January 20, 2022

Dear Colleagues,

The National Social Anxiety Center (NSAC) provides information about relevant and current research in service of disseminating and promoting evidence-based treatment. This month’s research summary is written by Julie DiMatteo, PhD, ABPP, representing NSAC North Jersey, and examines the article, The Medium is the Message: Effects of Mediums of Communication on Perceptions and Emotions in Social Anxiety Disorder.

In this article, Oren-Yagoda and Aderka (2021) examined modes of communication and their impact on perceptions and emotions in individuals with Social Anxiety Disorder (SAD). The authors hypothesized that individuals with SAD would report greater interactions in voice/text mediums and less interactions in visual mediums. Additionally, they predicted that individuals with SAD would report more positive perceptions and emotions in visual mediums.

Participants included 44 individuals diagnosed with SAD and 44 comparison controls without social anxiety. All participants identified as White/Middle Eastern (primarily Israeli) and had access to a smartphone with data plan. Participants were sent a daily text message for 3 weeks that included a link to the Positive and Negative Affect Schedule-Expanded (PANAS-X) where they rated the intensity of 8 positive and 8 negative emotions experienced over the last hour, as well as the Daily Events Survey assessing social interaction, and perceptions of these social interactions, during the day.

As predicted, participants with SAD reported fewer visual social interactions and more voice/text interactions compared to those without SAD. Interactions were rated more negatively by participants with SAD. However, participants with SAD rated interactions in visual mediums more positively compared to voice/text, whereas medium of communication was not significant for those without social anxiety. Although participants with SAD reported lower levels of positive emotions and higher levels of negative emotions compared to those without SAD, it was found that visual mediums resulted in higher levels of positive emotions and lower levels of negative emotions compared to voice/text. In visual mediums, participants with SAD had significant increases in happiness, excitement, pride, satisfaction, and love, and notable decreases in sadness, anger, guilt, and loneliness.

Interestingly, participants also had increases in shame and envy. The authors propose that the increase of these emotions may be due to concerns regarding the outward display of physiological symptoms and observation of the social skills of others that can only occur in visual mediums.

The authors conclude that these findings suggest reductions in safety behaviors associated with use of voice/text mediums to more in-person, visual mediums can improve positive emotions, perceptions, and experiences of those with SAD. The authors also assert that assessing client’s preferred use of communication can aid in understanding patterns of avoidance and safety behaviors engaged in, and thus be used in designing relevant exposures. Of course, it would be helpful to see these findings replicated in more diverse samples.

How do you account for mode of communication when planning exposures? In the digital age where so much communication is done by text, how do you motivate and engage clients to use in-person mediums?

Oren-Yagoda, R., and Aderka, I. M. The Medium is the Message: Effects of Mediums of Communication on Perceptions and Emotions in Social Anxiety Disorder. Journal of Anxiety Disorders, volume 83, October 2021.

Julie DiMatteo, PhD, ABPP
Board Member representing NSAC North Jersey
(CBT Specialists of New Jersey)