Adolescent Social Anxiety Research Articles

Peer relations, parental social coaching, and young adolescent social anxiety

Links between peer relationship difficulties, parental social coaching, and social anxiety were examined among young adolescents (N=80). In a lab protocol simulating peer stress, adolescents led a 3-min conversation, while ostensibly being evaluated by (fictitious) peer judges. Parental coaching was measured via observed cognitive framing and advice-giving; parents also reported on their facilitation of access to peers, and their adolescent's peer victimization and rejection. Social anxiety was measured through both global- and context-specific reports. More socially anxious youths (1) experienced more peer rejection and (2) had parents who engaged in poorer quality coaching (i.e., lower prosocial advice, benign interpretation, and facilitation). Evidence of additive effects of peer problems and parenting was found, and the pattern of findings was similar after controlling for adolescent social skills. Results suggest that both negative peer experiences and parental coaching may need to be targeted to reduce social anxiety during early adolescence.

Measuring online interpretations and attributions of social situations: Links with adolescent social anxiety

ObjectiveWe evaluated the utility of a novel, picture-based tool to measure how adolescents interpret and attribute cause to social exchanges and whether biases in these processes relate to social anxiety. Briefly presented ambiguous visual social scenes, each containing a photograph of the adolescent as the protagonist, were followed by three possible interpretations (positive, negative, neutral/unrelated) and two possible causal attributions (internal, external) to which participants responded. MethodNinety-five adolescents aged 14 to 17 recruited from mainstream schools, with varying levels of social anxiety rated the likelihood of positive, negative and unrelated interpretations before selecting the single interpretation they deemed as most likely. This was followed by a question prompting them to decide between an internal or external causal attribution for the interpreted event. ResultsAcross scenarios, adolescents with higher levels of social anxiety rated negative interpretations as more likely and positive interpretations as less likely compared to lower socially anxious adolescents. Higher socially anxious adolescents were also more likely to select internal attributions to negative and less likely to select internal attributions for positive events than adolescents with lower levels of social anxiety. ConclusionsAdolescents with higher social anxiety display cognitive biases in interpretation and attribution. This tool is suitable for measuring cognitive biases of complex visual-social cues in youth populations with social anxiety and simulates the demands of daily social experiences more closely. LimitationsAs we did not measure depressive symptoms, we cannot be sure that biases linked to social anxiety are not due to concurrent low mood.

Two dimensions of social anxiety disorder: a pilot study of the Questionnaire for Social Anxiety and Social Competence Deficits for Adolescents.

BackgroundThe Questionnaire for Social Anxiety and Social Competence Deficits for Adolescents (SASKO-J) was developed as an instrument for clinical diagnostics of social anxiety disorder in youths by measuring social anxiety and social deficits in two separate dimensions. The study provides an initial assessment of the scale’s psychometric properties in a clinical sample.MethodThe reliability and validity of the SASKO-J were assessed in a mixed clinical sample of 12- to 19-year-old German adolescents (N = 85; mean age 15.71 years; SD = 1.92; 62.4 % girls). In a second step, the diagnostic validity was evaluated in a clinical sample of 31 adolescent patients with social anxiety disorder (mean age 16.10 years; SD = 1.54; 74.2 % girls) and a sample of 115 German high school students (mean age 15.84 years; SD = 1.65; 60.9 % girls) via Receiver Operating Characteristic (ROC) analysis.ResultsThe internal consistencies of the total scale and the subscales were good to excellent (0.80 ≤ α ≤ 0.96), and the results indicated a good convergent and divergent validity. The ROC analysis revealed a satisfying area under curve (AUC = 0.866), and a cutoff of 41.5 for the SASKO-J total score represented the best balance of sensitivity (0.806) and specificity (0.826).ConclusionsThe results of this pilot study provide initial support for the clinical use of the SASKO-J in the diagnostic process. Future research should address the question of psychometric properties in a social anxiety disorder sample as well as the questionnaire’s sensitivity for detecting change in symptoms during therapy.

Brief Measures to Screen for Social Anxiety in Adolescents.

Social anxiety disorder (SAD) in adolescents is considerably underdetected and undertreated despite the availability of efficacious treatments. Our main study objective was to examine brief, valid, and reliable screening measures for adolescent social anxiety, and to then conduct diagnostic interviews to evaluate the measures' ability to identify adolescents with SAD. We examined 7 brief and valid social anxiety measures and compared their diagnostic accuracy with diagnoses established by a semistructured interview. The sample included 421 Spanish adolescents with and 613 without a clinical diagnosis of SAD. Data revealed that short social anxiety measures are accurate in detecting Spanish-speaking socially anxious adolescents. All questionnaires showed good or excellent discriminating ability, with the Social Anxiety Scale for Adolescents (SAS-A) and the Social Phobia and Anxiety Inventory-Brief (SPAI-B) having the best sensitivity and specificity values, respectively. Excellent areas under the receiver operating characteristic curves were found for most measures, except for the Liebowitz Social Anxiety Scale for Children and Adolescents and the Mini-Social Phobia Inventory, which had good discriminatory ability. There was little statistical difference in the ability of the brief social anxiety measures to identify cases accurately, although the SPAI-B cutoff score yielded the best balance between sensitivity and specificity and the highest Youden Index. Overall, results suggest that brief measures for social anxiety symptoms can be effective in detecting SAD in Spanish-speaking adolescents. Depending on the purpose of the study, SAS-A may be especially useful for reducing false negatives and the SPAI-B for false positives.

Adolescent and Parental Contributions to Parent–Adolescent Hostility Across Early Adolescence

Early adolescence is characterized by increases in parent-adolescent hostility, yet little is known about what predicts these changes. Utilizing a fairly large sample (N = 416, 51 % girls, 91 % European American), this study examined the conjoint and unique influences of adolescent social anxiety symptoms and parental intrusiveness on changes in parent-adolescent hostility across early adolescence. Higher mother and father intrusiveness were associated with increased mother- and father-adolescent hostility. An examination of reciprocal effects revealed that mother- and father-adolescent hostility predicted increased mother and father intrusiveness. Significant associations were not substantiated for adolescent social anxiety symptoms. These findings suggest that intrusive parenting has important implications for subsequent parent-adolescent interactions and that similar patterns may characterize some aspects of mother- and father-adolescent relationships.

Social anxiety, disengagement coping, and alcohol-use behaviors among adolescents

ABSTRACTBackground and Objectives: Although research indicates that social anxiety (SA) is associated with problematic drinking, few studies have examined these relations among adolescents, and all alcohol-related assessments have been retrospective. Socially anxious youth may be at risk to drink in an effort to manage negative affectivity, and a proclivity toward disengagement coping (e.g. avoidance of aversive stimuli) may enhance the desire to drink and learning of coping-related use. Design: Adding to research addressing adolescent SA and alcohol use, the current study examined (1) proportional drinking motives (subscale scores divided by the sum of all subscales), (2) current desire to drink in a socially relevant environment (introduction to research laboratory), and (3) the indirect effect of retrospectively reported disengagement in social stress contexts on proportional coping motives and desire to drink. Method: Participants were 70 community-recruited adolescents who reported recent alcohol use. Level of SA, disengagement coping, drinking motives, and desire to drink following laboratory introduction were assessed. Results: Proclivity toward disengagement in prior socially stressful contexts accounted for significant variance in the positive relations between SA and both proportional coping motives and current desire to drink. Conclusions: These data complement existing work. Continued efforts in building developmentally sensitive models of alcohol use are needed.

Longitudinal associations between social anxiety symptoms and cannabis use throughout adolescence: the role of peer involvement.

There appear to be contradicting theories and empirical findings on the association between adolescent Social Anxiety Disorder (SAD) symptoms and cannabis use, suggesting potential risk as well as protective pathways. The aim of this six-year longitudinal study was to further examine associations between SAD symptoms and cannabis use over time in adolescents from the general population, specifically focusing on the potential role that adolescents’ involvement with their peers may have in these associations. Participants were 497 Dutch adolescents (57 % boys; Mage = 13.03 at T1), who completed annual self-report questionnaires for 6 successive years. Cross-lagged panel analysis suggested that adolescent SAD symptoms were associated with less peer involvement 1 year later. Less adolescent peer involvement was in turn associated with lower probabilities of cannabis use as well as lower frequency of cannabis use 1 year later. Most importantly, results suggested significant longitudinal indirect paths from adolescent SAD symptoms to cannabis use via adolescents’ peer involvement. Overall, these results provide support for a protective function of SAD symptoms in association with cannabis use in adolescents from the general population. This association is partially explained by less peer involvement (suggesting increased social isolation) for those adolescents with higher levels of SAD symptoms. Future research should aim to gain more insight into the exact nature of the relationship between anxiety and cannabis use in adolescents from the general population, especially regarding potential risk and protective processes that may explain this relationship.

Cannabis Use and Social Anxiety in Adolescence: The Role of Facilitation Expectancies

Cannabis use is frequently related to social anxiety in young adulthood, but the nature of this relationship is unclear. Moreover, much research has been conducted on the role of cannabis effects expectancies and their relationship to social anxiety among young adults, but less is known about adolescence. The study examined the relationship between social anxiety, cannabis use patterns, and cannabis effects expectancies among a nonclinical sample of 1,305 adolescents (51% female). Non-users reported higher social anxiety scores than non-problematic and risky users. Compared to users, non-users had more negative expectancies. Risky and problematic users showed higher social and sexual facilitation expectancies and perceptual and cognitive enhancement expectancies. In addition, social anxiety was related to global negative expectancies and social and sexual facilitation expectancies. Moreover, we found that among socially anxious adolescents, social and sexual facilitation expectancies are dissuasive reasons to use cannabis. Clinical implications and future directions are discussed.

Allelic Variation of Risk for Anxiety Symptoms Moderates the Relation Between Adolescent Safety Behaviors and Social Anxiety Symptoms.

Social anxiety often develops in adolescence, and precedes the onset of depression and substance use disorders. The link between social anxiety and use of behaviors to minimize distress in social situations (i.e., safety behaviors) is strong and for some patients, this link poses difficulty for engaging in, and benefiting from, exposure-based treatment. Yet, little is known about whether individual differences may moderate links between social anxiety and safety behaviors, namely variations in genetic alleles germane to anxiety. We examined the relation between adolescent social anxiety and expressions of safety behaviors, and whether allelic variation for anxiety moderates this relation. Adolescents (n=75; ages 14-17) were recruited from two larger studies investigating measurement of family relationships or adolescent social anxiety. Adolescents completed self-report measures about social anxiety symptoms and use of safety behaviors. They also provided saliva samples to assess allelic variations for anxiety from two genetic polymorphisms (BDNF rs6265; TAQ1A rs1800497). Controlling for adolescent age and gender, we observed a significant interaction between social anxiety symptoms and allelic variation (β=0.37, t=2.41, p=.02). Specifically, adolescents carrying allelic variations for anxiety evidenced a statistically significant and relatively strong positive relation between social anxiety symptoms and safety behaviors (β=0.73), whereas adolescents not carrying allelic variation evidenced a statistically non-significant and relatively weak relation (β=0.22). These findings have important implications for treating adolescent social anxiety, in that we identified an individual difference variable that can be used to identify people who evidence a particularly strong link between use of safety behaviors and expressing social anxiety.

Cyber victimization by peers: Prospective associations with adolescent social anxiety and depressive symptoms

Peer victimization that occurs via electronic media, also termed cybervictimization, is a growing area of concern for adolescents. The current study evaluated the short-term prospective relationship between cybervictimization and adolescents' symptoms of social anxiety and depression over a six-week period. Participants were 839 high-school aged adolescents (14–18 years; 58% female; 73% Hispanic White), who completed measures of traditional peer victimization, cybervictimization, depression, and social anxiety at two time points. Findings supported the distinctiveness of cybervictimization as a unique form of peer victimization. Furthermore, only cybervictimization was associated with increased levels of depressive symptoms over time, and only relational victimization was associated with increased social anxiety over time, after controlling for the comorbidity of social anxiety and depression among youth. Cybervictimization appears to be a unique form of victimization that contributes to adolescents' depressive symptoms and may be important to target in clinical and preventive interventions for adolescent depression.

Forgetting the best when predicting the worst: Preliminary observations on neural circuit function in adolescent social anxiety

Social anxiety disorder typically begins in adolescence, a sensitive period for brain development, when increased complexity and salience of peer relationships requires novel forms of social learning. Disordered social learning in adolescence may explain how brain dysfunction promotes social anxiety. Socially anxious adolescents (n = 15) and adults (n = 19) and non-anxious adolescents (n = 24) and adults (n = 32) predicted, then received, social feedback from high and low-value peers while undergoing functional magnetic resonance imaging (fMRI). A surprise recall task assessed memory biases for feedback. Neural correlates of social evaluation prediction errors (PEs) were assessed by comparing engagement to expected and unexpected positive and negative feedback. For socially anxious adolescents, but not adults or healthy participants of either age group, PEs elicited heightened striatal activity and negative fronto-striatal functional connectivity. This occurred selectively to unexpected positive feedback from high-value peers and corresponded with impaired memory for social feedback. While impaired memory also occurred in socially-anxious adults, this impairment was unrelated to brain-based PE activity. Thus, social anxiety in adolescence may relate to altered neural correlates of PEs that contribute to impaired learning about social feedback. Small samples necessitate replication. Nevertheless, results suggest that the relationship between learning and fronto-striatal function may attenuate as development progresses.

Social Anxiety in Adolescents: the Role of Early Negative Memories and Fear of Compassion

Introduction Social anxiety refers to the discomfort felt in situations of social interaction or performance and may be an especially intense emotion in adolescence due to characteristics and developmental tasks of this age group. Although it is a common emotion and has an adaptive function, it can also develop as a negative experience raising serious difficulties in school and social life of young people. Objectives This study analyses the contribution of childhood negative memories and fear of compassion in social anxiety in adolescence. Method Three hundred and twenty adolescents (186 boys and 134 girls) with ages ranging from 12 to 19 years old took part in the study. Participants completed the following self-report measures: Early Life Experiences Scale for Adolescents, Fear of Compassion Scale (FCS-A) and the Social Anxiety Scale for Adolescents (SAS-A). Results Significant gender differences were found regarding social anxiety, empathy and early unvalued experiences within the family. Age was only correlated with social anxiety. Social anxiety showed a significant and expected correlation with the study variables. The model including fear of compassionate feelings (from other and from oneself) and early unvalued experiences showed to be the best predictor of social anxiety. Conclusions This study integrates the contribution of less explored variables, as the fear of compassion and early negative memories, in the understanding of social anxiety in adolescents. Results suggest that these variables may have an important role and should be incorporated in psychological interventions for social anxiety in adolescence.

Infant attachment security and early childhood behavioral inhibition interact to predict adolescent social anxiety symptoms.

Insecure attachment and behavioral inhibition (BI) increase risk for internalizing problems, but few longitudinal studies have examined their interaction in predicting adolescent anxiety. This study included 165 adolescents (ages 14-17years) selected based on their reactivity to novelty at 4months. Infant attachment was assessed with the Strange Situation. Multimethod BI assessments were conducted across childhood. Adolescents and their parents independently reported on anxiety. The interaction of attachment and BI significantly predicted adolescent anxiety symptoms, such that BI and anxiety were only associated among adolescents with histories of insecure attachment. Exploratory analyses revealed that this effect was driven by insecure-resistant attachment and that the association between BI and social anxiety was significant only for insecure males. Clinical implications are discussed.

Brooding rumination as a mediator in the relation between early maladaptive schemas and symptoms of depression and social anxiety in adolescents

Theory states that different cognitive constructs can be included in an integrated sequential model. This 3-wave longitudinal study assessed whether schema domains predict brooding rumination and brooding in turn predict depression and social anxiety symptoms among adolescents. A total of 1170 adolescents (Mage = 13.44 years old, SDage = 1.30) completed measures of schema domains, brooding rumination, depression and social anxiety symptoms at baseline, 6- and 12-month follow-up (T1, T2, T3, respectively). Results revealed that the Disconnection and Rejection schema domain at T1 predicted prospective depression symptoms at T3 directly but not through brooding rumination. However, this schema domain did not predict social anxiety symptoms. The Other-Directedness schema domain at T1 predicted social anxiety symptoms at T3 both directly and through brooding at T2. Furthermore, this schema domain also predicted depression symptoms at T3 through brooding at T2. Identifying specific schema domains and the mechanisms through which these domains predict psychological symptoms has implications for interventions with adolescents.

Interpretation bias modification for youth and their parents: A novel treatment for early adolescent social anxiety

Social anxiety is the most prevalent anxiety disorder of late adolescence, yet current treatments reach only a minority of youth with the disorder. Effective and easy-to-disseminate treatments are needed. This study pilot tested the efficacy of a novel, online cognitive bias modification for interpretation (CBM-I) intervention for socially anxious youth and their parents. The CBM-I intervention targeted cognitive biases associated with early adolescents’ maladaptive beliefs regarding social situations, and with parents’ intrusive behavior, both of which have been theoretically linked with the maintenance of social anxiety in youth. To investigate the efficacy of intervening with parents and/or children, clinically diagnosed early adolescents (ages 10–15; N=18) and their mothers were randomly assigned to one of three conditions: the first targeted early adolescents’ cognitive biases related to social anxiety (Child-only condition); the second targeted parents’ biases associated with intrusive behavior (Parent-only condition); and the third targeted both youth and parents’ biases in tandem (Combo condition). The use of a multiple baseline design allowed for the efficient assessment of causal links between the intervention and reduction in social anxiety symptoms in youth. Results provided converging evidence indicating modest support for the efficacy of CBM-I, with no reliable differences across conditions. Taken together, results suggest that online CBM-I with anxious youth and/or their parents holds promise as an effective and easily administered component of treatment for child social anxiety that deserves further evaluation in a larger trial.

Can parent training for parents with high levels of expressed emotion have a positive effect on their child's social anxiety improvement?

The role that parents’ involvement may play in improving their child's social anxiety is still under debate. This paper aimed to investigate whether training parents with high expressed emotion (EE) could improve outcomes for adolescent social anxiety intervention. Fifty-two socially anxious adolescents (aged 13–18 years), whose parents exhibited high levels of expressed emotion, were assigned to either (a) a school-based intervention with an added parent training component, or (b) a school-based program focused solely on intervening with the adolescent (no parental involvement). Post-treatment and 12-month follow-up findings showed that school-based intervention with parent training was superior to the adolescent-specific program, yielding significant reductions in diagnosis remission, social and depressive symptomatology, particularly when the EE status of parents changed. Overall, the findings suggest that high-EE parents of children with social anxiety need to be involved in their child's therapy.

Gender differences in the relationship between attentional bias to threat and social anxiety in adolescents

In the current study, gender differences in the relationship between attentional bias to threat and social anxiety were tested in 10- to 16-year-olds. Emotional faces were used as the experiment material, and a modified dot probe task was used to measure attentional bias. The level of social anxiety, depression, and loneliness were also measured via the Social Anxiety Scale for Children, Children’s Depression Inventory, and Children’s Loneliness Scale. Results indicated that males’ attentional bias to threat was significantly, positively correlated with their social anxiety, yet no correlation was found for females. For adolescents, the gender differences in the relationship between attentional bias to threat and social anxiety was notable.

The importance of perceived care and connectedness with friends and parents for adolescent social anxiety.

Nonclinical social anxiety in adolescence can be highly problematic, as it likely affects current and especially new social interactions. Relationships with significant others, such as close friends, mothers, and fathers, could aid socially anxious adolescents' participation in social situations, thereby helping reduce feelings of social anxiety. We examined whether making friends as well as high friendship quality help reduce social anxiety over time, and whether friends', mothers', and fathers' care interact in reducing social anxiety. Using longitudinal data from 2,194 participants in a social network (48% girls; Mage = 13.58) followed for 3 years, we estimated friendship selection and influence processes via a continuous time-modeling approach using SIENA. We controlled for the effects of depressive symptoms, self-esteem, gender, age, and family structure. Our findings suggest that perceived care by friends mediated the effect of making friends on social anxiety. Perceptions of mother and father, as well as friend care and connectedness, respectively, did not interact in decreasing social anxiety. Nonetheless, care and connectedness with mothers, fathers, and friends jointly predicted decreases in social anxiety. Caring relationships with friends and parents each play a role in mutually protecting early adolescents against increasing in social anxiety over time.

The relationship between self-Image and social anxiety in adolescence.

Self-image is the subjective perception about one's own self, body, mental functioning, social attitudes, and adjustment in different aspects of life. Research has linked negative self-image with a number of problem behaviors and psychiatric symptoms in adolescence; however, studies of the relationship between self-image and anxiety disorders are still scarce. This study involved a community sample of 1305 high-school students (51.4% female) who ranged in age from 14 to 19years old. They completed self-report measures of self-image and social anxiety disorder (SAD). A quarter of the students reported high levels of social anxiety. Statistical analyses showed significant differences between these students and the other students in all the self-image subscales. Several dimensions of impaired self-image (emotional tone, social attitudes, vocational and educational goals, family relationships, external mastery, and psychological health) were associated with high levels of social anxiety, with some gender differences underpinning these relationships. Clinicians treating SAD in youth may wish to consider that a negative self-image may play a critical role in the onset and retention of social anxiety symptoms.

The Impact of Internalized Shame on Social Anxiety in Adolescence: The Mediating Role of Experiential Avoidance

The Impact of Internalized Shame on Social Anxiety in Adolescence: The Mediating Role of Experiential Avoidance