Gaze as an Indicator of Selective Attention in Adolescents with Social Anxiety Disorder

Cognitive Therapy and Research - Attention bias, conceptualized to be involved in the development and maintenance of SAD, may differentiate teens with SAD from those without. Although SAD typically...     

Attention and Memory Biases in Social Anxiety Disorder: The Role of Comorbid Depression

Cognitive biases play an important role in the onset and maintenance of Social Anxiety Disorder (SAD). Few studies, however, have examined the role of comorbid Major Depressive Disorder (MDD) in the processing of emotional material. In addition, little is known about the relation among different cognitive biases. In the current study, 73 participants (54.79% female) completed an emotion face dot-probe task followed by a recognition memory test. Compared to participants with SAD, participants with comorbid SAD and MDD oriented away from supraliminally presented angry faces. Subsequently, SAD participants with and without comorbidity recognized fewer angry faces than non-disordered controls. Furthermore, attention biases for subliminally presented stimuli predicted recognition accuracy only for comorbid participants. These results suggest that the presence of comorbid MDD affects attentional orienting in SAD participants. In addition, it highlights the interconnectedness of attention and memory biases for comorbid participants.     

Lack of Differential Symptom Change with Cognitive-Behavioral versus Light Therapy for Winter Depression: A Network Intervention Analysis

Cognitive Therapy and Research - This study is a network intervention analysis comparing the symptomatic response of two first-line treatments for winter seasonal affective disorder (SAD): light...     

Assessing the efficacy of imagery-enhanced cognitive behavioral group therapy for social anxiety disorder: Study protocol for a randomized controlled trial

Cognitive behavior group therapy (CBGT) is effective for social anxiety disorder (SAD), but a substantial proportion of patients do not typically achieve normative functioning. Cognitive behavioral models of SAD emphasize negative self-imagery as an important maintaining factor, and evidence suggests that imagery is a powerful cognitive mode for facilitating affective change. This study will compare two group CBGT interventions, one that predominantly uses verbally-based strategies (VB-CBGT) and another that predominantly uses imagery-enhanced strategies (IE-CBGT), in terms of (a) efficacy, (b) mechanisms of change, and (c) cost-effectiveness. This study is a parallel groups (two-arm) single-blind randomized controlled trial. A minimum of 96 patients with SAD will be recruited within a public outpatient community mental health clinic in Perth, Australia. The primary outcomes will be self-reported symptom severity, caseness (SAD present: yes/no) based on a structured diagnostic interview, and clinician-rated severity and life impact. Secondary outcomes and mechanism measures include blind observer-rated use of safety behaviors, physiological activity (heart rate variability and skin conductance level) during a standardized speech task, negative self-beliefs, imagery suppression, fear of negative and positive evaluation, repetitive negative thinking, anxiety, depression, self-consciousness, use of safety behaviors, and the EQ-5D-5L and TiC-P for the health economic analysis. Homework completion, group cohesion, and working alliance will also be monitored. The outcomes of this trial will inform clinicians as to whether integrating imagery-based strategies in cognitive behavior therapy for SAD is likely to improve outcomes. Common and distinct mechanisms of change might be identified, along with relative cost-effectiveness of each intervention.     

Social anxiety disorder is Associated with Vaccination attitude,stress, and coping responses during COVID-19

Cognitive Therapy and Research - Individuals with Social Anxiety Disorder (SAD) may be at a higher risk for negative outcomes during the COVID-19 pandemic due to isolation that is both...     

The Impact of Negative Emotions on Drinking Among Individuals with Social Anxiety Disorder in Daily Life: The Moderating Effect of Maladaptive Emotion Regulation Strategies

Cognitive Therapy and Research - Emerging evidence suggests that increased negative emotions and maladaptive emotion regulation (ER) strategies underlie social anxiety disorder (SAD) and alcohol...     

The Relationship Between Negative Self-imagery and Social Anxiety in a Clinically Diagnosed Sample

Cognitive Therapy and Research - The current study aimed to investigate the content of negative self-imagery (NSI) in Social Anxiety Disorder (SAD) and to explore the relationship between NSI and...     

Frozen with Fear? Attentional Mechanisms in Children with Selective Mutism

Cognitive Therapy and Research - Children with selective mutism (SM) are consistently unable to speak in certain social situations. Due to an overlap between SM and social anxiety disorder (SAD) in...     

Does Exposure Therapy Lead to Changes in Attention Bias and Approach-Avoidance Bias in Patients with Social Anxiety Disorder?

Cognitive biases have been suggested to play a crucial role in the etiology and maintenance of social anxiety disorder (SAD). The aim of the present study was to investigate the effects of exposure therapy on attention- and approach-avoidance bias in SAD. In a randomized controlled trial, we compared changes from pre- to posttreatment in both biases in patients receiving stand-alone exposure therapy to a waiting-list control condition comprising 60 participants (Mage?=?36.9 years) with SAD with heterogeneous social fears. Before and after treatment, attention bias was assessed using the dot probe task and approach-avoidance bias using the approach avoidance task. Results revealed that pre- to posttreatment changes in attention bias and approach-avoidance bias in exposure therapy did not significantly differ from changes in the waiting-list condition. Limitations and potential implications of the current results are discussed.     

The Cognitive Distortions Questionnaire (CD-Quest): Validation in a Sample of Adults with Social Anxiety Disorder

Cognitive distortions are thought to be central to the development and maintenance of anxiety disorders and are a widely acknowledged treatment target in cognitive-behavioral interventions. However, little research has focused on the measurement of cognitive distortions. The Cognitive Distortions Questionnaire (CD-Quest; de Oliveira, Trial-based cognitive therapy: A manual for clinicians, Routledge, New York, 2015), a brief, 15-item questionnaire, assesses the frequency and intensity of cognitive distortions. The CD-Quest has been shown to have sound psychometric properties in American, Australian, and Brazilian undergraduate samples and one Turkish-speaking outpatient clinical sample. The current study aimed to provide the first evaluation of the psychometric properties of the English version of the CD-Quest in a clinical sample and the first evaluation of any version of the CD-Quest in a sample of adults diagnosed with social anxiety disorder (SAD). In a sample of treatment-seeking adults with SAD, the CD-Quest demonstrated good convergent validity, discriminant validity, known-groups validity, and treatment sensitivity. It also showed good internal consistency, and both confirmatory and exploratory factor analyses supported the previously reported unitary factor structure. Findings extend prior research indicating the reliability and validity of the CD-Quest.     

散发性阿尔茨海默病易患性与人类白细胞抗原基因频率的相关性

目的探讨人类白细胞抗原HLA-DR2,DRB1*04,DRB1*09基因频率与散发性阿尔茨海默病(SAD)的关系,试图从分子免疫遗传学角度揭示SAD的发病机制。方法SAD组44例(广州市精神病院中筛选),男11例,女33例,年龄59～91岁。正常对照组45例(中山大学附属第二医院保健科体检的自愿健康老年人),男14例,女31例,年龄61～88岁。采用序列特异性引物聚合酶链反应(PCR-SSP)技术分别测定44例SAD患者(SAD组)和45例正常老年人(对照组)的HLA-DR2,DRB1*04,DRB1*09基因频率。结果SAD患者中3种基因频数分别为25,5,16;频率分别为28.41%,5.68%,18.18%。而正常老年人中的相应基因频数分别为16,13,19;频率分别为17.78%,14.44%,21.11%。其中HLA-DR2,DRB1*04较对照组差异有显著性意义(χ2=4.002,4.187,P<0.05),DRB1*09差异无显著性意义(χ2=0.050,P>0.05)。结论HLA-DR2可能是SAD的易感基因,而HLA-DRB1*04可能对SAD的发病起到保护作用。HLA-DRB1*09与SAD发病无关联。     

Manualized Cognitive-Behavioral Treatment of Social Anxiety Disorder: A Case Study

Social anxiety disorder (SAD), also known as social phobia, is one of the most common anxiety disorders and has been shown to be effectively treated using cognitive-behavioral therapy (CBT). Recently, a manualized CBT treatment for SAD has been developed (Hope, Heimberg, & Turk, 2006), with research demonstrating superior treatment outcomes with CBT relative to alternatives (e.g., psychotropic medication). The current case study of Henry, a 26-year old Caucasian male with SAD, implemented this manualized CBT for SAD. Treatment consisted of 15 individual sessions, with follow-ups occurring 2 and 8 months post-treatment. Henry showed marked reductions in SAD symptoms throughout the course of treatment, resulting in complete remission of SAD at the end of formal treatment. His SAD continued to be in remission at the 2-and 8-month follow-up sessions. This case study demonstrates the usefulness of a manualized, individual CBT treatment for SAD.     

Role of ethnicity in social anxiety disorder: A cross-sectional survey among health science students

AIM: To investigate the influence of ethnicity in social anxiety disorder (SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences'' students .METHODS: This was a cross-sectional survey of 112 1^st, 2^nd and 3^rd year students from the Faculty of Medicine and Health Sciences at Stellenbosch University, Cape Town, South Africa. The self-reported Social Anxiety Spectrum questionnaire was used to assess for SAD. The Social Phobia Inventory (SPIN) was adapted to a version called the E-SPIN (Ethnic-SPIN) in order to evaluate the effects of ethnicity. Two sub-questions per stem question were included to assess whether SAD symptoms in social interactions were ethnicity dependent. Substance use was assessed with the Alcohol Use Disorders Identification Test and Drug Use Disorders Identification Test, and depression with the Centre for Epidemiological Studies Depression Scale.RESULTS: Of 112 students who completed the E-SPIN questionnaire, 54.4% (n = 61) met criteria for SAD, with significantly more females than males meeting criteria. Ethnicity had a significant effect on SAD symptomatology, but there was no effect of ethnicity on the rates of drug and alcohol abuse in students with and without SAD. Overall significantly more students with SAD met criteria for depression compared with students without the disorder.CONCLUSION: Among university students, SAD is prevalent regardless of whether interactions are with individuals of the same or different ethnic group. However, ethnicity may be an important determinant of social anxiety for some ethnic groups. SAD was significantly associated with major depression but not significantly associated with drug or alcohol abuse.     

Maternal Parenting and Child Behaviour: An Observational Study of Childhood Social Anxiety Disorder

Etiological models of social anxiety disorder (SAD) suggest parenting is involved in the development of SAD. However, previous studies have often neglected potential contributions of child behaviour to parenting behaviour. Further, parent–child interaction has often been assessed in artificial laboratory settings thereby impairing ecological validity. Children (aged 9–13 years) with SAD (n?=?27) and healthy controls (HC, n?=?27) completed a puzzle task with mothers present at home. Parent–child interactions were analysed for parenting (e.g., negativity, involvement) and child behaviour (e.g., dependence, helplessness). Mothers of children with SAD showed more involvement than mothers of HC children. Maternal involvement was related to child dependence in HC dyads only, while maternal negativity was correlated with negative child behaviour in both groups. The study indicates maternal over-involvement in their interactions with children with SAD at home. The lack of relation to child behaviour in SAD dyads points to inflexibility in mother–child interactions.     

Seasonal affective disorder: its recognition and treatment

This article provides an introduction to seasonal affective disorder (SAD) and outlines various therapies, including phototherapy (light therapy), used in its treatment. SAD, colloquially termed 'winter blues', is a common condition that is thought to be caused by reduced levels of daylight in winter. During this period sufferers generally feel low and may experience clinical depression. The Department of Psychiatry at the University of Southampton has an established SAD service as part of its mood disorders clinic, which was developed from a research-based clinical investigation unit set up in the early 1990s. SAD is described as a mood disorder with a seasonal pattern and has a greater prevalence in countries with greater northern latitude. The aetiology of SAD is unclear, although the most promising theory suggests the role of the neurotransmitter serotonin. SAD is difficult to treat with conventional antidepressants although there is evidence that serotonin selective reuptake inhibitors may be useful for some patients. Phototherapy (light therapy) has been used successfully by many patients although it remains controversial and difficult to obtain on the NHS.     

Trait and Daily Emotion Regulation in Social Anxiety Disorder

Emotion regulation strategies vary widely in use and effectiveness across psychological diagnostic categories. However, little data exists on (1) the use of these strategies in social anxiety disorder (SAD), and (2) how trait measures compare with actual daily use of emotion regulation strategies. We collected trait and daily assessments of emotion suppression, cognitive reappraisal, and positive and negative emotions from 40 adults with SAD and 39 matched healthy controls. Participants with SAD reported greater trait suppression and less cognitive reappraisal than healthy controls, and exhibited this same pattern of emotion regulation in daily life. Participants overall reported worse emotional experiences when suppressing positive (vs. negative) emotions, and better emotional experiences when reappraising to feel more positive (vs. less negative) emotions. However, SAD participants exhibited greater benefits (specifically increased positive emotions) from reappraising to feel less negative than healthy controls. These findings highlight the importance of positive emotion regulation strategies, particularly for individuals with SAD.     

Anxious but Thoroughly Informed? No Jumping-to-Conclusions Bias in Social Anxiety Disorder

Social anxiety disorder (SAD) is maintained by biased information processing, which might involve hasty decision making. This study tested whether SAD is associated with jumping-to-conclusions in neutral and socially threatening situations. Sixty participants with SAD and 56 healthy controls completed a beads-task and a Social Beads-Task (SBT) with neutral, threat-relevant, and self-relevant situations. Dependent variables were draws to decision (DTD) and certainty about the decision. In the beads-task, participants with SAD showed more DTD than controls. In the SBT, all participants drew fewer beads in threat- and self-relevant situations than in neutral scenarios. Participants with SAD reported higher certainty regarding their decision in the beads-task and in the threat- and self-relevant scenarios of the SBT. Jumping-to-conclusions increases when decision making is framed in a threatening or social-evaluative context. SAD may be linked to more certainty about decisions, but findings on group differences require further investigation.     

Sagittal abdominal diameter is a strong anthropometric marker of insulin resistance and hyperproinsulinemia in obese men

OBJECTIVE: It is clinically important to find noninvasive markers of insulin resistance and hyperproinsulinemia because they both predict cardiovascular and diabetes risk. Sagittal abdominal diameter (SAD) or "supine abdominal height" is a simple anthropometric measure previously shown to predict mortality in men, but its association with insulin resistance and hyperproinsulinemia is unknown. RESEARCH DESIGN AND METHODS: In a common high-risk group of 59 moderately obese men (aged 35-65 years, BMI 32.6 +/- 2.3 kg/m(2)), we determined anthropometry (SAD, BMI, waist girth, and waist-to-hip ratio [WHR]); insulin sensitivity (euglycemic-hyperinsulinemic clamp); and plasma concentrations of intact proinsulin, specific insulin, C-peptide, glucose, and serum IGF binding protein-1 (IGFBP-1). To compare SAD with other anthropometric measures, univariate and multiple regression analyses were used to determine correlations between anthropometric and metabolic variables. RESULTS: SAD showed stronger correlations to all measured metabolic variables, including insulin sensitivity, than BMI, waist girth, and WHR. SAD explained the largest degree of variation in insulin sensitivity (R(2) = 0.38, P < 0.0001) compared with other anthropometric measures. In multiple regression analyses, including all anthropometric measures, SAD was the only independent anthropometric predictor of insulin resistance (P < 0.001) and hyperproinsulinemia (P < 0.001). CONCLUSIONS: In obese men, SAD seems to be a better correlate of insulin resistance and hyperproinsulinemia (i.e., cardiovascular risk) than other anthropometric measures. In overweight and obese individuals, SAD could represent a simple, cheap, and noninvasive tool that could identify the most insulin resistant in both the clinic and clinical trials evaluating insulin sensitizers. These results need confirmation in larger studies that also include women and lean subjects.     

The Temporal Development of Mood, Cognitive, and Vegetative Symptoms in Recurrent SAD Episodes: A Test of the Dual Vulnerability Hypothesis

Recent literature on seasonal affective disorder (SAD) has begun to focus on diathesis–stress models, including Young and colleagues’ dual vulnerability hypothesis. The dual vulnerability hypothesis posits that individuals must possess both a biological vulnerability to developing vegetative symptoms and a psychological vulnerability to developing mood symptoms in order to develop SAD episodes. However, few studies have directly tested this model until very recently. Research has demonstrated a temporal relation between mood and vegetative symptoms, with vegetative symptoms having an earlier onset than mood symptoms supporting the idea that separate factors related to the two symptom clusters exist. The current study represents a longitudinal assessment of vegetative and mood symptoms, as well as cognitive factors (i.e., rumination, automatic thoughts) that may represent part of the psychological vulnerability shared by SAD sufferers. Furthermore, the present study represents only the second to assess state levels of cognitive factors that may impact recurrent SAD episode severity. Fifty-one individuals participated in the study across two groups, individuals with a history of SAD, and with no history of depression or SADs. Findings supported the dual vulnerability hypothesis, with an early vegetative symptom onset than mood symptom evident for the individuals with a history of SAD. Participants with a history of SAD also reported more ruminative responses and negative automatic thoughts about the seasons. Findings are generally supportive of Young and colleagues’ dual vulnerability hypothesis and directions for future research are suggested.