Relationship Between Social Anxiety and Self-esteem Among Undergraduate Nursing Students.

Social anxiety disorder is the third most common disorder in the general population. Social phobia has a significant impact on nursing colleagues' self-esteem. The purpose of the current study was to assess social anxiety and its relation to self-esteem among nursing students. The study was a cross-sectional study. Data were collected from 231 nursing students through a convenience sampling method. The instruments of the study included "Social Phobia Inventory (SPIN)" and the "Rosenberg self-esteem scale." The results indicated that the social anxiety mean was 15.1 ± 11.1 (ranging from 0 to 68) and the self-esteem was 19.9 ± 4.5 (ranging from 0 to 30). The current study indicates that female and social anxiety are predictors of self-esteem among nursing students. Also, the present study concludes that lower social anxiety is associated significantly with higher self-esteem among Palestinian undergraduate nursing students (r = -.35, P < .001). The study concludes that there are inverse correlation between social anxiety and self-esteem among Palestinian undergraduate nursing students. Even though most students showed modest levels of social anxiety and normal self-esteem.

If I Share With You, Will You Share With Me? A Quasi-Experimental Study on Social Anxiety and Self-Disclosure in Dictator Game.

Social anxiety is characterized by a constant fear of negative evaluation, falling short of standards, low perceived likeability, and difficulties meeting social criteria. Using a quasi-experiment and a zero-acquaintance paradigm, this paper examines sharing behavior, which is represented by the willingness to give money in a Dictator Game. It explores gender and social anxiety differences related to this behavior, in terms of who is prone to receive more money. In addition to this, we investigated how the receiver's self-disclosure (positive or negative) influences the dictators' sharing behavior. Based on the original version of Dictator Game, involving a dictator and a receiver, one hundred and five adolescents aged 12-15, played Dictator Game in which they divided coins between themselves and the receiver. Our findings indicate that self-disclosure led to positive and gradual changes for non-anxious speakers. The anxious boy consistently achieved the highest money rate among all speakers, while the anxious girl received the lowest. However, her self-disclosure resulted in an increase in receiving. Across all situations, respondents reported slightly increased feelings of guilt and shame. Taken together, this study sheds light on adolescents' giving behavior by examining the interaction between adolescents' social traits and diverse social contexts throughout their developmental stages, ultimately influencing prosocial decision-making.

Poor face recognition predicts social anxiety in autism: A short report.

LAY ABSTRACT: Research has shown that some autistic people have severe difficulties in recognising other people's faces. However, little is understood about how these difficulties impact the daily life and the mental well-being of autistic people. In this study, we asked 60 autistic adults with varying degrees of face recognition ability to complete two tests of face recognition, a questionnaire about social anxiety and a bespoke survey which asked participants about their experiences of face recognition and social interaction. We found that participants who had poor face recognition reported experiencing higher levels of social anxiety compared to those with average or better face recognition skills. More than half felt that their face recognition difficulties affected their social interactions, and over a third believed it hindered their ability to make friends. These findings suggest that face recognition difficulties may contribute to social anxiety among autistic individuals.

The Role of Self-Compassion and Social Anxiety in the Relationship Between Cognitive Distortions and Emotional Eating.

This study aimed to examine the mediating role of self-compassion and social anxiety in the relationship between cognitive distortions and emotional eating. The research was carried out on 406 adult individuals between the ages of 18-25 living in different regions of Turkey. To measure research variables, Liebowitz social anxiety, thought types, self-sensitivity, and Turkish emotional eating scale were used. The scales were distributed to the participants online. The data were analyzed through the SPSS program. In the study, it was determined that self-compassion predicted emotional eating negatively and social anxiety predicted emotional eating positively. According to the results of the serial mediation analysis, it was determined that self-compassion and social anxiety mediated the relationship between cognitive distortions and emotional eating separately.

Risk avoidance and social anxiety in adolescence: Examination of event-related potentials and theta-dynamics on the Balloon Risk Avoidance Task.

Adolescents are at relatively high-risk for developing anxiety, particularly social anxiety. A primary hallmark of social anxiety is the impulse to avoid situations that introduce risk. Here, we examined the neural and behavioral correlates of risk avoidance in adolescents (N=59) 11 to 19 years of age. The Balloon Risk Avoidance Task was used with concurrent electroencephalography to measure event-related potentials (frontal P2; late slow-wave; N2, feedback-related negativity, FRN; posterior P3) and oscillatory dynamics (midfrontal theta, 4-7 Hz) in response to unsuccessful and successful risk avoidance conditions. Social anxiety was measured using the Social Phobia and Anxiety Inventory for Children. Results indicated that, across the whole sample, youth exhibited smaller P3, larger FRN, and larger theta responses to unsuccessful risk avoidance. Youth reporting high (compared to low) levels of social anxiety exhibited larger P2, slow-wave, and FRN responses to unsuccessful, compared to successful, risk avoidance. Further, greater social anxiety was associated with reduced theta responses to successful avoidance. Youth with higher levels of social anxiety showed smaller theta responses to both conditions compared to those with low levels of social anxiety. Taken together, the ERP-component differences and weakened theta power in socially anxious youth following unsuccessful avoidance are informative neural correlates for socially anxious youth during risk avoidance.

Development and validation of the Social Touch Experiences and Attitudes Questionnaire-Chinese version (STEAQ-C): How interpersonal touch relates to subclinical traits and symptoms.

Social touch has a vital role in human development and psychological well-being. However, there is a lack of measures assessing individual differences in social touch experiences and attitudes, especially under Eastern cultures. This study developed the Social Touch Experiences and Attitudes Questionnaire - Chinese version (STEAQ-C) and examined its psychometric properties with healthy young Chinese adults. In Study 1, an item pool was generated and principal component analysis (PCA) was used to identify the factor structure of the STEAQ. Study 2 recruited an independent sample and examined its reliability and validity. Network analysis further explored the interrelations between social touch and a variety of subclinical traits and symptoms. PCA identified four factors of the STEAQ-C, relating to childhood touch experiences, current touch with intimate partners, with family and friends, and with unfamiliar people. Study 2 confirmed the four-factor structure and upheld its internal consistency and stability. Positive attitudes towards and greater experiences of social touch were negatively correlated with sensory over-responsiveness and sensory hyposensitivity, as well as childhood trauma particularly emotional neglect, supporting the convergent validity. Evidence of criterion-related validity was accrued via its concurrent and predictive associations with secure attachment style, higher levels of social competence, and lower levels of social anxiety. Network analysis highlighted altered perception of social touch may be a shared feature for psychiatric conditions with social dysfunctions (e.g., autism, social anxiety and negative schizotypy). The newly-developed STEAQ-C may be a timely tool in assessing social touch experiences and attitudes under Eastern cultures.

Association of depression and social anxiety symptom scores with disease characteristics in pediatric patients with chronic immune thrombocytopenia: a cross-sectional study.

Patients with ITP have been reported to experience higher levels of depression and anxiety than their healthy counterparts. The limited research conducted on this subject in the pediatric age group has demonstrated that patients have psychosocial difficulties, and their quality of life is adversely affected. The correlation of depressive symptoms with disease characteristics of cITP has never been investigated. This was a cross-sectional study in patients being treated for cITP. Communication with participants was done during routine outpatient visits or by telephone or e-mail, and a survey about demographics and the Children's Depression Inventory (CDI) and the Social Anxiety Scale for Children-Revised (SAS-CR) was administered prospectively. A total of 56 children with cITP were recruited. The mean CDI score was 17 (SD: ± 9.44). Approximately half of the patients had higher CDI scores than healthy Turkish children. Older age, time since diagnosis, a number of hospitalizations (both total and within the last year) were positively correlated with CDI scores. There was no significant correlation between SAS-CR scores and disease characteristics. Depressive symptom scores were higher in children with cITP compared with healthy children in this study. Psychological needs may be overlooked in the medical management of children with cITP.

Decoding Cognitive Control and Cognitive Flexibility as Concomitants for Experiential Avoidance in Social Anxiety.

Background and objectives: Avoidance is regarded as a central hallmark of social anxiety. Experiential avoidance is perilous for social anxiety, specifically among university students (young adults). Additionally, cognitive control and cognitive flexibility are crucial components of executive functions for a fulfilling and healthy lifestyle. The current research is a modest attempt to understand how cognitive flexibility and cognitive control affect the emergence of experiential avoidance in social anxiety in young adults. Methods: Using an ex-post facto design, the Social Phobia Inventory was employed to screen university students with social anxiety based on which one hundred and ninety-five were identified. Thereafter, participants completed the standardized measures on experiential avoidance, cognitive control and cognitive flexibility. Results: A stepwise multiple regression analysis was computed wherein the cognitive control predicts an amount of 5% of variance towards experiential avoidance, whereas a 10% of additional variance has been contributed by cognitive flexibility. Interpretation and Conclusions: The statistical outcome indicated that cognitive control is positively associated with experiential avoidance which is a negative correlate to cognitive flexibility among university students. Both also emerged as significant predictors of experiential avoidance and add a cumulative variance of 15% towards the same. This conclusion supports the need for improved and efficient management techniques in counseling and clinical settings.

Too much social media? Unveiling the effects of determinants in social media fatigue.

Introduction: With the boom in social media, many people spend a lot of time on these platforms. Among them, some developed negative emotions, such as fatigue, depression, or disinterest in communicating, and used social media temporarily or permanently. Therefore, this study aims to explore the antecedents of social media fatigue, including social media helpfulness, social media self-efficacy, online subjective well-being, social comparison, compulsive social media use, privacy concerns, fear of missing out, and information overload, and to further discuss the determinants of social media fatigue on social anxiety and lurking. Methods: An online questionnaire was distributed to social media users, and 659 valid samples were obtained with the help of a purposive sampling strategy. The data was analyzed by the partial least square (PLS) method. Results: The study found that social media self-efficacy had a significant negative effect on social media fatigue; compulsive social media use, fear of missing out, and information overload had a significant positive effect on social media fatigue; and social media fatigue had a significant positive effect on social anxiety and lurking. Discussion: The research results can be used as a reference for social media marketers and internet service providers in developing business strategies.

Abnormal large-scale brain functional network dynamics in social anxiety disorder.

AIMS: Although static abnormalities of functional brain networks have been observed in patients with social anxiety disorder (SAD), the brain connectome dynamics at the macroscale network level remain obscure. We therefore used a multivariate data-driven method to search for dynamic functional network connectivity (dFNC) alterations in SAD. METHODS: We conducted spatial independent component analysis, and used a sliding-window approach with a k-means clustering algorithm, to characterize the recurring states of brain resting-state networks; then state transition metrics and FNC strength in the different states were compared between SAD patients and healthy controls (HC), and the relationship to SAD clinical characteristics was explored. RESULTS: Four distinct recurring states were identified. Compared with HC, SAD patients demonstrated higher fractional windows and mean dwelling time in the highest-frequency State 3, representing "widely weaker" FNC, but lower in States 2 and 4, representing "locally stronger" and "widely stronger" FNC, respectively. In State 1, representing "widely moderate" FNC, SAD patients showed decreased FNC mainly between the default mode network and the attention and perceptual networks. Some aberrant dFNC signatures correlated with illness duration. CONCLUSION: These aberrant patterns of brain functional synchronization dynamics among large-scale resting-state networks may provide new insights into the neuro-functional underpinnings of SAD.

Ruminative Variability Predicts Increases in Depression and Social Anxiety.

Background: Rumination is a well-established contributor to the severity of depression and anxiety. It is unknown, however, whether individual differences in the temporal dynamics of rumination over time predict longitudinal increases in depression or anxiety. Methods: The current study examined whether the dynamic indices of ruminative inertia and variability assessed over 14 days via ecological momentary assessment predicted change in symptoms of depression, general anxiety, and social anxiety at a 90-day follow-up (n = 115). Results: Controlling for ruminative variability, baseline levels of the dependent variable, sex, and mean levels of momentary rumination, ruminative inertia did not predict change in symptoms of depression, general anxiety, or social anxiety at the 90-day follow-up. In contrast, greater ruminative variability predicted increases in symptoms of both depression and social anxiety but not general anxiety at follow-up. Individuals endorsing higher baseline levels of depressive symptoms demonstrated greater amounts of inertia and variability in their momentary rumination. Greater ruminative variability but not inertia was also associated with higher baseline levels of general anxiety and social anxiety. Conclusions: These results suggest that ruminative variability may be a risk factor for increases in symptoms of depression and social anxiety over time and a potentially useful target for clinical intervention.

Multiclassification of the symptom severity of social anxiety disorder using digital phenotypes and feature representation learning.

Objective: Social anxiety disorder (SAD) is characterized by heightened sensitivity to social interactions or settings, which disrupts daily activities and social relationships. This study aimed to explore the feasibility of utilizing digital phenotypes for predicting the severity of these symptoms and to elucidate how the main predictive digital phenotypes differed depending on the symptom severity. Method: We collected 511 behavioral and physiological data over 7 to 13 weeks from 27 SAD and 31 healthy individuals using smartphones and smartbands, from which we extracted 76 digital phenotype features. To reduce data dimensionality, we employed an autoencoder, an unsupervised machine learning model that transformed these features into low-dimensional latent representations. Symptom severity was assessed with three social anxiety-specific and nine additional psychological scales. For each symptom, we developed individual classifiers to predict the severity and applied integrated gradients to identify critical predictive features. Results: Classifiers targeting social anxiety symptoms outperformed baseline accuracy, achieving mean accuracy and F1 scores of 87% (with both metrics in the range 84-90%). For secondary psychological symptoms, classifiers demonstrated mean accuracy and F1 scores of 85%. Application of integrated gradients revealed key digital phenotypes with substantial influence on the predictive models, differentiated by symptom types and levels of severity. Conclusions: Leveraging digital phenotypes through feature representation learning could effectively classify symptom severities in SAD. It identifies distinct digital phenotypes associated with the cognitive, emotional, and behavioral dimensions of SAD, thereby advancing the understanding of SAD. These findings underscore the potential utility of digital phenotypes in informing clinical management.

The impact of body image on social cognition: Fear of negative evaluation mediates the relationship between body surveillance and interpersonal distance in women.

Interpersonal distance (IPD) refers to the distance naturally maintained during social interactions, while peripersonal space (PPS) refers to the immediate space surrounding the body, or the space within reaching distance. Previous research has preliminarily indicated that IPD is associated with body image disturbances. We sought to expand extant literature by exploring associations between aspects of positive and negative body image, IPD, and PPS. Seventy-five women from the United Kingdom aged 18-40 years completed measures of body appreciation, body image flexibility, body shame, body surveillance, and body dissatisfaction. IPD boundaries were estimated using a lab-based comfort-distance task, whereas PPS boundaries were estimated using an audio-tactile reaction-time task. Measures of body acceptance by others and fear of negative evaluation were completed as potential mediators. Overall, we identified positive associations between IPD, body surveillance, and fear of negative evaluation, with no statistically significant associations identified between the other indices. The association between active IPD and body surveillance was mediated by fear of negative evaluation, even after controlling for demographic factors. These findings suggest a nuanced relationship between IPD and body image-related factors, highlighting the role of social evaluation anxiety. Future investigations should use experimental designs to further understand these relationships and their implications.

Distinct characteristics of social anxiety among youths with childhood sexual abuse: A latent profile analysis.

BACKGROUND: Childhood sexual abuse (CSA) is one type of childhood trauma that has long-term effects on physical and mental health, predisposing to social anxiety. OBJECTIVE: This study attempted to investigate the characteristics of different subgroups of social anxiety among youths with CSA experiences. PARTICIPANTS AND SETTING: 83,219 participants were recruited in a cross-sectional study from 63 colleges and universities in Jilin Province, China. METHODS: The main variables were measured by a series of self-report questionnaires. Latent profile analysis was used to classify different subgroups of social anxiety, and multiple logistic regression was employed to investigate factors influencing transitions between different subgroups. RESULTS: 3022 (3.63 %) youths who suffered from CSA (46.8 % were male, Mage = 19.57, SD = 1.76) could be divided into four subgroups of social anxiety: low-risk social anxiety (16.4 %), medium-risk social anxiety with high public speaking anxiety (30.3 %), medium-risk social anxiety with no prominent characteristics (22.9 %), and high-risk social anxiety (30.4 %). Shy bladder and bowel and virtual life orientation increased the level of social anxiety from low to medium and high risk. Smoking and drinking were more prevalent in the low- and medium-risk subgroups than in the high-risk subgroup. CONCLUSIONS: There was heterogeneity in different subgroups of social anxiety among youths with CSA experiences. Potential targeted prevention and intervention suggestions could be beneficial in mitigating the risk of social anxiety and further preventing the aggravation of risk between subgroups.

Psychological interventions for social anxiety disorder in children and adolescents: A systematic review and network meta-analysis.

BACKGROUND: Social anxiety disorder (SAD) is a high-prevalence mental disorder among children and adolescents. The aim of this study is to compare and rank the effectiveness of several psychotherapies for SAD among children and adolescents. METHODS: Only randomized controlled trials (RCTs) were utilized by searching PubMed, Embase, Cochrane Library, and Web of Science. We used network meta-analysis in the Bayesian framework to analyze the data. This study is registered with PROSPERO, number CRD42023476829. RESULTS: In total, 30 RCTs with 1547 individuals were included, and nine psychotherapies with three control conditions were compared and ranked in this study. The findings revealed that internet-delivered cognitive behavioural therapy (surface under the cumulative ranking curve [SUCRA: 71.2 %]), group cognitive behavioural therapy (SUCRA: 68.4 %), and individual cognitive behavioural therapy (SUCRA: 66.0 %) significantly reduced social anxiety symptoms; internet-delivered cognitive behavioural therapy also significantly decreased depression symptoms in these patients (SUCRA: 92.2 %). In addition, group cognitive behavioural therapy can enhance functioning in these patients (SUCRA: 89.6 %). CONCLUSION: These results suggest that internet-delivered cognitive behavioural therapy is the optimal type of psychotherapy for reducing social anxiety and depression symptoms in children and adolescents with SAD, internet-delivered parent-child interaction therapy and cognitive bias modification of interpretation have relatively poor treatment effects on social anxiety symptoms in children than other psychological interventions, and group cognitive behavioural therapy has better benefits in enhancing the functioning among children and adolescents with SAD. Further studies are needed to ascertain these results due to the limited number of included studies.

Left-behind experience and mobile phone addiction among college students: A moderated mediation of social anxiety and sex.

Background: With the popularity of smartphone among Chinese college students, mobile phone addiction (MPA) is emerging a remarkable behavior problem in this population. Thus, the present study was aimed at investigating a moderated mediation model of left-behind experience (LBE) affecting MPA via social anxiety moderated by sex difference. Methods: A total of 1268 college students (Mage = 20.74, SD = 2.21) were recruited to complete self-administered questionnaires of mobile phone addiction index (MPAI) and interaction anxiousness scale (IAS). The participants also reported their sex, grade, and childhood and juvenile LBE. Results: The results indicated that LBE increased the level of MPA among college students via mediation by social anxiety. Furthermore, sex moderated the influence of social anxiety on MPA in the mediating model. Specifically, social anxiety affects male college students more strongly than female ones in terms of MPA. Conclusion: Our findings support that LBE, social anxiety, and sex difference should be critically included into consideration when performing interventions to buffer MPA among college students.

Social anxiety, voice confrontation and voice recognition: A bilingual exploration.

Many people dislike the sound of their voices, especially when listening back to audio recordings (voice confrontation). Previous research reports that disliking the sound of one's voice is associated with elevated levels of social anxiety. The present study investigated the relationship between social anxiety and voice dislike and voice misrecognition among a bilingual population: Arabic (L1) and English (L2). Participants (N = 176) completed self-report measures of social anxiety and own voice liking. Additionally, they performed a novel own voice recognition task, assessing their ability to recognise a recording of their voice, differentiating it from digitally altered versions of the same recording. Social anxiety symptomatology was associated with disliking the sound of one's voice, with a larger effect for L1 than L2. Social anxiety was also associated with own voice misrecognition, but only for L1. Highly negative evaluations about the sound of one's voice may represent a vulnerability for social anxiety disorder.

Differences in attentional bias between self-related information and external cues from others in individuals with social anxiety: An event-related potential study.

Individuals with high social anxiety show a more considerable attentional bias toward self-relevant information and outwardly threatening stimuli than do those with low social anxiety. Some studies have investigated the attentional bias between self-relevant information and external social cues in people with high social anxiety but have not reached consistent conclusions. This study used a modified dot-probe task and collected temporal and electroencephalogram responses to three self-other face pairs among 15 people with high social anxiety and 20 people with low social anxiety. Both groups responded more quickly to self-relevant information than external social cues. Others' emotional potencies moderated the attentional bias. Individuals with high social anxiety exhibited larger P1 amplitudes and smaller N170 amplitudes (mainly in the right hemisphere) for all face pairs and larger P2 amplitudes for the self-neutral and other-angry face pairs than those with low social anxiety. These findings suggest that people with social anxiety prioritize allocating attentional resources to self-relevant information, with others' angry faces having the greatest influence on the allocation. Individuals with high social anxiety showed more attentional vigilance and less structural coding for all three face pairs compared to those with low social anxiety. They devoted more attentional resources to threat cues than low social anxiety individuals.

Comparison of Resting-State Functional Connectivity Between Generalized Anxiety Disorder and Social Anxiety Disorder: Differences in the Nucleus Accumbens and Thalamus Network.

Background: Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are distinguished by whether anxiety is limited to social situations. However, reports on the differences in brain functional networks between GAD and SAD are few. Our objective is to understand the pathogenesis of GAD and SAD by examining the differences in resting brain function between patients with GAD and SAD and healthy controls (HCs). Methods: This study included 21 patients with SAD, 17 patients with GAD, and 30 HCs. Participants underwent psychological assessments and resting-state functional magnetic resonance imaging. Whole-brain analyses were performed to compare resting-state functional connectivity (rsFC) among the groups. In addition, logistic regression analysis was conducted on the rsFC to identify significant differences between GAD and SAD. Results: Patients with SAD and GAD had significantly higher rsFC between the bilateral postcentral gyri and bilateral amygdalae/thalami than HCs. Compared with patients with SAD, those with GAD had significantly higher rsFC between the right nucleus accumbens and bilateral thalami and between the left nucleus accumbens and right thalamus. rsFC between the left nucleus accumbens and right thalamus positively correlated with state anxiety in patients with SAD and GAD, respectively. In addition, logistic regression analysis revealed that the right nucleus accumbens and the right thalamus connectivity could distinguish SAD from GAD. Conclusions: GAD and SAD were distinguished by the right nucleus accumbens and the right thalamus connectivity. Our findings offer insights into the disease-specific neural basis of SAD and GAD. Clinical Trial Registration Number: M10545. Impact Statement This study is the first to identify a resting state functional connectivity that distinguishes social anxiety disorder (SAD) from generalized anxiety disorder (GAD) and to clarify a common connectivity in both disorders. We found that the connectivity between the right nucleus accumbens and the right thalamus differentiated SAD from GAD. Furthermore, these rsFC differences suggest an underlying basis for fear overgeneralization. Our findings shed light on the pathophysiology of these conditions and could be used as a basis for further studies to improve outcomes for such patients.

Risk factor patterns define social anxiety subtypes in adolescents with brain and clinical feature differences.

Social anxiety disorder (SAD) is one of the most common psychiatric disorders in adolescents. The heterogeneity of both symptoms and etiology is an essential source of difficulties in the treatment and prevention of SAD. The study aimed to identify subtypes of adolescent SAD based on etiology-related phenotype dimensions and examine symptom and brain associations of the subtypes. We used a deeply phenotyped sample (47 phenotype subscales from 13 measures) of adolescents with SAD (n = 196) and healthy controls (n = 109) to extract etiology-relevant risk factors, based on which we identified subtypes of SAD. We compared the subtypes on clinical characteristics and brain morphometrics and functional connectivity, and examined subtype-specific links between risk factors, brain aberrance, and clinical characteristics. We identified six etiology-relevant risk factors and two subtypes of adolescent SAD. One subtype showed mainly elevated negative emotionality trait and coping style and diminished positive emotionality trait and coping style, while the other additionally had significantly high environmental risk factors, more severe impairments in social functioning, and significant abnormalities in brain structure and function. There were subtype-specific links between the risk factor profiles, brain aberrance, and clinical characteristics. The finding suggests two etiology-based subtypes of adolescent SAD, providing novel insights to the diversity of pathological pathways and precise intervention strategies.