Purpose: There is accumulating evidence that treatment preference may significantly impact treatment compliance and satisfaction in individuals with psychological disorders. Very few studies have examined treatment preferences in clients with social anxiety disorder (SAD). Moreover, little is known if treatment preference for a conventional therapy such as cognitive behavioural therapy versus mindfulness-based interventions, influence outcomes. The primary objective of the current study was to determine whether treatment expectancy and preferences for a mindfulness intervention adapted for SAD (MBI-SAD), cognitive behavior group therapy (CBGT), or no preference, would influence treatment compliance and treatment satisfaction. Method: The sample included 97 participants who met the DSM-5 criteria for SAD. After selecting a treatment preference, participants were randomly assigned to a treatment group. Analyses of variance, chi-square, and logistic regressions were conducted to determine if being matched to one’s preferred treatment influenced outcomes, and if those with no preference differed from those who indicated a preference. Hierarchical multiple regression was used to determine if participants’ perceptions of credibility and expectations and match to treatment influenced compliance and satisfaction. Results: There was some support that treatment preference and match to treatment influenced compliance and satisfaction, however the majority of the analyses revealed no impact of treatment preferences. CBGT met expectations more often than did MBI-SAD when participants were matched to their preferred treatment. When participants were matched to their preferred treatment or had no preference, they were more compliant with homework than those who were not matched. Those with no preference had lower attendance than both the matched and not matched groups. Perceived credibility and expectancy were higher for those who were matched to their preferred group, however this did not have an impact on compliance and satisfaction. The remainder of the analyses did not find a relationship between treatment preference or match to treatment on compliance or satisfaction.

Purpose: There is growing interest in the clinical application of mindfulness meditation. However, little is known about the extent to which clients prefer mindfulness-based interventions (MBI) over conventional psychological therapies. The present study examined predictors of treatment preference and credibility in individuals with social anxiety disorder (SAD) who participated in a randomized trial of a mindfulness intervention adapted for SAD (MBI-SAD) versus a conventional psychological therapy (cognitive behavior group therapy; CBGT). Method: The sample included 97 adults who met DSM-5 criteria for SAD. Binary logistic and multiple linear regressions were conducted to examine baseline sociodemographic and clinical predictors of treatment preference for the MBI-SAD and perception of treatment credibility. Analysis of variance was used to compare levels of trait mindfulness across treatment preference groups. Results: The majority of participants (49%) reported a preference for the MBI-SAD. Ratings of treatment credibility were comparable for the two interventions. Employment status significantly predicted preference for CBGT versus the MBI-SAD, whereas younger age predicted preference for CBGT. Higher household income, a history of psychotherapy, elevated scores on clinician ratings of depression and social anxiety, and lower scores on self-report depression predicted no treatment preference. Higher household income predicted greater perceived credibility of treatment. Trait mindfulness did not differ across the treatment preference groups or predict treatment credibility. Discussion: Mindfulness meditation appears to be an acceptable and credible treatment for SAD. However, few baseline demographic and clinical characteristics predicted preference for the MBI-SAD. Additional research is needed to explore factors that shape preference and beliefs about mind-body interventions.

Purpose: This study assessed whether a mindfulness-based intervention (MBI) adapted for social anxiety disorder (SAD) led to increases in self-compassion and trait mindfulness, and whether these increases mediated change in SAD symptom severity. Methods: Participants were randomly assigned to a 12-week MBI adapted for SAD (MBI-SAD, n = 21) or a wait-list control (WLC, n = 18). The MBI-SAD included aspects of the mindfulness-based stress reduction program, as well as explicit training in self-compassion and “mindful exposure”. Participants were assessed at baseline and weeks 6 and 12. Results: The MBI-SAD resulted in higher self-compassion and trait mindfulness and lower levels of social anxiety, compared to the WLC. Mediation analyses revealed that self-compassion and aspects of trait mindfulness mediated clinical response. Implications: Results suggest that self-compassion and aspects of trait mindfulness are possible mechanisms of change for the MBI-SAD. Results and their implications are discussed.

Research suggests that patients with social anxiety disorder (SAD) have an attentional bias toward socially threatening stimuli, and recent studies have shown that computerized interventions designed to train attention away from such stimuli decrease attentional bias and SAD symptomatology. The current study sought to replicate findings from previous attention retraining studies and to examine neural mechanisms underlying attentional biases in SAD using functional magnetic resonance imaging (fMRI). Thirty-two SAD patients were randomized to complete either eight 15-minute sessions of a probe detection task designed to train attention away from disgust faces (n=16), or a placebo control task (n=16). Before and after these sessions, patients completed an fMRI probe detection task. Sixteen matched healthy controls also completed this fMRI task on one occasion. Study hypotheses were as follows: (a) post-intervention, SAD patients in the retraining condition would show greater reductions in attentional bias and SAD symptomatology compared to patients in the placebo condition; (b) SAD patients would show greater amygdala activation, and less prefrontal cortex (PFC) activation, when viewing negative faces than healthy controls; and (c) post-intervention, SAD patients in the retraining condition would show less amygdala activation, and greater PFC activation, when viewing negative faces than patients in the placebo condition. Results showed no between-group differences in attentional bias or SAD symptomatology post-intervention, with both groups showing significant symptom reduction. However, attentional bias change was significantly correlated with symptom change across the entire SAD sample (N=32) and was predictive of Liebowitz Social Anxiety Scale scores at post-intervention. Neuroimaging results showed hypo-activation in the orbitofrontal cortex and anterior cingulate cortex at pre-treatment for the SAD group compared to healthy controls. At post-treatment, this difference was no longer significant across the entire SAD group (N=32). Finally, results indicated that activation at pre-treatment in the posterior cingulate cortex/precuneus was significantly correlated with symptom change across the entire SAD sample. These results suggest that SAD patients may not be engaging higher-level cortical regions as readily as healthy controls and add to the recent growing body of research suggesting that attention retraining may not be an effective treatment for patients with SAD.

: Social anxiety can have severe negative consequences for individuals, from lack of crucial social interaction to lower quality of life. A self-presentation theory of social anxiety posits that social anxiety results from outcome expectancies of social interactions (impression efficacy) and how motivated the individual is to create a good impression (impression motivation). There is also a proposed interaction effect, theorizing that as impression efficacy increases, the association between impression motivation and social anxiety weakens. In a lab study (N=125), measures of impression motivation and impression efficacy were measured situationally (e.g., “I believe I will make the impression that I want to achieve”). These measures were collected both prior to a social interaction with a confederate and after, with the belief that another interaction would take place. Conversely, an online survey (N=301) collected the two measures from a dispositional viewpoint (e.g., “In social interactions, other people probably see me as I like them to see me”). Both pre and post interaction moderation analyses in the lab study failed to find a significant interaction effect. However, a significant interaction was found in the online survey data. This inconsistency may point to differences between the variables, depending on whether they are observed from a situational or dispositional perspective. Analysis of this discrepancy could have implications for further understanding the mechanisms of social anxiousness, as well as potential alleviation techniques and/or treatments.

The relationship between racial identity attitudes derived from Crossis (1978) theory of Racial Identity Development, the cognitive correlates of social anxiety, and indices of psychological functioning were explored. Subjects were 101 African American college students. Preencounter, Encounter and Immersion attitudes were all positively related to increased personal distress as indicated by positive relations to fear of negative evaluation, social avoidance and distress, and negative relation to indices of healthy psychological functioning. Internalization attitudes were indicative of healthy psychological functioning as indicated by negative relations to measures of social anxiety and positive relations to indices of healthy psychological functioning. Implications for future research and service delivery to African American populations are discussed. / Master of Science

The purpose of this study was to examine the relationship between perfectionism and social anxiety in general as well as social phobia, specifically. Subjects completed the Personal Standards Scale, the Fear of Negative Evaluation scale, and the Social Phobia and Agoraphobia Inventory. Results indicated that neurotic perfectionism is positively associated with both general social anxiety and social phobia. Moreover, the neurotic elements of perfectionism -- "concern over making mistakes" and "doubts about actions" -- appeared to be better predictors of social anxiety than high performance standards alone. Differences between social phobia and social anxiety secondary to agoraphobia as related to perfectionism were addressed, and directions for future research are discussed.

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Crucial research about suicidal thoughts and behaviors is often done in a cross-sectional manner that only considers limited risk factors. This research is limited in scope and rarely produces meaningful results to inform treatment. This study uses a longitudinal design to follow 93 participants over approximately 6 months. Participants are individuals with autism and social anxiety who were part of high-risk groups for suicidality, sleep problems, and social isolation. Participants recorded their sleep patterns and suicidal thoughts daily via the phone app MetricWire and continuously wore a GENEActiv actigraphy device to tract their objective sleep patterns. The Columbia Suicide Severity Rating Scale (C-SSRS): Baseline/Screening Version, C- SSRS: Since Last Visit Version; The Insomnia Severity Index (ISI); The Pittsburgh Sleep Quality Index (PSQI); and The Patient-Reported Outcome Measurement Information System (PROMIS) Level 2 Sleep Disturbance Adult Form were used to characterize the sample population. Data were analyzed using a longitudinal multilevel regression design. Findings indicate that perceived sleep quality was negatively correlated to suicide ideation over time. Self- reported sleep duration, gender, and Autism-Spectrum Quotient (AQ) score were not significant predictors of suicidal ideation over time. Liebowitz Social Anxiety Scale-Self Report (LSAS) score was positively correlated to suicide ideation. Clinical implications of these findings suggest a renewed effort must be made to assess for suicidality in persons reporting social anxiety and that effective intervention to improve sleep quality could reduce suicidal ideation.