Five to ten percent of adolescents have a social anxiety disorder. It is one of the most common psychological disorders among young people. Eva de Hullu and Esther Sportel conducted a study of 1,800 schoolchildren to find out more about test anxiety and social anxiety. Online training and group sessions work particularly well for test anxiety. De Hullu and Sportel will be awarded PhDs by the University of Groningen.
Unstable hormones, ever-changing social networks and pressure to achieve; adolescents don’t have an easy life. But some schoolchildren cope less well than others. Their fear of being rejected or given a poor assessment makes them more susceptible to developing a social anxiety disorder. The situations they fear most are often routine situations for most young people: looking for somewhere to sit in the school canteen, walking across the hall or having a conversation with people they don’t know. Some adolescents are affected specifically by a test anxiety; anxiety confined to tests, exams and presentations.
‘Social anxiety is a deep-rooted, persistent disorder. People who suffer during their schooldays will usually continue to be affected in the long term. It concerns the way you process information’, says De Hullu. ‘Many social situations are somewhat ambiguous. You don’t always know exactly what people want or mean. People who are socially anxious tend to misinterpret the signs. If someone looks at them, they brand it negatively rather than thinking that the other person may be interested in them.’ Research is currently being carried out into methods that can change this distorted way of processing information by means of computer tasks. It is called Cognitive Bias Modification (CBM).
Sportel’s research focuses on specific characteristics that may predict whether a person will develop a social disorder. ‘Attention control and temperamental factors would appear to play an important role’, according to Sportel. Schoolchildren with a test anxiety often have difficulty controlling the subject of their attention. To illustrate her point, Sportel cites the first question on an exam paper. ‘On discovering that he doesn’t know the answer to the first question, a pupil that is afraid of failure will tend to get stuck on that first question instead of carrying on with the questions he does understand.’
The temperamental factor ‘behavioural inhibition’ is all about the way people deal with unpleasant situations they encounter. ‘People that score high in this area have a strong tendency to avoid certain situations or retreat into themselves. They are quick to interpret signs as frightening’, says Sportel. It is striking that these two characteristics also reinforce each other. ‘A person who scores high on behavioural inhibition and low on attention control will display more anxiety problems.’
To prevent social anxiety during or after adolescence from escalating into a social anxiety disorder, De Hullu and Sportel looked into various interventions. They selected 240 schoolchildren with test anxiety or social anxiety from the 1,800 schoolchildren that took part in the screening at 25 schools. These children were either given online CBM training, cognitive behavioural training (CGT) in a group at school, or no training at all.
De Hullu: ‘Anxious people view the world through dark glasses. They focus their attention on the more threatening information they receive from their surroundings. For example, they tend to look at people with angry expressions rather than those with ordinary faces. The online training taught the schoolchildren to focus their attention on positive information (i.e. neutral or smiling faces) in computer tasks that required a fast reaction.’
After two years, the children were noticeably less anxious. Even the ones who had not had any training. ‘This is a comforting thought for schoolchildren. Most of them simply grow out of their anxieties.’ However, this does not mean that the training is pointless, adds De Hullu. ‘It helps to give adolescents with symptoms of social anxiety a short-term push in the right direction.’
The training programmes are particularly effective for children with a test anxiety. De Hullu: ‘In the long term, the CBM training resulted in a drop in test anxiety and negative automatic associations, and the group training produced a drop in test anxiety.’ The researchers think that the low costs of CBM and the fact that training via internet is more accessible than seeking psychological help mean that it could benefit a large group of schoolchildren. ‘But,’ says De Hullu, ‘the training could be made even better and more effective. I would recommend a similar study with a greater focus on test anxiety.’
Eva de Hullu (Wageningen, 1980) studied psychology in Nijmegen and conducted her PhD research in the Clinical Psychology Department of the University of Groningen, in association with Accare, centre for child and youth psychiatry. Her thesis is entitled: 'Threat is in the eye of the beholder - Cognitive bias modification in the prevention of adolescent social anxiety'. She will receive a PhD in Behavioural and Social Sciences, having been supervised by Prof. P.J. de Jong and Prof. R.B. Minderaa. Dr M.H. Nauta was her co-supervisor.
Esther Sportel (Veendam, 1976) studied psychology at the University of Groningen and is currently completing her PhD research in the Clinical Psychology Department of the University of Groningen, in association with Accare, centre for child and youth psychiatry. She will become a Doctor of Medical Science next autumn. Sportel is a lecturer in Experimental Psychopathology in the Faculty of Behavioural and Social Sciences.
Contact: Eva de Hullu, e-mail: firstname.lastname@example.org or Esther Sportel, tel. +31 (0)50363 73 99, e-mail: email@example.com
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