The Social Interaction Anxiety Scale (SIAS) is a globally used scale for clinical diagnostic purposes for social anxiety disorder (SAD). This article investigates the psychometric properties of the SIAS, followed by its adaptation and validation in Urdu. The study consisted of two phases. The initial phase involved the translation of the scale, and the second phase was of a cross-sectional nature and consisted of evaluating factor structure and psychometric properties of the scale. For this purpose, the study enrolled a purposive sample of 573 adults aged between 18 to 45 years (mean [standard deviation (SD)] age: 23.68 [4.28] years) with a diagnosis of SAD. The sample was recruited from educational institutes, hospitals, and clinics in Lahore, Pakistan. The data was collected using a demographic form and the Urdu version of the SIAS, along with the Multidimensional Psychological Flexibility Inventory (MPFI). The analyses of the study were carried out using SPSS V27 and AMOS V24. Confirmatory factor analysis revealed a single factor structure of the Urdu version of the SIAS consisting of 16 items. The psychometric values of the scale shown were excellent, as Cronbach\'s alpha equaled 0.91, convergent validity r equaled 0.37 at p less than 0.01 with psychological inflexibility, and discriminant validity r equaled -0.47 at p less than 0.01 with psychological flexibility. The study concluded that the Urdu version of the SIAS was a valid and reliable measure for the assessment of social anxiety in the Pakistani population.

The bivalent fear of evaluation (BFOE) model of social anxiety divides fear of evaluation into two distinct valences: fear of positive evaluation (FPE) and fear of negative evaluation (FNE). However, there is evidence that the two most widely utilized and psychometrically supported measures of FNE and FPE contain items which are ambiguous with regard to valence of evaluative fear. To formally address this, the BFOE Scale (BFOES) was developed, by merging items from measures of FNE and FPE into a single scale with an integrated response format. The present studies examined the psychometric profile of the BFOES across a large pooled archival dataset (N = 2216), which included approximately 10 % (n = 224) patients with social anxiety disorder (SAD). The factorial validity, internal consistency, and construct validity of the BFOES were examined. Additionally, item response theory analyses were employed for the purpose of merging items from self-report scales which utilized different Likert-type response formats. Results from both studies provided support for the psychometric profile of the BFOES. The implications of the BFOES for the assessment of social anxiety, and theoretical models of fear of evaluation and SAD, are discussed.

BACKGROUND: Imagery rescripting (ImRs) is a psychotherapeutic intervention targeting aversive memories. During the three-phase intervention, patients reexperience their aversive memory (phase 1), observe the scene from their adult perspective, and intervene to help their former selves (phase 2), and reexperience it again with the positive changes (phase 3). Previous studies have rarely investigated emotional and regulatory processes taking place during the intervention.
OBJECTIVE: This randomized controlled trial investigated self-reported affective and physiological responses during ImRs.
METHODS: Seventy-seven patients with social anxiety disorder (SAD) were randomly assigned to a single session of ImRs or a control intervention (recall and discussion of the memory) targeting an aversive social memory. Heart rate (HR) and heart rate variability (HRV) were assessed during and post hoc ratings of positive and negative feelings after baseline and the intervention phases.
RESULTS: Relative to the control intervention, ImRs resulted in an initial increase in negative feelings from baseline to phase 1 and a following larger (phase 1 to phase 2) and more stable (phase 2 to phase 3) decrease in negative feelings/increase in positive feelings. On the physiological level, during ImRs compared to the control intervention, mean HR was significantly higher during phase 1 and HRV during phase 3, each compared to baseline.
CONCLUSIONS: These results provide further information about the specific sequence of emotional responses on different response levels during ImRs, being consistent with known theories of emotional processing and supposed mechanisms of ImRs.

Do adults who stutter have abnormally high social anxiety? Is it related to maladaptive cognition? As these are persistent, unresolved questions in stuttering research, it behooves clinicians to at least assess and attempt to identify social anxiety in patients who stutter and its basis before decisions are made about stuttering treatment. The Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scale is a self-administered questionnaire that measures the degree of non-adaptive cognition in people who stutter (PWS) due to social anxiety. The 66-item UTBAS is time-consuming to complete, prompting the development of a shorter 6-item version, the UTBAS-6, which is in English. Here, we aimed to assess some psychometric properties of the Japanese version of the UTBAS-6, the UTBAS-6-J, which has not been done to date. In 56 adult patients (mean 32.6 ± 11.1 years) who stutter, we quantified the reliability, the internal consistency, and the concurrent validity of the UTBAS-6-J. Along with the UTBAS-6-J, patients also were administered the Overall Assessment of the Speaker\'s Experience of Stuttering - Japanese version (OASES-A-J), the Modified Erickson Communication Attitude Scale - Japanese version (S-24-J), and the Liebowitz Social Anxiety Scale - Japanese version (LSAS-J). Cronbach\'s alpha for UTBAS-6-J total scores was 0.974, indicating excellent internal consistency. UTBAS-6-J scores were significantly correlated with scores on the OASES-A-J, the S-24-J, and the LSAS-J (all p < 0.005). Concurrent validity of the UTBAS-6-J with these three questionnaires was confirmed. The UTBAS-6-J has good internal consistency and concurrent validity, which will aid clinical decision-making about stuttering treatments.

Fear of positive evaluation (FPE) is becoming recognised as an important component of social anxiety that is distinct from fear of negative evaluation (FNE). While core belief scales exist for fear of negative evaluation (FNE), none has been developed for FPE. Therefore, this paper describes the development and validation of a measure of core beliefs that is specific to FPE. An exploratory factor analysis was performed on 60 initial items with an Australian undergraduate sample, in which a confirmatory factor analysis was performed with an independent Australian general population sample. A series of further analyses were performed to test convergent and divergent validity. The Positive Evaluation Core Beliefs Scale (PECS) emerged as a 17-item two-factor psychometrically valid measure that correlates more strongly with measurement of FPE than FNE. The PECS measure offers a new opportunity for researchers and clinicians to better explore cognitions associated with social anxiety.

The temperamental trait behavioral inhibition (BI) is related to the development and maintenance of anxiety, particularly much so to social anxiety disorder. We investigated if BI and social anxiety disorder predicted cognitive behavioral therapy (CBT) outcomes for youth anxiety. Youth (N = 179; Mage = 11.6 years) were assessed 4 years following a randomized controlled CBT effectiveness trial. BI was measured by the parent-reported Behavioral Inhibition Questionnaire at baseline. The outcomes were diagnostic recovery, youth- and parent-reported anxiety symptoms, and clinical severity at post-treatment, 1-year, and 4-year follow-up. Having social anxiety disorder negatively predicted diagnostic recovery and predicted higher clinical severity at all assessment points and was the only significant predictor of outcomes at 4-year follow-up. Higher BI negatively predicted diagnostic recovery and predicted higher clinical severity and parent-reported symptom levels at post-treatment and 1-year follow-up, and predicted higher youth-reported anxiety levels at 1-year follow-up. Higher BI was the only predictor of youth- and parent-reported anxiety symptoms. BI and social anxiety disorder seem to be unique predictors of CBT outcomes among youth with anxiety disorders. CBT adaptations may be indicated for youth with high BI and social anxiety disorder.

Hikikomori (prolonged social withdrawal) has been discussed as a hidden worldwide epidemic and a significant social and healthcare issue. Social anxiety disorder is the most common psychiatric disorder preceding the onset of Hikikomori. Although studies exist suggesting the effectiveness of family-support interventions, little is known about psychotherapeutic approaches for Hikikomori individuals. Here, we present a case of Hikikomori wherein an internet-delivered cognitive therapy for social anxiety disorder (iCT-SAD) worked effectively in improving the client\'s social anxiety symptoms and social interaction behaviors. This case study demonstrates the principle that evidence-based psychological interventions focusing on social anxiety can be effective for clients with Hikikomori. Furthermore, the online mode of treatment delivery, along with a variety of relevant modules, may facilitate clients\' engagement with treatment at home. The findings suggest that iCT-SAD might be a promising option for Hikikomori clients who have social anxiety problems, within the recommended stepped-intervention approach.

Social anxiety disorder is a common psychiatric condition that severely affects quality of life of individuals and is a significant societal burden. Although many risk factors for social anxiety exist, it is currently unknown how social fear sensitivity manifests biologically. Furthermore, since some individuals are resilient and others are susceptible to social fear, it is important to interrogate the mechanisms underpinning individual response to social fear situations. The microbiota-gut-brain axis has been associated with social behaviour, has recently been linked with social anxiety disorder, and may serve as a therapeutic target for modulation. Here, we assess the potential of this axis to be linked with social fear extinction processes in a murine model of social anxiety disorder. To this end, we correlated differential social fear responses with microbiota composition, central gene expression, and immune responses. Our data provide evidence that microbiota variability is strongly correlated with alterations in social fear behaviour. Moreover, we identified altered gene candidates by amygdalar transcriptomics that are linked with social fear sensitivity. These include genes associated with social behaviour (Armcx1, Fam69b, Kcnj9, Maoa, Serinc5, Slc6a17, Spata2, and Syngr1), inflammation and immunity (Cars, Ckmt1, Klf5, Maoa, Map3k12, Pex5, Serinc5, Sidt1, Spata2), and microbe-host interaction (Klf5, Map3k12, Serinc5, Sidt1). Together, these data provide further evidence for a role of the microbiota-gut-brain axis in social fear responses.

Social anxiety disorder is a prevalent mental health condition that significantly impairs social interactions, academic performance, and professional functioning in children, adolescents, and youth. This study aimed to investigate the global prevalence of social anxiety disorder across these developmental stages. Six electronic databases (PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar) were systematically searched for studies related to the prevalence of social anxiety disorder in children, adolescents and youth. Random-effects models were employed for data analysis and Comprehensive Meta-Analysis Version 2.0. Heterogeneity was assessed using the I2 index. A total of 38 studies were included in the final analysis. The global prevalence of social anxiety disorder was estimated to be 4.7% in children, 8.3% in adolescents, and 17% in youth. These findings suggest a progressive increase in the prevalence of SAD across these developmental stages. Considering the prevalence of social anxiety disorder in this study, policymakers can use the findings of this study to inform and develop effective prevention strategies for individuals and communities most susceptible to this disorder.

Cognitive-behavioral therapy (CBT) is an effective treatment for a variety of psychiatric disorders. However, historic underrepresentation, misapplication of techniques, and neglected consideration for the unique experiences of marginalized groups-including racial, ethnic, sexual, and gender minorities-have led to mistrust of mental health treatment among these communities and decreased access to quality, evidence-based care. Although these treatments are not inherently harmful to individuals with marginalized identities, clinicians can cause harm if they do not consider the role of culture in their conceptualization, assessment, and treatment of individuals with marginalized identities. Thus, this Special Issue details important considerations for conceptualization, assessment, treatment, and research related to a variety of psychiatric disorders in individuals with marginalized identities. In particular, this Special Issue describes substance use disorders among Black men, eating disorders among queer and transgender individuals, obsessive-compulsive disorder in Hispanic and Latin American individuals, and social anxiety disorder in Black adolescents.