Social avoidance has been associated with more persistent social anxiety disorder (SAD) symptoms and low testosterone levels in individuals with SAD. We tested whether pre-treatment avoidance ...tendencies moderate the efficacy of testosterone-augmented exposure therapy. Fifty-five females with SAD received two exposure sessions during which fear levels were assessed. Session 1 was augmented with testosterone (0.50 mg) or placebo. Avoidance tendencies and symptom severity were assessed pre- and post-exposure. Participants showed stronger avoidance for social versus non-social stimuli and this tendency remained stable over time. Stronger pretreatment avoidance tendencies were associated with larger fear reduction in the testosterone but not the placebo condition. This effect did not transfer to the second non-enhanced session or symptom severity. The findings support the hypothesis that individuals suffering from SAD with relatively stronger pretreatment avoidance tendencies benefit more from testosterone-augmentation, pointing to a potential behavioral marker for testosterone enhancement of exposure therapy.
•Individuals with SAD show stronger avoidance for social versus non-social stimuli.•Social Avoidance is associated with fear reduction in testosterone-enhanced-exposure.•Social Avoidance tendencies remained stable from pre- to post exposure.
This study examines the relationships between social anxiety, individual differences in emotion regulation strategies such as expressive suppression (ES) and cognitive reappraisal (CR), and their ...effects on depressive symptoms. Drawing upon a sample of 369 university students, the study employs a three-wave longitudinal design. Findings indicate a significant association between social anxiety and ES, but not with CR. Additionally, ES is positively associated with depressive symptoms, while CR is not. Path analysis results reveal that social anxiety at Time 1 predicts ES at Time 2, which, in turn, predicts depressive symptoms at Time 3. Furthermore, mediation analysis suggests that ES mediates the relationship between social anxiety and depressive symptoms. These findings underscore the importance of strategies aimed at reducing emotional suppression tendencies in clinical interventions targeting co-occurring social anxiety and depression.
Objective
Despite the ample literature on gender differences in anxiety and mood disorders, gender differences in social anxiety disorder (SAD) have received little empirical attention. The aim of ...the present study is to examine gender differences in 12‐months prevalence, patterns of comorbidity, clinical presentation, subjective distress and functional impairment, age of onset, and treatment seeking, and discuss their clinical implications.
Method
We used data from the National Comorbidity Survey‐Replication (NCS‐R; n = 652, 63.3% women) to examine gender differences.
Results
Main findings highlighted that compared with men, women are more likely to have SAD, to have a more severe clinical presentation of the disorder and to have greater subjective distress. Women are more likely than men to have comorbid specific phobia, generalized anxiety disorder and posttraumatic stress disorder, whereas men are more likely to have comorbid substance abuse disorders and conduct disorder.
Conclusions
Greater SAD prevalence and severity among women can have implications for assessment (e.g., potentially setting gender‐specific cutoffs) and treatment (e.g., guiding exposures) of SAD.
Abstract
The brain’s default mode network has a central role in the processing of information concerning oneself. Dysfunction in this self-referential processing represents a key component of ...multiple mental health conditions, particularly social anxiety disorder (SAD). This case-control study aimed to clarify alterations to network dynamics present during self-appraisal in SAD participants. A total of 38 adolescents and young adults with SAD and 72 healthy control participants underwent a self-referential processing fMRI task. The task involved two primary conditions of interest:
direct self-appraisal
(thinking about oneself) and
reflected self-appraisal
(thinking about how others might think about oneself). Dynamic causal modeling and parametric empirical Bayes were then used to explore differences in the effective connectivity of the default mode network between groups. We observed connectivity differences between SAD and healthy control participants in the reflected self-appraisal but not the direct self-appraisal condition. Specifically, SAD participants exhibited greater excitatory connectivity from the posterior cingulate cortex (PCC) to medial prefrontal cortex (MPFC) and greater inhibitory connectivity from the inferior parietal lobule (IPL) to MPFC. In contrast, SAD participants exhibited reduced intrinsic connectivity in the absence of task modulation. This was illustrated by reduced excitatory connectivity from the PCC to MPFC and reduced inhibitory connectivity from the IPL to MPFC. As such, participants with SAD showed changes to afferent connections to the MPFC which occurred during both reflected self-appraisal as well as intrinsically. The presence of connectivity differences in reflected and not direct self-appraisal is consistent with the characteristic fear of negative social evaluation that is experienced by people with SAD.
Current first-line treatment for social anxiety disorder (SAD), one of the most prevalent anxiety disorders, is limited in its efficacy. Hence, novel treatment approaches are urgently needed. The ...current review suggests a combination of meditation-based interventions and the administration of a psychedelic as a future alternative treatment approach. While both separate treatments show promise in the treatment of (other) clinical conditions, their combination has not yet been investigated in the treatment of psychopathologies.
With a systematic literature review, we aim to identify the potential mechanisms by which combined psilocybin and mindfulness treatment could adjust anomalous neural activity underlying SAD and exert therapeutic effects.
Thirty experimental studies investigating the neural effects of meditation or psilocybin treatment in healthy and patient samples were included. Findings suggest that psilocybin-assisted meditation interventions might change cognitive processes like biased attention to threat linked to SAD by modulating connectivity of the salience network, balancing the activity and connectivity of cortical-midline structures, and increasing frontoparietal control over amygdala reactivity.
Future studies should investigate whether psilocybin-assisted mindfulness-based intervention can provide therapeutic benefits to SAD patients who are do not remit following conventional therapy.
•Psychedelics’ and MM’s complementary effects on neurological mechanisms are suggested in SAD symptomatology.•Psilocybin can cause acute disintegration of core neural networks involved in SAD symptomatology.•MM intervention can exert modulatory effects during the post-psilocybin period when neural networks are reintegrated.•Psychedelic-MM therapy might help in SAD by changing self-focused attention, negative self-perception and emotion regulation.•Psychedelic-MM therapy might help in SAD via complementary effects on frontoparietal control over the limbic cortex.
The highly contagious Covid-19 virus is spreading around the world, and quarantining at home has become one of the main preventative behaviors, but it has also led to news blackouts, affecting ...people's normal life and interactions. In order to determine a predictor of cellphone addiction (CPA), the present study, based on the Risk of Information Seeking and Processing (RISP) model, investigated the relationship between personality (Neuroticism and Extraversion) and CPA during the epidemic, mediated by online social anxiety (OSA) and cyber danger belief (CDB). A total of 683 questionnaires were collected through snowball sampling and analyzed by Mplus. Results indicated that neurotic and extroverted individuals developed CPA through different mediating factors. Neuroticism affected CPA through OSA while Extraversion affected CPA through CDB. These findings highlight the importance of different mechanisms of individuals with different personalities. Corresponding cognitive treatments on the perception of social anxiety and cyber danger are recommended on neurotic and extroverted individuals, respectively, in order to reduce their degree of CPA.
•Neurotic people and Extroversive people develop cellphone addiction through different mediating factors and mechanisms.•Neuroticism affects cellphone addiction through online social anxiety.•Extraversion affects cellphone addiction through cyber danger belief.•The good fit of the current model supports the feasibility of the RISP theory at the micro level of mobile phone addiction.•COVID-19 increased individuals' reliance on smartphones while their personalities become more tendentious.
Objective
The Liebowitz Social Anxiety Scale‐Self Report (LSAS‐SR) is a self‐report measure of social anxiety (SA), which has shown adequate psychometric properties across cultures. However, no study ...has systematically evaluated its measurement invariance (MI) between (a) individuals with and without a diagnosis of social anxiety disorder (SAD) and (b) males and females. The current study addresses this issue.
Methods
We collected data on 257 (158 females) Italian individuals diagnosed with SAD and 356 (232 females) community‐dwelling adults.
Results
We initially found support for the unidimensionality of the Italian LSAS‐SR measurement model in all samples. Using the Graded Response Model, we obtained evidence of partial MI and differential item functioning between community‐dwelling and SAD‐diagnosed individuals and evidence of strong MI between male and female participants.
Conclusions
The results of this study suggest that the Italian LSAS‐SR measures the same trait in the same way across the symptom continuum and sexes, making it a psychometrically sound tool for assessment, screening, and research purposes.
Social anxiety disorder (SAD) and major depressive disorder (MDD) are highly comorbid, and together they result in greater functional impairment and a poorer prognosis than either condition alone. ...Theoretical models implicate impairments in emotion regulation in the development and maintenance of internalizing disorders, yet there has been no systematic comparison of emotion regulation in social anxiety and depression. The current review presents an in-depth examination of the literature on two widely-studied emotion regulation strategies, expressive suppression (ES) and cognitive reappraisal (CR), in SAD and MDD. Our review indicated that SAD is broadly characterized by an overreliance on ES, which is associated with negative social and emotional consequences. SAD is also characterized by ineffective utilization of CR, which inhibits the potential positive emotional benefits of this adaptive emotion regulation strategy. In contrast, MDD is broadly characterized by an underutilization of CR, which may be particularly detrimental in stressful or uncontrollable situations. For both SAD and MDD, treatment intervention appears to address deficits in CR but not ES. After reviewing the literature, we propose multiple pathways by which impairments in ES and CR may increase risk for the co-occurrence of SAD and MDD. Clinical implications and future research directions are also discussed.
•Social anxiety is characterized by an overreliance on expressive suppression.•Social anxiety is also connected to ineffective use of cognitive reappraisal.•Evidence is mixed regarding the role of expressive suppression in depression.•Depression is strongly associated with an underutilization of cognitive reappraisal.•Emotion regulation may play a role in co-occurring social anxiety and depression.
This meta-analysis examined the relationships between dimensions of perfectionism and social anxiety. A literature search using the databases PsychINFO, Medline, and Embase yielded 40 studies. Our ...findings showed large to very-large-sized associations between social anxiety and dimensions of perfectionism related to perfectionistic concerns, namely socially prescribed perfectionism, doubts about actions, concerns over mistakes, and discrepancy, as well as self-presentational perfectionism. Overall, our findings suggest that when understanding and treating social anxiety, it would be worthwhile considering the individual’s beliefs that others expect perfection, their tendency to doubt their own action, their concern over making mistakes, and beliefs about needing to present themselves perfectly. Explorative moderation analysis suggests that individual differences such as age, sex, and type of social anxiety did not moderate the relationship between perfectionism and social anxiety. Region moderated the association between perfectionistic strivings and social anxiety. Sample setting should be considered when understanding how dimensions of perfectionism relate to social anxiety. Our results shed light on the importance of perfectionism in social anxiety, which may inform the future development of interventions that target perfectionism in social anxiety. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)
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