Social Anxiety and Empathy: A Systematic Review and Meta-analysis

Pittelkow, Merle-Marie; Rot, Marije aan het; Seidel, Lea Jasmin; Feyel, Nils; Roest, Annelieke M.

doi:10.1016/j.janxdis.2021.102357

Cited by 56 publications

(55 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study integrated empathic abilities as one important diagnostic measure of social communication. Patients with SAD do not differ overall from healthy controls in their cognitive or emotional empathy level, a finding already documented by other researchers (33). But interestingly, we found that empathy buffered the detrimental effects of social stress on social behavior in SAD during the conversation paradigm.…”

Section: Discussionsupporting

confidence: 83%

“…What remains unclear about social anxiety is whether empathic abilities are better, worse or the same as HC. A recent meta-analysis ( 33 ) describes an overall association between emotional empathy and social anxiety but no association between cognitive empathy and social anxiety. In their subgroup analyses they report a slightly negative association with lower cognitive empathy in SAD.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Empathy Modulates the Effects of Acute Stress on Anxious Appearance and Social Behavior in Social Anxiety Disorder

et al. 2022

View full text Add to dashboard Cite

Patients suffering from social anxiety disorder (SAD) fear social interaction and evaluation, which severely undermines their everyday life. There is evidence of increased prosocial behavior after acute social stress exposure in healthy individuals, which may be interpreted as stress-regulating “tend-and-befriend” behavior. In a randomized controlled trial, we measured empathic abilities in a first diagnostic session. In the following experimental session, we investigated how patients with SAD (n = 60) and healthy control participants (HC) (n = 52) respond to an acute social stressor (Trier Social Stress Test for groups) or a non-stressful control condition, and whether empathic abilities and acute social stress interact to modulate anxious appearance and social behavior in a social conversation test. Salivary cortisol, heart rate, and subjective stress response were repeatedly measured. The anxious appearance and social behavior of participants were rated by the conversation partner. SAD patients demonstrated stronger subjective stress responses while the biological responses did not differ from HC. Moreover, patients performed worse overall in the conversation task, which stress additionally undermined. Finally, we found that both emotional and cognitive empathy buffered the negative effects of acute stress on social behavior in SAD, but not in HC. Our data highlight the importance of empathic abilities for SAD during stressful situations and call for multimodal clinical diagnostics. This may help to differentiate clinical subtypes and offer better-tailored treatment for patients.General Scientific Summary: This study shows that high levels of cognitive and emotional empathy can buffer the negative effects of acute stress on social behavior in social anxiety disorder (SAD). Empathic abilities may be included as an additional diagnostic resource marker for SAD.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Empathy Modulates the Effects of Acute Stress on Anxious Appearance and Social Behavior in Social Anxiety Disorder

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Overall, the increased cognitive distance between self and friend in individuals who often experience loneliness provides further evidence that social connection can be reflected at the cognitive level (Cacioppo & Hawkley, 2009;Courtney & Meyer, 2020). For example, recently loneliness was associated with greater egocentricity during a visual perspective taking task (De Lillo et al, 2022), aligning with the greater egocentricity seen in several social cognitive tasks across several affective conditions (Bora et al, 2009;Bora & Berk, 2016;Erle et al, 2019;Pittelkow et al, 2021;Schreiter et al, 2013). The results of the current study should provide impetus for the study of such cognitive biases as a mediator or predictor of the development of affective conditions in those who experience chronic loneliness.…”

Section: Discussionmentioning

confidence: 73%

Loneliness is associated with greater cognitive distance between the self and a close friend

Kokici¹,

Chirtop

et al. 2021

Preprint

View full text Add to dashboard Cite

Loneliness describes the distressing experience associated with perceived social disconnection. Despite the clear links between loneliness and mental and physical health, relatively little is known about how loneliness affects cognition. To assess the effects of loneliness on cognitive distance between the self and others, participants completed an implicit memory task for adjectives encoded in relation to the self, a close friend, or a celebrity. We assessed item memory accuracy and sensitivity, and depth of processing was assessed through source monitoring and metamemory performance. In addition, participants reported their trait loneliness and depression. An overall self-referential advantage was identified compared with both friend and celebrity encoded items. Likewise, a friend-referential advantage was identified compared to celebrity-encoded items. Metacognitive sensitivity (sensitivity of confidence for correct and incorrect responses) and metacognitive bias (confidence regardless of accuracy) showed a similar pattern. Lonelier individuals showed a greater self-referential bias in comparison to words encoded in relation to a close friend, coupled with a smaller friend-referential bias in comparison to words encoded in relation to celebrity. More depressed individuals also showed a greater self-referential bias in comparison to words encoded in relation to a close friend, but this did not explain the relationship with loneliness. Therefore, perceived social isolation (loneliness) is reflected in a greater cognitive distance between self and close friends and this operates independent of depression. The results have important implications for understanding the social contextual effects on memory and the cognitive ramifications of loneliness.

show abstract

“…Here, findings from the field of social anxiety disorders might be relevant for AvPD as well. The complexity of assessing empathy in individuals with social anxiety has been highlighted in several meta-analyses (O'Toole et al, 2013;Pittelkow et al, 2021). For instance, O' Toole et al (2013) found that social anxiety was Online survey in which mental health clinicians provided information on one of their patients, including rating of separate criteria for section II PDs and the criteria for all three parts of the AMPD, i.e., LPFS, pathological traits, and specific diagnostic criteria for the six AMPD diagnoses.…”

Section: Discussionmentioning

confidence: 99%

“…Here, findings from the field of social anxiety disorders might be relevant for AvPD as well. The complexity of assessing empathy in individuals with social anxiety has been highlighted in several meta-analyses (O’Toole et al, 2013; Pittelkow et al, 2021). For instance, O’Toole et al (2013) found that social anxiety was associated with a decreased ability to understand complex emotions rather than to recognize basic emotions.…”

Section: Discussionmentioning

confidence: 99%

Is the alternative model for personality disorders able to capture avoidant personality disorder according to Section II of the DSM–5? A systematic review.

Hummelen

Eikenæs

Wilberg

2022

Personality Disorders: Theory, Research, and Treatment

View full text Add to dashboard Cite

This review aims at examining the continuity between the categorical model for personality disorders (PDs) as defined by Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the alternative model for personality disorders (AMPD) with respect to Section II avoidant personality disorder (AvPD). Because the Criterion A of the AMPD, that is, the Level of Personality Functioning Scale (LPFS), is a prerequisite for a PD diagnosis, only studies assessing the LPFS were included, whether or not the Criterion B, that is, pathological personality traits, were assessed as well. A total of 13 studies met the inclusion criteria, with 6 studies comprising community/undergraduate samples and 7 studies comprising clinical samples. Weighted correlation between global LPFS and AvPD was .39 (rw = .55 for community/undergraduate studies; rw =.17 for clinical studies). When AvPD-specific impairment was evaluated, that is, impairment of personality functioning characterizing AvPD in the AMPD, correlations were substantially larger. In studies using regression analyses, the Criterion B appeared to have incremental utility in predicting the presence of Section II AvPD. To capture Section II AvPD in a sufficient degree by the AMPD, it might be necessary to use an AvPD-specific impairment questionnaire.

show abstract

Social Anxiety and Empathy: A Systematic Review and Meta-analysis

Cited by 56 publications

References 85 publications

Empathy Modulates the Effects of Acute Stress on Anxious Appearance and Social Behavior in Social Anxiety Disorder

Empathy Modulates the Effects of Acute Stress on Anxious Appearance and Social Behavior in Social Anxiety Disorder

Loneliness is associated with greater cognitive distance between the self and a close friend

Is the alternative model for personality disorders able to capture avoidant personality disorder according to Section II of the DSM–5? A systematic review.

Contact Info

Product

Resources

About