Advertisement

A Situational Context Training for Socially Anxious Children

  • Daniela SchwabEmail author
  • Anne Schienle
Brief Report
  • 12 Downloads

Abstract

The processing of facial expressions is biased in social anxiety (SA). We tested whether a brief situational context training in the school setting might be helpful in changing biased facial processing and reducing relevant symptoms in children with SA. A final sample of 118 children aged 8 to 13 years with high vs. low SA were randomly assigned to a training group or a control group without intervention. During the training, the children were exposed to images depicting negative facial expressions with masked and later unmasked backgrounds, in order to demonstrate that negative expressions can also occur in emotion-irrelevant contexts (e.g., during onion cutting). Especially for socially anxious children, the intervention effectively reduced harmful expectations during the presentation of images showing negative facial expressions. Moreover, socially anxious children having undertaken the training were able to perform a subjectively more challenging social evaluation task in front of the class.

Keywords

Social anxiety Facial expression processing Cognitive bias Situational context information Social evaluation 

Notes

Compliance with Ethical Standards

Conflict of interest

Daniela Schwab and Anne Schienle declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study were approved by the ethics committee of the University of Graz and were in accordance with the 1964 Helsinki declaration and its later amendments.

Animal Rights Statements

All institutional and national guidelines for the care and use of laboratory animals were followed.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (national and institutional). Informed consent was obtained from all individual subjects participating in the study.

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, D.C: American Psychiatric Association.CrossRefGoogle Scholar
  2. Beard, C. (2011). Cognitive bias modification for anxiety: current evidence and future directions. Expert Review of Neurotherapeutics,11(2), 299–311.  https://doi.org/10.1586/ern.10.194.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Beesdo, K., Bittner, A., Pine, D. S., Stein, M. B., Höfler, M., Lieb, R., et al. (2007). Incidence of Social Anxiety Disorder and the Consistent Risk for Secondary Depression in the First Three Decades of Life. Archives of General Psychiatry,64(8), 903.  https://doi.org/10.1001/archpsyc.64.8.903.CrossRefPubMedGoogle Scholar
  4. Beesdo-Baum, K., Knappe, S., Fehm, L., Hofler, M., Lieb, R., Hofmann, S. G., et al. (2012). The natural course of social anxiety disorder among adolescents and young adults. Acta Psychiatrica Scandinavica,126(6), 411–425.  https://doi.org/10.1111/j.1600-0447.2012.01886.x.CrossRefPubMedGoogle Scholar
  5. De Jong, P. J., Merckelbach, H., Bögels, S., & Kindt, M. (1998). Illusory correlation and social anxiety. Behaviour Research and Therapy,36(11), 1063–1073.  https://doi.org/10.1016/S0005-7967(98)00099-0.CrossRefPubMedGoogle Scholar
  6. Garner, M., Mogg, K., & Bradley, B. P. (2006a). Fear-relevant selective associations and social anxiety: Absence of a positive bias. Behaviour Research and Therapy,44(2), 201–217.  https://doi.org/10.1016/j.brat.2004.12.007.CrossRefPubMedGoogle Scholar
  7. Garner, M., Mogg, K., & Bradley, B. P. (2006b). Orienting and maintenance of gaze to facial expressions in social anxiety. Journal of Abnormal Psychology,115(4), 760–770.  https://doi.org/10.1037/0021-843X.115.4.760.CrossRefPubMedGoogle Scholar
  8. Gazelle, H., & Rubin, K. H. (2010). Social anxiety in childhood: bridging developmental and clinical perspectives. New Directions for Child and Adolescent Development,2010(127), 1–16.  https://doi.org/10.1002/cd.259.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Grant, B. F., Hasin, D. S., Blanco, C., Stinson, F. S., Chou, S. P., Goldstein, R. B., et al. (2005). The epidemiology of social anxiety disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. The Journal of Clinical Psychiatry,66(11), 1351–1361.CrossRefGoogle Scholar
  10. Hadwin, J. A., Donnelly, N., Richards, A., French, C. C., & Patel, U. (2009). Childhood anxiety and attention to emotion faces in a modified stroop task. British Journal of Developmental Psychology,27(2), 487–494.  https://doi.org/10.1348/026151008X315503.CrossRefPubMedGoogle Scholar
  11. Kashdan, T. B., & Herbert, J. D. (2001). Social anxiety disorder in childhood and adolescence: current status and future directions. Clinical Child and Family Psychology Review,4(1), 37–61.CrossRefGoogle Scholar
  12. Kessler, R. C., Angermeyer, M., Anthony, J. C., de Graaf, R., Demyttenaere, K., Gasquet, I., et al. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry : Official Journal of the World Psychiatric Association (WPA),6(3), 168–176.Google Scholar
  13. Klein, A. M., Rapee, R. M., Hudson, J. L., Schniering, C. A., Wuthrich, V. M., Kangas, M., et al. (2015). Interpretation modification training reduces social anxiety in clinically anxious children. Behaviour Research and Therapy,75, 78–84.  https://doi.org/10.1016/j.brat.2015.10.006.CrossRefPubMedGoogle Scholar
  14. Kolassa, I.-T., Kolassa, S., Musial, F., & Miltner, W. H. R. (2007). Event-related potentials to schematic faces in social phobia. Cognition & Emotion,21(8), 1721–1744.  https://doi.org/10.1080/02699930701229189.CrossRefGoogle Scholar
  15. Kolassa, I.-T., Kolassa, S., Bergmann, S., Lauche, R., Dilger, S., Miltner, W. H. R., et al. (2009). Interpretive bias in social phobia: An ERP study with morphed emotional schematic faces. Cognition & Emotion,23(1), 69–95.  https://doi.org/10.1080/02699930801940461.CrossRefGoogle Scholar
  16. Kujawa, A., MacNamara, A., Fitzgerald, K. D., Monk, C. S., & Phan, K. L. (2015). Enhanced Neural Reactivity to Threatening Faces in Anxious Youth: Evidence from Event-Related Potentials. Journal of Abnormal Child Psychology,43(8), 1493–1501.  https://doi.org/10.1007/s10802-015-0029-4.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Lau, J. Y. F. (2013). Cognitive bias modification of interpretations: a viable treatment for child and adolescent anxiety? Behaviour Research and Therapy,51(10), 614–622.  https://doi.org/10.1016/j.brat.2013.07.001.CrossRefPubMedGoogle Scholar
  18. McGorry, P. D., Purcell, R., Goldstone, S., & Amminger, G. P. (2011). Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Current Opinion in Psychiatry,24(4), 301–306.  https://doi.org/10.1097/YCO.0b013e3283477a09.CrossRefPubMedGoogle Scholar
  19. Melfsen, S. (1998). Die deutsche Fassung der Social Anxiety Scale for Children Revised (SASC-R-D): Psychometrische Eigenschaften und Normierung. Diagnostica,44(3), 153–163.Google Scholar
  20. Merikangas, K. R., He, J.-P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., ... Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017
  21. Merikangas, K. R., He, J.-P., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., ... Olfson, M. (2011). Service utilization for lifetime mental disorders in U.S. adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 50(1), 32–45. https://doi.org/10.1016/j.jaac.2010.10.006
  22. Mobini, S., Reynolds, S., & Mackintosh, B. (2013). Clinical implications of cognitive bias modification for interpretative biases in social anxiety: An integrative literature review. Cognitive Therapy and Research,37(1), 173–182.  https://doi.org/10.1007/s10608-012-9445-8.CrossRefGoogle Scholar
  23. Ollendick, T. H., & Hirshfeld-Becker, D. R. (2002). The developmental psychopathology of social anxiety disorder. Biological Psychiatry,51, 44–58.CrossRefGoogle Scholar
  24. Rossignol, M., Campanella, S., Maurage, P., Heeren, A., Falbo, L., & Philippot, P. (2012a). Enhanced perceptual responses during visual processing of facial stimuli in young socially anxious individuals. Neuroscience Letters,526(1), 68–73.  https://doi.org/10.1016/j.neulet.2012.07.045.CrossRefPubMedGoogle Scholar
  25. Rossignol, M., Philippot, P., Bissot, C., Rigoulot, S., & Campanella, S. (2012b). Electrophysiological correlates of enhanced perceptual processes and attentional capture by emotional faces in social anxiety. Brain Research,1460, 50–62.  https://doi.org/10.1016/j.brainres.2012.04.034.CrossRefPubMedGoogle Scholar
  26. Rossignol, M., Campanella, S., Bissot, C., & Philippot, P. (2013). Fear of negative evaluation and attentional bias for facial expressions: An event-related study. Brain and Cognition,82(3), 344–352.  https://doi.org/10.1016/j.bandc.2013.05.008.CrossRefPubMedGoogle Scholar
  27. Ruscio, A. M., Brown, T. A., Chiu, W. T., Sareen, J., Stein, M. B., & Kessler, R. C. (2008). Social fears and social phobia in the USA: Results from the National Comorbidity Survey Replication. Psychological Medicine,38(1), 15–28.  https://doi.org/10.1017/S0033291707001699.CrossRefPubMedGoogle Scholar
  28. Schneier, F. R., Blanco, C., Antia, S. X., & Liebowitz, M. R. (2002). The social anxiety spectrum. Psychiatric Clinics of North America,25(4), 757–774.  https://doi.org/10.1016/S0193-953X(02)00018-7.CrossRefPubMedGoogle Scholar
  29. Schwab, D., & Schienle, A. (2017). Facial emotion processing in pediatric social anxiety disorder: Relevance of situational context. Journal of Anxiety Disorders,50, 40–46.  https://doi.org/10.1016/j.janxdis.2017.05.005.CrossRefPubMedGoogle Scholar
  30. Schwab, D., & Schienle, A. (2018). Facial affect processing in social anxiety disorder with early onset: Evidence of an intensity amplification bias. Social Neuroscience,13(3), 318–327.  https://doi.org/10.1080/17470919.2017.1304990.CrossRefPubMedGoogle Scholar
  31. Staugaard, S. R. (2010). Threatening faces and social anxiety: A literature review. Clinical Psychology Review,30(6), 669–690.  https://doi.org/10.1016/j.cpr.2010.05.001.CrossRefPubMedGoogle Scholar
  32. Stirling, L. J., Eley, T. C., & Clark, D. M. (2006). Preliminary evidence for an association between social anxiety symptoms and avoidance of negative faces in school-age children. Journal of Clinical Child and Adolescent Psychology,35(3), 431–439.  https://doi.org/10.1207/s15374424jccp3503_9.CrossRefPubMedGoogle Scholar
  33. Vassilopoulos, S. P., & Banerjee, R. (2012). Social anxiety and content specificity of interpretation and judgemental bias in children. Infant and Child Development,21(3), 298–309.  https://doi.org/10.1002/icd.746.CrossRefGoogle Scholar
  34. Vassilopoulos, S. P., Banerjee, R., & Prantzalou, C. (2009). Experimental modification of interpretation bias in socially anxious children: Changes in interpretation, anticipated interpersonal anxiety, and social anxiety symptoms. Behaviour Research and Therapy,47(12), 1085–1089.  https://doi.org/10.1016/j.brat.2009.07.018.CrossRefPubMedGoogle Scholar
  35. Waters, A., Mogg, K., Bradley, B., & Pine, D. (2011). Attention bias for angry faces in children with social phobia. Journal of Experimental Psychopathology,2(4), 475–489.  https://doi.org/10.5127/jep.018111.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Clinical PsychologyUniversity of GrazGrazAustria

Personalised recommendations