Re-assessing the assessment of fears of positive and negative evaluation: Scale development and psychometric evaluation of the Bivalent Fear of Evaluation Scale (BFOES).

The bivalent fear of evaluation (BFOE) model of social anxiety divides fear of evaluation into two distinct valences: fear of positive evaluation (FPE) and fear of negative evaluation (FNE). However, there is evidence that the two most widely utilized and psychometrically supported measures of FNE and FPE contain items which are ambiguous with regard to valence of evaluative fear. To formally address this, the BFOE Scale (BFOES) was developed, by merging items from measures of FNE and FPE into a single scale with an integrated response format. The present studies examined the psychometric profile of the BFOES across a large pooled archival dataset (N = 2216), which included approximately 10 % (n = 224) patients with social anxiety disorder (SAD). The factorial validity, internal consistency, and construct validity of the BFOES were examined. Additionally, item response theory analyses were employed for the purpose of merging items from self-report scales which utilized different Likert-type response formats. Results from both studies provided support for the psychometric profile of the BFOES. The implications of the BFOES for the assessment of social anxiety, and theoretical models of fear of evaluation and SAD, are discussed.

Development and validation of the positive evaluation core beliefs scale for social anxiety.

Fear of positive evaluation (FPE) is becoming recognised as an important component of social anxiety that is distinct from fear of negative evaluation (FNE). While core belief scales exist for fear of negative evaluation (FNE), none has been developed for FPE. Therefore, this paper describes the development and validation of a measure of core beliefs that is specific to FPE. An exploratory factor analysis was performed on 60 initial items with an Australian undergraduate sample, in which a confirmatory factor analysis was performed with an independent Australian general population sample. A series of further analyses were performed to test convergent and divergent validity. The Positive Evaluation Core Beliefs Scale (PECS) emerged as a 17-item two-factor psychometrically valid measure that correlates more strongly with measurement of FPE than FNE. The PECS measure offers a new opportunity for researchers and clinicians to better explore cognitions associated with social anxiety.

An experimental examination of appearance-related safety behaviors in a clinical sample of women.

Appearance-related safety behaviors (ARSBs) have been identified as a key mechanistic target in individuals with elevated appearance concerns, social anxiety symptoms, and body dissatisfaction. The aim of the present study was to experimentally test the effect of fading these behaviors in individuals with body dysmorphic disorder (BDD), social anxiety disorder, and/or an eating disorder (ED). Ninety-four female participants were randomized to either a 1-month text message-based ARSB fading condition (n = 47) or a self-monitoring control condition (n = 47). Findings demonstrated that individuals in the ARSB fading condition saw significantly greater reductions in postmanipulation appearance concerns, appearance importance, ED symptoms, general anxiety, and depression. ARSB fading also led to lower BDD and social anxiety disorder symptoms, though this was only found among those who met for these respective diagnoses. Furthermore, we found that changes in appearance importance partially mediated the effect of condition on appearance concerns, BDD symptoms, social anxiety symptoms, and ED symptoms. Compared to the control, the ARSB fading group also demonstrated less reactivity to an in vivo appearance-related stressor task. This study provides strong evidence for the importance of ARSBs in the maintenance of appearance-related psychopathology among a clinical sample. Findings demonstrate the potential utility of reducing ARSBs as an overarching treatment strategy for appearance-related psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Comorbidity and Quality of Life in DSM-5 Social Anxiety Disorder Among a Nationally Representative Sample.

Objective: Social anxiety disorder (SAD) is a prevalent and debilitating psychiatric disorder that is associated with impairments in functioning and detrimental outcomes such as suicide, poor physical quality of life (QOL), and overall mental health. The goal of the present study was to examine the past year comorbidities of DSM-5 SAD among a large nationally representative sample of US adults (N = 36,309) and to examine correlates of physical QOL and overall mental health among individuals with past-year SAD (N = 980).Methods: The study utilized data from the National Epidemiologic Survey on Alcohol and Related Conditions-III to examine diagnostic correlates of SAD as well as how symptoms and features of SAD are related to QOL using survey-weighted regression analyses.Results: We found that comorbid depression, anxiety disorders, posttraumatic stress disorder, and borderline personality disorder were positively associated with SAD. Further, presence of these disorders was also associated with poorer mental health among those with SAD. We also found that specific feared situations (eg, eating and drinking in public) and social anxiety symptoms (panic attack and avoidance) were linked to both forms of QOL (all ps <0.01).Conclusion: The present findings highlight that SAD is comorbid with other impairing disorders and that these comorbidities, specific feared situations, and SAD symptoms are related to worse QOL in individuals with SAD.

Correlates of alcohol use and alcohol use disorder among individuals with DSM-5 social anxiety disorder: A population based study.

Alcohol use disorder (AUD) commonly cooccurs with social anxiety disorder (SAD). With changes to diagnostic criteria of psychiatric disorders in the DSM-5, the present study sought to observe the associations between daily alcohol use, AUD, and social anxiety in a large sample of individuals with lifetime (N = 1255) and past-year (N = 908) SAD. The sample was derived from a large nationally representative study of adults in the United States. Of note, we found that at the symptom level, daily alcohol use and AUD were significantly related to panic attacks due to social anxiety, subjective distress, and impairment in relationships. Daily alcohol use and AUD were significantly associated with lifetime SAD severity; however, only past-year daily alcohol use was significantly related to past-year SAD severity. We also found that AUD was significantly related to greater treatment-seeking for SAD, and both AUD and daily alcohol use were significantly associated with lifetime history of suicide attempts even after covarying for SAD severity. The present study provides an updated investigation of alcohol use in individuals with DSM-5 SAD, and it underscores the significance of daily alcohol use as an important factor to consider in individuals with SAD.

The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review.

OBJECTIVE: This review aimed to systematically gather empirical data on the link between social anxiety disorder and ADHD in both clinical and non-clinical populations among adolescents and adults. METHOD: Literature searches were conducted in PsycInfo, PubMed, Scopus, and Web of Science, resulting in 1,739 articles. After screening, 41 articles were included. Results were summarized using a narrative approach. RESULTS: The prevalence of ADHD in adolescents and adults with SAD ranged from 1.1% to 72.3%, while the prevalence of SAD in those with ADHD ranged from 0.04% to 49.5%. Studies indicate that individuals with both SAD and ADHD exhibit greater impairments. All studies were judged to be of weak quality, except for two studies which were rated moderate quality. DISCUSSION: Individuals with SAD should be screened for ADHD and vice versa, to identify this common comorbidity earlier. Further research is needed to better understand the prevalence of comorbid ADHD and SAD in adolescents.

SADXAI: Predicting social anxiety disorder using multiple interpretable artificial intelligence techniques.

Social anxiety disorder (SAD), also known as social phobia, is a psychological condition in which a person has a persistent and overwhelming fear of being negatively judged or observed by other individuals. This fear can affect them at work, in relationships and other social activities. The intricate combination of several environmental and biological factors is the reason for the onset of this mental condition. SAD is diagnosed using a test called the "Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), which is based on several physical, emotional and demographic symptoms. Artificial Intelligence has been a boon for medicine and is regularly used to diagnose various health conditions and diseases. Hence, this study used demographic, emotional, and physical symptoms and multiple machine learning (ML) techniques to diagnose SAD. A thorough descriptive and statistical analysis has been conducted before using the classifiers. Among all the models, the AdaBoost and logistic regression obtained the highest accuracy of 88 % each. Four eXplainable artificial techniques (XAI) techniques are utilized to make the predictions interpretable, transparent and understandable. According to XAI, the "Liebowitz Social Anxiety Scale questionnaire" and "The fear of speaking in public" are the most critical attributes in the diagnosis of SAD. This clinical decision support system framework could be utilized in various suitable locations such as schools, hospitals and workplaces to identify SAD in people.

The Course of Anxiety-Specific Cognitive Bias Following Daycare/Inpatient Treatment in Youths with Social Phobia and School Absenteeism.

Social phobia (SP) is a common mental disorder in youth often accompanied by absence from school, which may require daycare or inpatient intervention (DC/IN). Objective: The present explorative study investigates changes in anxiety-specific implicit assumptions and interpretation bias following DC/IN. Methods: The study included 16 youths with SP (M age = 15.8 [SD = 1.24], females: 62.5 %) participating in DC/IN. We assessed the main outcomes using the Implicit Association Test and Affective Misattribution Procedure. Results: A large effect was shown for reducing implicit assumptions of feeling anxious (p = .142; η2p = .171) and for reducing the implicit interpretation bias (p = .137; η2p = .162). No change was indicated by effect size in implicit assumptions of feeling socially rejected (p = .649; η2p = .016). Social phobia symptoms initially correlated with changes in implicit assumptions of feeling anxious (r = .45). Conclusion: Effect sizes indicate that implicit anxiety-specific assumptions and interpretation bias descriptively improved following DC/IN. Thus, DC/IN may lead to meaningful improvements of anxiety-specific cognition in some individuals with high SP symptoms, emphasizing the relevance of cognitive behavioral approaches in the treatment of SP. Several limitations are discussed.

Nonverbal synchrony in diagnostic interviews of individuals with social anxiety disorder.

The present study examined nonverbal synchrony (i.e., synchrony between individuals' movement) during diagnostic interviews of individuals with and without social anxiety disorder (SAD). Specifically, 42 individuals with SAD and 42 individuals without SAD underwent a structured clinical interview, and videos of clinical interviews were analysed using Motion Energy Analysis (an objective machine-based video analysis) to quantify each individuals' movement as well as dyadic synchrony. Results indicated that interviews of individuals with SAD had significantly lower levels of nonverbal synchrony compared to interviews of individuals without SAD. In addition, interviews of individuals with SAD had lower levels of pacing compared to interviews of individuals without SAD (pacing refers to synchrony in which the interviewer initiates movement to which the participant responds). Analyses with social anxiety represented as a continuum of severity (vs. a diagnostic dichotomy) resulted in similar findings. Thus, individuals with SAD synchronized with interviewers' movement to a lesser extent compared to individuals without SAD, and social anxiety was associated with diminished synchrony. Implications for psychopathology and diagnosis of SAD are discussed.

Factor structure of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) in a clinical sample recruited from the community.

BACKGROUND: The Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) are widely used self-report questionnaires to assess symptoms of social anxiety. While SPS measures social performance anxiety, SIAS measures social interaction anxiety. They are mostly reported simultaneously, but there have not been consistent results of the joint factor structure and therefore no consistent recommendations on how to use and evaluate the questionnaires. This study aimed (1) to evaluate the underlying joint factor structure of the SPS and SIAS and (2) to test whether SPS and SIAS are reliable scales to assess two different aspects of social anxiety. METHODS: The one-factor, two-factor, and bifactor models were tested in a clinical sample recruited from the community and diagnosed with a social anxiety disorder. Exploratory and confirmatory factor analyses were conducted, bifactor-specific indices were calculated, and the content of the less fitting items was examined. RESULTS: Confirmatory factor analyses showed that the best-fitting model was the bifactor model with a reduced set of items. The bifactor-specific indices showed that the factor structure cannot be considered unidimensional and that SPS and SIAS are reliable subscales. A closer examination of the less fitting item content and implications for future studies are discussed. CONCLUSIONS: In conclusion, SPS and SIAS can be reported together as an overall score of social anxiety and are separately reliable measures to assess different aspects of social anxiety. TRIAL REGISTRATION: This is a secondary analysis of data from two trials registered under ISRCTN75894275 and ISRCTN10627379.

Exploring the clinical characteristics and etiological factors of comorbid major depressive disorder and social anxiety disorder.

The comorbidity between the major depressive disorder (MDD) and the social anxiety disorder (SAD) is significantly prevalent, necessitating a nuanced understanding of their overlapping clinical characteristics and shared etiological factors, including inflammatory biomarkers. To address this, we conducted a cross-sectional study from December 2021 to June 2022, encompassing 204 outpatients diagnosed with MDD-SAD comorbidity. We employed various psychometric assessments, such as the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Childhood Trauma Questionnaire (CTQ-28), Toronto Alexithymia Scale (TAS-20) and the Liebowitz Social Anxiety Scale (LSAS). Additionally, we analyzed inflammatory biomarkers including the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte platelet ratio (NLPR), systemic inflammation index (SII), and the systemic inflammation response index (SIRI). Our findings accentuated that patients primarily diagnosed with MDD exhibited elevated levels of certain inflammatory biomarkers. They reported more severe and atypical depressive symptoms (75.7% vs 58.5%; P = 0.010) and had significantly higher CTQ-28 subscale scores (P < 0.05). Our study unveils a complex relationship between MDD and SAD, with significant disparities in the symptom severity and inflammatory biomarker levels, thereby establishing a compelling case for dual-diagnosis treatment approaches. It elucidates the critical role of inflammation in the comorbidity of MDD and SAD, marking a pioneering step towards more comprehensive and holistic patient care strategies. These insights could potentially revolutionize therapeutic approaches in psychiatric care, promising significantly improved outcomes through early detection and integrated intervention strategies.

Examination of gaze behaviour in social anxiety disorder using a virtual reality eye-tracking paradigm: protocol for a case-control study.

INTRODUCTION: Social anxiety disorder (SAD) has an early onset, a high lifetime prevalence, and may be a risk factor for developing other mental disorders. Gaze behaviour is considered an aberrant feature of SAD. Eye-tracking, a novel technology device, enables recording eye movements in real time, making it a direct and objective measure of gaze behaviour. Virtual reality (VR) is a promising tool for assessment and diagnostic purposes. Developing an objective screening tool based on examination of gaze behaviour in SAD may potentially aid early detection. The objective of this current study is, therefore to examine gaze behaviour in SAD utilising VR. METHODS AND ANALYSIS: A case-control study design is employed in which a clinical sample of 29 individuals with SAD will be compared with a matched healthy control group of 29 individuals. In the VR-based eye-tracking paradigm, participants will be presented to stimuli consisting of high-res 360° 3D stereoscopic videos of three social-evaluative tasks designed to elicit social anxiety. The study will investigate between-group gaze behaviour differences during stimuli presentation. ETHICS AND DISSEMINATION: The study has been approved by the National Committee on Health Research Ethics for the Capital Region of Denmark (H-22041443). The study has been preregistered on OSF registries: https://doi.org/10.17605/OSF.IO/XCTAKAll participants will be provided with written and oral information. Informed consent is required for all the participants. Participation is voluntarily, and the participants can at any time terminate their participation without any consequences. Study results; positive, negative or inconclusive will be published in relevant scientific journals.

The effect of positive and negative evaluation on state anxiety and repetitive negative thinking in social evaluative situations: An experimental study.

The Bivalent Fear of Evaluation (BFOE) Model suggests that fears of negative and positive evaluation are core cognitive vulnerability and maintenance factors for social anxiety disorder The aim of this study was to experimentally assess cognitive and emotional effects of positive and negative feedback in social anxiety. False positive or negative feedback (vs no feedback) was provided following a speech task to high and low socially anxious individuals to investigate impacts on state anxiety and repetitive negative thinking (N = 152, Mage = 22.13, 69 % female). Measures were completed prior to the speech and after the false feedback but prior to an anticipated discussion with the group about participants' feedback and performance. High socially anxious participants reporting higher state anxiety and repetitive negative thinking than low socially anxious participants. There were no feedback type by group interactions, indicating that high socially anxious individuals experienced heightened social anxiety and repetitive negative thinking regardless of feedback type (or the absence of feedback). Exploratory analyses revealed that state fear of negative evaluation but not state fear of positive evaluation uniquely predicted both outcomes. Implications for theory and clinical practice are discussed.

Prevalence and correlates of cannabis use among individuals with DSM-5 social anxiety disorder: Findings from a nationally representative sample.

Cannabis use disorder (CUD) and frequency of use are highly related to social anxiety disorder (SAD). With updates to diagnostic criteria of psychiatric disorders and recent changes in cannabis laws, the present study sought to explore the relationships between cannabis use, CUD, and social anxiety in a large nationally representative sample of individuals with lifetime (N = 1255) and past-year SAD (N = 980). Notably, we found that at the symptom level, at least weekly cannabis use was significantly related to fear or avoidance of social situations interfering with relationships in both samples. Weekly + cannabis use and CUD were significantly associated with lifetime SAD symptom severity, but only weekly + cannabis use was related to SAD severity in the past-year sample. We also found that weekly + cannabis use but not CUD was related to greater odds of seeking treatment for SAD and suicide attempt history. Overall, these data provide an updated examination of cannabis use and SAD using DSM-5 criteria and a large nationally representative sample and also highlight the importance of weekly + cannabis use as a marker of severity and suicide risk in individuals with SAD.

Baseline Severity as a Moderator of the Waiting List-Controlled Association of Cognitive Behavioral Therapy With Symptom Change in Social Anxiety Disorder: A Systematic Review and Individual Patient Data Meta-analysis.

Importance: Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. Objective: To examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD. Data Sources: For this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial. Study Selection: Inclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD. Data Extraction and Synthesis: Authors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models. Main Outcomes and Measures: The main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS. Results: A total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list-controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = -20.3; 95% CI, -24.9 to -15.6; P < .001; Cohen d = -0.95; 95% CI, -1.16 to -0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = -0.22; 95% CI, -0.39 to -0.06; P = .009), indicating that individuals with severe symptoms had larger waiting list-controlled symptom reductions after CBT (Cohen d = -1.13 [95% CI, -1.39 to -0.88] for patients with very severe SAD; Cohen d = -0.54 [95% CI, -0.80 to -0.29] for patients with mild SAD). Conclusions and Relevance: In this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.

Evaluation of a smartphone application for self-help for patients with social anxiety disorder: a randomized controlled study-SMASH.

BACKGROUND: There is growing evidence that Internet-based cognitive behavioral therapy (ICBT) is as effective as a stand-alone treatment and helps facilitating access to treatment. Given the complexity of the treatment, we argue that the effect of ICBT could be even greater if guided by a therapist, as this could increase treatment adherence. We modified an established and well-evaluated treatment approach and developed a mobile application for treating social anxiety disorder (SAD). In the present study, we compare the efficacy of app use alone (APP) with video-based, therapist-guided app use (TG-APP) and with a wait-list control group (WLC) in terms of symptom reduction, and various secondary outcomes such as increase in quality of life or decrease of general psychological distress. METHODS/DESIGN: A within-between interaction design with randomization to one of three conditions will be used. In the APP condition, patients receive only the app without any additional contact with therapists, while in the TG-APP condition, therapists provide 8 sessions of video-based treatment in addition to using the app. The study will be conducted in two university outpatient treatment centers with reliably diagnosed SAD patients. The primary outcome will be defined as change in SAD symptoms, as measured by the Liebowitz Social Anxiety Scale (expert rating). Furthermore, a wide range of self-reports and clinician ratings for other symptoms (depression, general psychopathology) or quality of life will be used. A simulation-based power analysis for a 3 × 2 interaction effect (group × time) on the primary outcome in a linear mixed model resulted in a total sample size of N = 165. DISCUSSION: The present study will be one of the first to examine the additional benefit of therapist-guided video sessions regarding the use of an app treating SAD. Study results are pivotal to future treatment application in SAD.

Candidate Biological Markers for Social Anxiety Disorder: A Systematic Review.

Social anxiety disorder (SAD) is a common psychiatric condition associated with a high risk of psychiatric comorbidity and impaired social/occupational functioning when not promptly treated. The identification of biological markers may facilitate the diagnostic process, leading to an early and proper treatment. Our aim was to systematically review the available literature about potential biomarkers for SAD. A search in the main online repositories (PubMed, ISI Web of Knowledge, PsychInfo, etc.) was performed. Of the 662 records screened, 61 were included. Results concerning cortisol, neuropeptides and inflammatory/immunological/neurotrophic markers remain inconsistent. Preliminary evidence emerged about the role of chromosome 16 and the endomannosidase gene, as well as of epigenetic factors, in increasing vulnerability to SAD. Neuroimaging findings revealed an altered connectivity of different cerebral areas in SAD patients and amygdala activation under social threat. Some parameters such as salivary alpha amylase levels, changes in antioxidant defenses, increased gaze avoidance and QT dispersion seem to be associated with SAD and may represent promising biomarkers of this condition. However, the preliminary positive correlations have been poorly replicated. Further studies on larger samples and investigating the same biomarkers are needed to identify more specific biological markers for SAD.

Cognitive Variables in Social Anxiety Disorder in Children and Adolescents: A Network Analysis.

Clark and Wells' prominent model of social anxiety disorder (SAD) assumes that cognitive variables such as negative expectations or dysfunctional cognitions play a central role in the symptomatology of SAD. In contrast to adults, it is less clear how well the cognitive model can be applied to children and adolescents. A network analysis with seven nodes was conducted to explore the importance of cognitive variables and their interaction with symptoms of SAD based on N = 205 children and adolescents (8-18 years, M = 11.54 years). Cognitive variables had a high but differential impact within the positively connected network of SAD. Dysfunctional cognitions were most strongly connected within the network. Dysfunctional cognitions, as predicted by Clark and Wells' model, seem to act as a hub affecting several symptoms. The association between negative expectations and avoidance indicates that negative expectations may particularly contribute to the maintenance of SAD.

Measurement invariance of the Liebowitz Social Anxiety Scale-Self-Report.

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.

A transdiagnostic evaluation of contrast avoidance across generalized anxiety disorder, major depressive disorder, and social anxiety disorder.

BACKGROUND: The contrast avoidance model (CAM) proposes that persons with generalized anxiety disorder (GAD) are sensitive to sharp increases in negative emotion or decreases in positive emotion (i.e., negative emotional contrasts; NEC) and use worry to avoid NEC. Sensitivity to and avoidance of NEC could also be a shared feature of major depressive disorder (MDD) and social anxiety disorder (SAD). METHODS: In a large college sample (N = 1409), we used receiver operating characteristics analysis to examine the accuracy of a measure of emotional contrast avoidance in detecting probable GAD, MDD, and SAD. RESULTS: Participants with probable GAD, MDD, and SAD all reported higher levels of contrast avoidance than participants without the disorder (Cohen's d = 1.32, 1.62 and 1.53, respectively). Area under the curve, a measure of predictive accuracy, was 0.81, 0.87, and 0.83 for predicting probable GAD, MDD, and SAD, respectively. A cutoff score of 48.5 optimized predictive accuracy for probable GAD and SAD, and 50.5 optimized accuracy for probable MDD. CONCLUSION: A measure of emotional contrast avoidance demonstrated excellent ability to predict probable GAD, MDD, and SAD. Sensitivity to and avoidance of NEC appears to be a transdiagnostic feature of these disorders.