Enhancing Social Connectedness in Anxiety and Depression Through Amplification of Positivity: Preliminary Treatment Outcomes and Process of Change.

BackgroundAnxiety and depressive disorders are often characterized by perceived social disconnection, yet evidence-based treatments produce only modest improvements in this domain. The well-established link between positive affect (PA) and social connectedness suggests that directly targeting PA in treatment may be valuable.MethodA secondary analysis of a waitlist-controlled trial (N=29) was conducted to evaluate treatment response and process of change in social connectedness within a 10-session positive activity intervention protocol-Amplification of Positivity (AMP)-designed to increase PA in individuals seeking treatment for anxiety or depression (ClinicalTrials.gov Identifier: NCT02330627). Perceived social connectedness and PA/negative affect (NA) were assessed throughout treatment. Time-lagged multilevel mediation models examined the process of change in affect and connectedness throughout treatment.ResultsThe AMP group displayed significantly larger improvements in social connectedness from pre- to post-treatment compared to waitlist; improvements were maintained through 6-month follow-up. Within the AMP group, increases in PA and decreases in NA both uniquely predicted subsequent increases in connectedness throughout treatment. However, experiencing heightened NA throughout treatment attenuated the effect of changes in PA on connectedness. Improvements in connectedness predicted subsequent increases in PA, but not changes in NA.ConclusionsThese preliminary findings suggest that positive activity interventions may be valuable for enhancing social connectedness in individuals with clinically impairing anxiety or depression, possibly through both increasing positive emotions and decreasing negative emotions

Resisting the mantle of the monstrous feminine : women's construction and experience of premenstrual embodiment

The female reproductive body is positioned as abject, as other, as site of defciency and disease, the epitome of the ‘monstrous feminine.’ Premenstrual change in emotion, behavior or embodied sensation is positioned as a sign of madness within, necessitating restraint and control on the part of the women experiencing it (Ussher 2006). Breakdown in this control through manifestation of ‘symptoms’ is diagnosed as PMS (Premenstrual Syndrome) or PMDD (Premenstrual Dysphoric Disorder), a pathology deserving of ‘treatment.’ In this chapter, we adopt a feminist material-discursive theoretical framework to examine the role of premenstrual embodiment in relation to women’s adoption of the subject position of monstrous feminine, drawing on interviews we have conducted with women who self-diagnose as ‘PMS sufferers.’ We theorize women’s self-positioning as subjectifcation, wherein women take up cultural discourse associated with idealized femininity and the reproductive body, resulting in self-objectifcation, distress, and self-condemnation. However, women can resist negative cultural constructions of premenstrual embodiment and the subsequent self-policing. We describe the impact of women-centered psychological therapy which increases awareness of embodied change, and leads to greater acceptance of the premenstrual body and greater self-care, which serves to reduce premenstrual distress

Patterns of Felt and Expressed Positive Affect in Social Anxiety: Concordance, Discordance, and their Correlates

Individuals with high social anxiety (HSA) may experience subtle impairments in social processes that, if identified and targeted in treatment, could enhance social relationship functioning. Discordance in positive affect (PA), i.e., mismatch between PA experience and expression, may be one impactful treatment target if it is prevalent among HSA and if it weakens social bonds. The current study tested whether, during a positive social interaction: 1) a cross-section of individuals with HSA vs. low social anxiety display heterogeneous, highly distinct “PA profiles,” reflecting four patterns of discordant or concordant PA; 2) displaying discordant profiles is linked to HSA, and displaying all predicted profiles aside from concordant high PA is linked to additional clinical symptoms; 3) discordance is associated with lower desire for future interaction (DFI) with one’s conversation partner and with conversation partners’ lower reciprocal DFI; and 4) discordant profiles reflect use of specific emotion regulation strategies. Ninety-six adults age 18-55 participated, with scores on the Liebowitz Social Anxiety Scale either ≥ 50 (HSA; n = 70) or ≤ 20 (n = 26). All engaged in a positive laboratory-based relationship formation task with a confederate conversation partner and rated their internally felt PA several times during the interaction. Next, participants and confederates rated their DFI, and participants rated their use of emotion regulation strategies. Automated software was later used to code video recordings of participants’ intensity of smiling. Latent profile analysis tested for the predicted PA profiles. Three of the four predicted profiles emerged, including one concordant high (n = 21), one concordant low (n = 23), and one discordant (high felt, low expressed) PA profile (n = 52). Compared to either of the other two profiles, displaying concordant low PA was associated with higher social anxiety, higher anhedonic depression, and higher use of expressive suppression to regulate emotions. Discordant PA was not more strongly associated with HSA and was not maladaptive for DFI. Instead, concordant low internally felt and low expressed PA was identified as a potentially useful indicator of both clinical severity and impairment in social relationship functioning and may point to more urgent or intensive treatment need

Patterns of Felt and Expressed Positive Affect in Social Anxiety: Concordance, Discordance, and their Correlates

Individuals with high social anxiety (HSA) may experience subtle impairments in social processes that, if identified and targeted in treatment, could enhance social relationship functioning. Discordance in positive affect (PA), i.e., mismatch between PA experience and expression, may be one impactful treatment target if it is prevalent among HSA and if it weakens social bonds. The current study tested whether, during a positive social interaction: 1) a cross-section of individuals with HSA vs. low social anxiety display heterogeneous, highly distinct “PA profiles,” reflecting four patterns of discordant or concordant PA; 2) displaying discordant profiles is linked to HSA, and displaying all predicted profiles aside from concordant high PA is linked to additional clinical symptoms; 3) discordance is associated with lower desire for future interaction (DFI) with one’s conversation partner and with conversation partners’ lower reciprocal DFI; and 4) discordant profiles reflect use of specific emotion regulation strategies. Ninety-six adults age 18-55 participated, with scores on the Liebowitz Social Anxiety Scale either ≥ 50 (HSA; n = 70) or ≤ 20 (n = 26). All engaged in a positive laboratory-based relationship formation task with a confederate conversation partner and rated their internally felt PA several times during the interaction. Next, participants and confederates rated their DFI, and participants rated their use of emotion regulation strategies. Automated software was later used to code video recordings of participants’ intensity of smiling. Latent profile analysis tested for the predicted PA profiles. Three of the four predicted profiles emerged, including one concordant high (n = 21), one concordant low (n = 23), and one discordant (high felt, low expressed) PA profile (n = 52). Compared to either of the other two profiles, displaying concordant low PA was associated with higher social anxiety, higher anhedonic depression, and higher use of expressive suppression to regulate emotions. Discordant PA was not more strongly associated with HSA and was not maladaptive for DFI. Instead, concordant low internally felt and low expressed PA was identified as a potentially useful indicator of both clinical severity and impairment in social relationship functioning and may point to more urgent or intensive treatment need

A tale of two systems: Testing a positive and negative valence systems framework to understand social disconnection across anxiety and depressive disorders

BackgroundSocial disconnection is a common and pernicious feature of anxiety and depressive disorders, yet is insufficiently addressed by our best available treatments. To better understand why people with anxiety and depression feel socially disconnected, we tested a positive and negative valence systems framework informed by research on how normative social connections develop and flourish.MethodIndividuals seeking treatment for anxiety or depression (N = 150) completed measures of perceived social connectedness, positive and negative valence temperament, social goals, affect, symptoms, and life satisfaction.ResultsFeeling less socially connected was associated with diminished life satisfaction, beyond clinical symptom severity. Regression analyses revealed that both diminished positive valence and heightened negative valence temperament, and their corresponding motivational and affective outputs, were significantly and uniquely (with no significant interaction between them) associated with lower perceived connectedness.LimitationsData was cross-sectional and based on self-report-limiting conclusions about causality and social disconnection processes at different units of analysis.ConclusionsUnderstanding social disconnection through the lens of a positive and negative valence systems framework may inform transdiagnostic models and treatment approaches

The affective tie that binds: Examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder

Individuals with social anxiety disorder (SAD) have difficulty forming social relationships. The prevailing clinical perspective is that negative emotions such as anxiety inhibit one's capacity to develop satisfying social connections. However, empirical findings from social psychology and affective neuroscience suggest that positive emotional experiences are fundamental to establishing new social bonds. To reconcile these perspectives, we collected repeated measurements of anxiety, positive emotions (pleasantness), and connectedness over the course of a controlled relationship formation encounter in 56 participants diagnosed with SAD (64% female; Mage=23.3, SD=4.7). Participants experienced both increases in positive emotions and decreases in anxiety throughout the interaction. Change in positive emotions was the most robust predictor of subsequent increases in connectedness, as well as a greater desire to engage one's partner in future social activities, above and beyond reductions in anxiety (medium to large sized effects). Those findings suggest that anxiety-based models alone may not fully explain difficulties in relationship formation in SAD, and underscore the potential value of considering positive emotional experiences in conceptual and treatment models of SAD

Enhancing Social Connectedness in Anxiety and Depression Through Amplification of Positivity: Preliminary Treatment Outcomes and Process of Change.

BackgroundAnxiety and depressive disorders are often characterized by perceived social disconnection, yet evidence-based treatments produce only modest improvements in this domain. The well-established link between positive affect (PA) and social connectedness suggests that directly targeting PA in treatment may be valuable.MethodA secondary analysis of a waitlist-controlled trial (N=29) was conducted to evaluate treatment response and process of change in social connectedness within a 10-session positive activity intervention protocol-Amplification of Positivity (AMP)-designed to increase PA in individuals seeking treatment for anxiety or depression (ClinicalTrials.gov Identifier: NCT02330627). Perceived social connectedness and PA/negative affect (NA) were assessed throughout treatment. Time-lagged multilevel mediation models examined the process of change in affect and connectedness throughout treatment.ResultsThe AMP group displayed significantly larger improvements in social connectedness from pre- to post-treatment compared to waitlist; improvements were maintained through 6-month follow-up. Within the AMP group, increases in PA and decreases in NA both uniquely predicted subsequent increases in connectedness throughout treatment. However, experiencing heightened NA throughout treatment attenuated the effect of changes in PA on connectedness. Improvements in connectedness predicted subsequent increases in PA, but not changes in NA.ConclusionsThese preliminary findings suggest that positive activity interventions may be valuable for enhancing social connectedness in individuals with clinically impairing anxiety or depression, possibly through both increasing positive emotions and decreasing negative emotions

The Association of Academic Cosmetic Dermatology: improving cosmetic dermatology education through collaboration, research, and advocacy.

Cosmetic and laser procedures are increasingly popular among patients and are skills in which dermatologists are regarded as well trained. Most dermatology residents intend to incorporate cosmetic procedures into their practice and prefer to learn such procedures during residency through direct patient care. However, there are notable challenges in optimizing how residents are trained in cosmetic and laser dermatology. To address these barriers and elevate the practice of cosmetic dermatology in academic medicine, the Association of Academic Cosmetic Dermatology (AACD) was founded in 2021 as the lead professional society for dermatologists who direct the education of resident trainees in cosmetic and laser dermatology. The AACD, a group of board-certified dermatologists who teach cosmetic and laser dermatology to residents, aims to improve cosmetic dermatology education through collaboration, research, and advocacy