Reactivity to Exclusion Prospectively Predicts Social Anxiety Symptoms in Young Adults

doi:10.1016/j.beth.2013.04.007

Behavior Therapy

Volume 44, Issue 3, September 2013, Pages 470-478

https://doi.org/10.1016/j.beth.2013.04.007 Get rights and content

Highlights

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We tested the effects of peer victimization on social anxiety over time
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We utilized Cyberball computer task to simulate peer victimization
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Reactivity to exclusion prospectively predicted social anxiety symptoms
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Self-reported past and current teasing did not predict social anxiety
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Interventions could target reactivity to peer victimization

Abstract

Peer victimization leads to negative outcomes such as increased anxiety and depression. The prospective relationship between peer victimization and social anxiety in children and adolescents is well established, and adults with social anxiety disorder (SAD) are more likely than individuals with other anxiety disorders to report a history of teasing. However, a crucial bridge between these findings (peer victimization in young adults) is missing. We manipulated perceptions of peer exclusion in a young adult sample (N = 108) using the Cyberball Ostracism Task. Reactivity to exclusion prospectively predicted social anxiety symptoms at a 2-month follow-up, whereas self-reported teasing during high school and current relational victimization did not. This research suggests that reactions to peer victimization may be a worthwhile target for clinical interventions in young adults. Targeting how young adults react to stressful social interactions such as exclusion may help prevent the development of SAD. Future research should test if reactivity to exclusion plays a role in the relationship between other disorders (e.g., depression) and peer victimization.

Section snippets

Participants

A total of 108 participants completed the Time 1 session and 100 participants returned to complete the Time 2 session to receive credit as part of their coursework at a midwestern metropolitan university. Participants were mostly white (n = 63; 58.3%) women (n = 67; 62.0%). Other ethnicities reported were Asian/Pacific Islander (n = 34; 31.5%), Black (n = 6; 5.6%), multiracial (n = 4; 3.7%), and Hispanic (n = 1; .9%). Two thirds of our participants were in either their freshman or sophomore year of college

Results

Table 1 displays means, standard deviations, and intercorrelations among all variables. In a single model, all Time 1 predictors were used to predict all Time 2 constructs. The initial model fit was perfect by definition because the model was saturated. However, model fit when nonsignificant paths (ps > .10) were dropped was excellent (df = 6; CFI = 1.00, TLI = 1.00, RMSEA = .00, SRMR = .03). As can be seen in Figure 1, reactivity to exclusion (estimate = .16, p = .008) was the only significant predictor of

Discussion

We found that reactivity to exclusion simulated by the Cyberball computer task prospectively predicted social anxiety 2 months later. Against hypothesis, and in contrast with findings regarding children and adolescents, past teasing through high school and current relational victimization at Time 1 did not prospectively predict social anxiety. These results bridge findings between childhood and adolescent research and research on adults with SAD (e.g., Erath et al., 2008, McCabe et al., 2003,

References (35)

A.C. Baldry
Bullying in schools and exposure to domestic violence
Child Abuse and Neglect
(2003)
C.Z. Berg et al.
Are emotions frightening? II: An analogue study of fear of emotion, interpersonal conflict, and panic onset
Behaviour Research and Therapy
(1998)
R.P. Mattick et al.
Development and validation of measures of social phobia scrutiny fear and social interaction anxiety
Behaviour Research and Therapy
(1998)
D.A. Moscovitch et al.
In the absence of rose-colored glasses: Ratings of self-attributes and their differential certainty and importance across multiple dimensions in social phobia
Behaviour Research and Therapy
(2009)
T.L. Rodebaugh et al.
More reasons to be straightforward: Findings and norms for two scales relevant to social anxiety
Journal of Anxiety Disorders
(2011)
D.A. Roth et al.
The relationship between memories for childhood teasing and anxiety and depression in adulthood
Journal of Anxiety Disorders
(2002)
L. Zadro et al.
How long does it last? The persistence of the effects of ostracism in the socially anxious
Journal of Experimental Social Psychology
(2006)
P.M. Bentler
Comparative fit indexes in structural models
Psychological Bulletin
(1990)
D.M. Clark et al.
A cognitive model of social phobia
N.I. Eisenberger
Why rejection hurts: What social neuroscience has revealed about the brain’s response to social rejection
Brain
(2011)

N.I. Eisenberger et al.

Functional magnetic resonance imaging responses relate to differences in real-world social experience

Emotion

(2007)

N.I. Eisenberger et al.

Does rejection hurt? An fMRI study of social exclusion

Science

(2003)

S.A. Erath et al.

Early adolescent school adjustment: Associations with friendship and peer victimization

Social Development

(2008)

P. Gilbert

Depression: The evolution of powerlessness

(1992)

D.J. Hawker et al.

Twenty years’ research on peer victimization and psychosocial maladjustment: A meta-analytic review of cross-sectional studies

Journal of Child Psychology and Psychiatry

(2000)

R.G. Heimberg et al.

A cognitive-behavioral model of social anxiety disorder: Update and extension

R.G. Heimberg et al.

Assessment of social phobia

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We created a composite score because composite measures generally provide more reliable estimates of constructs (Zeller & Carmines, 1980) and reduce the number of analyses conducted. Similar composite measures have been used in previous studies of SA (Clark et al., 2003, 2006; Kaplan, Levinson, Rodebaugh, Menatti, & Weeks, 2015; Levinson, Langer, & Rodebaugh, 2013) and have demonstrated very good internal consistency (e.g., Kaplan et al., 2015) and test-retest reliability (Levinson et al., 2013). To create the composite SA score, we summed the standardized scores of every item from each of the two measures.
Higher weight individuals experience frequent weight-related discrimination, which is associated with exercise avoidance. Exercise is a health behavior with multiple physical and mental health benefits and should be accessible to all. The current study examined another factor that might influence exercise in addition to weight stigma: social anxiety (SA). Given the often public nature of exercise, individuals with SA may feel scrutinized when exercising, which may lead to avoidance. This study examined whether SA moderates the relationship between body mass index (BMI) and exercise and whether SA and its interaction with BMI predict exercise behavior after accounting for weight stigma. We administered an online survey to 603 undergraduates (72 % female, 60 % White). SA was not significantly associated with BMI, but it was positively associated with weight stigma and exercise-avoidance motivation and negatively associated with self-reported exercise. SA moderated the relationship between BMI and exercise-avoidance motivation; individuals with higher BMIs were motivated to avoid exercise, but only if they reported higher SA. This interaction predicted exercise-avoidance motivation after accounting for weight stigma and its interaction with BMI. However, SA did not moderate the relationship between BMI and self-reported exercise. SA may be associated with exercise avoidance among higher weight individuals.
Social exclusion and rejection across the psychosis spectrum: A systematic review of empirical research
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Social exclusion and rejection have deleterious effects on psychological well-being. Research documents the negative effects of social exclusion and rejection on psychiatric problems like depression, social anxiety disorder, and non-suicidal self-injury. Additionally, prior research suggests that individuals with and at-risk for psychosis spectrum disorders may also be negatively affected by exclusion and rejection. Moreover, those on the psychosis spectrum may be at an even greater risk to experience social exclusion due to poor social functioning and the stigma surrounding the disorder. This systematic review aimed to investigate how individuals across the psychosis spectrum respond to social exclusion and rejection. We systematically searched PubMed and PsycINFO databases to identify studies that met the following eligibility criteria: 1) investigated social exclusion or rejection, 2) targeted a psychosis-related sample or symptoms, and 3) was an empirical study. 13 studies satisfied our eligibility criteria and were subsequently reviewed. Despite methodological variation and samples spanning the psychosis spectrum, the majority of the literature supports the conclusion that those with psychosis spectrum disorders report similar levels of exclusion-induced distress compared to healthy controls, but process and cope with exclusion differently, both behaviorally and neurobiologically.
Perceived burdensomeness and neural responses to ostracism in the Cyberball task
2020, Journal of Psychiatric Research
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The current sample showed average scores of 10.1 ± 6.1 and 26.2 ± 13.7 for PB and TB, respectively. As social anxiety and depression can impact both the performance and brain responses during the Cyberball task (Heeren et al., 2017; Jobst et al., 2015; Levinson et al., 2013), we assessed these characteristics using the Social Interaction Anxiety Scale (SIAS) (Mattick and Clarke, 1998) and Beck Depression Inventory (BDI) (Beck et al., 1996). The 20-item SIAS evaluates fear of general social interaction, with each item scored from 0 to 4 (3 items are reverse coded) and higher scores indicating greater anxiety.
Previous studies have identified the brain correlates of social pain processing during ostracism. However, the affective response to ostracism may vary according to individual differences in interpersonal needs and subsequent social actions. Despite this relationship, how the neural processes underlying ostracism may be modulated by interpersonal needs to regulate prosocial behaviors remains unknown. Here, in an fMRI study of 64 adults performing the Cyberball task, we quantified ball catching and tossing response time (RT) as a behavioral measure of participants’ willingness to seek and reciprocate social interactions. Neural activations to social exclusion were identified and characterized in relation to individual differences in behavioral performance and perceived burdensomeness (PB), a measure of interpersonal needs. The results showed that social exclusion elicited activity in the anterior insula, middle frontal gyrus, postcentral gyrus, and dorsomedial prefrontal cortex, replicating previous studies on ostracism. Importantly, those with higher PB also exhibited greater brain activations to exclusion as well as reduced prosocial behaviors, as reflected by slower ball catching and tossing RT in the Cyberball task. Taken together, these findings suggest that emotional distress in ostracism may increase with PB, resulting in stronger neural responses to social pain and behavioral avoidance of social interactions.
Social exclusion influences conditioned fear acquisition and generalization: A mediating effect from the medial prefrontal cortex
2020, NeuroImage
Fear acquisition and generalization play key roles in promoting the survival of mammals and contribute to anxiety disorders. While previous research has provided much evidence for the repercussions of social exclusion on mental health, how social exclusion affects fear acquisition and generalization has received scant attention. In our study, participants were divided into two groups according to two Cyberball paradigm conditions (exclusion/inclusion). Both groups underwent a Pavlovian conditioning paradigm, functional near-infrared spectroscopy (fNIRS), and skin conductance response (SCR) assessments. We aimed to determine the effects of social exclusion on fear acquisition and generalization and whether modulation of the medial prefrontal cortex (mPFC) mediates this relationship. Our results showed that socially excluded participants featured significantly higher and lower shock risk scores to safety stimuli (conditioned stimulus, CS-) and threatening stimuli (CS+), respectively, than did socially included subjects during fear acquisition. The exclusion group had increased skin conductance responses (SCRs) to CS and exhibited heightened shock risk and increased SCRs to generalized stimuli compared with the inclusion group. The fNIRS results demonstrated that the CS + evoked larger oxy-Hb changes in the mPFC in the inclusion group than in the exclusion group during fear acquisition. Furthermore, the oxy-Hb of left mPFC of CS + mediated the effect on the association between social exclusion and perceived risk of CS+ in the fear acquisition. Our results indicate that social exclusion impairs fear acquisition and generalization via the mediation of the mPFC and that social exclusion increases susceptibility to anxiety disorders through bias processing of fear discrimination in fear acquisition and generalization. By studying the role of social relationship in fear acquisition and generalization, our research provides new insights into the pathological mechanisms of anxiety disorder.
Can words be worse than stones? Understanding distressing social events and their relationship with social anxiety
2020, Journal of Anxiety Disorders
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First, frequencies of both antagonistic and non-antagonistic distressing social events were expected to be related to social anxiety (e.g., Storch & Masia-Warner, 2004). Second, responses to distressing social events captured by a measure of PTSD symptoms were expected to have a stronger relationship with social anxiety than the frequencies of the different kinds of antagonistic and non-antagonistic distressing social events (Carleton et al., 2011; Levinson et al., 2013; Rosen et al., 2012). Third, responses to distressing social events captured by a measure of PTSD symptoms were expected to statistically mediate the relationships between distressing social event frequencies and social anxiety.
Research on the relationship between distressing social events and social anxiety has focused on antagonistic social events (i.e., peer victimization, cyberbullying) in adolescent samples. There is little research examining such relationships in adults, and less examining the relationship between non-antagonistic distressing social events (i.e., accidental embarrassing events) and social anxiety. The current investigation utilized a retrospective design to examine how different distressing social events may be associated with posttraumatic stress-like reactions, which may relate to social anxiety in early adulthood. Characteristics of distressing social events (i.e., betrayal, presence of an antagonist) were explored as possible influences on the severity of stress responses. Community participants (n = 271; ages 18–25) completed online questionnaires measuring social anxiety and reactions to distressing social events. Antagonistic and non-antagonistic distressing social events were both related to social anxiety. Relationships between the frequencies of any distressing social events and social anxiety were mediated by reactions akin to posttraumatic stress. Responses to distressing social events were not influenced by the presence of an antagonist or betrayal. The results suggest that non-antagonistic distressing social events can be as distressing as antagonistic distressing social events and contribute to expanding evidence that reactions to distressing social events may resemble reactions to life-threatening events.
Social trauma and its association with posttraumatic stress disorder and social anxiety disorder
2020, Journal of Anxiety Disorders
The key characteristic of a traumatic event as defined by the Diagnostic and Mental Manual of Mental Disorders (DSM) seems to be a threat to life. However, evidence suggests that other types of threats may play a role in the development of PTSD and other disorders such as social anxiety disorder (SAD). One such threat is social trauma, which involves humiliation and rejection in social situations. In this study, we explored whether there were differences in the frequency, type and severity of social trauma endured by individuals with a primary diagnosis of SAD (n = 60) compared to a clinical control group of individuals with a primary diagnosis of obsessive compulsive disorder (OCD, n = 19) and a control group of individuals with no psychiatric disorders (n = 60). The results showed that most participants in this study had experienced social trauma. There were no clear differences in the types of experiences between the groups. However, one third of participants in the SAD group (but none in the other groups) met criteria for PTSD or suffered from clinically significant PTSD symptoms in response to their most significant social trauma. This group of SAD patients described more severe social trauma than other participants. This line of research could have implications for theoretical models of both PTSD and SAD, and for the treatment of individuals with SAD suffering from PTSD after social trauma.

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^☆: We would like to thank Simona C. Kaplan and Lauren Kramer for their research assistance. This research was funded in part by F31-MH096433-01 to Cheri A. Levinson.

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Reactivity to Exclusion Prospectively Predicts Social Anxiety Symptoms in Young Adults☆

Highlights

Abstract

Section snippets

Participants

Results

Discussion

Child Abuse and Neglect

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Journal of Anxiety Disorders

Journal of Anxiety Disorders

Journal of Experimental Social Psychology

Comparative fit indexes in structural models

Psychological Bulletin

A cognitive model of social phobia

Why rejection hurts: What social neuroscience has revealed about the brain’s response to social rejection

Brain

Functional magnetic resonance imaging responses relate to differences in real-world social experience

Emotion

Does rejection hurt? An fMRI study of social exclusion

Science

Early adolescent school adjustment: Associations with friendship and peer victimization

Social Development

Depression: The evolution of powerlessness

Twenty years’ research on peer victimization and psychosocial maladjustment: A meta-analytic review of cross-sectional studies

Journal of Child Psychology and Psychiatry

A cognitive-behavioral model of social anxiety disorder: Update and extension

Assessment of social phobia