonal threat evaluation system may be an important factor in SAD.