Adolescents who experience social anxiety concerns often display symptoms and impairments when interacting with unfamiliar peers. For adolescent clients, reducing symptoms and impairments within ...these interactions comprises a key treatment target within exposure-based therapies for social anxiety. Recent work on mechanisms of change in exposure-based therapies highlights the need for therapeutic exposures to simulate real-world manifestations of anxiety-provoking social situations. Yet, researchers encounter difficulty with gathering ecologically valid data about social interactions with unfamiliar peers. The lack of these data inhibits building an evidence base for understanding, assessing, and treating adolescent clients whose concerns manifest within these social interactions. Consequently, we developed a paradigm for understanding adolescent social anxiety within social interactions with unfamiliar peers. In this paradigm, we train peer confederates to interact with adolescents as if they were a same-age peer, within a battery of social interaction tasks that mimic key characteristics of therapeutic exposures. Leveraging experimental psychopathology and multi-modal assessment approaches, this paradigm allows for understanding core components of social interactions with unfamiliar peers relevant to exposure-based therapy, including stimuli variability, habituation, expectancy violations, peers’ impressions about socially anxious adolescents, and maladaptive coping strategies that inhibit learning from exposures (e.g., safety behaviors). We detail the conceptual and empirical foundations of this paradigm, highlight important directions for future research, and report “proof of concept” data supporting these research directions. The Unfamiliar Peer Paradigm opens new doors for building a basic science that informs evidence-based services for social anxiety, within clinically relevant contexts in adolescents’ social worlds.
Effective mental health services require accurate assessment of psychosocial impairments linked to mental health concerns. Youth who experience these impairments do so within and across various ...contexts (e.g., school, home). Youth may display symptoms of mental health concerns without co-occurring impairments, and vice versa. Yet, nearly all impairment measures presume that those assessed display mental health concerns. Consequently, we recently developed youth and parent versions of a five-item measure of youth psychosocial impairments (i.e., Work and Social Adjustment Scale for Youth WSASY), structured to assess any youth, regardless of mental health status. Across two studies, we developed and tested a WSASY teacher version, in a large sample of 382 student teacher reports (Study 1), and a subsample of 66 youth who, along with their parents and teachers, completed the WSASY and a series of school- and home-based behavioral tasks (Study 2). In Study 1, WSASY teacher reports demonstrated excellent internal consistency and unique relations with teacher reports on well-established measures of psychosocial strengths and difficulties. In Study 2, teacher, youth, and parent WSASY reports demonstrated low correspondence with each other and context-specific relations with criterion variables. This low correspondence allowed us to capitalize on an integrative approach designed to optimize informant-specific variance. Integrative scores demonstrated robust, large-magnitude relations with criterion variables across multiple information sources. These findings provide important psychometric support for use of WSASY teacher reports, and pave the way toward integrating WSASY reports from multiple informants who observe youth psychosocial impairments within different contexts and from different perspectives.
Public Significance Statement
Effectively addressing the needs of youth clients who receive mental health services requires accurately measuring how their behavior gets in the way or impairs their daily life. We evaluated a measure for assessing school-based impairments, and demonstrated a new strategy for accurately combining data from school-based and home-based impairment measures.
Adolescents frequently experience social anxiety, with parents often serving as the primary source of clinical referral. Yet, adolescents’ needs for services often revolve around social anxiety that ...manifests when interacting with unfamiliar peers. Emerging work indicates that parents’ reports about adolescent social anxiety fail to predict adolescents’ self-reported experiences in these unfamiliar peer interactions. Detecting modifiable factors in the family environment may facilitate accurate detection of social environments that contribute to adolescents’ anxiety-related needs, and thus inform the goals of anxiety-related services. Low levels of one such family factor—parental monitoring (i.e., parental efforts to track adolescents’ whereabouts and activities)—robustly pose risk for adolescent maladjustment across various domains. Further, emerging work highlights the value of understanding patterns of discrepancies between parents’ and adolescents’ reports about parental monitoring. In this study, 134 adolescents and their parents completed parallel reports on a widely used survey measure of parental monitoring. Adolescents also participated in a controlled laboratory task (i.e., Unfamiliar Peer Paradigm) that simulates how adolescents interact with same-age, unfamiliar peers. Using recommended regression-based procedures for testing discrepancy hypotheses (i.e., polynomial regression and response surface analyses), we found that the interaction between low levels of either adolescent- or parent-reported parental monitoring (i.e., relative to each other) predicted increased adolescent social anxiety, based on trained independent observers’ ratings of adolescents’ behavior within the Unfamiliar Peer Paradigm. These findings have important implications for delivering mental health services for adolescent social anxiety, and accurately interpreting discrepancies between parents’ and adolescents’ reports about parental monitoring.
Among individuals experiencing internalizing psychopathology, high levels of emotion reactivity—the degree to which they experience emotions strongly or intensely, over extended periods of time, and ...as elicited by a variety of stimuli—increase risk for self-injurious thoughts and behaviors. Researchers developed the Emotion Reactivity Scale (ERS) to assess emotion reactivity, with psychometric support for the measure largely restricted to at-risk clinical populations. We know little of the psychometric properties of the ERS when administered as a screening measure in community assessments. In a study of the psychometric properties of the ERS in a non-clinical assessment of adults, we recruited 105 participants (
M
age
= 44.6; 82.9% female) as part of a larger study of adolescent social anxiety and family relationships. Participants completed the ERS, self-report measures of various psychosocial domains, and an impromptu speech task, before and during which they self-reported their arousal. Scores taken from the ERS demonstrated strong internal consistency and demonstrated facets of validity: (a) positive relations with measures of internalizing psychopathology and parent-adolescent conflict, and negative relations with a measure of quality of life (convergent validity); (b) relations with self-reported anxiety and safety-seeking behaviors, over-and-above self-reported depressive symptoms (incremental validity); and (c) relation with self-reported state arousal during the impromptu speech task, over-and-above self-reported arousal at baseline (criterion-related validity). These findings support the psychometric properties of the ERS when administered in non-clinic assessments of adults. As such, they have important implications for screening assessments designed to identify adults who display the potential for self-injurious thoughts and behaviors.
Abstract Adolescent social anxiety (SA) assessments often include adolescent and parent reports, and low reporting correspondence results in uncertainties in clinical decision-making. Adolescents ...display SA within non-home contexts such as peer interactions. Yet, current methods for collecting peer reports raise confidentiality concerns, though adolescent SA assessments nonetheless would benefit from context-specific reports relevant to adolescent SA (i.e., interactions with unfamiliar peers). In a sample of 89 adolescents (30 Evaluation-Seeking; 59 Community Control), we collected SA reports from adolescents and their parents, and SA reports from unfamiliar peer confederates who interacted with adolescents during 20-minute mock social interactions. Adolescents and parents completed reports on trait measures of adolescent SA and related concerns (e.g., depressive symptoms), and adolescents completed self-reports of state arousal within mock social interactions. Adolescents’ SA reports correlated with reports on parallel measures from parents in the .30s and with peer confederates in the .40s to .50s, whereas reports from parent-confederate dyads correlated in the .07 to .22 range. Adolescent, parent, and peer confederate SA reports related to reports on trait measures of adolescent SA and depressive symptoms, and distinguished Evaluation-Seeking from Community Control Adolescents. Confederates’ SA reports incrementally predicted adolescents’ self-reported SA over and above parent reports, and vice versa, with combined R s ranging from .51 to .60. These combined R s approximate typical correspondence levels between informants who observe adolescents in the same context (e.g., mother-father). Adolescent and peer confederate (but not parent) SA reports predicted adolescents’ state arousal in social interactions. These findings have implications for clarifying patterns of reporting correspondence in clinical assessments of adolescent SA.
Attempts to understand subjectivity have historically involved distinguishing the strengths of subjective methods (e.g., survey ratings from informants) from those of alternative methods (e.g., ...observational/performance-based tasks). Yet a movement is underway in Psychology that considers the merits of intersubjectivity: Understanding the space between two or more informant’s subjective impressions of a common person or phenomenon. In mental health research, understanding differences between subjective impressions have less to do with informants’ characteristics and more to do with the social environments or contexts germane to the people or phenomena examined. Our article focuses on one relatively understudied social environment: the cultural context. We draw from seminal work on psychological universals, as well as emerging work on cultural norms (i.e., cultural tightness) to understand intersubjectivity effects through a cross-cultural lens. We report a meta-analysis of 314 studies of intersubjectivity effects in mental health, revealing that (a) this work involves independent research teams in more than 30 countries, (b) informants rating a target person’s mental health (e.g., parent and teacher ratings of a child’s behavior) commonly provide diverging estimates of that person’s mental health, and (c) greater convergence between subjective reports relates to a “tighter” or more norms-bound culture. Our article illustrates strategies for understanding divergence between subjective reports. In particular, we highlight theoretical and methodological frameworks for examining patterns of divergence between subjective reports in relation to data from nonsubjective methods. We also describe how research on intersubjectivity informs efforts to improve the interpretability of subjective assessments in multiple subdisciplines in Psychology.
Adolescents at a high-risk for experiencing social anxiety display elevated distress and social skills deficits in social interactions with unfamiliar peers. However, not all adolescents find the ...same interactions distressing, necessitating an approach that is sensitive to key aspects of the social contexts in which interactions manifest. Along these lines, socially anxious adolescents may display significant impairments within interactions with unfamiliar peers, and yet a core challenge in clinical assessment involves simulating social interactions with unfamiliar peers. Recent work suggests that one can construct cross-contextual interaction tasks using personnel trained to resemble unfamiliar same-age peers. This study examined the psychometric properties of independent observers’ ratings of adolescents’ social anxiety and social skills within these tasks. Eighty-nine adolescents (
M
= 14.50 years; 30 clinic-referred; 59 community control) and their parents completed reports of adolescent social anxiety on parallel surveys. Adolescents participated in a series of counterbalanced tasks with trained unfamiliar peer confederates. These tasks assessed adolescents’ reactions to interactions with unfamiliar peers within unstructured versus structured social contexts. Two trained observers independently completed behavioral ratings of adolescents using a well-established coding system, and peer confederates completed survey reports about social anxiety for the adolescents with whom they interacted. Observers’ ratings related to informants’ survey reports of adolescent social anxiety and social skills. Observers’ ratings distinguished adolescents on referral status. Observers rated adolescents’ social anxiety highest and social skills lowest during unstructured social contexts, relative to structured social contexts. These findings have important implications for constructing evidence-based, cross-contextual behavioral assessments of adolescents’ social anxiety.
A key component of delivering mental health services involves evaluating psychosocial impairments linked to mental health concerns. Youth may experience these impairments in various ways (e.g., ...dysfunctional family and/or peer relationships, poor school performance). Importantly, youth may display symptoms of mental illness without co-occurring psychosocial impairments, and the reverse may be true. However, all available instruments for assessing youth psychosocial impairments presume the presence of mental health concerns among those assessed. Consequently, key gaps exist in knowledge about the developmental psychopathology of psychosocial impairments; and thus how to understand impairments in the context of youth mental health. To address these issues we developed a modified version of a 5-item measure of adult psychosocial impairments (i.e., Work and Social Adjustment Scale for Youth WSASY) and tested its psychometric properties. A mixed clinical/community sample of adolescents and parents completed parallel versions of the WSASY, along with a multi-domain, multi-method battery of measures of adolescent internalizing and externalizing concerns, parent psychosocial functioning, adolescent-parent conflict, adolescent peer functioning, and observed social skills. On both versions of the WSASY, increased scores related to increased adolescent mental health concerns, adolescent–parent conflict, parent psychosocial dysfunction, and peer-related impairments. WSASY scores also distinguished adolescents who displayed co-occurring mental health concerns from those who did not, and related to observed social skills deficits within social interactions with unfamiliar peers. The WSASY opens doors to new areas of inquiry regarding the developmental psychopathology of impairment, including questions regarding the onset of impairments and their links to mental health.
Adolescents who experience social anxiety tend to hold fears about negative evaluations (e.g., taunting) and may also hold fears about positive evaluations (e.g., praise from a teacher). The Brief ...Fear of Negative Evaluation (BFNE) scale and Fear of Positive Evaluation Scale (FPES) are 2 widely used measures of adults' evaluative concerns. Yet we know little about their psychometric properties when assessing adolescents. In a mixed clinical/community sample of 96 adolescents (66.7% female; M = 14.50 years, SD = 0.50; 63.3% African American), we examined both self‐report and parent report versions of the BFNE and FPES. Adolescents and parents also provided reports about adolescents on survey measures of social anxiety and depressive symptoms. Adolescents participated in multiple social interactions in which they self‐reported their state arousal before and during the tasks. Adolescent and parent BFNE and FPES reports distinguished adolescents who displayed elevated social anxiety from those who did not. Both informants' reports related to survey measures of adolescent social anxiety, when accounting for domains that commonly co‐occur with social anxiety (i.e., depressive symptoms). Further, both the BFNE and FPES displayed incremental validity in relation to survey measures of adolescent social anxiety, relative to each other. However, only adolescents' BFNE and FPES reports predicted adolescents' self‐reported arousal within social interactions, and only adolescents' FPES displayed incremental validity in predicting self‐reported arousal, relative to their BFNE. Adolescent and parent BFNE and FPES reports display convergent validity and in some cases incremental and criterion‐related validity. These findings have important implications for evidence‐based assessments of adolescents' evaluative concerns.
Objectives
Socially anxious adolescents often display fears of negative evaluation (FNE) and fears of positive evaluation (FPE). The Bivalent Fear of Evaluation model posits that FNE and FPE ...represent two poles of socio-evaluative fears, and that individuals may simultaneously display high levels of FNE and FPE (high FNE/FPE). To what degree do adolescents who display high FNE/FPE differ in psychosocial functioning from adolescents who display high concerns on one domain and not the other (either high FNE/low FPE, or low FNE/high FPE), or low concerns on both domains (i.e., low FNE/FPE)? We tested this broader question (a) across multiple psychosocial domains, (b) using multiple informants’ reports to identify adolescents’ patterns of socio-evaluative fears, and (c) in relation to adolescents’ reactions to anxiety-provoking social situations with unfamiliar peers.
Methods
One-hundred twenty-seven 14–15-year-old adolescents and their parents completed measures of adolescents’ FNE, FPE, and domains of psychosocial functioning (i.e., social anxiety, safety behaviors, depressive symptoms, psychosocial impairments). Adolescents participated in several social interaction tasks with unfamiliar peers. Adolescents self-reported on their arousal during these tasks and the unfamiliar peers with whom they interacted completed measures of social anxiety about the adolescent.
Results
High FNE/FPE adolescents tended to display poorer psychosocial functioning relative to adolescents who displayed other patterns of socio-evaluative fears. Based on adolescent-classified groups, high FNE/FPE adolescents displayed greater self-reported arousal during social interactions, relative to the other groups.
Conclusions
Identifying adolescents’ patterns of socio-evaluative fears may inform interpretations of the individual differences among adolescents’ clinical presentations of social anxiety.
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