The Relationship Between Social Anxiety and Anxious Thinking Styles

Browse trials for

• Anxiety Disorders 4,868

Keywords

• social anxiety
• interpretation bias
• cognitive bias modification

Anxiety Disorders

4,868 studies on the registry are indexed under Anxiety Disorders; 1,390 are open to participants now.

This study's enrollment of 85 is close to the median of 80 across 4,174 interventional studies indexed under Anxiety Disorders.

Lead sponsor

Ruhr University of Bochum is the lead sponsor of 124 studies on the registry; 3 are open to participants now.

Study arms

• Experimental
  Cognitive Bias Modification for Interpretation (CBM-I)

  Participants in this arm complete an initial introductory session of Cognitive Bias Modification for Interpretation (CBM-I) in the lab followed by 6 sessions scheduled to be completed over the subsequent week (1 per day). CBM-I will be administered via an online platform using an individual login account.

  Behavioral: Cognitive Bias Modification for Interpretation (CBM-I)

• Sham comparator
  Sham Training Control Condition

  Participants in this arm complete an initial introductory session of the sham training control condition in the lab followed by 6 sessions scheduled to be completed over the subsequent week (1 per day). CBM-I will be administered via an online platform using an individual login account.

  Behavioral: Sham Training Control Condition

Interventions

• BehavioralCognitive Bias Modification for Interpretation (CBM-I)

  The CBM-I intervention is based on the interpretation training paradigm developed by Mathews and Mackintosh (2000). It comprises a series of training scenarios describing different (mostly everyday) socially-relevant situations, structured so they start ambiguously but always have a positive ending. The positive ending is presented as word fragment, which participants are instructure to complete. In about 25% of trials, participants are further requested to respond to comprehension questions about the scenario presented. Each CBM-I session comprises 45 trials presented in 5 blocks of 9 scenarios.

• BehavioralSham Training Control Condition

  The sham training is in an identical format to the CBM-I training, except that the scenarios are all entirely neutral, with no reference to social situations and no emotional ambiguity.

Primary outcomes

1. Change from baseline to follow-up (2 weeks post-baseline) in score on the Liebowitz Social Anxiety Scale, Self-Report (LSAS-SR)

   A 24-item self-report scale assessing social anxiety symptoms over the past 7 days (Consbruch, Stangier \& Heidenreich, 2016; Liebowitz, 1987). Possible scores range from 0 (minimum) to 144 (maximum), with higher scores reflecting higher levels of social anxiety (i.e. worse outcomes). The primary outcome measure is change in score on the LSAS-SR from baseline to follow-up.

   Time frame: Baseline, Follow-up (2 weeks post-baseline)

Secondary outcomes

1. Liebowitz Social Anxiety Scale, Self-Report (LSAS-SR)

   A 24-item self-report scale assessing social anxiety symptoms over the past 7 days (Consbruch, Stangier \& Heidenreich, 2016; Liebowitz, 1987). Possible scores range from 0 (minimum) to 144 (maximum), with higher scores reflecting higher levels of social anxiety (i.e. worse outcomes).

   Time frame: Post-training (1 week post-baseline)

2. Social Phobia and Anxiety Inventory, German version (SPAI-G)

   A 22-item self-report scale used for screening different levels of social anxiety (Turner et al., 1989; Fydrich, 2016). Possible scores range from 0 (minimum) to 132 (maximum), with higher scores reflecting higher levels of social anxiety (i.e. worse outcomes).

   Time frame: Screening, Baseline, Post-training (1 week post-baseline), Follow-up (2 weeks post-baseline)

3. Depression, Anxiety, and Stress Scale-21 (DASS)

   A 21-item self-report questionnaire assessing symptoms of depression, stress and anxiety (7 items per subscale) over the past week (Lovibond \& Lovibond, 1995; Nilges \& Essau, 2015). Possible scores on each subscale range from 0 (minimum) to 21 (maximum), with higher scores reflecting higher levels of symptoms (i.e. worse outcomes).

   Time frame: Baseline, Post-training (1 week post-baseline), Follow-up (2 weeks post-baseline)

4. Brief Fear of Negative Evaluation Scale (BFNE)

   A 12-item self-report scale used to assess fear of being negatively evaluated by others in social situations (Leary, 1983; Reichenberger, Schwarz, König, Wilhelm, .. \& Blechert, 2016). Possible scores range from 12 (minimum) to 60 (maximum), with higher scores reflecting higher levels of fear (i.e. worse outcomes).

   Time frame: Baseline, Post-training (1 week post-baseline), Follow-up (2 weeks post-baseline)

5. Encoding Recognition Task (ERT)

   The ERT is a 10-item computerized measure of interpretation bias (Salemink \& van den Hout, 2010). Four versions are used, applied in a counterbalanced order across participants.

   Time frame: Baseline, After last intervention session (~6 days post-baseline), Post-training (1 week post-baseline), Follow-up (2 weeks post-baseline)

6. Scenario Rating Task (SRT)

   The SRT is used to assess interpretation biases and their neurophysiological correlates via EEG (N400). Participants read ambiguous scenarios (i.e., sentence stems) that are completed by either congruent or incongruent endings, and have to rate how well the endings complete the sentence stems. Participants will be presented with a total of 96 trials, 48 of which are neutral and 48 of which are social anxiety-related. In addition to behavioural responses, the N400 amplitude will be measured via EEG in the 300-450 ms time window post-stimulus onset (i.e., the target word, e.g., Feng et al., 2019; Moser et al., 2008).

   Time frame: Baseline, Post-training (1 week post-baseline)

7. Anagram Task

   The Anagram task is used to investigate stress reactivity towards social-evaluative threats in performance situations (Van Bockstaele et al., 2020). During the Anagram Task, heart rate, heart rate variability, and corrugator activity will be recorded. The state mood ratings (listed below) are used to measure mood response to the task.

   Time frame: Post-training (1 week post-baseline)

8. Salivary cortisol

   Salivary concentrations of cortisol will be collected during both lab assessments. During the first lab assessment, it will be collected once at baseline prior to the administration of the questionnaires. During the second lab assessment, it will be collected four times, at baseline prior to the administration of the questionnaires, pre-Anagram Task, post-Anagram task, post-Anagram task+25 min.

   Time frame: Baseline, Post-training (1 week post-baseline)

9. Salivary alpha-amylase

   Salivary concentrations alpha-amylase will be collected during both lab assessments. During the first lab assessment, it will be collected once at baseline prior to the administration of the questionnaires. During the second lab assessment, it will be collected four times, at baseline prior to the administration of the questionnaires, pre-Anagram Task, post-Anagram task, post-Anagram task+25 min.

   Time frame: Baseline, Post-training (1 week post-baseline)

10. Frontal Asymmetry

    Following Moscovitch et al. (2011), resting frontal alpha asymmetry will be recorded using EEG during an 8-minute resting period (in alternating 1-min eyes-open/eyes-closed segments) at both pre- and post-training. In addition, frontal assymetry will be recorded during the SRT, i.e., when presenting the ambiguous stems.

    Time frame: Baseline, Post-training (1 week post-baseline)

Other outcomes

1. Expectancy Questionnaire (EQ)

   Expectancy effects will be assessed prior to training using the three expectancy items from the Credibility and Expectancy Questionnaire (Borkovec \& Mathews, 1988). A total score is made by standardizing (z-transforming) the three items and adding the z-transformed scores together (i.e. no minimum or maximum scores). Higher scores indicate higher expectancy of improvement.

   Time frame: Baseline

2. Feedback Questionnaire

   A questionnaire asking for feedback about the CBM/Sham intervention will be used, adapted from Woud et al. (2021). Each individual item is interpreted separately (i.e. no sum score is created).

   Time frame: Follow-up (2 weeks post-baseline)

3. Negative Effects Questionnaire (NEQ)

   The short (20-item) version of the Negative Effects Questionnaire (Rozental et al., 2019) will be used to assess potential negative effects and adverse events linked to the study. The scale will be adapted for the purpose of the study with terms like 'therapy' and 'therapist' changed to e.g. 'study' and 'researchers' (as per Blackwell et al., 2022). The number of reported negative effects for each category are summed for reporting purposes.

   Time frame: Follow-up (2 weeks post-baseline)

4. State affect

   State affect will be measured repeatedly throughout the assessment sessions (i.e., at baseline, pre-stressor, post-stressor, during and after the recovery phase) using a 7-item scale developed by Becker et al. (2016). This scale includes the following items: "I feel... tense / sad / anxious / confident / relaxed / happy / relieved", with each item being judged via a 5-point Likert scale.

   Time frame: Baseline, Post-training (1 week post-training)

Individual participant data

Plan to share: Yes — Anonymised data will be made available on publication via a suitable repository such as the Open Science Framework, and will be made available to reviewers at the time of submission (or publically with a pre-print version of the manuscript). Data made available will be the research data reported in the publication, withthe exception of any data that could compromise participant anonymity.

Supporting information: Study protocol, Sap, Icf, Analytic code