Communicative Challenges in Social Anxiety: Preliminary Findings and Future Directions
Saskia B.J. Koch1, Margot Mangnus1, Ivan Toni1, Jana Bašnáková1, Arjen Stolk1,2; 1Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands, 2Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
Patients with social anxiety disorder (SAD) are afraid of situations that expose them to possible negative evaluation by others, causing them to endure those situations with excessive fear or to avoid them altogether (APA, 2013). Cognitive models postulate that SAD patients overestimate how anxious they appear, while underestimating their actual social performance (Clark, 2001). However, there is also evidence for decreased social performance in social anxiety, which might pull patients into a downward cycle of decreased likability and social rejection (Voncken ea., 2008, 2010). This project investigates the relatively unexplored territory of social communication deficits in SAD. Currently, several empirical obstacles limit our understanding of communicative challenges in social anxiety. Previous studies quantified social performance using ratings of anxious appearance and social behavior in the form of Likert scales and questionnaires. However, these social performance ratings are subjective, meta-cognitive, and unable to identify exactly which aspects of communication are affected in social anxiety. Furthermore, objective neurobiological measures have been almost universally ignored, hampering mechanistic understanding of communication deficits in SAD. Here we set out to identify neurocognitive mechanisms underlying communicative challenges in social anxiety by manipulating uncertainty of communicative signals and addressee’s characteristics during communicative exchanges in the context of live interpersonal interactions. We are conducting a dual-fMRI study in which pairs of high and low socially anxious individuals solve novel communication problems, namely how to jointly reproduce a spatial configuration of geometric tokens on a digital gameboard. Only one participant (the Communicator) sees the goal configuration, and can share this knowledge with the other pair member (the Addressee) by moving his token on the gameboard. These roles are alternated every trial. Communicative problems consist of Known trials, with previously established joint solutions, and of Novel trials, requiring the creation of novel signals. Given heightened intolerance of uncertainty in SAD (Carleton ea., 2010), we expect that communicative performance and interpersonal coordination in brain activity will decrease on Novel trials, but not in Known trials, as a function of social anxiety. We are also investigating whether socially anxious participants build different cognitive models of an Addressee, namely their reliance on apriori stereotype beliefs about Addressee’s communicative abilities, versus reliance on interpersonal cues about those abilities based on communicative interaction. We administer an online communicative game where participants are told they are playing with two partners in alternating blocks: a child and an adult. In fact, a role-blind confederate plays both roles, such that the two partners differ only in terms of participant’s stereotype beliefs about their cognitive abilities. Given difficulties in interpreting social situations in SAD (Buhlmann ea., 2015), we hypothesize to find less sensitivity to interpersonal cues during the unfolding interaction in social anxiety. Results of the dual-fMRI study and online communication game will be presented, as well as future research directions aimed at quantifying social communication difficulties in social anxiety. Gaining mechanistic insights in these social deficits may ultimately lead to improved treatment of SAD aimed at enhancing social skills, thereby breaking the social anxiety - social rejection cycle.
Topic Areas: Disorders: Acquired, Methods