Movement Synchrony and Attachment Related Anxiety and Avoidance in Social Anxiety Disorder

• Published in: Journal of psychotherapy integration 2021-06, Vol.31 (2), p.163-179
• Main Authors: Schoenherr, Désirée, Strauss, Bernhard, Paulick, Jane, Deisenhofer, Anne-Katharina, Schwartz, Brian, Rubel, Julian A., Boyle, Kaitlyn, Lutz, Wolfgang, Stangier, Ulrich, Altmann, Uwe
• Format: Article
• Language: English
• Subjects: Anxiety; Attachment Behavior; Avoidance; Cognitive Behavior Therapy; Female; Human; Interpersonal Interaction; Interpersonal Relationships; Male; Outpatient; Psychodynamic Psychotherapy; Psychotherapy; Social Phobia; Synchrony; Therapeutic Alliance
• ISSN: 1053-0479; 1573-3696
• DOI: 10.1037/int0000187

Attachment relates to an individual's ability to self-regulate within interpersonal interactions, making it an important variable in psychotherapy. Movement synchrony-the association between individuals' movements-is related to interpersonal relationships such as the therapeutic alliance. This study examines the association between attachment, social anxiety/avoidance, and movement synchrony. One hundred patients with social anxiety disorder were examined, of which n = 57 were treated with cognitive-behavioral therapy (CBT) and n = 43 with psychodynamic therapy. Symptoms were assessed using the Liebowitz Social Anxiety Scale, while attachment-related anxiety and avoidance was assessed using the Experience in Close Relationships Questionnaire (ECR-R). Body movements were extracted from videos of the 8th session via motion energy analysis. Synchrony frequency and time lag were determined using time series analysis methods. Statistical analyses were performed via correlation analyses and mixed linear models. Results showed that initial attachment anxiety and avoidance were not related to synchrony. However, at the end of therapy, synchrony was negatively related to the extent of attachment anxiety. Episodes in which the therapist initiated synchrony were particularly predictive, especially in CBT. Higher attachment avoidance was associated with a longer time lag until synchrony was established. Our results showed that movement synchrony was associated with attachment anxiety. Therefore, it may be beneficial for therapists to lead synchrony, possibly conveying a feeling of the therapist being a secure base for the patient. As there was no association between anxiety symptoms and synchrony, synchrony rather seems to be a variable proximal to interpersonal constructs. Sincronía de movimiento y ansiedad relacionada con el apego y evitación en el trastorno de ansiedad socialEl apego se relaciona a la habilidad de un individuo en autorregular en las interacciones interpersonales, haciéndolo un variable importante en la psicoterapia. La sincronía del movimiento-la asociación entre los movimientos de individuos-es relacionado a las relaciones interpersonales como la alianza terapéutica. Este estudio examina la asociación entre el apego, ansiedad social/evitación, y la sincronía del movimiento. Cien pacientes con trastorno de ansiedad social fueron examinados, de los cual n = 57 fueron tratados con terapia cognitiva conductual (TCC) y n = 43 con terapia psicodinámica.