Abstract
Adolescents who experience social anxiety concerns often display symptoms and impairments when interacting with unfamiliar peers. For adolescent clients, reducing symptoms and impairments within these interactions comprises a key treatment target within exposure-based therapies for social anxiety. Recent work on mechanisms of change in exposure-based therapies highlights the need for therapeutic exposures to simulate real-world manifestations of anxiety-provoking social situations. Yet, researchers encounter difficulty with gathering ecologically valid data about social interactions with unfamiliar peers. The lack of these data inhibits building an evidence base for understanding, assessing, and treating adolescent clients whose concerns manifest within these social interactions. Consequently, we developed a paradigm for understanding adolescent social anxiety within social interactions with unfamiliar peers. In this paradigm, we train peer confederates to interact with adolescents as if they were a same-age peer, within a battery of social interaction tasks that mimic key characteristics of therapeutic exposures. Leveraging experimental psychopathology and multi-modal assessment approaches, this paradigm allows for understanding core components of social interactions with unfamiliar peers relevant to exposure-based therapy, including stimuli variability, habituation, expectancy violations, peers’ impressions about socially anxious adolescents, and maladaptive coping strategies that inhibit learning from exposures (e.g., safety behaviors). We detail the conceptual and empirical foundations of this paradigm, highlight important directions for future research, and report “proof of concept” data supporting these research directions. The Unfamiliar Peer Paradigm opens new doors for building a basic science that informs evidence-based services for social anxiety, within clinically relevant contexts in adolescents’ social worlds.
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References
Achenbach, T. M. (2017). Future directions for clinical research, services, and training: Evidence-based assessment across informants, cultures, and dimensional hierarchies. Journal of Clinical Child and Adolescent Psychology,46, 159–169. https://doi.org/10.1080/15374416.2016.1220315.
Alfano, C. A., & Beidel, D. C. (2011). Social anxiety in adolescents and young adults: Translating developmental science into practice. Washington, D. C.: American Psychological Association.
Ambady, N., & Rosenthal, R. (1992). Thin slices of expressive behavior as predictors of interpersonal consequences: A meta-analysis. Psychological Bulletin,111, 256–274. https://doi.org/10.1037/0033-2909.111.2.256.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders 5th ed. (DSM-V). Washington, D. C.: American Psychiatric Association.
Anderson, E. R., & Hope, D. A. (2009). The relationship among social phobia, objective and perceived physiological reactivity, and anxiety sensitivity in an adolescent population. Journal of Anxiety Disorders,23, 18–26. https://doi.org/10.1016/j.janxdis.2008.03.011.
Anderson, P. L., Price, M., Edwards, S. M., Obasaju, M. A., Schmertz, S. K., Zimand, E., et al. (2013). Virtual reality exposure therapy for social anxiety disorder: A randomized controlled trial. Journal of Consulting and Clinical Psychology,81, 751–760. https://doi.org/10.1037/a0033559.
Balaji, M., Chatterjee, S., Koschore, M., Rangsawamy, T., Chavan, A., Dabholkar, H., et al. (2012). The development of a lay health worker delivered collaboratie community based intervention for people with schizophrenia in India. BioMed Central Health Services Research,12, 42. https://doi.org/10.1186/1472-6963-12-42.
Beale, A., Keeley, L. M., Okuno, H., Szollos, S., Rausch, E., Makol, B. A., et al. (2018). Efficient screening for impairments in peer functioning among mid-to-late adolescents receiving clinical assessments for social anxiety. Child and Youth Care Forum,47, 613–631. https://doi.org/10.1007/s10566-018-9458-x.
Becker-Haimes, E. M., Jensen-Doss, A., Birmaher, B., Kendall, P. C., & Ginsburg, G. S. (2018). Parent–youth informant disagreement: Implications for youth anxiety treatment. Clinical Child Psychology and Psychiatry,23, 42–56. https://doi.org/10.1177/1359104516689586.
Beidel, D. C., Alfano, C. A., Kofler, M. J., Rao, P. A., Scharfstein, L., & Sarver, N. W. (2014). The impact of social skills training for social anxiety disorder: A randomized controlled trial. Journal of Anxiety Disorders,28, 908–918. https://doi.org/10.1016/j.janxdis.2014.09.016.
Beidel, D. C., Rao, P. A., Scharfstein, L., Wong, N., & Alfano, C. A. (2010). Social skills and social phobia: An investigation of DSM-IV subtypes. Behaviour Research and Therapy,48, 992–1001. https://doi.org/10.1016/j.brat.2010.06.005.
Beidel, D. C., Turner, S. M., & Morris, T. L. (1995). A new inventory to assess childhood social anxiety and phobia: The Social Phobia and Anxiety Inventory for Children. Psychological Assessment,7, 73–79. https://doi.org/10.1037/1040-3590.7.1.73.
Beidel, D. C., Turner, S. M., & Morris, T. L. (2000). Behavioral treatment of childhood social phobia. Journal of Consulting and Clinical Psychology,68, 1072–1080. https://doi.org/10.1037/0022-006X.68.6.1072.
Bögels, S. M., Alden, L., Beidel, D. C., Clark, L. A., Pine, D. S., Stein, M. B., et al. (2010). Social anxiety disorder: Questions and answers for the DSM-V. Depression and Anxiety,27, 168–189. https://doi.org/10.1002/da.20670.
Bradley, M. M., & Lang, P. J. (1994). Measuring emotion: the self-assessment manikin and the semantic differential. Journal of Behavior Therapy and Experimental Psychiatry,25, 49–59. https://doi.org/10.1016/0005-7916(94)90063-9.
Brown-Jacobsen, A. M., Wallace, D. P., & Whiteside, S. P. (2011). Multimethod, multi-informant agreement, and positive predictive value in the identification of child anxiety disorders using the SCAS and ADIS-C. Assessment,18, 382–392. https://doi.org/10.1177/1073191110375792.
Bunnell, B. E., Beidel, D. C., & Mesa, F. (2013). A randomized trial of attention training for generalized social phobia: Does attention training change social behavior? Behavior Therapy,44, 662–673. https://doi.org/10.1016/j.beth.2013.04.010.
Card, N. A., & Hodges, E. V. E. (2008). Peer victimization among school children: Correlations, causes, consequences, and considerations in assessment and intervention. School Psychology Quarterly,23, 451–461. https://doi.org/10.1037/a0012769.
Chibanda, D., Mesu, P., Kajawu, L., Cowan, F., Araya, R., & Abas, M. A. (2011). Problem-solving therapy for depression and common mental disorders in Zimbabwe: Piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BioMed Central Public Health,11, 828. https://doi.org/10.1186/1471-2458-11-828.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Comer, J. S., & Myers, K. (2016). Future directions in the use of telemental health to improve the accessibility and quality of children's mental health services. Journal of Child and Adolescent Psychopharmacology,26(3), 296–300. https://doi.org/10.1089/cap.2015.0079.
Craske, M. G., Hermans, D., & Vervliet, B. (2018). State-of-the-art and future directions for extinction as a translational model for fear and anxiety. Philosophical Transactions of the Royal Society B: Biological Sciences,373, 20170025. https://doi.org/10.1098/rstb.2017.0025.
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy,58, 10–23. https://doi.org/10.11016/j.brat.2014.04.006.
Cuming, S., Rapee, R. M., Kemp, N., Abbott, M. J., Peters, L., & Gaston, J. E. (2009). A self-report measure of subtle avoidance and safety behaviors relevant to social anxiety: Development and psychometric properties. Journal of Anxiety Disorders,23, 879–883. https://doi.org/10.1016/j.anxdis.2009.05.002.
De Los Reyes, A. (2020, February 15). Materials described in the paper, “A paradigm for understanding adolescent social anxiety with unfamiliar peers: Conceptual foundations and directions for future research.” Retrieved from https://bit.ly/CCFPRPeerParadigmOSF
De Los Reyes, A., Aldao, A., Thomas, S. A., Daruwala, S. E., Swan, A. J., Van Wie, M., et al. (2012). Adolescent self-reports of social anxiety: Can they disagree with objective psychophysiological measures and still be valid? Journal of Psychopathology and Behavioral Assessment, 34, 308–322. https://doi.org/10.1007/s10862-012-9289-2.
De Los Reyes, A., Alfano, C. A., & Beidel, D. C. (2011). Are clinicians’ assessments of improvements in children’s functioning “global”? Journal of Clinical Child and Adolescent Psychology,40, 281–294. https://doi.org/10.1080/15374416.2011.546043.
De Los Reyes, A., Augenstein, T. M., Wang, M., Thomas, S. A., Drabick, D. A. G., Burgers, D., et al. (2015). The validity of the multi-informant approach to assessing child and adolescent mental health. Psychological Bulletin,141, 858–900. https://doi.org/10.1037/a0038498.
De Los Reyes, A., & Kazdin, A. E. (2006). Conceptualizing changes in behavior in intervention research: The range of possible changes model. Psychological Review,113, 554–583. https://doi.org/10.1037/0033-295X.113.3.554.
De Los Reyes, A., & Makol, B. A. (2019). Evidence-based assessment. In T. H. Ollendick, L. Farrell, & P. Muris (Eds.), Innovations in CBT for childhood anxiety, OCD, and PTSD: Improving access and outcomes (pp. 28–51). Cambridge: University Printing House.
De Los Reyes, A., Lerner, M. D., Keeley, L. M., Weber, R., Drabick, D. A. G., Rabinowitz, J., et al. (2019a). Improving interpretability of subjective assessments about psychological phenomena: A review and cross-cultural meta-analysis. Review of General Psychology,23, 293–319. https://doi.org/10.1177/108926801983764.
De Los Reyes, A., Makol, B. A., Racz, S. J., Youngstrom, E. A., Lerner, M. D., & Keeley, L. M. (2019b). The Work and Social Adjustment Scale for Youth: A measure for assessing youth psychosocial impairment regardless of mental health status. Journal of Child and Family Studies,28, 1–16. https://doi.org/10.1007/s10826-018-1238-6.
De Los Reyes, A., Thomas, S. A., Goodman, K. L., & Kundey, S. M. A. (2013). Principles underlying the use of multiple informants’ reports. Annual Review of Clinical Psychology,9, 123–149. https://doi.org/10.1146/annurev-clinpsy-050212-185617.
Deros, D. E., Racz, S. J., Lipton, M. F., Augenstein, T. M., Karp, J. N., Keeley, L. M., et al. (2018). Multi-informant assessments of adolescent social anxiety: Adding clarity by leveraging reports from unfamiliar peer confederates. Behavior Therapy,49, 84–98. https://doi.org/10.1016/j.beth.2017.05.001.
DiBartolo, P. M., Albano, A. M., Barlow, D. H., & Heimberg, R. G. (1998). Cross-informant agreement in the assessment of social phobia in youth. Journal of Abnormal Child Psychology,26, 213–220. https://doi.org/10.1023/A:1022624318795.
Dryman, M. T., Gardner, S., Weeks, J. W., & Heimberg, R. G. (2016). Social anxiety disorder and quality of life: How fears of negative and positive evaluation relate to specific domains of life satisfaction. Journal of Anxiety Disorders,38, 1–8. https://doi.org/10.1016/j.janxdis.2015.12.003.
Eckshtain, D., Kuppens, S., Ugueto, A., Ng, M. Y., Vaughn-Coaxum, R., Corteselli, K., et al. (2020). Meta-analysis: 13-year follow-up of psychotherapy effects on youth depression. Journal of the American Academy of Child and Adolescent Psychiatry,59, 45–63. https://doi.org/10.1016/j.jaac.2019.04.002.
Epkins, C. C., & Heckler, D. R. (2011). Integrating etiological models of social anxiety and depression in youth: Evidence for a cumulative interpersonal risk model. Clinical Child and Family Psychology Review,14, 329–376. https://doi.org/10.1007/s10567-011-0101-8.
Funder, D.C., & Colvin, C.R. (1988). Friends and strangers: Acquaintanceship, agreement, and the accuracy of personality judgment. Journal of Personality and Social Psychology,55, 149–158. https://doi.org/10.1037/0022-3514.55.1.149.
Garcia-Lopez, L.-J., Salvador, M. C., & De Los Reyes, A. (2015). Assessment of social anxiety in adolescents. In K. Ranta, A. M. La Greca, L.-J. Garcia-Lopez, & M. Marttunen (Eds.), Social anxiety and phobia in adolescents: Development, manifestation and intervention strategies (pp. 121–150). Cham: Springer.
Glenn, L. E., Keeley, L. M., Szollos, S., Okuno, H., Wang, X., Rausch, E., et al. (2019). Trained observers’ ratings of adolescents’ social anxiety and social skills within controlled, cross-contextual social interactions with unfamiliar peer confederates. Journal of Psychopathology and Behavioral Assessment,41, 1–15. https://doi.org/10.1007/s10862-018-9676-4.
Grant, B. F., Hasin, D. S., Blanco, C., Stinson, F. S., Chou, S. P., Goldstein, R. B., et al. (2005). The epidemiology of social anxiety disorder in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. The Journal of Clinical Psychiatry,66, 1351–1361. https://doi.org/10.4088/JCP.v66n1102.
Graphpad Software (2019). Graphpad quickcalcs random number generator. Retrieved from https://www.graphpad.com/quickcalcs/randomN1/
Grills, A. E., & Ollendick, T. H. (2003). Multiple informant agreement and the Anxiety Disorders Interview Schedule for parents and children. Journal of the American Academy of Child and Adolescent Psychiatry,42, 30–40. https://doi.org/10.1097/00004583-200301000-00008.
Groth-Marnat, G., & Wright, A. J. (2016). Handbook of psychological assessment (6th ed.). Hoboken: Wiley.
Harrigan, J. A., Wilson, K., & Rosenthal, R. (2004). Detecting state and trait anxiety from auditory and visual cues: A meta-analysis. Personality and Social Psychology Bulletin,30, 56–66. https://doi.org/10.1177/0146167203258844.
Hawley, K. M., & Weisz, J. R. (2003). Child, parent, and therapist (dis)agreement on target problems in outpatient therapy: The therapist’s dilemma and its implications. Journal of Consulting and Clinical Psychology,71, 62–70. https://doi.org/10.1037/0022-006X.71.1.62.
Hedtke, K. A., Kendall, P. C., & Tiwari, S. (2009). Safety seeking and coping behavior during exposure tasks with anxious youth. Journal of Clinical Child and Adolescent Psychology,38, 1–15. https://doi.org/10.1080/15374410802581055.
Hoffman, L. J., & Chu, B. C. (2015). Target problem (mis) matching: Predictors and consequences of parent–youth agreement in a sample of anxious youth. Journal of Anxiety Disorders,31, 11–19. https://doi.org/10.1016/j.janxdis.2014.12.015.
Hofmann, S. G., Albano, A. M., Heimberg, R. G., Tracey, S., Chorpita, B. F., & Barlow, D. H. (1999). Subtypes of social phobia in adolescents. Depression and Anxiety,9, 15–18. https://doi.org/10.1002/(SICI)1520-6394(1999)9:1%3c15:AID-DA2%3e3.0.CO;2-6.
Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy,36, 193–209. https://doi.org/10.1080/16506070701421313.
Hunsley, J., & Lee, C. M. (2014). Introduction to clinical psychology (2nd ed.). Hoboken: Wiley.
Hunsley, J., & Mash, E. J. (2007). Evidence-based assessment. Annual Review of Clinical Psychology,3, 29–51. https://doi.org/10.1146/annurev.clinpsy.3.022806.091419.
Ingersoll, G. M. (1989). Adolescents (2nd ed.). Englewood Cliffs NJ: Prentice Hall.
Jarrett, M. A., & Ollendick, T. H. (2008). A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety: Implications for future research and practice. Clinical Psychology Review,28, 1266–1280. https://doi.org/10.1016/j.cpr.2008.05.004.
Kampmann, I. L., Emmelkamp, P. M., Hartanto, D., Brinkman, W. P., Zijlstra, B. J., & Morina, N. (2016). Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial. Behaviour Research and Therapy,77, 147–156. https://doi.org/10.1016/j.brat.2015.12.016.
Karp, J., Makol, B. A., Keeley, L. M., Qasmieh, N., Deros, D. E., Racz, S. J., et al. (2018). Convergent, incremental, and criterion-related validity of multi-informant assessments of adolescents’ fears of negative and positive evaluation. Clinical Psychology and Psychotherapy,25, 217–230. https://doi.org/10.1002/cpp.2156.
Kazdin, A. (2017). Addressing the treatment gap: A key challenge for extending evidence-based psychosocial interventions. Behaviour Research and Therapy,88, 7–18. https://doi.org/10.1016/j.brat.2016.06.004.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry,62, 593–602. https://doi.org/10.1001/archpsyc.62.6.593.
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research,21, 169–184. https://doi.org/10.1002/mpr.1359.
La Greca, A., & Lopez, N. (1998). Social anxiety among adolescents: Linkages with peer relations and friendships. Journal of Abnormal Child Psychology,26, 83–94. https://doi.org/10.1023/A:1022684520514.
Lang, P. J. (1980). Behavioral treatment and bio-behavioral assessment: Computer applications. In J. B. Sidowski, J. H. Johnson, & T. A. Williams (Eds.), Technology in mental health care delivery systems (pp. 119–137). Norwood, NJ: Ablex.
Langer, D. A., & Jensen-Doss, A. (2018). Shared decision-making in youth mental health care: Using the evidence to plan treatments collaboratively. Journal of Clinical Child & Adolescent Psychology,47, 821–831. https://doi.org/10.1080/15374416.2016.1247358.
Lilienfeld, S. O., Ritschel, L. A., Lynn, S. J., Cautin, R. L., & Latzman, R. D. (2014). Why ineffective psychotherapies appear to work: A taxonomy of causes of spurious therapeutic effectiveness. Perspectives on Psychological Science,9, 355–387. https://doi.org/10.1177/1745691614535216.
Mash, E. J., & Barkley, R. A. (Eds.). (2014). Child psychopathology. New York: Guilford Publications.
Masia-Warner, C., Storch, E. A., Pincus, D. B., Klein, R. G., Heimberg, R. G., & Liebowitz, M. R. (2003). The Liebowitz social anxiety scale for children and adolescents: An initial psychometric investigation. Journal of the American Academy of Child and Adolescent Psychiatry,42, 1076–1084. https://doi.org/10.1097/01.CHI.0000070249.24125.89.
Miller, A. B., & Prinstein, M. J. (2019). Adolescent suicide as a failure of acute stress response systems. Annual Review of Clinical Psychology,15, 425–450. https://doi.org/10.1146/annurev-clinpsy-050718-095625.
Murphy, N. A., Hall, J. A., Schmid Mast, M., Ruben, M. A., Frauendorfer, D., Blanch-Hartigan, D., et al. (2015). Reliability and validity of nonverbal thin slices in social interactions. Personality and Social Psychology Bulletin,41, 199–213. https://doi.org/10.1177/0146167214559902.
Mystkowski, J. L., Craske, M. G., & Echiverri, A. M. (2002). Treatment context and return of fear in spider phobia. Behavior Therapy,33, 399–416. https://doi.org/10.1016/S0005-7894(02)80035-1.
Piccirillo, M. L., Dryman, M. T., & Heimberg, R. G. (2016). Safety behaviors in adults with social anxiety: Review and future directions. Behavior Therapy,47, 675–687. https://doi.org/10.1016/j.beth.2015.11.005.
Piqueras, J. A., Olivares, J., & Hidalgo, M. D. (2012). Screening utility of the Social Anxiety Screening Scale in Spanish speaking adolescents. The Spanish Journal of Psychology,15, 710–723. https://doi.org/10.5209/rev_SJOP.2012.v15.n2.38882.
Prinstein, M. J. (2017). Popular: The power of likability in a status-obsessed world. New York: Penguin.
Prinstein, M. J. (2007). Assessment of adolescents’ preference and reputation-based peer status using sociometric experts. Merrill-Palmer Quarterly,53, 243–261. https://doi.org/10.1353/mpq.2007.0013.
Prinstein, M. J., & Dodge, K. A. (Eds.). (2008). Understanding peer influence in children and adolescents. New York: Guilford Press.
Prinstein, M. J., & Giletta, M. (2016). Peer relations and developmental psychopathology. In D. Cicchetti (Ed.), Developmental psychopathology (3rd ed., Vol. 1, pp. 527–579). Hoboken, NJ: Wiley.
Prinstein, M. J., Rancourt, D., Adelman, C. B., Ahlich, E., Smith, J., & Guerry, J. D. (2018). Peer status and psychopathology. In W. Bukowski, B. Laursen, & K. H. Rubin (Eds.), Handbook of peer interactions, relationships, and groups (2nd ed., pp. 617–636). New York: Guilford.
Qasmieh, N., Makol, B. A., Augenstein, T. M., Lipton, M. F., Deros, D. E., Karp, J., et al. (2018). A multi-informant approach to assessing safety behaviors among adolescents: Psychometric properties of the Subtle Avoidance Frequency Examination. Journal of Child and Family Studies,27, 1830–1843. https://doi.org/10.1007/s10826-018-1040-5.
Quirk, G. J. (2002). Memory for extinction of conditioned fear is long-lasting and persists following spontaneous recovery. Learning & Memory,9, 402–407. https://doi.org/10.1101/lm.49602.
Raggi, V. L., Samson, J. G., Felton, J. W., Loffredo, H. R., & Berghorst, L. H. (2018). Exposure therapy for treating anxiety in children and adolescents: A comprehensive guide. Oakland, CA: New Harbinger Publications.
Rapee, R. M., Gaston, J. E., & Abbott, M. J. (2009). Testing the efficacy of theoretically derived improvements in the treatment of social phobia. Journal of Consulting and Clinical Psychology,77(2), 317–327. https://doi.org/10.1037/a0014800.
Rausch, E., Racz, S. J., Augenstein, T. M., Keeley, L., Lipton, M. F., Szollos, S., et al. (2017). A multi-informant approach to measuring depressive symptoms in clinical assessments of adolescent social anxiety using the Beck Depression Inventory-II: Convergent, incremental, and criterion-related validity. Child and Youth Care Forum,46, 661–683. https://doi.org/10.1007/s10566-017-9403-4.
Rescorla, L. A., Ewing, G., Ivanova, M. Y., Aebi, M., Bilenberg, N., Dieleman, G. C., et al. (2017). Parent-adolescent cross-informant agreement in clinically referred samples: Findings from seven societies. Journal of Clinical Child and Adolescent Psychology,46, 74–87. https://doi.org/10.1080/15374416.2016.1266642.
Rescorla, R. A., & Wagner, A. R. (1972). A theory of Pavlovian conditioning: variations in the effectiveness of reinforcement and non-reinforcement. In A. H. Prokasy (Ed.), Classical conditioning II: Current research and theory (pp. 64–99). New York: Appleton-Century-Croft.
Rudolph, K. D. (2014). Puberty as a developmental context of risk for psychopathology. In M. Lewis & K. D. Rudolph (Eds.), Handbook of developmental psychopathology (pp. 331–354). Boston: Springer.
Sewart, A. R., & Craske, M. G. (2020). Inhibitory learning. In J. S. Abramowitz & S. M. Blakey (Eds.), Clinical handbook of fear and anxiety: Maintenance processes and treatment mechanisms (pp. 265–285). Washington: American Psychological Association.
Silverman, W. K., & Ollendick, T. H. (2005). Evidence-based assessment of anxiety and its disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology,34, 380–411. https://doi.org/10.1207/s15374424jccp3403_2.
Singla, D. R., Kohrt, B. A., Murray, L. K., Anand, A., Chorpita, B. F., & Patel, V. (2017). Psychological treatments for the world: lessons from low-and middle-income countries. Annual Review of Clinical Psychology,13, 149–181. https://doi.org/10.1146/annurev-clinpsy-032816-045217.
Slepian, M. L., Bogart, K. R., & Ambady, N. (2014). Thin-slice judgments in the clinical context. Annual Review of Clinical Psychology,10, 131–153. https://doi.org/10.1146/annurev-clinpsy-090413-123522.
Smetana, J. G. (2008). ‘‘It’s 10 o’clock: Do you know where your children are?’’ Recent advances in understanding parental monitoring and adolescents’ information management. Child Development Perspectives,2, 19–25. https://doi.org/10.1111/j.1750-8606.2008.00036.x.
Stangier, U., Heidenrich, T., & Schermelleh-Engel, K. (2006). Safety behaviors and social performance in patients with generalized social phobia. Journal of Cognitive Psychotherapy,20, 17–31. https://doi.org/10.1891/jcop.20.1.17.
Stein, M. B., & Kean, Y. M. (2000). Disability and quality of life in social phobia: Epidemiologic findings. The American Journal of Psychiatry,157, 1606–1613. https://doi.org/10.1176/appi.ajp.157.10.1606.
Szollos, S., Keeley, L. M., Makol, B. A., Weeks, J. W., Racz, S. J., Lipton, M. F., et al. (2019). Multi-informant assessments of individual differences in adolescents’ socio-evaluative fears: Clinical correlates and links to arousal within social interactions. Journal of Child and Family Studies,28, 3360–3373. https://doi.org/10.1007/s10826-019-01517-2.
Tackett, J. L., Smack, A. J., Herzhoff, K., Reardon, K. W., Dauod, S., & Granic, I. (2017). Measuring child personality when child personality was not measured: Application of a thin-slice approach. Personality and Mental Health,11, 4–13. https://doi.org/10.1002/pmh.1351.
Thomas, S. A., Aldao, A., & De Los Reyes, A. (2012a). Implementing clinically feasible psychophysiological measures in evidence-based assessments of adolescent social anxiety. Professional Psychology: Research and Practice,43, 510–519. https://doi.org/10.1037/a0029183.
Thomas, S. A., Daruwala, S. E., Goepel, K. A., & De Los Reyes, A. (2012b). Using the Subtle Avoidance Frequency Examination in adolescent social anxiety assessments. Child and Youth Care Forum,41, 547–559. https://doi.org/10.1007/s10566-012-9181-y.
Tolin, D. F. (2019). Inhibitory learning for anxiety-related disorders. Cognitive and Behavioral Practice,26, 225–236. https://doi.org/10.1016/j.cbpra.2018.07.008.
Tulbure, B. T., Szentagotai, A., Dobrean, A., & David, D. (2012). Evidence based clinical assessment of child and adolescent social phobia: a critical review of rating scales. Child Psychiatry and Human Development,43, 795–820. https://doi.org/10.1007/s10578-012-0297-y.
Walton, K. M., & Ingersoll, B. R. (2016). The utility of thin slice ratings for predicting language growth in children with autism spectrum disorder. Autism,20, 374–380. https://doi.org/10.1177/1362361315584465.
Weisz, J. R., Jensen Doss, A., & Hawley, K. M. (2005). Youth psychotherapy outcome research: A review and critique of the evidence base. Annual Review of Psychology, 56, 337–363. https://doi.org/10.1146/annurev.psych.55.090902.141449.
Williams, K. D., Cheung, C. K. T., & Choi, W. (2000). Cyberostracism: Effects of being ignored over the internet. Journal of Personality and Social Psychology,79, 748–762. https://doi.org/10.1037/0022-3514.79.5.748.
Wong Sarver, N., Beidel, D. C., & Spitalnick, J. S. (2014). The feasibility and acceptability of virtual environments in the treatment of childhood social anxiety disorder. Journal of Clinical Child and Adolescent Psychology,43, 63–73. https://doi.org/10.1080/15374416.2013.843461.
Wong, N., Sarver, D. E., & Beidel, D. C. (2012). Quality of life impairments among adults with social phobia: The impact of subtype. Journal of Anxiety Disorders,26, 50–57. https://doi.org/10.1016/j.janxdis.2011.08.012.
Yeh, M., & Weisz, J. R. (2001). Why are we here at the clinic? Parent-child (dis)agreement on referral problems at outpatient treatment entry. Journal of Consulting and Clinical Psychology, 69, 1018–1025. https://doi.org/10.1037/0022-006X.69.6.1018.
Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2004). Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problems. Journal of Affective Disorders,82, S5–S16. https://doi.org/10.1016/j.jad.2004.05.016.
Zubeidat, I., Salinas, J. M., & Sierra, J. C. (2007). Exploration of the psychometric characteristics of the Liebowitz Social Anxiety Scale in a Spanish adolescent sample. Depression and Anxiety,25, 977–987. https://doi.org/10.1002/da.20404.
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The second, third, fourth, and seventh authors’ work on this paper was supported by the Institute of Education Sciences, U.S. Department of Education, through Grant R324A180032 to University of Maryland at College Park. The opinions expressed are those of the authors and do not represent views of the Institute or the U.S. Department of Education.
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CJC assisted with data analyses and wrote the paper. BAM assisted in executing the study, assisted with data analyses, and collaborated in editing the paper. LMK, NQ, and HO assisted in executing the study and collaborated in editing the paper. SJR collaborated in editing the paper. ADLR designed and executed the study, planned and executed data analyses, and wrote the paper.
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Cannon, C.J., Makol, B.A., Keeley, L.M. et al. A Paradigm for Understanding Adolescent Social Anxiety with Unfamiliar Peers: Conceptual Foundations and Directions for Future Research. Clin Child Fam Psychol Rev 23, 338–364 (2020). https://doi.org/10.1007/s10567-020-00314-4
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DOI: https://doi.org/10.1007/s10567-020-00314-4