Self-focused attention vs. negative attentional bias during public speech task in socially anxious individuals.

Enhanced self-focused attention (SFA) and negative attentional bias (NAB) towards social cues are characteristic hallmarks of social anxiety. It is essential to investigate these two attentional phenomena under socially relevant situations using comparable stimuli. In the present study, individuals with high social anxiety (HSA, n = 32) and low social anxiety (LSA, n = 29) were compared according to their attention toward self-related stimuli and toward positive, neutral, and negative feedback related stimuli. Video stimuli of moving indicators of self-anxiety-status and positive, neutral, and negative feedback from an audience were presented during an impromptu speech task (high anxiety condition) and a re-watching phase (low anxiety condition). Eye movements in response to the different stimuli served as readouts for attentional preference. An interaction effect suggested that the HSA group directed more attention to self-related stimuli relative to other stimuli and the LSA group only during the high anxiety condition. The LSA group exhibited a general attentional preference toward positive feedback, especially during the low anxiety condition. Meanwhile, only the total duration of fixation on positive feedback negatively correlated with subjective anxiety rating. Our results point to increased SFA rather than NAB in HSA individuals under social threats.

Psychometric properties and measurement invariance of Depression, Anxiety and Stress Scales (DASS-21) across cultures.

Cross-culturally measurement invariant instruments are useful for the assessment of mental symptoms across cultures. The current study aimed to investigate the psychometric properties and measurement invariance of the Depression, Anxiety and Stress Scales (DASS-21) (DASS) across Pakistan and Germany. German participants were recruited through an online survey (N = 1323), while Pakistani participants were recruited through online survey or paper-and-pencil survey (N = 1841). The DASS-21 showed good reliability, construct and structure validity in both countries. The DASS-21 indicated partial weak (stress subscale) and partial strong measurement invariance (depression and anxiety subscales) between both countries. Latent mean comparison of depression and anxiety symptoms between Pakistani and German students indicated that Pakistani university students experience more symptoms of depression and anxiety. Results suggest that the DASS-21 could be used in Pakistan and Germany, but caution should be taken when making direct comparisons between the two countries.

Salutogenic constructs across Pakistan and Germany: A cross sectional study / Constructos de salud en Pakistán y Alemania: un estudio transversal

BACKGROUND/OBJECTIVE: Protective factors are relevant for mental health in general, however, universality of the instruments has been rarely tested. Therefore, the current study aimed to examine psychometric properties and cross-cultural measurement invariance of salutogenic constructs. METHOD: Data was collected from university students of Pakistan (n = 1,841) and Germany (n = 7,890). Single-group confirmatory analysis (CFA) and multiple-group CFA was tested to examine the proposed factor structure and measurement invariance of Positive Mental Health Scale, Resilience Scale, Perceived Social Support Questionnaire, and Life Satisfaction Scale across student samples from Pakistan and Germany respectively. RESULTS: We found strong measurement invariance for the Positive Mental Health Scale, Life Satisfaction Scale, and partial strong measurement for the Resilience Scale, and Perceived Social Support Questionnaire. CONCLUSIONS: The results indicate that these scales could be recommended for the meaningful comparison of latent means across cultures. Understanding these differences would further advance our knowledge about the mechanism underlying positive mental health

ANTECEDENTES/OBJETIVO: Los factores de protección son relevantes para la salud mental en general. Sin embargo, la universalidad de los instrumentos ha sido raramente probada. Por lo tanto, el presente estudio tiene como objetivo examinar las propiedades psicométricas y la invariabilidad de las mediciones interculturales de constructos salutogénicos. MÉTODO: Se recogieron datos de estudiantes universitarios de Pakistán (n = 1.841) y Alemania (n = 7.890). El análisis confirmatorio de un solo grupo (CFA) y el CFA de múltiples grupos fueron probados para examinar la estructura de factores propuesta y la invariabilidad de la medición de la Escala de Salud Mental Positiva, la Escala de Resiliencia, el Cuestionario de Apoyo Social Percibido y la Escala de Satisfacción de Vida a través de muestras de estudiantes de Pakistán y Alemania, respectivamente. RESULTADOS: Encontramos una fuerte invariancia en las mediciones de la Positive Mental Health Scale, la Life Satisfaction Scale, y una medición parcial fuerte en la Resilience Scale y el Perceived Social Support Questionnaire. CONCLUSIONES: Los resultados indican que estas escalas podrían recomendarse para la comparación significativa de los medios latentes entre culturas. La comprensión de estas diferencias aumentaría aún más nuestro conocimiento sobre el mecanismo que subyace a la salud mental positiva

Salutogenic constructs across Pakistan and Germany: A cross sectional study.

BACKGROUND/OBJECTIVE: Protective factors are relevant for mental health in general, however, universality of the instruments has been rarely tested. Therefore, the current study aimed to examine psychometric properties and cross-cultural measurement invariance of salutogenic constructs. METHOD: Data was collected from university students of Pakistan (n = 1,841) and Germany (n = 7,890). Single-group confirmatory analysis (CFA) and multiple-group CFA was tested to examine the proposed factor structure and measurement invariance of Positive Mental Health Scale, Resilience Scale, Perceived Social Support Questionnaire, and Life Satisfaction Scale across student samples from Pakistan and Germany respectively. RESULTS: We found strong measurement invariance for the Positive Mental Health Scale, Life Satisfaction Scale, and partial strong measurement for the Resilience Scale, and Perceived Social Support Questionnaire. CONCLUSIONS: The results indicate that these scales could be recommended for the meaningful comparison of latent means across cultures. Understanding these differences would further advance our knowledge about the mechanism underlying positive mental health.

ANTECEDENTES/OBJETIVO: Los factores de protección son relevantes para la salud mental en general. Sin embargo, la universalidad de los instrumentos ha sido raramente probada. Por lo tanto, el presente estudio tiene como objetivo examinar las propiedades psicométricas y la invariabilidad de las mediciones interculturales de constructos salutogénicos. MÉTODO: Se recogieron datos de estudiantes universitarios de Pakistán (n = 1.841) y Alemania (n = 7.890). El análisis confirmatorio de un solo grupo (CFA) y el CFA de múltiples grupos fueron probados para examinar la estructura de factores propuesta y la invariabilidad de la medición de la Escala de Salud Mental Positiva, la Escala de Resiliencia, el Cuestionario de Apoyo Social Percibido y la Escala de Satisfacción de Vida a través de muestras de estudiantes de Pakistán y Alemania, respectivamente. RESULTADOS: Encontramos una fuerte invariancia en las mediciones de la Positive Mental Health Scale, la Life Satisfaction Scale, y una medición parcial fuerte en la Resilience Scale y el Perceived Social Support Questionnaire. CONCLUSIONES: Los resultados indican que estas escalas podrían recomendarse para la comparación significativa de los medios latentes entre culturas. La comprensión de estas diferencias aumentaría aún más nuestro conocimiento sobre el mecanismo que subyace a la salud mental positiva.

Predictors of treatment outcomes and adherence in internet-based cognitive behavioral therapy for social anxiety in China.

BACKGROUND: Although internet-based cognitive behaviour therapy (ICBT) is an effective treatment for social anxiety disorder (SAD), a substantial proportion of patients do not achieve clinically significant improvement. More research is needed to identify which factors predict treatment adherence and outcomes. AIMS: The aims of this study were to (1) identify demographic and clinical factors associated with treatment adherence and outcomes in ICBT for social anxiety in China, and (2) explore whether low-intensity therapist support results in improved treatment adherence or outcomes. METHOD: Participants were assigned to either therapist-guided (N = 183) or self-guided ICBT (N = 72). Level of social anxiety was measured at both pre- and post-treatment. Treatment adherence and outcomes were analysed using a two-step linear and logistic regression approach. Clinical and demographic characteristics were examined. RESULTS: No significant group differences were found for treatment adherence or outcomes between the therapist-guided and self-guided conditions. Participants diagnosed with SAD were significantly less likely to drop out (OR 0.531, p = .03) compared with subclinical participants with social anxiety symptoms. Older participants (B = 0.17, SE = 0.04, p = .008) and participants with a diagnosis of SAD (B = 0.16, SE = 0.44, p = .01) tended to complete more modules. Participants who completed more modules (B = 0.24, SE = 0.03, p = .01) and participants who identified as female (B = -0.20, SE = 0.18, p = .04) reported greater reductions in SAD symptoms. CONCLUSIONS: Understanding of factors related to adherence and outcome is necessary to prevent drop-out and optimize outcome.

Avoidance of all feedback? Attention allocation during and after public speech in social anxiety.

BACKGROUND AND OBJECTIVES: Attention avoidance of feedback-related stimuli is proposed to be associated with and maintain social anxiety. However, previous research has mainly focused on comparing the attention bias between two types of stimuli, while little is known about attention distribution patterns among positive, neutral, and negative feedback and non-feedback stimuli in individuals with high trait social anxiety (HSA) or low trait social anxiety (LSA). METHODS: The current study assessed eye movement pattern of participants with HSA or LSA during a speech task (high anxiety condition) or while solely watching audience feedback of the speech (low anxiety condition). A pre-recorded audience who displayed approving, neutral, or disapproving gestures was presented as feedback stimuli, while neutral facial photos were used as non-feedback stimuli. RESULTS: Only in the high anxiety condition, participants with HSA exhibited longer total fixation on non-feedback stimuli compared to those with LSA; whereas in the low anxiety condition, both groups paid more attention to emotional feedback stimuli. LIMITATIONS: The final sample size was modest due to a high suspicion rate of the reality of the audience. CONCLUSIONS: These findings suggest that only in highly anxious social situations, socially anxious individuals lack the attentional preference toward positive feedback that individuals with low anxious have.

Bullying History and Mental Health In University Students: The Mediator Roles of Social Support, Personal Resilience, and Self-Efficacy.

Bullying victimization by peers is highly prevalent in childhood and adolescence. There is convincing evidence that victimization is associated with adverse mental health consequences. In contrast, it has been found that perpetrators suffer no adverse mental health consequences. These findings originate from Western countries such as Germany but have rarely been investigated in collectivistic societies such as China. Furthermore, it has been rarely studied whether positive intrapersonal characteristics (e.g., personal resilience and self-efficacy) and interpersonal positive resources (e.g., social support) may mediate the impact of bullying on mental health. The current study used a path analytic model to examine, firstly, whether previous bullying experiences (both victimization and perpetration) are associated with current positive and negative mental health in university students and, secondly, whether these influences are mediated by social support, resilience, and self-efficacy. The model was tested in 5,912 Chinese and 1,935 German university students. It was found that in both countries, higher victimization frequency was associated with lower levels of social support, personal resilience, and self-efficacy, which in turn predicted poorer mental health. Moreover, and only in China, perpetration was negatively associated with social support and personal resilience but not self-efficacy. In contrast, in the German sample, perpetration experience was found to enhance one's self-efficacy, and the later was associated with better mental health. The results support a mediation model in which social support, personal resilience, and self-efficacy partially mediate the influence of victimization on mental health in both countries. For the relationship between perpetration and mental health, self-efficacy was the only full mediator in Germany, whereas in China, both social support and personal resilience were partial mediators. In conclusion, peer victimization has adverse effects on mental health in both Germany and China. Only in China, however, is perpetration also associated with adverse mental health outcomes. In contrast, getting ahead by bullying in an individualistic society such as Germany is associated with increased self-efficacy and mental health. The differences found between an individualistic country and a collectivistic country have important implications for understanding and planning interventions to reduce bullying.

Brief form of the Perceived Social Support Questionnaire (F-SozU K-6): Validation, norms, and cross-cultural measurement invariance in the USA, Germany, Russia, and China.

The present study evaluates a brief, cross-cultural scale that maps a wide range of social resources, useful in large-scale assessments of perceived social support. The Brief Perceived Social Support Questionnaire (Fragebogen zur Sozialen Unterstützung Kurzform mit sechs Items, F-SozU K-6) was examined in representative and university student samples from the United States (Nrepresentative = 3038), Germany (Nrepresentative = 2007, Nstudent = 5406), Russia (Nrepresentative = 3020, Nstudent = 4001), and China (Nstudent = 13,582). Cross-cultural measurement invariance testing was conducted in both representative and student samples across countries. Scores on the F-SozU K-6 demonstrated good reliability and strong model fit for a unidimensional structure in all samples, with the exception of poor model fit for German students. The scores on F-SozU K-6 correlated negatively with scores on depression, anxiety, and stress measures and positively with scores on positive mental health measures. Norms for gender and age groups were established separately based on each representative sample. Cross-cultural measurement invariance testing found partial strong measurement invariance across three general population samples and three student samples. Furthermore, a simulation study showed that the amount of invariance observed in the partial invariance model had only a negligible impact on mean comparisons. Psychometric findings across diverse cultural contexts supported the robustness and validity of the F-SozU K-6 for cross-cultural epidemiologic studies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Bidirectional Relationship between Positive Mental Health and Social Rhythm in College Students:A Three-Year Longitudinal Study.

Social rhythm refers to the general regularity of engaging in basic social activities during the week, and was found to be associated with individuals' positive mental health. The present study investigated the relationship between social rhythm and emotional well-being in a cohort of 2,031 college students over 3 years with a cross-lagged longitudinal panel design. Results revealed that regularity of social rhythm positively predicted emotional well-being in the following year, and vice versa, when the level of both factors in the previous year was controlled. Our study provides evidence of a longitudinal positive reciprocal relationship between social rhythm and positive mental health in younger adult populations.

Social Anxiety and Interpretation Bias: Effect of Positive Priming.

This study examined how positive-scale assessment of ambiguous social stimuli affects interpretation bias in social anxiety. Participants with high and low social anxiety (N = 60) performed a facial expression discrimination task to assess interpretation bias. Participants were then randomly assigned to assess the emotion of briefly presented faces either on a negative or on a positive scale. They subsequently repeated the facial expression discrimination task. Participants with high versus low social anxiety made more negative interpretations of ambiguous facial expressions. However, those in the positive-scale assessment condition subsequently showed reduced negative interpretations of ambiguous facial expressions. These results suggest that interpretation bias in social anxiety could be mediated by positive priming rather than an outright negative bias.

Attentional biases in high social anxiety using a flanker task.

BACKGROUND AND OBJECTIVES: The existence of threat-related attentional bias has been well supported in social anxiety research. However, most previous studies investigated separately attentional bias toward targets or distractors. This study examined the selective attention of socially anxious individuals in the presence of both emotional targets and distractors. METHODS: Participants with high vs. low social anxiety (HSA vs. LSA) took part in a modified flanker task. Participants initially focused on the center of the screen, and then were required to identify the emotion of the central face (target) regardless of the flanking faces (distractors). RESULTS: The response times (RTs) of the HSA and LSA groups did not differ significantly when responding to different central faces (targets), but the HSA group responded more slowly to central faces when the flankers (distractors) were negative faces as opposed to positive or neutral. LIMITATIONS: The depression levels of participants in this non-clinical sample were not controlled. CONCLUSION: The results support attention control theory and suggest impaired inhibition control in HSA..

Attention allocation in social anxiety during a speech.

Cognitive models assume that social anxiety is associated with and maintained by biased information processing, leading to change in attention allocation, which can be measured by examining eye movement. However, little is known about the distribution of attention among positive, neutral and negative stimuli during a social task and the relative importance of positive versus negative biases in social anxiety. In this study, eye movement, subjective state anxiety and psychophysiology of individuals with high trait social anxiety (HSA) and low trait social anxiety (LSA) were measured during a speech task with a pre-recorded audience. The HSA group showed longer total fixation on negative stimuli and shorter total fixation on positive stimuli compared to the LSA group. We observed that the LSA group shifted attention away from negative stimuli, whereas the HSA group showed no differential attention allocation. The total duration of fixation on negative stimuli predicted subjective anxiety ratings. These results point to a negative bias as well as a lack of a positive bias in HSA individuals during social threat.

Loving-Kindness Meditation to Target Affect in Mood Disorders: A Proof-of-Concept Study.

Conventional treatments for mood disorders primarily focus on reducing negative affect, but little on enhancing positive affect. Loving-kindness meditation (LKM) is a traditional meditation practice directly oriented toward enhancing unconditional and positive emotional states of kindness towards oneself and others. We report here two independent and uncontrolled studies carried out at different centers, one in Boston, USA (n = 10), and one in Frankfurt, Germany (n = 8), to examine the potential therapeutic utility of a brief LKM group intervention for symptoms of dysthymia and depression. Results at both centers suggest that LKM was associated with large-sized effects on self-reported symptoms of depression (d = 3.33 and 1.90), negative affect (d = 1.98 and 0.92), and positive affect (d = 1.63 and 0.94). Large effects were also found for clinician-reported changes in depression, rumination and specific positive emotions, and moderate effects for changes in adaptive emotion regulation strategies. The qualitative data analyses provide additional support for the potential clinical utility of the intervention. This proof-of-concept evaluation of LKM as a clinical strategy warrants further investigation.

Enhanced association between perceptual stimuli and trauma-related information in individuals with posttraumatic stress disorder symptoms.

BACKGROUND AND OBJECTIVES: Intrusive memories in traumatized individuals are often triggered by stimuli that are perceptually (rather than conceptually) similar to those present just before or during the trauma. The present study examined whether those individuals with high levels of Posttraumatic Stress Disorder (PTSD) symptoms show a memory bias recall to perceptual cues and trauma target words compared to those with low levels of PTSD. METHODS: The sample consisted of 30 adult participants who were involved in motor-vehicle or work-related accidents; 15 of the participants endorsed clinically elevated symptoms of PTSD, while a comparison group of 15 participants reported low levels of symptoms. Participants performed an associative recognition task with conceptual or perceptual cue words and trauma-related or neutral target words. Participants were tested for their recognition accuracy by reporting the corresponding target when a cue was given. RESULTS: Both groups performed better for the perceptual word pairs than for the conceptual word pairs, irrespective of the target word type. However, only the high PTSD symptoms group exhibited an additional enhancement in performance for the perceptual word pairs with trauma-related target words. LIMITATIONS: A nonclinical sample was utilized for this study; although PTSD was assessed, diagnoses were not confirmed. In addition, there was lack of a healthy non-traumatized control group. CONCLUSIONS: These results provide partial support for the cognitive model and the notion that intrusive memories are specific to the trauma-related event rather than to a general associative learning bias.

Time-course of attentional bias for positive social words in individuals with high and low social anxiety.

BACKGROUND: Although accumulating research demonstrates the association between attentional bias and social anxiety, the bias for positive stimuli has so far not been adequately studied. AIMS: The aim is to investigate the time-course of attentional bias for positive social words in participants with high and low social anxiety. METHOD: In a modified dot-probe task, word-pairs of neutral and positive social words were randomly presented for 100, 500, and 1250 milliseconds in a nonclinical sample of students to test their attentional bias. RESULTS: Non-significant interaction of Group × Exposure Duration was found. However, there was a significant main effect of group, with significantly different response latencies between the high social anxiety (HSA) and low social anxiety (LSA) groups in the 100 ms condition, without for 500 or 1250 ms. With respect to attentional bias, the LSA group showed enhanced preferential attention for positive social words to which the HSA group showed avoidance in the 100 ms condition. In the 500 ms condition, preferential attention to positive social words was at trend in the LSA group, relative to the HSA group. Neither group showed attentional bias in the 1250 ms condition. CONCLUSIONS: These findings extend recent research about the attention training program and add to the empirical literature suggesting that the initial avoidance of positive stimuli may contribute to maintaining social anxiety.