Psychophysiology of fear imagery: Differences between focal phobia and social performance anxiety.

Studied 11 spider phobics and 16 speech anxious undergraduates who imaged fear scenes with spider and public-speaking content and a series of standard scenes that were constructed to vary in degree of emotional arousal and movement. Phobic levels were determined by the Fear Survey Schedule, the Speech Anxiety Questionnaire, and the Spider Fear Questionnaire. Both S groups did not differ on Taylor Manifest Anxiety Scale scores. Heart rate, skin conductance, and ocular activity were recorded. Spider phobics rated all imagery contents as more vivid and reported more scene movement than speech anxious Ss. Both groups responded to their own fear scenes with higher ratings of emotion and a greater physiological response than to the other group's fear scenes. The arousal response of spider phobics to relevant fear scenes was greater than that of speech anxious Ss. The data suggest that the outcome of imagery-based therapies may be partly determined by type of fear. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of performance expectancy and self-focused attention on social interaction.

Investigated the impact of performance expectancies and self-focused attention on social performance in mixed-sex dyads of 48 undergraduate men with self-reported moderate social anxiety on a modified Social Avoidance and Distress Scale. Ss were divided into 2 groups on the basis of their high or low performance expectancies. Ss were asked to respond to several self-report questionnaires before and after making a telephone call lasting 4–5 min to a female confederate for the purpose of getting acquainted. Results show that half of the Ss in each expectancy group performed in the presence of a self-focusing stimulus (video-camera). When anxiety level was controlled for, focus of attention alone had a very limited effect on performance. Expectancy had a significant influence on social performance, but only if Ss were self-focused. Thus confident Ss were rated by judges as more socially skilled than were doubtful Ss, but only when the camera was present. The interaction between these variables parallels previous research by C. S. Carver et al (see record 1980-32489-001) and Carver and M. F. Scheier (see record 1980-25774-001) and supports the self-regulation model of Carver and Scheier (1983). (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exposure and anxiety management in the treatment of social phobia.

Divided 45 18–65 yr old social phobia outpatients into 3 groups of 15 Ss each: Group 1 received exposure with anxiety management. Group 2 received exposure with a nonspecific "filler" treatment instead of anxiety management. Group 3 served as a waiting-list control. Results show that Groups 1 and 2 improved more than Group 3 and the improvement was maintained for 6 mo. At the end of treatment, Group 1 had lower scores than Group 2 on 2 cognitive measures of social anxiety. Six months later, Group 1 had lower scores on 4 additional measures. No S in Group 1 requested additional treatment within a year, while 40% of Group 2 did so. It is suggested that anxiety management increases the effect of exposure treatment because it helps Ss adapt to unpredictable situations, relaxation and distraction are useful techniques, and emphasis on self-help and rationale are important. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implicit memory bias for threat-relevant information in individuals with generalized social phobia.

The authors used a noise judgment task to investigate implicit memory bias for threat in individuals with generalized social phobia (GSP). Participants first heard neutral sentences (e.g., "The manual tells you how to set up the tent.") and social-threat sentences (e.g., "The classmate asks you to go for drinks."). Implicit memory for these sentences was then tested by asking participants to rate the volume of noise accompanying the presentation of these "old" sentences intermixed with "new" sentences that had not been previously presented. Implicit memory for old sentences is revealed when participants rate the noise accompanying old sentences as less loud than the noise accompanying new sentences. Those with GSP demonstrated an implicit memory bias for social-threat sentences, whereas controls did not. This differential priming effect suggests that information about threat may be automatically accessed in GSP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep Deprivation in social phobia and generalized anxiety disorder

BACKGROUND: Sleep deprivation has been shown to improve depressive symptoms in some patients with major depressive disorder, but it has not been tested in patients with generalized anxiety disorder (GAD) or social phobia (SP). METHODS: To determine if sleep deprivation altered anxiety or depressive symptoms in patients with GAD (n = 7) or SP (n = 8), we sleep deprived patients and normal controls (n = 18) for one night. RESULTS: On one measure of anxiety, GAD patients improved compared with controls, but there were otherwise no significant change differences between controls and SP or GAD patients. CONCLUSIONS: The lack of benefit is consistent with previous findings that sleep deprivation provides no benefit to patients with other anxiety disorders. Sleep deprivation may be a biological intervention that distinguishes anxiety from affective disorders.     

The effect of practice on recall of emotional information in individuals with generalized social phobia.

Understanding memory processes in social anxiety is important because these individuals often report negative memories of anxiety-provoking situations and because of the recent emphasis on learning and memory in models of anxiety. The authors examined the effect of learning on memory for negative social, positive social, and nonsocial information using the retrieval-induced forgetting paradigm in individuals with generalized social phobia (GSPs) and in nonanxious controls (NACs). Words were presented in 1 of 3 practice conditions: practiced words from a practiced category, unpracticed words from a practiced category, and unpracticed words from an unpracticed category. GSPs and NACs showed the same patterns of memory for practice categories for positive social and nonsocial words. However, for negative social words, GSPs benefited less from practice and were hurt less from the effect of practicing competing negative social information than were NACs. This pattern of processing may hamper GSPs' learning of, and habituation to, negative social information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional imagery in simple and social phobia: Fear versus anxiety.

In a 1st study, 60 phobic volunteer Ss reacted psychophysiologically with greater vigor to imagery of their own phobic content than to other fearful or nonaffective images. Imagery heart rate responses were largest in Ss with multiple phobias. For simple (dental) phobics, cardiac reactivity was positively correlated with reports of imagery vividness and concordant with reports of affective distress; these relationships were not observed for social (speech) phobics. In a 2nd study, these phobic volunteers were shown to be similar on most measures to an outpatient clinically phobic sample. In an analysis of the combined samples, fearful and socially anxious subtypes were defined by questionnaires. Only the fearful subtype showed a significant covariation among physiological responses, imagery vividness, and severity of phobic disorder. This fearful–anxious distinction seems to cut across diagnostic categories, providing a heuristic perspective from which to view anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing reliable and clinically significant change in social phobia: validity of the social phobia and anxiety inventory

The ability of the Social Phobia and Anxiety Inventory (SPAI) to measure change as a function of treatment for social phobia was assessed. In addition to determining treatment sensitivity of the SPAI, changes over the course of treatment were examined to determine if they were reliable and clinically significant. The results indicated that although a number of measures showed statistically significant change, only on the SPAI was that change reliable and clinically significant. The use of outcome measures that are reliable and clinically significant for social phobia as well as other disorders is discussed.     

Mediation of changes in anxiety and depression during treatment of social phobia.

To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive- behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated 91% of the improvements in depression over time. Conversely, decreases in depression only accounted for 6% of the decreases in social anxiety over time. Changes in social anxiety fully mediated changes in depression during the course of treatment. The theoretical and clinical implications of these findings for the relationship between anxiety and depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attention training in individuals with generalized social phobia: A randomized controlled trial.

The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or neutral emotional expression cued different locations on the computer screen. In the attention modification program (AMP), participants responded to a probe that always followed neutral faces when paired with a threatening face, thereby directing attention away from threat. In the attention control condition (ACC), the probe appeared with equal frequency in the position of the threatening and neutral faces. Results revealed that the AMP facilitated attention disengagement from threat from pre- to postassessment and reduced clinician- and self-reported symptoms of social anxiety relative to the ACC. The percentage of participants no longer meeting Diagnostic and Statistical Manual (4th ed.) criteria for GSP at postassessment was 50% in the AMP and 14% in the ACC. Symptom reduction in the AMP group was maintained during 4-month follow-up assessment. These results suggest that computerized attention training procedures may be beneficial for treating social phobia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-administration of alcohol before and after a public speaking challenge by individuals with social phobia.

[Correction Notice: An erratum for this article was reported in Vol 16(3) of Psychology of Addictive Behaviors (see record 2009-17717-001). On page 121, in the abstract, the penultimate sentence incorrectly reads, “As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking following the 2 activities.” The sentence should read as follows: “As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking preceding the 2 activities.”] K. Abrams, M. Kushner, K. Medina, and A. Voight (2001) showed that alcohol attenuates social anxiety symptoms in socially phobic individuals. This article examines whether social anxiety symptoms can lead to increased alcohol use in this same population. Forty-four individuals with social phobia attended 2 laboratory sessions, spaced 1 week apart, in groups of approximately 10. Participants underwent a social anxiety challenge during 1 session and a control task during the other. Half of the sample self-administered alcohol immediately before, and half immediately after, these 2 activities. As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking following the 2 activities. These findings add to an understanding of why social phobia and alcohol problems tend to co-occur. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frequency and comorbidity of social anxiety and social phobia in adolescents. Results of a Bremen adolescent study

Using data from the Bremen Adolescent Study, this report presents findings on the frequency, comorbidity and psychosocial impairment of social phobia and social fears among 1035 German adolescents of 12-17 years of age. The adolescents were randomly selected from 36 schools in the city and provincial government area of Bremen, Germany. Social phobia and other psychiatric disorders were coded based on DSM-IV criteria using the computerized personal interview of the Munich version of the Composite International Diagnostic Interview. Seventeen (1.6%) of the adolescents had met the DSM-IV criteria for social phobia at some time in their life. More girls than boys were diagnosed as suffering from social phobia. The incidence of the disorder increased with age. The lifetime frequency of social fears is much higher. The most common types of feared social situations were fear of doing something in front of other people, followed by public speaking. Social phobia very often co-occurred with depressive disorders, somatoform disorders and disorders caused by excessive or inappropriate consumption of substances. Over 94% of those with social phobia and 54.4% with any social fears were severely impaired in their daily life during the worst episode. Despite the high level of psychosocial impairment, only a small portion of the cases received professional help.     

Attachment in individuals with social anxiety disorder: The relationship among adult attachment styles, social anxiety, and depression.

Despite their apparent implications for social functioning, adult attachment styles have never been specifically explored among persons with social anxiety disorder. In the current study, a cluster analysis of the Revised Adult Attachment Scale (N. L. Collins, 1996) revealed that 118 patients with social anxiety (58.6% males and 41.4% females, mean age 32.43 yrs) were best represented by anxious and secure attachment style clusters. Members of the anxious attachment cluster exhibited more severe social anxiety and avoidance, greater depression, greater impairment, and lower life satisfaction than members of the secure attachment cluster. This pattern was replicated in a separate sample of 56 patients and compared with the pattern found in 36 control participants. Social anxiety mediated the association between attachment insecurity and depression. Findings are discussed in the context of their relevance to the etiology, maintenance, and cognitive-behavioral treatment of social anxiety disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reinforcing effects of diazepam under anxiogenic conditions in individuals with social anxiety.

Diazepam (DZ) reinforcement was tested under anxiogenic (public speaking) and neutral (computer task) conditions. Individuals with social anxiety disorder (n=11) and healthy controls (n=11) participated in two 5-session phases. Each phase used a standard choice procedure (2 sample, 3 choice sessions) comparing 10-mg DZ and placebo. During the public speaking condition, DZ preference was greater among the participants with social anxiety compared with controls (81.8% vs. 36.4%; p     

Psychopharmacologic treatment of panic, generalized anxiety disorder, and social phobia

The anxiety disorders discussed in this article are common, affecting 5% to 10% of the general population. They may cause significant distress and disability and are often complicated by substance abuse and depression. Fortunately, these disorders can be treated successfully in the majority of patients, with alleviation of the most distressing symptoms and significant improvement in occupational and social functioning. Systematic research studies during the past decade have identified both specific medication-responsive anxiety syndromes and a variety of psychopharmacologic agents effective in their management. Psychopharmacologic treatment, often in combination with cognitive-behavioral therapies, can be tailored for the individual patient based on that patient's specific anxiety syndrome, comorbid disorders, and vulnerability to side effects. Careful monitoring of target symptoms can be used to assess the efficacy of treatment. Future research will help to develop new classes of antianxiety agents for currently treatment-resistant patients, and to investigate further the necessary duration of psychopharmacologic treatment.     

Effect of anxiety reduction on children's school performance and social adjustment.

[Correction Notice: An erratum for this article was reported in Vol 43(2) of Developmental Psychology (see record 2007-02739-020). The byline and author note should have included the author's middle initial, J. Thus, the byline and author note should refer to "Jeffrey J. Wood." The correction is reflected in this record.] This study tested the effect of reductions in children's anxiety over time on improvements in school performance and social functioning in the context of participation in a cognitive-behavioral intervention program. Participants included 40 children with high anxiety (6-13 years of age). Independent evaluators, children, and parents rated child anxiety; parents rated school performance; and children and parents rated social functioning. Measures were completed at preintervention, midintervention, and postintervention. Fixed-effects regression analyses and random-effects regression analyses indicated that decreased anxiety was predictive of improved school performance and social functioning over the course of the intervention. These findings suggest that changes in anxiety influence trajectories of children's scholastic and social functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The spatial focus of attention is controlled at perceptual and cognitive levels.

Selective attention has been hypothesized to reduce distractor interference at both perceptual and postperceptual levels (Lavie, 2005), respectively, by focusing perceptual resources on the attended location and by blocking at postperceptual levels distractors that survive perceptual selection. This study measured the impact of load on these selection mechanisms using a flanker paradigm (Eriksen & St. James, 1986) and indexing distractor interference as a function of separation. It distinguished changes in the extent of focus of the distractor-interference function of separation (reflecting perceptual selection) from changes in the amplitude of distractor interference not accompanied by changes in focus (reflecting postperceptual selection). It showed that: (1) the spatial profile of perceptual resources is shaped like a “Mexican hat” (Müller et al., 2005); (2) increasing perceptual load focuses perceptual resources (Caparos & Linnell, 2009); (3) increasing cognitive load defocuses perceptual resources; and (4) participants with reduced working-memory span show reduced postperceptual blocking of distractors. While these findings are consistent with two levels of selective attention, they show that the first perceptual level is affected not only by perceptual but also by cognitive-control mechanisms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of social anxiety and alcohol expectancies on stress-induced drinking.

The utility of trait social anxiety and alcohol expectancies in predicting increased alcohol consumption under socially stressful conditions was investigated. Forty-two male and 42 female undergraduates participated in a 2-day study, serving as their own controls. In each session, participants consumed their preferred alcoholic beverage during a 30-min drinking period. The lst session established baseline consumption under nonstressful conditions, while in the 2nd session, participants drank while anticipating the required delivery of a speech. Measures of social anxiety and alcohol expectancies were completed. Participants consumed more absolute alcohol during the stressful session, but those with high trait social anxiety and men expecting alcohol to increase assertiveness were most likely to show this effect. These findings suggest specificity in the connection between individual characteristics and stress-induced drinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of severe social phobia: Effects of guided exposure with and without cognitive restructuring.

Fifty-one social phobics with severe scrutiny fears were randomly assigned to treatment in an experiment designed to assess the effectiveness of therapist-guided exposure and to determine the extent to which cognitive restructuring alone increases the effects of this exposure. Additionally, the ability of treatment-induced changes in locus of control, of irrational attitudes, and of within-session habituation to predict level of functioning at follow-up was assessed. Treatment integrity assessment showed compliance with instructions that was consistent with the respective treatments. The combined condition proved to be significantly more effective than guided exposure alone in endstate functioning, in increasing behavioral approach, and in decreasing self-rated avoidance. Regression analysis showed that treatment-induced changes in fear of negative evaluation (FNE), irrational beliefs, locus of control, and exposure-practice habituation were significantly predictive of endstate functioning at follow-up; the change in FNE accounted for virtually all the explained variance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)