A Randomized Trial of Brief Online Interventions to Facilitate Treatment Seeking for Social Anxiety.

This study developed and evaluated a brief, single-session online intervention designed to facilitate treatment seeking among adults with clinically significant social anxiety (SA) symptoms, who generally seek treatment at exceptionally low rates. Adults (N = 267) reporting significant SA symptoms were recruited online and randomized to a brief, single-session online intervention: Education consisted of brief psychoeducation and treatment resources, or Education+Motivation which added treatment seeking-focused motivational content adapted from Motivational Interviewing and Acceptance and Commitment Therapy. Attitudes, intentions, perceived control, and treatment seeking were assessed at Pre, Post, and 1-month follow-up (FU). Both interventions were feasible (90% completion) and improved all outcomes. At FU, 70% reported engaging in one or more SA treatment-seeking behaviors. Education+Motivation was more effective than Education at improving treatment-seeking attitudes and behaviors. A brief online intervention with educational and motivational content is a promising direction for promoting treatment seeking for adults with SA symptoms.

Self-compassion induction enhances recovery from social stressors: Comparing adults with social anxiety disorder and healthy controls.

BACKGROUND AND OBJECTIVES: This study evaluates the process and consequence of inducing self-compassion during recovery from social performance stressors. Though interest in self-compassion as an intervention target is growing, extant findings suggest that initially cultivating self-compassion can be challenging for those with high self-criticism and anxiety, common features of social anxiety disorder (SAD). DESIGN: Quasi-experimental design. METHODS: The current study evaluates the feasibility, content, and outcomes of a brief written self-compassion induction administered after consecutive laboratory social stressors, among adults with SAD (n = 21) relative to healthy controls (HC; n = 35). RESULTS: Findings demonstrate the feasibility of employing a written self-compassion induction among adults with (and without) SAD, reveal group differences in written responses to the induction, and suggest that the SAD group benefitted more from the induction than the HC group, based on greater reductions in state anxiety and greater increases in self-compassion during stressor recovery. Greater use of negative affect words within written responses to the self-compassion induction, but not during general writing, predicted lower subsequent state anxiety across groups, by a medium effect size. CONCLUSIONS: Collectively, the findings support the feasibility and utility of cultivating self-compassion among adults with SAD.

The Longitudinal Effect of Emotion Regulation Strategies on Anxiety Levels in Children and Adolescents.

There is growing evidence linking emotion dysregulation to anxiety. However, few studies have examined this relationship longitudinally or developmentally. Additionally, no studies have specifically examined the predictive relevance of the emotion regulation skills taught in mindfulness- and acceptance-based therapies. We explore whether specific emotion regulation processes differentially predict specific anxiety symptoms over time among children and adolescents. METHODS: Initial emotion non-awareness, nonacceptance, and difficulties with goal-directed behavior were assessed in a community sample (n = 312, age range = 8-16, mean age = 11.68, 59% female, 69% Caucasian). Social anxiety, separation anxiety, and physical anxiety symptoms were assessed every 3 months for 3 years. Hierarchical linear modeling was used to examine the concurrent and longitudinal effects of emotion dysregulation assessed at baseline or 18 months on anxiety. RESULTS: After controlling for depression, age, and gender, all three processes concurrently predicted physical and social anxiety, and all but nonacceptance predicted separation anxiety. Only difficulties with goal-directed behavior, however, predicted longitudinal change in separation anxiety over time with covariates. Additionally, emotion non-awareness and difficulties with goal-directed behavior predicted subsequent changes in social anxiety. CONCLUSIONS: Emotion dysregulation may serve as a potential risk factor for the development of anxiety symptoms among youth. It may be beneficial to target reductions in maladaptive strategies in prevention or intervention work.

Predictors and moderators of biopsychological social stress responses following brief self-compassion meditation training.

Arch et al. (2014) demonstrated that brief self-compassion meditation training (SCT) dampened sympathetic (salivary alpha-amylase) and subjective anxiety responses to the Trier Social Stress Test (TSST), relative to attention and no-instruction control conditions. The present study examined baseline predictors and moderators of these SCT intervention effects. Baseline characteristics included two stress vulnerability traits (social anxiety and rumination) and two potential resiliency traits (non-attachment and self-compassion). We investigated how these traits moderated the effects of SCT on response to the TSST, relative to the control conditions. We also tested how these individual differences predicted TSST responses across conditions in order to uncover characteristics that confer increased vulnerability and resiliency to social stressors. Trait non-attachment, rumination (for sympathetic TSST response only), and social anxiety (for subjective TSST response only) interacted with training condition to moderate TSST responses such that following SCT, lower attachment and lower social anxiety predicted lower TSST stress responses, relative to those scoring higher on these traits. In contrast, trait self-compassion neither moderated nor predicted responses to the TSST. Thus, although SCT had robust effects on buffering stress across individuals with varying levels of trait self-compassion, other psychological traits enhanced or dampened the effect of SCT on TSST responses. These findings support the importance of examining the role of relevant baseline psychological traits to predict sympathetic and subjective responses to social evaluative threat, particularly in the context of resiliency training.

The credibility of exposure therapy: Does the theoretical rationale matter?

OBJECTIVE: Little is understood about how the public perceives exposure-based therapy (ET) for treating anxiety and trauma-related disorders or how ET rationales affect treatment credibility. Distinct approaches to framing ET are practiced, including those emphasized in traditional cognitive behavioral therapy, acceptance and commitment therapy, and the more recent inhibitory learning model. However, their relative effect on ET's credibility remains unknown. METHOD: A final sample of 964 U.S. adults provided baseline views of ET. Participants rated ET treatment credibility following a simple ET definition (pre-rationale) and following randomization to rationale modules addressing ET goals, fear, and cognitive strategies from distinct theoretical perspectives (post-rationale). Baseline ET views, symptoms, and sociodemographic characteristics were examined as putative moderators and predictors. RESULTS: At baseline, the majority had never heard of ET. From pre- to post-rationale, ET treatment credibility significantly increased but the rationales' theoretical perspective had little impact. More negative baseline ET views, specific ethnic/racial minority group status, and lower education moderated or predicted greater increases in treatment credibility following the rationale. CONCLUSIONS: ET remains relatively unknown as a treatment for anxiety or trauma, supporting the need for direct-to-consumer marketing. Diverse theory-driven rationales similarly increased ET credibility, particularly among those less likely to use ET.

Self-compassion training modulates alpha-amylase, heart rate variability, and subjective responses to social evaluative threat in women.

A growing body of research has revealed that social evaluative stressors trigger biological and psychological responses that in chronic forms have been linked to aging and disease. Recent research suggests that self-compassion may protect the self from typical defensive responses to evaluation. We investigated whether brief training in self-compassion moderated biopsychological responses to the Trier Social Stress Test (TSST) in women. Compared to attention (placebo) and no-training control conditions, brief self-compassion training diminished sympathetic (salivary alpha-amylase), cardiac parasympathetic, and subjective anxiety responses, though not HPA-axis (salivary cortisol) responses to the TSST. Self-compassion training also led to greater self-compassion under threat relative to the control groups. In that social stress pervades modern life, self-compassion represents a promising approach to diminishing its potentially negative psychological and biological effects.