Catching a (sine) wave: Temporal dynamics of nonverbal synchrony in social anxiety disorder.

Individuals with social anxiety disorder (SAD) experience a range of interpersonal problems and studies have found that nonverbal synchrony (the coordination between interaction partners' movements) may be impaired in dyads in which one individual has SAD (Asher et al., 2020). In the present study, we examined the temporal dynamics of nonverbal synchrony during "getting aquatinted" conversations of individuals with and without SAD. Specifically, participants (n = 146) formed either SAD dyads (dyads in which one individual had SAD and the other did not; n = 37 dyads), or control dyads (dyads in which both individuals did not have SAD; n = 36 dyads). Dyads were randomized to either small talk or closeness-generating (i.e., intimate) conversations. We found that during conversations, nonverbal synchrony followed a repeating pattern of increases and decreases that was best modeled by a sinusoidal wave (explained variance = 63.74 %). We found significant Diagnosis × Social Context interactions in the temporal dynamics of nonverbal synchrony (i.e., in the parameters of sine waves). Specifically, we found that for SAD dyads (but not control dyads), the average sine wave amplitude which indicates increases and decreases in nonverbal synchrony was greater during small talk conversations compared to closeness-generating conversations. In addition, we found that among control dyads (but not SAD dyads), the average vertical offset of sine waves (i.e., the average level of nonverbal synchrony) during closeness-generating conversations was greater compared to small talk conversations. The findings are interpreted within the context of the social anxiety literature as capturing two distinct social-anxiety related processes, and suggest that when examined temporally (rather than averaged), nonverbal synchrony may be an important implicit biomarker of SAD.

Man vs. machine: A comparison of human and computer assessment of nonverbal behavior in social anxiety disorder.

Social anxiety disorder (SAD) is a common psychological disorder associated with broad interpersonal impairment. Most previous studies have examined nonverbal behavior in SAD using human coders. However, one recent study utilized a machine-based analysis of nonverbal behavior and dyadic synchrony in SAD (Asher, Kauffmann, & Aderka, 2020). In the present study, we compared human and computer assessments of nonverbal behavior in social anxiety to enhance our knowledge about their commonalities and unique differences in capturing nonverbal behavior in the context of SAD. Specifically, the present study included 152 individuals: 38 individuals diagnosed with SAD and 114 individuals without SAD. Participants formed 76 opposite-sex interaction dyads comprising either two individuals without SAD (n = 39 control dyads) or one individual with SAD and one individual without SAD (n = 37 SAD dyads). All participants underwent a getting-acquainted task and were videotaped during the conversation. Half of the interactions were small talk interactions and half were closeness-generating interactions that required significant self-disclosure. We found that both types of coding were associated with self-reported social anxiety but that machine-based coding was superior in capturing social anxiety in closeness-generating contexts. Implications for research on nonverbal behavior in SAD are discussed.

When two hearts beat as one: Heart-rate synchrony in social anxiety disorder.

Individuals with social anxiety disorder (SAD) experience significant interpersonal impairment. However, little is known about the physiological processes that are associated with interpersonal dysfunction in the disorder. In the present study we examined heart-rate (HR) synchrony in SAD during "getting-acquainted" interactions between opposite-sex partners. Participants included 118 individuals who formed 59 dyads: 30 dyads that included one individual with SAD and one non-socially anxious (NSA) individual (SAD dyads) and 29 dyads that included two NSA individuals (control dyads). Dyads were randomly assigned to either a closeness-generating conversation or a small talk conversation. For closeness-generating conversations, we found that social anxiety was positively associated with HR synchrony in control dyads but negatively associated with HR synchrony in SAD dyads. These results remained when controlling for depressive symptoms and participants' movement. Our findings suggest that in more intimate social contexts, SAD may impair the ability to create HR synchrony between interlocuters and this can have negative relational consequences. Our findings are further discussed in the context of cognitive behavioral and interpersonal models of SAD, and clinical and research implications are delineated.

I'm Not Feeling It: Momentary Experiential Avoidance and Social Anxiety Among Individuals With Social Anxiety Disorder.

Previous studies have found that social anxiety and experiential avoidance (EA) are significantly associated, but the directionality of this relationship has not been firmly established. The present study examined momentary EA and social anxiety using repeated measurements during an opposite-sex interaction. Participants were 164 individuals (50% female): 42 were diagnosed with social anxiety disorder (SAD) and the remaining 122 were non-socially-anxious individuals (NSAs). Participants formed 42 experimental dyads including 1 individual with SAD and 1 NSA individual, and 40 control dyads including 2 NSA individuals. Lower-level mediational modeling indicated that for individuals with SAD, a reciprocal relationship was observed in which changes in both EA and social anxiety mediated changes in each other. However, changes in EA explained approximately 89% of changes in social anxiety whereas changes in social anxiety explained approximately 52% of changes in EA throughout the interaction. For NSA individuals, only social anxiety predicted EA. These findings point to a deleterious cycle driven mostly by EA among individuals with SAD, but not NSA individuals. Findings are discussed within the context of previous empirical findings as well as acceptance and commitment therapy (ACT) and cognitive-behavioral models of psychopathology.

How real do you feel? Self- and partner-authenticity in social anxiety disorder.

Individuals with social anxiety disorder (SAD) experience substantial impairment in close and intimate relationships. To enhance our understanding of this impairment and the way it develops, we examined dyadic opposite sex interactions of individuals with and without SAD. Participants were 160 individuals who formed 80 dyads including either 1 individual with SAD and another nonsocially anxious (NSA) individual (42 experimental dyads), or 2 NSA individuals (38 control dyads). We examined self- and partner-ratings of authenticity of both partners at 3 time points over the course of the 30-min interaction. Multilevel linear models indicated that individuals with SAD reported lower self-authenticity compared to NSA individuals (both compared to their interaction partners and compared to those from control dyads). In addition, increases in self-authenticity during the interaction were significantly lower for the experimental dyads compared to the control dyads. Specifically, both individuals with SAD and their NSA partners experienced lower increases in self-authenticity compared to NSA individuals from the control dyads. We also found that individuals with SAD rated their partners as less authentic compared to both their NSA interaction partners as well as NSA individuals from the control dyads. We discuss our findings in the context of cognitive and interpersonal models and suggest that authenticity may contribute to deleterious maintaining processes of SAD. Clinical implications of our findings are also discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Gender differences in social anxiety disorder.

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.

Gender differences in social anxiety disorder: A review.

Gender differences in social anxiety disorder (SAD) have not received much empirical attention despite the large body of research on the disorder, and in contrast to significant literature about gender differences in other disorders such as depression or posttraumatic stress disorder. To address this gap, we comprehensively reviewed the literature regarding gender differences in eight domains of SAD: prevalence, clinical presentation, functioning and impairment, comorbidity, course, treatment seeking, physiological arousal, and the oxytocin system. Findings from the present review indicate that women are more likely to have SAD and report greater clinical severity. Notwithstanding, men with the disorder may seek treatment to a greater extent. According to the present review, the course of SAD seems to be similar for men and women, and findings regarding gender differences in functional impairment and comorbidity are inconclusive. We highlight areas requiring future research and discuss the findings in the context of a number of theoretical perspectives. We believe that further research and integration of scientific findings with existing theories is essential in order to increase our understanding and awareness of gender differences in SAD, thus facilitating gender-sensitive and specifically-tailored interventions for both men and women with the disorder.

An intervention program to reduce the number of hospitalizations of elderly patients in a primary care clinic.

BACKGROUND: The elderly population consumes a large share of medical resources in the western world. A significant portion of the expense is related to hospitalizations. OBJECTIVES: To evaluate an intervention program designed to reduce the number of hospitalization of elderly patients by a more optimal allocation of resources in primary care. METHODS: A multidimensional intervention program was conducted that included the re-engineering of existing work processes with a focus on the management of patient problems, improving communication with outside agencies, and the establishment of a system to monitor quality of healthcare parameters. Data on the number of hospitalizations and their cost were compared before and after implementation of the intervention program. RESULTS: As a result of the intervention the mean expenditure per elderly patient was reduced by 22.5%. The adjusted number of hospitalizations/1,000 declined from 15.1 to 10.7 (29.3%). The number of adjusted hospitalization days dropped from 132 to 82 (37.9%) and the mean hospitalization stay declined from 8.2 to 6.7 days (17.9%). The adjusted hospitalization cost ($/1,000 patients) dropped from $32,574 to $18,624 (42.8%). The overall clinic expense, for all age groups, dropped by 9.9%. CONCLUSION: Implementation of the intervention program in a single primary care clinic led to a reduction in hospitalizations for the elderly patient population and to a more optimal allocation of healthcare resources.