Social Anxiety Symptoms Research Articles

School completion and progression to higher education in adolescents with social anxiety: a linkage between Young-HUNT3 and national educational data (2008-2019), Norway.

Social anxiety disorder (SAD) most commonly develops in adolescence-a period of life that includes a transition to upper secondary school. The aim of this study is to investigate the extent to which social anxiety in adolescence is associated with the completion of upper secondary school and progression to higher education. This longitudinal study includes 8,192 adolescents aged 13-19 years who participated in the Norwegian Young-HUNT 3 population-based study. Social anxiety is measured employing (1) diagnostic interview screening questions (interview) and (2) a self-reported symptom index (questionnaire). Notably, we define the cohorts based on these two methods. Using national educational data (2008-2019), we follow educational attainment among the cohorts until they turn 25 years of age. We found that adolescents who screened positive (SP) for SAD had a predicted probability of upper secondary school completion at 21 years of age that was 14% points lower than those who screened negative (SN). Further, differences remained when looking at completion rates at age 25 years. Moreover, predicted probabilities for completion were inversely associated with increasing levels of self-reported social anxiety symptoms. Similarly, the proportion of the completers of an academic program in the SP group that were enrolled in higher education by 25 years of age, were lower than for the SN group (87 vs. 92%). Social anxiety in adolescence, both self-reported symptoms and diagnostic screening, has long-term negative impact on upper secondary school completion and to some extent enrollment to higher education.

Resting-state amygdala subregion and precuneus connectivity provide evidence for a dimensional approach to studying social anxiety disorder

Social anxiety disorder (SAD) is a prevalent and disabling mental health condition, characterized by excessive fear and anxiety in social situations. Resting-state functional magnetic resonance imaging (fMRI) paradigms have been increasingly used to understand the neurobiological underpinnings of SAD in the absence of threat-related stimuli. Previous studies have primarily focused on the role of the amygdala in SAD. However, the amygdala consists of functionally and structurally distinct subregions, and recent studies have highlighted the importance of investigating the role of these subregions independently. Using multiband fMRI, we analyzed resting-state data from 135 participants (42 SAD, 93 healthy controls). By employing voxel-wise permutation testing, we examined group differences of fMRI connectivity and associations between fMRI connectivity and social anxiety symptoms to further investigate the classification of SAD as a categorical or dimensional construct. Seed-to-whole brain functional connectivity analysis using multiple ‘seeds’ including the amygdala and its subregions and the precuneus, revealed no statistically significant group differences. However, social anxiety severity was significantly negatively correlated with functional connectivity of the precuneus - perigenual anterior cingulate cortex and positively correlated with functional connectivity of the amygdala (specifically the superficial subregion) - parietal/cerebellar areas. Our findings demonstrate clear links between symptomatology and brain connectivity in the absence of diagnostic differences, with evidence of amygdala subregion-specific alterations. The observed brain-symptom associations did not include disturbances in the brain’s fear circuitry (i.e., disturbances in connectivity between amygdala - prefrontal regions) likely due to the absence of threat-related stimuli.

Social anxiety moderates the association between adolescent irritability and bully perpetration.

Preliminary work suggests anxiety moderates the relationship between irritability and bullying. As anxiety increases, the link between irritability and perpetration decreases. We hypothesize that any moderation effect of anxiety is driven by social anxiety symptoms. We sought to explicate the moderating effect of anxiety, while clarifying relations to other aggressive behaviors. A sample of adolescents (n = 169, mean = 12.42 years of age) were assessed using clinician rated assessments of anxiety, parent reports of irritability and bullying behaviors (perpetration, generalized aggression, and victimization). Correlations assessed zero-order relations between variables, and regression-based moderation analyses were used to test interactions. Johnson-Neyman methods were used to represent significant interactions. Irritability was significantly related to bullying (r = .403, p < .001). Social, but not generalized, anxiety symptoms significantly moderated the effect of irritability on bully perpetration (t(160) = -2.94, b = -.01, p = .0038, ΔR2 = .0229, F(1, 160) = 8.635). As social anxiety symptoms increase, the link between irritability and perpetration decreases. Understanding how psychopathology interacts with social behaviors is of great importance. Higher social anxiety is linked to reduced relations between irritability and bullying; however, the link between irritability and other aggression remains positive. Comprehensively assessing how treatment of psychopathology impacts social behaviors may improve future intervention.

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

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

Salivary CRP predicts treatment response to virtual reality exposure therapy for social anxiety disorder

BackgroundSocial anxiety disorder (SAD) places a profound burden on public health and individual wellbeing. Systemic inflammation may be important to the onset and maintenance of SAD, and anti-inflammatory treatments have shown promise in relieving symptoms of SAD. In the present study, we conducted secondary analyses on data from a randomized clinical trial to determine whether C-reactive protein (CRP) concentrations and social anxiety symptoms decreased over the course of virtual reality exposure therapy, and whether changes in social anxiety symptoms as a function of treatment varied as a function of CRP. MethodAdult participants (N = 78) with a diagnosis of SAD (59 % female) were randomized to receive exposure therapy alone, or exposure therapy supplemented with scopolamine. Social anxiety symptoms, salivary CRP, and subjective units of distress were measured across three exposure therapy sessions, at a post-treatment extinction retest, and at a 1-month follow-up. ResultsCRP decreased over the course of treatment, b = −0.03 (SE = 0.01), p =.02 95 %CI [−0.06, −0.004], as did all social anxiety symptom domains and subjective distress. Higher CRP was associated with greater decreases from pre-treatment to 1-month follow-up in fear, b = −0.45 (SE = 0.15), p =.004 95 %CI [−0.74, −0.15], and avoidance, b = −0.62 (SE = 0.19), p =.002 95 %CI [−1.01, −0.23], and in-session subjective distress from pre-treatment to post-treatment, b = −0.42 (SE = 0.21), p =.05 95 %CI [−0.83, −0.001]. However, declines in CRP were not correlated with declines in fear, r = −0.07, p =.61, or avoidance, r = −0.10, p =.49, within-persons. ConclusionsVirtual reality exposure therapy may be associated with an improvement in systemic inflammation in patients with severe SAD. Pre-treatment CRP may also be of value in predicting which patients stand to benefit the most from this treatment.

Emotion regulation as a mediator in the relationship between childhood maltreatment and symptoms of social anxiety among college students

Objective The current study explored emotion regulation strategies (ie, suppression, cognitive reappraisal, experiential avoidance) as mediators in the relationship between childhood maltreatment and social anxiety. Participants One hundred and ninety-three undergraduate students (M age = 19.5 years; 83.9% female) were recruited from a public university in the northeastern United States. Methods Participants completed measures assessing childhood maltreatment, emotion regulation strategies, and social anxiety. Results Structural equation modeling was used to examine the mediation paths. Childhood maltreatment was negatively associated with cognitive reappraisal and experiential avoidance, and positively associated with suppression. Higher suppression was associated with higher social anxiety, and higher experiential avoidance was associated with lower social anxiety. The association between childhood maltreatment and symptoms of social anxiety was mediated by suppression and experiential avoidance, but not cognitive reappraisal. All other paths were nonsignificant. Conclusions Findings suggest that treatments for childhood maltreatment should aim to bolster experiential avoidance and minimize suppression to address social anxiety symptoms.

Low-intensity mindfulness and cognitive–behavioral therapy for social anxiety: a pilot randomized controlled trial

BackgroundCognitive–behavioral therapy (CBT) effectively improves the clinical symptoms of social anxiety disorder. However, there are non-responders who cannot decrease their cost/probability bias significantly; hence, their social anxiety symptoms remain unaddressed. Mindfulness training and cognitive–behavioral approaches promote a reduction in cost/probability bias and social anxiety symptoms. This study examines the effectiveness of a four-session program of mindfulness and CBT (M-CBT) in a non-clinical sample of individuals with high social anxiety.MethodsParticipants were 50 Japanese undergraduate students (37 women and 13 men) randomly allocated to an intervention group (n = 27) and a control group (n = 23). The intervention group underwent a four-session M-CBT program, while the control group did not receive any treatment.ResultsA group × time analysis of covariances showed significant interactions in the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. M-CBT also produced significant pre-post improvements in the above outcomes with moderate to high effect sizes (ds = .51–1.55). Conversely, there were no interactions in social anxiety symptoms and self-focused attention.ConclusionsThese results indicate that M-CBT was effective for the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. The combination of mindfulness training with cognitive restructuring is proposed as potentially helpful for individuals with probability bias, leading to negative cognition from paying attention to others.Trial registrationUniversity Hospital Medical Information Network (UMIN CTR) UMIN000036763. Registered May 16, 2019.

Psychological Factors Associated with Functional Tic-like Behaviours during the COVID-19 Pandemic.

Functional tic-like behaviours (FTLB) are a female predominant functional neurological disorder that escalated in incidence during the SARS CoV2 pandemic. This study compared social and adaptive functioning, social media use, pandemic experiences, and psychiatric comorbidities between FTLB (n = 35), Tourette Syndrome (TS) (n = 22), and neurotypical (NT) (n = 25) participants ages 11 to 25 years. The psychiatric comorbidity burden for participants with FTLB was formidable, with frequencies ranging from 1.5 to 10 times higher for major depressive disorder and panic disorder compared to TS and NT participants. Borderline personality disorder (BPD), agoraphobia, social anxiety disorder, and generalized anxiety disorder were also significantly more common in FTLB compared to NT participants. Vulnerable attachment scores, social phobia and social interaction anxiety symptoms were higher in participants with FTLB than NT but not TS. Overall distress tolerance, resilient coping, suggestibility, hours on social media, and exposure to tic and TS content were not significantly different between groups. FTLB participants rated their mental health declined more severely during the pandemic than both TS and NT participants and were more likely to experience trouble sleeping, loneliness, and difficulty affording housing and food than NT participants. Participants with FTLB were significantly more likely to identify as gender minority people than TS and NT, though there were no significant differences based on gender identity in the study variables within the FTLB group. The association and potential pathways explaining how psychiatric disorders may be contributing to FTLB, and why certain groups appear at particular risk are discussed.

Underlying Processes in the Norwegian Universal Preventive Program for Social Anxiety

Few prevention investigations undergo testing of mechanistic hypotheses. To date, no published study has reported the processes underlying the effectiveness of a prevention program aimed at reducing social anxiety in a population-based sample of preadolescents. A parallel multiple mediator model was used to examine the mediation of outcomes from the Norwegian Universal Prevention Program for Social Anxiety (NUPP-SA) by five intermediary variables that well approximate established DSM-5 social anxiety disorder diagnostic criteria. The NUPP-SA works differently for preadolescents with subsyndromal versus syndromal social anxiety. Among the former, the NUPP-SA intervention works via public performance, avoidance, physical/cognitive, and assertiveness factors. For the latter, the NUPP-SA works via the public performance factor. The intervention did not work for either group via the social encounter factor. Universal prevention programs are essential for reducing the impacts of chronic disorders at the individual, institutional, and societal levels. Introducing a universal prevention program in school settings requires validation, including these results demonstrating that the NUPP-SA affects both those with syndromal and subsyndromal social anxiety symptoms via public performance. These results support the notion that many children with subsyndromal social anxiety disorder can be impacted with adequate intervention, which is both feasible and, given the widespread problem with public speaking, suggests a target for universal implementation.

Peer victimization and social anxiety in adolescence: a comparison between migrant and native students in Italy.

The first aim of this study is to investigate the relationship between bullying victimization and social anxiety in native and migrant adolescents in Italy. Specifically, it was hypothesized that migrant adolescents (in comparison with natives) experience more frequent episodes of bullying victimization, which in turn, may be a risk factor for the development of social anxiety symptoms. The second aim of the study is to explore the relationships from reflected minority categorization to perceived ethnic discrimination at school and social anxiety symptoms, in the subgroup of migrant students. Results showed that the migrant (vs. native) status was predictive of higher scores in social anxiety dimensions (Fear of Negative Evaluation, Social Avoidance and Distress in New Situations, and General Social Avoidance Distress), via the mediating effect of increased peer victimization. Moreover, in the subgroup of migrant participants, an indirect effect of reflected minority categorization on social anxiety was observed, mediated by perceived ethnic discrimination at school. These findings may contribute to the understanding of health inequalities among migrant and native people in the Italian context. Limitations and practical implications of the study were discussed.

Alterations in cortical thickness of frontoparietal regions in patients with social anxiety disorder

Although functional changes of the frontal and (para)limbic area for emotional hyper-reactivity and emotional dysregulation are well documented in social anxiety disorder (SAD), prior studies on structural changes have shown mixed results. This study aimed to identify differences in cortical thickness between SAD and healthy controls (CON). Thirty-five patients with SAD and forty-two matched CON underwent structural magnetic resonance imaging. A vertex-based whole brain and regional analyses were conducted for between-group comparison. The whole-brain analysis revealed increased cortical thickness in the left insula, left superior parietal lobule, left superior temporal gyrus, and left frontopolar cortex in patients with SAD compared to CON, as well as decreased thickness in the left superior/middle frontal gyrus and left fusiform gyrus in patients (after multiple-correction). The results from the ROI analysis did not align with these findings at the statistically significant level after multiple corrections. Changes in cortical thickness were not correlated with social anxiety symptoms. While consistent results were not obtained from different analysis methods, the results from the whole-brain analysis suggest that patients with SAD exhibit distinct neural deficits in areas involved in salience, attention, and socioemotional processing.

Individual, family and social-related factors of eating behavior among Chinese children with overweight or obesity from the perspective of family system.

The purpose of the present study is to examine the factors contributing to the development of eating behavior in overweight and obese children from the perspective of the family system. A cross-sectional survey was conducted by using convenience sampling method to select 388 participants in two primary schools in Jiangsu, China. Individual, family and social-related factors were collected. Individual factors included age, gender, ethnicity, single child, social anxiety, depression, physical activity, sleep duration, screen time. Family factors included family environment, family structure, family function, family income, parenting style, parental feeding behavior, home food environment and marital satisfaction. Social-related factors included place of residence, number of surrounding restaurants and social support. Univariate analysis, correlation analysis and multivariate analysis were used to identify factors of eating behavior among Chinese children with overweight and obese. In this study, 388 participants took part with a 94.865% response rate. In the univariate analysis, the significant differences regarding Dutch Eating Behavior Questionnaire (DEBQ) scores were found between children aged 6-9 years and those aged >9 years. Correlation analysis indicated that parent's nutrition literacy (r = 0.118, P < 0.05), pressure to eat (r = 0.212, P < 0.01), perception of child weight (r = -0.112, P < 0.05) and family function (r = -0.563, P < 0.01) were associated with children's eating behavior. With regard to psychosocial factors, children's social anxiety (r = 0.299, P < 0.01) and depressive symptoms (r = 0.081, P < 0.05) were in positive correlation with eating behavior. The independent variables included in the initial model were age, father's employment status, social anxiety, maternal punishment and harshness, parents' nutrition literacy, pressure to eat, family function and perception of child weight. These variables in the final model accounted for 20.7% of the variance. We found that age, father's employment status, social anxiety, maternal punishment and harshness, parents' nutrition literacy, pressure to eat, family function and perception of child weight have great effect on children's eating behavior who are overweight or obese. As early childhood is a critical timeline for child development, children's social anxiety, parenting style, parent's nutrition literacy, parent's feeding behavior and family function should be intervened to promote eating behavior. Intervention programs aimed at promoting healthy eating behaviors among children, thereby mitigating the risk of pediatric obesity, should primarily target parents.

Validation of the Brief Shame and Guilt Questionnaire for Children and young adolescents in Persian

ABSTRACT Social emotions such as shame and guilt are critical to social-emotional development in any culture because they help children and adolescents learn to adhere to the social rules and norms of their culture. However, most instruments that currently measure these emotions were validated only in samples from Western countries. This study aimed to translate and validate the Brief Shame and Guilt Questionnaire for Children (BSGQ-C) in children and adolescents living in Iran. A total of 453 children and adolescents aged 8 to 16 years filled out the BSGQ-C, consisting of 2 scales (Guilt: 6 items; Shame: 6 items) and questionnaires for social anxiety and worry. Factorial validity was confirmed by the intended two-factor structure, with an adequate test-score reliability for the scales. Concurrent validity was also confirmed: as expected, shame but not guilt was related to symptoms of social anxiety and worry.

Japanese Translation of the Concerns of Social Reprisal Scale and Examination of the Bivalent Fear of Evaluation Model for Social Anxiety in Japan

AbstractThe bivalent fear of evaluation model explains the association of fear of evaluation and heightened social anxiety via concerns of social reprisal (CSR) and disqualification of positive social outcomes (DPSO). The constructs of the model may differ in individualistic (e.g., Australia) and collectivistic countries (e.g., Japan); however, no study has examined the model, including CSR, in collectivistic countries. This study develops the Japanese translation of the Concerns of Social Reprisal Scale (CSRS) and examines constructs of the bivalent fear of evaluation model in Japan. Overall, 496 participants completed CSR and social‐anxiety‐related questionnaires. Exploratory factor analysis revealed a 1‐factor structure for the Japanese translation of the CSRS. Convergent validity and internal consistency were supported by significant relationships between social‐anxiety‐related variables and high McDonald's ω coefficient. Discriminant validity was partially supported by higher correlation between the CSRS and DPSO scale than correlation to the fear of negative evaluation scale. Path analysis revealed that the best fitting bivalent fear of evaluation model is similar to the individualistic country model, although DPSO contributes to social anxiety symptoms more than fear of positive evaluation.

Social Evaluation in Emerging Adults: Associations with Interpretation Bias and Perceived Social Support.

Social anxiety symptoms are one of the most common mental health concerns across the lifespan (Bandelow and Michaelis in Dialogues Clin Neurosci 17(3):327-335, 2015. https://doi.org/10.31887/DCNS.2015.17.3/bbandelow ) and are especially relevant during emerging adulthood, when social feedback occurs daily (Auxier and Anderson in Social media use in 2021, 2021. https://www.pewresearch.org/internet/2021/04/07/social-media-use-in-2021/ ) as emerging adults navigate new social environments. Two cognitive processes have been identified as relevant to social anxiety: high threat interpretation bias (i.e., the tendency to appraise threat from ambiguity; Rozenman et al. in Behav Ther 45(5):594-605, 2014. https://doi.org/10.1016/j.beth.2014.03.009 ; J Anxiety Disord 45:34-42, 2017. https://doi.org/10.1016/j.janxdis.2016.11.004 ) is associated with high social anxiety, whereas high perceived social support is associated with low social anxiety. In this study, emerging adults (N = 303) completed an online adaptation of the Chatroom task (Guyer et al. in Arch Gener Psychiatry 65(11):1303-1312, 2008. https://doi.org/10.1001/archpsyc.65.11.1303 ), an experimental paradigm designed to simulate social acceptance and rejection, as well as a performance-based measure of interpretation bias (Word Sentence Association Paradigm; Beard and Amir in Behav Res Ther 46(10):1135-1141, 2008. https://doi.org/10.1016/j.brat.2008.05.012 ), and a self-report measure of perceived social support (Multidimensional Scale of Perceived Social Support; Zimet et al. in J Pers Assess 52(1), 30-41, 1988. https://doi.org/10.1207/s15327752jpa5201_2 ). Social anxiety symptoms did not increase as a function of acceptance or rejection during the Chatroom task. However, there were significant interactions between each cognitive predictor and social anxiety change: emerging adults with low interpretation bias towards threat and emerging adults with high perceived social support both experienced decreases in social anxiety from pre- to post-Chatroom task, regardless of whether they were accepted or rejected during the Chatroom task. If replicated, low interpretation bias and high perceived social support may serve as promotive factors in social interactions for emerging adults.

Prevalence and Severity of Social Anxiety Symptoms and Their Relationship With Body Dysmorphic Symptoms.

Background Social anxiety disorder (SAD) is a subtype of anxiety characterized by avoidance, fear, and physical symptoms such as dry mouth, sweating, palpitations, and blushing. SAD is one of the most common mental disorders. Body dysmorphic disorder (BDD) is a mental disorder marked by a distressing or impairing preoccupation with imagined or minor flaws in one's physical appearance. Both disorders share similar symptoms. No satisfactory data have been provided about the prevalence of social anxiety symptoms in our region. In our study, we measured the prevalence and severity of SAD symptoms among adults in Riyadh City, as well as the sociodemographic factors associated with it. Additionally, the correlation between SAD and BDD was assessed. Methods Our study is quantitative, observational, and cross-sectional. It was conducted by administering a translated Arabic version of the Severity Measure for Social Anxiety Disorder scale and BDD scales in five locations in Riyadh, which include two general hospitals and three shopping malls. Data were analyzed using the SPSS version 22 (IBM Corp., Armonk, NY, USA). Descriptive statistical data are presented through mean values, standard deviations, and percentages. Results A total of 752 responses were received, of which 509 (68.32%) were from females with a mean age of 30.12 years. The majority of the sample had a low to middle family income, with 64% earning less than $2555 monthly. The sample possessed a good educational level; 63% had a bachelor's degree or higher. Our study also shows that 233 subjects (30.98%) had scores indicating a moderate to severe form of SAD. Among these participants, 86 (36.9%) had scores indicating a moderate to severe form of BDD. There was a significant positive correlation between SAD and BDD (r = 0.496). Conclusion The prevalence of SAD was 30.98%, which is higher compared to Western countries. Low income, education, and female gender have roles in the disease condition. Moreover, there was a linear relationship between SAD and BDD.

The Pattern of Structural Relationships between Emotional Schemas and Cognitive Fusion and Social Anxiety Symptoms in Students with the Mediating Role of Anxiety Sensitivity: A Descriptive Study

The Pattern of Structural Relationships between Emotional Schemas and Cognitive Fusion and Social Anxiety Symptoms in Students with the Mediating Role of Anxiety Sensitivity: A Descriptive Study

Association between social capital and quality of life in older adults with subjective cognitive decline: A cross-sectional study

BackgroundSubjective cognitive decline (SCD) is increasingly recognized as a clinical and medical risk factor for mild cognitive impairment (MCI) and dementia. Currently, there is little evidence regarding the quality of life (QoL) in older adults with SCD and the impact of social capital on their QoL. AimsTo examine the perceptions of social capital and QoL among older adults with SCD. MethodsA total of 325 participants (92.9 % response rate) with a self-reported diagnosis of SCD completed the Chinese version of the 36-item Short-Form Health Survey, the Chinese Shortened Social Capital Scale and the Generalized Anxiety Disorder Scale. A t-test was used to compare the QoL score of our sample with the Chinese norm. Pearson correlation analysis and multivariate linear regression analysis were used to assess the association of social capital with QoL. ResultsSocial capital were strongly correlated with the total QoL, as well as its physical component summary and mental component summary. The QoL score of older adults with SCD was significantly lower than the Chinese norm (P < 0.001). Multivariate analysis showed that social capital, physical activity, nutrition and anxiety symptoms were factors associated with QoL among older SCD population (P < 0.05). ConclusionThe findings of the current study suggest that older adults with SCD may experience lower QoL. Social capital is associated with the QoL in older adults with SCD. These findings have implications for clinicians who work with older adults with SCD.

Longitudinal associations of daily affective dynamics with depression, generalized anxiety, and social anxiety symptoms

BackgroundLow average affect, measured using ecological momentary assessment (EMA), has been consistently linked with depression, generalized anxiety, and social anxiety, supporting trait-like negative affect as a shared underlying feature. However, while theoretical models of emotion regulation would also implicate greater variability in daily affect in these conditions, empirical evidence linking EMA of mood variability with affective disorders is mixed. We used multilevel modeling to test relationships of daily mood and mood variability with depression, generalized anxiety, and social anxiety symptoms. MethodsParticipants (N = 1004; 72.31 % female; Mage = 40.85) responded to EMA of mood 2-3×/day and completed measures of depression (PHQ-8), generalized anxiety (GAD-7), and social anxiety (SPIN) every three weeks. ResultsLower mean affect predicted all symptoms at both the between-person (PHQ-8: β = −0.486, p < 0.001; GAD-7: β = −0.429, p < 0.001; SPIN: β = −0.284, p < 0.001) and within-person (PHQ-8: β = −0.219, p < 0.001; GAD-7: β = −0.196, p < 0.001; SPIN: β = −0.049, p < 0.001) levels. Similarly, at the between-person level, greater affective variability was linked with all three clinical symptoms (PHQ-8: β = 0.617, p < 0.001; GAD-7: β = 0.703, p < 0.001; SPIN: β = 0.449, p < 0.001). However, within-person, affective variability related to depression (β = 0.144, p < 0.001) and generalized anxiety (β = 0.150, p < 0.001), but not social anxiety (β = 0.006, p = 0.712). LimitationsThe COVID-19 pandemic lockdown period occurred midway through the study. ConclusionFindings point to common and specific emotion dynamics that characterize affective symptoms severity, with implications for affective monitoring in a clinical context.

Exploring the facilitators and barriers to addressing social media's impact on anxiety within primary care: a qualitative study.

Several researchers and policymakers have acknowledged the alarming association between social media (SM) usage and anxiety symptoms in young adults. While primary care holds a crucial role in the improvement of health outcomes for those presenting with anxiety, there has been no research on GPs' perceptions of the impact of SM on anxiety. Furthermore, there has been little discussion of SM as a risk factor in anxiety-related consultations. This study is the first to use empirical research to inform how primary care can adapt to address SM's impact on anxiety within young adults. To identify the facilitators and barriers within primary care to addressing SM's impact on anxiety among young adults. A qualitative study of GPs in the UK. Following an exploratory pilot interview, semi-structured interviews with GPs (n = 7) were transcribed and thematically analysed, following an inductive approach. The following six facilitators were identified: a framework to facilitate discussion; open GP attitudes; GP training; referral pathways; larger stakeholder influence; and young adult education of social media's impact on anxiety. The following three barriers were identified: a lack of GP awareness of SM's impact on anxiety; cautious GP attitudes; and increased pressure on the health service. This qualitative study revealed a diversity of perceptions, and these novel findings are instructive in the adaptation of primary care services to meet the current mental health needs of young adults, as well as better assisting GPs in engaging in these conversations, especially within university practice.