User experiences of college students using mental health applications to improve self-care: Implications for improving engagement.

The purpose of this study is to evaluate themes on 'user experiences' among college students (N = 265) enrolled in an upper-division Psychopathology course who were assigned a project in which they were instructed to identify a self-care goal, choose from a list of six mental health-focused mobile applications (apps) provided by the instructor, and use the app over the course of three weeks to support progress towards their goal. Prior literature on user experiences typically evaluates user reviews, or asks participants to reflect on past app use or anticipate future use. Students reported their experiences using the app during key decision points: app selection, while using the app, and at the conclusion of the assignment. Using thematic analysis, results identified seven central themes and eight subthemes pertaining to the content of the app (e.g., app features) and the context of using the app (e.g., classroom assignment). Content-wise students liked: 1) features with a strong evidence base, namely, thought diaries and guided meditations; 2) progress tracking, because it increased awareness of mood/stressors, motivated students to see improvement, and helped them stay on track. Students appreciated having 3) crisis support resources; 4) app interfaces that allowed for customization (poor app interfaces were sometimes cited as the reason for disengagement); and 5) apps that included varied, comprehensive resources such that it felt like a one-stop shop. In addition to the content of features and design interface, the context in which mental health apps are introduced and used is important. The remaining themes related to the context in which the app was used, including 6) preparation for app usage, such as reviewing scholarly/credible sources, and 7) social support from fellow students completing the same assignment. Future research should evaluate the 'who, what, when, why, where, and how' of app utilization during key decision points, such as initial app selection or subscription renewal, to better understand the impact of user experience on engagement.

A qualitative exploration of college students' experiences using mobile apps to improve self-care during the COVID-19 pandemic.

Objective: This project examines students' experiences using a mental health mobile application (app) as part of a class assignment developed to support student well-being. Participants: Data was collected from 265 undergraduate students enrolled in a psychology course during the COVID-19 pandemic. Methods: Students developed a self-care goal and used an app to support progress toward it. Thematic analysis was applied to students' written reflections about their experiences using the app and practicing self-care. Results: Students reported using an app for self-care was 1) more helpful than expected for improving focus, productivity, motivation, sleep, and mental health symptoms; 2) challenging due to loss of interest, slow improvement, difficulty integrating into routine, or negative feelings triggered; and 3) influenced by the pandemic and transition to remote learning. Conclusions: A classroom assignment designed to promote self-care using a mental health app shows promise. Future research is needed to better understand engagement and impact.

Culturally adapted digital mental health interventions for ethnic/racial minorities: A systematic review and meta-analysis.

OBJECTIVE: Digital mental health interventions (DMHIs) are typically designed as "one-size fits all" which may perpetuate health disparities for racialized minorities. This systematic review identified culturally adapted DMHIs and examined their efficacy and acceptability among racial and ethnic minorities. METHOD: PsycINFO, Web of Science, and Pubmed databases were searched between 2000 and 2021. Studies that examined the development or impact of a culturally adapted DMHI for racial or ethnic minority populations using quantitative and/or qualitative methodologies were included. Meta-analyses explored the efficacy of DMHIs, and moderator analyses were used to identify differences in effect sizes due to study quality, clinical outcomes, therapist support, and attrition. RESULTS: Thirty-two studies met inclusion criteria and were reviewed. DMHIs were deemed acceptable and feasible in most studies (n = 24). Among eligible randomized controlled studies (n = 12) comprising 653 participants, results indicated that culturally adapted DMHIs produced a large, positive, significant effect (g = 0.90) across a range of outcomes when compared to wait-list and treatment as usual control conditions. The average attrition rate per study was 42%, and most participants did not complete all modules despite reporting high satisfaction. CONCLUSIONS: Culturally adapted DMHIs are efficacious and acceptable. Such interventions represent a powerful opportunity to circumvent barriers to mental health treatment and improve mental health equity among racially and ethnically minoritized communities. However, the prevalence of feasibility studies, lack of active comparison treatments-and limited research for Black and Indigenous populations-indicate that more research is needed to achieve this purpose. Recommendations are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A novel computer task to assess outcome probability bias.

This research describes the development of a novel computer task to assess outcome probability bias for social anxiety - the tendency to make unrealistically high evaluations of the probability of experiencing a negative outcome when anticipating a social encounter - that improves upon existing measures by using images and by assessing the construct at automatic and controlled levels of processing. The first study evaluated the images selected for the task and the extent to which the task elicited automatic responding, and the second study evaluated the task's reliability and validity. Across both studies, 203 college students completed the outcome probability bias computer task, standardized self-report questionnaires of outcome probability bias, outcome cost bias, depression and stress, and safety behaviors, and completed a behavioral avoidance task. The task demonstrated good to excellent internal consistency (α = 0.82 - 0.96) and significant positive correlations with a standardized measure of outcome probability bias (r = 0.33 - 0.48). With one exception, all hypotheses regarding the convergent, discriminant, construct, and criterion validity of the task were supported. Pending replication and additional evaluation, the outcome probability bias computer task may advance research on social anxiety disorder and may be adapted for use with other related disorders.

Increasing Acceptability and Outcome Expectancy for Internet-Based Cognitive Behavioral Therapy During the COVID-19 Pandemic.

Background:e-Health interventions for mental health have the potential to reduce burdens on health care systems, but large survey studies find low acceptability for these interventions. The COVID-19 pandemic may make attitudes toward e-health more malleable. The current study examined whether an intervention to improve attitudes toward Internet-based cognitive behavioral therapy (iCBT) has a greater impact during the COVID-19 pandemic than before the pandemic.Materials and Methods:Individuals (N = 662) recruited from a large university and surrounding community who participated in a study about the acceptability of iCBT in 2018 and 2019 were asked to participate in a follow-up survey. In the original study, participants were randomized to receive or not receive a rationale designed to increase acceptability of iCBT, and then they completed measures of acceptability and outcome expectancy for iCBT. Fifty-one participants enrolled in the follow-up study from May to July 2020. They received a treatment rationale for iCBT (or not) in keeping with randomization from the parent study and re-completed measures assessing the acceptability and outcome expectancy for iCBT.Results:Contrary to hypotheses, two-way analyses of covariance (ANCOVA's) demonstrated that there was no significant interaction between time point and rationale condition on acceptability or outcome expectancy for iCBT. There was a significant main effect of rationale condition on acceptability, such that participants who received a treatment rationale reported greater acceptability for iCBT. There were no significant main effects of time.Conclusions:A treatment rationale was effective in improving acceptability for iCBT in a general population sample, but not more so during the COVID-19 pandemic.

The use of trial-level bias scores to examine attention bias and attention bias variability among people with and without social anxiety disorder.

BACKGROUND: Cognitive models of anxiety propose that people with anxiety disorders show elevated levels of attention bias toward threat, but the most commonly used index of attention bias, which measures the construct with an aggregate score of multiple trials across an experimental session, shows poor test-retest reliability. Newer indices that measure attention bias dynamically on a trial-to-trial basis show good reliability and enable researchers to measure not only overall attention bias toward threat, but also attention bias variability. METHODS: The current study tested the hypothesis that people diagnosed with social anxiety disorder would show higher attention bias variability and higher attention bias toward threat when calculated dynamically and when calculated using the traditional aggregate index. Participants diagnosed with social anxiety disorder (n = 47) and controls (n = 57) completed a 160-trial version of the dot-probe task using emotional and neutral images of faces as stimuli. RESULTS: Relative to controls, participants diagnosed with social anxiety disorder showed higher mean bias toward threat, but only when calculated using trial-level bias scores. There were no differences between groups on attention bias variability. DISCUSSION: This is the first study to examine differences in attention bias and attention bias variability between people with and without social anxiety disorder using trial-level bias scores. Results suggest that attention bias, but not attention bias variability, is a feature of social anxiety psychopathology and that trial-level bias scores may be more sensitive than aggregated mean scores to detect it. These findings have implications for clinical interventions such as attention bias modification programs, which require precise measures of attention bias to accurately assess treatment outcomes.

Improving Acceptability and Uptake Behavior for Internet-Based Cognitive-Behavioral Therapy.

Internet-based cognitive behavioral therapy (iCBT) programs have the potential to improve access to mental healthcare, but they are not viewed as acceptable nor widely utilized by the general public. This study tested whether two acceptance-facilitating interventions improved acceptability and uptake-related behavior for therapist assisted and self-guided iCBT. Participants were randomly assigned to read a treatment rationale for iCBT (vs. a brief definition) and to receive a small financial incentive (or not) for seeking more information about evidence-based iCBT programs. Participants (N = 662) were a diverse group recruited from a University participant pool and the surrounding community. Participants completed standardized measures of attitudes toward and outcome expectancy for iCBT and a single question about willingness to use it and were given the opportunity to get information about accessing evidence-based iCBT programs. A series of MANCOVAs showed small, positive effects of the treatment rationale on attitudes and outcome expectancy for both self-guided and therapist-assisted iCBT, but not for willingness to use it. A hierarchical logistic regression model found no effect of the treatment rationale or financial incentive on whether participants sought additional information about how to access iCBT, although psychopathology symptoms and identifying as White or multiracial were positively associated with information-seeking. Inconsistent with past research, participants rated therapist-assisted and self-guided iCBT as equally acceptable. Participants recruited from the community reported greater willingness to use iCBT than University students. These results underscore the urgent need for further research toward improving the acceptability and uptake of iCBT so that it may better fulfill its potential to fill the gap in unmet mental health need.

Engagement with mobile health interventions for depression: A systematic review.

BACKGROUND: Depressive disorders are a major public health problem, and many people face barriers to accessing evidence-based mental health treatment. Mobile health (mHealth) interventions may circumvent logistical barriers to in-person care (e.g., cost, transportation), however the symptoms of depression (low motivation, concentration difficulties) may make it difficult for people with the disorder to engage with mHealth. OBJECTIVE: The aim of this systematic review is to examine assessment and reporting of engagement in clinical trials of mHealth interventions for depression, including objective engagement (e.g., number of times program is used), subjective engagement (e.g., qualitative data on users' experiences), and associations between engagement and other clinically important variables (e.g., symptom improvement, participant characteristics). METHODS: Three electronic databases (PsycINFO, Web of Science, PubMed) were searched in February 2020 using search terms for mHealth and depression. Studies were included in the review if they tested a mHealth intervention designed for people with depressive disorders or elevated depression symptoms. RESULTS: Thirty studies met inclusion criteria and were reviewed. Most studies reported objective engagement (N = 23, 76.7%), approximately half reported subjective engagement (N = 16, 53.3%), and relatively few examined associations between engagement and clinical improvement, participant characteristics, or other clinically relevant variables (N = 13, 43.3%). CONCLUSIONS: Although most studies in this small but rapidly growing literature report at least one measure of engagement, there is substantial heterogeneity. Intentional, theory-driven, and consistent measurement of engagement with mHealth interventions for depression may advance the field's understanding of effective engagement to facilitate clinical improvement, identify dose-response relationships, and maximize generalizability for underserved populations.

Integrating virtual realities and psychotherapy: SWOT analysis on VR and MR based treatments of anxiety and stress-related disorders.

The use of virtual reality (VR) and mixed reality (MR) technology in clinical psychology is growing. Efficacious VR-based treatments for a variety of disorders have been developed. However, the field of technology-assisted psychotherapy is constantly changing with the advancement in technology. Factors such as interdisciplinary collaboration, consumer familiarity and adoption of VR products, and progress in clinical science all need to be taken into consideration when integrating virtual technologies into psychotherapies. We aim to present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders. An anonymous survey was distributed to a select group of researchers and clinicians, using an analytic framework known as Strengths, Weaknesses, Opportunities, and Threats (SWOT). Overall, the respondents had an optimistic outlook regarding the current use as well as future development and implementation of technology-assisted interventions. VR and MR psychotherapies offer distinct advantages that can overcome shortcomings associated with traditional therapy. The respondents acknowledged and discussed current limitations of VR and MR psychotherapies. They recommended consolidation of existing knowledge and encouraged standardisation in both theory and practice. Continued research is needed to leverage the strengths of VR and MR to develop better treatments.Abbreviations: AR: Augmented Reality; MR: Mixed Reality; RCT: Randomised Controlled Trial; SWOT: Strengths, Weaknesses, Opportunities, and Threats; VR: Virtual Reality; VR-EBT: Virtual Reality Exposure-Based Therapy.

Maximizing the impact of virtual reality exposure therapy for anxiety disorders.

The impact of virtual reality on access to exposure therapy and recovery from anxiety is unrealized, but an argument can be made that this is about to change. Virtual reality exposure therapy for anxiety disorders is safe, effective, and, in most cases, as effective as in vivo exposure therapy. Clinician attitudes toward virtual reality are now more positive than negative. Moderately priced virtual reality systems are commercially available. Self-guided and fully automated programs for specific fears are new, scalable, potentially game-changing developments. Future research that assesses cultural bias and external validity will position virtual reality exposure therapy to address mental health disparities, to realize its potential to increase access to effective treatment for anxiety disorders, and to improve public health.

Evaluating the reliability of attention bias and attention bias variability measures in the dot-probe task among people with social anxiety disorder.

The dot-probe task is a widely used experimental paradigm that evaluates attention biases within anxiety disorders. Considerable research has focused on improving the reliability of dot-probe scores because the task's original attention bias index has shown very low test-retest reliability. The current study serves as a replication and extension of Price et al. (2015), who systematically examined the effects of methodological choices on reliability of dot-probe task results. Fifty-six adults diagnosed with social anxiety disorder were asked to complete a facial dot-probe task twice, approximately 1 week apart. Test-retest reliability and internal consistency were examined for 10 dot-probe attention bias indices across 55 sets of outlier cutoffs. Both Pearson's r and intraclass correlation coefficients were used. Trial-level bias score indices of mean bias toward threat and attention bias variability, which measure attention bias dynamically using individual pairs of trials, demonstrated the highest reliability and were less sensitive to changes in outlier cutoffs as compared with the dot probe's classic attention bias index and others. Results demonstrate the potential for post hoc outlier cutoff selection to artificially inflate reliability, particularly for unreliable indices. A priori cutoff selection is recommended for future research. Intraclass correlation coefficients are also recommended for assessment of reliability because Pearson's r does not account for poor agreement between scores. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Amygdala volume and social anxiety symptom severity: Does segmentation technique matter?

The amygdala factors prominently in neurobiological models of social anxiety (SA), yet amygdala volume findings regarding SA have been inconsistent and largely focused on case-control characterization. One source of discrepant findings could be variability in volumetric techniques. Therefore, we compared amygdala volumes derived via an automated technique (Freesurfer) against a manually corrected approach, also involving Freesurfer. Additionally, we tested whether the relationship between volume and SA symptom severity would differ across volumetric techniques. We pooled participants (n = 76) from archival studies. SA severity was assessed with the Liebowitz Social Anxiety Scale; scores ranged from non-clinical to clinical levels. Freesurfer produced significantly larger amygdalar volumes for participants with poor image quality. Even after excluding such participants, paired sample t-tests showed Freesurfer's boundaries produced significantly larger amygdalar volumes than manually corrected ones, bilaterally. Yet, intra-class correlation coefficients between the two methods were high, which suggests that Freesurfer's over-estimation of amygdala volume was systemic. Regardless of segmentation technique, volumes were not associated with SA symptom severity. Potentially, amygdala sub-regions may yield clearer patterns regarding SA symptoms. Further, our study underscores the importance of image quality for segmentation of the amygdala, and image quality may be particularly valuable when examining anatomical data for subtle inter-individual differences.

A meta-analytic examination of attrition in virtual reality exposure therapy for anxiety disorders.

A proposed advantage of virtual reality exposure therapy for anxiety disorders is that people will be less likely to drop out of treatment prematurely if the treatment involves facing one's fear in a virtual world rather than the real world, but this has yet to be empirically tested. The present meta-analyses assess the odds of dropout from virtual reality exposure therapy compared to in vivo exposure therapy, estimate the overall rate of dropout from virtual reality exposure treatment, and test potential moderating variables. The odds ratio meta-analysis indicated that there was no significant difference in the likelihood of attrition from virtual reality exposure therapy relative to in vivo exposure therapy. The overall attrition rate for virtual reality exposure therapy across 46 studies with a combined sample size of 1057 participants was 16%. This rate is slightly lower than other estimates of dropout from in vivo therapy and from cognitive-behavioral therapy for anxiety disorders. Incorporation of between-session intervention (i.e., homework) was identified as a moderator; specifically, inclusion of between-session interventions in the treatment was associated with better retention. Overall, the findings of the present study indicate that virtual reality exposure and in vivo exposure therapy show similar rates of attrition.

Deterioration rates in Virtual Reality Therapy: An individual patient data level meta-analysis.

Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31-1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups.

A Case Series on the Effects of Kripalu Yoga for Generalized Anxiety Disorder.

Generalized anxiety disorder (GAD) is a prevalent psychiatric disorder associated with substantial impairment and poor treatment response. Yoga influences processes that are linked to the maintenance of GAD including mindfulness, anxiety, and heart rate variability, but has yet to be evaluated among people with the disorder. The present study is a first step toward documenting the efficacy of yoga for reducing worry among people with GAD using a single-subject AB design case series and daily ratings of worry. Standardized self-report measures of worry, trait anxiety, experiential avoidance, mindfulness, and heart rate variability were assessed pre- and post-intervention. Three participants with primary GAD received eight twice-weekly Kripalu yoga sessions following a baseline data collection period. All participants showed systematic improvement in daily worry ratings on at least one index and all scores on self-reported measures of worry, anxiety, experiential avoidance, and mindfulness changed in the expected direction following yoga (with one or two exceptions). Participants also showed improved heart rate variability during a worry period from pre- to post-intervention. Yoga has the potential to improve the processes linked to GAD and should stimulate further research in this area.

Don't ask, don't tell: a systematic review of the extent to which participant characteristics are reported in social anxiety treatment studies.

BACKGROUND AND OBJECTIVES: This study examined the extent to which social anxiety treatment studies report the demographic characteristics of their participants. One hundred and 56 treatment studies published in English between 2001 and 2012 articles were collected. METHODS: Each study was evaluated on whether or not it reported information on gender, age, race, relationship status, education, socioeconomic status, sexual orientation, and disability and also the extent to which the racial composition of the sample was described. RESULTS: The majority of studies reported information on age (96.2%) and gender (94.2%), but the percentage of studies that reported anything else is much lower: race (50.0%), education (42.3%), relationship status (37.8%), socioeconomic status (5.1%), disability (2.6%), and sexual orientation (1.3%). One third (34.0%) of studies reported the race of all participants in their samples, while the remaining reported no information or information for only a subset of participants (e.g. "mostly white"). CONCLUSIONS: Participants of social anxiety disorder treatment studies generally are not described beyond their age and gender. Standards for reporting participant characteristics of treatment studies (similar to standards for reporting the methodology of treatment studies) could improve clinical researchers' and clinicians' ability to evaluate the external validity of this body of work.

Evaluating changes in judgmental biases as mechanisms of cognitive-behavioral therapy for social anxiety disorder.

Reductions in judgmental biases concerning the cost and probability of negative social events are presumed to be mechanisms of treatment for SAD. Methodological limitations of extant studies, however, leave open the possibility that, instead of causing symptom relief, reductions in judgmental biases are correlates or consequences of it. The present study evaluated changes in judgmental biases as mechanisms explaining the efficacy of CBT for SAD. Participants were 86 individuals who met DSM-IV-TR criteria for a primary diagnosis of SAD, participated in one of two treatment outcome studies of CBT for SAD, and completed measures of judgmental (i.e., cost and probability) biases and social anxiety at pre-, mid-, and posttreatment. Treated participants had significantly greater reductions in judgmental biases than not-treated participants; pre-to-post changes in cost and probability biases statistically mediated treatment outcome; and probability bias at midtreatment was a significant predictor of treatment outcome, even when modeled with a plausible rival mediator, working alliance. Contrary to hypotheses, cost bias at midtreatment was not a significant predictor of treatment outcome. Results suggest that reduction in probability bias is a mechanism by which CBT for SAD exerts its effects.

The course of the working alliance during virtual reality and exposure group therapy for social anxiety disorder.

BACKGROUND: Psychoanalytic theory and some empirical research suggest the working alliance follows a "rupture and repair" pattern over the course of therapy, but given its emphasis on collaboration, cognitive behavioral therapy may yield a different trajectory. AIMS: The current study compares the trajectory of the working alliance during two types of cognitive behavioral therapy for social anxiety disorder - virtual reality exposure therapy (VRE) and exposure group therapy (EGT), one of which (VRE) has been proposed to show lower levels of working alliance due to the physical barriers posed by the technology (e.g. no eye contact with therapist during exposure). METHOD: Following randomization, participants (N = 63) diagnosed with social anxiety disorder received eight sessions of manualized EGT or individual VRE and completed a standardized self-report measure of working alliance after each session. RESULTS: Hierarchical linear modeling showed overall high levels of working alliance that changed in rates of growth over time; that is, increases in working alliance scores were steeper at the beginning of therapy and slowed towards the end of therapy. There were no differences in working alliance between the two treatment groups. CONCLUSION: Results neither support a rupture/repair pattern nor the idea that the working alliance is lower for VRE participants. Findings are consistent with the idea that different therapeutic approaches may yield different working alliance trajectories.

Stereotype confirmation concerns predict dropout from cognitive behavioral therapy for social anxiety disorder.

BACKGROUND: There are high attrition rates observed in efficacy studies for social anxiety disorder, and research has not identified consistent nor theoretically meaningful predictors of dropout. Pre-treatment symptom severity and demographic factors, such as age and gender, are sometimes predictive of dropout. The current study examines a theoretically meaningful predictor of attrition based on experiences associated with social group membership rather than differences between social group categories--fear of confirming stereotypes. METHODS: This is a secondary data analysis of a randomized controlled trial comparing two cognitive behavioral treatments for social anxiety disorder: virtual reality exposure therapy and exposure group therapy. Participants (N = 74) with a primary diagnosis of social anxiety disorder who were eligible to participate in the parent study and who self-identified as either "African American" (n = 31) or "Caucasian" (n = 43) completed standardized self-report measures of stereotype confirmation concerns (SCC) and social anxiety symptoms as part of a pre-treatment assessment battery. RESULTS: Hierarchical logistic regression showed that greater stereotype confirmation concerns were associated with higher dropout from therapy--race, age, gender, and pre-treatment symptom severity were not. Group treatment also was associated with higher dropout. CONCLUSIONS: These findings urge further research on theoretically meaningful predictors of attrition and highlight the importance of addressing cultural variables, such as the experience of stereotype confirmation concerns, during treatment of social anxiety to minimize dropout from therapy.

Stereotype confirmation concern and fear of negative evaluation among African Americans and Caucasians with social anxiety disorder.

Fear of negative evaluation is a central component of social anxiety. The current study examines the relation between fear of negative evaluation and fears of confirming stereotypes about social groups to which one belongs among people diagnosed with social anxiety disorder. Participants (N=94) with a primary diagnosis of social anxiety disorder who self-identified as either African American (n=41) or Caucasian (n=53) completed standardized self-report measures of stereotype confirmation concerns and fear of negative evaluation. Results from hierarchical logistical regression showed that stereotype confirmation concerns predicted fear of negative evaluation for both racial groups, with greater concern predicting greater fear. This association was moderated by race, B=-.24, t=-2.67, p<.01, such that stereotype confirmation concerns had a stronger association with fear of negative evaluation for Caucasians (b=.38, p<.01) than for African Americans (b=.14, p<.05). This study is the first to directly examine the relation between stereotypes and fear of negative evaluation within a socially anxious sample. Although we cannot identify the specific social group to which each participant's stereotype confirmation concerns apply, this study provides quantitative evidence that the social context within which socially anxious individuals view themselves impacts their fear of negative evaluation and highlights the need for further research in this area.