Is interpretation bias for threat content specific to youth anxiety symptoms/diagnoses? A systematic review and meta-analysis

The association between sleep quality and anxiety symptoms: a cross-sectional study based on Tibetan university students at high altitude in China

Background

There have been more previous studies on sleep quality and anxiety symptoms among university students in plains areas. However, fewer studies have been conducted on Tibetan university students at high altitude. Analyzing the relationship between sleep quality and anxiety symptoms due to increased altitude may provide a reference for mental health promotion and intervention for Tibetan university students in high altitude areas.

Methods

Stratified whole cluster sampling was used. The pittsburgh sleep quality index (PSQI) scale was used to investigate the sleep quality of 4,777 university students at high altitude in China. The self-rating anxiety scale (SAS) was used to investigate anxiety symptoms. The chi-square test was used to compare the detection rates of anxiety symptoms among different groups, and logistic regression analysis was used to analyze the association between sleep quality and anxiety symptoms.

Results

The prevalence of anxiety symptoms among Tibetan university students at high altitude in China was 25.7%. The detection rate of anxiety symptoms among girls (28.4%) was higher than that of boys (22.1%), and the difference was statistically significant (χ 2 = 24.634, p < 0.001). The detection rates of anxiety symptoms among university students with sleep quality of "Good," "Medium" and "Poor" were 1.8, 4.8 and 39.2%, respectively, and the differences were statistically significant (χ 2 = 779.759, p < 0.001). Logistic regression analysis after adjusting for relevant covariates showed that the risk of anxiety symptoms was higher in the "Medium" (OR:3.479, 95%CI:1.946 ~ 6.221) and "Poor" (OR:44.817, 95%CI:29.175 ~ 68.847) groups, compared with the "Good" group. The same trend was observed in both men and women at the university level.

Conclusion

There is a close relationship between sleep quality and the occurrence of anxiety symptoms among Tibetan university students at high altitude in China. Improving sleep quality may have a positive effect on reducing the occurrence of anxiety symptoms among Tibetan university students at high altitude.

Social Evaluation in Emerging Adults: Associations with Interpretation Bias and Perceived Social Support

Social anxiety symptoms are one of the most common mental health concerns across the lifespan (Bandelow and Michaelis in Dialogues Clin Neurosci 17(3):327-335, 2015. https://doi.org/10.31887/DCNS.2015.17.3/bbandelow ) and are especially relevant during emerging adulthood, when social feedback occurs daily (Auxier and Anderson in Social media use in 2021, 2021. https://www.pewresearch.org/internet/2021/04/07/social-media-use-in-2021/ ) as emerging adults navigate new social environments. Two cognitive processes have been identified as relevant to social anxiety: high threat interpretation bias (i.e., the tendency to appraise threat from ambiguity; Rozenman et al. in Behav Ther 45(5):594-605, 2014. https://doi.org/10.1016/j.beth.2014.03.009 ; J Anxiety Disord 45:34-42, 2017. https://doi.org/10.1016/j.janxdis.2016.11.004 ) is associated with high social anxiety, whereas high perceived social support is associated with low social anxiety. In this study, emerging adults (N = 303) completed an online adaptation of the Chatroom task (Guyer et al. in Arch Gener Psychiatry 65(11):1303-1312, 2008. https://doi.org/10.1001/archpsyc.65.11.1303 ), an experimental paradigm designed to simulate social acceptance and rejection, as well as a performance-based measure of interpretation bias (Word Sentence Association Paradigm; Beard and Amir in Behav Res Ther 46(10):1135-1141, 2008. https://doi.org/10.1016/j.brat.2008.05.012 ), and a self-report measure of perceived social support (Multidimensional Scale of Perceived Social Support; Zimet et al. in J Pers Assess 52(1), 30-41, 1988. https://doi.org/10.1207/s15327752jpa5201_2 ). Social anxiety symptoms did not increase as a function of acceptance or rejection during the Chatroom task. However, there were significant interactions between each cognitive predictor and social anxiety change: emerging adults with low interpretation bias towards threat and emerging adults with high perceived social support both experienced decreases in social anxiety from pre- to post-Chatroom task, regardless of whether they were accepted or rejected during the Chatroom task. If replicated, low interpretation bias and high perceived social support may serve as promotive factors in social interactions for emerging adults.

Specific interpretation biases as a function of social anxiety and callous-unemotional traits in a community and a clinical adolescent sample

BACKGROUND

Threatening and hostile interpretation biases are seen as causal and maintaining mechanisms of childhood anxiety and aggression, respectively. However, it is unclear whether these interpretation biases are specific to distinct problems or whether they are general psychopathological phenomena. The specificity versus pervasiveness of interpretation biases could also differ depending on mental health status. Therefore, in the current study, we investigated whether social anxiety and callous-unemotional (CU) traits were uniquely related to threatening and hostile interpretation biases, respectively, in both a community and a clinical sample of adolescents.

METHODS

A total of 161 adolescents between 10 to 15 years of age participated. The community sample consisted of 88 participants and the clinical sample consisted of 73 inpatients with a variety of psychological disorders. Social anxiety and CU-traits were assessed with self-report questionnaires. The Ambiguous Social Scenario Task was used to measure both threatening and hostile interpretations in response to written vignettes.

RESULTS

Results showed that social anxiety was uniquely related to more threatening interpretations, while CU-traits were uniquely related to more hostile interpretations. These relationships were replicated for the community sample. For the clinical sample, only the link between social anxiety and threatening interpretations was significant. Explorative analyses showed that adolescents with externalizing disorders scored higher on hostile interpretations than adolescents with internalizing disorders.

CONCLUSIONS

Overall, these results support the content-specificity of threatening interpretation biases in social anxiety and of hostile interpretation biases in CU-traits. Better understanding the roles of interpretation biases in different psychopathologies might open avenues for tailored prevention and intervention paradigms.