Psychosis, social anxiety, and autism are clinical constructs that share important phenotypic features, particularly social dysfunction. A critical determinant of social functioning is an individual’s ability to recognize when social cues, such as eye gaze, are meant for them. Emerging computational modeling data in psychosis suggest that altered gaze perception stems from deficits in evidence accumulation – the process of gathering and integrating information – when processing social cues. We investigated whether aberrant evidence accumulation during gaze perception is associated with social functioning or, as a secondary aim, with psychopathology in a transdiagnostic sample with varying levels of psychotic, socially anxious, or autistic characteristics.

We examined gaze perception in 111 individuals (aged 14–30) with varying levels of social dysfunction, psychosis proneness, social anxiety, and autistic traits. Drift diffusion models (DDM) characterized key processes driving perceptual judgements in a self-referential gaze perception task, including the efficiency of evidence accumulation. We tested whether evidence accumulation was associated with social functioning, social cognition, and these different psychopathology dimensions.

Impaired evidence accumulation during gaze perception showed strong associations with impaired social cognition and modest associations with diminished social functioning and elevated psychosis and social anxiety symptoms. Evidence accumulation was not associated with autism traits.

Evidence accumulation for social cues relates to social cognition – a key determinant of social functioning. It may also be relevant to real-world social functioning and multiple psychopathology dimensions, including psychosis and social anxiety. Therefore, evidence accumulation should be investigated as a mechanism supporting social difficulties and related psychopathology.

The prevalence and burden of depression are increasing among young people. Despite this, relatively few treatments specifically target this critical developmental period, and under-addressed mental health difficulties in youth often have lifelong consequences. Social isolation is commonly reported by young adults and is both a risk and maintenance factor for depression. There is a need for accessible, engaging interventions that can reduce depressive symptoms and improve social connectedness.

Building on evidence of the therapeutic potential of social dance-based activities for depression, this randomized controlled trial evaluated the efficacy of an 8-week salsa dance intervention for young adults (aged 18–24 years) with mild to moderately severe depressive symptoms. 121 participants were randomly assigned to either a salsa intervention or a waitlist control. Participants completed the Patient Health Questionnaire (PHQ-9), a validated measure of depressive symptoms, and additional mental health measures at baseline, during, and after the intervention.

Participants in the salsa dance condition showed a significantly greater reduction in depressive symptoms than the waitlist control, with a −2.45 PHQ-9 point between-group difference, exceeding the criterion for clinical significance. Both groups reported improvements in social anxiety, generalized anxiety, loneliness, and daily happiness, but salsa participants had significantly greater reductions in social anxiety and greater improvements in daily happiness.

These findings support the value of social dance as a novel, accessible intervention for reducing depressive symptoms. Implementing such programs within a suite of wellbeing-oriented interventions for young people could provide cost-effective mental health benefits.

Social anxiety is characterized by fear and avoidance of social situations, yet many everyday decisions are made in the presence of others and are shaped by social influence. However, the influences of social anxiety on social decision-making and the underlying neural processes are not well understood.

Fifty-five adults with varying levels of social anxiety completed a social risk decision-making task during functional magnetic resonance imaging (fMRI). In each trial, participants chose between a safe option and a risky gamble against either a human or a computer opponent, with or without information about others’ choices. Social influence on choice was quantified using repeated-measures analyses and drift–diffusion modeling, while brain activity and functional connectivity were examined using whole-brain analyses.

Compared to individuals with lower social anxiety, those with higher social anxiety showed reduced conformity to others’ risky choices, specifically when interacting with human, but not computer, opponents, together with a stronger starting-point bias toward safe options. These behavioral differences were accompanied by lower dorsolateral prefrontal cortex (dlPFC) activation and stronger dlPFC–temporoparietal junction (TPJ) functional connectivity.

Social anxiety is associated with decreased social approach and reduced social influence from others in social decision contexts. Decreased activation of the prefrontal control system and its increased interactions with the social brain network point toward a conflict between heightened social monitoring and inefficient executive control. By distinguishing social-context effects from general risk aversion, this study provides a refined mechanistic framework for understanding how impaired regulatory control shapes maladaptive social decision-making in social anxiety.

Cognitive reappraisal deficits are a transdiagnostic risk factor for major depressive disorder (MDD) and social anxiety disorder (SAD) and are observed in patients with these disorders at the neural level. Preliminary research suggests less activation of prefrontal regions during reappraisal (vs. viewing) of negative stimuli associates with overall symptom severity in patients with MDD or SAD, however, this is not reliably observed across studies. Consistent with research showing that reappraisal may only be adaptive when employed to cope with uncontrollable adversity, this study sought to examine whether neighborhood-level adversity (i.e. socioeconomic disadvantage, crime) moderated the relation between internalizing symptom severity and neural correlates of reappraisal.

This study included patients with a current diagnosis of MDD (n = 51) or SAD (n = 39). Patients completed measures of symptom severity as well as an emotion regulation task while in the scanner to assess neural activation during reappraisal. Patients’ addresses were geocoded to assess neighborhood socioeconomic disadvantage and crime.

Results indicated that greater symptom severity was associated with decreased activation of key prefrontal regions underlying reappraisal, but only for patients living in neighborhoods characterized by high levels of personal (i.e. violent) crime. Unexpectedly, the opposite was found for patients living in low-crime neighborhoods, such that greater symptom severity was associated with increased neural activation during reappraisal (vs. viewing) of negative stimuli.

Findings highlight the critical importance of considering patients’ neighborhood contexts when evaluating associations between symptom severity and neural correlates of reappraisal in patients with internalizing disorders.

Social anxiety is a common and impairing condition that often emerges in adolescence.

This study aimed to examine the prevalence and severity of social anxiety among Chinese youths in the post-COVID-19 era, and to develop a predictive model identifying key factors associated with social anxiety severity.

A total of 555 youths aged 15–25 years completed an online survey via WeChat on social anxiety (Social Phobia Inventory), depressive symptoms (Patient Health Questionnaire), sleep problems (Pittsburgh Sleep Quality Index), social support (Multidimensional Scale of Perceived Social Support) and internalised stigma (Internalized Stigma of Mental Illness Scale). Social anxiety severity and rates were described, and comparisons were made across sociodemographic groups. Hierarchical multiple regression was used to predict social anxiety severity from depression, sleep, social support and stigma. An additional regression examined which components of social anxiety (fear, avoidance, physical symptoms) predict internalised stigma.

In total, 69.55% of participants reported at least mild social anxiety, with 20% reaching severe or very severe levels. Female, younger participants and those with fewer close friends reported significantly higher anxiety. Depressive symptoms (β = 0.31, P < 0.05) and internalised stigma (β = 0.40, P < 0.05) were strong predictors of anxiety severity, while sleep problems and social support were not significant after controlling for these factors. Among social anxiety dimensions, only avoidance significantly predicted higher stigma (β = 0.17, P < 0.01).

The high post-pandemic prevalence of social anxiety among youths highlights the need for early identification, stigma reduction and interventions targeting depression and avoidance to prevent long-term impairments.

1. (1) Understand the efficacy of RFCBT in reducing internalized shame, negative interpretation bias, and rumination in adolescents with SAD.

2. (2) Gain insight into the cognitive and behavioural mechanisms through which RFCBT addresses core maintaining factors of SAD, such as negative self-perceptions and avoidance behaviours.

3. (3) Learn about the application of functional analysis, self-compassion training, and cognitive restructuring within RFCBT to disrupt maladaptive thought patterns in adolescents.

4. (4) Recognize the potential of group-based RFCBT to foster peer support and enhance treatment engagement among adolescents with SAD.

5. (5) Explore the study’s findings on the sustainability of RFCBT outcomes at follow-up and their implications for long-term management of social anxiety symptoms.

Although social anxiety remains prevalent, conventional exposure therapy faces limitations such as limited accessibility, high cost, and low ecological validity. These barriers highlight the need for alternative, scalable methods that can effectively simulate social evaluative contexts.

This study aims to evaluate the anxiety-inducing effects of videoconferencing exposure, measured through heart rate variability (HRV), using a fully online-based methodology.

A total of 31 participants who reported social anxiety were recruited online and engaged in a simulated videoconference task, where they interacted with multiple audience members’ emotional faces on a 3 × 3 split screen. Their video recordings were analysed using imaging photoplethysmography to obtain HRV data. Baseline anxiety levels were assessed using validated self-report questionnaires, including the State Anxiety Scale (STAI-X1), Trait Anxiety Scale (STAI-X2), Social Interaction Anxiety Scale, and Social Phobia Scale.

Pearson correlation analysis revealed that STAI-X1 scores negatively correlated with high-frequency normalised units (HFnu) changes and positively correlated with low-frequency high-frequency (LF–HF) ratio and low-frequency normalised units (LFnu) changes. Similar patterns were observed for STAI-X2. These findings suggest that higher levels of trait and state anxiety are associated with greater reductions in parasympathetic activity and increased sympathetic activation during online videoconferencing.

This study underscores the clinical potential of online videoconferencing as a scalable and accessible exposure therapy for the digital era, eliminating spatial and logistical constraints associated with traditional in-person exposure therapy.

Mentalizing—our ability to make inferences about the mental states of others—is impaired across psychiatric disorders and robustly associated with functional outcomes. Mentalizing deficits have been prominently linked to aberrant activity in cortical regions considered to be part of the “social brain network” (e.g., dorsomedial prefrontal cortex, temporoparietal junction), yet emerging evidence also suggests the importance of cerebellar dysfunction. In the present study—using a transdiagnostic, clinical psychiatric sample spanning the psychosis-autism-social anxiety spectrums—we examined the role of the cerebellum in mentalizing and its unique contributions to broader social functioning.

Sixty-two participants (38 with significant social dysfunction secondary to psychiatric illness and 24 nonclinical controls without social dysfunction) completed a mentalizing task during functional magnetic resonance imaging. General linear model analysis, latent variable modeling, and regression analyses were used to examine the contribution of cerebellum activation to the prediction of group status and social functioning.

Mentalizing activated a broad set of social cognitive brain regions, including cerebral mentalizing network (MN) nodes and posterior cerebellum. Higher posterior cerebellum activation significantly predicted clinical status (i.e., individuals with psychiatric disorders versus nonclinical controls). Finally, cerebellar activation accounted for significant variance in social functioning independent of all other cerebral MN brain regions identified in a whole-brain analysis.

Findings add to an accumulating body of evidence establishing the unique role of the posterior cerebellum in mentalizing deficits and social dysfunction across psychiatric illnesses. Collectively, our results suggest that the posterior cerebellum should be considered – alongside established cerebral regions – as part of the mentalizing network.

To understand caregivers’ perceptions about their children’s mealtime social experiences at school and how they believe these social experiences impact their children’s consumption of meals at school (both meals brought from home and school meals).

Qualitative data were originally collected as part of a larger mixed methods study using an embedded-QUAN dominant research design.

Semi-structured interviews were conducted with United States (U.S.) caregivers over ZoomTM in English and Spanish during the 2021–2022 school year. The interview guide contained 14 questions on caregivers’ perceptions about their children’s experiences with school meals.

Caregivers of students in elementary, middle and high schools in rural, suburban and urban communities in California (n 46) and Maine (n 20) were interviewed. Most (60·6 %) were caregivers of children who were eligible for free or reduced-price meals.

Caregivers reported that an important benefit of eating meals at school is their child’s opportunity to socialise with their peers. Caregivers also stated that their child’s favourite aspect of school lunch is socialising with friends. However, some caregivers reported the cafeteria environment caused their children to feel anxious and not eat. Other caregivers reported that their children sometimes skipped lunch and chose to socialise with friends rather than wait in long lunch lines.

Socialising during school meals is important to both caregivers and students. Policies such as increasing lunch period lengths and holding recess before lunch have been found to promote school meal consumption and could reinforce the positive social aspects of mealtime for students.

Loneliness has become a major public health issue of the recent decades due to its severe impact on health and mortality. Little is known about the relation between loneliness and social anxiety. This study aimed (1) to explore levels of loneliness and social anxiety in the general population, and (2) to assess whether and how loneliness affects symptoms of social anxiety and vice versa over a period of five years.

The study combined data from the baseline assessment and the five-year follow-up of the population-based Gutenberg Health Study. Data of N = 15 010 participants at baseline (Mage = 55.01, s.d.age = 11.10) were analyzed. Multiple regression analyses with loneliness and symptoms of social anxiety at follow-up including sociodemographic, physical illnesses, and mental health indicators at baseline were used to test relevant covariates. Effects of loneliness on symptoms of social anxiety over five years and vice versa were analyzed by autoregressive cross-lagged structural equation models.

At baseline, 1076 participants (7.41%) showed symptoms of social anxiety and 1537 (10.48%) participants reported feelings of loneliness. Controlling for relevant covariates, symptoms of social anxiety had a small significant effect on loneliness five years later (standardized estimate of 0.164, p < 0.001). Vice versa, there was no significant effect of loneliness on symptoms of social anxiety taking relevant covariates into account.

Findings provided evidence that symptoms of social anxiety are predictive for loneliness. Thus, prevention and intervention efforts for loneliness need to address symptoms of social anxiety.

Delineation of changes in neural function associated with novel and established treatments for social anxiety disorder (SAD) can advance treatment development. We examined such changes following selective serotonin reuptake inhibitor (SSRI) and attention bias modification (ABM) variant – gaze-contingent music reward therapy (GC-MRT), a first-line and an emerging treatments for SAD.

Eighty-one patients with SAD were allocated to 12-week treatments of either SSRI or GC-MRT, or waitlist (ns = 22, 29, and 30, respectively). Baseline and post-treatment functional magnetic resonance imaging (fMRI) data were collected during a social-threat processing task, in which attention was directed toward and away from threat/neutral faces.

Patients who received GC-MRT or SSRI showed greater clinical improvement relative to patients in waitlist. Compared to waitlist patients, treated patients showed greater activation increase in the right inferior frontal gyrus and anterior cingulate cortex when instructed to attend toward social threats and away from neutral stimuli. An additional anterior cingulate cortex cluster differentiated between the two active groups. Activation in this region increased in ABM and decreased in SSRI. In the ABM group, symptom change was positively correlated with neural activation change in the dorsolateral prefrontal cortex.

Brain function measures show both shared and treatment-specific changes following ABM and SSRI treatments for SAD, highlighting the multiple pathways through which the two treatments might work. Treatment-specific neural responses suggest that patients with SAD who do not fully benefit from SSRI or ABM may potentially benefit from the alternative treatment, or from a combination of the two.

ClinicalTrials.gov, Identifier: NCT03346239. https://clinicaltrials.gov/ct2/show/NCT03346239