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Social anxiety disorder (SAD) is a high-prevalence mental disorder among children and adolescents. The aim of this study is to compare and rank the effectiveness of several psychotherapies for SAD among children and adolescents. Only randomized controlled trials (RCTs) were utilized by searching PubMed, Embase, Cochrane Library, and Web of Science. We used network meta-analysis in the Bayesian framework to analyze the data. This study is registered with PROSPERO, number CRD42023476829. In total, 30 RCTs with 1547 individuals were included, and nine psychotherapies with three control conditions were compared and ranked in this study. The findings revealed that internet-delivered cognitive behavioural therapy (surface under the cumulative ranking curve [SUCRA: 71.2 %]), group cognitive behavioural therapy (SUCRA: 68.4 %), and individual cognitive behavioural therapy (SUCRA: 66.0 %) significantly reduced social anxiety symptoms; internet-delivered cognitive behavioural therapy also significantly decreased depression symptoms in these patients (SUCRA: 92.2 %). In addition, group cognitive behavioural therapy can enhance functioning in these patients (SUCRA: 89.6 %). These results suggest that internet-delivered cognitive behavioural therapy is the optimal type of psychotherapy for reducing social anxiety and depression symptoms in children and adolescents with SAD, internet-delivered parent-child interaction therapy and cognitive bias modification of interpretation have relatively poor treatment effects on social anxiety symptoms in children than other psychological interventions, and group cognitive behavioural therapy has better benefits in enhancing the functioning among children and adolescents with SAD. Further studies are needed to ascertain these results due to the limited number of included studies. • Network meta-analysis examines interventions for social anxiety disorder. • Internet-delivered CBT is an optimal psychotherapy for social anxiety disorder. • Group CBT has better benefits in enhancing the functioning. • Findings can provide recommendations for health care professionals and patients. [ABSTRACT FROM AUTHOR]

Background: Social anxiety disorder imposes impacts of functional disability, poor educational achievement, loss of work productivity, social impairment, greater financial dependency, and impairment in quality of life. Therefore, the aim of this study was to assess the prevalence and identify determinants of social anxiety disorder among people living with HIV/AIDS. Methods: A cross-sectional study was conducted from 1 to 30 May 2022 among 354 people living with HIV using a simple random sampling technique. The Social Phobia Inventory (SPIN) Scale was used to assess the presence of social anxiety disorder. Data were gathered using chart review tools and a structured questionnaire, which was administered by a pretested face-to-face interviewer. SPSS version 25 was used to analyse the data once they were imported into EpiData Manager version 4.6. Binary and multivariable logistic regressions were performed. After calculating odds ratios with a 95% confidence interval (CI), statistical significance was established at p < 0.05. Results: A total of 336 respondents participated in the study, resulting in a response rate of 94.91%. The magnitude of social anxiety disorder was 32.44% (95% CI: 27.4, 37.2). Being female [adjusted odds ratio (AOR) = 3.55, 95% CI: 1.61, 7.84], having a stage III/IV HIV/AIDS status (AOR = 3.17, 95% CI: 1.10, 9.13), being alcohol dependent (AOR = 2.81, 95% CI: 1.45, 5.44), and having perceived stigma (AOR = 5.62, 95% CI: 2.95, 10.72) were predictors of social anxiety disorder. Conclusion: In this study, approximately one-third of people living with HIV/AIDS had social anxiety disorder. Being female, having a stage III/IV HIV/AIDS status, being alcohol dependent, and having perceived stigma were predictors of social anxiety disorder. Therefore, training for health care providers on the screening, counselling, and management of social anxiety disorder is important. [ABSTRACT FROM AUTHOR]

Objective: Research on the experience of performance anxiety (PA) in musicians is often explored through the use of the term music performance anxiety (MPA). Current diagnostic classifications include PA as a specifier for social anxiety disorder (SAD). This inclusion aims to acknowledge a distinct group of individuals who demonstrate the same cluster of symptoms as SAD but in a performance specific context. This present review aims to examine and sythesise these distinct literatures from a cognitive-behavioural perspective. Method: Relevant literature from the cognitive-behavioural perspective of SAD and MPA were identified, compared, and critically reviewed. Results: Despite a continued focus in the field of clinical psychology on developing diagnostic tools, disorder-specific models, and gold standard treatments for SAD, these advancements are not widely employed when understanding and managing debilitating PA in musicians. This review considers that research investigating debilitating PA in musicians could be examined as a context-specific form of SAD, informed by well-established cognitive-behavioural models and assessment tools, which can aid the development of standardised treatment protocols. Conclusions: Cognitive-behavioural models of SAD could aid in our understanding of PA in musicians, especially when considering treatment targets. Limitations for the model's application are also discussed, recognising the complex nature and research already conducted on MPA. Key Points: What do we already know about this topic: The experience of performance anxiety (PA) in musicians is often referred to using the term music performance anxiety (MPA). Research on social anxiety disorder (SAD) continues to evolve, with the development of cognitive-behavioural models that aid in treatment and conceptualisation. A performance-only specifier has been included in the DSM-5-TR as a specifier for SAD, whilst the term MPA continues to be used when exploring the experience of PA in musicians. What does this topic add: Established cognitive-behavioural models could support our understanding of the development and maintance of PA in musicians. Key models for MPA incorporate components of available cognitive models of SAD, demonstrating shared constructs which may aid in the development of context-specific cognitive-behavioural interventions. Given the development of a performance-only specifier for SAD in DSM-5-TR, the term performance anxiety (PA) may offer a simpler term to characterise the experience of debilitating anxiety surrounding the fear of evaluation despite available skills. Future research is needed support the integration of PA research across fields (i.e. sport, public speaking). This will not negate the complexities of individual performers experiences, rather provide clarity on the shared fear of negative evaluation underlying experienced PA. [ABSTRACT FROM AUTHOR]

Public speaking is one of the most commonly feared situations reported in both community and university samples. Despite extensive theoretical models and empirical studies aimed at delineating the underlying factors of Public Speaking Anxiety (PSA), the specific variables contributing to its onset remain incompletely characterised. The research involved 297 participants from an AmazonTurk survey, engaging with virtual public speaking scenarios differentiated by audience size, engagement levels, and room spatial dimensions. Participants' anticipated anxiety levels were quantitatively assessed across these scenarios, enabling a comprehensive exploration of the interaction between situational variables and PSA, thereby providing a framework to explore the influence of audience size, engagement, and spatial dimensions on PSA. The mixed-effect model revealed a significant interaction among audience size, audience engagement, and room spatial dimensions. Further analyses using principal axis factoring and multiple regression identified three main factors: F1 (Engagement in a Large Audience), F2 (Confinement or Evaluation Anxiety), and F3 (Audience Disengagement). These factors significantly predict PSA scores. This study reveals that PSA is influenced by a complex interplay of audience size, room dimensions, and audience engagement. The finding underscores the viable way to incorporate these situational variables in both empirical investigations and therapeutic interventions. Specifically, it introduces a novel framework for standardising audience size relative to room capacity. • Investigated factors influencing Public Speaking Anxiety (PSA) in virtual scenarios • Mixed-effect model shows interaction of audience size, room dimensions, and engagement. • Identified three key factors: Large Audience Engagement, Evaluation Anxiety, and Audience Disengagement • Factors significantly predict PSA scores in diverse public speaking situations. • Introduced a new framework for standardising audience size relative to room capacity [ABSTRACT FROM AUTHOR]

Social Anxiety Disorder (SAD) is a highly heterogeneous disorder. To enlighten its heterogeneity, this study focused on recalled parental behavior and aimed to empirically identify if there are subgroups of SAD based on recalled parental behavior by means of cluster analysis. Further, the study investigated whether those subgroups differed on clinical, trauma, and personality variables. This study included 505 individuals diagnosed with SAD and 98 adult controls who were asked to fill out the Parental Bonding Instrument (PBI), the Adverse Childhood Experiences Questionnaire (ACE), and the Temperament and Character Inventory (TCI). Cluster analysis determined whether there are meaningful SAD subgroups based on PBI. The clusters obtained were compared with each other and with the control group with regard to clinical, ACE, and TCI variables. The cluster analysis revealed two SAD clusters based on recalled parental behavior. SAD individuals in the first cluster (49.3 %) perceived their parents as intermediately caring, but not as overcontrolling. SAD individuals in the second cluster (50.7 %) perceived their parents as less caring and overcontrolling, reported more severe clinical symptoms and trauma, and had lower values in Self-Directedness and Cooperativeness. The present study is cross-sectional, therefore unable to confirm causal interpretations. Parenting is meaningful to enlighten the heterogeneity of SAD symptomatology and to specify treatment approaches as there are two meaningful subgroups in individuals with SAD corresponding to differences in clinical presentation, trauma, and personality. • Parental behavior is of great relevance for SAD and can uncover its heterogeneity. • Based on recalled parental behavior cluster analysis can identify two subgroups of SAD. • Subgroups account for 50.7 % and 49.3 % of 505 individuals with SAD. • Less care and overcontrol characterize the clinically more severe subgroup. • Subgroups differ significantly in character dimensions according to the TCI. [ABSTRACT FROM AUTHOR]

Studies comparing the brain functions of major depressive disorder (MDD) and social anxiety disorder (SAD) at the regional and network levels remain scarce. This study aimed to elucidate their pathogenesis using neuroimaging techniques and explore biomarkers that can differentiate these disorders. Resting-state fMRI data were collected from 48 patients with MDD, 41 patients with SAD, and 82 healthy controls. Differences in the amplitude of low-frequency fluctuations (ALFF) among the three groups were examined to identify regions showing abnormal regional spontaneous activity. A seed-based functional connectivity (FC) analysis was conducted using ALFF results as seeds and different connections were identified between regions showing abnormal local spontaneous activity and other regions. The correlation between abnormal brain function and clinical symptoms was analyzed. Patients with MDD and SAD exhibited similar abnormal ALFF and FC in several brain regions; notably, FC between the right superior frontal gyrus (SFG) and the right posterior supramarginal gyrus (pSMG) in patients with SAD was negatively correlated with depressive symptoms. Furthermore, patients with MDD showed higher ALFF in the right SFG than HCs and those with SAD. Potential effects of medications, comorbidities, and data type could not be ignored. MDD and SAD showed common and distinct aberrant brain function patterns at the regional and network levels. At the regional level, we found that the ALFF in the right SFG was different between patients with MDD and those with SAD. At the network level, we did not find any differences between these disorders. [Display omitted] • Local brain activity and its connectivity during rest were compared in MDD and SAD. • MDD and SAD showed similar ALFF and rsFC in several brain regions. • In the right superior frontal gyrus, MDD had increased ALFF than SAD. • Different ALFF and rsFC were significantly correlated with clinical data. [ABSTRACT FROM AUTHOR]

Social anxiety disorder is a prevalent mental health condition that significantly impairs social interactions, academic performance, and professional functioning in children, adolescents, and youth. This study aimed to investigate the global prevalence of social anxiety disorder across these developmental stages. Six electronic databases (PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar) were systematically searched for studies related to the prevalence of social anxiety disorder in children, adolescents and youth. Random-effects models were employed for data analysis and Comprehensive Meta-Analysis Version 2.0. Heterogeneity was assessed using the I2 index. A total of 38 studies were included in the final analysis. The global prevalence of social anxiety disorder was estimated to be 4.7% in children, 8.3% in adolescents, and 17% in youth. These findings suggest a progressive increase in the prevalence of SAD across these developmental stages. Considering the prevalence of social anxiety disorder in this study, policymakers can use the findings of this study to inform and develop effective prevention strategies for individuals and communities most susceptible to this disorder. [ABSTRACT FROM AUTHOR]

The present study focused on the emotional experience of anger among individuals with and without social anxiety disorder (SAD). Eighty-eight participants took part in the study, half (n = 44) met diagnostic criteria for SAD and half (n = 44) did not meet criteria for SAD. Participants completed a 21-day experience sampling measurement (ESM) in which they reported on daily social interactions and emotions. Using multilevel linear modeling we found that individuals with SAD experienced more anger compared to individuals without SAD. We also found a Diagnosis × Social Context interaction such that interactions with distant others were associated with elevated anger compared to interactions with close others for individuals with SAD but not for individuals without SAD. Finally, we found that for individuals with SAD (but not those without SAD) anger on a given day (day t) was associated with elevated anxiety on the following day (day t + 1), above and beyond previous anxiety, sadness and guilt (i.e. anxiety, sadness and guilt reported on day t). This suggests that anger may play a unique role in maintaining or exacerbating anxiety among individuals with SAD. Additional implications of our findings for models of psychopathology and for treatment of SAD are discussed. [ABSTRACT FROM AUTHOR]

The Mini Social Phobia Inventory (Mini-SPIN) is a short 3-item measure of social anxiety disorder (SAD). Using existing data, the current study examined the psychometric properties of the Mini-SPIN using a large, treatment seeking sample of children aged 6–16 years with data available for youth (n = 695, 170) and their caregivers (n = 703, 177) at pre-treatment and follow-up, respectively. The ability of the Mini-SPIN to discriminate between those with and without SAD was examined at pre-treatment and 6-month follow-up, across caregiver and child report. The criterion group validity, internal consistency and construct validity of the measure was also examined. Results revealed that at pre-treatment the Mini-SPIN demonstrated good discriminant validity in detecting cases of SAD from non-SAD (with cut-off of 4 on child report, and 6 on caregiver report). At 6-month follow-up, the discriminant ability of the Mini-SPIN was found to be less than acceptable for child reported scores, but acceptable for caregiver reported scores. The Mini-SPIN further demonstrated good criterion group validity, internal consistency and construct validity across caregiver and child report. Overall, the findings from the current study lend further support for the use of the Mini-SPIN as a screening tool for SAD. [ABSTRACT FROM AUTHOR]

Introduction: While abnormal responses to threat, including overgeneralization to conditioned fear, have been postulated to play a critical role in pathological anxiety, the relevance of previous findings to social anxiety disorder (SAD) is unclear. We investigated conditioned and generalized fear responses in patients with SAD using socially relevant stimuli. Methods: A total of 26 patients with SAD and 25 healthy controls participated in a fear conditioning and generalization paradigm consisting of two neutral faces as conditioned stimuli (CS+ or CS-) and an angry face with contemptuous comments as unconditioned stimuli. Eight morphed faces of two conditioned stimuli in each continuum were given to test generalization. Behavioral data and physiological responses were acquired. Results: Successful conditioning was observed in the risk ratings for both groups, while only a marginal indication of conditioning was noted in physiological measures. During the generalization phase, patients rated the risk higher than CS-when the stimuli close to CS- contained a portion of CS+ features. Larger skin conductance responses to this stimulus were linked to higher fear of negative evaluation. In addition, patients spent a longer time evaluating safe and ambiguous stimuli than healthy controls and exhibited consistently high levels of subjective arousal. Discussion: Taken together, our findings suggest that SAD patients may exhibit a tendency towards overgeneralization of fear responses and show distinct patterns in processing generalized threat stimuli compared to healthy controls. Even though overgeneralization was not evident in physiological measures, it is necessary to consider this behavioral characteristic in the clinical management of patients with SAD. [ABSTRACT FROM AUTHOR]

Psychological treatments for social anxiety disorder (SAD) in adolescents have shown poorer outcomes than for other anxiety disorders. A relevant factor to consider for improving outcomes may be negative imagery. In this pilot study, we examined negative 'flashforward' imagery of feared catastrophic outcomes in adolescents with SAD and evaluated the feasibility and preliminary outcomes of a short eye movement desensitization and reprocessing (EMDR) intervention targeting this imagery. We used a case series design with a 1‐week baseline period. Outcomes included symptoms of social anxiety and avoidance related to selected social situations and features of associated flashforward imagery as the proposed mechanism of change during the intervention. We found that six out of seven assessed adolescents reported to experience flashforwards and rated image distress, vividness and threat appraisal as high. In these six participants (aged 14–17 years old), the short EMDR flashforward intervention appeared feasible and was followed by a decrease in social anxiety and avoidance in five participants, while no notable changes were observed during the baseline period. Furthermore, we observed a decrease in flashforward imagery features in at least five participants. Nonparametric tests of the overall (group‐based) changes during the intervention period partially supported these findings. Limitations include the small sample size and the lack of a control group. Results suggest that vivid and distressing flashforward imagery is a common experience and that targeting flashforwards with EMDR may be beneficial in treating social anxiety in youth. Further experimental research on effects and added value to current treatments is necessary. Trial Registration: Dutch Clinical Trial Register (National Trial Register [NTR]): NL8974 [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) commonly cooccurs with social anxiety disorder (SAD). With changes to diagnostic criteria of psychiatric disorders in the DSM-5, the present study sought to observe the associations between daily alcohol use, AUD, and social anxiety in a large sample of individuals with lifetime (N = 1255) and past-year (N = 908) SAD. The sample was derived from a large nationally representative study of adults in the United States. Of note, we found that at the symptom level, daily alcohol use and AUD were significantly related to panic attacks due to social anxiety, subjective distress, and impairment in relationships. Daily alcohol use and AUD were significantly associated with lifetime SAD severity; however, only past-year daily alcohol use was significantly related to past-year SAD severity. We also found that AUD was significantly related to greater treatment-seeking for SAD, and both AUD and daily alcohol use were significantly associated with lifetime history of suicide attempts even after covarying for SAD severity. The present study provides an updated investigation of alcohol use in individuals with DSM-5 SAD, and it underscores the significance of daily alcohol use as an important factor to consider in individuals with SAD. • Social anxiety is highly comorbid with alcohol use; further investigation using DSM-5 criteria is necessary. • We examined AUD and daily alcohol use in lifetime and past-year samples of individuals with SAD. • Daily alcohol use and AUD were significantly associated with lifetime SAD severity. • Only daily alcohol use was associated with past-year SAD. • AUD was related to greater odds of treatment seeking and suicide attempt history. [ABSTRACT FROM AUTHOR]

Background and aims: Due to its nature, social anxiety can disturb the social adjustment of adolescents. The purpose of this study was to compare the effectiveness of cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) on the social adjustment of adolescents with social anxiety disorder. Methods: This research employed a quasi-experimental design with a pre-/post- test format alongside a control group. The statistical population consisted of male students diagnosed with social anxiety disorder in the second year of high school within the first district of Babol city during the 1401-1402 academic year. A total of 45 participants were selected from this population using purposeful sampling, ensuring they met the study's inclusion criteria. These participants were randomly assigned to three groups: 15 in the CBT group, 15 in the ACT group, and 15 in the control group. Data were collected using social adjustment questionnaire, and the analysis of covariance (ANCOVA) was utilized for data analysis. Results: The findings indicated that both CBT and ACT significantly improved social adjustment in adolescents with social anxiety disorder (p<0.001), with no significant difference in effectiveness between the two treatments. Conclusion: CBT and ACT, both can be recommended for enhancing social adjustment among adolescents with social anxiety disorder. [ABSTRACT FROM AUTHOR]

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The temperamental trait behavioral inhibition (BI) is related to the development and maintenance of anxiety, particularly much so to social anxiety disorder. We investigated if BI and social anxiety disorder predicted cognitive behavioral therapy (CBT) outcomes for youth anxiety. Youth (N = 179; Mage = 11.6 years) were assessed 4 years following a randomized controlled CBT effectiveness trial. BI was measured by the parent-reported Behavioral Inhibition Questionnaire at baseline. The outcomes were diagnostic recovery, youth- and parent-reported anxiety symptoms, and clinical severity at post-treatment, 1-year, and 4-year follow-up. Having social anxiety disorder negatively predicted diagnostic recovery and predicted higher clinical severity at all assessment points and was the only significant predictor of outcomes at 4-year follow-up. Higher BI negatively predicted diagnostic recovery and predicted higher clinical severity and parent-reported symptom levels at post-treatment and 1-year follow-up, and predicted higher youth-reported anxiety levels at 1-year follow-up. Higher BI was the only predictor of youth- and parent-reported anxiety symptoms. BI and social anxiety disorder seem to be unique predictors of CBT outcomes among youth with anxiety disorders. CBT adaptations may be indicated for youth with high BI and social anxiety disorder. [ABSTRACT FROM AUTHOR]

Social anxiety disorder (SAD), a highly prevalent and impairing psychological condition in adolescents, is characterized by persistent fear of social and performance situations. Existing evidence suggests that racism and discrimination may heighten risk for SAD and present barriers to treatment in Black youth. Yet, intervention research on SAD in Black adolescents is virtually nonexistent. This paper discusses the development of the first culturally responsive, school-based intervention for SAD in Black adolescents, referred to as Interacting and Changing our Narratives (ICON). Following recommendations by Castro et al. (Ann Rev Clin Psychol 6(1):213–239, 2010), a multiple stage process was used to adapt an empirically based, school intervention for SAD to be culturally responsive to the unique lived experiences of Black teenagers. Utilizing a university-community-school partnership, key stakeholders, including content area experts, school personnel, caregivers and students, were invited to participate in this process. Their recommendations guided the modifications, and were clearly reflected in the newly developed intervention. Initial piloting showed high acceptability and feasibility of ICON, and informed further revisions prior to a controlled trial. This adaptation process highlights the significant value of learning directly from the community for which an intervention is being developed. [ABSTRACT FROM AUTHOR]

Background: A common symptom of SAD is significant impairment in interpersonal relationships that can affect various aspects of life as well as daily functioning and lead to decreased quality of life. Individuals with high social anxiety will tend to withdraw from social environments. Purpose: This can eventually lead to loneliness and depression. Therefore, early detection is needed to find a diagnosis early on and prevent the condition from worsening. This review aims to determine the clinical picture in patients with SAD and to find out the instruments that /have been used for clinical enforcement in the field. Methods: We conducted a comprehensive search for full-text articles comprising case reports, case-control studies, cohort studies, and cross-sectional studies published between January 1, 2013, and December 30, 2023. The search encompassed databases such as PubMed, ScienceDirect, SAGE, and Scopus. It's important to note that this review does not delve into other clinical conditions associated with Social Anxiety Disorder (SAD), such as anxiety and depression, as they have been addressed in separate discussions. Additionally, the identification of anxiety and depression is excluded from this review. Results: Out of 78 articles that were screened, only 56 met the eligibility criteria to be selected for further review. The initial steps that need to be taken include 1) defining the research objectives; 2) establishing inclusion criteria; 3) developing a search strategy for data retrieval or study selection; 4) collecting data; 5) assessing the quality of studies; and 6) synthesizing the results. Risk of bias was performed using FEAT principles and reviewers’ discussion. A total of 11 final articles that were reviewed showed a significant correlation between anxiety disorder and detection. Conclusion: As individuals with SAD are large in number, based on this review, early detection is required using methods used by local health regions such as through interviews or clinical symptom assessment. This aims to find cases as quickly as possible and provide appropriate interventions.

Social Anxiety Disorder is traditionally diagnosed using subjective scales that may lack accuracy. Recently, EEG technology has gained importance for anxiety detection due to its ability to capture stable and objective neurophysiological activities. However, existing methods mainly focus on extracting EEG features during resting states, with limited use of psychologically features like Event-Related Potential (ERP) in task-related states for anxiety detection in deep learning frameworks. We collected EEG data from 63 participants exposed to four facial expressions and extracted task-relevant features. Using the EEGNet model, we predicted social anxiety and evaluated its performance using metrics such as accuracy, F1 score, sensitivity, and specificity. We compared EEGNet's performance with Deep Convolutional Neural Network (DeepConvNet), ShallowConvNet, Bi-directional Long Short-Term Memory (BiLSTM), and SVM. To assess the generalizability of the results, we carried out the same procedure on our prior dataset. EEGNet outperformed other models, achieving 99.16 % accuracy with Late Positive Potential (LPP). ERP components yielded higher accuracy than time-domain and frequency-domain features for social anxiety recognition. Accuracy was better for neutral and negative facial stimuli. Consistency across two datasets indicates stability of findings. Due to limited publicly available task-state datasets, only our own were used. Future studies could assess generalizability on larger datasets from different sources. We conducted the first test of ERP features in anxiety recognition tasks. Results show ERP features have greater potential in social anxiety recognition, with LPP exhibiting high stability and accuracy. Outcomes indicate recognizing social anxiety with negative or neutral facial stimuli is more useful. • The ERP features outperformed other features, LPP may be a biomarker for anxiety detection. • EEGNet performed better in anxiety detection based on Mcnemar's test. • Better anxiety detection performance was observed under neutral and negative facial stimuli. [ABSTRACT FROM AUTHOR]

In Indonesia, 448.126 divorce cases were reported in 2023. Losing parent(s) as a consequence of parental divorce or death results in children becoming broken-home. In the absence of a parent figure, children experience harmful psychological effects, including ongoing social anxiety until they become young adults. This may disrupt young adults’ developmental task to form intimacy hence leading to poor psychological well-being. Young adults from broken home families must possess hardiness to cope with daily stress and traumatic experiences. Therefore, this study aimed to investigate the role of social anxiety disorder and hardiness in psychological well-being among broken-home young adults. Participants of this study were 200 young adults with broken-home family. The scales used were The Indonesian version of the Psychological Well-being Scale, The Social Phobia Inventory (SPIN), and the DRS-15 Dispositional Resilience Scale. Data was analyzed using the Multiple Regression Model. The results showed that there was a significant contribution of social anxiety disorder and hardiness on psychological well-being, with a total contribution of 53.8 percent. It is recommended for future interventions to detect social anxiety disorder potency, as well as to include hardiness variable in optimizing psychological well-being quality, especially in broken-home young adults.

In Indonesia, 448.126 divorce cases were reported in 2023. Losing parent(s) as a consequence of parental divorce or death results in children becoming broken-home. In the absence of a parent figure, children experience harmful psychological effects, including ongoing social anxiety until they become young adults. This may disrupt young adults' developmental task to form intimacy hence leading to poor psychological well-being. Young adults from broken home families must possess hardiness to cope with daily stress and traumatic experiences. Therefore, this study aimed to investigate the role of social anxiety disorder and hardiness in psychological well-being among broken-home young adults. Participants of this study were 200 young adults with broken-home family. The scales used were The Indonesian version of the Psychological Well-being Scale, The Social Phobia Inventory (SPIN), and the DRS-15 Dispositional Resilience Scale. Data was analyzed using the Multiple Regression Model. The results showed that there was a significant contribution of social anxiety disorder and hardiness on psychological well-being, with a total contribution of 53.8 percent. It is recommended for future interventions to detect social anxiety disorder potency, as well as to include hardiness variable in optimizing psychological well-being quality, especially in brokenhome young adults. [ABSTRACT FROM AUTHOR]

In the development of novel anxiolytics, the endocannabinoid system (ECS) is a promising therapeutic target primarily due to its ability to modulate synaptic plasticity and to act as a retrograde regulator of several neurotransmitter systems. Pharmacologically, it can target at CB1 and CB2 receptors (agonistitic or antagonistic activity) or by inhibiting FAAH and MAGL enzymes, which are involved in endocannabinoid degradation. The aim of this article is to provide a comprehensive systematic review of the clinical use of the endocannabinoid system as a pharmacotherapeutic target in anxiety spectrum disorders (posttraumatic stress disorder, generalized anxiety disorder, social phobia, and panic disorder). Method: In May 2023, a systematic search through the Medline (PubMed) and Web of Science (WOS) databases was performed. The keywords used were "(cannabinoid* OR endocannabinoid* OR cannabidiol* OR tetrahydrocannabinol*) AND ((PTSD OR posttraumatic stress disorder) OR (GAD OR generalized anxiety disorder) OR (PA OR panic attack) OR (SAD OR social anxiety disorder))" in the "Title OR Abstract" fields. Exclusion criteria included non-English language records, case reports, conference abstracts, and preclinical studies. Thus, only prospective, retrospective, randomized controlled trials using fixed doses of cannabinoids or combinations of cannabinoid receptor ligands compared with placebo were included in the review article. Results: Using the Medline and Web of Science databases, 420 and 458 publications respectively were retrieved, of which 410 and 454 were excluded from the review for not meeting the inclusion criteria. Thus, ten publications that were relevant to the topic were included in the review. There were six studies dealing with cannabinoids in the treatment of PTSD and further four studies referring to the use of cannabinoids in the treatment of SAD and GAD. Clinical trials in the treatment of panic disorder have not yet been conducted. Conclusion: Based on the results of clinical trials published to date, it appears that endocannabinoids have been tested in recent years as an alternative or complementary therapy in the indications of anxiety disorders, particularly PTSD, GAD and SAD. Four randomised clinical trials, which investigated the effect of cannabinoids in the treatment of SAD, found cannabidiol to be effective. Out of the six open-label or retrospective studies evaluating the effect of cannabinoids in the treatment of PTSD, nabilone or tetrahydrocannabinol have demonstrated efficacy in three studies. The remaining three studies showed clinical effect however not statistically significant or assessable. The favourable results of the studies may be affected by the low number of subjects and, in some studies, the absence of a control group. In addition, some studies have drawn conclusions based on the dose-response relationship with the use of measures such as neuroimaging and subjective scores on anxiety assessments, without assessing plasma levels of administered cannabinoids. Thus, although the available data suggest a promising potential for cannabinoids in the treatment of anxiety disorders, we should interpret the results with caution for the reasons mentioned above. Thus to draw evidence-based conclusions for clinical practice, it will be necessary to wait for the results of well-designed prospective, randomized, controlled trials to confirm the findings definitively [ABSTRACT FROM AUTHOR]

Background: Shame is an important emotion in social anxiety disorder (SAD). However, gender differences in shame, as well as the temporal relationship between shame and anxiety in SAD have not been examined. The present study aimed to address these gaps. Methods: Participants were 88 individuals (44 with SAD and 44 without SAD) who completed a 21-day experience sampling measurement (ESM). Specifically, participants reported on their emotions once a day at random times. Results: Hierarchical Linear Modeling indicated that individuals with SAD reported significantly more shame compared to individuals without SAD. In addition, women reported significantly more shame compared to men. Importantly, gender differences in shame were more pronounced among individuals with SAD compared to those without SAD. Finally, we found that for individuals without SAD, shame on a given day significantly predicted anxiety on the following day among men but not among women, whereas for individuals with SAD, shame on a given day significantly predicted anxiety on the following day among both men and women. Conclusions: Our findings suggest that shame may play a role in the maintenance of SAD. In addition, our findings suggest that social anxiety disorder may impact women's experience of shame more than men's. [ABSTRACT FROM AUTHOR]

• Social fear resiliency and susceptibility are associated with microbiota community composition. • Social fear response is strongly correlated with microbiota variability. • Alterations align with gene sets associated with behaviour, inflammation and immunity, and microbe-host interaction. Social anxiety disorder is a common psychiatric condition that severely affects quality of life of individuals and is a significant societal burden. Although many risk factors for social anxiety exist, it is currently unknown how social fear sensitivity manifests biologically. Furthermore, since some individuals are resilient and others are susceptible to social fear, it is important to interrogate the mechanisms underpinning individual response to social fear situations. The microbiota-gut-brain axis has been associated with social behaviour, has recently been linked with social anxiety disorder, and may serve as a therapeutic target for modulation. Here, we assess the potential of this axis to be linked with social fear extinction processes in a murine model of social anxiety disorder. To this end, we correlated differential social fear responses with microbiota composition, central gene expression, and immune responses. Our data provide evidence that microbiota variability is strongly correlated with alterations in social fear behaviour. Moreover, we identified altered gene candidates by amygdalar transcriptomics that are linked with social fear sensitivity. These include genes associated with social behaviour (Armcx1 , Fam69b , Kcnj9 , Maoa , Serinc5 , Slc6a17 , Spata2 , and Syngr1), inflammation and immunity (Cars , Ckmt1 , Klf5 , Maoa , Map3k12 , Pex5 , Serinc5 , Sidt1 , Spata2), and microbe-host interaction (Klf5 , Map3k12 , Serinc5 , Sidt1). Together, these data provide further evidence for a role of the microbiota-gut-brain axis in social fear responses. [ABSTRACT FROM AUTHOR]

Aims: Although static abnormalities of functional brain networks have been observed in patients with social anxiety disorder (SAD), the brain connectome dynamics at the macroscale network level remain obscure. We therefore used a multivariate data‐driven method to search for dynamic functional network connectivity (dFNC) alterations in SAD. Methods: We conducted spatial independent component analysis, and used a sliding‐window approach with a k‐means clustering algorithm, to characterize the recurring states of brain resting‐state networks; then state transition metrics and FNC strength in the different states were compared between SAD patients and healthy controls (HC), and the relationship to SAD clinical characteristics was explored. Results: Four distinct recurring states were identified. Compared with HC, SAD patients demonstrated higher fractional windows and mean dwelling time in the highest‐frequency State 3, representing "widely weaker" FNC, but lower in States 2 and 4, representing "locally stronger" and "widely stronger" FNC, respectively. In State 1, representing "widely moderate" FNC, SAD patients showed decreased FNC mainly between the default mode network and the attention and perceptual networks. Some aberrant dFNC signatures correlated with illness duration. Conclusion: These aberrant patterns of brain functional synchronization dynamics among large‐scale resting‐state networks may provide new insights into the neuro‐functional underpinnings of SAD. [ABSTRACT FROM AUTHOR]

Background: Cognitive therapy for social anxiety disorder (CT-SAD) has extensive empirical support and is recommended in several national guidelines. However, ensuring access to evidence-based psychological therapies such as CT-SAD remains a global challenge. An internet-delivered version of this treatment protocol (iCT-SAD) has recently been developed in the UK as a way to overcome this challenge, demonstrating comparable outcomes to face-to-face CT-SAD whilst requiring less therapist time per client. Initial findings also suggest its cross-cultural transferability, but the previous studies in other cultural settings used the English language programme and only included English-fluent participants as a second language. It is not yet known what outcomes can be achieved once the programme has been translated and adapted for a different cultural context. Therefore, this trial aims to evaluate the clinical efficacy of Japanese iCT-SAD when combined with treatment as usual (TAU) in clients with SAD. Methods: This two-arm, parallel-group, superiority randomised controlled trial will recruit 60 Japanese participants with SAD, randomly assigning them to either Japanese iCT-SAD + TAU or TAU alone at a ratio of 1:1. The primary outcome measure is the self-report Liebowitz Social Anxiety Scale, and secondary.outcomes include other measures of social anxiety symptoms and processes, general mood and functioning, and response to treatment. We will also assess treatment acceptability and gather participant feedback. Assessments will take place at baseline (week 0), mid-treatment (week 8), and post-treatment (week 15), with a further 3-month follow-up (week 27) for the iCT-SAD + TAU arm. The primary analyses will be conducted on an intent-to-treat basis, comparing the primary and secondary outcome measures between groups using linear mixed-effect models, along with additional mediation analysis. Discussion: Investigating the efficacy of translated and culturally adapted iCT-SAD in different cultural contexts is an important step in evaluating the global reach of internet interventions. This trial will provide valuable insights into the effects of iCT-SAD combined with usual care, and how this treatment could be delivered in routine clinical settings in Japan. Trial registration: International Standard Randomized Controlled Trials (ISRCTN), ISRCTN82859645, registered on January 19, 2024. UMIN Clinical Trials Registry (UMIN-CTR), UMIN000052702, registered on November 6, 2023. [ABSTRACT FROM AUTHOR]

Individuals with social anxiety disorder (SAD) experience overall emotion regulation difficulties, but less is known about the long-term role of such difficulties in cognitive behavior therapy (CBT) for SAD. Forty-six patients with SAD receiving internet-delivered CBT, and matched healthy controls (HCs; n = 39), self-reported the Difficulties in Emotion Regulation Scale (DERS), Liebowitz Social Anxiety Scale (LSAS-SR), and participated in anticipatory speech anxiety behavioral experiments. Patients were measured at seven time points before, during and after CBT over a total period of 28 months, and HCs at two timepoints. Disaggregated growth curve models with a total of 263 observations were used, as well as intra-class correlation coefficients and regression models. Patients’ LSAS-SR and DERS ratings were reliable (ICC = .83 and .75 respectively), and patients, relative to controls, showed larger difficulties in emotion regulation at pre-treatment (p < .001). During CBT, within-individual improvements in emotion regulation significantly predicted later LSAS-SR reductions (p = .041, pseudo-R2 = 43%). Changes in emotion regulation may thus be important to monitor on an individual level and may be used to improve outcomes in future developments of internet-delivered CBT. [ABSTRACT FROM AUTHOR]

The present research aimed to assess the efficacy of Cognitive Behavioral Therapy in Asian country of Pakistan in treating anxiety disorders. Conducted as a qualitative study, this study targeted 80 individuals from Lahore, Multan, Islamabad and Karachi. In this qualitative study adopting a semi-structured interview, notable improvements in patient's CBT anxiety symptomatology level was revealed; major CBT approaches including cognitive restructuring, exposure therapy, and relaxation training exerted potentials. It also noted the role played by the therapist-client relationship as well as the value of using culturally sensitive CBT. The outcomes support the effectiveness of CBT for anxiety disorders as well as application of cultural sensitivity in their treatment amongst the people of Pakistan. [ABSTRACT FROM AUTHOR]

Introduction: Excessive reassurance seeking from others and interpersonal sensitivity with a temporary reduction of anxiety play an essential role in the persistence of anxiety disorders. The present study investigated the role of excessive reassurance seeking of others and interpersonal sensitivity in predicting social anxiety and obsessive-compulsive symptoms. Materials and Methods: The statistical population consisted of all the housewives of Sabzevar City, Iran, in the summer of 2022. A sample of 339 housewives were selected using two-stage cluster sampling. They filled the questionnaires about obsessive-compulsive, social anxiety, seeking reassurance from others, and interpersonal sensitivity. The data were analyzed using correlation, regression, and analysis of variance tests. Results: The findings showed that excessive reassurance and interpersonal sensitivity have a significant correlation with the total score of obsessive-compulsive and social anxiety, and excessive reassurance and interpersonal sensitivity predict 6% of the variance related to social anxiety and 33% of the variance of obsessive- compulsive. Also, the results showed that the group with obsessive symptoms compared to the group with social anxiety symptoms and the healthy group had the highest score in interpersonal sensitivity and excessive reassurance (P< 0.001). Conclusion: Excessive reassurance and interpersonal sensitivity are important explanations for anxiety disorders, especially obsessive-compulsive disorder. [ABSTRACT FROM AUTHOR]

Many individuals with social anxiety disorder (SAD) have depressive symptoms that meet criteria for major depressive disorder (MDD). In our study, we examined the temporal relationship between symptoms of social anxiety and symptoms of depression during the course of an 11-week internet-delivered cognitive behavioral treatment (ICBT) for SAD (n = 170). Specifically, we investigated whether weekly changes in social anxiety mediated changes in depression, changes in depression mediated changes in anxiety, both or neither. In addition, we compared individuals with SAD and MDD (n = 50) and individuals with SAD and no MDD (n = 120) to examine the role of MDD as a moderator of the social anxiety—depression relationship. Lower-level mediational modeling revealed that changes in social anxiety symptoms mediated changes in depression symptoms to a greater extent than vice versa. In addition, mediation among individuals with SAD and MDD was significantly greater compared to individuals with SAD and no MDD. Our findings suggest that ICBT is effective in treating individuals with SAD regardless of comorbid depression, and that focusing ICBT interventions on social anxiety can lead to significant reductions in depression among individuals with SAD. [ABSTRACT FROM AUTHOR]

Introduction: Imagery rescripting (ImRs) is a psychotherapeutic intervention targeting aversive memories. During the three-phase intervention, patients reexperience their aversive memory (phase 1), observe the scene from their adult perspective, and intervene to help their former selves (phase 2), and reexperience it again with the positive changes (phase 3). Previous studies have rarely investigated emotional and regulatory processes taking place during the intervention. Objective: This randomized controlled trial investigated self-reported affective and physiological responses during ImRs. Methods: Seventy-seven patients with social anxiety disorder (SAD) were randomly assigned to a single session of ImRs or a control intervention (recall and discussion of the memory) targeting an aversive social memory. Heart rate (HR) and heart rate variability (HRV) were assessed during and post hoc ratings of positive and negative feelings after baseline and the intervention phases. Results: Relative to the control intervention, ImRs resulted in an initial increase in negative feelings from baseline to phase 1 and a following larger (phase 1 to phase 2) and more stable (phase 2 to phase 3) decrease in negative feelings/increase in positive feelings. On the physiological level, during ImRs compared to the control intervention, mean HR was significantly higher during phase 1 and HRV during phase 3, each compared to baseline. Conclusions: These results provide further information about the specific sequence of emotional responses on different response levels during ImRs, being consistent with known theories of emotional processing and supposed mechanisms of ImRs. [ABSTRACT FROM AUTHOR]

Appearance-related safety behaviors (ARSBs) have been identified as a key mechanistic target in individuals with elevated appearance concerns, social anxiety symptoms, and body dissatisfaction. The aim of the present study was to experimentally test the effect of fading these behaviors in individuals with body dysmorphic disorder (BDD), social anxiety disorder, and/or an eating disorder (ED). Ninety-four female participants were randomized to either a 1-month text message-based ARSB fading condition (n = 47) or a self-monitoring control condition (n = 47). Findings demonstrated that individuals in the ARSB fading condition saw significantly greater reductions in postmanipulation appearance concerns, appearance importance, ED symptoms, general anxiety, and depression. ARSB fading also led to lower BDD and social anxiety disorder symptoms, though this was only found among those who met for these respective diagnoses. Furthermore, we found that changes in appearance importance partially mediated the effect of condition on appearance concerns, BDD symptoms, social anxiety symptoms, and ED symptoms. Compared to the control, the ARSB fading group also demonstrated less reactivity to an in vivo appearance-related stressor task. This study provides strong evidence for the importance of ARSBs in the maintenance of appearance-related psychopathology among a clinical sample. Findings demonstrate the potential utility of reducing ARSBs as an overarching treatment strategy for appearance-related psychopathology. General Scientific Summary: This study found that instructions to monitor and reduce behaviors related to checking appearance led to reductions in symptoms of body dysmorphia, social anxiety, and eating disorders. These findings support the notion that these behaviors are a modifiable factor that is relevant to multiple psychological disorders. [ABSTRACT FROM AUTHOR]

To date, although several studies have investigated the circulating levels of brain-derived neurotrophic factor (BDNF) in children with autism spectrum disorder (ASD), only a few authors have addressed their evaluation in adults. Furthermore, an important limitation of these studies lies in the fact that circulating BDNF is stored in platelets and released into the circulation when needed. To the best of our knowledge, a very limited number of studies have related peripheral BDNF values to platelet counts, and yet no study has evaluated intra-platelet BDNF levels in adults with ASD. In this framework, the aim of the present work is to pave the way in this field and evaluate platelet BNDF levels in adult ASD patients, as well as their correlation with autistic symptoms and related psychopathological dimensions. We recruited 22 ASD and 22 healthy controls, evaluated with the Adult autism subthreshold spectrum (AdAS Spectrum), the Social Anxiety Spectrum—self report (SHY-SR), the Trauma and loss spectrum—self report (TALS-SR), the Work and Social Adjustment Scale (WSAS), and the Mood Spectrum—self report for suicidality. Intra-platelet BDNF levels were also assessed. The results highlighted lower BDNF levels in the ASD group; moreover, AdAS Spectrum and WSAS total score as well as AdAS Spectrum Restricted interest and rumination, WSAS Private leisure activities, TALS-SR Arousal, and SHY-SR Childhood domains were significant negative predictors of platelet BDNF levels. [ABSTRACT FROM AUTHOR]

Do adults who stutter have abnormally high social anxiety? Is it related to maladaptive cognition? As these are persistent, unresolved questions in stuttering research, it behooves clinicians to at least assess and attempt to identify social anxiety in patients who stutter and its basis before decisions are made about stuttering treatment. The Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scale is a self-administered questionnaire that measures the degree of non-adaptive cognition in people who stutter (PWS) due to social anxiety. The 66-item UTBAS is time-consuming to complete, prompting the development of a shorter 6-item version, the UTBAS-6, which is in English. Here, we aimed to assess some psychometric properties of the Japanese version of the UTBAS-6, the UTBAS-6-J, which has not been done to date. In 56 adult patients (mean 32.6 ± 11.1 years) who stutter, we quantified the reliability, the internal consistency, and the concurrent validity of the UTBAS-6-J. Along with the UTBAS-6-J, patients also were administered the Overall Assessment of the Speaker's Experience of Stuttering -- Japanese version (OASES-A-J), the Modified Erickson Communication Attitude Scale -- Japanese version (S-24-J), and the Liebowitz Social Anxiety Scale -- Japanese version (LSAS-J). Cronbach's alpha for UTBAS-6-J total scores was 0.974, indicating excellent internal consistency. UTBAS-6-J scores were significantly correlated with scores on the OASES-A-J, the S-24-J, and the LSAS-J (all p < 0.005). Concurrent validity of the UTBAS-6-J with these three questionnaires was confirmed. The UTBAS-6-J has good internal consistency and concurrent validity, which will aid clinical decision-making about stuttering treatments. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusions\nKey PointsCognitive behaviour therapy (CBT) for social anxiety disorder (SAD) can be delivered through several modalities, including individually-administered CBT (ICBT), group-based CBT (GCBT), and CBT delivered remotely (RCBT). We synthesised the current literature on ICBT, GCBT, and RCBT approaches in adults with SAD, and compared their relative effectiveness using a meta-analytic approach.This review included randomised controlled trials comparing a disorder specific CBT monotherapy (ICBT, GCBT, or RCBT) to a non-active control group in adults with diagnosed SAD. Eligible studies were searched through PsycINFO, Scopus, and EMBASE databases to April 2023. A total of 37 studies met the inclusion criteria (with 55 between-group comparisons; N = 3234). Between-group effect sizes were conducted using random effects models.Analyses indicated that RCBT (k = 23; g = 0.90; 95% CI = 0.74–1.06) and ICBT (k = 17; g = 0.95; 95% CI = 0.66–1.23) demonstrated large effects, while GCBT demonstrated medium effects (k = 15; g = 0.71; 95% CI = 0.49–0.94). The groups, however, did not differ significantly (Q2 = 2.17, p > .05).This study builds on the existing literature demonstrating the efficacy of these treatment approaches.What is already known about this topic: Cognitive behaviour therapy (CBT) is an effective treatment for adults with social anxiety disorder (SAD).CBT for SAD can be delivered using a variety of treatment approaches.Individually-administered CBT, group-based CBT and remotely-delivered CBT are the primary treatment modalities.Cognitive behaviour therapy (CBT) is an effective treatment for adults with social anxiety disorder (SAD).CBT for SAD can be delivered using a variety of treatment approaches.Individually-administered CBT, group-based CBT and remotely-delivered CBT are the primary treatment modalities.What this topic adds: This study compared the effectiveness of different CBT delivery methods.Individually-administered CBT and remotely delivered CBT result in large effect sizes, while group-based CBT results in medium effect sizes.Individually-administered CBT, group-based CBT and remotely-delivered CBT can be delivered with equal confidence based on client preference.This study compared the effectiveness of different CBT delivery methods.Individually-administered CBT and remotely delivered CBT result in large effect sizes, while group-based CBT results in medium effect sizes.Individually-administered CBT, group-based CBT and remotely-delivered CBT can be delivered with equal confidence based on client preference. [ABSTRACT FROM AUTHOR]

Hikikomori (prolonged social withdrawal) has been discussed as a hidden worldwide epidemic and a significant social and healthcare issue. Social anxiety disorder is the most common psychiatric disorder preceding the onset of Hikikomori. Although studies exist suggesting the effectiveness of family-support interventions, little is known about psychotherapeutic approaches for Hikikomori individuals. Here, we present a case of Hikikomori wherein an internet-delivered cognitive therapy for social anxiety disorder (iCT-SAD) worked effectively in improving the client's social anxiety symptoms and social interaction behaviors. This case study demonstrates the principle that evidence-based psychological interventions focusing on social anxiety can be effective for clients with Hikikomori. Furthermore, the online mode of treatment delivery, along with a variety of relevant modules, may facilitate clients' engagement with treatment at home. The findings suggest that iCT-SAD might be a promising option for Hikikomori clients who have social anxiety problems, within the recommended stepped-intervention approach. [ABSTRACT FROM AUTHOR]

In the cognitive-behavioral model of social anxiety disorder, fear of negative evaluation by others, estimated social cost, self-focused attention, and perceived anxiety control are considered the key maintaining components in a social situation. This study examined the relationship between cognitive biases and social anxiety symptoms using a cross-sectional design. All of the 309 participants were Japanese individuals with social anxiety disorder at outpatient medical institutions. The hypothesized model's path analysis was conducted. The models assumed that fear of negative evaluation by others affected the relationship between each cognitive bias and that biases influenced social anxiety symptoms. The best-fit model by path analysis showed that self-focused attention and perceived anxiety control have the influence on cost/probability bias and cost bias highly affected social anxiety symptoms. These results indicate cognitive biases may function to maintain social anxiety symptoms. Hence, a reduction in cost bias can be effective in improving excessive anxiety in social situation. [ABSTRACT FROM AUTHOR]

The Ryerson Social Anxiety Scales (RSAS) are a new measure to assess the severity of social anxiety symptoms. The purpose of the present study was to develop the Persian version of the Ryerson Social Anxiety Scales (RSAS-P) and examine its factor structure, measurement invariance, reliability and validity from different dimensions in both the general population and individuals with social anxiety disorder (SAD) as well as its treatment sensitivity. This research involved 1023 participants from various normal and pathological groups. The RSAS was translated to Farsi and administered to all participants. Participants also completed the Fear of Negative Evaluation Scale (BFNE-S) and the Emotion Regulation Questionnaire (CERQ-P-Short). Confirmatory factor analysis supported the unidimensional structure of the RSAS-P. The RSAS-P showed excellent internal consistency. Correlations between RSAS-P and other related and distinct conceptual measures supported the discriminant validity of RSAS. The reliability test results were satisfactory. The RSAS was also sensitive to changes in the severity and status of social anxiety following treatment. Findings suggest that the Persian version of the RSAS is a valid and reliable instrument for measuring the severity of social anxiety symptoms in Iranian samples. However, further psychometric evaluation of the questionnaire is recommended. [ABSTRACT FROM AUTHOR]

BackgroundSocial anxiety disorder imposes impacts of functional disability, poor educational achievement, loss of work productivity, social impairment, greater financial dependency, and impairment in quality of life. Therefore, the aim of this study was to assess the prevalence and identify determinants of social anxiety disorder among people living with HIV/AIDS.MethodsA cross-sectional study was conducted from 1 to 30 May 2022 among 354 people living with HIV using a simple random sampling technique. The Social Phobia Inventory (SPIN) Scale was used to assess the presence of social anxiety disorder. Data were gathered using chart review tools and a structured questionnaire, which was administered by a pretested face-to-face interviewer. SPSS version 25 was used to analyse the data once they were imported into EpiData Manager version 4.6. Binary and multivariable logistic regressions were performed. After calculating odds ratios with a 95% confidence interval (CI), statistical significance was established at p < 0.05.ResultsA total of 336 respondents participated in the study, resulting in a response rate of 94.91%. The magnitude of social anxiety disorder was 32.44% (95% CI: 27.4, 37.2). Being female [adjusted odds ratio (AOR) = 3.55, 95% CI: 1.61, 7.84], having a stage III/IV HIV/AIDS status (AOR = 3.17, 95% CI: 1.10, 9.13), being alcohol dependent (AOR = 2.81, 95% CI: 1.45, 5.44), and having perceived stigma (AOR = 5.62, 95% CI: 2.95, 10.72) were predictors of social anxiety disorder.ConclusionIn this study, approximately one-third of people living with HIV/AIDS had social anxiety disorder. Being female, having a stage III/IV HIV/AIDS status, being alcohol dependent, and having perceived stigma were predictors of social anxiety disorder. Therefore, training for health care providers on the screening, counselling, and management of social anxiety disorder is important.

Background: Previous research has shown that emotion-focused therapy is effective in reducing the symptoms of social anxiety disorder and improving the social efficiency of people suffering from it. On the other hand, the review of studies shows that many treatment approaches will be more effective if they are used in the form of group psychotherapy. But so far, the protocol of this type of treatment has not been developed in such a way that its intervention techniques are suitable and compatible for implementation in the group. Aims: The present study was conducted with the aim of developing a group therapy protocol focused on emotion and trial on the symptoms of social anxiety disorder. Methods: The design of the current research was a type of exploratory combined research that has a qualitative and quantitative nature. The first stage of the research was conducted with a qualitative approach and thematic analysis method. In order to identify themes and draw a network of themes, first 121 related sources were identified and among them, 11 Persian sources published between 1392 and 1401 and 23 English sources published between 2000-2022 were selected. In the quantitative part, the research method was a quasi-experimental design of pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all the clients who referred to the Sense of Presence clinic in Tehran in the second half of 2022. 20 people with social anxiety disorder were selected from among the clients using the available method and were randomly divided into two experimental and control groups. The members of the experimental group were exposed to 16 sessions of emotion-focused group therapy protocol (designed by the researchers). The instrument used in the quantitative part was the social anxiety scale (Connor et al., 2000). For data analysis, thematic analysis method was used in the qualitative part and Variance analysis with repeated measurements was used in the quantitative part. Results: The findings of the present study in the qualitative part led to the identification of two overarching themes, including emotion-focused therapy and social anxiety, and finally, a 16-session protocol of emotion-focused therapy group. The results in the quantitative part also showed that the effectiveness of the group therapy focused on emotion was significant in reducing all the symptoms of social anxiety disorder, fear, avoidance, Physiological symptoms and the total score of social anxiety (P

Background: Social anxiety disorder often has a poorer recovery rate than other anxiety disorders. A review of previous studies shows that two variables, social anxiety disorder and the focused – attention (which is one of the predictors of social anxiety disorder), respond less well to conventional psychological treatments. Among the newest integrated alternative approaches are paradoxical time table therapy and virtual reality technology therapy, there is a research gap regarding the comparison of their effectiveness in improving the focused – attention and reducing the symptoms of social anxiety disorder. Aims: The present study was conducted with the aim of comparing the effectiveness of paradoxical time table therapy and virtual reality technology therapy on the focused – attention and symptoms of social anxiety disorder. Methods: The current research design was a semi-experimental pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all people who referred to counseling centers and psychotherapy clinics in Tehran in the fall and winter of 2022. The statistical sample included 45 people with social anxiety disorder who were selected as available samples and were divided into three groups of 15 people (two experimental groups and one control group). To collect data, the Focous of Attention Questionnaire (Woody et al., 1997) and the social anxiety scale (Connor et al., 2000) were used. Also, the treatment of the paradoxical time table therapy (Besharat, 2017) was implemented in six sessions on the first experimental group and and the virtual reality technology therapy was implemented in 8 sessions on the second experimental group. Data analysis was done using multivariate analysis, variance analysis with repeated measures, Bonferroni post hoc test and SPSS-25 software. Results: The results showed that both treatments of paradoxical time table therapy and virtual reality technology therapy had a significant effect on the focus of attention and symptoms of social anxiety disorder (P

• Research is needed on the effectiveness of internet-based interventions in different cultures. • Internet-based CBT was evaluated in a different culture compared to face-to-face CBT and wait-list control. • Findings showed that Internet-based CBT has several clinical, cultural, and implementation weaknesses. • Both forms of intervention were effective in reducing social anxiety and associated symptoms. During the COVID-19 epidemic, face-to-face mental health services faced obstacles. Using Internet-based interventions was a good solution and had the potential to overcome these treatment barriers. However, there is no strong research evidence about the effectiveness of these methods for social anxiety disorder in different cultures and developing countries. Therefore, the present study aimed to investigate the effectiveness and application of Internet-based cognitive-behavioral therapy for social anxiety disorder in Iran. The current study was a pretest-posttest follow-up experimental design. Fifty-four adolescents with social anxiety disorder were selected from Lorestan province (Iran) by cluster sampling method and randomly assigned to three groups: face-to-face, internet-based, and wait-list control. At the beginning and end of the study and 3-month follow-up, three groups were interviewed and answered questionnaires related to the primary and secondary symptoms of social anxiety disorder. Two experimental groups were treated with the same therapeutic intervention during 10 weekly sessions. ANCOVA analysis showed that both forms of intervention effectively reduced social phobia, fear of negative evaluation and social interaction anxiety and increased emotion regulation. Also, a significant decrease in secondary outcomes, including physical symptoms, insomnia, social dysfunction, and depression symptoms, was observed in both groups. The treatment effects were stable during a 3-month follow-up. Our findings showed that although Internet-based cognitive-behavioral therapy for adolescents with social anxiety disorder can be effective, several clinical, cultural, and implementation weaknesses should be considered. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the rates of peer bullying and stress-coping strategies in adolescents with SAD and to investigate the relationship between SAD and different types of peer bullying. Materials and Methods: This cross-sectional study included ninety-two adolescents aged 14 to 17 years with SAD and one hundred-five typically developing adolescents. A semi-structured psychiatric interview, the Social Anxiety Scale for Adolescents (SAS-A), the Peer Bullying Scale-Adolescent Form (PBS-AF), and the Coping Scale for Adolescents (CSA) were applied to all participants. Peer bullying was classified into six types (physical, verbal, exclusion, spreading rumors, attacks against property, and sexual) and two roles (bullying and victimization). Results: On every subscale of the PBS-AF victimization dimension, the SAD group's mean scores were significantly higher than those of the controls. Regarding the PBSAF bullying dimension, the Physical Bullying and Sexual Bullying scores of the SAD group were significantly lower than the control group, but the Isolation/Exclusion scores were significantly higher than the control group. Compared to the control group, the mean scores of Active Coping of CSA were significantly lower, while the mean scores of Negative Coping and Avoidant Coping were significantly higher in the SAD group. The SAS-A's total score had a significant positive correlation with all subscales of the PBS-AF victimization dimension. Age, gender, academic performance, and psychiatric comorbidity had a predictive effect on some of the victimization dimension variables of peer bullying. Conclusion: This study has revealed that SAD is an important risk factor for peer victimization. The routine psychiatric examination of adolescents with SAD should also include a screening for peer bullying. [ABSTRACT FROM AUTHOR]

• Higher CRP predicts greater SAD symptom improvement during VR exposure therapy. • CRP, SAD symptoms, and subjective distress all decline during VR exposure therapy. • However, declines in CRP and SAD symptoms are not associated within-persons. Social anxiety disorder (SAD) places a profound burden on public health and individual wellbeing. Systemic inflammation may be important to the onset and maintenance of SAD, and anti-inflammatory treatments have shown promise in relieving symptoms of SAD. In the present study, we conducted secondary analyses on data from a randomized clinical trial to determine whether C-reactive protein (CRP) concentrations and social anxiety symptoms decreased over the course of virtual reality exposure therapy, and whether changes in social anxiety symptoms as a function of treatment varied as a function of CRP. Adult participants (N = 78) with a diagnosis of SAD (59 % female) were randomized to receive exposure therapy alone, or exposure therapy supplemented with scopolamine. Social anxiety symptoms, salivary CRP, and subjective units of distress were measured across three exposure therapy sessions, at a post-treatment extinction retest, and at a 1-month follow-up. CRP decreased over the course of treatment, b = −0.03 (SE = 0.01), p =.02 95 %CI [−0.06, −0.004], as did all social anxiety symptom domains and subjective distress. Higher CRP was associated with greater decreases from pre-treatment to 1-month follow-up in fear, b = −0.45 (SE = 0.15), p =.004 95 %CI [−0.74, −0.15], and avoidance, b = −0.62 (SE = 0.19), p =.002 95 %CI [−1.01, −0.23], and in-session subjective distress from pre-treatment to post-treatment, b = −0.42 (SE = 0.21), p =.05 95 %CI [−0.83, −0.001]. However, declines in CRP were not correlated with declines in fear, r = −0.07, p =.61, or avoidance, r = −0.10, p =.49, within-persons. Virtual reality exposure therapy may be associated with an improvement in systemic inflammation in patients with severe SAD. Pre-treatment CRP may also be of value in predicting which patients stand to benefit the most from this treatment. [ABSTRACT FROM AUTHOR]

We are rapidly entering the age of no privacy where everyone is always open to surveillance, where there are no secrets – William O Douglas. This case aims to explore the effects of camera surveillance on individual behaviour at the workplace. We observe that we unconsciously tend to modify our natural behaviour into a designed one as required by the camera, what is called prosocial behaviour. Workplace surveillance has many advantages and applications for theft detection and employee discipline. However, it also impacts employees who may not be enacting deviant behaviour at the workplace. This issue needs to be addressed, as it can affect not only psychological behaviours leading to unseen disorders, but also productivity at the workplace. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine the relationship between university students' Internet addiction levels, communication skills, and social anxiety. The sample for the research is 5660 university students from Türkiye. The participants were reached through an easily accessible sampling method. The Addiction Scale, Interpersonal Communication Competence Inventory, and Social Anxiety Scale were used to collect data. A relational survey model was used in the analysis of the data. The prominent result of the research is that the Internet addiction status, communication skills, and social anxiety status of university students show significant differences according to different variables. It was found that there was a low negative relationship between Internet addiction and communication skills, and a moderate positive relationship between Internet addiction and social anxiety among university students. In the model established to predict the Internet addiction of university students through communication skills and social anxiety variables, the social anxiety variable was found to be a statistically significant predictor of Internet addiction. [ABSTRACT FROM AUTHOR]

Social anxiety disorder (SAD) is characterized by significant distress and avoidance surrounding social and performance situations, with marked interpersonal and academic impairment. This review article highlights cultural considerations relevant to the conceptualization, identification, and treatment of SAD in Black youth. Research evaluating the utility of evidence-based measures to assess SAD suggests they are culturally relevant; however, gaps in knowledge regarding the psychometric properties of even the most widely used instruments are evident. In regard to intervention, cognitive behavioral therapy (CBT) approaches hold promise, yet there is a lack of research on the use of CBT with Black adolescents. Recommendations to incorporate cultural factors into CBT are provided, and future work investigating culturally adapted interventions is needed. Finally, given significant disparities in access and utilization of mental health services among Black youth, strategies to increase treatment engagement, such as school-based services, are important to consider. [ABSTRACT FROM AUTHOR]

Cognitive-behavioral therapy (CBT) is an effective treatment for a variety of psychiatric disorders. However, historic underrepresentation, misapplication of techniques, and neglected consideration for the unique experiences of marginalized groups—including racial, ethnic, sexual, and gender minorities—have led to mistrust of mental health treatment among these communities and decreased access to quality, evidence-based care. Although these treatments are not inherently harmful to individuals with marginalized identities, clinicians can cause harm if they do not consider the role of culture in their conceptualization, assessment, and treatment of individuals with marginalized identities. Thus, this Special Issue details important considerations for conceptualization, assessment, treatment, and research related to a variety of psychiatric disorders in individuals with marginalized identities. In particular, this Special Issue describes substance use disorders among Black men, eating disorders among queer and transgender individuals, obsessive-compulsive disorder in Hispanic and Latin American individuals, and social anxiety disorder in Black adolescents. [ABSTRACT FROM AUTHOR]

Background: Although not approved for the treatment of anxiety disorders (except trifluoperazine) there is ongoing off‐label, unapproved use of first‐generation antipsychotics (FGAs) and second‐generation antipsychotics (SGAs) for anxiety disorders. There have been systematic reviews and meta‐analyses on the use of antipsychotics in anxiety disorders, most of which focused on SGAs. Objective: The specific aims of this umbrella review are to: (1) Evaluate the evidence of efficacy of FGAs and SGAs in anxiety disorders as an adjunctive treatment to traditional antidepressant treatments and other nonantipsychotic medications; (2) Compare monotherapy with antipsychotics to first‐line treatments for anxiety disorders in terms of effectiveness, risks, and side effects. The review protocol is registered on PROSPERO (CRD42021237436). Methods: An initial search was undertaken to identify systematic reviews and meta‐analyses from inception until 2020, with an updated search completed August 2021 and January 2023. The searches were conducted in PubMed, MEDLINE (Ovid), EMBASE (Ovid), APA PsycInfo (Ovid), CINAHL Complete (EBSCOhost), and the Cochrane Library through hand searches of references of included articles. Review quality was measured using the AMSTAR‐2 (A MeaSurement Tool to Assess Systematic Reviews) scale. Results: The original and updated searches yielded 1796 and 3744 articles respectively, of which 45 were eligible. After final review, 25 systematic reviews and meta‐analyses were included in the analysis. Most of the systematic reviews and meta‐analyses were deemed low‐quality through AMSTAR‐2 with only one review being deemed high‐quality. In evaluating the monotherapies with antipsychotics compared with first‐line treatments for anxiety disorder there was insufficient evidence due to flawed study designs (such as problems with randomization) and small sample sizes within studies. There was limited evidence suggesting efficacy of antipsychotic agents in anxiety disorders other than quetiapine in generalized anxiety disorder (GAD). Conclusions: This umbrella review indicates a lack of high‐quality studies of antipsychotics in anxiety disorders outside of the use of quetiapine in GAD. Although potentially effective for anxiety disorders, FGAs and SGAs may have risks and side effects that outweigh their efficacy, although there were limited data. Further long‐term and larger‐scale studies of antipsychotics in anxiety disorders are needed. [ABSTRACT FROM AUTHOR]

Social anxiety disorder (SAD) is a psychiatric condition characterized by impaired social functioning that negatively impacts individuals' quality of life. Previous neuroimaging studies have revealed morphological and functional changes in various brain regions associated with SAD. Recent advances in diffusion tensor imaging (DTI) and diffusion-weighted imaging (DWI) have enabled the investigation of microstructural white matter (WM) alterations in SAD. This study aims to provide an overview of DTI/DWI studies exploring WM microstructure changes in SAD. A systematic search on PubMed, Scopus, Web of Science, and PsycINFO was conducted for relevant records on July 8, 2023. An exploratory meta-analysis was also performed. Eight studies were reviewed. Consistent findings indicated reduced fractional anisotropy and increased diffusivity measures in different WM tracts in SAD patients compared to healthy controls. These alterations were mostly observed within regions of the fronto-limbic network, like uncinate fasciculus (UF) and superior and inferior longitudinal fasciculi (SLF and ILF). Finally, our exploratory meta-analysis on four studies utilizing a voxel-wise analytic approach yielded no significant differences between SAD patients and controls. Limited number of studies, small sample sizes, and heterogeneity in analysis methods. Patients with SAD exhibited altered WM integrity, particularly in the UF, SLF, and ILF, compared to healthy controls. However, due to the limited number of included studies, our meta-analysis yielded no significant differences between SAD patients and controls. Therefore, future research is crucial to unravel the link between altered WM structure and the involvement of other limbic and cortical structures in SAD pathogenesis. • SAD is associated with various microstructural WM alterations. • Reduced FA in UF and SLF were the most consistent DTI/DWI finding in SAD patients. • Various correlations were identified between the SAD severity and DTI/DWI features. • Future research is necessary to determine the exact WM changes associated with SAD. [ABSTRACT FROM AUTHOR]