Research paperMapping network connectivity among symptoms of social anxiety and comorbid depression in people with social anxiety disorder
Section snippets
Participants
The sample consisted of 174 individuals (72% female) with a primary DSM-IV-TR diagnosis of SAD. In addition, 47 had a comorbid diagnosis of major depressive disorder, 26 had a diagnosis of depression (not otherwise specified), and 5 had a diagnosis of dysthymia. The participants constitute a convenience sample of individuals who were recruited for five other studies who had, as a result of participating in those studies, completed questionnaires measuring symptoms of social anxiety and
Network estimation
We used a Graphical Gaussian Model (GGM) to estimate networks whose edges represent conditional independence relationships between nodes when controlling for the effects of all other nodes (Epskamp et al., 2017a). We regularized our model by running the graphical LASSO (Least Absolute Shrinkage and Selection Operator; Friedman et al., 2008). The aims of this procedure are two-fold. First, it computes (regularized) partial correlations between pairs of symptoms, thereby eliminating spurious
Results
In the figures depicting the networks and the centrality plots, we used the following abbreviations to designate the fear and avoidance of social situations as well as depressive symptoms. Each social situation from the LSAS is designated by a number ranging from 1 to 24 accompanied either by the letter “f” or “a”, representing fear and avoidance, respectively. Depressive symptoms are identified by the letter “d” and a number ranging from 1 to 21, referring to the 21 symptoms of the BDI-II.
Discussion
Many people with SAD also suffer from depression. To our knowledge, this is the first study to examine the empirical network structure of fear and avoidance of distinct situations among individuals with SAD and their relation with comorbid depression symptoms. Perhaps the most striking result was the observation, in line with previous network studies (e.g., Bekhuis et al., 2016; McNally et al., 2017b; Robinaugh et al., 2014), that not all nodes were equally important in determining the
Acknowledgments
The authors are thankful to the McNally Lab's members for their thoughtful comments and suggestions on a previous version of this manuscript.
Funding
This work was supported by a postdoctoral fellowship from the Helaers Foundation for Clinical Neuroscience; the Belgian Foundation for Vocation (“Vocatio”); and the WBI World Excellence Grant—BioWin: The Competitive Cluster in Health and Life Sciences of Wallonia [grant number: sub/2015/228106243177], all awarded to Dr. Alexandre Heeren. These foundations did not exert any editorial influence over this article.
References (72)
- et al.
Fear, avoidance and physiological symptoms during cognitive-behavioral therapy for social anxiety disorder
Behav. Res. Ther.
(2013) Centrality and network flow
Soc. Netw.
(2005)- et al.
Networks containing negative ties
Soc. Netw.
(2014) - et al.
Untangling attention bias modification from emotion: a double-blind randomized experiment among individuals with social anxiety disorder
J. Behav. Ther. Exp. Psychiatry
(2016) - et al.
Revisiting attentional processing of non-emotional cues in social anxiety: a specific impairment for the orienting network of attention
Psychiatry Res.
(2015) - et al.
Does attention bias modification improve attentional control? A double-blind randomized experiment with individuals with social anxiety disorder
J. Anxiety Disord.
(2015) - et al.
An integrative network approach to social anxiety disorder: the complex dynamic interplay among attentional bias for threat, attentional control, and symptoms
J. Anxiety Disord.
(2016) Temperamental contributions to the development of psychological profiles: II. Two candidates
- et al.
A transactional approach to social anxiety and the genesis of interpersonal closeness: self, partner, and social context
Behav. Ther.
(2005) The effect of the decreased safety behaviors on anxiety and negative thoughts in social phobics
J. Anxiety Disord.
(2005)
The link between social anxiety disorder, treatment outcome, and sleep difficulties among patients receiving cognitive behavioural group therapy
Sleep Med.
Does chocolate consumption really boost Nobel award chances? The peril of over-interpreting correlations in nutrition and health studies
J. Nutr.
Can network analysis transform psychopathology?
Behav. Res. Ther.
What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment
Cogn. Behav. Pract.
Bipolar II and unipolar comorbidity in 153 outpatients with social phobia
Compr. Psychiatry
Recurrence of anxiety disorders and its predictors
J. Affect Disord.
Social comparison and negative self-evaluations: an application to depression
Clin. Psychol. Rev.
Relationship of social phobia with other psychiatric illness
J. Affect. Disord.
The aetiology and maintenance of social anxiety disorder: A synthesis of complimentary theoretical models and formulation of a new integrated model
J. Affect. Disord.
Social phobia, avoidant personality disorder and atypical depression: co-occurrence and clinical implications
Psychol. Med.
Network analysis of depression and anxiety symptom relationships in a psychiatric sample
Psychol. Med.
Beck Depression Inventory Manual
The network structure of major depressive disorder, generalized anxiety disorder and somatic symptomatology
Psychol. Med.
Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life
Arch. Gen. Psychiatry
Unpacking rumination and executive control: a network perspective
Clin. Psychol. Sci.
What characteristics of primary anxiety disorders predict subsequent major depressive disorder?
J. Clin. Psychiatry
A network theory of mental disorders
World Psychiatry
Network analysis: an integrative approach to the structure of psychopathology
Annu. Rev. Clin. Psychol.
The network structure of psychopathology in a community sample of preadolescents
J. Abnorm. Psychol.
Protocoles et échelles d’évaluation en psychiatrie et psychologie
Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample
J. Abnorm. Psychol.
Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study
Am. J. Psychiatry
Reductions in the social anxiety of women associated with group membership distraction, anonymity, security, or diffusion of evaluation
Group Dyn. Theor. Res.
Becoming the center of attention in social anxiety disorder: startle reactivity to a virtual audience during speech anticipation
J. Clin. Psychiatry
Suicidal ideation and suicide attempts in panic disorder and social phobia
Am. J. Psychiatry
Cited by (101)
The longitudinal relationships between short video addiction and depressive symptoms: A cross-lagged panel network analysis
2024, Computers in Human BehaviorNetwork analysis of well-being of managerial employees in the construction industry
2023, Journal of Building EngineeringCentral psychological symptoms from a network analysis of patients with anxiety, somatoform or personality disorders before psychotherapy
2023, Journal of Affective DisordersComorbidity of loneliness and social anxiety in adolescents: Bridge symptoms and peer relationships
2023, Social Science and MedicineA network perspective on cognitive function and obsessive-compulsive related symptoms
2023, Journal of Affective Disorders