Children with social phobia have lower quality friendships than children with other anxiety disorders

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

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

Does Cognitive-Behavioral Therapy for Youth Anxiety Disorders Improve Social Functioning and Peer Relationships?

Child and adolescent anxiety disorders (ADs) contribute to impairment in social functioning and peer relationships, exacerbating anxiety and related difficulties. The extent to which the AD treatment with the strongest evidence-base, cognitive-behavioral therapy (CBT), improves social functioning and peer relationships is unclear. In this article, we report results of the first systematic narrative review of this topic. Randomized clinical trials of CBT for child and/or adolescent ADs were included if they used at least one measure of social functioning or peer relationships as a treatment outcome. Sixteen studies met our inclusion criteria. From each study, we extracted the sample characteristics, treatment arms, social and/or peer outcome measures, and statistical findings. Results show that social functioning and/or peer relationships improved over time in the majority of studies, highlighting an important aspect of treatment efficacy beyond anxiety reduction. There were also several treatment-specific effects, but considerable variability across studies' samples, methods, and findings, makes it difficult to draw firm conclusions about which specific treatments improve specific outcomes. We recommend next steps for research to reconcile these findings, including improved operationalization and standardization of social and peer outcomes, and research on treatment specificity and mechanisms.

The relationship between anxiety and internet gaming disorder in children during COVID-19 lockdown: a network analysis

Background

Internet gaming disorder (IGD) has become a social problem in children. Evidence from previous studies has proven that anxiety is associated with IGD. However, IGD was always assessed as a whole based on total scores, and the fine-grained relationship between anxiety and IGD was hidden.

Objective

The present study aims to investigate the fine-grained relationship between anxiety and IGD in elementary school students during the COVID-19 lockdown, and to identify potential targets for psychological interventions.

Methods

During the lockdown caused by the COVID-19 pandemic, 667 children from a primary school in China were investigated by the Spence Children's Anxiety Scale-Short Version and Internet Gaming Disorder Scale. R4.1.1 software was used to construct a network model, assess bridge centrality, and test the robustness of the network and conduct a network.

Results

There were 23 cross-community edges (weight ranged from -0.03 to 0.12), and each node of anxiety was connected to different nodes of IGD. The nodes with the top 80th percentile bridge expected influence were A2 "social phobia" (0.20), A3 "panic disorder" (0.21) and IGD5 "escape" (0.22). The robustness of the network was acceptable.

Conclusion

From the perspective of network analysis, the present study explored the correlation pathways between anxiety and IGD in children and identified social phobia and panic disorder as the best targets for intervention to reduce IGD.

Anxiety and Social Functioning: The Moderating Roles of Family Accommodation and Youth Characteristics

It is well established that anxiety can contribute to social functioning difficulties during childhood and adolescence. It is less clear which anxious youth are most likely to struggle socially, and what types of difficulties they are likely to experience, limiting the extent of identification and intervention efforts. In this study, we aim to improve specification of the linkages between youth anxiety severity and social functioning by examining several potential moderators of these associations. Specifically, we examine whether family accommodation of youth anxiety, in addition to youth age, sex, and the presence of a social anxiety disorder diagnosis, influence associations between anxiety severity and social functioning among youth with anxiety disorders. Youth (N = 158, M_age = 9.99 years, SD = 2.74) and their mothers completed diagnostic interviews and questionnaires assessing anxiety and depression symptoms, family accommodation, and a range of social functioning variables. In a series of hierarchical linear regressions, we found that youth anxiety severity was most strongly associated with social impairment at high levels of family accommodation for adolescents and for youth without social anxiety disorder (mother-report). We also found several direct effects of anxiety severity, family accommodation, and youth age, sex, and diagnosis on different facets of youth social functioning (youth- and/or mother-report). We discuss clinical implications and future research directions focused on specifying the nature of associations between youth anxiety and their social functioning.

Safety behaviours in social anxiety: An examination across adolescence

BACKGROUND

Safety behaviours have been shown to be a key maintaining factor in Social Anxiety Disorder (SAD). In adults, a two-factor structure of safety behaviours reflecting 'avoidance' and 'impression-management' types has been identified. This has not yet been investigated in adolescents.

AIMS

We set out to investigate the factor structure of safety behaviours in relation to adolescent social anxiety symptoms and SAD, the extent to which this varies by age, and then to examine the association between the derived factor scores and other social anxiety related phenomena.

METHOD

Questionnaire measures of social anxiety symptoms, cognitions and safety behaviours, peer relationship outcomes, general anxiety and depression were collected from a community sample of 584 younger (11-14 years) and 208 older (16-18 years) adolescents, and a clinical sample of 80 adolescents (11-18 years) with a primary diagnosis of SAD. Four hypotheses were investigated using exploratory and confirmatory factor analyses, regressions, correlations and path analyses.

RESULTS

A two-factor structure reflecting 'avoidance' and 'impression-management' safety behaviours was supported in the community and clinical sample. Older adolescents were found to use 'impression-management' behaviours more than younger adolescents after controlling for overall safety behaviour score. Both types of safety behaviour were significantly positively associated with social anxiety symptoms and cognitions. Path analyses revealed an indirect effect of social anxiety symptoms on peer victimisation, social satisfaction and friendship quality via 'avoidance', but not 'impression-management' safety behaviours.

CONCLUSIONS

Both 'avoidance' and 'impression-management' safety behaviours are associated with social anxiety symptoms and cognitions in youth, with age-related differences in their frequency. 'Avoidance' behaviours are specifically associated with negative outcomes for quality of peer relationships.

Selective Mutism and Its Relations to Social Anxiety Disorder and Autism Spectrum Disorder

In current classification systems, selective mutism (SM) is included in the broad anxiety disorders category. Indeed, there is abundant evidence showing that anxiety, and social anxiety in particular, is a prominent feature of SM. In this article, we point out that autism spectrum problems in addition to anxiety problems are sometimes also implicated in SM. To build our case, we summarize evidence showing that SM, social anxiety disorder (SAD), and autism spectrum disorder (ASD) are allied clinical conditions and share communalities in the realm of social difficulties. Following this, we address the role of a prototypical class of ASD symptoms, restricted and repetitive behaviors and interests (RRBIs), which are hypothesized to play a special role in the preservation and exacerbation of social difficulties. We then substantiate our point that SM is sometimes more than an anxiety disorder by addressing its special link with ASD in more detail. Finally, we close by noting that the possible involvement of ASD in SM has a number of consequences for clinical practice with regard to its classification, assessment, and treatment of children with SM and highlight a number of directions for future research.