Interpretation Flexibility in Children with Social Anxiety Disorder

Background: Children with social anxiety disorder are known to interpret ambiguous situations negatively. However, are children with social anxiety disorder, for example, able to consider positive and neutral interpretations, or do they only consider the negative interpretations (nuanced flexibility)? And do these children interpret all situations negatively, or are their interpretations dependent on the situation (situational flexibility)? Considering that inflexibility may hinder treatment outcomes, this study examines interpretation flexibility in children with social anxiety disorder. Methods: This cross-sectional study included 132 children aged 7-12. Children with social anxiety disorder (n = 42) were compared to children with other anxiety disorders (n = 40) and children without anxiety disorders (n = 50). Children read ten ambiguous stories about social and separation situations. Following each story, they rated the likelihood of each given positive, neutral, and negative...Show moreBackground: Children with social anxiety disorder are known to interpret ambiguous situations negatively. However, are children with social anxiety disorder, for example, able to consider positive and neutral interpretations, or do they only consider the negative interpretations (nuanced flexibility)? And do these children interpret all situations negatively, or are their interpretations dependent on the situation (situational flexibility)? Considering that inflexibility may hinder treatment outcomes, this study examines interpretation flexibility in children with social anxiety disorder. Methods: This cross-sectional study included 132 children aged 7-12. Children with social anxiety disorder (n = 42) were compared to children with other anxiety disorders (n = 40) and children without anxiety disorders (n = 50). Children read ten ambiguous stories about social and separation situations. Following each story, they rated the likelihood of each given positive, neutral, and negative interpretation. Results: All children rated positive interpretations as more likely than negative interpretations. As expected, children without an anxiety disorder showed a significantly stronger preference for positive interpretations than children with an anxiety disorder. Nuanced flexibility was similar for the three groups: all children showed equal openness to alternative interpretations. However, there were differences between the groups in situational flexibility: children with an anxiety disorder demonstrated greater situational flexibility when rating negative interpretations (than children without anxiety disorders), thus adjusting their interpretation based on the context of the situation. Children without an anxiety disorder, on the other hand, provided constantly low ratings for negative interpretations. These differences were only observed for negative interpretations, not for positive or neutral ones. Additionally, no content-specificity was found; flexibility did not differ between social and separation situations. There were also no differences between the two anxiety groups. Conclusion: These findings replicate earlier findings showing that children with an anxiety disorder show a lower preference for positive interpretations than children without an anxiety disorder. In addition, our results suggest that children with an anxiety disorder were open to alternative interpretations and did not consistently interpret situations negatively. Future research is needed to examine whether pre-treatment flexibility can predict treatment outcome, to entail whether it is effective to train flexibility.Show less

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Interpretation Flexibility in Children with Social Anxiety Disorder