Gaze Avoidance Explains the Association Between Anxiety Sensitivity Social Concerns and Social Anxiety

A two-sample study on the relationship between polygenic risk score of serotonergic polymorphisms and social phobia: Interpersonal adaptability as a mediator

BACKGROUNDS

The influence of serotonin function on social phobia has been well-documented, yet the polygenic risk score of serotonergic polymorphisms for social phobia remains unclear.

METHODS

We assessed two aspects of social phobia (i.e., social interaction anxiety and social phobia scrutiny fear) and created a polygenic risk score of seven serotonergic polymorphisms in two independent samples.

RESULTS

The results from both samples indicated that a greater polygenic risk score, denoting a higher risk of anxiety, was associated with higher levels of social interaction anxiety and social phobia scrutinizing fear. Interestingly, the association between polygenic risk score and social interaction anxiety was mediated by interpersonal adaptability.

CONCLUSION

These findings demonstrate the importance of serotonergic polymorphisms in social phobia and unveil a psychological pathway whereby interpersonal adaptability mediates the effect of serotonergic polymorphisms on social phobia.

Variations in the Appearance and Interpretation of Interpersonal Eye Contact in Social Categorizations and Psychiatric Populations Worldwide: A Scoping Review with a Critical Appraisal of the Literature

BACKGROUND

Eye contact is one of the most fundamental forms of interhuman communication. However, to date, there has been no comprehensive research comparing how eye contact is made and interpreted in all possible populations worldwide. This study presents a summary of the existing literature on these modalities stratified to social categorizations and psychiatric disorders.

METHOD

A scoping review with critical appraisal of the literature according to the Joanna Briggs Institute (JBI) methodology. Databases AnthroSource, Medline, CINAHL, the Psychology and Behavioral Sciences Collection (EBSCO) and PsychInfo were searched.

RESULTS

7068 articles were screened for both the grey literature and reference lists, of which 385 were included, 282 for social categorizations and 103 for psychiatric disorders. In total, 603 thematic clustered outcomes of variations were included. Methodological quality was generally moderate to good.

CONCLUSIONS

There is a great degree of variation in the presentation and interpretation of eye contact between and within populations. It remains unclear why specific variations occur in populations. Additionally, no gold standard for how eye contact should be used or interpreted emerged from the studies. Further research into the reason for differences in eye contact between and within populations is recommended.

Does gaze anxiety predict actual gaze avoidance and is it more informative than social anxiety?

BACKGROUND AND OBJECTIVES

In recent years eye-tracking studies have provided converging evidence that socially anxious individuals avoid looking at other people's faces in social situations. In addition to these objective measures, the Gaze Anxiety Rating Scale (GARS) has increasingly been used as a self-report measure of gaze avoidance. However, extant results concerning its predictive validity were inconsistent. Moreover, no study has considered social anxiety and gaze anxiety together to examine their relative contributions to actual gaze behavior.

METHODS

To address these two questions, eye-tracking data collected from 81 female students during the initial 6 min of a face-to-face conversation with a female confederate were analyzed. Gaze anxiety and social anxiety were measured via the GARS and the Leibowitz Social Anxiety Scale.

RESULTS

The results revealed that gaze anxiety was associated with reduced face gaze while speaking. Social anxiety was not only associated with decreased face gaze during speaking, but also across the initial conversation. Moreover, there was no evidence that gaze anxiety made an additional contribution to social anxiety in predicting face gaze behavior.

LIMITATIONS

This study examined face gaze instead of eye gaze. Additionally, the self-report data were not collected on the same day as the eye-tracking data.

CONCLUSIONS

The findings indicate that, in a community sample, gaze anxiety does predict actual gaze behavior during a face-to-face initial encounter, but social anxiety is a stronger predictor.

Social anxiety is related to reduced face gaze during a naturalistic social interaction

BACKGROUND

Social anxiety has long been related to reduced eye contact, and this feature is seen as a causal and a maintaining factor of social anxiety disorder. The present research adds to the literature by investigating the relationship between social anxiety and visual avoidance of faces in a reciprocal face-to-face conversation, while taking into account two aspects of conversations as potential moderating factors: conversational role and level of intimacy.

METHOD

Eighty-five female students (17-25 years) completed the Leibowitz Social Anxiety Scale and had a face-to-face getting-acquainted conversation with a female confederate. We alternated conversational role (talking versus listening) and manipulated intimacy of the topics (low versus high). Participants' gaze behavior was registered with Tobii eye-tracking glasses. Three dependent measures were extracted regarding fixations on the face of the confederate: total duration, proportion of fixations, and mean duration.

RESULTS

The results revealed that higher levels of social anxiety were associated with reduced face gaze on all three measures. The relation with total fixation duration was stronger for low intimate topics. The relation with mean fixation duration was stronger during listening than during speaking.

CONCLUSION

The results highlight the importance of studying gaze behavior in a naturalistic social interaction.

Out of Sight, Still in Mind: The Consequences of Nonfoveal Viewing of Emotional Faces in Social Anxiety

Background: Anxiety sensitivity social concerns (ASSC) is a risk factor for social anxiety disorder that may motivate avoidance of eye contact (i.e., gaze avoidance), thereby maintaining anxiety. Gaze avoidance displaces socially relevant stimuli (e.g., faces) from foveal (i.e., center) vision, possibly reducing visual sensation of faces and giving an opportunity to misperceive others as rejecting. Methods: We tested the effects of non-foveal viewing on perceiving faces as rejecting, whether there is an indirect effect of ASSC on state anxiety explained by perceived rejection, and whether the indirect effect depended on non-foveal viewing of faces. Participants (N = 118) viewed faces presented within foveal and non-foveal positions and rated how rejecting each face appeared to be, followed by ratings of their own state anxiety. Results: ASSC was associated with perceiving faces as rejecting regardless of face position. There was an indirect effect of ASSC on state anxiety ratings that was explained by perceived rejection, but only in the non-foveal positions. The indirect effect was due to an association between perceived rejection and state anxiety that was only present when faces were viewed in non-foveal vision. Discussion: The findings suggest ASSC may maintain state anxiety partially through the perceived rejection someone experiences while avoiding the gaze of others. This study supports cognitive theories of social anxiety and encourages cognitive-behavioral interventions for gaze avoidance in people with social anxiety disorder.

Frozen with Fear? Attentional Mechanisms in Children with Selective Mutism

Background

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 children, similar mechanisms could apply to both disorders. Especially biased attentional processing of threat and fear-induced reduced visual exploration (referred to as attentive freezing) appear promising in SM.

Methods

A total of N = 84 children (8–12 years, SM: n = 28, SAD: n = 28, typical development (TD): n = 28) participated in an eye-tracking paradigm with videos of a social counterpart expressing a question, a social evaluation or a neutral statement. We investigated gaze behavior towards the social counterpart’s eye-region and the extent of visual exploration (length of scanpath), across conditions.

Results

There were no group differences regarding gaze behavior on the eye region. Neither gaze behavior with respect to the eye region nor visual exploration were dependent on the video condition. Compared to children with TD, children with SM generally showed less visual exploration, however children with SAD did not.

Conclusion

Reduced visual exploration might be due to the mechanism of attentive freezing, which could be part of an extensive fear response in SM that might also affect speech-production. Interventions that counteract the state of freezing could be promising for the therapy of SM.