A Model for Recruiting Clinical Research Participants With Anxiety Disorders in the Absence of Service Provision: Visions, Challenges, and Norms Within a Canadian Context.

High-quality research in clinical psychology often depends on recruiting adequate samples of clinical participants with formally diagnosed difficulties. This challenge is readily met within the context of a large treatment center, but many clinical researchers work in academic settings that do not feature a medical school, hospital connections, or an in-house clinic. This article describes the model we developed at the University of Waterloo Centre for Mental Health Research for identifying and recruiting large samples of people from local communities with diagnosable mental health problems who are willing to participate in research but for whom treatment services are not offered. We compare the diagnostic composition, symptom profile, and demographic characteristics of our participants with treatment-seeking samples recruited from large Canadian and American treatment centers. We conclude that the Anxiety Studies Division model represents a viable and valuable method for recruiting clinical participants from the community for psychopathology research.

Just do something: An experimental investigation of brief interventions for reducing the negative impact of post-event processing in social anxiety disorder.

Post-Event Processing (PEP) is prevalent and problematic in Social Anxiety Disorder (SAD) but is typically not a direct target in evidence-based treatments such as cognitive behavioural therapy (CBT) for SAD. The primary aim of the current study was to examine the impact of several theoretically and empirically derived interventions for PEP in SAD, including concrete thinking, abstract thinking, and distraction in comparison to a control (i.e., do nothing) condition. Based on prior research, we hypothesized that the concrete and distract conditions would be associated with positive benefits, including reductions in PEP and improvements in self-perception, whereas the abstract and control conditions would not. The second aim of the study was to identify baseline variables that predict the trajectory of change in PEP over time. Participants (N=92) with a principal diagnosis of SAD completed a social stress task and were randomly assigned to one of four conditions. Participants completed measures at baseline, post-intervention/control, and at 1-week, and 1-month follow-up. Contrary to hypotheses, all three active conditions were similarly effective at reducing PEP and improving self-perceptions relative to the control condition. In the absence of an intervention, engagement in PEP remained high up to a month following the social stress task. Higher levels of baseline state anxiety, intolerance of uncertainty, and use of safety behaviours predicted greater PEP, even in the presence of an intervention. These results highlight the benefits of relatively brief interventions that disrupt the course of PEP for people with SAD. Such interventions can be easily incorporated into CBT protocols for SAD to enhance their effects.

Out of my league: Appraisals of anxiety and confidence in others by individuals with and without social anxiety disorder.

Forty participants with social anxiety disorder (SAD) and 42 healthy controls (HCs) were randomized to watch a confederate deliver a speech in either a visibly anxious or confident manner. Participants rated their perception of the presenter's desirability across five attributes and compared themselves to the presenter along these same dimensions. Participants then delivered their own speeches, and were rated in a similar manner by trained research assistants who were naïve to participants' group status and study objectives. Results demonstrated that all participants, irrespective of group status, judged the visibly anxious presenter as being less desirable and the confident presenter as more desirable. Socially anxious participants tended to view themselves as inferior to confident others. Coders also rated participants with SAD, based on their speeches, as being less interpersonally desirable than HCs. These results suggest that individuals who appear visibly anxious may be objectively disadvantaged in their ability to make a positive first impression on others. We discuss these findings in relation to theoretical models of social anxiety and explore how to address such interpersonal factors in psychological interventions for SAD.

Working memory capacity in social anxiety disorder: Revisiting prior conclusions.

In one of the few studies examining working memory processes in social anxiety disorder (SAD), Amir and Bomyea (2011) recruited participants with and without SAD to complete a working memory span task with neutral and social threat words. Those with SAD showed better working memory performance for social threat words compared to neutral words, suggesting an enhancement in processing efficiency for socially threatening information in SAD. The current study sought to replicate and extend these findings. In this study, 25 participants with a principal diagnosis of SAD, 24 anxious control (AC) participants with anxiety disorders other than SAD, and 27 healthy control (HC) participants with no anxiety disorder completed a working memory task with social threat, general threat, and neutral stimuli. The groups in the current study demonstrated similar working memory performance within each of the word type conditions, thus failing to replicate the principal findings of Amir and Bomyea (2011). Post hoc analyses revealed a significant association between higher levels of anxiety symptomatology and poorer overall WM performance. These results inform our understanding of working memory in the anxiety disorders and support the importance of replication in psychological research. (PsycINFO Database Record

Social Anxiety and the Accuracy of Memory for Childhood Teasing Frequency.

Adults' recollections of how often they were teased as children are positively associated with their social anxiety symptoms. It has therefore been suggested that childhood teasing may play a role in the development of social anxiety disorder (SAD). However, existing studies have not determined whether adults with SAD were actually teased more as children or whether their current symptoms have distorted their memories of childhood events. This study examined reports of childhood teasing in adults with SAD before and after cognitive behavioral therapy (CBT). If recollections of childhood teasing are colored by SAD symptoms, then reported frequency of teasing might be more likely to decrease as symptoms improve after CBT. However, if individuals' memories of teasing are unbiased, they should not substantially change with the reduction of symptoms after CBT. Ninety-one participants with SAD completed the Teasing Questionnaire-Revised (TQ-R) before and after 12 sessions of group CBT. CBT was effective in reducing SAD symptoms, whereas recollections of the frequency of childhood teasing did not change significantly after treatment. These results are consistent with the possibility that recollections of childhood teasing are not substantially biased by symptoms of SAD, and they lend support to previous studies which suggest that adults with SAD endured higher frequencies of teasing as children compared to controls.

Out of the shadows and into the spotlight: Social blunders fuel fear of self-exposure in social anxiety disorder.

In a study designed to clarify and extend previous research on social blunders in social anxiety, 32 participants with social anxiety disorder (SAD), 25 anxious control (AC) participants with anxiety disorders other than SAD, and 25 healthy control (HC) participants with no history of anxiety problems estimated the costs of hypothetical blunders committed by either themselves or by others. Participants with SAD rated the costs of their own imagined blunders as highly inflated relative to both AC and HC participants. In contrast, for blunders participants imagined others committing, only SAD and healthy control participants' cost estimates differed from one another. Moreover, concerns about revealing self-flaws--and, in particular, about appearing socially incompetent--accounted for significant, unique variance in SAD participants' exaggerated cost estimates of self blunders, over and above symptoms of social anxiety and depression. These results enhance our understanding of how and why socially anxious individuals negatively appraise social blunders and help to clarify the potential function and role of social mishap exposures in the treatment of SAD.