Social anxiety disorder (SAD) is the most common anxiety disorder with a lifetime prevalence of 12%. In comparison to other anxiety disorders, young people with a principle diagnosis of SAD have less favourable treatment outcomes and many continue to show clinically significant symptoms following treatment. In adults, there is a strong evidence base for cognitive behavioural models of SAD, and strategies which optimise treatment outcomes have been identified. However, there is little evidence of the applicability of adult SAD models to children and young people. The symposium will cover several potential mechanisms for young people with SAD, and any subsequent insights for treatment. This symposium brings together researchers from different European universities who will highlight new research on SAD in young people. We will consider the association between pre- and post-event social performance appraisals and SAD in pre-adolescent children. We will also discuss how positive peer feedback can influence self-perceptions of socially anxious individuals in a positive direction. In addition, we will explore the relationship between social anxiety and performance anxiety in youth by examining heart rate during a public speaking task. Finally, we will present findings from an experimental study on how to optimise exposure for young people with performance anxiety.
Brynjar Halldorsson. 1*, Anne Miers. 2*, Esther van den Bos. 3*, Hannah Rogers. 4*.
1. Anxiety and Depression in Young People Research Unit (AnDY) School of Psychology and Clinical Language Sciences, University of Reading, UK.
2. Developmental and Educational Psychology Unit, Department of Psychology Leiden University, Netherlands.
3. Developmental and Educational Psychology Unit, Department of Psychology Leiden University, Netherlands.
4. Anxiety and Depression in Young People Research Unit (AnDY) School of Psychology and Clinical Language Sciences University of Reading, UK.
Symposium Presenters :
- Dr Brynjar Halldorsson, Anxiety and Depression in Young People Research Unit (AnDY) School of Psychology and Clinical Language Sciences, University of Reading, UK
Title of talk: Anticipatory and post-event processing in childhood social anxiety disorder: Is it different to adult social anxiety?
The cognitive theory of social anxiety disorder (SAD) suggests that adults with SAD have a tendency to anticipate poor social performance and reflect negatively on their performance following a social event. While a number of studies with socially anxious adults have supported the role of poor performance anticipation and post-event rumination in SAD, to date, only a few studies have addressed whether this also applies to children with SAD. In this study, we exposed children diagnosed with SAD (n=40), other anxious children (n=40) and non-anxious children (n=34) to a social stressor speech task and assessed their pre- and post-performance appraisals, taking into account objective performance ratings. Although observers rated some aspects of performance as significantly worse among children with SAD than children with other anxiety disorders, children with SAD were not more likely than their anxious or non-anxious peers to show a general bias in their pre- or post-performance appraisals. Furthermore, children with SAD were just as likely as their anxious and non-anxious peers to recognize good performance but were more critical of themselves when their performance was poor. Findings are discussed in relation to current cognitive and developmental models of SAD, as well as treatment implications.
- Dr Anne Miers, Developmental and Educational Psychology Unit, Department of Psychology, Leiden University, Netherlands
Title of talk: The influence of positive peer feedback on cognitions after a speech task: A pilot study
Research indicates that youth with high levels of social anxiety are caught in a vicious cycle of their own negative social perceptions and negative responses from their age peers. Breaking this vicious cycle by using peers to modify the negative social perceptions may be crucial to preventing the worsening of social anxiety. This pilot study investigated whether positive peer feedback can influence self-perceptions of socially anxious individuals in a positive direction. Sixty undergraduate students gave an impromptu speech and received either neutral or positive feedback post-speech. The participants rated their expected performance prior to the speech. One week later participants returned to the laboratory and completed questionnaires about their ruminative thoughts related to the impromptu speech and expected performance for a future speech. High socially anxious participants who received positive feedback reported a higher frequency of positive ruminative thoughts about their speech in the week between the two sessions compared to high socially anxious participants receiving neutral feedback. Findings also showed that speech performance expectations increased between the two sessions in high socially anxious students receiving positive but not neutral feedback. These findings suggest that, in high socially anxious students, positive peer feedback can modify self-perceptions in a positive direction.
- Dr Esther van den Bos, Developmental and Educational Psychology Unit, Department of Psychology, Leiden University, Netherlands
Title of talk: Social anxiety and performance anxiety in youth: Different relations with heart rate
Although performance anxiety (e.g. public speaking anxiety) is recognized as a specific form of social anxiety in DSM-5, the relevance of this distinction in youth is under debate. The present study investigated how social anxiety and performance anxiety are related to heart rate (HR) during a public speaking task. A community sample of 327 children and adolescents, aged 8-17 years, gave a 5-minute speech in front of a prerecorded audience. Heart rate was measured continuously. Twelve epochs of 30 seconds were selected for analysis: end of the preparation phase, entrance of the audience on screen and ten segments during the speech. Social anxiety and public speaking anxiety were measured by self-report questionnaires. Data were analyzed with regression analysis with clustered bootstrap. HR was higher during the speech than before. After peaking in minute 1, it stabilized at a lower level in minutes 2 to 4 and decreased further in minute 5. Public speaking anxiety was associated with higher HR in the minute before the speech and a smaller decrease in minute 2. Social anxiety was unrelated to HR. These differential associations with HR in a public speaking task support the distinction between social anxiety and performance anxiety in youth.
- Hannah Rogers, Anxiety and Depression in Young People Research Unit (AnDY) School of Psychology and Clinical Language Sciences, University of Reading, UK
Title of talk: Affect labelling enhances exposure for adolescents who fear public speaking
Exposure-based treatments are highly effective for treating anxiety disorders, yet approximately 40-50% of young people do not benefit. Research with adults has identified strategies to optimise learning during exposure. However, most of these strategies have not been considered in young people. This study investigated whether affect labelling enhances exposure (impromptu speeches in front of a pre-recorded audience) effectiveness in adolescents who fear public speaking. Eighty-one adolescents were randomised to either 1) exposure with affect labelling (EXP+AL), 2) exposure with positive coping statements (EXP+PC) or 3) exposure with neutral statements (EXP+NS). Self-reported anxiety and heart rate were assessed before and after three assessment timepoints and compared between groups. Whilst adolescents in the EXP+PC condition reported a greater reduction in self-reported anxiety at immediate post-test, at 1-week follow-up the adolescents in the EXP-PC condition reported significantly higher fear compared to EXP+AL and EXP+NS. No significant effects were found for heart rate. The findings suggest that, compared to more traditional exposure-based treatment approaches, behavioural strategies thought to optimise inhibitory learning (e.g. affect labelling) can enhance treatment effectiveness for adolescents who fear public speaking.