Mutual eye gaze and vocal pitch in relation to social anxiety and depression: A virtual interaction task.

BACKGROUND: Individuals with high social interaction anxiety (SIA) and depression often behave submissively in social settings. Few studies have simultaneously examined the associations between objectively assessed submissive behaviors and SIA or depression, despite their high comorbidity and unknown mechanisms regarding submissiveness. METHODS: A sample of 45 young adults self-reported trait SIA and depression, state positive/negative affect (PA/NA) before and after a virtual social interaction. Participants engaged in a four-minute conversation with a confederate who was trained to behave neutrally. Mutual eye gaze, via eye-tracking, and vocal pitch were assessed throughout the interaction. RESULTS: Depression and SIA were positively correlated with NA, poorer self-rated performance, and vocal pitch. Highly socially anxious women engaged in less mutual eye gaze than highly socially anxious men. Also, vocal pitch was inversely associated with mutual eye gaze and positively related to NA and (nonsignificantly) to self-ratings of poor performance. Finally, our data partially replicated past research on the use of vocal pitch during social stress to detect social anxiety disorder. LIMITATIONS: The current sample is relatively homogenous in educational attainment, age, and race. All research confederates were women. Future research should examine whether these archival data replicate with the latest telecommunication technologies. CONCLUSION: Our findings highlight nuanced relationships among SIA, depression, emotions, self-perceptions, and biobehavioral indicators of submissive behavior-in response to an ambiguously negative/positive social interaction. Sex/gender may interact with these effects, emphasizing considerations for research method designs.

"Fear guides the eyes of the beholder": Assessing gaze avoidance in social anxiety disorder via covert eye tracking of dynamic social stimuli.

Gaze avoidance is an important feature of social anxiety disorder (SAD) and may serve as a biobehavioral marker of SAD. The purpose of the present study was to replicate and extend findings on gaze avoidance in SAD via eye tracking during a computerized social simulation. Patients with SAD (n = 27) and a (sub)sample of demographically-matched healthy controls (HC; n = 22) completed a computerized, dynamic social simulation task involving video clips of actors giving positive and negative social feedback to the participant. All participants were unknowingly eye tracked during the simulation, and post-study consent was obtained to examine responses. Consistent with the bivalent fear of evaluation (BFOE) model of social anxiety, fear of positive evaluation related systematically to state anxiety in response to positive social feedback, and fear of negative evaluation related systematically to state anxiety in response to negative social feedback. Moreover, compared to HCs, SAD patients exhibited significantly greater global gaze avoidance in response to both the positive and negative video clips. Our results provide strong additional support for gaze avoidance as a biobehavioral marker of SAD, as well as additional support for the BFOE model. Implications for the assessment and treatment of SAD are discussed.

Intolerance of uncertainty moderates the relations among religiosity and motives for religion, depression, and social evaluation fears.

OBJECTIVES: Intolerance of uncertainty (IU) underlies several psychological disorders, and religion may help some individuals cope with IU and/or protect against psychological symptoms. It was hypothesized that IU would moderate the relations between coping motives for being religious, as well as religiosity, and common psychological disorder symptoms: Depression and social evaluation fears. METHODS: Study 1 included 473 self-reporting community members (M age = 48, 48% female, 80% Protestant/Catholic). Study 2 included 412 self-reporting undergraduates ( M age = 19, 71% female, 76% Protestant/Catholic). RESULTS: For Study 1, coping-based motives related to greater depression for young adults with above-average IU and to lower depression for young adults with below-average IU. For Study 2, religiosity related to lower depression and fear of negative evaluation for individuals with above-average IU and to greater fear of positive evaluation for individuals with below-average IU. CONCLUSION: IU may be an important mechanism between aspects of religion and psychological disorder symptoms.

Web-based CBT for the prevention of anxiety symptoms among medical and health science graduate students.

Medical and health science graduate students report greater anxiety problems than the general population, but they are less likely to seek treatment due to cultural and logistical barriers. One preventative approach that overcomes these barriers is web-based cognitive behavioral therapy (webCBT). It is unknown whether webCBT is effective for preventing anxiety escalation within this population. A randomized controlled trial was conducted, comparing the effects of webCBT versus a control group (CG). Medical university students (n=594; Mage=27; 67% female; 80% Caucasian) completed online baseline measures and four assigned online activities. Measures were re-administered after approximately three months. There was a small interaction effect between time of assessment and treatment condition. Anxiety severity was lower in the webCBT (M[SD]=2.88[3.36]) versus CG condition (M[SD]=3.69 [3.35]) at follow-up. This effect was moderate for students with mild, versus minimal, anxiety at baseline. The proportion of students with possible anxiety disorder was lower in the webCBT (4.5%) versus CG (8.5%) condition, and the proportion of mildly anxious students with a clinically significant increase in symptoms was lower in the webCBT (10%) versus CG (20%) condition. WebCBT may aid in preventing anxiety escalation in this population, particularly for at-risk students who report mild anxiety symptoms.

Preliminary evidence for differential olfactory and trigeminal processing in combat veterans with and without PTSD.

Structural and functional changes in the olfactory system are increasingly implicated in the expression of PTSD. Still, very little is known about the neurobiological networks of trauma-related odor sensitivity or how they relate to other objective and subjective measures of olfaction and PTSD. The purpose of this study was to replicate prior findings and further characterize olfactory function in trauma-exposed combat veterans with and without PTSD. We also sought to extend this area of research by exploring the effects of time since the combat-related index trauma (TST) on post-trauma olfactory function, as well as by correlating odor-elicited brain activity to general olfactory ability and odor-elicited PTSD symptoms. Participants included combat veterans with PTSD (CV+PTSD; n = 21) or without any psychiatric disorder (CV-PTSD; n = 27). TST was coded as greater (n = 24) or less (n = 24) than 5 years. There were main effects and/or interaction for PTSD-status and TST across several parameters of olfactory function: odor detection, odor identification, ratings for trauma-related odor intensity and triggered PTSD symptoms, and trauma odor-elicited brain activation. Overall, results suggest olfactory impairment in chronic PTSD, but not necessarily in the earlier stages of the disorder, although some early-stage olfactory findings may be predictive of later olfactory impairment. Results also suggest that trauma-exposed individuals who never develop PTSD may demonstrate olfactory resiliency. Finally, results highlight a potentially unique role of trigeminal odor properties in the olfactory-PTSD relationship.

Effects of gender role self-discrepancies and self-perceived attractiveness on social anxiety for women across social situations.

BACKGROUND AND OBJECTIVES: Psychosocial factors, such as gender role norms, may impact how social anxiety disorder (SAD) is experienced and expressed in different social contexts for women. However to date, these factors have not been examined via experimental methodology. DESIGN: This was a cross-sectional, quasi-experimental controlled study. METHODS: The current study included 48 highly socially anxious (HSA) women (70.9% meeting criteria for SAD) and examined the relationships among psychosocial factors (i.e. gender role self-discrepancies and self-perceived physical attractiveness), self-perceived social performance, and state anxiety, across two in vivo social tasks (i.e. conversation and opinion speech). RESULTS: On average, participants reported belief that they ought to be less feminine for the speech task and more masculine for both the conversation and speech tasks. Also, for the conversation task, only lower self-rated attractiveness predicted poorer self-perceived performance and greater post-task state anxiety, above gender role self-discrepancies and confederate gender. For the speech task, only greater self-discrepancy in prototypical masculine traits predicted poorer performance ratings, and it was related to greater state anxiety in anticipation of the task. CONCLUSION: For HSA women, psychosocial factors may play different roles in social anxiety across social contexts.

Relations among Social Anxiety, Eye Contact Avoidance, State Anxiety, and Perception of Interaction Performance during a Live Conversation.

There is building evidence that highly socially anxious (HSA) individuals frequently avoid making eye contact, which may contribute to less meaningful social interactions and maintenance of social anxiety symptoms. However, research to date is lacking in ecological validity due to the usage of either static or pre-recorded facial stimuli or subjective coding of eye contact. The current study examined the relationships among trait social anxiety, eye contact avoidance, state anxiety, and participants' self-perceptions of interaction performance during a live, four-minute conversation with a confederate via webcam, and while being covertly eye-tracked. Participants included undergraduate women who conversed with same-sex confederates. Results indicated that trait social anxiety was inversely related to eye contact duration and frequency averaged across the four minutes, and positively related to state social anxiety and negative self-ratings. In addition, greater anticipatory state anxiety was associated with reduced eye contact throughout the first minute of the conversation. Eye contact was not related to post-task state anxiety or self-perception of poor performance; although, trends emerged in which these relations may be positive for HSA individuals. The current findings provide enhanced support for the notion that eye contact avoidance is an important feature of social anxiety.

Fear of positive evaluation and alcohol use problems among college students: the unique impact of drinking motives.

BACKGROUND AND OBJECTIVES: There is strong empirical support that individuals with elevated social anxiety are at risk for alcohol-related impairment. Because social anxiety is a multifaceted construct, it is important to consider which specific facets contribute to alcohol problem vulnerability. For example, although social anxiety has traditionally been conceptualized as a fear of negative evaluation (FNE), emerging data suggest that fear of positive evaluation (FPE) is also an important factor in pathological social anxiety. The current manuscript reports novel findings regarding FPE, alcohol use motives, and reported alcohol use problems. DESIGN AND METHODS: Participants included undergraduates from two American universities (n = 351) who completed a battery of measures assessing fears of evaluation, drinking motives, and alcohol usage related problems. RESULTS: FPE significantly predicted alcohol use problems, above and beyond FNE. Also, coping and conformity motives for drinking, but not social or enhancement motives, each uniquely mediated the relationship between FPE and alcohol use problems. CONCLUSIONS: FPE may be an important cognitive-affective vulnerability factor. With additional clinical research, FPE could serve as a meaningful therapeutic target in interventions designed to decrease problem drinking among highly socially anxious patients.

Psychometric evaluation of the Concerns of Social Reprisal Scale: Further explicating the roots of fear of positive evaluation.

Fear of positive evaluation (FPE) has been proposed to be an important feature of social anxiety disorder (SAD) and to be rooted, at least partly, in concerns of social reprisal due to positive impressions. In order to formally test this hypothesis, the Concerns of Social Reprisal Scale (CSRS) was developed. The purpose of the present series of studies was to examine the psychometric profile of the CSRS across several independent samples including: a large (n=981) undergraduate sample; a clinical sample of individuals diagnosed with social anxiety disorder (n=27), and a demographically-matched subsample of healthy control participants (n=24). The factorial validity, internal consistency, and construct validity of the CSRS were examined. Results across both studies provided support for the psychometric profile of the CSRS. The implications of concerns of social reprisal for the assessment of social anxiety symptoms, theoretical models of fear of evaluation and SAD, and their potential clinical utility with regard to treating SAD are discussed.

Culture of honour theory and social anxiety: Cross-regional and sex differences in relationships among honour-concerns, social anxiety and reactive aggression.

Consistent with the "flight or fight" model of anxiety, social anxiety may incite withdrawal or attack; yet, it is unclear why some socially anxious individuals are vulnerable to aggress. It may be that culture impacts tendencies to "fight" or "flee" from social threat. Honour cultures, including the American South, permit or even promote aggression in response to honour-threats. Thus, social anxiety in the South may be more associated with aggression than in non-honour cultures. In the current sample, region moderated the relation between social anxiety and aggression; social anxiety related positively to reactive (but not proactive) aggression among Southerners (n = 285), but not Midwesterners (n = 258). Participant sex further moderated the relationship, such that it was significant only for Southern women. Also, for Southerners, prototypically masculine honour-concerns mediated the relationship between social anxiety and reactive aggression. Cultural factors may play key roles in aggressive behaviour among some socially anxious individuals.

Gaze avoidance in social anxiety disorder.

BACKGROUND: The relationship between gaze avoidance and social anxiety has been examined previously using eye-tracking and static social images. Overall, findings to date highlight increased gaze avoidance as a behavioral marker of social anxiety. The purpose of the present study was to better elucidate the relationship between gaze avoidance and social anxiety disorder (SAD) symptoms via covert eye tracking of gaze tendencies in response to a dynamic computerized social interaction simulation. On the basis of the bivalent fear of evaluation (BFOE) model of social anxiety,([1]) it was expected that participants with SAD, compared to nonsocially anxious control (NSAC) participants, would exhibit gaze avoidance in response to both positive and negative social feedback. METHODS: Participants with SAD (n = 20), and a sample of demographically equivalent NSAC (n = 19), were administered clinical diagnostic interviews and a computerized social simulation task. The simulation task consisted of viewing 26 dynamic videos (13 positive and 13 negative), each 12 s in duration. All participants were covertly eye tracked during the simulation. RESULTS: SAD participants exhibited greater global gaze avoidance in response to both the positive and negative video clips in comparison to the controls. Moreover, the SAD group exhibited equivalent gaze avoidance in response to stimuli of both emotional valences. CONCLUSIONS: These results provide additional support for gaze avoidance as a behavioral marker of SAD, as well as additional support for the BFOE model. Implications for the assessment of SAD are discussed.

"The Sound of Fear": assessing vocal fundamental frequency as a physiological indicator of social anxiety disorder.

The relationship between vocal pitch and social anxiety disorder (SAD) has been examined with encouraging initial results, highlighting increased fundamental frequency (F0) as a physiological indicator of SAD. The present series of studies examined the relationship between F0 emitted during social threat and SAD symptoms. Two independent samples of SAD patients, and a sample of demographically-equivalent non-socially anxious controls (NSACs), completed varying social threat tasks which involved speech. Mean F0 emitted throughout the tasks was examined. Male SAD patients emitted greater F0 in comparison to NSACs across studies. For females, this relationship was significant only when examined in patients with SAD of the generalized subtype, and in response to in vivo social exposures. Furthermore, gender-specific thresholds for overall F0 emitted during social threat were identified which demonstrated excellent differentiation between patients with generalized SAD and NSACs. These results provide additional support for increased F0 as a physiological indicator of SAD.

The bivalent fear of evaluation model of social anxiety: further integrating findings on fears of positive and negative evaluation.

Accumulating evidence supports the premise that fear of evaluation in general is important in social anxiety, including fear of positive evaluation (FPE) as well as fear of negative evaluation (FNE). This study tested various hypotheses pertaining to a novel, expanded conceptualization of social anxiety involving these two distinct fears: the bivalent fear of evaluation (BFOE) model. Responses from a large undergraduate sample (N = 585) were examined. In addition, responses from a subsample of participants qualifying for a probable diagnosis of social anxiety disorder (SAD; n = 133) were examined, via mediational analyses, for potential mechanisms underlying FPE within highly socially anxious individuals. FPE exhibited a unique and significantly stronger relationship with concerns of social reprisal due to making positive impressions than did FNE. FPE related uniquely and negatively to trait positive affect/automatic thoughts, whereas FNE, FPE, and social anxiety all related uniquely and positively to trait negative affect/automatic thoughts. FPE, FNE, and social anxiety all related uniquely and positively to disqualification of positive social outcomes (DPSO). However, FPE related most strongly to DPSO attributions at the level of the self, and these attributions mediated the relationship between FPE and negative automatic thoughts in an analog clinical sample. Concerns of social reprisal due to making positive impressions on others mediated the relationship between FPE and DPSO attributions to others in an analog clinical sample. The obtained findings replicate and extend support for the BFOE model of social anxiety. Implications for the theoretical conceptualization and treatment of SAD are discussed.

Assessing the latent structure of the intolerance of uncertainty construct: an initial taxometric analysis.

Researchers have increasingly suggested that people with anxiety disorders share a common fear that the uncertain future will be catastrophic. Intolerance of uncertainty (IU) - the tendency to consider possible negative events as unacceptable and threatening, irrespective of probabilities - is representative of such fears. A key role has been indicated for IU in several anxiety and mood disorders; however, the present study appears to be the first latent structure examination of IU. Responses were obtained from a large sample (n=977; 65% women) unselected with regard to IU level, comprising anxiety disorder outpatients (i.e., putative taxon members), and community residents (i.e., putative complement class members). MAXEIG, MAMBAC, and L-Mode were performed with indicator sets drawn from the Intolerance of Uncertainty Scale-12. Assessments also included objective Comparison Curve Fit Indices. Results yielded converging evidence that IU symptoms have a dimensional latent structure. Comprehensive findings, implications, and future research directions are discussed.

Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers.

Anxiety sensitivity, distress tolerance, and discomfort intolerance have been identified as important factors related to alcohol use motives and alcohol-related problems. Yet, these variables are highly correlated and little work has delineated whether these psychological vulnerability factors are differentially related to alcohol use motives and problems. To fill this gap in the existing literature, the present study evaluated whether anxiety sensitivity, distress tolerance, and discomfort intolerance were differentially related to high-risk alcohol use motives (i.e., coping and conformity motives) and alcohol use problems among 224 young adult, current drinkers (52.3% women; M(age)=21.18, SD=7.08). Results indicated that distress tolerance, but not anxiety sensitivity or discomfort intolerance, was significantly related to coping motives for alcohol use. Additionally, anxiety sensitivity, but not distress tolerance or discomfort intolerance, was significantly related to conformity motives for drinking. For both sets of analyses, the observed significant effects were evident above and beyond the variance accounted for by alcohol consumption level, smoking rate, negative affectivity, and non-criterion alcohol use motives. Additionally, discomfort intolerance and anxiety sensitivity each predicted alcohol use problems; effects were not attributable to negative affectivity, cigarettes smoked per day, or shared variance with distress tolerance. Findings are discussed in relation to the role of emotional sensitivity and intolerance in terms of the motivational bases for alcohol use and alcohol use problems among young adult drinkers.