Psychophysiological arousal and biased perception of bodily anxiety symptoms in socially anxious children and adolescents: a systematic review

Abstract

Cognitive models of social anxiety [Clark and Wells, Social phobia: Diagnosis, assessment, and treatment, Guilford Press, New York, 1995], diagnostic criteria and studies on adult samples suggest that both an overestimation of bodily anxiety symptoms and psychophysiological abnormalities play an important role in social anxiety. To date, less is known about such a perception bias and physiological characteristics in children and adolescents with social anxiety. We performed a systematic review of the literature in the electronic databases Medline, PsycINFO, and PSYNDEX. Additional studies were identified by hand search using the ancestry approach. We identified 1,461 studies, screened their titles and abstracts, viewed 94 papers, and included 28 of these. Study samples were heterogeneous and consisted of socially phobic, high socially anxious, shy and test anxious children and adolescents. Regarding a biased perception, most studies in the review suggest that bodily symptoms of anxiety were overestimated by children and adolescents across the social anxiety spectrum when compared with control groups. An elevated psychophysiological reactivity to social stress was present in samples of high social anxiety, shyness, and test anxiety. In clinical samples with social phobia, by contrast, no differences or an even lower physiological responding compared with healthy control groups were reported. In addition, some evidence for a chronic psychophysiological hyperarousal was found across all sample types. The results are discussed with regard to current models of social anxiety, psychophysiological theories, and treatment implications.

Executive function in children with externalizing and comorbid internalizing behavior problems

“…This notion was supported by the negative correlation between physiological reactivity and behavioral performance. Consistent with previous research, higher heart rate reactivity was associated stronger with MIXED compared to EXT status (Siess, Blechert, & Schmitz, ; Stein & Rapee, ).…”

Incidence, clinical correlates and treatment effect of rage in anxious children

“…For example, anxious arousal resulting from actual or threatened exposure to feared stimuli may initiate an outburst in anxious children (Suveg and Zeman, 2004; Weems et al, 2005; Hannesdottir and Ollendick, 2007; Siess et al, 2014). Children who are anxious may be more emotionally reactive in general or may have less regulatory capacities as a result of chronic arousal (Hannesdottir and Ollendick, 2007; Siess et al, 2014), increasing the potential for rage in response to relatively minor triggers. Another possibility is that recurrent rage outbursts occur as a result of negative reinforcement from caregivers of externalizing or demanding behaviors.…”

Socioeconomic inequalities in mental well-being among Hungarian adolescents: a cross-sectional study

“…[14,15]. Adolescents’ low mental health may lead to illnesses such as depression and social phobias [16] and may have major implications for adult morbidity and mortality [17]. …”