Anne C. Miers

Interpretation bias and social anxiety in adolescents

Interpretation bias, described as the tendency to interpret social situations in a negative or threatening manner, has been widely linked to social anxiety in adult populations. This study aimed to extend research on interpretation bias to an adolescent population. Thirty-seven high socially anxious and a control group of 36 non-socially anxious adolescents rated the likelihood of different interpretations of ambiguous social and non-social situations coming to mind and which interpretation they most believed. Results showed that negative interpretations of social situations were more common in the high anxious than control group. Such negative bias could not be accounted for by high levels of negative affect. The groups did not differ as to their positive interpretations. Furthermore, there was evidence for content specificity of interpretation bias; high anxious adolescents were not more negative than control participants in their interpretations of non-social situations. Findings are discussed in relation to the adult literature and their clinical relevance is considered.

A prepared speech in front of a pre-recorded audience: Subjective, physiological, and neuroendocrine responses to the Leiden Public Speaking Task

This study describes a new public speaking protocol for youth. The main question asked whether a speech prepared at home and given in front of a pre-recorded audience creates a condition of social-evaluative threat. Findings showed that, on average, this task elicits a moderate stress response in a community sample of 83 12- to 15-year-old adolescents. During the speech, participants reported feeling more nervous and having higher heart rate and sweatiness of the hands than at baseline or recovery. Likewise, physiological (heart rate and skin conductance) and neuroendocrine (cortisol) activity were higher during the speech than at baseline or recovery. Additionally, an anticipation effect was observed: baseline levels were higher than recovery levels for most variables. Taking the anticipation and speech response together, a substantial cortisol response was observed for 55% of participants. The findings indicate that the Leiden Public Speaking Task might be particularly suited to investigate individual differences in sensitivity to social-evaluative situations.

Age and puberty differences in stress responses during a public speaking task: Do adolescents grow more sensitive to social evaluation?

During adolescence pubertal development is said to lead to an increase in general stress sensitivity which might create a vulnerability for the emergence of psychopathology during this period. However, the empirical evidence for increasing stress sensitivity is scarce and mixed. Biological responses (salivary cortisol and alpha-amylase) were investigated during a social-evaluative stressor, the Leiden Public Speaking Task, in 295 nine to 17-year olds. Specific attention was paid to different elements of the task, that is anticipation to and delivery of the speech. Biological reactivity to the speech task increased with age and puberty, particularly during anticipation. Current findings support the idea that biological stress sensitivity increases during adolescence, at least in response to a social-evaluative situation. The increasing stress sensitivity appears related to both age and pubertal maturation, but unique contribution could not be distinguished. The importance of measuring anticipation is discussed.

Developmental pathways of social avoidance across adolescence: The role of social anxiety and negative cognition☆

It is argued that the adolescent onset of social anxiety disorder (SAD) may be partly attributable to an increase in avoidance of social situations across this period. The current cohort-sequential study investigated developmental pathways of social avoidance in adolescence and examined the explanatory role of social anxiety and negative cognitive processes. A community sample of youth (9-21 years, N=331) participated in a four-wave study. Trajectory analyses revealed two pathways: an increased avoidance pathway and a low avoidance pathway. The pathways were hardly distinguishable at age 9 and they steadily diverged across adolescence. Logistic regression analyses showed that social anxiety and post-event rumination were significantly related to the increased avoidance pathway; anticipatory processing and self-focused attention were not. The findings suggest that adolescence is a key developmental period for the progression of social avoidance among youth who show relatively high levels of social anxiety and post-event rumination.

Negative Social Cognitions in Socially Anxious Youth: Distorted Reality or a Kernel of Truth?

We review studies that investigate negative social cognitions of socially anxious youth in relation to two specific domains: interpretation of ambiguous social situations and self-evaluation of social performance, including social skills and nervous behaviors. In this review, we address the question whether socially anxious youth’s negative perceptions are distortions of reality or reflect a kernel of truth as compared to other sources of information including independent adult observers and age peers. Studies key to this question are those that investigate not only the social perceptions themselves but also the social behavior of socially anxious youth. Hence the selection of studies for the review was based on this criterion. From the relevant literature it is, as yet, unclear whether the negative interpretations of ambiguous social situations shown by socially anxious youth are distorted or a reflection of reality. Socially anxious youth’s self-evaluations of social skills appear partly distorted and partly true, depending on the person judging the social skills. In contrast, self-evaluations of nervous behaviors appear distorted. The studies reviewed indicate that research would benefit from including a wider range of perceptions from persons relevant to the socially anxious youth’s daily social environment, not only parents and teachers but also their age peers.

Subjective and objective arousal correspondence and the role of self-monitoring processes in high and low socially anxious youth

Previous research found weak correspondence between subjective and objective arousal measures during social-evaluative tasks, particularly in high socially anxious individuals. This study evaluated subjective-objective correspondence in high versus low socially anxious youth (9–17 years). Sixty-six high (HSA; 38 boys and 28 girls) and 61 low (LSA; 37 boys and 24 girls) socially anxious youth participated in a speech task, with a moderately (pre-speech), high (speech), and low anxious (recovery) phase. Subjective experience of nervousness, heart rate and sweaty palms were measured along with salivary cortisol, actual heart rate, and skin conductance. Participants also completed questionnaires measuring 3 self-monitoring variables; self-focused attention, emotional awareness, and negative thoughts. Results showed that HSA participants had exaggerated perceptions of their physiological arousal. However, they did not have weaker subjective-objective correspondence than LSA participants. Correspondence was rather low in both groups. Finally, inclusion of the self-monitoring variables improved the prediction of subjectively experienced arousal in both groups.

Social Anxiety and the School Environment of Adolescents

Adolescents spend a great deal of their daily life at school, necessitating a considerable amount of social interaction. For the socially anxious adolescent, the school environment presents many potentially stressful situations such as giving an oral presentation, answering questions in class, making friends, and participating in groups. In these situations, they may be ridiculed, excluded, or even victimized. The socially anxious student may stop socializing with classmates and friends, stop attending certain classes, or even refuse to attend school altogether. The first part of this chapter describes how social anxiety manifests itself in the school setting. We review situations which are distressful for and even avoided by socially anxious students. An extreme consequence of this distress and avoidance, school refusal, is also discussed. In the second part of the chapter, we describe the way in which socially anxious students’ behavior, and the behavior of their classmates or peers, may contribute to the difficulty that socially anxious students experience at school. In addition to these behavioral and interpersonal factors, we consider the negative social cognitions of socially anxious students. Finally, we offer suggestions for intervention and future research. Because socially anxious students are trapped in a vicious cycle of social anxiety, negative expectations about their social performance, and negative peer responses, it is a complex task to break this vicious cycle. Effective interventions should address a variety of factors, notably negative thinking, poor social skills and as perhaps also physical appearance features.

Anger response styles in Chinese and Dutch children: a sociocultural perspective on anger regulation

In this study, we evaluated hypotheses about cultural convergence and divergence in the nature and correlates of anger expressions. With a sample of 141 11-year-olds from the Netherlands and Hong Kong, we first examined a broad range of strategies for responding to a provocateur, finding that both Chinese and Dutch children were more likely to use intrapersonal strategies (for coping internally with the angry feelings) than interpersonal responses (to communicate anger to the provocateur). No cultural divergence was shown in the overall extent to which anger would be verbally expressed, but differences became apparent when we asked children precisely what they would say to an aggressor in a hypothetical anger-eliciting situation. As predicted, Chinese children were more likely to react tolerantly to the aggressor than their Dutch peers, whereas Dutch children indicated that they would verbally confront the aggressor more often, trying to reinstate their personal goals. In comparison with Dutch children, the Chinese sample viewed their chosen strategies as more likely to elicit positive reactions from the aggressor and to reduce anger. Directions for further research on the personal and socio-cultural functionality of anger response styles are discussed.

The Speech Performance Observation Scale for Youth (SPOSY): Assessing Social Performance Characteristics Related to Social Anxiety

This study describes the development of the SPOSY, an observation scale for speech performance of socially anxious youth. The scale was designed as a research tool to address specific behaviors that are readily noticed by non-expert others and might explain why socially anxious youth are rejected by peers. In Phase 1 of the study, items for the scale were generated based on “free” observations by naive observers. In Phase 2, the psychometric properties of the scale were evaluated using a sample of 218 speakers aged between 9 and 16 years. PCA with oblimin rotation yielded three reliable and stable factors, Expressiveness, Lack of confidence, and Agitation. Expressiveness was negatively related to Lack of confidence. Importantly, socially anxious youth were rated as less expressive and confident but not as more agitated in their behavior as compared to non- socially anxious youth. Low expressiveness seems related to safety behaviors and may play a significant role in peer rejection.

Adolescent Social Anxiety and Substance Use: The Role of Susceptibility to Peer Pressure

The aim of this study was to further our understanding of the link between social anxiety and substance use in adolescents, in particular the role susceptibility to peer pressure plays in this link. The relation between social anxiety and susceptibility to peer pressure was studied in two community samples ( and ) each consisting of two age groups (12-13 and 15–17 years). The relation of these two variables with substance use was evaluated in the second sample using regression analysis. Social anxiety was related to susceptibility to peer pressure in both groups and not related to substance use in the younger group and negatively related to substance use in the older group. Susceptibility to peer pressure acted as a suppressor in the relation between social anxiety and substance use. Results suggest that socially anxious adolescents basically avoid substance use but, if susceptible, may yield to peer pressure and start using substances. Parents, teachers, and therapists should be aware of this susceptibility to possibly negative peer pressure of socially anxious adolescents.