A Two-Person Neuroscience Approach for Social Anxiety: A Paradigm With Interbrain Synchrony and Neurofeedback

Social anxiety disorder has been widely recognised as one of the most commonly diagnosed mental disorders. Individuals with social anxiety disorder experience difficulties during social interactions that are essential in the regular functioning of daily routines; perpetually motivating research into the aetiology, maintenance and treatment methods. Traditionally, social and clinical neuroscience studies incorporated protocols testing one participant at a time. However, it has been recently suggested that such protocols are unable to directly assess social interaction performance, which can be revealed by testing multiple individuals simultaneously. The principle of two-person neuroscience highlights the interpersonal aspect of social interactions that observes behaviour and brain activity from both (or all) constituents of the interaction, rather than analysing on an individual level or an individual observation of a social situation. Therefore, two-person neuroscience could be a promising direction for assessment and intervention of the social anxiety disorder. In this paper, we propose a novel paradigm which integrates two-person neuroscience in a neurofeedback protocol. Neurofeedback and interbrain synchrony, a branch of two-person neuroscience, are discussed in their own capacities for their relationship with social anxiety disorder and relevance to the paradigm. The newly proposed paradigm sets out to assess the social interaction performance using interbrain synchrony between interacting individuals, and to employ a multi-user neurofeedback protocol for intervention of the social anxiety.

Perancangan Buku Ilustrasi Anxiety Disorder sebagai Media Edukasi Bagi Usia 19-24 Tahun

Masalah anxiety disorder banyak mendapat stigma buruk dari masyarakat karena dikaitkan dengan kegilaan. Media untuk mempelajari anxiety disorder ini masih kurang diminati oleh masyarakat, mengakibatkan kurangnya wawasan masyarakat tentang masalah ini. Bentuk buku tebal dan padat membuat kesan intimidatif bagi orang yang ingin membacanya. Maka dari itu situasi ini memerlukan media yang dapat menarik minat orang untuk membacanya. Maka dari itu media yang dipilih adalah buku ilustrasi. Ilustrasi di sini akan dijadikan sebagai cara untuk menampilkan konsep anxiety disorder dalam wujud visual. Konsep tentang macam-macam tipe anxiety disorder akan dijelaskan melalui narasi karakter. Target audiens merupakan masyarakat berusia 19- 24 tahun. Dengan adanya media ini diharapkan dapat menarik minat, menambah wawasan, serta mengubah persepsi yang mengaitkan anxiety disorder dengan kegilaan dan pengasingan.

An Explorative Study to Assess the Prevalence of Social Anxiety Disorder (SAD) and Its Determinants among High School Students of Selected High School of Bagalkot

Introduction: As per research studies have shown that social anxiety disorder has a worldwide prevalence of 5 to 10% and a lifetime prevalence rate of 8.4% to 15% among high school students.1 Rural Indian children are facing this problem of lethal evil more as compared to Urban high school students in India. Objective: To assess the prevalence of social anxiety disorder [sad] and its determinants among high school students of selected high school of Bagalakote. Methods: Descriptive survey approach was used for the study with cross sectional survey design. 120 high school students between 14 years to 16 years of age were selected Disproportionate stratified random sampling technique method from high school students studying in selected high school of Bagalkot. The data regarding determinants was collected by structured interview schedule and self-report method. The Social Phobia Inventory (abbreviated as SPIN) is a five point scale was used to categories the high school students according to their social anxiety disorders. The association was explored by Chi square test, Fisher’s exact probability test and linear regression. Results: Total 120 high school students were responded for Social Phobia Inventory (SPIN) scale, in that level of social anxiety disorders had reveals that majority 83.3% had non phobic, 15.8% had mild and 0.8% had moderate, there is no extremely phobic. A significant association was found between the social anxiety disorders of adolescents and their selected socio-demographic variables like monthly income (χ2= 21.199; P<0.05). Conclusion: The findings revealed that there was a positive correlation found between the psychological wellbeing and academic performance among adolescents, recommended health education, early recommended understanding the social anxiety disorder and its determinants by their students especially among the fresher`s. Effectiveness of teaching programmes regarding impact of its determinants on level of social anxiety disorders among adolescents can be done had positive effect on adolescents health, which were also statistically significant. Key words: Social anxiety disorder, Determinants, Adolescents, high school students, academic performance, Spin scale.

Neural predictors of cognitive-behavior therapy outcome in anxiety-related disorders: a meta-analysis of task-based fMRI studies

Background Cognitive-behavior therapy (CBT) is a well-established first-line intervention for anxiety-related disorders, including specific phobia, social anxiety disorder, panic disorder/agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. Several neural predictors of CBT outcome for anxiety-related disorders have been proposed, but previous results are inconsistent. Methods We conducted a systematic review and meta-analysis of task-based functional magnetic resonance imaging (fMRI) studies investigating whole-brain predictors of CBT outcome in anxiety-related disorders (17 studies, n = 442). Results Across different tasks, we observed that brain response in a network of regions involved in salience and interoception processing, encompassing fronto-insular (the right inferior frontal gyrus-anterior insular cortex) and fronto-limbic (the dorsomedial prefrontal cortex-dorsal anterior cingulate cortex) cortices was strongly associated with a positive CBT outcome. Conclusions Our results suggest that there are robust neural predictors of CBT outcome in anxiety-related disorders that may eventually lead (probably in combination with other data) to develop personalized approaches for the treatment of these mental disorders.

Functional dissection of neural connectivity in generalized anxiety disorder

Differences in the correlated activity of networked brain regions have been reported in individuals with generalized anxiety disorder (GAD) but an overreliance on the null-hypothesis significance testing (NHST) framework limits the identification and characterization of disorder-relevant relationships. In this preregistered study, we applied a Bayesian statistical framework as well as NHST to the analysis of resting-state fMRI scans from females with GAD and demographically matched healthy comparison females. Eleven a-priori hypotheses about functional correlativity (FC) were evaluated using Bayesian (multilevel model) and frequentist (t-test) inference. Reduced FC between the ventromedial prefrontal cortex (vmPFC) and the posterior-mid insula (PMI) was confirmed by both statistical approaches. FC between the vmPFC-anterior insula, the amygdala-PMI, and the amygdala-dorsolateral prefrontal cortex (dlPFC) region pairs did not survive multiple comparison correction using the frequentist approach. However, the Bayesian model provided evidence for these region pairs having decreased FC in the GAD group. Leveraging Bayesian modeling, we demonstrate decreased FC of the vmPFC, insula, amygdala, and dlPFC in females with GAD. Exploiting the Bayesian framework revealed FC abnormalities between region pairs excluded by the frequentist analysis, as well as other previously undescribed regions, demonstrating the benefits of applying this statistical approach to resting state FC data.

Anxiety disorders in patients with noncardiac chest pain: association with health-related quality of life and chest pain severity

Background Patients with noncardiac chest pain (NCCP) report more severe symptoms and lowered health-related quality of life when they present with comorbid panic disorder (PD). Although generalized anxiety disorder (GAD) is the second most common psychiatric disorder in these patients, its impact on NCCP and health-related quality of life remains understudied. This study describes and prospectively compares patients with NCCP with or without PD or GAD in terms of (1) NCCP severity; and (2) the physical and mental components of health-related quality of life. Methods A total of 915 patients with NCCP were consecutively recruited in two emergency departments. The presence of comorbid PD or GAD was assessed at baseline with the Anxiety Disorder Schedule for DSM-IV. NCCP severity at baseline and at the six-month follow-up was assessed with a structured telephone interview, and the patients completed the 12-item Short-Form Health Survey Version 2 (SF-12v2) to assess health-related quality of life at both time points. Results Average NCCP severity decreased between baseline and the six-month follow-up (p < .001) and was higher in the patients with comorbid PD or GAD (p < .001) at both time points compared to those with NCCP only. However, average NCCP severity did not differ between patients with PD and those with GAD (p = 0.901). The physical component of quality of life improved over time (p = 0.016) and was significantly lower in the subset of patients with PD with or without comorbid GAD compared to the other groups (p < .001). A significant time x group interaction was found for the mental component of quality of life (p = 0.0499). GAD with or without comorbid PD was associated with a lower mental quality of life, and this effect increased at the six-month follow-up. Conclusions Comorbid PD or GAD are prospectively associated with increased chest pain severity and lowered health-related quality of life in patients with NCCP. PD appears to be mainly associated with the physical component of quality of life, while GAD has a greater association with the mental component. Knowledge of these differences could help in the management of patients with NCCP and these comorbidities.

Mental health of people living with HIV during the COVID-19 epidemic in Tokyo

Background The COVID-19 pandemic significantly impacts physical health and mental health. People living with HIV (PLWH) have a higher prevalence of psychiatric disorders than the general population. We examined the mental health of PLWH during the COVID-19 pandemic in Japan. Methods We retrospectively examined the medical records of PLWHs who underwent the Kessler Psychological Distress Scale-10, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 at an HIV referral hospital in Tokyo. Stringency Index (SI) values were used to measure the intensity of social infection control measures. Results Between February 2020-May 2021, 30 PLWH were examined at least once. The median age was 49 years, 29 PLWH were on antiretroviral therapy, and the median CD4 count was 580.5/µL. A total of 30% of the patients experienced distress, 45% depression, and 21.4% generalized anxiety disorder. Fourteen PLWH were taken for a median of four tests (IQR:2.0-7.3) and classified into three types: 1) Moderate distress or mild depression or anxiety at the beginning that decreased gradually (six patients, 43%), 2) persistent severe distress, but moderate depression or anxiety gradually decreased (six patients, 43%), and 3) extremely severe distress and depression or anxiety continued to syncope with the SI values (two patients, 14%). Having no partners, unemployment, and a history of psychiatric diseases were more commonly observed in the highly severe mental health groups. Conclusions PLWH are more vulnerable to the COVID-19 pandemic than the general population, especially those with substantial social isolation. Attention should be paid to the mental health of PLWH.