The Potential of Video Game Streaming as Exposure Therapy for Social Anxiety

2021 ◽  
Vol 5 (CHI PLAY) ◽  
pp. 1-25
Author(s):  
Julian Frommel ◽  
Martin J. Dechant ◽  
Regan L. Mandryk
Keyword(s):  
Social Anxiety ◽  
Video Game ◽  
Exposure Therapy ◽  
Cognitive Restructuring ◽  
Social Situations ◽  
Socially Anxious ◽  
Controlled Exposure ◽  
Anxiety Treatment ◽  
Social Anxieties ◽  
And Performance

Social anxiety is a prevalent problem that affects many people with varying severity; digital exposure therapy-which involves controlled exposure to simulations of feared social situations alongside cognitive restructuring-can help treat patients with anxieties. However, the need to personalize exposure scenarios and simulate audiences are barriers to treating social anxieties through digital exposure. In this paper, we propose game streaming as an exposure therapy paradigm for social anxiety, supporting it with data from two studies. We first propose a framework describing requirements for exposure therapy and how game streaming can fulfill them. We select demand and performance visibility from these characteristics to showcase how to manipulate them for experiences of gradual exposure. With Study 1, we provide evidence for these characteristics and support for the framework by showing that a game's demand affected expected fear of streaming games. In Study 2, we show that the prospect of streaming led to elevated fear, a necessary property for effective exposure therapy. Further, we show that the effect of streaming on expected fear was similar for participants who can be considered socially anxious. These findings provide evidence for the essential effect of exposure therapy, which serves as a first step towards the validation of streaming as a social anxiety treatment. Our paper provides an initial, important step towards a novel, broadly applicable, and widely accessible digital approach for the treatment of social anxiety.

scholarly journals Imagery rescripting versus cognitive restructuring for social anxiety: Treatment effects and working mechanisms

2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Miriam Strohm ◽  
Marena Siegesleitner ◽  
Anna E. Kunze ◽  
Thomas Ehring ◽  
Charlotte E. Wittekind
Keyword(s):  
Social Anxiety ◽  
Positive Emotions ◽  
Cognitive Restructuring ◽  
Anxiety Symptoms ◽  
Socially Anxious ◽  
Speech Task ◽  
Anxiety Treatment ◽  
Imagery Rescripting ◽  
Working Mechanisms

Background Negative mental images in social anxiety are often linked to memories of distressing social experiences. Imagery Rescripting (ImRs) has been found to be a promising intervention to target aversive memories, but mechanisms underlying ImRs are largely unknown. The present study aimed (a) to investigate the effects of ImRs compared to cognitive restructuring (CR) on social anxiety symptoms and (b) to extend previous research by examining whether ImRs works by fostering reappraisal of negative emotional self-beliefs. Method Highly socially anxious individuals (N = 77) were randomly allocated to ImRs, CR, or no intervention control (NIC). A speech task was performed at baseline and at 1-week follow-up. Results Only CR significantly reduced social anxiety symptoms from baseline to follow-up. Decreases in negative appraisals and emotional distress in response to the speech task did not differ between conditions. Regarding working mechanisms, ImRs led to stronger increases in positive emotions than CR and NIC. Both CR and ImRs yielded short-term reductions in emotionally anchored idiosyncratic self-beliefs, but CR was superior to ImRs at follow-up. Conclusions The present study provides evidence for the efficacy of a single-session of CR for social anxiety symptoms. As one specific version of ImRs was applied, it is conceivable that other or optimized versions of ImRs might be more effective.

scholarly journals Autistic Traits Predict Social-Contact Uncertainty in University Students

2021 ◽  
Vol 12 ◽  
Author(s):  
Alex Bertrams ◽  
Myriam Zäch
Keyword(s):  
Social Anxiety ◽  
University Students ◽  
Social Contact ◽  
Autistic Traits ◽  
Well Being ◽  
Cross Sectional ◽  
Socially Anxious ◽  
And Performance ◽  
The Moment ◽  
The University

Social anxiety (alternatively: social-contact uncertainty) in the university context can lead to reduced health, well-being, and performance, and can even cause premature leaving of education. With the present study, we intended to supplement cross-sectional studies on students' autistic traits and social anxiety with longitudinal findings. We measured autistic traits and social-contact uncertainty of 118 university students on two occasions, roughly 1 year apart. Correlation, multiple regression, and cross-lagged analyses showed that more pronounced autistic traits predicted higher future social-contact uncertainty. Social-contact uncertainty did not predict autistic traits. We conclude that university students who are high in autistic traits tend not only to be more socially anxious at the moment but have a heightened risk of still being so in the future.

Assessing Social Anxiety: The Inventory of Interpersonal Situations (IIS)

1999 ◽  
Vol 15 (1) ◽  
pp. 25-38 ◽  
Author(s):  
Rien van Dam-Baggen ◽  
Floris Kraaimaat
Keyword(s):  
Social Anxiety ◽  
Reliability And Validity ◽  
Self Report ◽  
Social Situations ◽  
Socially Anxious ◽  
Overt Behavior ◽  
Frequency Scale ◽  
Significant Relationships ◽  
High Internal Consistency ◽  
Interpersonal Situations

Summary: The purpose of this study was to develop a self-report questionnaire for the assessment of social anxiety in adults. The Inventory of Interpersonal Situations (IIS) consists of 35 items formulated as responses to specific social situations. The IIS is based on an interactive concept of social anxiety and provides scores for both a Discomfort and a Frequency scale. The reliability and validity of the IIS were investigated in several adult psychiatric and nonpsychiatric samples. The scales for Discomfort and Frequency showed stability over time. Cronbach's α's revealed a sufficiently high internal consistency on both scales, while the conceptual structure was shown to be rather invariant across socially anxious and nonsocially anxious groups. The IIS scales were able to discriminate between socially anxious and nonsocially anxious samples, and showed significant relationships with independent measures of social anxiety. The IIS scales demonstrated high predictive validity for overt behavior in social situations.

The impact of metacognitive beliefs and anticipatory processing on state anxiety in high socially anxious individuals in a speech task

2016 ◽  
Vol 7 (4) ◽  
pp. 588-600 ◽  
Author(s):  
Styliani Gkika ◽  
Adrian Wells
Keyword(s):  
Social Anxiety ◽  
Emotional Disorders ◽  
State Anxiety ◽  
Social Situations ◽  
Socially Anxious ◽  
Negative Beliefs ◽  
Anticipatory Processing ◽  
Metacognitive Beliefs ◽  
Perseverative Thinking ◽  
The Impact

The metacognitive model (Wells & Matthews, 1994) proposes that metacognitions (e.g., positive or negative beliefs about worry and thoughts) are involved in emotional disorders alongside perseverative thinking, such as worry. In social anxiety, worry about forthcoming social situations, termed anticipatory processing (AP), is considered an important maintaining factor (Clark & Wells, 1995), but a role of metacognition is less clear. This study investigated AP and metacognition in 80 high socially anxious individuals asked to engage in either AP or a filler task before delivering a speech. AP and higher uncontrollability/danger metacognitive beliefs were associated with greater state anxiety overall. Individuals with higher positive beliefs about worry experienced less of an increase in anxiety before the speech, but their anxiety persisted until after the speech, compared to individuals with lower beliefs. The results support an effect of metacognitions and are discussed in terms of the social anxiety model and its implications.

scholarly journals Self-Focused Cognition in Social Anxiety: A Review of the Theoretical and Empirical Literature

2016 ◽  
Vol 33 (1) ◽  
pp. 44-64 ◽  
Author(s):  
Alice R. Norton ◽  
Maree J. Abbott
Keyword(s):  
Social Anxiety ◽  
Cognitive Processes ◽  
Empirical Literature ◽  
Similar Process ◽  
Negative Effects ◽  
Social Situations ◽  
Socially Anxious ◽  
Substantial Body ◽  
Growing Body

Social anxiety disorder (SAD) is characterised by a marked and persistent fear of social or performance situations. Cognitive models suggest that self-focused cognitive processes play a crucial role in generating and maintaining social anxiety, and that self-focused cognition occurs prior to, during, and following social situations (Clark & Wells, 1995; Rapee & Heimberg, 1997). There is a substantial body of empirical evidence demonstrating that socially anxious individuals engage in self-focused cognition during and following a social or performance situation. A smaller but growing body literature suggests that a similar process occurs prior to such situations, and that these three processes are interdependent. Furthermore, the vast majority of research to date indicates that self-focused cognitive processes are detrimental, and that they generate and maintain social anxiety in a variety of ways. However, there remains considerable scope for research to further explicate the role of these processes in the maintenance of SAD, and to enhance interventions designed to ameliorate their negative effects.

scholarly journals The efficacy of cognitive restructuring and mindfulness strategies in reducing post-event processing among socially anxious individuals

2021 ◽  
Author(s):  
Bethany A. Gee
Keyword(s):  
State Anxiety ◽  
Cognitive Restructuring ◽  
Single Session ◽  
Negative Effects ◽  
Social Situations ◽  
Socially Anxious ◽  
Negative Thoughts ◽  
Postevent Processing ◽  
Maladaptive Beliefs ◽  
Reduced State

Social anxiety disorder (SAD) is defined as a marked and persistent fear of social situations in which an individual is exposed to potential scrutiny from others (American Psychiatric Association, 2013). Prominent models of SAD (Clark & Wells, 1995 ; Rapee & Heimberg, 1997) postulate that postevent processing (PEP), which involves reviewing a past social event in detail (typically in a negative way), serves as a key maintenance factor of SAD. The current study examined the efficacy of a single session cognitive restructuring or mindfulness strategy on decreasing PEP and its associated effects, and also investigated the cognitive processes involved. Seventy-four socially anxious participants completed a speech task to elicit PEP, were taught a cognitive restructuring, mindfulness, or control strategy to manage their negative thoughts related to the speech, and completed several questionnaires. Participants in the cognitive restructuring condition reported decreased PEP (degree and associated distress) and improved affect (but not reduced state anxiety), as compared to the control condition. Participants in the mindfulness condition also reported decrease PEP (degree but no associate distress) and improved affect (including reduced state anxiety), as compared to the control condition. No significant differences were found between the cognitive restructuring and mindfulness conditions. Participants in the cognitive restructuring condition also reported decreased beliefs about the perceived costs of negative social situations. Regardless of study condition, decreases in cost biases and maladaptive beliefs sign significantly predicted reductions in PEP. Thus, cognitive restructuring and mindfulness appear to be promising strategies to decrease PEP and its associated negative effects.

scholarly journals The efficacy of cognitive restructuring and mindfulness strategies in reducing postevent processing among socially anxious individuals.

2021 ◽  
Author(s):  
Bethany A. Gee
Keyword(s):  
State Anxiety ◽  
Cognitive Restructuring ◽  
Single Session ◽  
Negative Effects ◽  
Social Situations ◽  
Socially Anxious ◽  
Negative Thoughts ◽  
Postevent Processing ◽  
Maladaptive Beliefs ◽  
Reduced State

Social anxiety disorder (SAD) is defined as a marked and persistent fear of social situations in which an individual is exposed to potential scrutiny from others (American Psychiatric Association, 2013). Prominent models of SAD (Clark & Wells, 1995; Rapee & Heimberg, 1997) postulate that postevent processing (PEP), which involves reviewing a past social event in detail (typically in a negative way), serves as a key maintenance factor of SAD. The current study examined the efficacy of a single session cognitive restructuring or mindfulness strategy on decreasing PEP and its associated effects, and also investigated the cognitive processes involved. Seventy-four socially anxious participants completed a speech task to elicit PEP, were taught a cognitive restructuring, mindfulness, or control strategy to manage their negative thoughts related to the speech, and completed several questionnaires. Participants in the cognitive restructuring condition reported decreased PEP (degree and associated distress) and improved affect (but not reduced state anxiety), as compared to the control condition. Participants in the mindfulness condition also reported decreased PEP (degree but not associated distress) and improved affect (including reduced state anxiety), as compared to the control condition. No significant differences were found between the cognitive restructuring and mindfulness conditions. Participants in the cognitive restructuring condition also reported decreased beliefs about the perceived costs of negative social situations. Regardless of study condition, decreases in cost biases and maladaptive beliefs significantly predicted reductions in PEP. Thus, cognitive restructuring and mindfulness appear to be promising strategies to decrease PEP and its associated negative effects.

scholarly journals Self-Focus and Cardiovascular Effects of Stressor Anticipation and Active Coping: The Moderating Influence of Trait Social Anxiety

2017 ◽  
Vol 10 (1) ◽  
pp. 61-70
Author(s):  
Margit Gramer ◽  
Stephanie Frei
Keyword(s):  
Social Anxiety ◽  
Vascular Reactivity ◽  
Cardiac Activity ◽  
Cardiovascular Effects ◽  
Task Engagement ◽  
Self Awareness ◽  
Socially Anxious ◽  
Cardiac Reactivity ◽  
High Anxious ◽  
And Performance

Background: Self-focused attention has been found to facilitate task engagement and cardiac activity in active performance situations. According to theories on self-awareness this facilitating effect might be confined to individuals with favorable outcome expectancies, though. Objective: To provide information on this issue, the present study evaluated the moderating influence of trait social anxiety, a dispositional indicator of impaired confidence. In extension of prior research, effects of enhanced self-awareness were assessed during both anticipation and performance of an active social stressor. Method: Sixty normotensive female students characterized as either high or low in trait social anxiety engaged in an evaluative speaking task either in the context of high or low self-awareness. Results: The moderating influence of social anxiety was found to vary with type of demand. During passive stressor anticipation, self-focus augmented distress-related vascular reactivity in high but not in low socially anxious individuals. During speech preparation self-focus was found to facilitate task engagement and cardiac reactivity in low socially anxious individuals, whereas high anxious showed some withdrawal. Greater self-awareness during speech performance elicited cardiac increases in both social anxiety groups. However, among high anxious individuals this sustained engagement was accompanied by increased negative affect and negative self-evaluations. Conclusion: These findings seem to suggest that only in high socially anxious individuals heightened self-awareness may contribute to dysfunctional cardiovascular and psychological processes.

Interpretations for Safety Behaviours in High and Low Socially Anxious Individuals

2009 ◽  
Vol 37 (2) ◽  
pp. 167-178 ◽  
Author(s):  
Stephanos P. Vassilopoulos
Keyword(s):  
Social Anxiety ◽  
Normal Level ◽  
Psychological Problem ◽  
Negative Effects ◽  
Social Situations ◽  
Socially Anxious ◽  
Wide Range ◽  
Emotional Condition

Background: It has been suggested that socially anxious individuals often engage in a wide range of safety behaviours in social situations that are intended to reduce the risk of social failure and humiliation. Method: This study explored the interpretations that people make for behaviours considered to be safety seeking. High and low socially anxious individuals completed one version of a questionnaire that assessed how the safety behaviours that they may exhibit are interpreted by others, and then completed a second version of the same questionnaire that assessed how they typically interpret safety behaviours in other people. Participants rated the extent to which each of eight interpretations was viewed as a likely interpretation of the behaviour. Results: Individuals high in social anxiety were more likely than low socially anxious participants to think that being arrogant, suffering from a psychological problem, or experiencing a normal level of anxiety, nervousness or fear are likely explanations for safety behaviours, regardless of who exhibits them. Additionally, high socially anxious participants were more likely than those low in social anxiety to think that others interpreted these behaviours as being indicative of intense anxiety or other negative emotional condition. Conclusions: The results suggested that socially anxious people are, at least, aware of the negative effects of certain behaviours characterized as safety seeking.

scholarly journals The efficacy of cognitive restructuring and mindfulness strategies in reducing postevent processing among socially anxious individuals.

2021 ◽  
Author(s):  
Bethany A. Gee
Keyword(s):  
State Anxiety ◽  
Cognitive Restructuring ◽  
Single Session ◽  
Negative Effects ◽  
Social Situations ◽  
Socially Anxious ◽  
Negative Thoughts ◽  
Postevent Processing ◽  
Maladaptive Beliefs ◽  
Reduced State

Social anxiety disorder (SAD) is defined as a marked and persistent fear of social situations in which an individual is exposed to potential scrutiny from others (American Psychiatric Association, 2013). Prominent models of SAD (Clark & Wells, 1995; Rapee & Heimberg, 1997) postulate that postevent processing (PEP), which involves reviewing a past social event in detail (typically in a negative way), serves as a key maintenance factor of SAD. The current study examined the efficacy of a single session cognitive restructuring or mindfulness strategy on decreasing PEP and its associated effects, and also investigated the cognitive processes involved. Seventy-four socially anxious participants completed a speech task to elicit PEP, were taught a cognitive restructuring, mindfulness, or control strategy to manage their negative thoughts related to the speech, and completed several questionnaires. Participants in the cognitive restructuring condition reported decreased PEP (degree and associated distress) and improved affect (but not reduced state anxiety), as compared to the control condition. Participants in the mindfulness condition also reported decreased PEP (degree but not associated distress) and improved affect (including reduced state anxiety), as compared to the control condition. No significant differences were found between the cognitive restructuring and mindfulness conditions. Participants in the cognitive restructuring condition also reported decreased beliefs about the perceived costs of negative social situations. Regardless of study condition, decreases in cost biases and maladaptive beliefs significantly predicted reductions in PEP. Thus, cognitive restructuring and mindfulness appear to be promising strategies to decrease PEP and its associated negative effects.

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