Testing the role of attentional and audio vocal mechanisms in a new internet-based intervention for social anxiety: iExposure - Project Summary (Abstract)
Social anxiety is a prevalent mental health concern that impacts approximately 12% of the US population. Yet,
the majority of individuals with social anxiety do not receive treatment in large part because it is difficult to access
mental health resources. There is a need for targeted mechanism-focused interventions for social anxiety that
are also highly scalable. The PI developed a naturalistic paradigm to study social anxiety using simulated
teleconferencing interactions and demonstrated their utility for both eliciting social evaluative threat and testing
attention and audio vocal mechanisms. The PI then used these simulated teleconferencing interactions as the
basis of a new brief exposure-focused self-guided internet-based intervention called iExposure. The intervention
only required four sessions, completed over two weeks. The pilot study also tested two potential attention
mechanisms thought to maintain social anxiety, avoidance and attention control. Results were promising, with
the majority of participants completing the entire intervention and reporting medium-large decreases in
symptoms of social anxiety. Additionally, the attention augmentations appeared to enhance the efficacy of the
intervention. However, a larger study is needed to validate these results and to test potential mechanisms in
social anxiety. The overarching goal of this proposal is to test several mechanisms implicated in social anxiety
using the newly developed self-guided internet-based intervention called iExposure. Aim 1 will directly test two
different attention mechanisms implicated in social anxiety by augmenting iExposure with attention guidance or
attention control. Aim 2 will test the causal role of attentional processes in the intervention’s efficacy for reducing
social anxiety symptoms through mediation and moderation models. Aim 3 will test the role of engagement
(proportion of time spent speaking) as a causal factor in treatment outcomes and other audio vocal features
(pitch or amplitude) as potential predictors of treatment response. This project will provide graduate student
mentees experience with mechanism-focused research in the context of a clinical trial. Additionally, mentees will
learn a highly adaptable framework for conducting internet-based interventions for their own future mentored
research. Mentees will also gain advanced theoretical, technical, and statistical knowledge critical for conducting
eye movement (i.e., visual attention) and audio-vocal based research. This proposal will also offer mentees
opportunities to connect with the scientific community through conference presentations and journal publications,
as well as provide them with training opportunities in other labs. Findings will test potential targetable and
modifiable mechanisms maintaining social anxiety, in the context of a highly adaptable and scalable internet
intervention framework. Results may inform tailored treatments for individuals with social anxiety addressing
person-specific maintaining factors. Taken together, this project offers important advances in the training of
future clinical scientists and the development of targeted digital therapeutics for social anxiety.
