Effects of alcohol on ratings of emotional facial expressions in social phobics

The acute effects of alcohol on social cognition: A systematic review of experimental studies

RATIONALE

Alcohol effects on social cognition have been studied by measuring facial emotion recognition, empathy, Theory of Mind (ToM) and other forms of information processing.

OBJECTIVES

Using the PRISMA guidelines, we reviewed experimental studies that examined acute effects of alcohol on social cognition.

METHODS

Scopus, PsycInfo, PubMed, and Embase were searched between July 2020 - January 2023. The PICO strategy was used for identifying participants, interventions, comparators, and outcomes. Participants (N = 2330) were adult social alcohol users. Interventions consisted of acute alcohol administration. Comparators included placebo or the lowest alcohol dose. Outcome variables were grouped into three themes: facial processing, empathy and ToM, and perceptions of inappropriate sexual behavior.

RESULTS

A total of 32 studies were reviewed. Studies measuring facial processing (67%) often found no effects of alcohol on the recognition of specific emotions, facilitated emotion recognition at lower doses and worsened emotion recognition at higher doses. In studies measuring empathy or ToM (24%), lower doses were more likely to lead to improvements while higher doses were generally impairing. Within the third group of studies (9%), moderate to high alcohol doses made it more difficult to perceive sexual aggression accurately.

CONCLUSIONS

Lower alcohol doses might sometimes help facilitate social cognition, but most data were in line with the idea that alcohol tends to worsen social cognition, particularly at higher doses. Future studies might focus on examining other moderators of the effects of alcohol on social cognition, particularly interpersonal characteristics such as trait emotional empathy, and participant and target gender.

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.

Emotion processing in depression and anxiety disorders in older adults: systematic review

BACKGROUND

Emotional cognition and effective interpretation of affective information is an important factor in social interactions and everyday functioning, and difficulties in these areas may contribute to aetiology and maintenance of mental health conditions. In younger people with depression and anxiety, research suggests significant alterations in behavioural and brain activation aspects of emotion processing, with a tendency to appraise neutral stimuli as negative and attend preferentially to negative stimuli. However, in ageing, research suggests that emotion processing becomes subject to a 'positivity effect', whereby older people attend more to positive than negative stimuli.

AIMS

This review examines data from studies of emotion processing in Late-Life Depression and Late-Life Anxiety to attempt to understand the significance of emotion processing variations in these conditions, and their interaction with changes in emotion processing that occur with ageing.

METHOD

We conducted a systematic review following PRISMA guidelines. Articles that used an emotion-based processing task, examined older persons with depression or an anxiety disorder and included a healthy control group were included.

RESULTS

In Late-Life Depression, there is little consistent behavioural evidence of impaired emotion processing, but there is evidence of altered brain circuitry during these processes. In Late-Life Anxiety and Post-Traumatic Stress disorder, there is evidence of interference with processing of negative or threat-related words.

CONCLUSIONS

How these findings fit with the positivity bias of ageing is not clear. Future research is required in larger groups, further examining the interaction between illness and age and the significance of age at disease onset.

Social anxiety and the interpretation of morphed facial expressions following exclusion and inclusion

BACKGROUND AND OBJECTIVES

Negative interpretation biases are postulated to play etiological and maintaining roles in social anxiety (SA). However, empirical support for interpretation biases of facial expression in SA is inconsistent. Given the importance of signals of (dis)approval in SA, our objective was to examine whether SA is associated with enhanced sensitivity to such signals especially following exclusion.

METHODS

In Study 1, participants (N = 139) underwent an exclusion/inclusion manipulation and were then presented with video clips of smiles gradually changing into disgust expressions (smile-to-disgust). In Study 2 (N = 203), participants saw smile-to-disgust as well as disgust-to-smile clips following an exclusion/inclusion manipulation. Participants' task in both studies was to detect the offset of the initial expression.

RESULTS

Results of Study 1 show that detection latency of smiles' disappearance is negatively associated with SA severity. The results of Study 2 suggest that this association is stronger following exclusion, and specific to the smile-to-disgust as opposed to the disgust-to-smile, transitions.

LIMITATIONS

Our studies did not examine whether the observed interpretation bias was specific to SA.

CONCLUSIONS

Our findings support and refine cognitive theories of SA, suggesting that interpretation biases for facial information in SA may be especially pronounced following exclusion.

Associations between feelings of social anxiety and emotion perception

BACKGROUND

Abnormally biased perceptual judgment is a feature of many psychiatric disorders. Thus, individuals with social anxiety disorder are biased to recall or interpret social events negatively. Cognitive behavioral therapy addresses such bias by teaching patients, via verbal instruction, to become aware of and change pathological misjudgment. The present study examined whether targeting verbal instruction to specific decision parameters that influence perceptual judgment may affect changes in anger perception.

METHOD

We used a signal detection framework to decompose anger perception into three decision parameters (base rate of encountering anger vs. no-anger, payoff for correct vs. incorrect categorization of face stimuli, and perceptual similarity of angry vs. not-angry facial expressions). We created brief verbal instructions that emphasized each parameter separately. Participants with social anxiety disorder, generalized anxiety disorder, and healthy controls, were assigned to one of the three instruction conditions. We compared anger perception pre-vs. post-instruction.

RESULTS

Base rate and payoff instructions affected response bias over and above practice effects, across the three groups. There was no interaction with diagnosis.

DISCUSSION

The ability to target specific decision parameters that underlie perceptual judgment suggests that cognitive behavioral therapy might be improved by tailoring it to patients' individual parameter "estimation" deficits.

Social Anxiety and the Quality of Everyday Social Interactions: The Moderating Influence of Alcohol Consumption

Most research on the link between social anxiety and alcohol consumption has examined problematic outcomes without consideration of potential adaptive functions. Alcohol is an anxiolytic that has the short-term benefit of reducing anxiety; consumption may act as a social lubricant that facilitates higher quality social interactions. Using experience-sampling methodology, we examined how consuming alcohol attenuates the adverse effects of social anxiety in naturally occurring social interactions. Participants (N = 160) completed demographic and trait measures, then completed daily assessments for 14 consecutive days. Results from multilevel model analyses revealed that during face-to-face social interactions, state social anxiety was inversely related to 10 indicators of healthy social interactions (e.g., enjoyment, laughter, feelings of acceptance). Alcohol consumption moderated seven of these associations, such that when participants consumed alcohol in social situations, state social anxiety was no longer associated with social interaction quality. The quantity of alcoholic drinks consumed moderated two of these associations. Furthermore, we found evidence for directionality, such that social anxiety in a given social interaction predicted alcohol consumption in a subsequent social interaction, but not the reverse (i.e., alcohol consumption did not prospectively predict state social anxiety). In social situations that involved alcohol, experiences of social anxiety no longer thwarted one's ability to derive social benefits. These results should be interpreted in the context of a participant sample with relatively low levels of trait social anxiety and frequency of alcohol use. Nonetheless, obtaining social rewards may be a reinforcement mechanism that maintains the link between social anxiety and alcohol consumption.

Neurobiological Correlates and Predictors of Two Distinct Personality Trait Pathways to Escalated Alcohol Use

BACKGROUND

The delineation of the behavioral neurobiological mechanisms underlying the heterogeneous pathways for alcohol use disorders (AUDs) is ostensibly imperative for the development of more cost-effective treatments predicated on better understanding of this complex psychopathology.

METHODS

1) Forty-eight high anxiety sensitive (HAS) and high sensation seeking (HSS) psychopathology-free emerging adults (mean (SD) age: 20.4 (1.9) years) completed a Face Emotion Processing Task and a social stress paradigm (Montreal Imaging Stress Task) during functional magnetic resonance imaging sessions with and without alcohol ingestion (1ml/kg of 95% USP alcohol, p.o.). Drug and alcohol use was reassessed during follow-up interviews 2-3years later.

OUTCOMES

The effects of alcohol (versus placebo) ingestion depended upon the task and risk group. In response to negative (versus neutral) faces, alcohol diminished amygdala (AMYG) activations in HAS but not HSS subjects. In response to psychosocial evaluative stress, alcohol enhanced activations of the medial orbitofrontal cortex (mOFC), perigenual anterior cingulate cortex, and nucleus accumbens in HAS male subjects (HASMS), but decreased mOFC activity in HSS male subjects (HSSMS). At follow-up, a greater alcohol versus placebo differential for threat-related AMYG activations predicted escalating drinking and/or illicit drug use among HAS but not HSS participants, whereas a greater differential for mOFC activations during acute social stress predicted escalating substance use among HSS but not HAS participants.

INTERPRETATION

This double dissociation provides evidence of distinct neurobiological profiles in a priori identified personality trait-based risk groups for AUDs, and links these signatures to clinically relevant substance use outcomes at follow-up. AUD subtypes might benefit from motivationally and personality-specific ameliorative and preventative interventions.

The association of Social Anxiety Disorder, Alcohol Use Disorder and reproduction: Results from four nationally representative samples of adults in the USA

Social Anxiety Disorder (SAD) and Alcohol Use Disorder (AUD) are highly prevalent and frequently co-occur. The results of population studies suggest that SAD tends to precede AUD, and the results of laboratory studies suggest that alcohol use facilitates social behaviors in socially anxious individuals. Therefore, we posited that, in a modern context, a tendency to consume alcohol may be positively selected for among socially anxious individuals by its effect on the likelihood of finding a partner and reproducing. We tested the hypothesis that a higher proportion of individuals with a lifetime diagnosis of SAD and AUD reproduce (i.e., have at least one child) relative to individuals with SAD absent AUD in an individual participant meta-analysis based on over 65,000 adults derived from four nationally representative cross-sectional samples. We then cross-validated these findings against the results of a 10-year follow up of one of these surveys. Lifetime history of SAD was not associated with reproduction whereas lifetime history of AUD was positively associated with reproduction. There was no statistically detectable difference in the proportion of individuals with a lifetime history of SAD with or without AUD who reproduced. There was considerable heterogeneity in all of the analyses involving SAD, suggesting that there are likely to be other pertinent variables relating to SAD and reproduction that should be delineated.

Alcohol acutely enhances decoding of positive emotions and emotional concern for positive stimuli and facilitates the viewing of sexual images

RATIONALE

Social cognition influences social interactions. Alcohol reportedly facilitates social interactions. However, the acute effects of alcohol on social cognition are relatively poorly studied.

METHODS

We investigated the effects of alcoholic or non-alcoholic beer on emotion recognition, empathy, and sexual arousal using the dynamic face emotion recognition task (FERT), Multifaceted Empathy Test (MET), and Sexual Arousal Task (SAT) in a double-blind, random-order, cross-over study in 60 healthy social drinkers. We also assessed subjective effects using visual analog scales (VASs), blood alcohol concentrations, and plasma oxytocin levels.

RESULTS

Alcohol increased VAS ratings of stimulated, happy, talkative, open, and want to be with others. The subjective effects of alcohol were greater in participants with higher trait inhibitedness. Alcohol facilitated the recognition of happy faces on the FERT and enhanced emotional empathy for positive stimuli on the MET, particularly in participants with low trait empathy. Pictures of explicit sexual content were rated as less pleasant than neutral pictures after non-alcoholic beer but not after alcoholic beer. Explicit sexual pictures were rated as more pleasant after alcoholic beer compared with non-alcoholic beer, particularly in women. Alcohol did not alter the levels of circulating oxytocin.

CONCLUSIONS

Alcohol biased emotion recognition toward better decoding of positive emotions and increased emotional concern for positive stimuli. No support was found for a modulatory role of oxytocin. Alcohol also facilitated the viewing of sexual images, consistent with disinhibition, but it did not actually enhance sexual arousal. These effects of alcohol on social cognition likely enhance sociability.

TRIAL REGISTRATION

www.clinicaltrials.gov/ct2/show/NCT02318823.

Randomized controlled trial of attention bias modification in a racially diverse, socially anxious, alcohol dependent sample

OBJECTIVE

Attention biases may be an important treatment target for both alcohol dependence and social anxiety. This is the first ABM trial to investigate two (vs. one) targets of attention bias within a sample with co-occurring symptoms of social anxiety and alcohol dependence. Additionally, we used trial-level bias scores (TL-BS) to capture the phenomena of attention bias in a more ecologically valid, dynamic way compared to traditional attention bias scores.

METHOD

Adult participants (N = 86; 41% Female; 52% African American; 40% White) with elevated social anxiety symptoms and alcohol dependence were randomly assigned to an 8-session training condition in this 2 (Social Anxiety ABM vs. Social Anxiety Control) by 2 (Alcohol ABM vs. Alcohol Control) design. Symptoms of social anxiety, alcohol dependence, and attention bias were assessed across time.

RESULTS

Multilevel models estimated the trajectories for each measure within individuals, and tested whether these trajectories differed according to the randomized training conditions. Across time, there were significant or trending decreases in all attention TL-BS parameters (but not traditional attention bias scores) and most symptom measures. However, there were not significant differences in the trajectories of change between any ABM and control conditions for any symptom measures.

CONCLUSIONS

These findings add to previous evidence questioning the robustness of ABM and point to the need to extend the effects of ABM to samples that are racially diverse and/or have co-occurring psychopathology. The results also illustrate the potential importance of calculating trial-level attention bias scores rather than only including traditional bias scores.

Emotional Reactions to Facial Expressions in Social Anxiety: A Meta-Analysis of Self-Reports

The current meta-analysis reviews 24 studies on self-reported emotional reactions to facial expressions (social rejection, social acceptance, and neutral) in socially anxious versus nonanxious individuals. We hypothesized that socially anxious individuals would perceive all face types as less approachable, more negative, and more arousing. After correcting for biases, results showed that socially anxious individuals, compared to controls, reported lower approachability to all types of expressions and higher arousal in response to neutral expressions. Variances among effects usually could not be explained by the proposed moderators. This suggests that current conceptualizations of social anxiety should take into account the willingness to approach social stimuli rather than global measures of emotion or arousal.

An evolutionary perspective on the co-occurrence of social anxiety disorder and alcohol use disorder

Social Anxiety Disorder (SAD) commonly co-occurs with, and often precedes, Alcohol Use Disorder (AUD). In this paper, we address the relationship between SAD and AUD by considering how natural selection left socially anxious individuals vulnerable to alcohol use, and by addressing the underlying mechanisms. We review research suggesting that social anxiety has evolved for the regulation of behaviors involved in reducing the likelihood or consequences of threats to social status. The management of potential threats to social standing is important considering that these threats can result in reduced cooperation or ostracism - and therefore to reduced access to coalitional partners, resources or mates. Alcohol exerts effects upon evolutionarily conserved emotion circuits, and can down-regulate or block anxiety (or may be expected to do so). As such, the ingestion of alcohol can artificially signal the absence or successful management of social threats. In turn, alcohol use may be reinforced in socially anxious people because of this reduction in subjective malaise, and because it facilitates social behaviors - particularly in individuals for whom the persistent avoidance of social situations poses its own threat (i.e., difficulty finding mates). Although the frequent co-occurrence of SAD and AUD is associated with poorer treatment outcomes than either condition alone, a richer understanding of the biological and psychosocial drives underlying susceptibility to alcohol use among socially anxious individuals may improve the efficacy of therapeutic interventions aimed at preventing or treating this comorbidity.

The effects of alcohol on the recognition of facial expressions and microexpressions of emotion: enhanced recognition of disgust and contempt

OBJECTIVE

The study compared alcohol's effects on the recognition of briefly displayed facial expressions of emotion (so-called microexpressions) with expressions presented for a longer period.

METHOD

Using a repeated-measures design, we tested 18 participants three times (counterbalanced), after (i) a placebo drink, (ii) a low-to-moderate dose of alcohol (0.17 g/kg women; 0.20 g/kg men) and (iii) a moderate-to-high dose of alcohol (0.52 g/kg women; 0.60 g/kg men). On each session, participants were presented with stimuli representing six emotions (happiness, sadness, anger, fear, disgust and contempt) overlaid on a generic avatar in a six-alternative forced-choice paradigm. A neutral expression (1 s) preceded and followed a target expression presented for 200 ms (microexpressions) or 400 ms. Participants mouse clicked the correct answer.

RESULTS

The recognition of disgust was significantly better after the high dose of alcohol than after the low dose or placebo drinks at both durations of stimulus presentation. A similar profile of effects was found for the recognition of contempt. There were no effects on response latencies.

CONCLUSION

Alcohol can increase sensitivity to expressions of disgust and contempt. Such effects are not dependent on stimulus duration up to 400 ms and may reflect contextual modulation of alcohol's effects on emotion recognition.

Similar effects of intranasal oxytocin administration and acute alcohol consumption on socio-cognitions, emotions and behaviour: Implications for the mechanisms of action

Oxytocin (OT) plays a critical role in the formation of long lasting social attachments across a range of mammalian species. Raising intracerebral OT levels by intranasal administration of the neuropeptide (inOT) can also have pronounced effects on human sociocognitive functioning. inOT has been associated with increasing altruism, generosity, empathy and trust while decreasing fear, anxiety and stress reactions via neural mechanisms which are yet to be fully elucidated. The observation of the prosocial effects of OT has led to speculation about the role the peptide might play in some psychiatric conditions and debate as to its potential therapeutic uses. Here we note the great similarity in the sociocognitive effects that can be induced by inOT and the effects of acute consumption of modest does of alcohol. We further reflect on how both compounds may act on limbic and prefrontal cortical structures to increase GABAergic transmission, thereby facilitating the release of prepotent responses, that is, more automatic responses which are associated with earlier developmental stages.

Oxytocin receptor gene methylation: converging multilevel evidence for a role in social anxiety

Social anxiety disorder (SAD) is a commonly occurring and highly disabling disorder. The neuropeptide oxytocin and its receptor (OXTR) have been implicated in social cognition and behavior. This study-for the first time applying a multilevel epigenetic approach-investigates the role of OXTR gene methylation in categorical, dimensional, and intermediate neuroendocrinological/neural network phenotypes of social anxiety. A total of 110 unmedicated patients with SAD and matched 110 controls were analyzed for OXTR methylation by direct sequencing of sodium bisulfite-converted DNA extracted from whole blood. Furthermore, OXTR methylation was investigated regarding SAD-related traits (Social Phobia Scale (SPS) and Social Interaction Anxiety Scale (SIAS)), salivary cortisol response during the Trier social stress test (TSST), and amygdala responsiveness to social phobia related verbal stimuli using fMRI. Significantly decreased OXTR methylation particularly at CpG Chr3: 8 809 437 was associated with (1) the categorical phenotype of SAD (p<0.001, Cohen's d=0.535), (2) increased SPS and SIAS scores (p<0.001), (3) increased cortisol response to the TSST (p=0.02), and (4) increased amygdala responsiveness during social phobia-related word processing (right: p(corr)<0.001; left: p(corr)=0.005). Assuming that decreased OXTR methylation confers increased OXTR expression, the present finding may reflect a compensatory upregulation for pathologically reduced oxytocin levels or a causally relevant increased OXTR activation in SAD and related traits. OXTR methylation patterns might thus serve as peripheral surrogates of oxytocin tone and aid in establishing accessible biomarkers of SAD risk allowing for indicated preventive interventions and personalized treatment approaches targeting the oxytocin system.

Subliminal cues bias perception of facial affect in patients with social phobia: evidence for enhanced unconscious threat processing

Socially anxious individuals have been shown to exhibit altered processing of facial affect, especially expressions signaling threat. Enhanced unaware processing has been suggested an important mechanism which may give rise to anxious conscious cognition and behavior. This study investigated whether individuals with social anxiety disorder (SAD) are perceptually more vulnerable to the biasing effects of subliminal threat cues compared to healthy controls. In a perceptual judgment task, 23 SAD and 23 matched control participants were asked to rate the affective valence of parametrically manipulated affective expressions ranging from neutral to angry. Each trial was preceded by subliminal presentation of an angry/neutral cue. The SAD group tended to rate target faces as “angry” when the preceding subliminal stimulus was angry vs. neutral, while healthy participants were not biased by the subliminal stimulus presentation. The perceptual bias in SAD was also associated with higher reaction time latencies in the subliminal angry cue condition. The results provide further support for enhanced unconscious threat processing in SAD individuals. The implications for etiology, maintenance, and treatment of SAD are discussed.

Effects of acute alcohol consumption and processing of emotion in faces: Implications for understanding alcohol-related aggression

The negative consequences of chronic alcohol abuse are well known, but heavy episodic consumption ("binge drinking") is also associated with significant personal and societal harms. Aggressive tendencies are increased after alcohol but the mechanisms underlying these changes are not fully understood. While effects on behavioural control are likely to be important, other effects may be involved given the widespread action of alcohol. Altered processing of social signals is associated with changes in social behaviours, including aggression, but until recently there has been little research investigating the effects of acute alcohol consumption on these outcomes. Recent work investigating the effects of acute alcohol on emotional face processing has suggested reduced sensitivity to submissive signals (sad faces) and increased perceptual bias towards provocative signals (angry faces) after alcohol consumption, which may play a role in alcohol-related aggression. Here we discuss a putative mechanism that may explain how alcohol consumption influences emotional processing and subsequent aggressive responding, via disruption of orbitofrontal cortex (OFC)-amygdala connectivity. While the importance of emotional processing on social behaviours is well established, research into acute alcohol consumption and emotional processing is still in its infancy. Further research is needed and we outline a research agenda to address gaps in the literature.

Threat processing in generalized social phobia: an investigation of interpretation biases in ambiguous facial affect

Facial affect is one of the most important information sources during the course of social interactions, but it is susceptible to distortion due to the complex and dynamic nature. Socially anxious individuals have been shown to exhibit alterations in the processing of social information, such as an attentional and interpretative bias toward threatening information. This may be one of the key factors contributing to the development and maintenance of anxious psychopathology. The aim of the current study was to investigate whether a threat-related interpretation bias is evident for ambiguous facial stimuli in a population of individuals with a generalized Social Anxiety Disorder (gSAD) as compared to healthy controls. Participants judged ambiguous happy/fearful, angry/fearful and angry/happy blends varying in intensity and rated the predominant affective expression. The results obtained in this study do not indicate that gSAD is associated with a biased interpretation of ambiguous facial affect.

Alcohol use, drinking consequences, and sensitivity to social cues among college women

College students who drink vary in the extent to which they experience drinking consequences, prompting a need to identify factors that differentiate higher-risk drinkers from others. The present study investigated whether difficulty in processing subtle social information is related to negative drinking consequences experienced within the past year. Specifically, poor ability to detect subtle non-verbal sarcasm cues was predicted to contribute to drinking consequences. Participants were 39 women, aged 18 to 27 (M=22), who were enrolled in a public, four-year university. Participants completed a video measure of ability to detect sarcastic comments. After controlling for (high school drinking consequences, maximum drinks in the past 3 months, age), poorer performance in the Simple Sarcasm condition (which provided no cues to others' intentions) explained an additional 10.8% of the variance in recent drinking consequences (ΔF (1, 34)=6.15, p=.018). When predicting risky/hazardous alcohol use consequences (e.g., driving intoxicated, fights, unplanned/unprotected sex), Simple Sarcasm again improved prediction by explaining an additional 8.6% of the variance (ΔF (1, 34)=4.75, p=.036). Sarcasm conditions that provided additional cues to others' meanings were unrelated to alcohol consequences. Findings are discussed within the context of neurological (orbito-frontal-subcortical) pathways that are common to social information and alcohol reinforcement processes.

Enhanced avoidance behavior in social anxiety: evidence from a probabilistic learning task

BACKGROUND AND OBJECTIVES

Social phobia is characterized by avoidance of feared social situations. Although avoidance is a central feature of social anxiety, few studies have examined avoidance learning.

METHODS

We used a probabilistic instrumental learning paradigm where participants had to learn by trial and error which response led to the disappearance of a neutral or angry face. 20 high socially anxious and 20 non-socially anxious individuals with an average level of social anxiety learned to avoid an angry or a neutral face by choosing one of two cues. Each of the cues led to the disappearance of the face either with high or low reinforcement probability.

RESULTS

Groups learned to choose the more effective cue across trials and did not differ with regard to self-report valence, arousal for the faces or the a posteriori estimated reinforcement probability for both cues. High socially anxious individuals as compared to the controls chose the high probability cue significantly more often and were slower particularly when the neutral face could be avoided. Notably, HSA engaged in more avoidance responding to the neutral as compared to the angry face early on during the experiment.

LIMITATIONS

Due to the experimental design, the observed avoidance behavior most likely reflects the motivation for avoidance rather than contingency learning per se.

CONCLUSIONS

In social anxiety, neutral faces might be processed as ambiguous social cues and strongly motivate avoidance behavior.

Relationship between social anxiety and perceived trustworthiness

Four different patterns of biased ratings of facial expressions of emotions have been found in socially anxious participants: higher negative ratings of (1) negative, (2) neutral, and (3) positive facial expressions than nonanxious controls. As a fourth pattern, some studies have found no group differences in ratings of facial expressions of emotion. However, these studies usually employed valence and arousal ratings that arguably may be less able to reflect processing of social information. We examined the relationship between social anxiety and face ratings for perceived trustworthiness given that trustworthiness is an inherently socially relevant construct. Improving on earlier analytical strategies, we evaluated the four previously found result patterns using a Bayesian approach. Ninety-eight undergraduates rated 198 face stimuli on perceived trustworthiness. Subsequently, participants completed social anxiety questionnaires to assess the severity of social fears. Bayesian modeling indicated that the probability that social anxiety did not influence judgments of trustworthiness had at least three times more empirical support in our sample than assuming any kind of negative interpretation bias in social anxiety. We concluded that the deviant interpretation of facial trustworthiness is not a relevant aspect in social anxiety.

Increased anxiety, voluntary alcohol consumption and ethanol-induced place preference in mice following chronic psychosocial stress

Stress exposure is known to be a risk factor for alcohol use and anxiety disorders. Comorbid chronic stress and alcohol dependence may lead to a complicated and potentially severe treatment profile. To gain an understanding of the interaction between chronic psychosocial stress and drug exposure, we studied the effects of concomitant chronic stress exposure on alcohol reward using two-bottle choice and ethanol-conditioned place preference (CPP). The study consisted of exposure of the chronic subordinate colony (CSC) mice "intruders" to an aggressive "resident" mouse for 19 consecutive days. Control mice were single housed (SHC). Ethanol consumption using two-bottle choice paradigm and ethanol CPP acquisition was assessed at the end of this time period. As expected, CSC exposure increased anxiety-like behavior and reduced weight gain as compared to SHC controls. Importantly, in the two-bottle choice procedure, CSC mice showed higher alcohol intake than SHC. When testing their response to ethanol-induced CPP, CSC mice achieved higher preference for the ethanol-paired chamber. In fact, CSC exposure increased ethanol-CPP acquisition. Taken together, these data demonstrate the long-term consequences of chronic psychosocial stress on alcohol intake in male mice, suggesting chronic stress as a risk factor for developing alcohol consumption and/or anxiety disorders.

To be or Not to be Threatening, but What was the Question? Biased Face Evaluation in Social Anxiety and Depression Depends on How You Frame the Query

Scientific evidence is equivocal on whether Social Anxiety Disorder (SAD) is characterized by a biased negative evaluation of facial expressions, even though it is assumed that such a bias plays a crucial role in the maintenance of the disorder. The way of framing the evaluation question may play an important role in the inconsistencies of earlier results. To investigate this issue, an unselected sample of 95 participants (11 males) with varying degrees of social anxiety and depressive symptoms rated facial crowds with different ratios of neutral-disgust, neutral-sad, neutral-happy, and neutral-surprised expressions in terms of friendliness, approval, difficulty to make contact, and threat. It appeared that the impact of social anxiety on ratings was highly dependent on the type of question that was asked, but not on the type of emotion that was shown: a high degree of social anxiety was related to a more positive evaluation of crowds when friendliness was assessed. When asking about the difficulty to make contact, social anxiety was related to more difficulty. When the threat evoked by a crowd had to be evaluated, higher degrees of social anxiety were tendentiously correlated with higher threat ratings. Degree of depression, on the other hand, was negatively correlated only to approval ratings. In addition, with an increasing degree of depression, the negative impact that any additional emotional face had on approval ratings increased as well. The theoretical and methodological implications of the results are discussed.

Individual differences in elevated plus-maze exploration predicted higher ethanol consumption and preference in outbred mice

Psychiatric illnesses, such as anxiety, are highly comorbid with drug use disorders in general and alcohol abuse in particular. Unfortunately, the causal role of anxiety in ethanol addiction is still unclear. We asked the question whether high anxiety predicts predilection of mice to voluntarily consume more alcohol than water. In the current study, we used the voluntary alcohol intake in two bottle choice drinking paradigm to explore whether high anxiety predicts higher alcohol preference and intake in outbred Tuck-Ordinary "TO" mice. To this end, mice were tested for their anxiety-like behavior using the elevated plus maze, open field and the marble burying test prior to voluntary continuous access to increasing concentrations of alcohol solutions. To assess their taste discrimination, mice had access to saccharin and quinine solutions. Results showed that compared to low-anxious mice (LAM), high-anxious mice (HAM) showed greater consumption and preference for ethanol but not for saccharin and quinine suggesting alterations in the rewarding effects of alcohol. Taken together, these findings suggest a correlative link between trait anxiety and the behavioral responses to ethanol.

Drinking behaviors by stress level in Korean university students

The purposes of this study are to estimate the stress level of university students, and to verify the relationships between stress level and drinking behavior. A questionnaire survey was administered to 430 university students in the Gangwon area in Korea from November 5 to November 28, 2008, and data from 391 students were used for the final statistical analysis. The most stressful factor was "Worry about academic achievements" (2.86 by Likert-type 4 point scale). The subjects were divided into two groups, a low stress group (≤ 65.0) and a high stress group (≥ 66.0), by the mean value (65.1) and median value (66.0) of the stress levels. The drinking frequency was not different between the two stress groups, but the amount of alcohol consumption was significantly different (P < 0.05). The portion of students reporting drinking "7 glasses or over" was higher in the lower stress group than in the higher stress group. In addition, factor 6, "Lack of learning ability", was negatively correlated with drinking frequency and the amount of alcohol consumption (P < 0.05), and factor 3, "Worry about academic achievements", was negatively correlated with the amount of drinking (P < 0.05). The major motive for drinking was "When overjoyed or there is something to celebrate" (2.62), and the main expected effect of drinking was "Drinking enables me to get together with people and shape my sociability" (2.73). The higher stress group showed significantly higher scores on several items in the categories of motives (P < 0.01), negative experience (P < 0.05), and expected effects (P < 0.05) of drinking than the lower stress group. Our results imply that university students at the lower stress level may drink more from social motives in positive drinking environments, while those at the higher stress level may have more problematic-drinking despite their smaller amount of alcohol consumption.

Alcohol affects the emotional modulation of cognitive control: an event-related brain potential study

OBJECTIVE

The present study aimed to determine whether alcohol affects the emotional modulation of cognitive control and its underlying neural mechanisms, which is pivotal to an understanding of the socially maladaptive behaviors frequently seen in alcohol-intoxicated individuals.

METHOD

Event-related potentials (ERPs) were recorded in male participants receiving either a moderate dose of alcohol (0.65 g/kg alcohol; n = 32) or a non-alcoholic placebo beverage (n = 32) while performing an emotional Go/No-Go task that required response execution (Go trials) to pictures of a "target" emotional facial expression (angry, happy, neutral) and response inhibition (No-Go trials) to a different "non-target" expression.

RESULTS

Overall, N200 and P300 amplitudes were more enhanced during No-Go than Go trials. Interestingly, alcohol-intoxicated individuals displayed larger No-Go N200 amplitudes across all emotional conditions than controls, accompanied by decreased task performance (i.e., more errors), particularly in response to angry faces. P300 amplitude in the alcohol group was significantly reduced for both Go and No-Go trials, but only following angry and happy emotional expressions.

CONCLUSIONS

These results suggest that alcohol-intoxicated individuals need to effortfully activate more cognitive resources during the early inhibition process in order to regulate a response than controls. Moreover, alcohol affected the emotional modulation of both response inhibition and execution in the later stages of cognitive control. Alcohol dampened emotional responsiveness, which may restrict the availability of attentional resources for cognitive control. Yet, these findings may underlie the lack of control in alcohol-intoxicated individuals when faced with emotionally or socially challenging situations.

The misclassification of facial expressions in generalised social phobia

The aim of this study was to investigate facial expression recognition (FER) accuracy in social phobia and in particular to explore how facial expressions of emotion were misclassified. We hypothesised that compared with healthy controls, subjects with social phobia would be no less accurate in their identification of facial emotions (as reported in previous studies) but that they would misclassify facial expressions as expressing threatening emotions (anger, fear or disgust). Thirty individuals with social phobia and twenty-seven healthy controls completed a FER task which featured six basic emotions morphed using computer techniques between 0 percent (neutral) and 100 percent intensity (full emotion). Supporting our hypotheses we found no differences between the groups on measures of the accuracy of emotion recognition but that compared with healthy controls the social phobia group were more likely both to misclassify facial expressions as angry and to interpret neutral facial expressions as angry. The healthy control group were more likely to misclassify neutral expressions as sad. The importance of the role of these biases in social phobia needs further replication but may help in understanding the disorder and provide an interesting area for future research and therapy.

The comprehensive alcohol expectancy questionnaire: confirmatory factor analysis, scale refinement, and further validation

The Comprehensive Alcohol Expectancy Questionnaire (CAEQ; Demmel & Hagen, 2003a, 2003b) is a self-report measure designed to assess an individual's alcohol expectancies. In this study, we examined the CAEQ in a student sample (N= 932) and in a clinical sample of alcohol-dependent inpatients (N= 744). The Five-factor structure was confirmed by means of confirmatory factor analysis. Convergent validity of the revised CAEQ was supported by showing significant relationships to quantity and frequency of drinking. The results of this study suggest that the revised CAEQ appears to be a psychometrically sound tool for the assessment of alcohol expectancies among both students and alcohol-dependent inpatients.

Effects of alcohol on brain responses to social signals of threat in humans

Alcohol is a known exogenous modulator of negative affect (anxiety, tension) in both animals and humans. It has been proposed that the anxiolytic effects of alcohol are mediated via the amygdala, an area critical to fear perception and responding. However, little is known about the acute effects of alcohol on amygdala reactivity to threatening information in humans. We used functional magnetic resonance imaging and a validated task to probe amygdala responses to social signals of threat in 12 healthy, social drinkers after a double-blind crossover administration of alcohol or placebo. We found that alcohol significantly reduced amygdala reactivity to threat signals. The current findings fit well with the notion that alcohol may attenuate threat-based responding and provide a potential brain-based mechanism for the link between alcohol and anxiety and/or social threat perception.

Attention to social threat as a vulnerability to the development of comorbid social anxiety disorder and alcohol use disorders: an avoidance-coping cognitive model

Despite the frequent comorbidity of social anxiety disorder and alcohol use disorders, no theoretical model currently exists to explain the specific mechanisms underlying the comorbidity between these two disorders. An integration of existing theoretical models and empirical evidence across the social anxiety and alcohol use literatures is presented as the Avoidance-Coping Cognitive Model, which proposes that socially anxious individuals may be particularly vulnerable to the anxiolytic effects of alcohol through reductions in attention biases to social threat. The disproportionate reduction in anxiety may then make alcohol an attractive method of avoidance coping. Gaps in the empirical literature are reviewed in light of this model as future directions are suggested.

Analgesic effects of ethanol are influenced by family history of alcoholism and neuroticism

BACKGROUND

Although personality factors and family history of substance abuse influence how individuals experience pain and respond to analgesics, the combined effects of those factors have not been extensively studied. The objective of this study was to consider the possible role of personality trait of neuroticism and family history of alcoholism on the experience of pain and their role in the analgesic response to an ethanol challenge.

METHODS

Forty-eight healthy subjects participated in this study; thirty-one had a positive family history of alcoholism (FHP), seventeen had a negative family history of alcoholism (FHN). They were also categorized based on their neuroticism (N) scores (low N = 28, and high N = 20). This was a double-blind, placebo-controlled, randomized, within-subject design study of intravenous administration of three doses of ethanol. The testing consisted of 3 separate test days scheduled at least 3 days apart. Test days included a placebo day (saline solution), low-exposure ethanol day (targeted breathalyzer = 0.040 g/dl), and high-exposure ethanol day (targeted breathalyzer = 0.100 g/dl). Noxious electrical stimulation and pain assessments were performed prior to start of infusion and at the 60-minute infusion mark.

RESULTS

The analgesic effect of ethanol was mediated by an interaction between the personality trait of neuroticism and family history. Individuals with family history of alcoholism and high N scores reported significantly more analgesia on low dose of ethanol than those with low N scores. There was no difference in the analgesic response to ethanol among FHNs with low and high N scores.

CONCLUSION

These findings support the conclusion that neuroticism and family history of alcoholism both influence the analgesic response of alcohol. Individuals with high N scores and FHP have the strongest response to ethanol analgesia particularly on the low exposure to alcohol.

Selbstmedikation und Sozialphobie

Zusammenfassung. Hintergrund: Der Fragebogen „Trinken wegen sozialer Angst” (TWSA; Wagner, Stangier, Heidenreich & Schneider, 2004 ) erfasst das Motiv, Alkohol zur Reduktion sozialer Angst einzusetzen. Das Instrument wurde bisher nur bei Alkoholabhängigen untersucht. Hier sollen Reliabilität und konvergente Validität in einer sozialphobischen sowie einer gesunden Stichprobe geprüft werden. Methode: 120 Patienten mit Sozialphobie und 120 Gesunde bearbeiteten den TWSA. Zur Überprüfung der Konstruktvalidität wurden Maße zur Psychopathologie, die Alkoholwirkungserwartungen und die Höhe des Alkoholkonsums erfasst. Ergebnisse: Der TWSA hat eine gute Reliabilität (Cronbachs α = .96). Es zeigen sich bedeutsame Korrelationen mit Maßen zur sozialen Angst. Ebenfalls ergeben sich Zusammenhänge zu Alkoholwirksamkeitserwartungen sowie zur konsumierten Alkoholmenge. Teilnehmer mit Sozialphobie erzielten höhere Werte als Gesunde. Diskussion: Die Ergebnisse belegen, dass der TWSA auch bei Patienten mit Sozialphobie und gesunden Personen reliabel und valide eingesetzt werden kann. Die für Patienten mit Sozialphobie erhöhten Werte unterstreichen die Notwendigkeit der Diagnostik komorbider substanzbezogener Störungen.