Testing the efficacy of a brief exercise intervention for enhancing exposure therapy outcomes.

Recently, it has been hypothesized that a brief bout of exercise could cognitively enhance extinction learning processes theorized to underlie exposure therapy for pathological anxiety. The present study tested the exercise enhancement hypothesis in a sample of speech-anxious undergraduates (n = 84). During the first laboratory session, participants engaged in either 30 min of moderate-intensity exercise on a cycling ergometer (n = 37) or seated rest (n = 47) immediately following a brief speech exposure trial. They returned approximately one week later to give a follow-up speech. Contrary to expectation, there were no significant between-group differences in memory of a brief word list across four recall trials, which served as a manipulation check. Further, all main effects and interactions involving condition were nonsignificant. Post hoc tests revealed that participants who reported higher average perceived exertion during exercise demonstrated increases in an average anxiety composite across speeches relative to those who reported lower average perceived exertion, indicating that trying hard during the intervention predicted worse exposure trial outcomes. The implications of these findings, as well as future directions for this line of research, are explored.

Exposure therapy augmentation: A review and extension of techniques informed by an inhibitory learning approach.

Although exposure therapy is often considered a gold standard behavioral intervention for pathological anxiety, questions remain surrounding the mechanisms underlying exposure interventions, and some individuals are characterized by suboptimal treatment outcomes. Recently, a formulation known as the inhibitory learning theory, which is grounded in basic science principles of extinction learning and memory, has been proposed to provide a more parsimonious mechanistic explanation for the effects of exposure than previous, habituation-based models [Craske, M.G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. 2008. Optimizing inhibitory learning during exposure therapy. Behaviour Research and Therapy, 46, 5-27; Craske, M.G., Treanor, M., Conway, C.C., Zbozinek, T., & Vervliet, B. 2014. Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23]. Strategies informed by this theory are proposed to maximize extinction learning by fostering the development of new, non-threat associations between stimuli in memory and enhancing the accessibility and retrieval of these safety-based associations. This comprehensive review serves as a critical examination of the empirical literature regarding major tenets of inhibitory learning theory and the potential for such techniques to augment exposure therapy for anxiety disorders. Limitations of the extant research, as well as potential future directions, are explored.

The behavioral economics of social anxiety disorder reveal a robust effect for interpersonal traits.

Recent evidence suggests that reduced generosity among individuals with social anxiety disorder (SAD) in behavioral economic tasks may result from constraint in changing behavior according to interpersonal contingencies. That is, people with SAD may be slower to be more generous when the situation warrants. Conversely, more global effects on generosity may be related to interpersonal vindictiveness, a dimension only somewhat related to SAD. A total of 133 participants, 73 with the generalized form of SAD, completed self-report instruments and a behavioral economic task with simulated interpersonal (friend, romantic partner, stranger) interactions. In a separate visit, friends (n = 88) also came to the lab and rated participants on vindictiveness. Interpersonal vindictiveness was associated with reduced initial and overall giving to simulated friends. SAD predicted a lack of increased giving to a simulated friend, and attenuated an increase in giving to simulated known versus unknown players compared to participants without SAD. Friend-reported vindictiveness predicted in the same direction as diagnosis. However, the findings for SAD were less robust than those for vindictiveness. SAD is perhaps weakly related to behavioral constraint in economic tasks that simulate interpersonal interactions, whereas vindictiveness is strongly related to lower overall generosity as well as (via friend report) behavioral constraint. Further study is needed to better characterize the construct of vindictiveness. Our findings dovetail with the suggestion that SAD is related to impairment in the proposed affiliation and attachment system, but further suggest that direct study of that system may be more fruitful than focusing on disorders.

Predicting short-term positive affect in individuals with social anxiety disorder: The role of selected personality traits and emotion regulation strategies.

Recently, research has provided support for a moderate, inverse relationship between social anxiety and dispositional positive affect. However, the dynamics of this relationship remain poorly understood. The present study evaluates whether certain personality traits and emotion regulation variables predict short-term positive affect for individuals with social anxiety disorder and healthy controls. Positive affect as measured by two self-report instruments was assessed before and after two tasks in which the participant conversed with either a friend or a romantic partner. Tests of models examining the hypothesized prospective predictors revealed that the paths did not differ significantly across diagnostic group and both groups showed the hypothesized patterns of endorsement for the emotion regulation variables. Further, a variable reflecting difficulty redirecting oneself when distressed prospectively predicted one measure of positive affect. Additional research is needed to explore further the role of emotion regulation strategies on positive emotions for individuals higher in social anxiety.

Positive Affect and Social Anxiety Across the Lifespan: An Investigation of Age as a Moderator.

Recent literature has supported a moderate, inverse relationship between social anxiety and positive affect. It has been proposed, but not clearly established, that the inverse relationship between the constructs may be stronger in younger adults than in adults who are older. We tested this hypothesis in two archival data sets of community participants. The expected age-related interaction was not found in Study 1, which used a measure capturing a conflation of valence and arousal known as activated positive affect. Conversely, the interaction was present in Study 2, in which the positive affect measure was primarily based on valence. We found only partial support for the hypothesis, and results highlight the need for a more comprehensive measure of positive affect.

Short-term affective recovery from hip fracture prospectively predicts depression and physical functioning.

OBJECTIVE: The goals of the current study were to determine the average affective experiences in the weeks and months after a hip fracture and assess how these experiences relate to physical and mental health functioning over time. METHOD: Positive and negative affect were assessed over time in a sample of older adults recruited after surgery for hip fracture (n = 500) and a comparison sample of older adults without hip fracture (n = 102) for 1 year longitudinally. RESULTS: For most of the individuals with a hip fracture, positive affect tended to increase over time and negative affect tended to decrease over time, suggesting that most people had at least some recovery of affect. In addition, individuals who showed a slower decrease in negative affect had higher levels of depression 1 year later, and individuals who showed a sharper increase in positive affect had superior physical function 1 year later. CONCLUSION: The current study provides evidence that both positive and negative affect in the first 12 weeks of recovery from hip fracture are potential targets for intervention to maximize psychological and physical recovery in the ensuing year.

Self and friend's differing views of social anxiety disorder's effects on friendships.

Social anxiety disorder is known to be associated with self-report of global friendship quality. However, information about specific friendships, as well as information beyond self-report, is lacking. Such information is crucial, because known biases in information processing related to social anxiety disorder render global self-ratings particularly difficult to interpret. We examined these issues focusing on diagnosed participants (n = 77) compared with community control participants (n = 63). We examined self-report regarding global (i.e., overall) friendship quality and a specific friendship's quality; in addition, we examined friend-report of that friendship's quality. Results suggested that social anxiety disorder has a negative impact on self-perception of friendship quality for a specific friendship, but that this effect is less evident as reported by the friends. Specifically, social anxiety disorder was associated with a tendency to report worse friendship quality in comparison to friend-report, particularly in participants who were younger or had less long-lasting friendships. However, friend-report did show clear differences based on diagnostic group, with friends reporting participants with social anxiety disorder to be less dominant in the friendship and less well-adjusted. Overall, the findings are consistent with results of other studies indicating that social anxiety disorder has a strong association with self-ratings of impairment, but that these ratings appear out of proportion with the report of observers (in this case, friends).