Measures Of Social Anxiety Research Articles

Bivalent Fears of Evaluation in Social Anxiety: Evaluation of an Extended Psychoevolutionary Model

Fears of negative evaluation (FNEs) and fears of positive evaluation (FPEs) comprise a bivalent model of evaluation that can explain the aetiology and maintenance of Social Anxiety Disorder (SAD). In this study, we examined an extended version of this model which incorporates two related cognitive processes (concerns about reprisal and discounting of positive outcomes) as partial mediators of the effects of FNEs and FPEs. We built on earlier work by including a broader measure of social anxiety across different social situations and comparing models for groups of participants with and without probable SAD. Structural equation modelling was utilised to test the model in a sample of 890 university students (74.8% female, mean age 29.49). We replicated the findings of Cook et al. in the overall sample and in the group with probable SAD. FNEs and FPEs predicted social anxiety directly and were serially mediated by concerns about reprisal and discounting positive outcomes. The model was also a good fit for those without SAD; however, in the model, FNEs were no longer a direct predictor of social anxiety. The findings confirm the utility of the extended bivalent model and have implications for psychoevolutionary accounts of social anxiety.

The development and validation of the Intolerance of Uncertainty in Social Interactions Scale.

Intolerance of uncertainty (IU) is commonly defined as the tendency for one to interpret uncertainty as negative or threatening. Most general or non-specific measures of IU show a strong relationship with worry and generalized anxiety disorder symptoms; however, a specialized measure of intolerance of uncertainty in social situations could provide insight into the role of IU in social anxiety. The purpose of this study was the development and preliminary validation of the Intolerance of Uncertainty in Social Interactions Scale (IU-SIS), a comprehensive measure designed to assess intolerance of uncertainty in social situations. Participants consisted of a non-referred sample. Based on an exploratory factor analysis, a two-factor solution was retained, with factors labelled Social Ambiguity and Need to Reduce. Both subscales were found to have good reliability and validity. Both subscales of the IU-SIS predicted up variance on measures of social anxiety after controlling for variance explained by a well-established general/non-specific measure of IU. Overall, the IU-SIS shows promise as a tool to elucidate the association between intolerance of uncertainty and social anxiety.

Assessing Gym Intimidation in Female College Students: Understanding This as a Barrier to Physical Activity and Exercise

Background: Women enrolled in college participate in less physical activity and exercise, specifically resistance training, than men. Aim: This study measured gym intimidation and assessed factors that may influence intimidation levels in female college students. Methods: A survey was emailed to female college students at a large, public university in the southeastern United States. Class standing, academic college, major, gym frequency, gym equipment used, and sports participation were assessed. Gym intimidation was measured using the Social Exercise and Anxiety Measure (SEAM) subscales: social exercise self-efficacy (SES: assesses confidence in the ability to exercise in various environments), gym avoidance (GA: assesses gym avoidant behavior), and exercise importance (EI: assesses priority of exercise). Pearson’s correlations and ANOVAs identified significant relationships. Results: Participants included 357 students. Pearson’s correlations revealed a relationship (p < 0.01) between frequency of gym attendance and all SEAM questions. Mean subscale scores showed moderate gym intimidation: SES (347.41 + 103.17) of a possible 500; GA (15.68 + 7.66) of 28; EI (15.24 + 3.75) of 21. Freshmen (13.55 + 7.94) showed significantly higher gym avoidance than sophomores (16.589 + 782), F (3,353) = 3.18, p = 0.007. Conclusions: Gym intimidation is prevalent among female college students and is a barrier to exercise participation. Combatting intimidation is critical to this population’s health.

Exploration of the Links Between Psychosocial Well-being and Face Recognition Skills in a French-Speaking Sample.

Face recognition abilities vary tremendously in the general population. People at the lower end of the spectrum, those with developmental prosopagnosia, report stress, anxiety or social interaction issues due to their poor face recognition abilities. It is thus important to develop adequate diagnostic tools convenient to use for clinicians and to examine relationships between face recognition skills and negative affects. In the present study, we provide a validated French translation of the 20-item prosopagnosia index (PI20), a self-report measure used to detect people with developmental facial identity recognition deficits (Shah et al., 2015; Tsantani et al., 2021). We also examined links between face recognition skills measured with the PI20 and a standard face recognition test (Cambridge face memory test-CFMT; Duchaine & Nakayama, 2006) and measures of social anxiety (social interaction anxiety scale, social phobia scale) and negative affects (state trait anxiety scale, Beck depression inventory). We did not find any significant correlation between the CFMT and measures of psychosocial well-being and only found a weak positive association between the PI20 and social interaction anxiety. Although this association is weak and warrants further research, raising awareness about developmental face recognition issues may help improve the well-being of people with facial identity recognition deficits and provide new investigation or intervention avenues for clinicians who treat patients with social interaction anxiety.

Social anxiety, voice confrontation and voice recognition: A bilingual exploration.

Many people dislike the sound of their voices, especially when listening back to audio recordings (voice confrontation). Previous research reports that disliking the sound of one's voice is associated with elevated levels of social anxiety. The present study investigated the relationship between social anxiety and voice dislike and voice misrecognition among a bilingual population: Arabic (L1) and English (L2). Participants (N = 176) completed self-report measures of social anxiety and own voice liking. Additionally, they performed a novel own voice recognition task, assessing their ability to recognise a recording of their voice, differentiating it from digitally altered versions of the same recording. Social anxiety symptomatology was associated with disliking the sound of one's voice, with a larger effect for L1 than L2. Social anxiety was also associated with own voice misrecognition, but only for L1. Highly negative evaluations about the sound of one's voice may represent a vulnerability for social anxiety disorder.

The Measurement of Reactions to Face Masks and the Relation to Social Anxiety.

Introduction: Following a period of social isolation from the COVID-19 pandemic, social interactions may be particularly complicated for individuals with elevated levels of social anxiety. One potential implication relates to the use of face masks. Face masks have been used as an effective tool to prevent the transmission of COVID-19. However, for individuals with elevated social anxiety, face masks may be a form of avoidance and type of safety behavior and discontinued use of face masks may be associated with increases in social anxiety. In response to these possibilities, the purpose of this study was to develop a measure to assess potential anxiety-related reactions to face masks. Method: Participants were 564 nonreferred young adults who completed a measure developed for this study to assess behaviors and reactions to face masks (Reaction to Face Masks Questionnaire), including anxiety and avoidance behaviors. Measures of social anxiety, more general avoidance, and safety behaviors were also included. Results: Based on an exploratory factor analysis, a two-factor model was retained. Safety-Seeking and Avoidance (SSA) measures reductions in social anxiety derived from a feeling of safety when wearing a face mask, and Social Interference measures increases in social anxiety symptoms related to the interference/inhibition of social interactions related to wearing masks. Both subscales were found to be associated with general measures of social anxiety, more general avoidance, and safety behaviors; however, the correlations were more robust for the SSA subscale. Discussion: Based on the current findings, general social anxiety and common correlates of social anxiety, including safety-seeking behaviors, were found to be associated with face mask anxiety and avoidance. Implications for future research and potential clinical practice are discussed.

Social comparison, resilience, life satisfaction, depression, and anxiety among earthquake survivors in Turkey

The aftermath of seismic disasters presents a multifaceted challenge for survivors, impacting various aspects of their well-being and mental health. The present study aimed to investigate the mediating role of resilience in the relationships between social comparison, life satisfaction, depression, and anxiety. The study included 388 participants (age range: 18–69 years; mean age = 34.50 ± 13.18) who were residing in the most earthquake-stricken regions of Turkey and completed the self-reported measures of social comparison, resilience, life satisfaction, depression, and anxiety using a paper-and-pencil format. The results showed that social comparison significantly predicted resilience, satisfaction with life, depressive symptoms, and anxiety. Resilience significantly predicted life satisfaction, depression, and anxiety. More importantly, resilience partially mediated the associations between social comparison and life satisfaction, depression, and anxiety. These findings suggest the importance of interventions that contribute to resilience in earthquake survivors. Post-disaster interventions should focus on strategies to diminish the influence of social comparison on mental health and well-being by cultivating the capacity to bounce back from adversity and cope effectively with challenges.

How Society Anxiety Influences Attention Control in College Students: The Moderated Mediation Effect of Cognitive Flexibility and Resting-state Electroencephalography Activity.

Social anxiety is a prevalent issue among college students, adversely affecting their overall well-being. Drawing from the cognitive model of social anxiety and attention control theory, heightened levels of social anxiety may correspond to poorer attention control ability. However, little is known about the underlying cognitive mechanisms of the relationship between social anxiety and attention control. To address this research gap, the current study recruited a sample of 156 college students (56 women) who underwent self-report measures of social anxiety, cognitive flexibility, and attention control, followed by a resting-state EEG recording. The results revealed a significant negative predictive effect of social anxiety on attention control, with cognitive flexibility partially mediating this relationship. Furthermore, resting-state theta power emerged as a significant moderator, accentuating the negative impact of social anxiety on cognitive flexibility among individuals with lower theta power. In addition, frontal alpha asymmetry (FAA) demonstrated a moderating effect, with lower FAA intensifying the predictive influence of cognitive flexibility on attention control. Taken together, these results suggested that social anxiety can predict attention control either directly or indirectly via the mediating role of cognitive flexibility, and lower theta power and FAA has a risk amplification effect, which provide novel insights into the treatment and prevention of social anxiety and its negative impact on college students.

Do All of Us Camouflage? Exploring Levels of Camouflaging and Mental Health Well-Being in the General Population

AbstractCamouflaging refers to behaviours observed in autistic people to hide or compensate for difficulties experienced during social interaction. As it is unknown to what extent neurotypical individuals camouflage, this study looked at camouflaging and mental well-being in the general population. We employed a cross-sectional survey design to recruit 164 people (123 female, 35 male, 5 non-binary, 1 prefer not to say) between 18 and 65 years of age online. Participants filled in measures of autistic traits, camouflaging, social anxiety, generalised anxiety and presence of autism diagnosis (5 self-diagnosed, 5 diagnosed, 154 not diagnosed) and additional mental health diagnoses. Camouflaging was significantly correlated with autistic traits, social anxiety, generalised anxiety and age. Hierarchical regression analyses revealed that autistic traits and social and generalised anxiety predicted camouflaging. Logistic regression analyses for mental health diagnoses showed camouflaging significantly reduced risk of depression, although the effect was small. No other mental health diagnoses were predicted by camouflaging. Neurotypical individuals who have higher autistic traits and experience more social and/or generalised anxiety may be more likely to camouflage.

Impact of Psychological Stress on Emotion Regulation Strategies during COVID-19 in Young Adults with Self-Reported Social Anxiety

Background: This study sought to evaluate the relations among expressive suppression (ES), cognitive reappraisal (CR), and stress during COVID-19 in young adults with self-reported social anxiety. We hypothesized that social anxiety would positively relate to ES but negatively relate to CR. Furthermore, we predicted that stress severity would moderate the relation between social anxiety and emotion regulation, where higher reports of stress and social anxiety would predict greater ES and lower CR. Methods: Participants were young adults (N = 84; 18-24 years old) who completed self-report measures of social anxiety, stress, and emotion regulation amid COVID-19. Zero-order correlations assessed relations among these variables. Moderation analyses assessed stress as a moderator of the relation between social anxiety and emotion regulation. Results: Results indicated that social anxiety was significantly correlated with ES but not CR. The relation between social anxiety and ES was moderated by stress severity, such that as stress increased, individuals with higher social anxiety engaged in less ES. Stress did not moderate the relation between social anxiety and CR. Conclusions: The current study suggests that self-reported social anxiety is positively associated with ES (but not CR) during COVID-19; however, individuals with high social anxiety and perceived stress engaged in less ES.

Altered cortical thickness of the superior frontal gyrus and fusiform gyrus in individuals with subthreshold social anxiety

Subthreshold social anxiety (SSA) is a condition in which individuals experience social anxiety that does not reach the threshold required for a clinical diagnosis of a social anxiety disorder (SAD). Although SSA may not impair lives as severely as SAD, it can affect social functioning. However, only a few studies focused on structural neural correlates of SSA. We recruited 65 individuals with SSA and used the Leibowitz Social Anxiety Scale to assess their social and performance anxiety levels and other relevant measures of social anxiety. Voxel-wise whole-brain correlational analyses showed a positive association between the cortical thickness (CT) of the superior frontal gyrus (SFG) and social anxiety levels and a negative correlation between the CT of the fusiform gyrus (FG) and performance anxiety levels in individuals with SSA. Exploratory Pearson’s correlation analyses showed significant positive correlations between the CT of the SFG and Generalized Anxiety Disorder-7 total scores and negative associations between the CT of the FG and Beck Anxiety Inventory total scores. Our study provides insight into the neural basis of SSA, particularly performance anxiety, by highlighting the association between CT in specific brain regions and SSA characteristics.

Virtual reality-assisted assessment of paranoid ideation in forensic psychiatric inpatients: A mixed-methods pilot study.

Reliable and valid assessment of paranoia is important in forensic psychiatry for providing adequate care. VR technology may add to current assessment procedures, as it enables observation within realistic (social) situations resembling the complexity of everyday life. VR constitutes a promising tool within forensics, due to the restricted nature of forensic psychiatric hospitals and ethical challenges arising from observing potentially dangerous behaviors in real life. To investigate the feasibility of VR assessment for paranoid ideation in forensic psychiatric inpatients qualitatively by assessing the experiences of patients and a clinician, and to explore how the VR measures relate to established clinical measures. One clinician (experienced psychiatrist) and 10 forensic psychiatric inpatients with a history or suspicion of paranoid ideation were included. Patients participated in two immersive VR scenarios (bus and supermarket) during which paranoia was assessed by the clinician. Qualitative interviews were performed with patients and the clinician performing the assessment to investigate experiences and feasibility. Further, measures of paranoia, social anxiety, and positive symptoms were obtained. Nine out of 10 participants with varying levels of paranoid ideation completed the assessment. Manifest inductive content analyses of the interviews revealed general experiences, advantages such as enabling observing participants from a different perspective, and challenges of the VR assessment, such as a lack of objectivity and the laboriousness of the assessment for the clinician. Although more paranoia was experienced during the supermarket scenario, correlates with classical measures were only significant for the bus scenario. The VR assessment was appreciated by most patients and the clinician. Based on our results short, standardized VR assessment scenarios are feasible, however, they do not appear reliable or objective for assessing paranoia. The clinical usefulness is most likely as a collaborative tool and add-on measure to existing methods.

Brief observable anxiety sensitivity treatment: intervention development and a pilot randomized-controlled acceptability and feasibility trial to evaluate a brief intervention for anxiety sensitivity social concerns

ABSTRACT Social anxiety disorder is one of the most prevalent anxiety disorders. There is a need to develop brief, virtual, single-session interventions targeting constructs associated with social anxiety, such as anxiety sensitivity social concerns (ASSC). ASSC is the maladaptive belief about consequences arising from observable symptoms of anxious arousal. This study was designed to evaluate the initial acceptability and feasibility of a brief ASSC reduction program (Brief Observable Anxiety Sensitivity Treatment [BOAST]) which included a single clinician-led intervention session followed by a two-week ecological momentary intervention (EMI), delivered via mobile app. Participants (N = 36) were adults with elevated ASSC who were randomly assigned to receive BOAST (n = 19) or a waitlist control (n = 17). The trial was prospectively registered at clinicaltrials.gov (NCT04859790). Results supported the acceptability of BOAST with mixed findings for feasibility. Feasibility metrics for the EMI component were below pre-defined thresholds; however, there was evidence that homework completion was associated with symptom reduction. Preliminary efficacy metrics indicated that participants in the BOAST condition had large reductions in ASSC and one measure of social anxiety at 1-month follow-up. This study provides preliminary support for the acceptability of BOAST and elucidates avenues for future clinical and research efforts.

Psychometric properties of the Distress Questionnaire-5 (DQ5) for measuring psychological distress in adolescents

Screening for psychological distress may assist in identifying at-risk adolescents. While several measures of adolescent psychological distress have been used, most have limited or suboptimal psychometric properties. This study aimed to assess the psychometric properties of the Distress Questionnaire-5 (DQ5), a brief measure of psychological distress, in a large community-based sample of adolescents. Data for the study (n = 3117) were drawn from the baseline and 6-week follow-up assessments of the Future Proofing Study, which collected data from three cohorts of Year 8 students (M = 13.9 years; 48% female) between August 2019 and May 2022. Participants completed the DQ5 at each measurement occasion, as well as measures of depression, generalised and social anxiety, and suicidal ideation. The DQ5 had good fit to a unidimensional construct, with standardised factor loadings ranging between 0.69 and 0.90. The scale had strong criterion (AUC ranged from 0.84 to 0.93) and predictive (AUC ranged from 0.81 to 0.87) validity when compared against indicators for depression, generalised anxiety, social anxiety and suicidal ideation. The DQ5 cut-point of ≥14 had 80% sensitivity and 90% specificity for identifying adolescents meeting symptom thresholds for any of the assessed mental health conditions. Changes in DQ5 scores over 6 weeks had moderate associations with changes in other symptom scales, suggesting sensitivity to change. In conclusion, the DQ5 demonstrates strong psychometric properties and is a reliable measure of psychological distress in adolescents. Given its brevity and ease of interpretation, the DQ5 could be readily used in schools to screen for psychological distress in students.

Thematic Analysis to Measure Social Anxiety among Students

The occurrence of social anxiety among students in higher education has become a growing concern, necessitating a comprehensive understanding of effective assessment methods. To address this, a study was conducted utilizing thematic analysis to explain prevailing trends in the measurement of social anxiety. By analyzing ten scholarly articles sourced from the Web of Sciences (WOS) database, the research sought to identify common patterns and themes in the approaches employed to assess social anxiety. The findings of the thematic analysis highlighted several prevalent tools frequently utilized in assessing social anxiety, including the Liebowitz Social Anxiety Scale, the State–Trait Anxiety Inventory, the Social Interaction Anxiety Scale, the Social Anxiety Scale, the Social and Emotional Competencies Evaluation Questionnaire, and the Social Anxiety Scale. These established measurements signify essential resources for researchers and practitioners aiming to comprehensively evaluate social anxiety in university students. This comprehensive review of existing literature not only contributes to a deeper understanding of the methodologies employed in studying social anxiety but also emphasizes the importance of employing a variety of measurement techniques in future research endeavors. By incorporating these findings, scholars and mental health professionals can devise more tailored interventions and support mechanisms to address the growing concerns surrounding social anxiety within higher education settings.

Cognitive and behavioural processes in adolescents with social anxiety disorder

BackgroundA better understanding of the processes that maintain social anxiety disorder (SAD) in adolescents could improve treatment outcomes. This study aimed to establish whether cognitive and behavioural processes known to be important in the maintenance of adult SAD are observed in adolescent populations and whether they are specific to SAD. MethodsWe recruited three groups of adolescents (12-18y): (1) 90 adolescents with a SAD diagnosis, (2) 58 adolescents with an anxiety disorder that was not SAD, and (3) 45 community-based adolescents. Participants completed measures of negative social cognitions, social attitudes, safety behaviours, self-focused attention, and social anxiety, anxiety, and depression symptoms. ResultsThe clinical SAD sample endorsed higher levels of negative social cognitions, attitudes, and safety behaviours compared to both control groups. Self-focused attention was higher in the clinical SAD sample compared to the anxiety clinical control group but not compared to the community control group. ConclusionsThis study provided evidence of SAD-specific mechanisms including negative social cognitions, attitudes and safety behaviours in adolescents. The study did not provide evidence of disorder-specific mechanisms of self-focused attention but this may have been due to methodological limitations. These findings indicate avenues for further research and point to the potential value of Cognitive Therapy for the treatment of adolescent SAD.

Daily use of digital technologies to feel better: Adolescents' digital emotion regulation, emotions, loneliness, and recovery, considering prior emotional problems.

Adolescents report using digital technologies for emotion regulation (digital ER), with the aim of feeling better (i.e., improving emotions and reducing loneliness). In this 7-day diary study, we investigated associations of digital ER, emotions, and loneliness, and tested whether prior emotional problems moderated these associations. Participants were 312 Australian adolescents (Mage = 13.91, SD = 1.52; 44% boys). Daily surveys measured digital ER; end-of-day happiness, sadness, worry, anger, and loneliness; and peak sadness, worry, and anger. End-of day emotions were subtracted from peak emotions to calculate emotion recovery for sadness, worry, and anger. Participants were randomly selected from two symptom strata (high/low) defined by depression and social anxiety measures collected before the diary. Data were analyzed using multilevel path modeling. Cross-level interactions tested whether symptom strata moderated associations. Digital ER was associated with more recovery from peak to end-of-day sadness and worry, but also with increased sadness, worry, anger, and loneliness by the next end-of-day. Higher end-of-day loneliness was associated with increased next-day digital ER. Prior emotional symptoms were not a significant moderator of daily digital ER and emotion associations. Adolescents who report more digital ER in a day show more recovery from the peak of negative emotion that day, but this recovery dissipates, with digital ER also associated with increased negative emotion and loneliness by the next day for all adolescents, regardless of prior symptom status. Lonelier adolescents use more digital ER by the next day, suggesting they need support to make social connections-online or offline.

Cognitive Behavior Group Therapy for Children and Adolescents With Social Anxiety Disorder

Abstract: Background: Social anxiety disorder (SAD) in children is highly prevalent but current treatments are not effective for all patients. Aim: A group treatment based on empirically driven etiological models including psychoeducation, cognitive restructuring, exposure, and social skills training was examined. Method: The study examined treatment success using a SAD-specific cognitive behavior group therapy in a randomized controlled trial ( N = 74, 8 – 12 years, blind randomized allocation to treatment [CBT; n = 42] and waitlist [WLC; n = 32]). Results: Compared to WLC, parents of children in the CBT group reported a decrease in symptoms (CBT: d = 1.02, WLC: d = 0.06), while children did not differ in two measures of social anxiety. An estimate of total treatment effects showed a steady decrease in social anxiety symptoms (child report pre- to posttreatment: d = 0.50 – 0.52, posttreatment to follow-up: d = 0.37 – 0.39; parent report pre- to posttreatment: d = 0.92, posttreatment to follow-up: d = 0.69). Conclusion: While group treatment is most likely an effective approach, parents reported stronger social anxiety symptom reduction than children. The selection of measures for the assessment of SAD and treatment success and further modifications of exposure-based approaches are to be considered in future research.

Differences in anxiety sensitivity and experiential avoidance between subtypes of social anxiety disorder.

Both anxiety sensitivity (AS) and experiential avoidance (EA) have been linked to social anxiety disorder (SAD). However, previous studies did not consider their joint variance and the heterogeneity of SAD. In this mixed methods cross-sectional survey, we examined 121 online participants (age range: 16-70 years) who self-reported as socially anxious. We compared AS and EA levels in individuals with a primary fear of noticeable anxiety symptoms vs. behaving ineptly. AS and EA were highly prevalent across the sample. Surprisingly, the noticeable symptoms subtype showed slightly lower AS and EA levels than the inept behavior subtype. The noticeable symptoms subtype scored notably lower on social anxiety measures (mean = 69.8) than the inept behavior subtype (mean = 89.3). EA was uniquely associated with social anxiety in both subtypes, while AS was uniquely associated with social anxiety only in the inept behavior subtype. The joint variance explained substantially more of the noticeable symptoms subtype's social anxiety (32.5%) compared to the inept behavior subtype's (9.4%). Qualitative themes aligned with these findings, indicating a self-reinforcing dynamic between high AS, high EA, and social anxiety symptoms. Potential clinical implications are discussed. Future research should examine causality in the AS-EA-SAD dynamic, considering the heterogeneity of SAD.

Development and Validation of the Bullied Cognitions Inventory (BCI)

BackgroundBullying increases risk of social anxiety and can produce symptoms of posttraumatic stress disorder (PTSD). According to cognitive models, these are maintained by unhelpful beliefs, which are therefore assessed and targeted in cognitive therapy. This paper describes psychometric validation of a new measure of beliefs related to bullying experiences.MethodsIn an online survey of 1879 young people before starting university or college in the UK, 1279 reported a history of bullying (N = 1279), and 854 rated their agreement with beliefs about self and others related to bullying experiences and completed symptom measures of social anxiety and PTSD related to bullying. An empirical structure for a Bullied Cognitions Inventory was established using exploratory and confirmatory factor analyses and assessed using model fit statistics and tests of reliability and validity.ResultsFifteen items clustered into four themes: “degraded in the eyes of others”, “negative interpretations of reactions to bullying”, “recognisable as a bullying victim” and “social defeat”. The measure has acceptable reliability and validity and, accounting for existing cognitive measures, explained additional variance in symptoms of PTSD but not social anxiety.ConclusionsThe Bullied Cognitions Inventory (BCI) is a valid and reliable tool for measuring cognitions related to bullying. It may be useful in therapy for identifying and monitoring unhelpful cognitions in those who were bullied.