Alice R. Norton

Social Anxiety, Reasons for Drinking, and College Students.

Recent research suggests that social anxiety may be associated with higher rates of alcohol problems in women, yet may be associated with lower levels of drinking in men. The current study investigated putative mechanisms that may underlie potential gender differences in the social anxiety-alcohol relationship. One hundred and eighteen college students (61.0% women) completed an interview assessing drinking behaviors and questionnaires measuring social anxiety, drinking motives, and drinking situations. Although college men and women both reported similar frequencies of drinking in positive situations and to enhance positive emotions, women reported drinking more often in negative situations and to cope with aversive emotions than men. Mediated moderation analyses suggested that women with social anxiety may be at greater risk of encountering adverse consequences because of their likelihood to drink to conform or to cope with the aversive affect they experience in negative situations. Conversely, when men experience high rates of adverse consequences, it may be due to drinking greater quantities of alcohol in positive situations. Highly socially anxious college men may drink less alcohol and experience fewer adverse consequences than their nonanxious or mildly anxious counterparts because they may find themselves in positive situations and drinking to enhance positive feelings less often, potentially due to avoidant behavior. These findings may help to explain why social anxiety serves as a potential risk factor for alcohol-related problems for college women, but a protective factor for college men.

Adverse consequences of student drinking : the role of sex, social anxiety, drinking motives

This study examined whether biological sex, social anxiety, and drinking motives relate differently to distinct types of alcohol-related consequences using Poisson regression. One hundred eighteen college students completed self-report measures assessing drinking motives and social anxiety and an interview assessing alcohol consumption and consequences. Highly socially anxious women were particularly apt to experience adverse role functioning consequences, while men were particularly apt to experience physical consequences. Although highly socially anxious women reported more personal consequences than did women with low to moderate social anxiety, men with low to moderate social anxiety reported experiencing more social and personal consequences than did women with low to moderate social anxiety. When taking into consideration the above associations, coping motives were statistically associated with social consequences and marginally related to personal consequences, while enhancement motives were significantly associated with physical consequences. Targeting these factors may lead to effective interventions for individuals with co-occurring social anxiety and drinking problems.

A Systematic Review of Mindfulness and Acceptance‐Based Treatments for Social Anxiety Disorder

CONTEXT The cultivation of mindfulness and acceptance has been theoretically and empirically associated with psychological ancillary well-being and has demonstrated efficacy in the treatment of various disorders. Hence, mindfulness and acceptance-based treatments (MABTs) have recently been explored for the treatment of social anxiety disorder (SAD). This review aims to evaluate the benefits of MABTs for SAD. METHODS Systematic review of studies investigating an MABT for individuals with SAD, using PsycInfo, Medline, PubMed, and Cochrane Central Register of Controlled Trials. RESULTS Nine studies were identified. Significant improvements in symptomatology were demonstrated following the MABT, but benefits were equivalent or less than yielded by cognitive-behavioral therapy (CBT). LIMITATIONS The few treatment studies available were compromised by significant methodological weaknesses and high risk of bias across domains. Studies were largely uncontrolled with small sample sizes. The hybrid nature of these interventions creates ambiguity regarding the specific utility of treatment components or combinations. CONCLUSIONS MABTs demonstrate significant benefits for reducing SAD symptomatology; however, outcomes should be interpreted with caution until appropriate further research is conducted. Furthermore, the benefit of MABTs above and beyond CBT must be considered tentative at best; thus, CBT remains best practice for first-line treatment of SAD.

Refining measurement in the study of social anxiety and student drinking: Who you are and why you drink determines your outcomes.

This study investigated inconsistencies in the literature regarding social anxiety and problematic drinking among college students. One hundred eighteen students (61% women) who experience anxiety in social or performance situations completed measures of social anxiety and a modified Timeline Followback that assessed the psychological context of drinking episodes and alcohol-related consequences. Results suggest that men who experience severe social anxiety drink less alcohol than men with lower levels of anxiety, whereas women high in social anxiety are likely to experience more alcohol-related consequences per drinking episode than women low in social anxiety, despite drinking similar amounts of alcohol. In addition, women with high social anxiety were found to experience more alcohol-related consequences than men with high social anxiety. These findings suggest that the inconsistencies noted in the literature on drinking to cope with social anxiety and alcohol-related consequences may reflect methodological differences and the failure to consider gender.

The efficacy of imagery rescripting compared to cognitive restructuring for social anxiety disorder

Imagery rescripting (IR) aims to alter negative meanings associated with distressing autobiographical memories. The current study aimed to extend demonstrated benefits of IR for social anxiety disorder (SAD), including direct comparison of IR with cognitive restructuring (CR) to assess the relative impact of these interventions on symptoms and processes. SAD individuals (N=60) were randomly allocated to IR, CR or Control conditions, and completed two speech tasks (before and after) their assigned intervention. Participants completed measures of symptomatology and state affective/cognitive variables in relation to the intervention and speech tasks. Results support the benefits of IR for SAD, with both IR and CR yielding large and equivalent reductions in trait social anxiety. However, IR and CR may function via differing pathways. Outcomes suggest that IR may be most effective in the treatment of SAD when delivered across multiple sessions or preceded by CR to target verbal and imaginal self-representations.

Autism, Early Psychosis, and Social Anxiety Disorder: a transdiagnostic examination of executive function cognitive circuitry and contribution to disability

The disability burden in clinical cohorts with social impairment is significant, leading to poor functional outcomes. Some of this impairment has been linked to executive dysfunction. In this study, a transdiagnostic approach was taken to identify executive function (EF) processes in young adults that may underpin social impairment and to evaluate their contribution to disability. Comparisons were made between three prominent disorders that are characterized by social impairments, Autism Spectrum Disorder (ASD), Early Psychosis (EP) and Social Anxiety Disorder (SAD), as well as a neurotypically developing group (TYP). We examined whether overall disability could be predicted by neuropsychological and self-report assessments of EF. Our study showed that ASD participants demonstrated impaired performance on most domains of EF compared to the TYP group (mental flexibility, sustained attention and fluency) while the EP group showed impairment on sustained attention and attentional shifting. The SAD participants showed EF impairment on self-report ratings, even though their objective performance was intact. Self-reports of EF explained a significant percentage (17%) of disability in addition to the variance explained by other predictors, and this was particularly important for ASD. This is the first study to compare EF measures across clinical groups of social impairment and suggests unique cognitive-circuitry that underpins disability within groups. Impairments in EF were broad in ASD and predicted disability, EP impairments were specific to attentional processes and SAD impairments likely relate to negative self-monitoring. Self-report, as opposed to performance-based EF, provided best capacity to predict disability. These findings contribute to transdiagnostic circuitry models and intervention strategies.

Experiential Self‐Focus in Social Anxiety Disorder: Is it Beneficial?

OBJECTIVE Self-focused processing is a significant maintaining factor in cognitive models of social anxiety disorder (SAD), but it may also be analytic (detached, evaluative, maladaptive) or experiential (concrete, nonevaluative, adaptive). The current study aimed to investigate the effect of self-focus modes in a sample meeting criteria for SAD as previous studies have yielded mixed results. METHOD Individuals meeting criteria for SAD and nonanxious controls (N = 80, 77.5% female; mean age = 19.46) were randomly allocated to complete a task inducing analytic or experiential self-focused processing, followed by a social interaction task, including measurement of affective and cognitive variables. RESULTS Controls demonstrated the expected benefits of experiential compared to analytic self-focus on social anxiety, negative affect, and self-beliefs. Unexpectedly, SAD participants reported no difference between self-focus conditions. CONCLUSION Results suggest that experiential processing may have no benefit for SAD individuals proximal to a social threat. Implications of these findings are discussed.

Bridging the Gap between Aetiological and Maintaining Factors in Social Anxiety Disorder: The Impact of Socially Traumatic Experiences on Beliefs, Imagery and Symptomatology

BACKGROUND A number of key environmental factors during childhood have been implicated in the aetiology of social anxiety disorder (SAD), including aversive social experiences, traumatic life events and parent-child interaction. However, understanding the nature, interactions and relative contributions of these factors remains unclear. Furthermore, the relation of aversive social experiences to the development of key maintaining factors in SAD requires elucidation. AIMS The current study aimed to extend previous research regarding the aetiology of SAD by investigating the relationship between key environmental factors in childhood, negative beliefs and self-imagery, and the development of SAD. METHOD Social anxiety disorder individuals (n = 40, 87.5% female, Mage  = 20.25 years) completed self-report measures of social anxiety symptomatology, traumatic experiences and parenting style. In addition, participants were administered interviews assessing various domains of childhood trauma, as well as negative self-imagery and associated socially traumatic memories. RESULTS Participants reported a high frequency of early traumatic experiences across all domains (physical, emotional, sexual, social and non-relational), as well as a high degree of parental overcontrol. However, social anxiety symptomatology was most strongly correlated with socially traumatic experiences, and mediation analyses suggest that appraisal of aversive social/peer experiences accounts for the relationship of SAD symptomatology with negative self-beliefs and imagery. CONCLUSIONS These outcomes suggest that social trauma may be a key proximal cause of SAD development, leading to the development of negative beliefs and imagery that subsequently maintain the disorder. These findings have implications for understanding SAD aetiology, and improving treatment outcomes for the disorder. Copyright