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The high-novelty-seeking, impulsive subtype of generalized social anxiety disorder
Abstract
This study examined potential subgroups of patients with generalized social anxiety disorder (SAD) based on novelty-seeking tendencies. Eighty-two outpatients with DSM-IV generalized SAD were recruited from an outpatient anxiety clinic and assessed with the Tridimensional Personality Questionnaire. The novelty-seeking subscales, reflecting risk-prone and disinhibited behavior tendencies, served as dependent measures in a series of cluster analysis procedures. Two qualitatively different SAD subgroups were identified: (1) low novelty-seeking tendencies and (2) high-novelty-seeking tendencies. These groups did not differ in social anxiety symptom severity. Women were less likely to be classified in the high-novelty-seeking group. Clinician severity ratings for comorbid substance use disorders were greater in the high-novelty-seeking group. These findings contribute to growing evidence for the heterogeneity of SAD. High-novelty-seeking, risk-prone, and disinhibited behavior tendencies are a characteristic feature of a distinct subgroup.
... However, there is also evidence for a more atypical subgroup of SAD, still affected by social anxiety, but simultaneously characterized by impulsive, exploratory and risky behaviour, reflecting increased NS [7,36,[40][41][42][43]. Individuals in the high NS subtype are more often affected by comorbid impulse control, bipolar [41] and substance use disorders [7,44], suffer more often from severe substance use [42] and greater functional impairment, are less educated and of younger age [41]. ...
... However, there is also evidence for a more atypical subgroup of SAD, still affected by social anxiety, but simultaneously characterized by impulsive, exploratory and risky behaviour, reflecting increased NS [7,36,[40][41][42][43]. Individuals in the high NS subtype are more often affected by comorbid impulse control, bipolar [41] and substance use disorders [7,44], suffer more often from severe substance use [42] and greater functional impairment, are less educated and of younger age [41]. Furthermore, there is some evidence that they are less likely to seek for, complete, or fare well in treatment [43]. ...
... In sum, the differentiation of these two SAD subtypes -both characterized by high HA but one displaying low and the other high NS -was repeatedly mirrored in cluster analytic approaches [7,40,42,46] and latent class analyses [41,47]. With respect to the proposed subtype-characteristics, it needs to be noted that the differences reported in previous studies are still inconsistent. ...
Background
Up to now several subtypes of social anxiety disorder (SAD) have been proposed.
Methods
In the present study, we used a cluster analytic approach to identify qualitatively different subgroups of SAD based on temperament characteristics, that is, harm avoidance (HA) and novelty seeking (NS) dimensions of Cloninger’s Temperament and Character Inventory.
Results
Based on a large, diverse clinical sample ( n = 575), we found evidence for two distinct subgroups of SAD: a larger (59%) prototypic, inhibited cluster characterized by high HA and low NS, and a smaller atypic, and comparatively more impulsive cluster characterized by medium to high HA and increased NS. The subgroups differed regarding a variety of sociodemographic and clinical variables. While the prototypic SAD subtype suffered from more severe SAD and depressive symptoms, suicidal ideation, and reduced social functioning, the atypic NS subtype showcased higher reproductive behaviour, self-directedness and -transcendence, comparatively. Additional hierarchical logistic regression highlights the contribution of age and education.
Conclusions
Our results valuably extend previous evidence for the existence of at least two distinct subtypes of SAD. A better knowledge of the characteristic differences in prototypic behaviour, personality, coping strategies and comorbidities between the identified (and further) subtypes can contribute to the development of effective prevention interventions and promotes the conceptualization of tailored treatments.
... Despite prototypical patterns of avoidance and withdrawal, some individuals with social interaction anxiety are more likely to engage in risky behaviors, including health-risk sexual behavior (HRSB; Kashdan et al. 2011a;Kashdan and Hofmann 2008;Rahm-Knigge et al. 2018). Previous studies have found two subgroups of social interaction anxiety, with one group engaging in risky behaviors and the other avoiding (Kashdan and Hofmann 2008;Kashdan et al. 2009). ...
... Despite prototypical patterns of avoidance and withdrawal, some individuals with social interaction anxiety are more likely to engage in risky behaviors, including health-risk sexual behavior (HRSB; Kashdan et al. 2011a;Kashdan and Hofmann 2008;Rahm-Knigge et al. 2018). Previous studies have found two subgroups of social interaction anxiety, with one group engaging in risky behaviors and the other avoiding (Kashdan and Hofmann 2008;Kashdan et al. 2009). Distinguishing between the risk-approach and risk-avoidant subgroups is clinically important. ...
... The profile with the highest social interaction anxiety also scored high in urgency, risk seeking, emotion dysregulation, and behavioral approach toward fun and was more likely to engage in HRSB than the profile high in social interaction anxiety and low in these individual differences. Examining individual differences associated with social interaction anxiety and engagement in HRSB added clarity between the previously identified risk-approach and risk-averse subgroups of social interaction anxiety (e.g., Kashdan and Hofmann 2008). ...
Social anxiety disorder is prevalent and negatively impacts adolescents and young adults. People with social interaction anxiety, a presentation category of social anxiety disorder pertaining to social relationships, tend to be more withdrawn, avoidant, and sexually dissatisfied. Some individuals with social interaction anxiety are more likely to engage in health-risk sexual behavior (HRSB), likely associated with individual differences. The present study used finite mixture modeling to discern profiles comprised of social interaction anxiety and individual differences previously associated with HRSB, replicating and extending previous findings (Rahm-Knigge et al. 2018). We also examined differences in sexual satisfaction among profiles. We replicated identifying two profiles high in social interaction anxiety that substantively differed in response to positive and negative emotions, emotion-regulation strategies, risk seeking, and non-acceptance of emotions. The profile high in social interaction anxiety and these individual differences was likelier to engage in HRSB than the other high social anxiety profile. Both high social interaction anxiety profiles were similarly low in sexual satisfaction. Despite differences in individual differences and engagement in HRSB, profiles high in social interaction anxiety reported similarly lower sexual satisfaction than the profiles low in social interaction anxiety.
... Indeed, elevations in negative affect are associated with increased use of both types of avoidance behaviors, (Rapee and Heimberg 1997;Clark and Wells 1995) however, what is unclear is the understanding of why one individual chooses to avoid social situations and why another individual may choose to attend social situations. Contemporary views of social anxiety suggest Kashdan and Hofmann 2008) that variability in factors associated with a drive to seek social interactions might help elucidate our understanding. Specifically, one factor worth consideration is extraversion, a dispositional trait representing a strong tendency to seek social rewards (McCrae and Costa 1997;McCrae and John 1992). ...
... The traditional assumption has largely been that socially anxious individuals are low in extraversion and sociability (Kotov et al. 2010;Watson et al. 1988;Brown et al. 2007;Gainey-Naragon et al. 2014;Watson et al. 2005), and utilize avoidance behaviors resulting in the removal from social situations (Rapee and Heimberg 1997;Clark and Wells 1995). However, considerable theory and research suggests this may not always be the case (Nikitin and Freund 2015;Kashdan and Hofmann 2008;Nicholls et al. 2014). Current views suggest that although individuals with social anxiety may be more inclined to withdraw or avoid social situations, there are individuals with social anxiety who desire to be social, and utilize behaviors (e.g., substance use) to manage discomfort while engaging in social situations Nicholls et al. 2014). ...
... Furthermore, empirical evidence examining dispositional tendencies within a sample of socially anxious individuals, suggests there might be distinct subtypes or subsets of individuals with social anxiety. These subtypes distinguish between individuals who may use substances to facilitate social behaviors or individuals who use social avoidance to manage their symptoms (Tillfors et al. 2013;Kashdan and Hofmann 2008;Nicholls et al. 2014). Findings from indicate multiple subsets of individuals with social anxiety. ...
Social anxiety is characterized by heightened fear and anxiety associated with social situations, resulting in the use of avoidance behaviors. Contemporary models suggest that some individuals with social anxiety may choose to completely avoid social situations, while others may seek social connections and interactions and utilize avoidance behaviors such as substance use as a means of distress tolerance, while engaging in these situations. Our aim is to test a theoretical model whereby extraversion could help to explain the heterogenous nature of social anxiety in relation to these behaviors. Lower levels of extraversion have been commonly associated with withdrawal behaviors and higher levels of extraversion have been associated with behaviors commonly enacted in social situations. Understanding factors which predict the use of one behavior over another is imperative to the conceptualization and successful treatment of patients with social anxiety. A sample of 195 college students completed self-report measures and a 10-day experience sampling diary with five diary signals each day. Participants were asked to rate their current negative emotions and behaviors during each diary signal. Using a multilevel modeling approach, we tested the association between social anxiety symptoms and negative affect predicting engagement in substance use or social avoidance and tested whether extraversion moderated this association. Negative affect was included as a covariate given the established associations between elevations in negative affect predicting both behaviors. Results indicated that higher levels of social anxiety symptoms and negative affectivity increased the probability of social avoidance and substance use, and extraversion was a significant predictor for only substance use. Moderation analysis indicated that extraversion moderated the relationship between social anxiety and substance use, suggesting a stronger positive relationship between substance use and social anxiety for individuals higher in extraversion. However, extraversion was not a significant moderator between social anxiety and social avoidance. Overall, the findings suggest that extraversion could be a key factor predicting the use of substances amongst individuals with social anxiety and may need further consideration in treatment.
... indicates that severity of substance use problems is greater in the impulsive subgroup compared to a low novelty-seeking group of socially anxious adults (Kashdan & Hofmann, 2008). High novelty-seeking, which is characterized by dislike of monotony and exploratory endeavors, is highly related to impulsivity (Kashdan & Hofmann, 2008). ...
... indicates that severity of substance use problems is greater in the impulsive subgroup compared to a low novelty-seeking group of socially anxious adults (Kashdan & Hofmann, 2008). High novelty-seeking, which is characterized by dislike of monotony and exploratory endeavors, is highly related to impulsivity (Kashdan & Hofmann, 2008). Studies on subclinical samples of socially anxious-impulsive adults show they have higher levels of risky behaviors such as aggression and drug use compared with adults low on novelty-seeking Kashdan et al., 2009;Lipton, Weeks, Daruwala, & De Los Reyes, 2016). ...
... According to the results from this study, this would be true for a small subset of adolescents with subclinical social anxiety. Social anxiety paired with impulsivity has indeed previously been linked with engaging in risky externalizing problems such as substance use (Kashdan & Hofmann, 2008), as well as drug use, unsafe sex, and aggression Kashdan et al., 2009) for adults. Anxious-Impulsive girls as well as boys in this study primarily had high levels of internalizing problems (anxiety and depressive symptoms) a year later, however, which could be a sample-or an age-specific effect. ...
A growing body of research has acknowledged the heterogeneity of subclinical social anxiety, identifying a subgroup of individuals who exhibit high levels of impulsivity. In a sample of Swedish early adolescents ( N = 2,509, M age = 13.64; 52.8% girls), we conducted latent transition analyses (LTA) to identify four classes of subclinical social anxiety-impulsivity across three time points. We identified a Low Social Anxiety-Low Impulsivity class, as well as a High Anxiety-High Impulsivity class for girls and boys, which had high levels of Time-4 internalizing problems. The latter class was less stable but larger for boys. There was also a more typical High Anxiety-Low Impulsivity class for both genders. Nevertheless, Low Anxiety-High Impulsivity girls and boys fared the worst in terms of both internalizing and externalizing problems later on. To our knowledge, this is the first study to adopt an LTA framework to investigate trajectories of early adolescent social anxiety-impulsivity over time.
... Moreover, studies have found evidence of qualitatively different SAD subgroups based on Cloninger's temperamental characteristics [22]. By use of cluster or latent class analysis, researchers have identified not only a prototypical SAD subgroup characterized by high harm-avoidance and low novelty seeking, but also an anxious-impulsive subtype scoring high on novelty seeking [36][37][38][39]. While individuals in the former group show behavioral inhibition and risk aversion, individuals in the latter exhibit an atypical pattern of risk-prone approach behaviors while still being highly anxious. ...
... It is not well understood how SAD subgroups compare with these personality types. Presumably, prototypical SAD individuals are overcontrollers but this may not be true for the anxious-impulsive SAD subtype [36][37][38][39]. Anyhow, studies exploring subtypes of SAD by personality inventories are scant and, to our knowledge, no previous study has evaluated potential subtypes of SAD derived from the widely researched Big Five personality dimensions. ...
... All differences remained significant also with healthy controls included in the analyses (Table 4). Differences between clusters at the facet level are listed in S3 Bonferroni post hoc comparisons revealed that all clusters differed significantly from the healthy controls on neuroticism and extraversion, cluster 1 having the most deviant profilesee Fig 2. This cluster was labelled Prototypical, to conform with terminology used in other studies [e.g., [36][37][38][39]. Although cluster 1 and 2 had comparable levels of low extraversion (significant differences were noticed only on assertiveness-E3), cluster 2 had much lower scores of neuroticism. ...
Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
... Past research has shown that most of the psychiatric disorders including anxiety disorders, mood disorders, and Attention Deficit and Hyperactivity Disorder (ADHD) may have some impulsivity characteristics, which make treatment and progress of the disorders poorer than those, which do not have impulsivity characteristics (13)(14)(15). Some studies in the literature also have shown that some subgroups of patients with SAD can display impulsive behaviors instead of the avoidance behaviors that we often expect to observe in patients with SAD (16)(17)(18). Kashdan et al. examined the behavior patterns and socio-demographic characteristics of a sample of 1,832 individuals in their study and, found that 79% of the SAD samples exhibited typical behavioral patterns such as behavioral inhibition and submission, whereas 21% of displayed more anger and impulsivity characteristics than individuals with typical behaviors (16). ...
... Examining impulsivity and anxiety sensitivity characteristics of patients with SAD can lead the way to administer treatment better for clinicians. Several studies in the literature proposed that different levels of impulsivity and anxiety sensitivity also might have affected the severity of SAD (6)(7)(8)(9)(10)(11)(12)(16)(17)(18). Interestingly the results of some of the studies related SAD and impulsivity suggest that impulsivity may have an indirect effect in relation to the severity of disorder symptoms, as well as other individual predisposing factors such as personality traits or anxiety sensitivity (16)(17)(18). ...
... Several studies in the literature proposed that different levels of impulsivity and anxiety sensitivity also might have affected the severity of SAD (6)(7)(8)(9)(10)(11)(12)(16)(17)(18). Interestingly the results of some of the studies related SAD and impulsivity suggest that impulsivity may have an indirect effect in relation to the severity of disorder symptoms, as well as other individual predisposing factors such as personality traits or anxiety sensitivity (16)(17)(18). It seems that impulsivity and anxiety sensitivity have a complex function in SAD. ...
Objective: The purpose of this study is to examine the
characteristics of impulsivity and anxiety sensitivity in
patients with Social Anxiety Disorder (SAD) and to investigate
relationships between these characteristics and
the severity of SAD. Method: The sample consisted of
outpatients (n=42) who had been diagnosed with only
SAD based on the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorder, in
addition to healthy individuals (n=51) serving as the
control group. Data collection tools were the sociodemographic
form, the Barratt Impulsivity Scale (BIS-11),
the Anxiety Sensitivity Index (ASI-3), and Liebowitz Social
Anxiety Scale (LSAS). Results: The mean total score of
the BIS-11 in the SAD group was found to be significantly
higher than the mean total BIS-11 score in the
control group (p <0.001). Compared to the mean total
ASI-3 score, the SAD group's mean score was significantly
higher than the control groups mean scores (p
<0.001). The analysis of variance revealed that the cognitive
and social dimensions and total ASI-3 scores were
positively correlated with total LSAS scores (r=0.434,
r=0.427, and r=0.351, respectively). Additionally, there
was a negative correlation between the attention impulsivity
subscore and the LSAS avoidance subscore (r=-
0.353). Discussion: Patients with SAD have more impulsivity
and anxiety sensitivity characteristics than healthy
individuals. Moreover, anxiety sensitivity and attention
impulsivity characteristics of patients with SAD are associated
with symptom severity.
... A review has pointed out that there are several explanation mechanisms for the link between impulsiveness and anxiety [42]. As indicated in this review, some previous research has found significant associations between impulsiveness and anxiety disorders [43,44]. Hence, there is a high comorbidity between anxiety and impulse control disorders [45]. ...
... In this sense, impulsivity has been demonstrated to be a significant predictor of the severity of symptoms in generalized anxiety disorder [46]. These results have been replicated when the association between impulsivity and anxiety symptoms has been tested in other disorders, such as social anxiety disorder [43]. Beyond anxiety disorders, impulsivity has been demonstrated to be a significant predictor of anxiety dimensions. ...
It has been demonstrated that athletes in competitive sports suffer from high levels of competitive anxiety, especially in the case of females. In this sense, it is necessary to identify possible risk and protective factors of those athletes in this collective who suffer from this type of anxiety. However, few studies analyze the relationship between Physical Activity (PA) and anxiety, identifying the possible mediation effect of trait variables such as impulsivity and mindfulness in female athletes. Hence, the aims of this study were: to determine differences between PA levels with anxiety, mindfulness, and impulsiveness; to identify the predictive value of sociodemographic factors and physical activity, impulsivity, and mindfulness on anxiety factors; and to analyze the possible mediating effects of mindfulness on the relationship between impulsivity and anxiety. A total of 242 female athletes underwent an assessment of physical activity, anxiety, mindfulness traits, and impulsivity using validated questionnaires. Data were analyzed according to (1) individual or collective sport, and (2) PA levels according to energy expended (METs min/day). Participants were grouped by light, moderate, and vigorous PA levels. There were 30.5% elite athletes and 73.2% collective sports athletes. Mean age was 22.1 years and mean light, moderate, and vigorous PA were 86.1 ± 136.2, 114.4 ± 159.8, and 370.1 ± 336.3 METs min/day, respectively. Those athletes performing vigorous PA exhibited lower levels of impulsiveness and higher mindfulness traits. As expected, the mindfulness trait was a mediating factor in the relationship between impulsiveness and each factor of competitive anxiety (cognitive, somatic, and self-efficacy). Female athletes could suffer competitive anxiety, especially those who present higher levels of impulsivity. However, higher levels of mindfulness traits seem to be a protective factor in the effects of impulsivity on anxiety in this population and have demonstrated to be significant mediators in this association. Further studies are needed with other female athletes to replicate these results and to determine the specific protective mechanisms of mindfulness traits in preventing competitive anxiety.
... This raises the question as to the extent to which impulsivity in these subjects is related to depression and mania alone. Similarly, a study by Kashdan and Hofmann (2008) found that a subtype of social anxiety patients, those with high levels of "novelty seeking," had higher levels of impulsivity which manifested as risk-taking behaviors and interpersonal instability. However, these patients also had comorbid substance abuse issues which could have contributed to levels of impulsivity. ...
... As discussed earlier, results from clinical studies have indicated that levels of impulsivity were elevated in the presence of comorbid mood and anxiety disorders (Kashdan & Hofmann, 2008;Swann et al., 2008). However, a knowledge gap existed with regard to the relationship between impulsivity and anxiety alone. ...
Schizophrenia is a mental disorder that affects how a person reacts with the surrounding world. Patients with schizophrenia have a lower quality of life. The long-term cost for supporting patients with schizophrenia is far greater than that of many other mental disorders. The cost of supporting schizophrenia patients is about 1%–3% of the national health care cost in most of the developed nations. This cost is almost up to 20% of the direct expenses of all types of mental health cost. Case studies are detailed qualitative investigation where a single or few participants are investigated. Case studies can explain social phenomena, that is, events happening in the society that relate to everyday living problem. Data in case studies can be gathered by documentation, interview, archival records, direct observation, participant observation, and physical artifact. Interview is a well-established technique for data collection in case study. There are various case studies on managing different symptoms and quality of life associated with schizophrenia patients. In the current study, the eligibility criteria for the selection of case studies are their effectiveness in addressing issues related to the management of schizophrenia. This chapter reviews prior case studies of the management of schizophrenia and explains why case studies are important for understanding and treating schizophrenia.
... In fact, recent work has reported that some individuals with social anxiety symptomology are also characterized by high impulsivitysuch as risk taking (Nicholls, Staiger, Williams, Richardson, & Kambouropoulos, 2014). For example, Kashdan and colleagues first reported on an impulsive social anxiety subtype characterized by high risk-taking behaviors and increased alcohol misuse (Kashdan & Hofmann, 2008;Kashdan, Elhai, & Breen, 2008). An approach-avoidance framework may help provide some insight into why social anxiety may be related to impulsive tendencies. ...
... In general, socially anxious individuals will emphasize avoidance behaviors to minimize the potential for social rejection, embarrassment, and negative outcomes. However, some individuals may use alternative strategies that are more approach-focused, which tend to fall into categories of impulsive or risk-taking behavior (Kashdan, 2007;Kashdan & Hofmann, 2008;Kashdan & McKnight, 2010). For example, some individuals with high social anxiety and disinhibition are more likely to have problems managing negative emotions, report less psychological flexibility (e.g., adapting to change), and engage in higher rates of substance misuse . ...
Individuals may drink or use cannabis to cope with social anxiety, and drinking or using cannabis prior to social situations (e.g., pregaming) may be a way to limit the experience of anxiety when entering social settings. However, theoretical and empirical work has reported mixed associations between social anxiety and substance use, specifically alcohol and cannabis. Little work has looked at how other variables, such as impulsivity (a central component to high risk drinking such as pregaming), may shed light onto these mixed findings. College students who reported past year pregaming (n = 363) completed self-report surveys. Supporting prior work, we found that social anxiety was associated with fewer pregaming days, even among those high in sensation seeking. However, those reporting higher social anxiety also reported higher cannabis use during pregaming, specifically among those who reported high sensation seeking and high positive urgency. Results suggest specific facets of impulsivity may affect the association between social anxiety and cannabis use during high risk drinking events.
... Although we did not find significant associations for antisocial peer affiliation, the link between social anxiety and antisocial peer affiliation warrants attention in future research. The null findings might be explained by important heterogeneity among individuals with social anxiety (Kashdan & Hofmann, 2008). It might be that only a subgroup of adolescents with social anxiety affiliate with antisocial peers, as research has identified a subgroup of individuals with social anxiety symptoms who also engage in risk-prone and disinhibited behaviors (Kashdan & Hofmann, 2008). ...
... The null findings might be explained by important heterogeneity among individuals with social anxiety (Kashdan & Hofmann, 2008). It might be that only a subgroup of adolescents with social anxiety affiliate with antisocial peers, as research has identified a subgroup of individuals with social anxiety symptoms who also engage in risk-prone and disinhibited behaviors (Kashdan & Hofmann, 2008). In contrast, other subgroups of youth with social anxiety might be too fearful of the consequences and pressures to engage with antisocial peers (Hodgins, Barbareschi, & Larsson, 2011). ...
The goal of this study was to broaden the developmental understanding of the implications of interparental conflict (IPC) and threat appraisals of conflict for adolescents' relationships with peers. Guided by the cognitive contextual framework and evolutionary perspectives, we evaluated a developmental model in which adolescents who are exposed to IPC perceive these conflicts as threatening to their well-being or that of their family. In turn, threat appraisals of IPC increase risk that adolescents experience worries and fears about the peer context (i.e., social anxiety), leading to decreased support from friends and increased feelings of loneliness and engagement with antisocial peers. Autoregressive analyses were conducted with a sample of 768 two-parent families across four measurement occasions. Exposure to IPC was related to increases in youths' perceived threat, which increased their risk for social anxiety symptoms. Consistent with our hypothesis, heightened social anxiety symptoms undermined youths' subsequent functioning in the peer context. Specifically, youth with greater adolescent social anxiety symptoms experienced increased feelings of loneliness and decreased perceptions of friendship support. Significant indirect effects were substantiated for adolescent loneliness and friendship support. Findings did not vary as a function of adolescent gender. The findings highlight the enduring implications of IPC and threat appraisals of IPC for youths' functioning, which can be expanded beyond broad measures of youth psychopathology, and the critical role of social anxiety symptoms as an explanatory mechanism in this process. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
... Social anxiety almost exclusively first manifests in individuals younger than 25, with onset generally in late childhood or early adolescence [30]. Like depression, social anxiety is associated with risk averse behaviour in experimental tasks [17,[31][32][33][34], though a growing body of evidence suggests a subset of socially anxious individuals develop risk prone behaviours to increase acceptance from others [35][36][37][38]. Differences in one's developmental status or competence may present as social and emotional immaturity [39]. ...
... Young people spend a substantial amount of time with their peers and a growing body of evidence suggests susceptibility to their influence, being it overt or just their mere presence [3,15,16,77]. Besides taking more risks to increase acceptance from peers, meet expectations or achieve status [35][36][37][38], it needs to be acknowledged that those who are more anxious in social situations often tend to be more risk avoidant and report to take fewer risks than their less socially anxious counterparts in experimental settings or self-report research. The latter was predicted and observed in the current study; socially anxious symptoms were associated with a decrease in risk-taking behaviour. ...
Risk-taking behaviour and onset of mental illness peak in adolescence and young adulthood. This study evaluated the interconnectedness of the domains of risk-taking behaviour, mental health (symptoms of depression and social anxiety), psychosocial maturity, risk perception, age, and gender in a sample of 306 adolescents and young adults. Participants between the ages of 16 and 35 completed online self-report measures assessing risk-taking behaviour, depressive symptoms, socially anxious symptoms, psychosocial maturity and risk perception. Socially anxious symptoms, psychosocial maturity, and risk perception were directly associated with risk-taking behaviour. Correlations between depressive symptoms, socially anxious symptoms, and psychosocial maturity were found. Psychosocial maturity proved a better predictor of risk-taking behaviour than age in this cohort. The findings indicate that mental health impacts upon risk-taking behaviour and that consideration should be given to psychosocial maturity in attempts to reduce adolescent and young adult risk-taking behaviour.
... Moreover, a study involving motivational enhancement therapy for drinking found that only individuals who were low in impulsivity and novelty seeking and/or who had the short DRD4 genotype (reported to be related to novelty seeking) exhibited significantly increased behaviour changes, suggesting a potential biological basis of this association (Ewing et al., 2009). We therefore hypothesized that, in lifestyle modifications, individuals with high conscientiousness and low novelty seeking are more adherent to the guidelines; those with low conscientiousness and high novelty seeking, who tend to be easily bored, reward demanding, and impulsive, lack perseverance and have self-regulation limitations (Bevins, 2001;Bulik et al., 1997;Fassino et al., 2002;Garcia-Ruiz-de-Gordejuela et al., 2017;Kashdan & Hofmann, 2008), may show less adherence and exhibit more difficulties in inhibiting appetite towards food and/or taking actions to change related behavioural patterns, resulting in a worse response to lifestyle interventions for obesity. ...
Lifestyle intervention has been widely used to manage obesity, but its effects varied across individuals. Personality traits have increasingly drawn researchers’ interest in exploring their role in obesity interventions, but findings remained mixed. We aimed to systematically review and rigorously assess the associations between personality traits and the response to lifestyle-based obesity interventions for adult obesity. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO, Scopus, Clinicaltrials.gov registry, and Medrxiv until February 8, 2023 and studies were screened as per the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. We grouped personality traits into 5 domains according to the widely used Five-Factor Model, and synthesized the results within each domain quantitatively (using meta-analyses) or narratively. We also used bubble plots to visualize the pattern and trend of results. We identified 3,289 records and finally included 9 eligible studies in this review, and found that high Conscientiousness tended to be positively associated with the response to lifestyle interventions for adult obesity, and low novelty seeking might
be the main facet of Conscientiousness that was related to the intervention effect. Most of the included studies were rated as having risk of bias due to inadequacy in comparison of baseline characteristics or short follow-up. Our review showed a tentatively positive association between high Conscientiousness and the response to lifestyle interventions for adult obesity, and noted the primary contribution of low
novelty seeking. However, studies in this field were still scarce in both quantity and quality.
... Novelty seeking is also regarded as an important factor in the risk-taking behavior context [76][77][78]. Berlyne [40] stated that an individual who seeks novelty is more willing to try new products/services and take risks. Zuckerman and Neeb [79] also support this finding by delving into the different dimensions of sensation seeking and discussing its implications in various areas of life, which include risk-taking behavior. ...
Smart farm technology contributes to sustainable environmental protection, and so it is important to investigate consumer behavior in this regard. Therefore, this paper constructs a theoretical model focusing on the consumers of indoor smart farm restaurants. The theoretical framework integrates the theory of planned behavior and the perceived risk theory. The constructed framework is deepened by testing the moderating role of novelty seeking in the effects of perceived risks on attitudes. The results revealed that (1) psychological and quality risks negatively affect attitude, (2) subjective norm positively affects attitude, (3) attitudes, subjective norm, and perceived behavioral control positively affect behavioral intentions, and (4) the moderating impact of novelty seeking was discovered in the relationship between psychological risk and attitude. This is the first investigation of the perceived risks of indoor smart farm restaurants, and this study empirically proved the moderating role of novelty seeking in the risk-taking behavior context. This study consequently contributes to advancing state-of-the-art methods and presents practical marketing recommendations.
... First, although social anxiety is typically characterized by shyness, introversion, submissiveness, inhibition, and risk aversion (Sepahvand & Karami, 2020), there are also atypical profiles. By using cluster analysis, Kashdan and Hofmann (2008) found that a proportion of outpatients with social anxiety disorder (41% of the sample) exhibited high impulsivity and disinhibition, while the majority (59% of the sample) exhibited typical shyness and behavioral inhibition. Several works replicated this atypical social anxiety in both clinical (Mörtberg et al., 2014) and non-clinical samples (Van Zalk et al., 2020). ...
Although previous studies identified a subgroup of social anxiety characterized by high impulsivity, it has not received sufficient attention. The purpose of this study was to explore social anxiety-impulsivity profiles and examine differences in aggression across profiles in a Chinese sample. The latent profile analysis was conducted to identify distinct profiles among 515 college students (53.98% male) based on social anxiety constructs and impulsive behaviors. The results revealed six distinct profiles: low social anxiety-low impulsivity, low social anxiety-high impulsivity, moderate social anxiety-high impulsivity, moderate social anxiety-moderate impulsivity, high social anxiety-low impulsivity, and high social anxiety-high impulsivity. The combination of moderate to high social anxiety and high impulsivity reported more aggression than the other profiles. In contrast, the low social anxiety-low impulsivity subgroup reported the lowest aggression. Current findings provide further evidence for the presence of impulsive social anxiety subtypes and offer novel insights into the mixed results regarding the relationship between social anxiety and aggression.
... We here proposed that baseline dietary behavior and treatment compliance may mediate the association between novelty seeking and response to lifestyle interventions for adult obesity (Figure 5). Individuals with higher novelty seeking tend to be more easily bored, reward demanding, impulsive and limited in self-regulatory resources 27,28 . ...
Personality traits and the response to lifestyle interventions for adult obesity
... Future experiments involving impulsive human subjects could test both the effects of this loss context and also incorporate a separate term in the model for perseverative drawing that is independent from drawing related to information seeking. Impulsive choice has also been shown to be related to novelty-seeking in clinical disorders and substance abuse [79][80][81][82][83]. However, these studies frequently use self-report questionnaires that measure sensation seeking as a metric for novelty seeking behavior. ...
Choice impulsivity is characterized by the choice of immediate, smaller reward options over future, larger reward options, and is often thought to be associated with negative life outcomes. However, some environments make future rewards more uncertain, and in these environments impulsive choices can be beneficial. Here we examined the conditions under which impulsive vs. non-impulsive decision strategies would be advantageous. We used Markov Decision Processes (MDPs) to model three common decision-making tasks: Temporal Discounting, Information Sampling, and an Explore-Exploit task. We manipulated environmental variables to create circumstances where future outcomes were relatively uncertain. We then manipulated the discount factor of an MDP agent, which affects the value of immediate versus future rewards, to model impulsive and non-impulsive behavior. This allowed us to examine the performance of impulsive and non-impulsive agents in more or less predictable environments. In Temporal Discounting, we manipulated the transition probability to delayed rewards and found that the agent with the lower discount factor (i.e. the impulsive agent) collected more average reward than the agent with a higher discount factor (the non-impulsive agent) by selecting immediate reward options when the probability of receiving the future reward was low. In the Information Sampling task, we manipulated the amount of information obtained with each sample. When sampling led to small information gains, the impulsive MDP agent collected more average reward than the non-impulsive agent. Third, in the Explore-Exploit task, we manipulated the substitution rate for novel options. When the substitution rate was high, the impulsive agent again performed better than the non-impulsive agent, as it explored the novel options less and instead exploited options with known reward values. The results of these analyses show that impulsivity can be advantageous in environments that are unexpectedly uncertain.
... The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, includes a specifier for performance-only social anxiety (APA, 2013), and research has supported two presentation categories of social anxiety: social interaction anxiety, which relates to apprehension about coming into contact with or speaking with others, and social observation or social performance anxiety, which concerns circumstances in which people are observed by others, presenting, or performing (see Kashdan, 2004). People who have high degrees of social interaction anxiety report losing interest in enjoyable activities, having less energy, being less satisfied in their relationships, and having more behavioural inhibition (Kashdan, 2004;Kashdan et al. 2008;Kashdan et al., 2011a;Kashdan et al., 2011b). ...
According to literature, a person's level of social connection greatly influences how brave they will be when speaking in front of others. In the twenty-first century, speaking up in public with confidence is crucial for all undergraduate students. Therefore, after completing their university degree, every undergraduate student needs to have sufficient social interaction. Additionally, a student's level of social anxiety affects how much they engage with others. The amount of social interaction anxiety experienced by undergraduate students at Nigerian universities, however, has received less attention in the literature. This study investigated the undergraduate students at the University of Nigeria, Nsukka's level of social interaction anxiety. A sample of 223 undergraduate students from the University of Nigeria was used in this cross-sectional survey study. Data were gathered using the social interaction anxiety scale (α = .86), and frequency, percentage, and bar charts were utilized to analyze the results. The findings showed that most undergraduate students reported very high levels of social interaction anxiety. This means that if this high degree of social interaction anxiety is not addressed, undergraduate students will not be able to properly develop their social interaction.
... Individuals with higher NS scores tend to be more enthusiastic, quick-tempered, impulsive, and more sensitive to rewards, which may lead to higher sensation-seeking experiences (Cloninger et al., 1993). Additionally, scoring high on NS is related to low dopaminergic activity (Cloninger, 1987), which is thought to be a potential risk factor for developing neuropsychiatric disorders (e.g., major depression, anxiety, bipolar disorder, post-traumatic stress disorder, schizophrenia, and addiction) (Kashdan and Hofmann, 2008;Loftus et al., 2008;Dervaux et al., 2010;Jaksˇic´et al., 2012;Ballon et al., 2015). ...
Previous neuroimaging studies have highlighted the role of prefrontal-subcortical circuits in personality trait of novelty seeking (NS), thought to be mediated by the dopaminergic system. However, it remains largely unknown whether cortico-basal-cerebellar connections, heavily influenced by dopamine, are implicated in this temperament dimension as well. The present study aimed to further investigate the relationship between the NS trait and the cortico-basal-cerebellar pathways by using structural covariance network analysis. Ninety-five healthy female volunteers were included in this work, and NS was assessed with the Temperament and Character Inventory (TCI). Our results showed that NS scores were associated with structural connections between the cerebellum and the cerebral cortex, thalamus, and basal ganglia, substantiating the implication of cortico-basal-cerebellar circuits in the NS construct. In addition, structural connections between visual and sensorimotor regions were also associated with NS scores, indicating that sensory and motor information processing may contribute to NS-related behaviors. Overall, the current findings may deepen our understanding of brain structural circuits related to this temperament dimension.
... Many transgenic rodent models have been generated to manipulate the function of this gene [9][10][11]. In many patients, the mental disorders are accompanied by varying levels of impairment in novelty-seeking [12][13][14] and risk-avoidance [15][16][17]. When animals face a novel environment, they show an innate avoidance of risky environments, which can be interpreted as reflecting phenotypes related to anxiety. ...
A strong animal survival instinct is to approach objects and situations that are of benefit and to avoid risk. In humans, a large proportion of mental disorders are accompanied by impairments in risk avoidance. One of the most important genes involved in mental disorders is disrupted-in-schizophrenia-1 ( DISC1 ), and animal models in which this gene has some level of dysfunction show emotion-related impairments. However, it is not known whether DISC1 mouse models have an impairment in avoiding potential risks. In the present study, we used DISC1-N terminal truncation ( DISC1-N TM ) mice to investigate risk avoidance and found that these mice were impaired in risk avoidance on the elevated plus maze (EPM) and showed reduced social preference in a three-chamber social interaction test. Following EPM tests, c-Fos expression levels indicated that the nucleus accumbens (NAc) was associated with risk-avoidance behavior in DISC1-N TM mice. In addition, in vivo electrophysiological recordings following tamoxifen administration showed that the firing rates of fast-spiking neurons (FS) in the NAc were significantly lower in DISC1-N TM mice than in wild-type (WT) mice. In addition, in vitro patch clamp recording revealed that the frequency of action potentials stimulated by current injection was lower in parvalbumin (PV) neurons in the NAc of DISC1-N TM mice than in WT controls. The impairment of risk avoidance in DISC1-N TM mice was rescued using optogenetic tools that activated NAc PV neurons. Finally, inhibition of the activity of NAc PV neurons in PV-Cre mice mimicked the risk-avoidance impairment found in DISC1-N TM mice during tests on the elevated zero maze. Taken together, our findings confirm an impairment in risk avoidance in DISC1-N TM mice and suggest that reduced excitability of NAc PV neurons is responsible.
... These challenges are particularly important for understanding anxious youths who will exhibit heightened risk taking (e.g., substance use, unprotected sex, impulsive decisions), which is often theorized to serve as a strategy for regulating affective distress (108)(109)(110)(111)(112)(113)(114). Whether the tendency toward heightened risk taking is specific to some anxiety disorders versus others and whether it is modulated by age and/or contextual factors also remains unclear. ...
Avoidant behavior is a defining feature of pediatric anxiety disorders. Although prior research has examined it from the perspective of early information processing events, there has been relatively less consideration of the processes by which anxious youth make avoidant decisions and how these choices are reinforced over time. Studies of risk taking are valuable in this regard as they consider how individuals identify the pros and cons of their choices, how they weight potential gains and losses and estimate their respective probabilities, and how they tolerate the uncertainty intrinsic to any decision. In this review, we place risk taking within existing models of information processing in pediatric anxiety disorders and highlight the particular value of this construct for informing models of developmental psychopathology and individual differences in outcome over time. We review existing behavioral and neurobiological studies of risk taking in anxious youth and conclude by identifying directions for future research.
... After engaging in the Trier Social Stress Test, socially anxious participants reported elevated alcohol cravings, but only when they were concurrently high in trait impulsivity. Finally, subtyping work from Kashdan and Hofmann (2008) and Kashdan et al. (2009) demonstrates that there are two general types of socially anxious people. One subtype is characterized by high levels of inhibition, social avoidance, and low levels of engagement in risky behaviours. ...
Aims
Alcohol use follows a developmental trajectory—steadily increasing and peaking in the early stages of emerging adulthood (e.g. first year of university) and declining thereafter. While most individuals ‘mature out’ of problem drinking as they move through emerging adulthood, some continue to drink heavily and experience serious problems. Tension reduction theory identifies social anxiety (SA) as a potential risk factor for problem drinking during emerging adulthood. However, mixed data suggest that the associations between SA and drinking behaviours are not straightforward. Cross-sectional studies demonstrate that socially anxious emerging adults are at risk for problem drinking, but only if they are also high in trait impulsivity. This study aimed to expand on previous work by examining trait impulsivity as moderator of the prospective associations between SA and maturing out of problem drinking in emerging adulthood.
Methods
Undergraduates (N = 302) completed online self-reports at regular intervals (6-months) over an 18-month period, resulting in four waves of data.
Results
Unconditional latent growth curve models indicated that alcohol problems (but not use) declined linearly over time. Next, conditional growth curve models revealed that SA was associated with impeded maturing out of alcohol problems, but this effect was only present in socially anxious participants with high levels of trait impulsivity.
Conclusion
Our study advances growing literature on the crucial moderating role that impulsivity plays in the SA pathway to problem drinking. Clinical interventions for problem drinking among socially anxious students should both assess for and target concurrent impulsivity.
... Relatedly, students with social anxiety may vary based on their responsiveness to risky behaviors. Kashdan and Hofmann (2008) found two subgroups of students with moderate-to-high levels of social anxiety that demonstrated approachversus avoidant-oriented behaviors, and Lipton, Weeks, Daruwala, and De Los Reyes (2016) identified two subgroups of students with high social anxiety that demonstrated high versus low levels of impulsivity. Thus, some students may internalize their symptoms whereas others engage in externalizing behaviors. ...
Background:
The social, normative nature of alcohol use may make college students with social anxiety vulnerable to problematic alcohol use. Yet, social anxiety is typically unrelated to drinking quantity or frequency. One potential explanation is that researchers primarily use a variable-centered approach to examine alcohol use among students with social anxiety, which assumes population homogeneity.
Methods:
The current study utilized a person-centered approach to identify distinct classes among 674 college students (69.6% female) based on social anxiety characteristics and alcohol use behaviors, and tested how these classes differed in their experience of adverse outcomes.
Results:
Latent profile analysis resulted in six distinct classes of students - two classes with low levels of social anxiety and non-problematic drinking behaviors that differed based on frequency of alcohol use, three classes with moderate levels of social anxiety that differed based on quantity, frequency, and extent of problematic drinking behaviors, and one class with high levels of social anxiety and low, frequent problematic drinking behaviors. Two classes - moderate levels of social anxiety and heavy, problematic drinking behaviors or high levels of social anxiety and light, problematic drinking behaviors - appeared to have riskier profiles due to endorsing more social anxiety-specific beliefs about social impressions while drinking and more emotional distress.
Conclusions:
Current findings offer clarity surrounding the role of alcohol use in the association between social anxiety and problematic alcohol use. Although preliminary, findings demonstrate that comorbid social anxiety and alcohol use disorder symptoms appear to place students at greater risk for adverse outcomes.
... This initial finding thus suggests that there are qualitatively distinct problematic responses to social events among SAD individuals, with one group being unified by impulsive and approach-like responses to social events rather than inhibited ones. This finding in clinical SAD patients was replicated and extended in a subsequent study by Kashdan and Hofmann, who similarly discovered two separate groups of SAD patients based on the temperament trait of novelty seeking, which is linked to impulsivity [66]. Fifty-nine percent of their sample showed the traditional low levels of novelty seeking when compared to healthy controls, while 41% showed significantly higher novelty seeking. ...
Anxiety disorders and substance use disorders (SUDs) frequently co-occur, and individuals with this comorbidity demonstrate exacerbated impairment and poorer treatment outcomes compared to individuals with only one of the disorders. This paper reviews the potential mechanisms underlying this comorbidity, with a particular focus on the influence of impulsivity. There is an atypical subset of individuals with anxiety disorders that display elevated impulsivity, and it is suggested that these individuals account for the clinically relevant group of anxiety disorder patients that have a concurrent SUD. Patients with anxiety disorders that show increased impulsivity, particularly within the negative urgency (NU) sub-domain, appear to have a predisposition to engage in risky behaviours to cope with their anxiety symptoms, which includes substance use. Given the promise of impulsivity and NU as endophenotypes of this anxiety-SUD comorbidity, it is recommended that future research investigate gene variants that modulate impulsivity and NU to establish biomarkers predicting an increased risk of a concurrent SUD among anxiety disorder patients. This subtype and endophenotypic investigation may ultimately establish treatment targets that can lead to greater personalization of treatments for the subgroup of anxiety disorder patients that have comorbid SUDs.
... One particularly challenging question in the risk taking literature is the impact of anxiety. While anxiety is more generally thought to be negatively re- lated to risk taking (e.g., Butler & Matthews, 1987), other evidence suggests that risk behaviors increase among those with anxiety in situations in which an anxiety-inducing stimulus is present (Kashdan & Hofmann, 2008). While this dichotomy makes intuitive sense it is dif- ficult to test tease apart the disposition vs situation impact on risk taking of those with elevated anxiety. ...
... We offer three explanations for this finding. First, although the prototypical person with SAD is characterized by avoidance and inhibited behavior, emerging research suggests that not all people with SAD engage in avoidance to manage their anxiety (Kachin, Newman, & Pincus, 2001;Kashdan, Elhai, & Breen, 2008;Kashdan & Hofmann, 2008). At least a subset of individuals with SAD, with some estimates as high as approximately 1 in 5, engage in approach-oriented behavior (Kashdan, McKnight, Richey, & Hofmann, 2009). ...
People with anxiety disorders tend to make decisions on the basis of avoiding threat rather than obtaining rewards. Despite a robust literature examining approach-avoidance motivation, less is known about goal pursuit. The present study examined the content, motives, consequences, and daily correlates of strivings among adults diagnosed with social anxiety disorder and healthy controls. Participants generated six strivings along with the motives and consequences of their pursuit. Compared with controls, people with social anxiety disorder were less strongly driven by autonomous motives and reported greater difficulty pursuing strivings. Coders analyzed strivings for the presence of 10 themes: achievement, affiliation, avoidance, emotion regulation, generativity, interpersonal, intimacy, power, self-presentation, and self-sufficiency. People with social anxiety disorder constructed more emotion regulation strivings than did controls, but they did not differ across other themes. This research illustrates how studying personality at different levels of analysis (traits, strivings) can yield novel information for understanding anxiety disorders.
... Functional impulsivity (FI), where people respond or act quickly and effectively 1 Dysfunctional impulsivity (DI), where people respond rapidly but inaccurately or in risky ways without considering consequences 1 Recent research found that lower FI was associated with greater symptom severity in individuals with Generalized Anxiety Disorder (GAD) 2 GAD may be associated with greater novelty-seeking behavior and negative urgency, which are dimensions of DI 3,4 To date, no research has examined the role of impulsivity in Social Anxiety Disorder (SAD) ...
... 16,17,26 Similar to previous literature, Novelty Seeking was higher in single compared to partnered participants. 27 High Novelty Seeking suggests a curious and exploratory nature and may reflect a more orderly or committed lifestyle of individuals who are partnered. ...
Introduction
Dentistry is known to be a challenging degree and students are often under considerable academic pressure which may lead to stress and difficulties in coping. Personality influences coping ability, yet very little is known about the personality traits of dentistry students. This study aimed to describe the personality profiles of students enrolled in an Australian undergraduate dental degree.
Methods
Students enrolled in year one and two of the undergraduate dental programme at The University of Queensland were invited to complete an online survey which included the Temperament and Character Inventory (TCI). Personality was measured by four dimensions of temperament: Novelty Seeking, Harm Avoidance, Reward Dependence and Persistence; and three‐character traits: Self‐Directedness, Cooperativeness and Self‐Transcendence. Data analysis was mostly descriptive, and t tests and univariate statistics compared groups.
Results
Participants (n = 134; 97% response rate; females = 51%) were generally single, spoke another language at home and lived in shared accommodation. The majority (55%) were 20‐29 years old, and 40% were international students. The sample had average levels of all TCI traits, except for Cooperativeness which was high.
Conclusions
This sample of dentistry students portrayed a profile of temperament and character similar to profiles of other health profession students with the intellectual ability and drives to undertake a competitive and challenging degree. Longitudinal studies are needed to track changes in personality throughout the degree. This would provide insight into how and when to best support students.
... For example, high interoceptive accuracy is a common occurrence among highly anxious individuals (Stevens et al., 2011). These individuals have also been shown to display more impulsive and disinhibited behavior (Kashdan and Hofmann, 2008) while simultaneously demonstrating more risk aversion for long-term decisions about the self (Eisenberg et al., 1998). Considering a differential impact of interoceptive awareness on different forms of action regulation could provide insight on such behavioral patterns and lead to a deeper understanding of factors underlying action regulation. ...
The notion of predictive coding assumes that perception is an iterative process between prior knowledge and sensory feedback. To date, this perspective has been primarily applied to exteroceptive perception as well as action and its associated phenomenological experiences such as agency. More recently, this predictive, inferential framework has been theoretically extended to interoception. This idea postulates that subjective feeling states are generated by top-down inferences made about internal and external causes of interoceptive afferents. While the processing of motor signals for action control and the emergence of selfhood have been studied extensively, the contributions of interoceptive input and especially the potential interaction of motor and interoceptive signals remain largely unaddressed. Here, we argue for a specific functional relation between motor and interoceptive awareness. Specifically, we implicate interoceptive predictions in the generation of subjective motor-related feeling states. Furthermore, we propose a distinction between reflexive and pre-reflexive modes of agentic action control and suggest that interoceptive input may affect each differently. Finally, we advocate the necessity of continuous interoceptive input for conscious forms of agentic action control. We conclude by discussing further research contributions that would allow for a fuller understanding of the interaction between agency and interoceptive awareness.
... In the case of ASPD combined with other disorders, such as SUD, associated negative effects have been increasing [23]. In the presence of additional psychopathology, SUDs were found to be associated with higher scores for impulsivity [28] and novelty seeking [30,33,41]. Impulsivity was even suggested to play a mediating role in the association between childhood trauma -known to be related to SUD in adulthood [61] -and psychopathology [53,63]. ...
Introduction: Although the strong association between antisocial personality disorder (ASPD) and impulsivity is well known, the question of which impulsivity dimensions are most closely associated with ASPD has not been answered. The aim of the present study was to evaluate the relationship between impulsivity and dimensions of impulsivity with ASPD, while testing the effects of psychopathology and novelty seeking in a sample of inpatients with heroin use disorder (HUD). Methods: Participants included 232 inpatients with HUD. Participants were evaluated with the Symptom Checklist-90-R (SCL-90-R), the Short Form of Barratt Impulsiveness Scale (BIS-11-SF), novelty-seeking subscale of the Temperament and Character Inventory (TCI) and with the relevant section of the Structured Clinical Interview for DSMIII-R-Personality Disorders (SCID-II) for antisocial personality disorder. Results: Severity of psychopathology, novelty seeking and impulsivity were higher among those with ASPD. Presence of ASPD predicted motor and attentional impulsivity, together with the severity of novelty seeking and psychopathology, but not non-planning impulsivity-a factor that was, instead, predicted by the severity of novelty seeking and psychopathology. Conclusion: These findings suggest that impulsivity (particularly its motor and attentional dimensions) is related to the presence of ASPD, together with the severity of psychopathology and novelty seeking among patients with HUD. Measurement and detection of these factors may contribute to directing patients with HUD to the most appropriate psychotherapy option available as an addition to the medication.
Background
Internalising disorders are highly prevalent emotional dysregulations during preadolescence but clinical decision-making is hampered by high heterogeneity. During this period impulsivity represents a major risk factor for psychopathological trajectories and may act on this heterogeneity given the controversial anxiety–impulsivity relationships. However, how impulsivity contributes to the heterogeneous symptomatology, neurobiology, neurocognition and clinical trajectories in preadolescent internalising disorders remains unclear.
Aims
The aim was to determine impulsivity-dependent subtypes in preadolescent internalising disorders that demonstrate distinct anxiety–impulsivity relationships, neurobiological, genetic, cognitive and clinical trajectory signatures.
Method
We applied a data-driven strategy to determine impulsivity-related subtypes in 2430 preadolescents with internalising disorders from the Adolescent Brain Cognitive Development study. Cross-sectional and longitudinal analyses were employed to examine subtype-specific signatures of the anxiety–impulsivity relationship, brain morphology, cognition and clinical trajectory from age 10 to 12 years.
Results
We identified two distinct subtypes of patients who internalise with comparably high anxiety yet distinguishable levels of impulsivity, i.e. enhanced (subtype 1) or decreased (subtype 2) compared with control participants. The two subtypes exhibited opposing anxiety–impulsivity relationships: higher anxiety at baseline was associated with higher lack of perseverance in subtype 1 but lower sensation seeking in subtype 2 at baseline/follow-up. Subtype 1 demonstrated thicker prefrontal and temporal cortices, and genes enriched in immune-related diseases and glutamatergic and GABAergic neurons. Subtype 1 exhibited cognitive deficits and a detrimental trajectory characterised by increasing emotional/behavioural dysregulations and suicide risks during follow-up.
Conclusions
Our results indicate impulsivity-dependent subtypes in preadolescent internalising disorders and unify past controversies about the anxiety–impulsivity interaction. Clinically, individuals with a high-impulsivity subtype exhibit a detrimental trajectory, thus early interventions are warranted.
Risk avoidance behaviors are essential for survival. "Uncontrollable" risk-taking behaviors in animals or humans may have severe adverse consequences. In humans, a large proportion of psychiatric disorders are accompanied by impairments in risk avoidance. Obesity is associated with psychiatric disorders. Peroxisome proliferator-activated receptor α (PPARα) takes part in regulating lipid metabolism and neuronal function. Here, we investigated the effect of high-fat diet (HFD)-induced obesity on risk avoidance and the role of PPARα in this behavior. Male PPARα-null (KO) mice and wild-type (WT) mice were assigned to four different groups: WT-CON and KO-CON (normal diet); WT-HFD and KO-HFD (high fat diet). The HFD began at week 6 and was continued until sampling. A series of behavioral tests were performed at week 11. We found that WT but not KO mice fed with a HFD exhibited weight gain and risk avoidance impairment, compared with the mice fed with a normal diet. The staining of c-Fos revealed that the hippocampus was the main brain region involved in risk avoidance behavior. Moreover, biochemical analysis suggested that the decreased levels of the brain-derived neurotrophic factor (BDNF) in the hippocampus might contribute to risk avoidance impairment induced by a HFD. These results indicated that PPARα is involved in HFD-induced risk avoidance impairment via the regulation of hippocampal BDNF.
Social avoidance behavior (SAB) produces impairment in multiple domains and contributes to the development and maintenance of several psychiatric disorders. Social behaviors such as SAB are influenced by approach-avoidance (AA) motivational responses to affective facial expressions. Notably, affective facial expressions communicate varying degrees of social reward signals (happiness), social threat signals (anger), or social reward-threat conflict signals (co-occurring happiness and anger). SAB is associated with dysregulated modulation of automatic approach-avoidance (AA) motivational responses exclusively to social reward-threat conflict signals. However, no neuroimaging research has characterized SAB-related modulation of automatic and subjective AA motivational responses to social reward-threat conflict signals. We recruited 30 adults reporting clinical, moderate, or minimal SAB based on questionnaire cutoff scores. SAB groups were matched on age range and gender. During fMRI scanning, participants completed implicit and subjective approach-avoidance tasks (AATs), which involved more incidental or more explicit evaluation of facial expressions that parametrically varied in social reward signals (e.g., 50%Happy), social threat signals (e.g., 50%Angry), or social reward-threat conflict signals (e.g., 50%Happy + 50%Angry). In the implicit AAT, SAB was associated with slower automatic avoidance actions and weaker amygdala-pgACC connectivity exclusively as a function of social reward-threat conflict signals. In the subjective AAT, SAB was associated with smaller increases in approach ratings, smaller decreases in avoidance ratings, and weaker dlPFC-pgACC connectivity exclusively in response to social reward-threat conflict signals. Thus, SAB is associated with dysregulated modulation of automatic and subjective AA motivational sensitivity to social reward-threat conflict signals, which may be facilitated by overlapping neural systems.
Young adulthood (ages 18 to 30 years old), a developmental age of exploration, is marked by new experiences and transitions. Cannabis use frequency is highest in young adulthood compared to other age periods. Social anxiety (characterized by fear, shyness, and inhibition in social situations where scrutiny and judgment is possible) is also prevalent during young adulthood. Social anxiety may be a complex predictor of cannabis use frequency and problems (e.g., any negative physical, emotional, or social outcome from use). Social anxiety may act as a risk factor as individuals may use cannabis frequently to manage their fear of negative evaluation and associated unpleasant affective states. The purpose of this meta-analysis was to quantify the magnitude of the associations between social anxiety and two cannabis variables (frequency of use and problems) in young adulthood. A comprehensive literature review was conducted to identify studies that included measures of social anxiety and at least one cannabis-related variable of interest among young adults. Eighteen studies were included in the meta-analysis. Results revealed a small, statistically significant positive association between social anxiety and cannabis problems (r = 0.197, k = 16, p = <0.001), and a nonsignificant association between social anxiety and cannabis use frequency (r = 0.002, k = 16, p = 0.929). The association between social anxiety and cannabis use frequency was moderated by the mean age such that samples with older mean ages exhibited a stronger correlation. Additionally, the association between social anxiety and cannabis problems was moderated by clinically significant levels of social anxiety, such that samples with fewer participants who met clinical levels of social anxiety exhibit a stronger correlation. This meta-analysis supports the idea that there is a complex relation between social anxiety and cannabis outcomes during young adulthood.
Background Anxiety and impulsivity represent transdiagnostic pathology dimensions yet their interaction and contribution to emotional disorders in adolescence and to disease development remain controversial, and previous studies indicate heterogeneity within the broad category of internalizing disorders.
Methods A combination of hierarchical and non-hierarchical clustering strategies was employed to determine impulsivity-related subtypes (based on the facets of negative urgency, lack of planning, lack of perseverance, sensation seeking and positive urgency in UPPS-P scales) in a large cohort of adolescents with internalizing disorders (n=2437) from Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effect models were employed to determine cortical thickness alterations of the subtypes.
Results Data-driven clustering identified two distinct subtypes of internalizing patients (subtype 1/subtype 2) with comparable levels of increased anxiety yet distinguishable levels of impulsivity, i.e., enhanced (subtype 1) or decreased (subtype 2) compared to healthy controls. Subtype 1 was further characterized by thicker prefrontal and temporal cortical regions involved in regulatory control and fear processing, while subtype 2 did not demonstrate significant thickness alterations. The differential neuroanatomical profiles remained stable over the two-year follow-up, while the two subtypes had different neurodevelopmental trajectories. Subtype 1 additionally reported more psychopathology and dysfunctionality including higher suicidal ideation, depressive symptoms and transition rates to externalizing disorders during follow-up as well as impaired neurocognitive and educational performance compared to subtype 2. Moreover, for subtype 1, anxiety at baseline (9-10 years) was significantly positively associated with impulsivity (lack of perseverance) at 2-year follow-up, while in subtype 2, baseline anxiety was significantly negatively associated with impulsivity (sensation seeking) at 2-year follow-up.
Conclusions Our results demonstrate an impulsivity-dependent heterogeneity in adolescent internalizing disorders, with high-impulsivity patients being characterized by neurodevelopmental delay at the neural and cognitive levels. Individuals with elevated impulsivity are at a greater risk to develop behavioral dysregulation over the following two years and may thus require specific early interventions.
The aim of the present study is to find out the role of social judgment and impulsiveness in predicting the reactivity of the girls with social phobia. The method of the study is of correlation kind. The statistical population of the study consists of all the girls with social phobia and normal girls of Islamic Azad University of Khoram Abad Branch in 2013. The sampling method of the study was multistage cluster one. In order to collect data, a comprehensive international clinical interview, social phobia scale, social judgment questionnaire, impulsiveness scale, interpersonal reaction index, and the inventory of a fear of evaluation (positive and negative) were used. The Pearson correlation coefficient and a stepwise multiple regression analysis were used in an attempt to analyze data. The findings indicated that there was a positive significant relationship between social judgment, impulsiveness and the reactions of women with social phobia, though there was a negative significant relation between a fear of positive and negative evaluation and reactivity. It was also made clear that 19%of the individual reactivity variance is explained by impulsiveness, social justice, and a fear of positive and negative evaluation variances. The results represent the contribution of social judgment and impulsiveness in predicting the reactivity of the girls with social phobia.
https://civilica.com/doc/390603/
Objectives
Tobacco smoking and gambling disorder (GD) often co-occur. However, few studies have assessed the extent to which cigarette smoking may serve to classify and/or better define GD behaviour profiles.
Methods
Among a large sample of n = 3,652 consecutive treatment-seeking patients with GD (91% men). Smokers were compared to non-smokers across different sociodemographic, clinical, psychopathological and personality variables. The effect sizes for the means and the proportion differences between the groups were estimated. An evaluation of the smoking changes over the last 15 years was also performed.
Results
From the total sample, 62.4% of gamblers reported tobacco use. A decreasing linear trend in tobacco use was observed within the studied period, women having a more irregular pattern. The use of tobacco was linked to the use of alcohol and other illegal drugs. Gamblers who smoke, as compared to those who don’t, presented lower education levels, lower social position indexes and active employment. They were younger, with an earlier age of onset, shorter duration of the gambling behavior, higher GD severity, more psychological symptoms, higher scores in novelty seeking and lower scores in reward dependence, self-directedness and self-transcendence.
Conclusions
Gamblers seeking treatment who smoke display particular social, clinical, psychological, temperamental and character features different from non-smoking gamblers, suggesting that the presence or absence of comorbid smoking condition in GD should always be considered when developing an optimal treatment, as gamblers who smoke might need treatment strategies different from non-smoking gamblers.
The aim of the current review article is to examine the association and effects of depression, anxiety and stress on impulsivity across different age groups in the general population. Impulsivity is a multidimensional construct and a core feature of human behavior that is commonly encountered in clinical settings with significant individual and public health implications. Most studies to date which have examined the relationships between impulsivity, anxiety, depression, and stress have been conducted in clinical populations. This review stresses that there is a positive correlation between impulsivity and depression, anxiety and stress. Prior studies revealed that the degree of association between impulsivity and these three factors varies with age. Our review suggests that when treating depression, clinicians need to take into account impulsivity as a factor during assessment and treatment plans, given the adverse impact of impulsivity on therapeutic outcomes. Future studies should investigate causality between impulsivity and the three factors of depression, anxiety, and stress.
Anxiety disorders (ADs) are one of the most common psychiatric disorders, and various epidemiological studies showed that they are more prevalent than mood, substance use, and impulse control disorders in many countries. ADs determine a great psychosocial impairment, represented by a reduced educational attainment, marital problems, and lower occupational status.
This manuscript critically assesses the relationship between novelty and memorable tourism experiences (MTEs). Prior literature indicates that novelty is an antecedent of attention, emotions, memory and behaviour. Despite this focus limited studies have considered the emergence of novelty in broader psychological literature. Subsequently, this manuscript explores the evolution of novelty across personality, behavioural, cognitive and neuropsychology. Drawing on a narrative review this manuscript observes that concepts from behavioural and personality psychology have traditionally dominated tourism literature. However, cognitive and neuropsychological approaches are emerging in prevalence, which presents an opportunity to advance discourse on MTEs. A core contribution of this manuscript is a visual representation which depicts the evolution of novelty across four schools of thought in psychology, outlining potential implications for the tourism scholarship. Future research on tourism experiences should consider advances in the parent discipline of psychology.
Somewhat surprisingly, social anxiety has been linked with aggressive behavior in adults. Among youth, this connection has been demonstrated with anxiety symptoms more broadly. This review extends previous work by evaluating this association specifically with social anxiety in the child and adolescent literature. Given the complexities of aggressive behavior, the review is organized by its various forms (relational and physical) and functions (reactive and proactive). Findings from sixteen identified studies are suggestive of links between social anxiety and reactive and relational forms of aggression. Albeit more tenuous, there appear to be associations with physical aggression as well. Overall, though suggestive of connections between social anxiety and aggression, confidence in the findings is attenuated by the relatively small number of relevant studies combined with inconsistent gender findings. Before suggesting directions for further study, we propose putative dysfunctional biological, emotional, and cognitive processes as factors that may underlie associations between social anxiety and these particular forms of aggression. Future research should target differences in age, gender, relationship type, and anxiety subtype. Determining the extent to which these associations may be attributable to comorbid pathology such as depression or a broader internalizing syndrome is also important.
Background: Individuals with social interaction anxiety, a facet of social anxiety disorder, are heterogeneous with respect to approaching or avoiding risky behaviors, including substance use. Additionally, the relation between social anxiety and cannabis use frequency has been inconsistent in the literature. Objective: The present study aimed to clarify the relation between social interaction anxiety and cannabis use by examining the effects of personality traits known to differentially predict substance use, including sensation seeking, emotion dysregulation, urgency, behavioral approach, and behavioral inhibition. Methods: We explored heterogeneity in social interaction anxiety using finite mixture modeling to discern profiles differing in mean scores on measures of social interaction anxiety and personality. We then examined how profiles differed in their likelihood of cannabis use. Results: The profile with low social interaction anxiety and high scores on personality measures was the most likely to use cannabis at all time periods. Two profiles with high social interaction anxiety scores were discerned. Between these two profiles, the profile with the highest levels of social interaction anxiety and most measured personality traits was more likely to use cannabis across all measured time periods. The profile with the high social interaction anxiety and low scores on personality measures was the least likely to use cannabis. Conclusions: Results of the present study identified personality traits most associated with increased risk of cannabis use for people high and low in social interaction anxiety, including facets of emotion regulation, urgency, and sensation seeking.
Social anxiety (SA) is thought to relate to alcohol misuse. However, current evidence is inconsistent - especially in young adulthood. Recent non-experimental data show that trait impulsivity moderates the effect of SA on alcohol misuse. Specifically, this work suggests that concurrently elevated impulsivity may draw attention to the immediate, anxiolytic effects of drinking - thus promoting alcohol misuse among those high in SA. Otherwise, without elevated impulsivity, a socially anxious person may not drink due to focusing on alcohol's possible negative outcomes (e.g., embarrassing behaviours). The next step in this research is to examine if impulsivity impacts in-the-moment subjective craving among socially anxious individuals. This was the goal of the present experiment. After baseline measures, undergraduate participants (N = 110) completed the Trier Social Stress Test followed by an alcohol (versus neutral) cue exposure. Subjective craving ratings were collected at both baseline and post-cue exposure. Moderation analyses revealed that socially anxious individuals endorsed strong cravings following an alcohol (but not a neutral) cue exposure, but only if they also had elevated impulsivity. In-lab craving was positively correlated with retrospective reports of alcohol misuse. Our findings demonstrate that impulsivity contributes to SA-related risk for alcohol misuse.
Introduction
Extant studies have examined the effect of psychological characteristics on clinical features that define behavior problems. The purpose of this study was to analyze the effects of temperament and character as both individual factors and complex profiles on behavior problems in a community sample of adolescents.
Methods
Behavior problems and personality of 670 Korean high school students were measured with the Youth Self-Report (YSR) and Junior version of the Temperament and Character Inventory (JTCI). Stepwise regression analysis analyzed the effects of JTCI character and temperament traits on YSR Total, Internalizing and Externalizing subscale scores, and Profile Analysis examined differences of JTCI personality profiles among three latent YSR subscale profiles acquired from Latent Profile Analysis.
Results
Seven subscales of the JTCI explained 38% of the YSR total degree of behavior problems, and JTCI Novelty-Seeking and Harm-Avoidance were found to account for vulnerability while JTCI Reward-Dependence and Self-Directedness explained resilience to behavior problems. There were three distinct latent YSR profile groups based on nine YSR subscales, and low behavior problem group showed a resilient personality profile characterized by low Novelty-Seeking and Harm-Avoidance and high Reward-Dependence, Persistence, Self-Directedness and Cooperativeness while high behavior problem group exhibited a vulnerable personality profile of the opposite tendency.
Discussion
Temperament and character explained behavior problems of Korean high school students as both individual personality traits and a complex personality profile. The results and implications of this study were examined in regard to mental health of adolescents, and the importance of education in the development of mature personality are discussed.
Emotion dysregulation has been identified as a transdiagnostic mechanism underlying social phobia and depression; however, there is much to learn about how emotion dysregulation leads to these specific outcomes. Thus, this study examined the relationship pattern between anger dysregulation and depression and how it is mediated by social phobia. Anger dysregulation was examined specifically considering anger as a significant emotional feature of both social phobia and depression. The mediation hypothesis within this study was empirically established. The data was drawn from the Collaborative Psychiatric Epidemiology Surveys (2001–2003), in which 2,827 participants met DSM-IV criteria for lifetime major depressive disorder (14.3%), and 1,905 participants met criteria for DSM-IV lifetime social anxiety disorder (9.6%). Among participants, 4,250 (21.5%) reported that they perceived their anger as out of control and either broke items or hit (or tried to hit) others. The mediation hypothesis was tested with logistic regression models. Anger dysregulation was significantly related to social phobia and depression. A significant indirect effect of social phobia was detected through bootstrap analysis, supporting the partial mediation hypothesis. This study represents the first attempt to examine the mediating role of social phobia in the relationship between anger dysregulation and depression. The findings of this study suggest that anger dysregulation may be a transdiagnostic factor across social phobia and depression.
Early life stress (ELS) increases the risk for later cognitive and emotional dysfunction, and has been implicated in the etiology of multiple psychiatric disorders. We hypothesize that combined insults during gestation and infancy, critical periods of neural development, could exacerbate neuropsychiatric outcomes in later life. Thus, we investigated the effects of maternal deprivation (MD) stress alone or combined with prenatal nicotine exposure (PNE) on negative affective states, ethanol drinking, and development of mesolimbic loci that regulate depression and drug dependence. On the elevated plus maze (EPM), MD rats exhibited ~50% increase in risk-taking behavior/decreased anxiety when compared to control, but the combined MD + PNE did not affect this specific behavior. In the open field test, however, both MD and MD + PNE groups showed 2-fold greater locomotor activity. Furthermore, whereas MD showed greater latency to fall at 40 RPM on the rotarod compared to CTL, the MD + PNE animals' latency to fall was significantly greater at all RPMs tested, with an approximate ~15% enhancement in motor coordination overall compared to control and MD. Analyses of depressive symptomatology with the forced swim test (FST) yielded 2- and 3-fold higher immobility times in MD and MD + PNE respectively. When tested in an operant drinking paradigm to quantify the effect of treatment on 10%v/v ethanol drinking, the MD and MD + PNE groups showed heightened ethanol consumption by ~3- and 2-fold respectively, with the experience of PNE reducing ethanol consumption in adults. To test the stressors' impact on neurons in the amygdala and ventral tegmental area (VTA), mesolimbic anatomical regions associated with mood and reward, unbiased stereological measurements were performed and revealed ~15% increase in number and density of neurons in the amygdala for both MD and MD + PNE, and ~13% reduction in dopaminergic-like neurons in the VTA compared to control. We report here that multiple early stressors including prenatal nicotine and MD can modulate the neuroanatomy of the amygdala and VTA. These early life stressors can interact to influence the development of depressive-like and addictive behaviors.
Objectives
The purpose of this study was to determine whether mood instability in people with anxiety disorders contributes to trait impulsivity, non‐suicidal self‐injury, and binge eating/purging.
Methods
Data were analysed from a general population sample of 7,221 adults (Mage = 51.0 years; 56.9% female). Logistic regression analyses with effect decompositions were used to establish the associations of five anxiety disorders (generalized anxiety disorder, social phobia, panic disorder, agoraphobia, and obsessive–compulsive disorder) with impulsivity, non‐suicidal self‐injury, and binge eating/purging, and then to determine the extent that adding mood instability to each model reduced these relationships.
Results
Participants with an anxiety disorder were more likely to report impulsivity compared to participants without an anxiety disorder (ORs = 2.40–3.92, all p < .001), but these relationships reduced by 59–78% and became non‐significant when mood instability was added to the models. Participants with an anxiety disorder were also more likely to report non‐suicidal self‐injury (ORs = 3.86–18.9, all p < .001) and binge eating/purging (ORs = 4.05–14.9, all p < .01); adding mood instability to the models reduced these relationships by at least 30%.
Conclusions
Mood instability and impulsivity are common in people with anxiety disorders. Anxiety disorders are associated with impulsivity largely because of the association between mood instability and impulsivity. Mood instability may contribute to non‐suicidal self‐injury and binge eating/purging in people with anxiety disorders. Treatments for mood instability in addition to standard anxiety disorder treatment may reduce impulsivity, non‐suicidal self‐injury, and binge eating/purging in people with anxiety disorders.
Practitioner points
• Many patients with anxiety disorders experience mood instability, which is associated with impulsivity, non‐suicidal self‐injury, and binge eating/purging.
• Treating mood instability alongside anxiety may help reduce impulsivity, non‐suicidal self‐injury, and binge eating/purging in people with anxiety disorders.
The validity of the social phobia subtype distinction was examined in a large sample of carefully diagnosed social phobics (N=89). Generalized and specific subtypes were diagnosed reliably, and the generalized subtype showed a consistent pattern of greater symptom severity than dit the specific subtype. In addition, generalized social phobics with and without avoidant personality disorder were compared, and a difference was found for only 1 of 4 parameters. The results are discussed in terms of the validity of subtyping in social phobia and the diagnostic boundary between social phobia and avoidant personality disorder
The authors conducted a meta-analysis of 150 studies in which the risk-taking tendencies of male and female participants were compared. Studies were coded with respect to type of task (e.g., self-reported behaviors vs. observed behaviors), task content (e.g., smoking vs. sex), and 5 age levels. Results showed that the average effects for 14 out of 16 types of risk taking were significantly larger than 0 (indicating greater risk taking in male participants) and that nearly half of the effects were greater than .20. However, certain topics (e.g., intellectual risk taking and physical skills) produced larger gender differences than others (e.g., smoking). In addition, the authors found that (a) there were significant shifts in the size of the gender gap between successive age levels, and (b) the gender gap seems to be growing smaller over time. The discussion focuses on the meaning of the results for theories of risk taking and the need for additional studies to clarify age trends.
• A systematic method for clinical description and classification of both normal and abnormal personality variants is proposed based on a general biosocial theory of personality. Three dimensions of personality are defined in terms of the basic stimulus-response characteristics of novelty seeking, harm avoidance, and reward dependence. The possible underlying genetic and neuroanatomical bases of observed variation in these dimensions are reviewed and considered in relation to adaptive responses to environmental challenge. The functional interaction of these dimensions leads to integrated patterns of differential response to novelty, punishment, and reward. The possible tridimensional combinations of extreme (high or low) variants on these basic stimulusresponse characteristics correspond closely to traditional descriptions of personality disorders. This reconciles dimensional and categorical approaches to personality description. It also implies that the underlying structure of normal adaptive traits is the same as that of maladaptive personality traits, except for schizotypal and paranoid disorders.
The development, reliability, and discriminative ability of a new instrument to assess social phobia are presented. The Social Phobia and Anxiety Inventory (SPAI) is an empirically derived instrument incorporating responses from the cognitive, somatic, and behavioral dimensions of social fear. The SPAI high test–retest reliability and good internal consistency. The instrument appears to be sensitive to the entire continuum of socially anxious concerns and is capable of differentiating social phobics from normal controls as well as from other anxiety patients. The utility of this instrument for improved assessment of social phobia and anxiety and its use as an aid for treatment planning are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A series of interrelated analyses were conducted on 2 samples of college students to examine the reliability and validity of the Tridimensional Personality Questionnaire (TPQ) and to develop and validate a short version of the scale. Factor analyses were conducted and tended to approximate Cloninger's proposed model, Novelty Seeking predicted a range of substance use and abuse measures, and substance use disorders. Harm Avoidance was unrelated to substance use but predicted alcohol problems and dependence phenomena. No support was found for the quadratic and specific interaction effects proposed by Cloninger (1987). The Short-TPQ, a 44-item scale derived through exploratory factor analysis, demonstrated levels of reliability and validity quite comparable to those of the full scale. These results provide moderate support for the reliability and validity of both the TPQ and the Short-TPQ. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The authors conducted a meta-analysis of 150 studies in which the risk-taking tendencies of male and female participants were compared. Studies were coded with respect to type of task (e.g., self-reported behaviors vs. observed behaviors), task content (e.g., smoking vs. sex), and 5 age levels. Results showed that the average effects for 14 out of 16 types of risk taking were significantly larger than 0 (indicating greater risk taking in male participants) and that nearly half of the effects were greater than .20. However, certain topics (e.g., intellectual risk taking and physical skills) produced larger gender differences than others (e.g., smoking). In addition, the authors found that (a) there were significant shifts in the size of the gender gap between successive age levels, and (b) the gender gap seems to be growing smaller over time. The discussion focuses on the meaning of the results for theories of risk taking and the need for additional studies to clarify age trends. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Ninety individuals with social phobia (social anxiety disorder) participated in a randomized controlled trial and completed cognitive-behavioral group therapy, exposure group therapy without explicit cognitive interventions, or a wait-list control condition. Both treatments were superior to the wait-list group in reducing social anxiety but did not differ from one another at postlest. Changes in estimated social cost mediated treatment changes in both treatment conditions from pre- to posttest. However, only participants who received cognitive-behavioral therapy showed continued improvement from postlest to 6-month follow-up, which was associated with a reduction of estimated social cost from pretest to posttest. These results suggest that cognitive intervention leads to better maintenance of treatment gains, which is mediated through changes in estimated social cost.
The validity of the social phobia subtype distinction was examined in a large sample of carefully diagnosed social phobics (N = 89). Generalized and specific subtypes were diagnosed reliably, and the generalized subtype showed a consistent pattern of greater symptom severity than did the specific subtype. In addition, generalized social phobics with and without avoidant personality disorder were compared, and a difference was found for only 1 of 4 parameters. The results are discussed in terms of the validity of subtyping in social phobia and the diagnostic boundary between social phobia and avoidant personality disorder.
The Tridimensional Personality Questionnaire is a self-report personality inventory measuring three major personality dimensions: Novelty Seeking, Harm Avoidance, and Reward Dependence. Normative data, based on a U.S. national probability sample of 1,019 adults, are presented and the psychometric properties of the questionnaire are discussed.
A systematic method for clinical description and classification of both normal and abnormal personality variants is proposed based on a general biosocial theory of personality. Three dimensions of personality are defined in terms of the basic stimulus-response characteristics of novelty seeking, harm avoidance, and reward dependence. The possible underlying genetic and neuroanatomical bases of observed variation in these dimensions are reviewed and considered in relation to adaptive responses to environmental challenge. The functional interaction of these dimensions leads to integrated patterns of differential response to novelty, punishment, and reward. The possible tridimensional combinations of extreme (high or low) variants on these basic stimulus-response characteristics correspond closely to traditional descriptions of personality disorders. This reconciles dimensional and categorical approaches to personality description. It also implies that the underlying structure of normal adaptive traits is the same as that of maladaptive personality traits, except for schizotypal and paranoid disorders.
It has been suggested that social phobia is associated with dysfunction of the noradrenergic and dopaminergic systems, but there are no published anatomic data on the monoaminergic abnormalities found in the brains of phobic patients. The authors studied the density of dopamine reuptake sites in patients with social phobia.
The study included 11 patients with social phobia and 28 healthy comparison subjects, 11 of whom were age- and gender-matched to the patients for the analyses. Measurement of the density of dopamine reuptake sites was performed by using a 123I-labeled cocaine analogue, [123I]beta-CIT, with single photon emission computed tomography (SPECT).
Blind quantitative analysis revealed that striatal dopamine reuptake site densities were markedly lower in the patients with social phobia than in the age- and gender-matched comparison subjects.
The results indicate that social phobia may be associated with a dysfunction of the striatal dopaminergic system.
The present study provides data on the reliability, validity and treatment sensitivity of the Liebowitz Social Anxiety Scale (LSAS), one of the most commonly used clinician-administered scales for the assessment of social phobia.
Three hundred and eighty-two patients from several studies of the treatment of social phobia were evaluated. An independent assessor administered the LSAS to each patient prior to the initiation of treatment. Patients also completed other measures of social anxiety and avoidance, although the specific measures varied across samples.
The LSAS and its subscales were normally distributed and demonstrated excellent internal consistency. The convergent validity of the LSAS was demonstrated via significant correlations with other commonly-used measures of social anxiety and avoidance. These correlations also tended to be larger than correlations with measures of depression, especially after treatment. However, the pattern of correlations of LSAS subscales with one another and with the other measures suggest that the fear subscales and the avoidance subscales may not be sufficiently distinct in clinical samples. The LSAS was also demonstrated to be sensitive to the effects of pharmacological treatments of social phobia over time and in comparison to double-blind pill placebo.
The LSAS appears to be a reliable, valid and treatment sensitive measure of social phobia. Further study of the LSAS, both in samples with severe social phobia and in community samples, is needed.
The authors review evidence that self-control may consume a limited resource. Exerting self-control may consume self-control strength, reducing the amount of strength available for subsequent self-control efforts. Coping with stress, regulating negative affect, and resisting temptations require self-control, and after such self-control efforts, subsequent attempts at self-control are more likely to fail. Continuous self-control efforts, such as vigilance, also degrade over time. These decrements in self-control are probably not due to negative moods or learned helplessness produced by the initial self-control attempt. These decrements appear to be specific to behaviors that involve self-control; behaviors that do not require self-control neither consume nor require self-control strength. It is concluded that the executive component of the self--in particular, inhibition--relies on a limited, consumable resource.
Why do people's impulse controls break down during emotional distress? Some theories propose that distress impairs one's motivation or one's ability to exert self-control, and some postulate self-destructive intentions arising from the moods. Contrary to those theories, Three experiments found that believing that one's bad mood was frozen (unchangeable) eliminated the tendency to eat fattening snacks (Experiment 1), seek immediate gratification (Experiment 2), and engage in frivolous procrastination (Experiment 3). The implication is that when people are upset, they indulge immediate impulses to make themselves feel better, which amounts to giving short-term affect regulation priority over other self-regulatory goals.
Self-presentation may require self-regulation, especially when familiar or dispositional tendencies must be overridden in service of the desired impression. Studies 1-4 showed that self-presentation under challenging conditions or according to counter-normative patterns (presenting oneself modestly to strangers, boastfully to friends, contrary to gender norms, to a skeptical audience, or while being a racial token) led to impaired self-regulation later, suggesting that those self-presentations depleted self-regulatory resources. When self-presentation conformed to familiar, normative, or dispositional patterns, self-regulation was less implicated. Studies 5-8 showed that when resources for self-regulation had been depleted by prior acts of self-control, self-presentation drifted toward less-effective patterns (talking too much, overly or insufficiently intimate disclosures, or egotistical arrogance). Thus, inner processes may serve interpersonal functions, although optimal interpersonal activity exacts a short-term cost.
The authors assess sex differences in the importance of 10 basic values as guiding principles. Findings from 127 samples in 70 countries (N = 77,528) reveal that men attribute consistently more importance than women do to power, stimulation, hedonism, achievement, and self-direction values; the reverse is true for benevolence and universalism values and less consistently for security values. The sexes do not differ on tradition and conformity values. Sex differences are small (median d = .15; maximum d = .32 [power]) and typically explain less variance than age and much less than culture. Culture moderates all sex differences and sample type and measurement instrument have minor influences. The authors discuss compatibility of findings with evolutionary psychology and sex role theory and propose an agenda for future research.
An illusory correlation paradigm was used to compare high and low socially anxious individuals’ initial, on-line and a posteriori covariation estimates between emotional faces and aversive, pleasant and neutral outcomes. Overall, participants demonstrated an initial expectancy bias for aversive outcomes following angry faces, and pleasant outcomes following happy faces. On-line expectancy biases indicated that initial biases were extinguished during the task, with the exception of low socially anxious individuals who continued to over-associate positive social cues with pleasant outcomes. In addition to lacking this protective positive on-line bias, the high social anxiety group reported retrospectively more negative social cues than the low socially anxious group. Findings are discussed in relation to similar evidence from recent interpretive and memory paradigms.
The reliability of current and lifetime Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) anxiety and mood disorders was examined in 362 outpatients who underwent 2 independent administrations of the Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV-L). Good to excellent reliability was obtained for the majority of DSM-IV categories, For many disorders, a common source of unreliability was disagreements on whether constituent symptoms were sufficient in number, severity, or duration to meet DSM-IV diagnostic criteria. These analyses also highlighted potential boundary problems for some disorders (e.g., generalized anxiety disorder and major depressive disorder), Analyses of ADIS-IV-L clinical ratings (0-8 scales) indicated favorable interrater agreement for the dimensional features of DSM-IV anxiety and mood disorders. The findings are discussed in regard to their implications for the classification of emotional disorders.
Although social phobia is defined as severe anxiety in social situations, little is known about the range or prevalence of social situations that elicit anxiety in social phobic individuals. The present study developed the concept of situational domains, groups of similar situations that may provoke anxiety in subsets of social anxious persons. Four conceptually derived situational domains were examined: formal speaking/interaction, informal speaking/interaction, observation by others, and assertion. Ninety-one social phobic patients were classified as anxiety-positive or anxiety-negative within each situational domain, varying inclusion criteria of anxiety experienced in each situation and the number of anxiety-producing situations within a domain. Patients were highly likely to be classified to the formal speaking/interaction domain, regardless of inclusion criteria employed or presence of anxiety within other domains. Support was also found for previous findings that most social phobics experience anxiety in more than one social situation, even under conservative classification criteria. Implications for the current diagnostic nosology and directions for future research are discussed.
It is argued that P-values and the tests based upon them give unsatisfactory results, especially in large samples. It is shown that, in regression, when there are many candidate independent variables, standard variable selection procedures can give very misleading results. Also, by selecting a single model, they ignore model uncertainty and so underestimate the uncertainty about quantities of interest. The Bayesian approach to hypothesis testing, model selection, and accounting for model uncertainty is presented. Implementing this is straightforward through the use of the simple and accurate BIC approximation, and it can be done using the output from standard software. Specific results are presented for most of the types of model commonly used in sociology. It is shown that this approach overcomes the difficulties with P-values and standard model selection procedures based on them. It also allows easy comparison of nonnested models, and permits the quantification of the evidence for a null hypothesis of interest, such as a convergence theory or a hypothesis about societal norms.
List of figures List of tables Preface Acknowledgements 1. Introduction 2. The Dunedin Multidisciplinary Health and Development Study 3. Sex differences in the amount of antisocial behaviour: dimensional measures 4. Sex differences in the prevalence of antisocial behaviour: categorical diagnostic measures 5. Sex differences in physical violence and sex similarities in partner abuse 6. Sex and the developmental stability of antisocial behaviour 7. Sex and the age of onset of delinquency and conduct disorder 8. Sex effects in risk predictors for antisocial behaviour: are males more vulnerable than females to risk factors for antisocial behaviour? 9. Sex effects in risk predictors for antisocial behaviour: are males exposed to more risk factors for antisocial behaviour? 10. Can sex differences in personality traits help to explain sex differences in antisocial behaviour? 11. Sex and comorbidity: are there sex differences in the co-occurrence of conduct disorder and other disorders? 12. Do girls who develop antisocial behaviour surmount a higher threshold of risk than their male counterparts? 13. Sex differences in the effects of antisocial behaviour on young adult outcomes 14. Sex, antisocial behaviour and mating: mate selection and early childbearing 15. Evaluating the recommendation to relax the criteria for diagnosing conduct disorder in girls 16. Life-course persistent and adolescence-limited antisocial behaviour among males and females 17. Priorities for a research agenda References Index.
Objective:
This study compared dopamine D(2) receptor binding potential in patients with social phobia and healthy comparison subjects.
Method:
Dopamine D(2) receptor binding potential was assessed in 10 unmedicated subjects with generalized social phobia and no significant lifetime psychiatric comorbidity and 10 healthy comparison subjects matched for age and sex. Binding potential was measured in the striatum by using single photon emission computerized tomography and constant infusion of the D(2) receptor radiotracer [(123)I]iodobenzamide ([(123)I]IBZM).
Results:
Mean D(2) receptor binding potential was significantly lower in the subjects with social phobia than in the comparison subjects. Within the social phobia group, there was a nonsignificant correlation of binding potential with the Liebowitz Social Anxiety Scale score.
Conclusions:
Generalized social phobia may be associated with low binding of [(123)I]IBZM to D(2) receptors in the striatum.
Public speaking is the most commonly reported fearful social situation. Although a number of contemporary theories emphasize the importance of cognitive processes in social anxiety, there is no instrument available to assess fearful thoughts experienced during public speaking. The Self-Statements During Public Speaking (SSPS) scale is a 10-item questionnaire consisting of two 5-item subscales, the Positive Self-Statements (SSPS-P) and the Negative Self-Statements subscale (SSPS-N). Four studies report on the development and the preliminary psychometric properties of this instrument.
The Social Phobia and Anxiety Inventory (SPAI) is an empirically derived self-report inventory developed as a specific measure of social phobia. The current investigation included two studies. The first examined the correlation of the SPAI with daily social behavior of a clinic sample of social phobics. The results indicated that the SPAI provides a reasonable indication of the distress experienced during daily social encounters in three dimensions: behavior, cognitions, and overall distress. The second study examined the validity of the SPAI with reference to the somatic response and avoidance behavior of social phobics. The results indicated that the somatic items of the SPAI are related to the somatic response of social phobics and that performance on the SPAI is associated with avoidance behavior in an anxiety-producing task.
A number of changes will occur in the criteria for diagnosis of anxiety disorders with the publication of DSM-IV. For social phobia, a central issue has been the specification and definition of subtypes. DSM-III-R specified a generalized subtype, but the DSM-IV subworkgroup on social phobia considered additional subtyping strategies, and struggled with issues of number and definition. This paper reviews the literature on subtyping in clinical samples of individuals with social phobia, and considers issues such as demographic differences, clinical features, and treatment response. The issue of overlap between generalized social phobia and avoidant personality disorder is considered. An analysis of the subtype issue from a situationist perspective is also presented. Options for subtyping that were considered for DSM-IV are presented, and issues that require further research on subtypes of social phobia are discussed.
Cloninger (1986, 1987) has recently proposed a theory purporting that personality is made up of three dimensions termed Novelty Seeking, Harm Avoidance, and Reward Dependence. The Tridimensional Personality Questionnaire (TPQ) is a self-report inventory designed to assess these three dimensions. The present study tested the construct validity of the dimensions of the TPQ by assessing their relationships with a series of established personality questionnaires in a sample of 807 university students. Correlational and principal-component analyses indicated that the Novelty Seeking and Harm Avoidance scales possess a good degree of construct validity, however, findings regarding the Reward Dependence scale were inconclusive. Although the Reward Dependence scale may require revision, the TPQ demonstrates promising applicability for both research and clinical purposes.
Twenty-four social phobic individuals and 22 nonphobic controls participated in an interview and questionnaire study. By applying the same criterion that was used in a previous study, both phobics and controls were retrospectively subdivided into groups with or without generalized social fear, yielding four groups: nongeneralized phobics (n = 9), generalized phobics (n = 15), nongeneralized controls (n = 10), and generalized controls (n = 12). The four groups differed in the severity ratings of their social anxiety. Generalized controls scored as high as nongeneralized phobics. These two groups showed lower scores than generalized phobics and higher scores than nongeneralized controls. A comparison with scores reported in other studies indicated that the nongeneralized controls can be characterized as “supernormal,” and generalized controls as “subclinical.” The results illustrate problems related to the use of control groups in social phobia research.
The goal of the present study was to determine whether the investigation of interpersonal problems in social phobia would lead to qualitatively different subgroups, subgroups that would provide additional nonoverlapping information to the Mental Disorders-IV (DSM-IV) classification. 30 generalized socially phobic (college students, aged 18-29 yrs old), 30 nongeneralized socially phobic, and 30 nondisordered control participants were selected based on dual structured interviews. All participants completed the Inventory of Interpersonal Problems Circumplex Scales (IIP-C). Results showed that when social phobia subtypes were classified using the DSM-IV definition, the IIP-C reflected subgroup differences in global severity of interpersonal problems, with the generalized social phobia group evidencing the greatest difficulty. However, the subgroups could not be discriminated on core or central interpersonal problems. In contrast, when an interpersonal analysis of subtype classification was employed, 2 groups were formed, each with discriminating core unifying features suggesting qualitatively different problematic reactions to interpersonal situations. The potential clinical relevance of an assessment of interpersonal dysfunction to the treatment of social phobia is discussed.
The current paper presents a model of the experience of anxiety in social/evaluative situations in people with social phobia. The model describes the manner in which people with social phobia perceive and process information related to potential evaluation and the way in which these processes differ between people high and low in social anxiety. It is argued that distortions and biases in the processing of social/evaluative information lead to heightened anxiety in social situations and, in turn, help to maintain social phobia. Potential etiological factors as well as treatment implications are also discussed.