On the context dependency of implicit self-esteem in social anxiety disorder

Vulnerabilities in social anxiety: Integrating intra- and interpersonal perspectives

What are the major vulnerabilities in people with social anxiety? What are the most promising directions for translational research pertaining to this condition? The present paper provides an integrative summary of basic and applied translational research on social anxiety, emphasizing vulnerability factors. It is divided into two subsections: intrapersonal and interpersonal. The intrapersonal section synthesizes research relating to (a) self-representations and self-referential processes; (b) emotions and their regulation; and (c) cognitive biases: attention, interpretation and judgment, and memory. The interpersonal section summarizes findings regarding the systems of (a) approach and avoidance, (b) affiliation and social rank, and their implications for interpersonal impairments. Our review suggests that the science of social anxiety and, more generally, psychopathology may be advanced by examining processes and their underlying content within broad psychological systems. Increased interaction between basic and applied researchers to diversify and elaborate different perspectives on social anxiety is necessary for progress.

Prevalence of bullying and its impact on self-esteem, anxiety and depression among medical and health sciences university students in RAS Al Khaimah, UAE

Bullying and peer victimization among medical and health sciences students is a public health issue. This is owing to its detrimental impact and greater risk of psychiatric diseases and psychopathology in childhood, adolescence, and adulthood. As a result, a descriptive cross-sectional research study was conducted to investigate the prevalence of bullying and its influence on self-esteem, anxiety, and depression among medical and health sciences university students in RAS Al- Khaimah, United Arab Emirates. Approximately 369 students from MBBS, BDS, B Pharm, and BSN colleges were selected. The instruments included sociodemographic questions, bullying queries, the Rosenberg Self-Esteem Scale, and the Primary Care Anxiety and Depression Scale. Participants averaged 21.49 ± 2.95. 34.1 % of medical students were bullied. 44.4 % of individuals were called insulting names, making verbal bullying the most common method. The linear regression analysis of bullying data shows that girls (53.2 %) are bullied more than boys (46.8 %). Bullied individuals had a mean score of 43.30 ± 19.74, indicating a higher rate of depression and anxiety. Bullied students had a mean score of 44.62 ± 9.94, indicating lower self-esteem. Significant differences were observed in relation to bullying when considering the variables of the university year, mother's education, and previous experience of bullying (P = 0.002, 0.038, 0.001). It is imperative that universities establish comprehensive protocols to identify instances of such behaviour and provide necessary assistance to victims and their families.

The Effect of Appearance Anxiety on Social Anxiety among College Students: Sequential Mediating Effects of Self-Efficacy and Self-Esteem

Social anxiety is a serious psychological problem prevalent among Chinese college students, and appearance anxiety plays an important role in its development. Although some studies have explored the relationship between the two, the mediating mechanism is unclear. This study constructed a sequential mediation model based on the cognitive-behavioral theory of body image disorder and social phobia to explore the mediating role of self-efficacy and self-esteem. A total of 234 college students were recruited using the convenience sampling method, including 68 males (29.10%) and 166 females (70.90%), with an average age of 21.25 years (SD = 1.75). Data were collected using the Social Appearance Anxiety Scale, the General Self-Efficacy Scale, the Self-Esteem Scale, and the Interaction Anxiety Scale. The study's results demonstrated a significant and positive predictive relationship between appearance anxiety and social anxiety (effect = 0.21, SE = 0.04, 95% CI = [0.13, 0.29], p < 0.001). Appearance anxiety not only directly affects social anxiety but also has three indirect paths affecting social anxiety: the independent mediating effect of self-efficacy (effect = 0.03, SE = 0.01, 95% CI = [0.00, 0.06], p < 0.001), the independent mediating effect of self-esteem (effect = 0.03, SE = 0.02, 95% CI = [0.01, 0.07], p < 0.001), and the serial mediation effect of self-efficacy and self-esteem (effect = 0.01, SE = 0.01, 95% CI = [0.00, 0.03], p < 0.001). Direct and indirect effects accounted for 73.81% and 26.19% of the total effect, respectively. These findings provide new perspectives on the intervention with and treatment of social anxiety in college students.

Mediating effects of self-esteem on the relationship between mindful parenting and social anxiety level in Chinese adolescents

This study aimed to investigate the relationship between mindful parenting and social anxiety level in Chinese adolescents and to explore the mediating roles of self-esteem between mindful parenting and social anxiety level. A total of 302 adolescents and their main caregivers were investigated by using the Chinese version of the Mindful Parenting Scale, Self-Esteem Scale and the Center for Epidemiological Studies Depression Scale and the Social Anxiety Scale. Related analysis was used to investigate the relationship between mindful parenting, self-esteem and social anxiety level. Mindful parenting and self-esteem were significantly associated with social anxiety level. Self-esteem mediated the relationship between mindful parenting and social anxiety level. Both mindful discipline and being in the moment influenced adolescents' social anxiety level through self-esteem. Self-esteem completely mediated the association between mindful parenting and social anxiety level. Longitudinal research is needed to better understand the relationship between mindful parenting and social anxiety level in adolescents.

How social support predicts anxiety among university students during COVID-19 control phase: Mediating roles of self-esteem and resilience

Public health emergency, such as COVID-19 pandemic, generally has severe impacts on mental health in public. One of the often-neglected negative consequences is that the control and prevention measures of COVID-19 in the post-epidemic can pose psychological threats to public mental health. This study aimed to seek the factors and mechanisms to alleviate this mental health threat based on a sample of university students in China. Accordingly, this study proposed an environmental-individual interaction model examining the multiple mediating effects of self-esteem and resilience in the association between social support and anxiety among university students during COVID-19 control phase. A questionnaire containing multiple scales were administered on the sample of 2734 Chinese university students. Results indicated that social support negatively predicted anxiety through the serial mediating effects of self-esteem and resilience sequentially. Our results highlight the impact of social support and the internal factors on relieving anxiety among university students in COVID-19 control phase. Findings suggest that effective psychological intervention tools should be designed and offered to college students to reduce anxiety distress and improve mental health in the post-epidemic era or the similar situations in the future.

Social Achievement Goals in Chinese Undergraduates: Associations With Self-Esteem and Symptoms of Social Anxiety and Depression

The pursuit of relationship goals is critical to the wellbeing of young adults. This study investigated different achievement goals toward social competence as potential predictors of social anxiety and depression symptoms. It proposed that self-esteem may function as a mediator on the pathway from endorsing social achievement goals to undergraduates' concurrent and longitudinal social anxiety and depression symptoms. Social achievement goal theory proposes three types of goals: social mastery goals (striving to improve one's social competence), social performance-approach goals (striving to prove one's social competence and win positive evaluation), and social performance-avoid goals (striving to avoid incompetent social behaviors and negative evaluation). One hundred and eighty-five Chinese undergraduates aged from 18 to 23 (50% female) completed this study across two-time points. Path analyses indicated that social mastery (marginally) and performance-approach goals were positively associated with self-esteem, whereas social performance-avoid goals were negatively associated with self-esteem; self-esteem was negatively associated with the concurrent social anxiety and depression symptoms and the longitudinal depression symptoms. The proposed mediation effects of self-esteem on the links from three types of social achievement goals to the concurrent and longitudinal social anxiety and depression symptoms were significant except on the links from social mastery goals and social performance-approach goals to the subsequent social anxiety symptoms. Self-esteem and the baseline social anxiety and depressive symptoms have a chain mediating effect between social achievement goals and the longitudinal symptoms of social anxiety and depression. These findings suggest that the pursuit of social mastery goals and performance-approach goals in initiating and maintaining social relationships boosts undergraduates' self-worth and reduces their concurrent and longitudinal depression experiences. However, the strivings to hide inadequacy and avoid negative evaluation in social contexts impede one's self-worth and increase concurrent and longitudinal social anxiety and depression symptoms. Implications and limitations are discussed.

All I Need Is Two: The Clinical Potential of Adding Evaluative Pairing Procedures to Cognitive Behavioral Therapy for Changing Self-, Body- and Food-Related Evaluations

Pairing procedures are among the most frequently used paradigms for modifying evaluations of target stimuli related to oneself, an object, or a specific situation due to their repeated pairing with evaluative sources, such as positive or negative images or words. Because altered patterns of evaluations can be linked to the emergence and maintenance of disordered cognitions and behaviors, it has been suggested that pairing procedures may provide a simple yet effective means of complementing more complex intervention approaches, such as cognitive behavioral therapy (CBT). Here, we summarize recent studies that explored the clinical potential of pairing procedures for improving self-esteem, body satisfaction, and food and consumption preferences. While no study has yet combined pairing procedures with CBT, there are several successful examples of pairing procedures in clinically relevant domains and clinical populations. We discuss potential sources of heterogeneity among findings, provide methodological recommendations, and conclude that pairing procedures may bear clinical potential as an add-on to classical psychotherapy.

A Multi-Country Analysis of Prevalence of Anxiety-Induced Sleep Disturbance and Its Associated Factors among In-School Adolescents in Sub-Saharan Africa Using the Global School-Based Health Survey

(1) Background: Among the health problems affecting adolescents, anxiety disorders are considered among the health-compromising or debilitating outcomes that affect adolescents' mental health. We examined the prevalence and factors associated with anxiety-induced sleep disturbance among in-school adolescents in sub-Saharan Africa (SSA). (2) Methods: This study involved a cross-sectional analysis of data from the Global School-Based Health Survey (GSHS). We analyzed data on 25,454 in-school adolescents from eleven (11) countries in SSA with a dataset between 2010 and 2017. Two multivariable logistic regression models were built to determine the strength of the association between anxiety-induced sleep disturbance and the explanatory variables. The results of the regression analyses were presented using adjusted odds ratios (aOR) and their respective 95% confidence intervals (CIs). Statistical significance was set at p-value < 0.05. (3) Results: The overall prevalence of anxiety-induced sleep disturbance among in-school adolescents in SSA was 12.2%. The prevalence ranged from 5.1% in Tanzania to 20.5% in Benin. The odds of anxiety-induced sleep disturbance was higher among adolescents aged 15 and above [aOR = 1.26, 95% CI = 1.15, 1.39] compared to those aged 14 or younger. Additionally, the odds of anxiety-induced sleep disturbance was higher among adolescents who were bullied [aOR = 1.54, 95% CI = 1.42, 1.67], those that felt lonely [aOR = 3.85, 95% CI = 3.52, 4.22], those who had suicidal ideations [aOR = 1.70, 95% CI = 1.52, 1.90], those who had suicidal plan [aOR = 1.26, 95% CI = 1.13, 1.41], those who have had suicidal attempt [aOR = 1.21, 95% CI = 1.08, 1.35], those who used marijuana [aOR = 1.27, 95% CI = 1.06, 1.52], and those who were truant at school [aOR = 1.33, 95% CI = 1.22, 1.46]. However, male adolescents had lower odds of anxiety-induced sleep disturbance [aOR = 0.88, 95% CI = 0.81, 0.95], compared to their female counterparts. (4) Conclusions: We found a relatively high prevalence of anxiety-induced sleep disturbance among in-school adolescents in SSA. Higher age, being female, being bullied, loneliness, having suicidal ideations/plan/attempt, use of marijuana and truancy were risk factors for anxiety-induced sleep disturbance. The findings, therefore, highlight the urgency for policies (e.g., early school-based screening) and interventions (e.g., Rational Emotive Behavioral Education (REBE), Social Emotional Learning (SEL) that target in-school adolescents within the most at-risk populations of anxiety-induced sleep disturbance in SSA.

Implicit Cognition and Psychopathology: Looking Back and Looking Forward

Implicit cognitive processing is theorized to have a central role in many forms of psychopathology. In the current review, we focus on implicit associations, by which we mean evaluative representations in memory that are difficult to control and do not require conscious reflection to influence affect, cognition, or behavior. We consider definitional and measurement challenges before examining recent empirical evidence for these associations in anxiety, obsessive–compulsive, posttraumatic stress, depressive, and alcohol use disorders. This examination is framed by a brief review of the ways that prominent models of psychopathology represent biased implicit processing of disorder-relevant information. We consider to what extent models reflect more traditional automatic/implicit versus strategic/explicit dual-process perspectives or reflect more recent dynamical systems perspectives in which mental representations are iteratively reprocessed, evolving continuously. Finally, we consider the future research needed to better understand the interactive and temporal dynamics of implicit cognition in psychopathology.