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"Beidel, Deborah C"
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Is There any Difference Between DSM-5 performance-only Specifier and Social Anxiety Disorder? Results from the Young-HUNT3 Study
With the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA, 2013), the diagnostic criteria for social anxiety disorder (SAD) changed; the generalized SAD specifier was removed, and a performance-only specifier was introduced. Despite growing awareness and understanding of the DSM-5 performance-only type specifier, information about its key aspects is lacking. Exploring a large, population-based adolescent sample (N = 8,216), we identified three SAD classes: full spectrum SAD, subclinical SAD, and the performance-only specifier. The three groups were compared across a broad range of parameters. The results indicate that adolescents with the performance-only specifier differed significantly from both the full spectrum and subclinical groups on most clinical indexes. By contrast, the subclinical and full spectrum groups differed less from each other on most parameters. Thus, there were specific aspects of the performance-only specifier group that differentiate this condition from subclinical and clinical SAD in our sample of adolescents. These data indicate that the specifier in the new version of the DSM may be valid in adolescents, and that policymakers and clinicians should not disregard adolescents who show subclinical SAD levels with performance-related challenges. Furthermore, researchers and clinicians should consider the extent to which adolescents with the SAD performance-only specifier may need a different treatment approach.
Journal Article
Olfactory Stimuli Increase Presence in Virtual Environments
Exposure therapy (EXP) is the most empirically supported treatment for anxiety and trauma-related disorders. EXP consists of repeated exposure to a feared object or situation in the absence of the feared outcome in order to extinguish associated anxiety. Key to the success of EXP is the need to present the feared object/event/situation in as much detail and utilizing as many sensory modalities as possible, in order to augment the sense of presence during exposure sessions. Various technologies used to augment the exposure therapy process by presenting multi-sensory cues (e.g., sights, smells, sounds). Studies have shown that scents can elicit emotionally charged memories, but no prior research has examined the effect of olfactory stimuli upon the patient's sense of presence during simulated exposure tasks.
60 adult participants navigated a mildly anxiety-producing virtual environment (VE) similar to those used in the treatment of anxiety disorders. Participants had no autobiographical memory associated with the VE. State anxiety, Presence ratings, and electrodermal (EDA) activity were collected throughout the experiment.
Utilizing a Bonferroni corrected Linear Mixed Model, our results showed statistically significant relationships between olfactory stimuli and presence as assessed by both the Igroup Presence Questionnaire (IPQ: R2 = 0.85, (F(3,52) = 6.625, p = 0.0007) and a single item visual-analogue scale (R2 = 0.85, (F(3,52) = 5.382, p = 0.0027). State anxiety was unaffected by the presence or absence of olfactory cues. EDA was unaffected by experimental condition.
Olfactory stimuli increase presence in virtual environments that approximate those typical in exposure therapy, but did not increase EDA. Additionally, once administered, the removal of scents resulted in a disproportionate decrease in presence. Implications for incorporating the use of scents to increase the efficacy of exposure therapy is discussed.
Journal Article
An Examination of Psychopathology and Daily Impairment in Adolescents with Social Anxiety Disorder
Although social anxiety disorder (SAD) is most often diagnosed during adolescence, few investigations have examined the clinical presentation and daily functional impairment of this disorder exclusively in adolescents. Prior studies have demonstrated that some clinical features of SAD in adolescents are unique relative to younger children with the condition. Furthermore, quality of sleep, a robust predictor of anxiety problems and daily stress, has not been examined in socially anxious adolescents. In this investigation, social behavior and sleep were closely examined in adolescents with SAD (n = 16) and normal control adolescents (NC; n = 14). Participants completed a self-report measure and an actigraphy assessment of sleep. Social functioning was assessed via a brief speech and a social interaction task, during which heart rate and skin conductance were measured. Additionally, participants completed a daily social activity journal for 1 week. No differences were observed in objective or subjective quality of sleep. Adolescents with SAD reported greater distress during the analogue social tasks relative to NC adolescents. During the speech task, adolescents with SAD exhibited a trend toward greater speech latency and spoke significantly less than NC adolescents. Additionally, SAD participants manifested greater skin conductance during the speech task. During the social interaction, adolescents with SAD required significantly more confederate prompts to stimulate interaction. Finally, adolescents with SAD reported more frequent anxiety-provoking situations in their daily lives, including answering questions in class, assertive communication, and interacting with a group. The findings suggest that, although adolescents with SAD may not exhibit daily impaired sleep, the group does experience specific behavioral and physiological difficulties in social contexts regularly. Social skills training may be a critical component in therapeutic approaches for this group.
Journal Article
Psychometric Properties of a Social Skills Assessment using a Virtual Environment
Social Anxiety Disorder (SAD) is a marked and persistent fear of social and/or performance situations in which embarrassment or scrutiny from others may occur. One form of behavioral assessment is a Role Play Task (RPT). However, RPTs often are not feasible in clinical settings due to the common obstacles in implementation. Thus, the current study examines the feasibility, acceptability and psychometric properties of a virtual environment based social skills assessment compared to the traditional RPT. Forty-six children, ages 7 to 14, participated in two assessment conditions: RPT and a virtual environment behavioral assessment (VE BAT). Participants reported self-ratings of anxiety and acceptability, while blinded observers rated social skills and overall social anxiety. An ANCOVA, covarying for age, revealed (a) no significant task difference for voice volume, speech latency, number of words spoken, effectiveness, and SAM ratings; (b) that the VE BAT was more feasible to implement in terms of personnel time and costs and; (c) more overall anxiety during the RPT task than during the VE BAT task. In addition, the VE BAT demonstrated moderate concurrent validity when correlating the self-report ratings of anxiety with the Social Phobia and Anxiety Inventory for Children (SPAI-C). The current study addresses many of the impediments to conducting RPTs in a clinical setting and, overall, supports the utilization of VE BATS as a viable alternative for the behavioral assessment of social skills in children. Further implications address the potential for the armamentarium for social skills training with children with SAD.
Journal Article
Comprehensive evidence-based interventions for children and adolescents
A complete guide to evidence based interventions for children and adolescents
The past decade has witnessed the development of numerous interventions proved to be highly effective; several treatments are now considered to be \"well established\" or \"probably efficacious\" interventions for children. Given the range of providers working with children—clinical psychologists, child psychiatrists, clinical social workers, school psychologists, and marriage and family therapists—this book is designed to provide all professionals the information they now need about the use of these evidence-based interventions (EBIs), as well as the evaluation criteria used to determine their efficacy in in meeting the mental health needs of children.
Alfano and Beidel have assembled a team of experts to write the disorder chapters. Each chapter begins with an overview of the disorder then delves into evidence-based approaches to treatment, the impact of parental involvement, case-by-case modifications, progress measurement, and clinical examples. In overview chapters the editors cover:
* The role of development in treatment planning and implementation
* Dissemination of EBIs into school and community settings
* The use of controversial therapies with children
* Emerging methods of service delivery and access improvement
Comprehensive Evidence Based Interventions for Children and Adolescents provides clinicians, researchers, and students alike with the theoretical, conceptual, and practical skills to provide children and adolescents with the best care possible.
eBook
Peer Support Programs for First Responders: A Critical Review and Research Roadmap
First responders face adverse health effects because they regularly encounter stressful situations and potentially traumatic events. Peer support programs have emerged as a method to reduce these adverse outcomes. A growing interest in peer programs exists despite a restricted body of research in this field. Additionally, the current research on this topic faces significant conceptual and methodological shortcomings. This paper conducts an extensive analysis of present peer support research gaps before proposing future study directions to improve our understanding of this intervention.
Journal Article
Social Skills Interventions for Children with Asperger’s Syndrome or High-Functioning Autism: A Review and Recommendations
This paper reviews the literature examining social skills training (SST) programs for youth with AS/HFA, with an emphasis on critically evaluating efficacy and highlighting areas of future research. The review highlights the disparity between SST programs described in the extant literature, including lack of a universal definition of social skills, various levels of intensity and duration of treatment, divergent theoretical backgrounds, and variety in services provided in clinic or classroom settings. Overall, it is clear that, despite their widespread clinical use, empirical support for SST programs for children with AS/HFA is minimal at this time. Based on this critical review, a “roadmap” for future research, consistent with recommendations put forth by a leading group of autism researchers, is presented.
Journal Article
Can Virtual Reality Effectively Elicit Distress Associated with Social Anxiety Disorder?
This study examined the ability of a Virtual Reality (VR) environment to elicit the physiological and subjective arousal typically associated with public speaking. Using 21 adults with Social Anxiety Disorder (SAD) and 24 adults with no disorder, this study had three objectives: (a) to determine whether speaking to a virtual audience elicited significant increases in physiological response (e.g., heart rate, electrodermal activity, and respiratory sinus arrhythmia) and subjective distress over baseline resting conditions (b) to determine if individuals with SAD had a greater increase in physiological arousal and subjective distress when speaking in front of a live audience vs. the virtual environment and (c) to determine whether individuals with SAD had greater changes in physiological and self-reported arousal during each speech task compared to controls. All participants gave an impromptu speech in front of an in vivo and VR audience while measures of physiological arousal and self-reported distress were obtained. Results demonstrated that the VR task elicited significant increases in heart rate, electrodermal activity, and respiratory sinus arrhythmia, and self-reported distress over baseline conditions but was less anxiety-producing than the in vivo speech task. In addition, participants reported a moderate level of presence in the VR task, but significantly less than in the in vivo task. No group differences were found on physiological measures. Clinical implications of these findings and the role of VR in the treatment of SAD are discussed.
Journal Article