The unique contribution of blushing to the development of social anxiety disorder symptoms: results from a longitudinal study

Effects of a 12-week dance intervention on left-behind children with co-occurring social anxiety and low self-concept

Objective

This study aimed to investigate the effects of a 12-week dance intervention on left-behind children (LBC) suffering from social anxiety and low self-concept, and to explore the relationship between social anxiety and self-concept.

Methods

Sixty LBC who met the criteria were selected from a school in Shaoyang City, Hunan Province, and were randomly divided into an Interventional group (n = 30) and a Control group (n = 30). The Interventional group received a 45-min dance intervention five times a week for 12 weeks, while the Control group maintained their original lifestyle. Social anxiety and self-concept were measured three times using the Social Anxiety Scale for Children and the Piers-Harris Child Self-concept Scale: at baseline (T0), post-intervention (12 weeks, T1), and follow-up (14 weeks after baseline, T2).

Results

(i) After the dance intervention, social anxiety and self-concept were significantly improved (p < 0.05). (ii) There was a significant negative correlation between the change scores (T1 minus T0) of social anxiety and self-concept (p < 0.05).

Conclusion

Dance intervention is an acceptable, practical and effective intervention that we can incorporate into a health programme to improve social anxiety and low self-concept in LBC.

Risk factor patterns define social anxiety subtypes in adolescents with brain and clinical feature differences

Social anxiety disorder (SAD) is one of the most common psychiatric disorders in adolescents. The heterogeneity of both symptoms and etiology is an essential source of difficulties in the treatment and prevention of SAD. The study aimed to identify subtypes of adolescent SAD based on etiology-related phenotype dimensions and examine symptom and brain associations of the subtypes. We used a deeply phenotyped sample (47 phenotype subscales from 13 measures) of adolescents with SAD (n = 196) and healthy controls (n = 109) to extract etiology-relevant risk factors, based on which we identified subtypes of SAD. We compared the subtypes on clinical characteristics and brain morphometrics and functional connectivity, and examined subtype-specific links between risk factors, brain aberrance, and clinical characteristics. We identified six etiology-relevant risk factors and two subtypes of adolescent SAD. One subtype showed mainly elevated negative emotionality trait and coping style and diminished positive emotionality trait and coping style, while the other additionally had significantly high environmental risk factors, more severe impairments in social functioning, and significant abnormalities in brain structure and function. There were subtype-specific links between the risk factor profiles, brain aberrance, and clinical characteristics. The finding suggests two etiology-based subtypes of adolescent SAD, providing novel insights to the diversity of pathological pathways and precise intervention strategies.

Anxiety Disorders: Diagnoses, Clinical Features, and Epidemiology

Although anxiety disorders present in many ways, they all share the key features of inappropriately high distress in the form of anxiety and fear responses to stimuli that are not actually dangerous and efforts to avoid or escape such stimuli. Problematic levels of fear and anxiety can result in many negative impacts on people's lives, across social, economic, and physical realms. Anxiety disorders as a whole are very prevalent in today's world, among both youth and adults.

Emotional and socio-cognitive processing in young children with symptoms of anxiety

Many children with anxiety disorders exhibit significant and persistent impairments in their social and interpersonal functioning. Two components essential for successful social interaction are empathy and theory of mind (ToM). Both constructs develop rapidly in childhood, but no study has simultaneously examined these skills in young children with emerging mental health problems, including those with symptoms of anxiety. This study investigated empathy and ToM in children with anxiety symptomatology and examined their relationship with anxiety severity. A cross-sectional study was carried out with 174 children aged 4-8 years with emerging mental health difficulties who were referred by school teachers for an assessment because of emotional, cognitive, or behavioural problems at school. Participants completed empathy and ToM tasks. Parents were interviewed and rated children's emotional and behavioural problems. Correlational analyses indicated that elevated anxiety was associated with better cognitive ToM and worse affective empathy; there were no associations between anxiety and either cognitive empathy or affective ToM. Subsequent regression analyses demonstrated that whilst enhanced cognitive ToM was explained by age and verbal IQ, anxiety symptoms uniquely predicted impaired affective empathy. These results indicate that children with symptoms of anxiety have difficulty in sharing in other people's emotions. As a result, they may find it difficult to behave in socially adequate ways in interactions with others that involve affective sharing. These findings encourage the use of early and targeted interventions that improve affective empathy development in children with anxiety symptoms.

Skin Complexion and the Blush

The implications of variation in skin pigmentation for the blush have attracted discussion for centuries. Two long-standing positions are identified. First, the blush has been identified with shame, giving rise to claims that because people with dark skin do not blush they do not have the capacity to experience shame. Second, the meaning of a visible blush can be ambiguous. A review of more recent theorizing and empirical research suggests that people blush whatever their level of pigmentation; the blush tends to be associated with embarrassment rather than shame; it serves both intraindividual and communicative functions. Nevertheless, there has been little systematic investigation into the impact of the relative discernibility of the blush on emotional experience or its functions.

Temperature Perception in the Blushing Region

Abstract. Background: Individuals with social phobia are characterized by a heightened sensitivity for physical symptom such as blushing. Objectives: We exploratorily examined whether blushing-fearful individuals with / without social phobia were more sensitive to perceiving facial temperature increases compared to healthy controls. Methods: 50 participants were tested using an adaptive two-alternative forced-choice task. A Peltier element was attached to the cheek and repeatedly warmed up in one of two phases. The participants’ task was to indicate in which of the two phases the temperature had increased. Results: Contrary to our hypothesis, blushing-fearful individuals with social phobia ( n = 11) were less sensitive to facial temperature increases, i. e., exhibited higher temperature perception threshold, than the subclinical group ( n = 14) and healthy controls ( n = 23). Limitations: The preliminary nature of our study should be noted, and replication in a larger sample is warranted. Conclusions: The findings may be best understood within a predictive coding framework: Individuals with social phobia may rely on priors when assessing their physical symptoms to form an impression of their public self in social situations.

Theory of Mind as a Mechanism That Accounts for the Continuity or Discontinuity of Behavioral Inhibition: A Developmentally Informed Model of Risk for Social Anxiety

Research has established that children with high levels of early behavioral inhibition (BI) - a subdued, timid, fearful response to novel or mildly challenging stimuli or events - are at an elevated risk for social anxiety in later childhood and adolescence. Yet, substantial heterogeneity has been documented in those developmental trajectories; consequently, understanding factors that moderate children's paths from early BI to social anxiety is an important goal. We proposed that the association between children's BI at toddler age and social anxiety at early school age is (a) mediated by their BI at preschool age, and (b) moderated by the level of social understanding, or Theory of Mind (ToM). In 102 typically developing community children, we observed BI in the laboratory at age 2 and 4.5 in "Risk Room" paradigms and assessed ToM at age 4.5 and 5.5 using false belief tasks. Mothers and fathers rated children's social anxiety symptoms at age 6.5. We supported the proposed moderated mediation model, with the path from BI at age 2 to BI at age 4.5 to social anxiety at age 6.5 unfolding only for children whose ToM abilities were relatively low, but not for those whose ToM abilities were relatively high. Results also supported a curvilinear relation between ToM and social anxiety, which highlights the risk of elevated social anxiety for children with extremely low ToM abilities. Taken together, proficiency in mindreading may help inhibited children navigate social environments and thus reduce risks for social anxiety.