Master of Arts in Psychology, Cleveland State University, 2019, College of Sciences and Health Professions

At its core, Social Anxiety Disorder (SAD) is an intense fear where an individual is afraid of being rejected, humiliated, embarrassed, or negatively judged by others in social situations. Due to these feelings, those affected by SAD avoid interpersonal situations, which maintain and worsen the disorder. SAD affects 15 million adults and impairs daily functioning in countless aspects. Through various research studies, evidence has shown that individuals who suffer from SAD have difficulty managing their emotional states such as fear and anxiety and are less willing to accept and forgive themselves than their healthy peers. Willingness to accept, be kind, and forgive one's self is known as self-compassion. It is not clear in what way self-compassion effects the anxious and fear emotional states that define SAD. As fear is an immediate response to manifest danger, it is likely that self-compassion is more closely tied to anxiety that is prospective in nature. Therefore, this study examines if effects of self-compassion are more pronounced for anxiety rather than fear in a distressing task. Undergraduate students (N=130) completed the self-compassion measure on a computer and participated in a Free Breathing task (measure baseline) and the Trier Social Stress Test (measure distress) where they prepared (anticipatory state) and delivered (fear state) a speech in front of researchers. Participant's negative affect (nervous and scared) ratings were obtained following each task. Results concluded that self-compassion had a trend effect in decreasing negative affect equally for both the anticipatory and fear tasks relative to baseline.

Committee: Ilya Yaroslavsky (Committee Chair); Elizabeth Goncy (Committee Member); Christopher France (Committee Member) Subjects: Clinical Psychology; Psychology

Doctor of Philosophy, The Ohio State University, 2017, Psychology

The identification of specific markers of psychopathology in social media data has the potential to provide new tools for the research and practice of clinical psychology, thus augmenting and addressing many of the limitations of existing self-report measures. This project sought to detect relationships between Facebook activity, interaction, word-use and self-reported depressive symptoms. Additionally, it extended the existing literature to examine multiple disorders by examining self-reported worry and social anxiety. These analyses were completed in both college student- and internet-based samples. Self-reported depressive symptoms were found to be associated with social media activity, interactions, and language in both samples. Self-reported depressive symptoms were associated with increased activity on Facebook, including posting more frequently to Facebook and documenting more life events. However, these symptoms were also associated with fewer and more negative interactions with other Facebook users, such as liking and commenting on less content produced by others, receiving fewer likes and tags, and receiving more negative reactions. There were also associations between self-reported depressive symptoms, emotional word use, and pronoun use in participants' posts to Facebook. The pattern of increased Facebook activity and decreased Facebook interaction was also shared with measures of worry and social anxiety, including posting more content, having fewer reactions to other's content, and receiving fewer tags. Additionally, social anxiety was associated with having a greater number of life events and receiving more negative reactions. There were fewer associations between social anxiety, worry, and Facebook language use, with worry being associated with decreased positive word use, and no associations were found with social anxiety. The tripartite model (Clark & Watson, 1991) was used to generate a hypothesized pattern in emotion word use across depre (open full item for complete abstract)

Committee: Steven Beck Ph.D. (Advisor); Amelia Aldao Ph.D. (Committee Member); Julian Thayer Ph.D. (Committee Member) Subjects: Psychology

Master of Arts, University of Toledo, 2023, Psychology - Clinical

Anxiety disorders are among the most prevalent psychological diagnoses globally, with over 30% of the United States population experiencing an anxiety disorder at some point during their lifetime (American Psychiatric Association [APA], 2013; Bandelow & Michaelis, 2015; Ruscio et al., 2017). Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5; APA, 2013), and symptoms of GAD have been increasing more recently with the COVID-19 pandemic (Barzilay et al., 2020; Marroquin et al., 2020; Twenge & Joiner, 2020). Although present models attempt to elucidate the underlying mechanisms of GAD, data are limited on how those with GAD perceive and experience social situations (Piedmont, 2015) despite the benefits of social behavior for physical and psychological well-being (Holt-Lunstad et al., 2017; Inagaki & Orehek, 2017). Given an increase in technology usage in social environments, through smartphone usage, and lack of literature surrounding how those with GAD utilize smartphones socially, the present study explored this gap in the literature. Informed by theoretical and empirical work on GAD the present study proposed a serial mediation model through which emotion regulation and social connectedness explain relations between GAD symptom severity and social smartphone use. A path analysis did not find adequate fit based on the proposed model, though the serial mediation analysis was revealed to be significant. This supports previous theoretical models of GAD theory (Borkovec, 1994; Borkovec et al., 2004; Mennin et al., 2002; 2005; Newman & Llera, 2011) and models of interpersonal interactions like Social Exchange theory (SET; Homans, 1958, 1961, & 1974; Thibaut & Kelley, 1959; Blau, 1964) and Internet-use with the Interaction of Person-Affect-Cognition-Execution (I-PACE) model (Brand et al., 2016).

Committee: Jon Elhai (Committee Chair); Peter Mezo (Committee Member); Jason Rose (Committee Member); Jason Levine (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, Miami University, 2022, Psychology

Introduction: This study applies positive emotion regulation models to identify within-person and between-person mechanisms that contribute to co-occurrence of Alcohol Use Disorder (AUD) and Social Anxiety Disorder (SAD) symptoms. SAD is a risk factor for the development of AUD, and comorbid SAD and AUD confer greater detrimental effects than either disorder alone. People high in social anxiety have difficulties regulating positive emotions, including difficulty accepting positive emotions. Although people with AUD symptoms often experience trait-level difficulties regulating positive emotions, in the short term, alcohol use may facilitate adaptive positive emotion regulation. Thus, an understudied area of research is whether alcohol consumption temporarily allows people experiencing elevated social anxiety symptoms to accept positive emotions, which, in the long term, could lead to alcohol-related problems. To address this gap in research, the present study (1): Tested whether alcohol consumption moderated within-person relations between state social anxiety and positive emotion acceptance in emerging adult hazardous drinkers, and (2): Tested whether, on a between-person level, the extent to which alcohol helped people accept positive emotions was associated with alcohol-related problems. Method: 104 young adults (aged 18-25) who reported hazardous drinking participated in a baseline session and a 14-day ecological momentary assessment (EMA) data collection period. During the EMA data collection period, participants initiated EMA reports about each social interaction they experienced, which assessed their social anxiety, positive emotion acceptance, and alcohol use. Results: Social anxiety was associated with lower positive emotion acceptance during social interactions. Alcohol consumption occurrence, but not quantity, was associated with lower positive emotion acceptance. Alcohol consumption did not moderate the relation between state social anxiety and positive e (open full item for complete abstract)

Committee: Elise Clerkin (Committee Chair); Joshua Magee (Committee Member); Elizabeth Kiel (Committee Member); Philip Smith (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, University of Toledo, 2021, Psychology - Clinical

Generalized anxiety disorder (GAD), a chronic disorder characterized by excessive and difficult-to-control worry, has been shown to be associated with a global pattern of avoidance, emotion dysregulation, negative affectivity, dysfunctional social cognition, and maladaptive interpersonal behavior. However, limited research exists examining functioning and connection during social interactions. The present study aimed to investigate how individuals with GAD respond while engaged in an intense, online social interaction aimed at increasing level of connectedness. Participants were adult females (N = 101) with and without GAD who engaged in either an evocative or non-evocative/control online interaction. Results revealed that individuals with GAD experienced lower positive affect, higher negative affect, and perceived their interaction partner more negatively (hostile-submissive, hostile, submissive) compared to those without GAD during the interaction. Relatedly, individuals with GAD were perceived more negatively and less positively by their interaction partner during the interaction. However, GAD status did not predict participant likeability, desire to engage in future interaction, intimacy, openness, or commitment to the relationship with their interaction partner. Individuals with GAD further reported experiencing lower levels of connectedness with their interaction partner while engaged in a deep and intimate interaction aimed at fostering connectedness. Results support the notion that the pathology associated with GAD interferes with the ability to engage in prosocial behavior and cultivate close connected relationships. Implications of these findings are discussed.

Committee: Jason Levine (Committee Chair); Matthew Tull (Committee Member); Kim Gratz (Committee Member); Jason Rose (Committee Member); Chad Wetterneck (Committee Member) Subjects: Clinical Psychology; Psychology

Doctor of Philosophy, Miami University, 2020, Psychology

Social anxiety disorder (SAD) is prevalent and debilitating. More research is needed on a) the factors driving SAD symptoms and b) targeted interventions to shift these factors. Experiential avoidance (EA) has been identified as a possible factor driving SAD symptoms. Many empirically-supported treatments focus on reducing EA as a mechanism of symptom change. However, past research on the relation between EA and SAD symptoms has almost exclusively focused on explicit (i.e., consciously controlled) as compared to implicit (i.e., outside of conscious control) measures of EA. Further, little is known about how EA and SAD symptoms bidirectionally interact throughout the course of an intervention. To address these limitations of past research, the present study: 1) evaluated the psychometric properties of two implicit measures of EA, 2) dynamically modeled the week-to-week temporal relations between explicit EA and SAD symptoms, and 3) tested the efficacy and acceptability of a novel, 3-session pilot intervention targeting EA, which included a computerized program and psychoeducation. Participants (N = 78) consisted of undergraduates with elevated explicit EA and SAD symptoms. There was mixed evidence that the implicit measures demonstrated adequate validity and reliability. In partial support of hypotheses, bidirectional models of explicit EA and SAD symptoms suggested that changes in SAD symptoms preceded and predicted changes in explicit EA from week to week, but not vice versa. Further, the pilot intervention was not associated with reductions in EA and SAD symptoms, but generally, was found to be acceptable and credible. These novel findings advance our understanding of the dynamic relationships between EA and SAD symptoms throughout treatment. Given that many empirically-supported treatments target EA as a mechanism of symptom change, this study highlights a need for future work to more clearly delineate the time course by which changes in mechanisms leads to chang (open full item for complete abstract)

Committee: Elise Clerkin PhD (Committee Chair); April Smith PhD (Committee Member); Josh Magee PhD (Committee Member); Neil Brigden PhD (Committee Member) Subjects: Clinical Psychology; Psychology

Doctor of Philosophy, The Ohio State University, 2020, Social Work

Background: The unique recovery process and treatment needs of persons with bipolar II disorder (BD II) has been subject of limited research. BD II is associated with high rates of disability worldwide and people with BD II are among the highest risk of suicide of all populations. Research of psychotherapy for bipolar disorders (BDs) in general has focused on clinical outcomes (i.e., reducing mood symptoms, remission of mood episodes) rather than functional outcomes, suicide risk, or co-occurring problems. This dissertation addresses these gaps in three quantitative studies, which investigate the recovery process of individuals with BDs and what treatment (i.e., psychotherapy alone or in combination with medication) works for whom (i.e., individuals with childhood trauma, anxiety, and various stages of illness progression) to improve symptoms, reduce suicidal thoughts, and restore functioning to all major life areas. The goal of these studies is to inform treatment considerations for BD II to decrease the high rates of mortality and disability associated with BD II. These studies are guided by kindling theory and social rhythms disruption therapy, which emphasize stressful life events and disruption of social and biological rhythms, in combination with genetic predisposition to explain the etiology and ongoing expression of BDs. Methods: Study design consisted of a randomized, double blind, controlled trial (ClinicalTrials.gov identifier: NCT01133821) testing the efficacy of interpersonal social rhythms therapy (IPSRT) plus placebo compared to IPSRT plus medication (i.e., quetiapine) for adults with BD II depression (n = 92). Study 1 used multilevel logistic regression with growth curve modeling to examine (1) the comparative effectiveness of IPSRT plus placebo compared to IPSRT plus medication on suicidal ideation outcomes, and (2) whether higher levels of childhood trauma and anxiety predicted change in suicidal ideation. Study 2 used multilevel modeling with gro (open full item for complete abstract)

Committee: Theresa Early PhD (Committee Chair); Tamara Davis PhD (Committee Member); Alicia Bunger PhD (Committee Member); Natasha Slesnick PhD (Committee Member) Subjects: Medicine; Mental Health; Psychology; Psychotherapy; Social Work

Master of Arts, Miami University, 2018, Psychology

Social anxiety symptoms are associated with diminished ability to up-regulate, or savor, positive emotional experiences. This study tested whether experiential avoidance, fear of positive evaluation, and fear of positive emotion, mediated the relation between social anxiety symptoms and change in positive emotions following a reminiscence savoring task, and whether reminiscence instructions moderated the relations between these mediators and change in positive emotions. 196 unselected participants were randomized to immersed, first-person reminiscence or distanced, third-person reminiscence, and reported positive emotions before and after reminiscence. As expected, in the immersed condition, participants high (vs. low) in experiential avoidance benefited less from reminiscence, and experiential avoidance mediated the relationship between social anxiety symptoms and change in positive emotions. Surprisingly, for participants in the immersed condition, fear of positive evaluation was positively associated with positive emotions, whereas for those in the distanced condition, fear of positive evaluation was negatively associated with positive emotions. Finally, there was no evidence of a moderated mediation effect for fear of positive emotion. Together, data suggest that social anxiety symptoms may lead to diminished positive emotions through multiple, disparate mechanisms, and that these mechanisms differentially interact with savoring strategies to influence change in positive emotions.

Committee: Elise Clerkin (Committee Chair); Aaron Luebbe (Committee Member); April Smith (Committee Member) Subjects: Clinical Psychology; Psychology

Master of Science (MS), Ohio University, 2018, Journalism (Communication)

Stigma against the mentally ill is pervasive in our society and on college campuses. Video can be an effective contact-based method to dispel this stigma. This study examined the impact of a video featuring three Ohio University students who self- identified as having anxiety disorders telling their stories of life with these illnesses. A total of 47 other students were in the study with 30 being part of a control group which did not see the video, 11 watching the video in its entirety and 6 being excluded from the study for watching less than 190 seconds of the video. Icek Ajzen's theory of planned behavior was used to contextualize the outcome which found that people who watched the video had a high level of behavioral intention and perceived behavioral control and were more likely to help people with an anxiety disorder than people who did not watch the video. They also had less desired social distance from people with anxiety disorders. The findings suggest that the video and filmed contact methods for interaction with the mentally ill are effective in combatting stigma.

Committee: Jatin Srivastava (Advisor); Bernard Debatin (Committee Member); Parul Jain (Committee Member) Subjects: Behavioral Sciences; Communication; Mental Health; Psychology

PHD, Kent State University, 2016, College of Arts and Sciences / Department of Psychological Sciences

Social Anxiety Disorder (SAD) is a chronic mental illness that affects a large number of people and is difficult to treat. There is a wealth of research identifying cognitive, behavioral, and biological mechanisms that contribute to the development and maintenance of this disorder. However, the phenomenology of fear, the emotion central to this disorder, is less well studied. It is assumed that individuals with SAD experience more fear than non-anxious individuals, but the empirical support stems primarily from self-report and laboratory studies. In fact, studies of physiological responses associated with fear (e.g., sympathetic nervous system arousal) have not consistently shown elevated fear. Although emotions are recognized as multi-dimensional response systems, fear has not yet been examined in more than one dimension at a time across contexts in daily life in SAD. This study measured fear in two dimensions (self-report and sympathetic nervous system arousal) over five days using experience-sampling and ambulatory monitoring equipment. Social context was also measured. Both the relative frequency of fear and concordance across fear dimensions were compared in individuals with SAD and healthy controls (HC). Findings reveal that individuals with SAD exhibit a higher relative frequency of fear as compared to HC and this finding was moderated by social context. Additionally, when compared to HCs, individuals with SAD did not exhibit greater concordance, or positive association between response dimensions. These findings support the dominant theoretical assumptions that individuals with SAD experience more fear, however, there are several caveats that have important implications for theories of fear in this disorder.

Committee: Karin Coifman Ph.D. (Committee Chair); David Fresco Ph.D. (Committee Co-Chair); Jeffrey Ciesla Ph.D. (Committee Member); John Updegraff Ph.D. (Committee Member); Tom Hollenstein Ph.D. (Committee Member); Clare Stacey Ph.D. (Committee Member) Subjects: Clinical Psychology

Master of Arts, University of Toledo, 2015, Psychology - Clinical

The current study is aimed at developing a multi-dimensional approach to understanding Generalized Anxiety Disorder (GAD). Within the United States there is a 2.9% prevalence rate of GAD over 12 months among adults, with a lifetime risk of 9.0% (American Psychiatric Association, 2013). This common disorder has been a significant area of study over the past several decades and various researchers have attempted to understand the factors that cause, maintain, and prevent GAD (Borkovec et al., 2004; Newman et al., 2011). The current study aimed to investigate infrequently assessed components (i.e., affect, heart rate variability, social abilities, and social perceptions) of GAD. A sample of 57 undergraduate participants completed measures of general anxiety, affect, and depression. They then entered a laboratory setting where they completed baseline measures of affect and worry, while ECG was recorded continuously throughout the duration of the study. Participants engaged in four subsequent phases: affect manipulation, two social interaction situations, and a recovery period. Some findings lend support to the Negative Contrast Avoidance Model, and results indicate that individuals with GAD present as being submissive, and are more likely to find others to be dominant, hostile, and less affectionate.

Committee: Jason Levine PhD (Committee Chair); Jon Elhai PhD (Committee Member); Andrew Geers PhD (Committee Member) Subjects: Psychology

Doctor of Philosophy (PhD), Ohio University, 2016, Clinical Psychology (Arts and Sciences)

Current theoretical models of social anxiety disorder (SAD) emphasize the importance of information processing biases in its etiology and maintenance. Prior research findings have been mixed with regard to the precise nature of both attention and memory biases among individuals with SAD, with some studies finding weak evidence and others finding support. The current study used a novel approach to studying attention and encoding among with the SAD (n=26) and non-SAD (n=25) groups. This approach involved asking participants to view a series of faces in a spatial grid for a short time, and then asking them to pick the faces they saw from among a series of distractor faces and place them in their original correct spatial location in a blank grid. Faces varied by displayed emotional expression (happy, angry, or neutral) as well as by apparent eye contact with the participant (direct gaze, averted gaze). Results showed that participants were generally more adept at recalling neutral faces compared to angry or happy faces, and more adept at recalling averted gaze faces than direct gaze faces, and this effect did not differ across social anxiety groups. Reasons for the lack of interaction effects are explored, and implications and future directions are discussed.

Committee: Julie Suhr Ph.D. (Advisor); Christina Gidycz Ph.D. (Committee Member); Zoccola Peggy Ph.D. (Committee Member); Weisenmuller Chantel Ph.D. (Committee Member); Thompson Charee Ph.D. (Committee Member) Subjects: Psychology

Master of Science (MS), Ohio University, 2014, Clinical Psychology (Arts and Sciences)

Research on implicit associations in psychopathology suggests that socially anxious individuals may have implicit associations congruent with the core cognitive constructs/concerns in social anxiety, such as stronger negative associations for social stimuli and fears of evaluation. The literature also indicates that implicit associations are useful for predicting spontaneous behavioral reactions. The present study recruited two groups (n=25 for each group) of persons high in social anxiety versus persons low in social anxiety (i.e., N = 50). Participants engaged in three implicit tests that assessed their attitudes towards: general social stimuli, positive social stimuli, and negative social stimuli. Participants then delivered an impromptu speech task, after which they completed each of the implicit tests once more. It was hypothesized that: (a) groups would differ significantly on implicit associations for social stimuli and fears of evaluation, such that persons high in social anxiety would demonstrate more negative implicit associations across social stimuli compared to low socially anxious persons; and (b) implicit measures would predict behavioral anxiety ratings based on performance during a speech task within the overall sample. Results were in partial support of the study hypotheses: (a) partially consistent with hypotheses, highly socially anxious persons demonstrated significantly greater negative implicit associations for negatively valenced social stimuli (but not general or positive social stimuli); and (b) implicit 4 measures assessing associations for general social stimuli, and negatively valenced social stimuli, significantly to marginally predicted observer-rated eye gaze during the speech task. There was also a significant decrease in the strength of implicit associations for positively-valenced social stimuli following the impromptu speech task. Treatment and assessment implications, and limitations to the study, will be discussed.

Committee: Justin Weeks PhD. (Advisor) Subjects: Psychology

Doctor of Philosophy, University of Toledo, 2007, Psychology

Recent studies have suggested that youth diagnosed with high-functioning autism spectrum disorders often suffer from a higher rate of anxiety compared to the general population and youth with other psychological disorders (e.g., Green, Gilchrist, Burton, & Cox, 2000). One hypothesis may be that a child's level of social skills directly affects his/her anxiety. However, there is little theoretical or empirical evidence that explains the development of anxiety within this population. Studies from the anxiety literature suggest that parental anxiety and parental behaviors (i.e., acceptance, control, and modeling of anxious behaviors) are associated with the development of child anxiety. In the current investigation of youth with high-functioning autism spectrum disorders, it was hypothesized that high parental anxiety and low child social skills would be directly related to more symptoms of child anxiety. Further, it was expected that the relationship between parental anxiety and child anxiety would be partially mediated by parenting behaviors of low acceptance, high control, and high modeling of anxious behaviors in the parent-child relationship. Given that theory suggests that these parenting behaviors may in part be related to children's perceptions of control and threat, it was hypothesized that parental acceptance and control would be mediated by the child's perception of control when predicting child anxiety symptomatology. Furthermore, parental modeling of anxious behaviors would be mediated by child's perception of threat when predicting childhood anxiety symptomatology. Participants were 62 children (50 males, 12 females) between the ages of 8 and 18 with a DSM-IV diagnosis of a high-functioning autistic spectrum disorder (ASD) and 43 primary caregivers of the children. Results partially supported the hypothesized model in explaining the development of childhood anxiety in a population with ASD but overall indices of fit suggested an inadequate fit of the data (open full item for complete abstract)

Committee: Laura Seligman (Advisor) Subjects: Psychology, Clinical

Master of Science (MS), Ohio University, 2012, Clinical Psychology (Arts and Sciences)

Individuals diagnosed with social anxiety disorder (SAD) tend to form negatively-distorted and inaccurate self-images during social situations (Clark & Wells, 1995; Heimberg, Brozovich, & Rapee, 2010). Extensive research has provided support for the existence of these negative mental representations, and has shown how they contribute to the maintenance of SAD symptoms. A cognitive-behavioral treatment component known as video feedback (VF) has been shown to be effective in altering such distorted self-representations; additionally, a modified VF technique involving cognitive preparation has been shown to enhance VF treatment effects. The present study evaluated whether the effects of VF with cognitive preparation replicate and extend to a semi-structured social interaction, and further examined the link between VF-induced changes in self-perception and state anxiety. A sample of 29 participants who met diagnostic criteria for SAD were randomly assigned to receive VF (VF condition) or a mental arithmetic task (No-VF condition) in between two social interaction role-plays with a trained confederate. Results suggest that, in response to a social interaction, VF: [1] results in improved self-evaluation of performance, and [2] exerts an effect on state anxiety in SAD individuals.

Committee: Justin Weeks PhD (Advisor) Subjects: Clinical Psychology

Bachelor of Arts, Miami University, 2005, College of Arts and Sciences - Psychology

One of the difficulties facing people with Anxiety disorders is the lack of understanding from society about what they go through. This thesis is an attempt to bring Post-Traumatic Stress Disorder and Social Anxiety/Phobia out of textbooks and theories through short stories, with the goal of allowing readers to understand and experience the disorders at a personal level. The diagnostic criteria in the DSM-IV and other research into each disorder are incorporated through the characters' personalities, thought patterns and reactions to their worlds, as well as the situations that brought about the development of the disorders. Each story is followed by a psychological analysis that provides a brief explanation of the disorder in clinical terms and demonstrates its presence in the story through specific examples.

Committee: Mia Biran (Advisor) Subjects: Psychology, Clinical