Interpretive biases for ambiguous stimuli in social anxiety

Effects of positive and negative affect inductions on interpretive and response bias

Affective states and interpretations of ambiguous stimuli are inherently related constructs, although effects of induced affective states on interpretive and response biases have not been comprehensively explored. The present study examined the relationship between induced affective states and interpretive and response bias in a sample of 189 undergraduates. Participants completed an online study in which they were randomized into one of two mood induction conditions and subsequently completed an interpretive bias task. Results demonstrated significant condition differences in affect after the mood induction; the positive induction condition demonstrated significantly more positive mood and the negative condition demonstrated more negative mood. A significant difference between conditions emerged with respect to positive interpretive bias for non-social scenarios, with the positive mood induction condition demonstrating more positive interpretive bias to non-social situations than the negative induction condition (p = .04). The negative induction condition demonstrated significantly greater negative response bias for social scenarios (p = .03) and, unexpectedly, a significantly higher positive response bias for non-social scenarios (p = .05). Findings offer some support for the notion that inducing positive affect may promote more positive interpretations of ambiguous scenarios.

Neural representations of ambiguous affective stimuli and resilience to anxiety in emerging adults

The tendency to interpret ambiguous stimuli as threatening has been associated with a range of anxiety disorders. Responses to ambiguity may be particularly relevant to mental health during the transition from adolescence to adulthood ("emerging adulthood"), when individuals encounter unfamiliar challenges and navigate novel social situations. However, it remains unclear whether neural representations of ambiguity relate to risk for anxiety. The present study sought to examine whether multivariate representations of ambiguity - and their similarity to representations of threat - relate to appraisals of ambiguity or anxiety in a sample of emerging adults. Participants (N = 41) viewed threatening (angry), nonthreatening (happy), and ambiguous (surprised) facial stimuli while undergoing fMRI. Outside of the scanner, participants were presented with the same stimuli and categorized the ambiguous faces as positive or negative. Using representational similarity analyses (RSA), we investigated whether the degree of pattern similarity in responses to ambiguous, nonthreatening, and threatening faces within the amygdala related to appraisals of ambiguous stimuli and anxiety symptomatology. We found that individuals who evidenced greater similarity (i.e., less differentiation) in neural representations of ambiguous and nonthreatening faces within the left amygdala reported lower concurrent anxiety. Additionally, trial-level pattern similarity predicted subsequent appraisals of ambiguous stimuli. These findings provide insight into how neural representations of ambiguity relate to risk or resilience for the development of anxiety.

Development and Testing of an Interpretational Bias Measure of Dental Anxiety

Objectives

We hypothesized that individuals with dental care-related anxiety and fear would interpret ambiguous dental situations more negatively than non-anxious individuals. The objectives of these studies were to develop and test a Measure of Dental Anxiety Interpretational Bias (MoDAIB).

Methods

In the development phase, participants completing an online survey provided qualitative and quantitative assessments of dental scenarios that could be interpreted in either positive or negative ways. Scenarios producing the greatest difference in visual analog (VAS) scores between individuals with high vs. low dental anxiety as measured by the Modified Dental Anxiety Scale (MDAS) were included in the MoDAIB. In the testing phase, participants completed an online survey including the newly developed MoDAIB and dental anxiety measures.

Results

In the development phase, participants (N = 355; 65.6% female) high in dental anxiety (MDAS ≥ 19) gave significantly higher (i.e., more negative) VAS scores to all the dental scenarios than did those low in dental anxiety (p's < 0.05). In the testing phase, the MoDAIB was significantly and positively correlated with the MDAS (r = 0.68, p < 0.001), meaning that those who were high in dental anxiety selected negative interpretations of ambiguous dental scenarios significantly more often than did individuals low in dental anxiety (p's <0.05). The MoDAIB showed good content validity and test-retest reliability.

Conclusions

Individuals high in dental anxiety interpret ambiguous dental situations more negatively than do less anxious individuals. Understanding individuals' interpretational styles may help dental providers avoid miscommunications. Interventions that train dentally anxious patients to consider more positive interpretations may reduce dental anxiety and should be investigated.

Am I really seeing what's around me? An ERP study on social anxiety under speech induction, uncertainty and social feedback

Cognitive models of social anxiety propose that socially anxious individuals engage in excessive self-focusing attention when entering a social situation. In the present study, speech anxiety was induced to socially anxious and control participants. Event-related potentials were recorded while participants performed a perceptual judgment task using distinct or ambiguous stimuli, before and after social feedback. Disputed feedback led to more revisions and decreased levels of confidence, especially among socially anxious individuals. Prior feedback, greater occipital P1 amplitudes in both groups for ambiguous probes indicated heightened sensory facilitation to ambiguous information, and greater anterior N1 amplitudes for ambiguous stimuli in highly anxious participants suggested anticipation of negative feedback in this group. Post-feedback, P1, N1 and LPP amplitudes were reduced overall among socially anxious individuals indicating a reduction in sensory facilitation of visual information. These results suggest excessive self-focusing among socially anxious individuals, possibly linked to anticipation of an anxiety-provoking social situation.

Comparing evaluations of social situations for adults who do and do not stutter

PURPOSE

Numerous research studies indicate that stuttering is associated with increased risk for social anxiety disorder (SAD). Interpretation bias is one of four cognitive biases thought to maintain symptoms associated with SAD. Interpretation bias occurs when one evaluates social situations as more negative than they actually are. The purpose of this study was to investigate if adults who do and do not stutter interpret positive, ambiguous, mildly negative, and profoundly negative social situations similarly, or-if like individuals with SAD-adults who stutter exhibit negative interpretation biases.

METHOD

Forty-eight adults who stutter and 42 age-and gender-matched adults who do not stutter participated. Participants completed the Fear of Negative Evaluation (FNE) and were assigned to one of four groups: adults who stutter with high FNE (AWS-High), adults who stutter with low FNE (AWS-Low), adults who do not stutter with high FNE (AWNS-High), and adults who do not stutter with low FNE (AWNS-Low). All participants completed the trait scale of the State Trait Anxiety Inventory (STAI) and the Interpretation and Judgmental Questionnaire (IJQ). The IJQ contains descriptions of four types of social situations: positive, mildly negative, profoundly negative, and ambiguous. Within each situation type there are five different scenarios, for a total of 20 scenarios across the four situation types. Participants provided written responses to these 20 social scenarios. Qualitative analyses were used to understand how members of each group interpreted the different social scenarios.

RESULTS

Thematic analysis revealed that each group responded in similar ways to each of the social scenarios, regardless of the type of situation. Adults who do and do not stutter with low and high FNE agreed on many themes related to the 20 social scenarios, and they agreed across all four types of social situations. Somewhat surprisingly, the theme "stuttering" was mentioned infrequently by the adults who stutter.

CONCLUSIONS

Results suggested that adults who do and do not stutter with low and high FNE interpret social situations similarly, and that no group demonstrated a negative interpretation bias consistent with what is observed in adults with SAD. The interpretations provided by each group were appropriate to the specific scenarios being evaluated.

Social anxiety, rejection sensitivity, and theory of mind decoding ability

OBJECTIVES

Recent initiatives have highlighted the importance of investigating clinically relevant variations in social processes that contribute to mental illness. Surprisingly little research has examined the associations between socially and clinically relevant transdiagnostic factors, such as social anxity (SA) and rejection sensitvity (RS), on theory of mind (ToM) decoding ability.

METHODS

The Reading the Mind in the Eyes Task and self-report measures of SA and RS were completed by 199 adult participants.

RESULTS

Linear regression analyses suggest a specific difficulty decoding positive emotion associated with SA and global decrements in ToM associated with RS that may reflect a negative interpretation bias.

CONCLUSIONS

These findings may have important implications for understanding how those with SA and RS perceive and navigate social interactions, which may contribute to the maintenance of symptoms and decreased psychosocial functioning.

Stressful Life Events Are Related to More Negative Interpretations, but Not Under Acute Stress

Studies have identified deleterious effects of stress on multiple cognitive processes such as memory and attention. Little is known about the impact of stress on interpretation. We investigated how an induced acute stress and more long-term stress related to life events were associated with interpretations of ambiguous stimuli. Fifty participants answered a questionnaire indexing the number of stressful life events. A median split was used to compare those reporting few or more events. Half of participants performed an arithmetic task that induced acute stress; they were compared to a control group performing a less stressful task. We measured the interpretation of ambiguous visual stimuli, which participants had to judge as “negative” or “positive”. We found a significant interaction between the number of stressful life events and the induced acute stress on the proportion of positive interpretations. In the control group, participants reporting more stressful events produced less positive interpretations than those reporting few events. In the induced stress condition, no significant difference was found. Life events tend to influence interpretation in the absence of an acute stressor, which seems to be more influent in the short term.

Ventromedial Prefrontal Cortex Activity and Sympathetic Allostasis During Value-Based Ambivalence

Anxiety is characterized by low confidence in daily decisions, coupled with high levels of phenomenological stress. Ventromedial prefrontal cortex (vmPFC) plays an integral role in maladaptive anxious behaviors via decreased sensitivity to threatening vs. non-threatening stimuli (fear generalization). vmPFC is also a key node in approach-avoidance decision making requiring two-dimensional integration of rewards and costs. More recently, vmPFC has been implicated as a key cortical input to the sympathetic branch of the autonomic nervous system. However, little is known about the role of this brain region in mediating rapid stress responses elicited by changes in confidence during decision making. We used an approach-avoidance task to examine the relationship between sympathetically mediated cardiac stress responses, vmPFC activity and choice behavior over long and short time-scales. To do this, we collected concurrent fMRI, EKG and impedance cardiography recordings of sympathetic drive while participants made approach-avoidance decisions about monetary rewards paired with painful electric shock stimuli. We observe first that increased sympathetic drive (shorter pre-ejection period) in states lasting minutes are associated with choices involving reduced decision ambivalence. Thus, on this slow time scale, sympathetic drive serves as a proxy for "mobilization" whereby participants are more likely to show consistent value-action mapping. In parallel, imaging analyses reveal that on shorter time scales (estimated with a trial-to-trial GLM), increased vmPFC activity, particularly during low-ambivalence decisions, is associated with decreased sympathetic state. Our findings support a role of sympathetic drive in resolving decision ambivalence across long time horizons and suggest a potential role of vmPFC in modulating this response on a moment-to-moment basis.

The influence of social anxiety-provoking contexts on context reinstatement effects

The context reinstatement (CR) effect is the finding that target stimuli are better remembered when presented in the same context as during initial encoding, compared with a different context. It remains unclear, however, whether emotional features of the context affect this memory benefit. In two experiments, we investigated whether the anxiety-provoking nature of a context scene might influence the CR effect. During encoding, participants viewed target faces paired with scenes validated as either highly anxiety-provoking or not, half of which contained other faces embedded within the scene. During retrieval, target faces were presented again with either the same or a new context scene. In Experiment 1, the expected CR effect was observed when the contexts were low-anxiety scenes or high-anxiety scenes without embedded faces. In contrast, the CR effect was absent when the contexts were high-anxiety scenes containing embedded faces. In Experiment 2, to determine whether the presence of embedded faces or the anxiety level of scenes reduced the CR effect, we included an additional context type: low-anxiety scenes with embedded faces. Once again, the CR effect was absent only when the context scene was highly anxiety-provoking with embedded faces: reinstating this context type failed to benefit memory for targets. Results suggest that the benefit to target memory via reinstating a context depends critically on emotional characteristics of the reinstated context.

Social anxiety symptoms, heart rate variability, and vocal emotion recognition in women: evidence for parasympathetically-mediated positivity bias

BACKGROUND AND OBJECTIVES

Individuals with social anxiety disorder show pronounced perceptual biases in social contexts, such as being hypervigilant to threat and discounting positive social cues. Parasympathetic activity influences responses to the social environment and may underlie these biases. This study examined the associations among social anxiety symptoms, heart rate variability (HRV), and vocal emotion recognition.

DESIGN AND METHOD

Female undergraduate students (N = 124) self-reported their social anxiety symptoms using the Social Anxiety Disorder Dimensional Scale and completed a computerized vocal emotion recognition task using stimuli from the Ryerson Audio-Visual Database of Emotional Speech and Song stimulus set. HRV was measured at baseline and during the emotion recognition task.

RESULTS

Women with more social anxiety symptoms had higher emotion recognition accuracy (p = .021) and rated positive stimuli as less intense (p = .032). Additionally, although those with greater social anxiety symptoms did not have lower resting HRV (p = .459), they did have lower task HRV (p = .026), which mediated their lower positivity bias and greater recognition accuracy.

CONCLUSIONS

A parasympathetically-mediated positivity bias may indicate or facilitate normal social functioning in women. Additionally, HRV during a symptom- or disorder-relevant task may predict task performance and reveal parasympathetic differences that are not found at baseline.

Interpretation bias in social anxiety: A systematic review and meta-analysis

BACKGROUND

Interpretation bias, which involves interpreting ambiguous social events negatively and catastrophising even mildly negative social events, has been suggested as a key maintenance factor of Social Anxiety Disorder. Although some individual studies and narrative reviews have demonstrated a role for negative interpretation bias in social anxiety (disorder), findings have been mixed. Given the lack of a quantitative synthesis of the evidence, the current systematic review and meta-analysis examined the strength of the relationship between interpretation bias and social anxiety. It also investigated potential moderators of this relationship (i.e., types of measures and stimuli, samples, and study designs).

METHODS

Five databases (PsycINFO, PubMed, Medline, Scopus, and CINAHL) were searched. Of 46 studies identified, 44 were suitable for meta-analysis (N = 3859).

RESULTS

There was a large effect for the relationship between social anxiety and interpretation bias (g = 0.83). Types of measures (subjective versus objective) and stimuli (verbal versus visual) were identified as significant moderators, with subjective measures and verbal stimuli particularly adept at capturing interpretation bias in socially anxious individuals.

LIMITATIONS

The effect sizes displayed significant heterogeneity between studies, which likely reflects some publication bias, and thus, the overall effect size may be inflated.

CONCLUSION

Findings may help to refine clinical models and interventions for Social Anxiety Disorder, which in turn may maximise evidence-based interventions that target negative interpretation bias in this disorder.

Does anxiety impact the neural processing of child faces in mothers of school-aged children? An ERP study using an emotional Go/NoGo task

Maternal anxiety during pregnancy and the early postpartum period is associated with heightened neural processing of neutral infant faces as measured by event-related potentials (ERPs). However, less is known about how anxiety shapes neural face processing in mothers of older children. In our study, 36 mothers of 8-10 year old children completed a Go/NoGo task consisting of neutral and emotional (happy, fearful) facial expressions posed by unfamiliar school-aged children while EEG was recorded. Higher levels of maternal anxiety -indexed via self-report- were associated with delayed behavioral responses to children's fearful faces and increased N170 and LPP amplitudes elicited by children's neutral faces. While anxiety was also positively related to the LPP elicited by children's emotional faces, it only led to increased N170 amplitude responses to children's fearful, but not happy, faces and only when they were NoGo cues. The study replicates and extends prior findings examining the impact of maternal anxiety on neural responses to neutral infant faces to later stages of parenting with further neural markers and emotional expressions being affected. Findings evidence the importance of studying these associations beyond infancy to increase our knowledge about processes potentially underlying the relation between anxiety and less optimal parenting across development.

Neuroticism and interpretive bias as risk factors for anxiety and depression

Neuroticism has been associated with depression and anxiety both cross-sectionally and longitudinally. Interpretive bias has been associated with depression and anxiety, primarily in cross-sectional and bias induction studies. The purpose of the current study was to examine the role of interpretive bias as a prospective risk factor and a mediator of the relation between neuroticism and depressive and anxious symptoms in young adults assessed longitudinally. Neuroticism significantly predicted a broad general distress dimension, but not intermediate fears and anhedonia-apprehension dimensions, nor a narrow social fears dimension. Neuroticism also significantly predicted negative interpretive bias for social scenarios. Negative interpretive bias for social scenarios did not significantly predict dimension scores, nor did it mediate the relation between neuroticism and general distress or social fears. These results suggest that although neuroticism relates to negative interpretive bias, its risk for symptoms of depression and anxiety is at most weakly conferred through negative interpretive bias.

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.

Threat and benign interpretation bias might not be a unidimensional construct

The tendency for individuals to interpret ambiguous information in a threatening way is theorised to maintain anxiety disorders. Recent findings suggest that positive and negative interpretation biases may have unique effects. This study tested the relationships between threat and benign biases with state and trait anxiety and quality of life, and whether individual differences moderate these relationships. N = 699 individuals with elevated trait anxiety symptoms completed web-based measures of interpretation bias, trait anxiety, state anxiety, and quality of life. Results demonstrated that threat interpretations predicted state anxiety, trait anxiety, and quality of life. Benign interpretations also predicted quality of life. However, benign interpretations only weakly (or not at all) predicted state and trait anxiety. Individual differences (e.g. gender, race, ethnicity, age) did not moderate findings. Results emphasise the need to consider benign and threat biases separately, both in cognitive models of anxiety and experimental designs.

The influences of virtual social feedback on social anxiety disorders

BACKGROUND

Social feedback in the virtual environment is a critical part of successful virtual reality exposure therapy (VRET), and identifying the influences of virtual social feedback on social anxiety patients is necessary.

AIMS

The present study aimed to explore the influences of ambiguous and negative virtual social feedback on social anxiety patients and a health control group (HCG).

METHOD

Twenty-six social anxiety patients and 26 healthy participants were recruited. All participants were exposed to a virtual public speaking scenario. The participants were required to make two 3-minute speeches while the virtual audiences gave them either ambiguous feedback or negative feedback. The subjective units of discomfort (SUD) and heart rate were collected during the process.

RESULTS

The results showed that SAD individuals reported higher levels of subjective anxiety than those in the HCG, and the between-group differences were larger in the mild ambiguous condition than in the intense negative condition.

CONCLUSIONS

This study indicates that social anxiety patients have an interpretation bias towards ambiguous virtual social feedback. Therefore, it is important for VR-based interventions to take into account not only the valence of the feedback but also the ambiguity aspect.

Cultural evidence for interpretation bias as a feature of social anxiety in Chinese adolescents

Background and Objectives: Interpretation bias (IB), defined as the tendency to interpret ambiguous social situations in a threatening manner, has increasingly been studied in children and adolescents. Compared to Western samples, the relation between IB and social anxiety in Chinese youth has received little attention. The present study was to mainly examine the relationship between IB and social anxiety among Chinese adolescents. Design: Cross-sectional design was utilized. Methods: IB, measured by the Adolescents' Interpretation Bias Questionnaire (AIBQ), and social anxiety were surveyed among a group of high socially anxious Chinese adolescents (n = 25) and a control group (n = 29). Participants were asked to rate the likelihood of interpretations coming to mind in social/non-social situations and to choose the most believable interpretation. Results: The high social anxiety group had more negative interpretations and beliefs in social situations, and the interpretation bias was particular to social anxiety versus depression. Additionally, the cognitive content-specificity hypothesis was supported; the high anxious group showed interpretation bias in social situations, but didn't have more negative interpretations of non-social situations, after controlling for depression. Conclusions: The present study yielded comparable findings as found in Western samples regarding the relation between IB and social anxiety.

What Does the Ambiguous Intentions Hostility Questionnaire Really Measure? The Importance of Context in Evaluating Hostility Bias

We examine the psychometric validity of the Ambiguous Intentions Hostility Questionnaire (AIHQ) by applying confirmatory factor analysis (CFA). Previous analysis of psychometric features of the AIHQ showed problems with internal consistency and stability of the tool over time. By using CFA we wanted to check whether the scenes depicted in the questionnaire actually measure the same construct and whether the subscale measures are intercorrelated. The analysis included ambivalent scenes and was conducted on offenders (N = 108) and the general population (N = 161). Results indicated that the structure proposed by the AIHQ authors differs from that revealed by the statistical procedures. It appears that the AIHQ factor structure is centered on situational contexts rather than on particular questions measuring constructs of hostility and blame. We discuss these findings with regard to application of the AIHQ in clinical samples.

When change is the only constant: The promise of longitudinal neuroimaging in understanding social anxiety disorder

Longitudinal studies offer a unique window into developmental change. Yet, most of what we know about the pathophysiology of psychiatric disorders is based on cross-sectional work. Here, we highlight the importance of adopting a longitudinal approach in order to make progress towards identifying the neurobiological mechanisms of social anxiety disorder (SAD). Using examples, we illustrate how longitudinal data can uniquely inform SAD etiology and timing of interventions. The brain's inherently adaptive quality requires that we model risk correlates of disorders as dynamic in their expression. Developmental theories regarding timing of environmental events, cascading effects and (mal)adaptations of the developing brain will be crucial components of comprehensive, integrative models of SAD. We close by discussing analytical considerations when working with longitudinal, developmental data.

Social anxiety and interpretation bias: examining clinical and subclinical components in adolescents

BACKGROUND

This study aimed to examine whether different components of interpretation bias are clinical or dimensional features of adolescent social anxiety. The study analyzed the components of this bias at a subclinical level of Social Anxiety Disorder (SAD) and compared these with a clinical sample of adolescents with SAD.

METHOD

Adolescents in the age range 13-17 years participated. A group with SAD (n = 30) was compared with a group with subclinical SAD (n = 60), and a non-socially anxious group (n = 95).

RESULTS

Negative interpretation bias for social situations was found to be a dimensional aspect of social anxiety. In contrast, belief in negative interpretations of social situations appears to be a clinical feature. Contrary to expectations, endorsement of positive interpretations did not differ between the three groups.

CONCLUSIONS

The results suggest that a screening instrument based on negative interpretations of social situations could be useful to detect adolescents at-risk of developing SAD. In a clinical setting, the belief in negative interpretations and the presence of the bias in nonsocial situations should also be considered.

Ethnicity's Role in the Relationship Between Anxiety and Negative Interpretation Bias Among Clinically Anxious Youth: A Pilot Study

Negative interpretation bias, a correlate of anxiety, is defined as an individual's tendency to interpret ambiguous events as negative or threatening. The current study examined associations between interpretation bias and anxiety symptoms in clinically anxious youth and potential moderators of these relationships. Thirty anxious youth and their parents participated in a clinical interview and reported on child anxiety symptoms. Youth completed implicit, explicit-personally irrelevant, and explicit-personally relevant interpretation bias measures. Child-reported anxiety was only associated with negative interpretation bias on the explicit-personally relevant measure and parent-reported social anxiety was negatively associated with positive bias on this measure. Hispanic individuals displayed marginally higher anxiety symptoms and significantly more intense negative interpretation on the implicit measure. While this pilot study revealed preliminary findings that Hispanic ethnicity may play a role in relationships between interpretation bias and anxiety, future work may further elucidate associations between interpretation bias, anxiety, and ethnicity in anxious youth.

Anxiety and the interpretation of ambiguous facial expressions: The influence of contextual cues

In 3 experiments, we investigate how anxiety influences interpretation of ambiguous facial expressions of emotion. Specifically, we examine whether anxiety modulates the effect of contextual cues on interpretation. Participants saw ambiguous facial expressions. Simultaneously, positive or negative contextual information appeared on the screen. Participants judged whether each expression was positive or negative. We examined the impact of verbal and visual contextual cues on participants’ judgements. We used 3 different anxiety induction procedures and measured levels of trait anxiety (Experiment 2). Results showed that high state anxiety resulted in greater use of contextual information in the interpretation of the facial expressions. Trait anxiety was associated with mood-congruent effects on interpretation, but not greater use of contextual information.

Valence and magnitude ambiguity in feedback processing

BACKGROUND

Outcome feedback which indicates behavioral consequences are crucial for reinforcement learning and environmental adaptation. Nevertheless, outcome information in daily life is often totally or partially ambiguous. Studying how people interpret this kind of information would provide important knowledge about the human evaluative system.

METHODS

This study concentrates on the neural processing of partially ambiguous feedback, that is, either its valence or magnitude is unknown to participants. To address this topic, we sequentially presented valence and magnitude information; electroencephalography (EEG) response to each kind of presentation was recorded and analyzed. The event-related potential components feedback-related negativity (FRN) and P3 were used as indices of neural activity.

RESULTS

Consistent with previous literature, the FRN elicited by ambiguous valence was not significantly different from that elicited by negative valence. On the other hand, the FRN elicited by ambiguous magnitude was larger than both the large and small magnitude, indicating the motivation to seek unambiguous magnitude information. The P3 elicited by ambiguous valence and ambiguous magnitude was not significantly different from that elicited by negative valence and small magnitude, respectively, indicating the emotional significance of feedback ambiguity. Finally, the aforementioned effects also manifested in the stage of information integration.

CONCLUSION

These findings indicate both similarities and discrepancies between the processing of valence ambiguity and that of magnitude ambiguity, which may help understand the mechanisms of ambiguous information processing.

Understanding Social Situations (USS): A proof-of-concept social-cognitive intervention targeting theory of mind and attributional bias in individuals with psychosis

OBJECTIVES

In this proof-of-concept trial, we examined the feasibility and preliminary efficacy of Understanding Social Situations (USS), a new social-cognitive intervention that targets higher level social-cognitive skills using methods common to neurocognitive remediation, including drill and practice and hierarchically structured training, which may compensate for the negative effects of cognitive impairment on learning.

METHOD

Thirty-eight individuals with schizophrenia spectrum disorders completed the same baseline assessment of cognitive and social-cognitive functioning twice over a 1-month period to minimize later practice effects, then received 7-10 sessions of USS training, and then completed the same assessment again at posttreatment.

RESULTS

USS training was well tolerated and received high treatment satisfaction ratings. Large improvements on the USS Skills Test, which contained items similar to but not identical to training stimuli, suggest that we were effective in teaching specific training content. Content gains generalized to improvements on some of the social-cognitive tasks, including select measures of attributional bias and theory of mind. Importantly, baseline neurocognition did not impact the amount of learning during USS (as indexed by the USS Skills Test) or the amount of improvement on social-cognitive measures.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

USS shows promise as a treatment for higher level social-cognitive skills. Given the lack of relationship between baseline cognition and treatment effects, it may be particularly appropriate for individuals with lower range cognitive function. (PsycINFO Database Record

A dimensional approach to modeling symptoms of neuropsychiatric disorders in the marmoset monkey

Some patients suffering from the same neuropsychiatric disorder may have no overlapping symptoms whilst others may share symptoms common to other distinct disorders. Therefore, the Research Domain Criteria initiative recognises the need for better characterisation of the individual symptoms on which to focus symptom-based treatment strategies. Many of the disorders involve dysfunction within the prefrontal cortex (PFC) and so the marmoset, due to their highly developed PFC and small size, is an ideal species for studying the neurobiological basis of the behavioural dimensions that underlie these symptoms.Here we focus on a battery of tests that address dysfunction spanning the cognitive (cognitive inflexibility and working memory), negative valence (fear generalisation and negative bias) and positive valence (anhedonia) systems pertinent for understanding disorders such as ADHD, Schizophrenia, Anxiety, Depression and OCD. Parsing the separable prefrontal and striatal circuits and identifying the selective neurochemical modulation (serotonin vs dopamine) that underlie cognitive dysfunction have revealed counterparts in the clinical domain. Aspects of the negative valence system have been explored both at individual- (trait anxiety and genetic variation in serotonin transporter) and circuit-based levels enabling the understanding of generalisation processes, negative biases and differential responsiveness to SSRIs. Within the positive valence system, the combination of cardiovascular and behavioural measures provides a framework for understanding motivational, anticipatory and consummatory aspects of anhedonia and their neurobiological mechanisms. Together, the direct comparison of experimental findings in marmosets with clinical studies is proving an excellent translational model to address the behavioural dimensions and neurobiology of neuropsychiatric symptoms. © 2016 Wiley Periodicals, Inc. Develop Neurobiol 77: 328-353, 2017.

A Systematic Review of Experimental Paradigms for Exploring Biased Interpretation of Ambiguous Information with Emotional and Neutral Associations

Interpretation biases have been extensively explored in a range of populations, including patients with anxiety and depressive disorders where they have been argued to influence the onset and maintenance of such conditions. Other populations in which interpretation biases have been explored include patients with chronic pain, anorexia nervosa, and alcohol dependency among others, although this literature is more limited. In this research, stimuli with threatening/emotional and neutral meanings are presented, with participant responses indicative of ambiguity resolution. A large number of paradigms have been designed and implemented in the exploration of interpretation biases, some varying in minor features only. This article provides a review of experimental paradigms available for exploring interpretation biases, with the aim to stimulate and inform the design of future research exploring cognitive biases across a range of populations. A systematic search of the experimental literature was conducted in Medline, PsychINFO, Web of Science, CINAHL, and Cochrane Library databases. Search terms were information, stimuli, and ambiguous intersected with the terms interpretation and bias*. Forty-five paradigms were found, categorized into those using ambiguous words, ambiguous images, and ambiguous scenarios. The key features, strengths and limitations of the paradigms identified are discussed.

Social Anxiety and Interpretation Bias

This study examined how positive-scale assessment of ambiguous social stimuli affects interpretation bias in social anxiety. Participants with high and low social anxiety ( N = 60) performed a facial expression discrimination task to assess interpretation bias. Participants were then randomly assigned to assess the emotion of briefly presented faces either on a negative or on a positive scale. They subsequently repeated the facial expression discrimination task. Participants with high versus low social anxiety made more negative interpretations of ambiguous facial expressions. However, those in the positive-scale assessment condition subsequently showed reduced negative interpretations of ambiguous facial expressions. These results suggest that interpretation bias in social anxiety could be mediated by positive priming rather than an outright negative bias.

Measuring online interpretations and attributions of social situations: Links with adolescent social anxiety

OBJECTIVE

We evaluated the utility of a novel, picture-based tool to measure how adolescents interpret and attribute cause to social exchanges and whether biases in these processes relate to social anxiety. Briefly presented ambiguous visual social scenes, each containing a photograph of the adolescent as the protagonist, were followed by three possible interpretations (positive, negative, neutral/unrelated) and two possible causal attributions (internal, external) to which participants responded.

METHOD

Ninety-five adolescents aged 14 to 17 recruited from mainstream schools, with varying levels of social anxiety rated the likelihood of positive, negative and unrelated interpretations before selecting the single interpretation they deemed as most likely. This was followed by a question prompting them to decide between an internal or external causal attribution for the interpreted event.

RESULTS

Across scenarios, adolescents with higher levels of social anxiety rated negative interpretations as more likely and positive interpretations as less likely compared to lower socially anxious adolescents. Higher socially anxious adolescents were also more likely to select internal attributions to negative and less likely to select internal attributions for positive events than adolescents with lower levels of social anxiety.

CONCLUSIONS

Adolescents with higher social anxiety display cognitive biases in interpretation and attribution. This tool is suitable for measuring cognitive biases of complex visual-social cues in youth populations with social anxiety and simulates the demands of daily social experiences more closely.

LIMITATIONS

As we did not measure depressive symptoms, we cannot be sure that biases linked to social anxiety are not due to concurrent low mood.

Social Anxiety and Misinterpretation of the Five Facet Mindfulness Questionnaire Describe Subscale

The Five Facet Mindfulness Questionnaire is a widely used measure assessing 5 aspects of mindfulness. The Describe subscale is intended to assess the ability to put one's inner experience into words for one's own understanding, but subscale items contain language that may be ambiguous in that regard. The current study investigated whether social anxiety is associated with a tendency to misinterpret Describe items as referring to describing one's experiences to others rather than oneself. Participants were randomized to receive one of 3 versions of the Describe subscale: the original version or one of two variants orienting participants to describe inner experience for self-communication or interpersonal communication. Social anxiety was negatively associated with Describe scores for the Standard Describe subscale and the interpersonal communication variant, but not for the self-communication variant. Results suggest that high levels of social anxiety are associated with misinterpretation of statements on the Describe subscale as probing for interpersonal communication.

Internet-based interpretation bias modification for social anxiety: A pilot study

BACKGROUND AND OBJECTIVES

The biased interpretation of ambiguous social situations is considered a maintaining factor of Social Anxiety Disorder (SAD). Studies on the modification of interpretation bias have shown promising results in laboratory settings. The present study aims at pilot-testing an Internet-based training that targets interpretation and judgmental bias.

METHOD

Thirty-nine individuals meeting diagnostic criteria for SAD participated in an 8-week, unguided program. Participants were presented with ambiguous social situations, were asked to choose between neutral, positive, and negative interpretations, and were required to evaluate costs of potential negative outcomes. Participants received elaborate automated feedback on their interpretations and judgments.

RESULTS

There was a pre-to-post-reduction of the targeted cognitive processing biases (d = 0.57-0.77) and of social anxiety symptoms (d = 0.87). Furthermore, results showed changes in depression and general psychopathology (d = 0.47-0.75). Decreases in cognitive biases and symptom changes did not correlate. The results held stable accounting for drop-outs (26%) and over a 6-week follow-up period. Forty-five percent of the completer sample showed clinical significant change and almost half of the participants (48%) no longer met diagnostic criteria for SAD.

LIMITATIONS

As the study lacks a control group, results lend only preliminary support to the efficacy of the intervention. Furthermore, the mechanism of change remained unclear.

CONCLUSION

First results promise a beneficial effect of the program for SAD patients. The treatment proved to be feasible and acceptable. Future research should evaluate the intervention in a randomized-controlled setting.

Individual differences in social anxiety affect the salience of errors in social contexts

The error-related negativity (ERN) is an event-related potential that occurs approximately 50 ms after an erroneous response. The magnitude of the ERN is influenced by contextual factors, such as when errors are made during social evaluation. The ERN is also influenced by individual differences in anxiety, and it is elevated among anxious individuals. However, little research has examined how individual differences in anxiety interact with contextual factors to impact the ERN. Social anxiety involves fear and apprehension of social evaluation. In the present study, we explored how individual differences in social anxiety interact with social contexts to modulate the ERN. The ERN was measured in 43 young adults characterized as being either high or low in social anxiety, while they completed a flanker task in two contexts: alone and during social evaluation. The results revealed a significant interaction between social anxiety and context, such that the ERN was enhanced in a social relative to a nonsocial context only among highly socially anxious individuals. Furthermore, the degree of such enhancement significantly correlated with individual differences in social anxiety. These findings demonstrate that social anxiety is characterized by enhanced neural activity to errors in social-evaluative contexts.

Functional neuroanatomy on the working memory under emotional distraction in patients with generalized anxiety disorder

AIMS

Patients with generalized anxiety disorder (GAD) suffer the symptoms of psychological distress, including excessive and uncontrollable anxiety. Until now, the functional neuroanatomy for working memory (WM) in conjunction with the major anxiety symptoms in GAD patients has not yet been clearly identified. This study investigated the neural activation patterns associated with the effect of neutral and anxiety-inducing distractors during the delayed-response WM task in GAD patients.

METHODS

Eighteen patients with GAD and 18 age-matched healthy controls participated in this study. The functional magnetic resonance images were obtained while the subjects performed a delayed-response WM task with neutral and anxiety-inducing distractors.

RESULTS

During the neutral distractor, GAD patients compared to controls showed significantly lower activities in the fusiform gyrus, superior parietal gyrus, precuneus, superior occipital gyrus, lingual gyrus, cuneus, calcarine gyrus, parahippocampal gyrus and cerebellar cortex. During the anxiety-inducing distractor, GAD patients showed significantly higher activity in the hippocampus, whereas they showed lower activities in the dorsolateral prefrontal cortex, fusiform gyrus, superior parietal gyrus, precuneus, superior occipital gyrus and cerebellar cortex. The blood-oxygen-level dependent signal changes in the dorsolateral prefrontal cortex in GAD patients during the anxiety-inducing distractor were negatively correlated with Anxiety Sensitivity Index-Revised scores.

CONCLUSIONS

This study identified the specific brain areas associated with the interaction between emotional regulation and cognitive function associated with neutral and anxiety-inducing distractors during WM maintenance in GAD patients. These findings will be helpful for understanding the neural mechanism on the WM-related cognitive deficits and emotional dysfunction with typical anxiety symptoms in GAD.

Impact of Deployment-Related Sexual Stressors on Psychiatric Symptoms After Accounting for Predeployment Stressors: Findings From a U.S. National Guard Cohort

This study used a longitudinal research design to examine the impact of predeployment stressors and deployment-related sexual stressors on self-reported psychiatric symptoms of U.S. National Guard soldiers returning from deployments to Iraq or Afghanistan. Prior to deployment, participants completed measures of depression and posttraumatic stress symptoms, along with an inventory of predeployment stressor experiences. At 3-months postdeployment, participants (468 men, 60 women) again completed self-report measures of psychiatric symptoms, along with an inventory of sexual stressors experienced during deployment. We compared a cross-sectional model of sexual stressors' impact on psychiatric symptoms, in which only postdeployment reports were considered, to a longitudinal model in which we adjusted for participants' predeployment stressors and psychiatric symptoms. No participants reported sexual assault during deployment, though sexual harassment was common. The cross-sectional model suggested that deployment-related sexual stressors were significantly associated with postdeployment depression (R(2) = .11) and posttraumatic stress symptoms (R(2) = .10). Once predeployment factors were taken into consideration, however, sexual stressors were no longer significant. The results did not support the notion of lasting negative impact for low-level sexual stressors (e.g., sexual harassment) during deployment after predeployment stressors are accounted for. Future studies of sexual stressors should consider longitudinal designs.

Maternal anxiety and neural responses to infant faces

BACKGROUND

Women may be especially vulnerable to anxiety during the postpartum period and early infancy. However, little is known regarding the potential impact of maternal anxiety on the neural processing of infant-relevant information.

METHODS

In this ERP study, 47 recent mothers viewed neutral and distressed infant faces, concurrent with EEG collection. We examined the N170 as a perceptual marker of face processing and the late positive potential (LPP) as an index of engagement with stimulus processing. Mothers also completed the Spielberger State-Trait Anxiety Inventory.

RESULTS

While the N170 was unaffected by infant affect and anxiety levels, the LPP was greater in amplitude for distressed vs. neutral faces. Moreover, the degree of LPP amplitude elicited by neutral infant faces was positively correlated with state anxiety. There were no associations between anxiety and the LPP elicited by distressed infant faces.

LIMITATIONS

We employed self-report measures of state and trait anxiety symptomatology and including diagnostic classification of anxiety disorders will be important in future research.

CONCLUSIONS

These results indicate that recent mothers with higher levels of state anxiety may be more engaged with processing neutral infant cues.

Social cognition

Social cognition is a major problem underlying deficiencies in interpersonal relationships in several psychiatric populations. And yet there is currently no gold standard for pharmacological treatment of psychiatric illness that directly targets these social cognitive areas. This chapter serves to illustrate some of the most innovative attempts at pharmacological modulation of social cognition in psychiatric illnesses including schizophrenia, borderline personality disorder, autism spectrum disorders, antisocial personality disorder and psychopathy, social anxiety disorder, and posttraumatic stress disorder. Pharmacological modulation includes studies administering oxytocin, ecstasy (MDMA), modafinil, methylphenidate, and D-cycloserine. Furthermore, some background on social cognition research in healthy individuals, which could be helpful in developing future treatments, is provided as well as the potential for each drug as a long-term treatment option.

Performance-based interpretation bias in clinically anxious youths: relationships with attention, anxiety, and negative cognition

This preliminary investigation sought to examine basic interpretive biases, as assessed via performance-based means, in the context of anxious symptomatology, attention, and negative cognition in children and adolescents. At a single assessment, 26 youths diagnosed with primary separation anxiety, social phobia, or generalized anxiety disorder completed performance-based assessments of interpretation and attention. Youths and parents also completed diagnostic interviews and youths completed a measure of negative self-statements. Components of interpretation (threat-valence judgments and speed of responding) were examined, and interpretation was explored as a correlate of youth anxiety, attention bias, and negative self-statements. Results found percentage of negative interpretations endorsed as the strongest predictor of anxiety symptoms; this index was also correlated with attention bias. Slower rejection of benign interpretations was also associated with youth-reported negative self-statements.This initial investigation provides support for a relationship between interpretation bias and anxiety and preliminary evidence for a relationship between attention and interpretation biases. Continued research dismantling the stages of basic cognition within the chain of information processing may provide a better understanding of the mechanisms underlying anxiety disorders in youths and lead to continued development and refinement of cognitive interventions.

Theory of mind impairments in social anxiety disorder

Social anxiety disorder (SAD) is a common psychiatric disorder characterized by a persistent, excessive fear and avoidance of social and performance situations. Research on cognitive biases indicates individuals with SAD may lack an accurate view of how they are perceived by others, especially in social situations when they allocate important attentional resources to monitoring their own actions as well as external threat. In the present study, we explored whether socially anxious individuals also have impairments in theory of mind (ToM), or the ability to comprehend others' mental states, including emotions, beliefs, and intentions. Forty socially anxious and 40 non-socially-anxious comparison participants completed two ToM tasks: the Reading the Mind in the Eyes and the Movie for the Assessment of Social Cognition. Participants with SAD performed worse on ToM tasks than did non-socially-anxious participants. Relative to comparison participants, those with SAD were more likely to attribute more intense emotions and greater meaning to what others were thinking and feeling. These group differences were not due to interpretation bias. The ToM impairments in people with SAD are in the opposite direction of those in people with autism spectrum conditions whose inferences about the mental states of other people are absent or very limited. This association between SAD and ToM may have important implications for our understanding of both the maintenance and treatment of social anxiety disorder.

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.