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Introduction: The boom of social media has provided a wider space for ordinary people to display themselves, but visual presentation has also intensified the focus on appearance, which in turn triggers anxiety about appearance. The study aims to investigate the impact of social media information exposure on appearance anxiety in young acne patients and the pathways and mechanisms that cause this effect. Methods: A moderated chain mediation model was constructed, and a questionnaire was used to collect information on social media information exposure, internalization of beauty ideals, fear of negative evaluation, self-esteem, and appearance anxiety in young acne patients (N = 382), and the relationships between the variables were explored through regression analysis. Results: The results show that there was a significant path of effect (t > 2.5, p < 0.05) between social media information exposure, internalization of beauty ideals, fear of negative evaluation, and appearance anxiety. Self-esteem significantly moderated the relationship between social media information exposure and internalization of beauty ideals (t < -2, p < 0.05). Discussion: In conclusion, in young acne patients, internalization of beauty ideals and fear of negative evaluation chain mediated the association between social media information exposure and appearance anxiety, and young acne patients' internalization of beauty ideals was inversely correlated with their level of self-esteem.

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BACKGROUND: Individuals diagnosed with hemifacial spasm (HFS) frequently undergo noticeable alterations in their facial appearance. Such changes can detrimentally influence both their physical and psychological well-being. While prior studies have identified self-esteem and fear of negative evaluation (FNE) as key elements in social anxiety, their role in studies concerning body image and its correlation with social anxiety has been seldom explored. This research seeks to explore how self-esteem and FNE concurrently mediate the relationship between body image and social anxiety among Chinese individuals with HFS. METHODS: Chinese patients with HFS (n=151) completed a cross-sectional questionnaire on the first day of admission that assessed body image, social anxiety, self-esteem, and FNE over the past week. Path analysis was used to test the hypothesis of the mediation model. RESULTS: The hypothesized model showed that FNE was positively correlated with body image and social anxiety, while negative associations were found among body image, self-esteem and social anxiety. Self-esteem and FNE play a mediating role between body image and social anxiety. CONCLUSION: Our findings suggest that self-esteem and FNE may be important psychological pathways that affect body image and social anxiety in Chinese patients with HFS. Supplementing mental health services that help increase self-esteem and reduce FNE should be considered to improve the psychological quality of patients with HFS.

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BACKGROUND: Navigating social situations can be challenging due to uncertainty surrounding the intentions and strategies of others, which remain hidden and subject to change. Prior research suggests that individuals with anxiety-related symptoms struggle to adapt their learning in uncertain, non-social environments. Anxiety-prone individuals encounter challenges in social functioning, yet research on learning under uncertainty in social contexts is limited. In this preregistered study, we investigated whether individuals with higher levels of trait anxiety and fear of negative evaluation encounter difficulties in adjusting their learning rates in social contexts with stable or volatile outcome contingencies. METHODS: We implemented a modified trust game (N = 190), where participants either retained or lost their investments based on their interactions with two players in volatile or stable environments. Participants also completed a matching non-social control task involving interactions with slot machines. RESULTS: Results from computational modeling revealed significantly higher learning rates in social compared to non-social settings. Trait anxiety did not affect the adaptability of learning rates. Individuals with heightened fear of negative evaluation were more sensitive to social compared to non-social outcomes, as reflected in their stay/switch behavior and, though less conclusive, in their learning rates. LIMITATIONS: While transdiagnostic and dimensional approaches are important for investigating disturbed social functioning, the inclusion of clinical samples in future studies may contribute to a broader generalization of these findings regarding behavioral variances in uncertain social environments. CONCLUSIONS: Individuals with increased fear of negative evaluation may demonstrate heightened sensitivity to learning in uncertain social contexts. This leads to heightened responsiveness to recent outcomes in their interactions with others, potentially contributing to their problems in social functioning.

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BACKGROUND: While wearing masks during the pandemic poses communication and social challenges for people in everyday life, those with social anxiety might find them plausible, aligning with contemporary cognitive theories. Social anxiety involves fearing negative assessments and holding a negative self-image. Concealing anxiety symptoms during mask use may contribute to a more positive self-perception. AIMS: Given that up to 60% of adults seeking stuttering treatment also meet criteria for social anxiety disorder, this study aims to investigate the complex relationship between communication freedom, self-perceived stuttering and anxiety in adults who stutter (AWS). The unique context of mandatory mask-wearing during the pandemic provides an opportunity to explore these dynamics and understand the conflicting relationships between stuttering, anxiety-related safety behaviours and the need for open communication in AWS. METHODS AND PROCEDURES: Twenty AWS participated in interviews, responding to open-ended questions to elucidate their affective, cognitive and behavioural experiences while wearing masks during the COVID-19 pandemic. Thematic analysis was used to identify the emerging themes and subthemes based on information-rich quotes, employing a six-phase recursive process. Various speech and anxiety-related measures were used to describe the characteristics of the study participants. OUTCOMES AND RESULTS: Three main themes and sub-themes emerged. The first theme highlights communication challenges for AWS wearing masks, impacting verbal and nonverbal interactions. The second theme reveals AWS wearing masks to conceal stuttering cues, experiencing reduced stress. The third theme indicates that, despite the comfort in concealment, most AWS prefer speaking freely without a face mask. CONCLUSIONS AND IMPLICATIONS: The conflict between the desire for authentic, fluent communication and the ease of hiding stuttering symptoms poses a major dilemma for AWS. According to the results of this study, most adults who stutter prioritize open communication. However, there were some individual differences. A major factor influencing their decision was their fear of negative evaluation. WHAT THIS PAPER ADDS: What is already known on the subject The prevalence of social anxiety is higher among adults who stutter (AWS), possibly stemming from their prior negative experiences with stuttering. In response, AWS may adopt adaptive or maladaptive coping behaviours to manage stuttering and mitigate fears of negative evaluation. Maladaptive strategies, like avoiding certain communication situations, can diminish their satisfaction with everyday speaking situations. What this study adds This study leveraged the mask-wearing mandate during the pandemic to explore the intricate relationship between anxiety-related symptoms and communication. While some participants saw masks as a plausible means to conceal stuttering and anxiety, most preferred open communication without the challenges posed by masks. Our findings offer additional support for the varied emotional, cognitive and behavioural responses that AWS may display in response to changes in daily life, emphasizing the individual differences within this population and highlighting that stuttering goes beyond observable speech dysfluencies. What are the clinical implications of this work? Our study underscores the need for comprehensive therapeutic interventions addressing both the physical and cognitive-emotional aspects of stuttering in AWS. Recognizing the role of safety behaviours and self-focused attention emphasizes the importance of an integrated approach, enhancing communication efficacy and social well-being for AWS. Addressing speech fluency alone, without considering pertinent cognitive-emotional factors, falls short in providing adequate stuttering treatment.

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Fear of positive evaluation (FPE) is becoming recognised as an important component of social anxiety that is distinct from fear of negative evaluation (FNE). While core belief scales exist for fear of negative evaluation (FNE), none has been developed for FPE. Therefore, this paper describes the development and validation of a measure of core beliefs that is specific to FPE. An exploratory factor analysis was performed on 60 initial items with an Australian undergraduate sample, in which a confirmatory factor analysis was performed with an independent Australian general population sample. A series of further analyses were performed to test convergent and divergent validity. The Positive Evaluation Core Beliefs Scale (PECS) emerged as a 17-item two-factor psychometrically valid measure that correlates more strongly with measurement of FPE than FNE. The PECS measure offers a new opportunity for researchers and clinicians to better explore cognitions associated with social anxiety.

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The bivalent fear of evaluation (BFOE) model of social anxiety divides fear of evaluation into two distinct valences: fear of positive evaluation (FPE) and fear of negative evaluation (FNE). However, there is evidence that the two most widely utilized and psychometrically supported measures of FNE and FPE contain items which are ambiguous with regard to valence of evaluative fear. To formally address this, the BFOE Scale (BFOES) was developed, by merging items from measures of FNE and FPE into a single scale with an integrated response format. The present studies examined the psychometric profile of the BFOES across a large pooled archival dataset (N = 2216), which included approximately 10 % (n = 224) patients with social anxiety disorder (SAD). The factorial validity, internal consistency, and construct validity of the BFOES were examined. Additionally, item response theory analyses were employed for the purpose of merging items from self-report scales which utilized different Likert-type response formats. Results from both studies provided support for the psychometric profile of the BFOES. The implications of the BFOES for the assessment of social anxiety, and theoretical models of fear of evaluation and SAD, are discussed.

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The main aim of orthognathic surgery is to provide a good occlusion and masticatory function and to achieve positive changes in facial aesthetics. The aim of this study was to determine the reasons behind patients' acceptance of orthognathic surgery and their expectations from this treatment, to assess whether their expectations were met, the change in their self-confidence and their satisfaction, and finally, to use the results obtained to inform future surgical procedures to increase patient satisfaction. The study was designed as a cross-sectional observational study and included 73 people treated with orthognathic surgery (surgery group) and 42 people with minimal crowding who did not require treatment (control group). The study found that the primary reason for requesting orthognathic surgery was to improve facial appearance and that patients had high expectations in this regard. Using the Social Appearance Anxiety Questionnaire and the Expectation and Satisfaction Questionnaire, 73.97 % of patients in our study said the treatment met their expectations and 90.41 % said they were satisfied with the overall results of the surgery. The study also highlighted the importance of surgeon-patient communication and the satisfaction of the patient's environment with the final result in determining patient satisfaction. In conclusion, since patients' high expectations of orthognathic surgery influence treatment success and patient satisfaction, it is important to know and manage patients' expectations before treatment and to have good patient-surgeon communication to increase patient satisfaction after surgery.

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The aim of this study was to examine psychological responses, fear of negative evaluation, and mood-related alexithymia in individuals in addiction recovery who have succeeded versus those who have not. This study employed a causal-comparative design. The research focused on all individuals who sought treatment for addiction at clinics within a specific district in Zahedan city, Iran. Out of the group, 100 individuals were chosen (50 who successfully stopped their addiction and 50 who were unsuccessful in their attempts to quit) through convenience sampling. Data were gathered using the depression, Anxiety, and Stress Scale (DASS-21), Lori's fear of negative evaluation scale, and Toronto's mood-emotional alexithymia scale. Data were examined through both descriptive statistics and multivariate analysis of variance. Based on the results, successful and unsuccessful individuals in addiction recovery showed varying levels of depression, stress, fear of negative evaluation, and having no fear of negative evaluation (p < .01). In simpler terms, unsuccessful individuals in addiction recovery scored higher in depression, stress, fear of negative evaluation, inability feeling emotions, inability to express feelings compared to successful individuals. But successful individuals in addiction recovery obtained higher mean scores than unsuccessful individuals in addiction recovery on having no fear of negative evaluation. According to the findings psychological reactions, fear of negative evaluation and mood-emotional alexithymia play a significant role in addiction treatment and can be helpful in addiction recovery in unsuccessful people in addiction recovery. It is feasible to enhance the effectiveness of addiction recovery by implementing interventions that target the reduction of depression, stress, fear of negative evaluation, and alexithymia.

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Based on previous theories and studies, fear of negative evaluation (FNE) may be a key predictor of suicidal ideation in adolescents. However, few studies examined the longitudinal relationships between FNE and suicidal ideation. This study aimed to explore the bidirectional longitudinal relationships between FNE and suicidal ideation. Meanwhile, based on the Interpersonal Theory of Suicide, this study would examine the longitudinal mediating role of interpersonal needs factors (thwarted belongingness and perceived burdensomeness) on the relationship between FNE and suicidal ideation. A sample of 515 adolescents (Mage = 12.309, SD = 0.807; 49.3 % girls) completed questionnaires on 4 waves, 6 months apart. The Random Intercept Cross-Lagged Panel Models (RI-CLPMs) were utilized to estimate the associations among study variables. The results showed that: (1) there was a significant bidirectional longitudinal relationship between FNE and suicidal ideation; (2) thwarted belongingness and perceived burdensomeness independently and serially mediated the relationship between FNE and suicidal ideation. This study contributed to understanding the complex relationship between FNE and suicidal ideation, emphasizing the critical roles of thwarted belongingness and perceived burdensomeness. The findings underscore the bidirectional nature of these associations and provide insights into the potential pathways involved in the development of suicidal ideation among adolescents.

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Purpose: The detrimental effects of social anxiety on college students require urgent mitigation. To explore the influencing factors and underlying mechanisms of social anxiety among college students, this study aims to examine the relationship between negative physical self and social anxiety, and the mediating effects of fear of negative evaluation and regulatory emotional self-efficacy. Methods: The Negative Physical Self Scale, Brief Fear of Negative Evaluation Scale, Regulatory Emotional Self-Efficacy Scale, and Interaction Anxiousness Scale were administered to 924 Chinese college students. SPSS 26.0 was used for analysis, and the Bootstrap method was used to test the significance level of the mediating effect. Results: Negative physical self was significantly and positively related to social anxiety in college students. Fear of negative evaluation and regulatory negative emotional self-efficacy played independent mediating roles between negative physical self and social anxiety. Fear of negative evaluation and regulatory negative emotional self-efficacy showed a bidirectional chain mediating effect between negative physical self and social anxiety. Conclusion: This study elucidates the mechanistic pathways between negative physical self and social anxiety. The relationship between negative physical self and social anxiety is influenced by the mediating effects of fear of negative evaluation, regulatory negative emotional self-efficacy, and the bidirectional chain mediating effect of fear of negative evaluation and regulatory negative emotional self-efficacy. This finding provides a reference for policy makers and educators to develop interventions for social anxiety in college students.

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The popularity of social media platforms, such as Instagram, has given rise to a surge in photo editing and filtering practices among users. Understanding the underlying psychological factors that drive individuals to employ filters is crucial in comprehending the impact of such behavior on self-perception and online interactions. This study aims to investigate the influence of self-esteem on the importance attributed to the use of Instagram filters, with a particular focus on the mediating role played by the fear of negative evaluation. A sample of participants (N = 2,657) from diverse demographic backgrounds has been recruited to complete a series of questionnaires measuring self-esteem, fear of negative evaluation, and Instagram filter usage patterns. Mediation analysis has been employed to assess the extent to which the fear of negative evaluation mediates the relationship between self-esteem and filter usage importance. In line with the hypotheses, the results revealed that participants self-esteem negatively predicted fear of negative evaluation, which in turn had a positive effect on use of filters. Furthermore, fear of negative evaluation fully mediated the relationship between self-esteem and use of filters. Overall, the implications of this research extend to both theoretical and practical domains. The findings can contribute to the existing literature on self-esteem, social media behavior, and body image by shedding light on the factors influencing digital self-presentation.

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INTRODUCTION: Elevated fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are thought to play key roles in the maintenance of social anxiety disorder (SAD). Although efficacious therapies exist for SAD, the potential mediating and moderating effects of FNE and FPE on social anxiety treatment outcome have not been examined. METHODS: This sample comprised a secondary analysis of 210 individuals who participated in one of three randomized controlled trials for the treatment of SAD. Participants were randomized to: individual cognitive behavioral therapy (CBT), group CBT, community mindfulness-based stress reduction (MBSR), group MBSR, or they were randomized to waitlist and offered treatment after waitlist. Assessments were completed pre- and post-treatment/waitlist and, for the treatment groups, at three-month follow-up. RESULTS: CBT and MBSR led to greater reductions in FNE and FPE than waitlist, with CBT more efficacious in reducing FPE than MBSR. For both CBT (vs. waitlist) and MBSR (vs. waitlist), there were significant indirect effects on post-treatment social anxiety through both FNE and FPE, and the indirect effect through FPE was greater for CBT than MBSR. However, in the fully longitudinal model testing mediation, CBT and MBSR were not differentially mediated by FPE. Baseline FNE and FPE each moderated CBT treatment outcome compared to waitlist - higher baseline FNE and FPE were associated with higher baseline social anxiety and greater reductions in social anxiety during CBT. DISCUSSION: FNE and FPE contributed in sometimes similar and sometimes distinct ways to the mediation and moderation of psychosocial approaches for treating SAD. This supports the importance of distinguishing between fears of negative and positive evaluation in the assessment and treatment of SAD.

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During the COVID-19 epidemic, face-to-face mental health services faced obstacles. Using Internet-based interventions was a good solution and had the potential to overcome these treatment barriers. However, there is no strong research evidence about the effectiveness of these methods for social anxiety disorder in different cultures and developing countries. Therefore, the present study aimed to investigate the effectiveness and application of Internet-based cognitive-behavioral therapy for social anxiety disorder in Iran. The current study was a pretest-posttest follow-up experimental design. Fifty-four adolescents with social anxiety disorder were selected from Lorestan province (Iran) by cluster sampling method and randomly assigned to three groups: face-to-face, internet-based, and wait-list control. At the beginning and end of the study and 3-month follow-up, three groups were interviewed and answered questionnaires related to the primary and secondary symptoms of social anxiety disorder. Two experimental groups were treated with the same therapeutic intervention during 10 weekly sessions. ANCOVA analysis showed that both forms of intervention effectively reduced social phobia, fear of negative evaluation and social interaction anxiety and increased emotion regulation. Also, a significant decrease in secondary outcomes, including physical symptoms, insomnia, social dysfunction, and depression symptoms, was observed in both groups. The treatment effects were stable during a 3-month follow-up. Our findings showed that although Internet-based cognitive-behavioral therapy for adolescents with social anxiety disorder can be effective, several clinical, cultural, and implementation weaknesses should be considered.

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Self-concept clarity is considered a crucial indicator of mental health. Although several studies have examined the correlation between self-concept clarity and loneliness, few studies have investigated the underlying mechanism. Based on the evolutionary theory of loneliness and social penetration theory, this cross-sectional study focused on cognitive and behavioral factors in interpersonal communication situations, aiming to explore the relationship between self-concept clarity and loneliness as well as its internal mechanism. An online questionnaire survey comprised 1145 college students in China to assess their self-concept clarity, fear of negative evaluation, self-disclosure, and loneliness. After controlling for demographic variables, the results showed that self-concept clarity was not only able to directly and negatively predict loneliness but also indirectly predict loneliness through the independent mediating effects of fear of negative evaluation and self-disclosure, as well as the chain-mediating effect of fear of negative evaluation to self-disclosure. This study provides important implications for cognitive and behavioral intervention strategies to alleviate people's loneliness and improve their mental health.

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Objective: To investigate the depersonalization status and to analyze the effect of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization in clinical nurses. Methods: In May 2019, 10 cities were selected as sampling cities by the method of grabbing random ball in Henan Province and Fujian Province. Using the stratified sampling, clinical nurses were selected as the research objects for a questionnaire survey in 22 tertiary hospitals and 23 secondary hospitals, included 1200 nurses. A total of 1200 questionnaires were issued and collected, and 1159 valid questionnaires were collected with effective recovery of 96.6%. Clinical nurses were investigated by Workplace Incivility Scale, Event Related Rumination Inventory, Fear of Negative Evaluation Scale, Maslach Burnout Inventory-General Survey. The demographic characteristics of nurses' depersonalization were compared and analyzed with t test and single factor analysis of variance. The influence mechanism of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization was analyzed with Bootstrap. Results: Depersonalization scores were (9.3±2.6) points, 467 of those had depersonalization symptoms in clinical nurses (40.3%). The scores of depersonalization of those with <3 years of service [ (10.5±2.9) points] was higher than those with 3-10 years [ (9.1±2.8) points] and 11-31 years [ (9.0±2.9) points]. The scores of depersonalization of those with monthly earning of <3000 yuan [ (10.1±2.8) points] was higher than those with 3000-7999 yuan [ (8.4±2.7) points] and 8000-12000 yuan [ (8.0±2.9) points]. The scores of depersonalization of clinical nurses in surgical departments [ (10.0±2.9) points] was higher than those in non-surgical departments [ (8.7±2.6) points]. The scores of depersonalization of clinical nurses in tertiary hospitals [ (10.0±2.7) points] was higher than those in secondary hospitals [ (8.6±2.8) points]. The differences were statistically significant (P<0.05). Workplace incivility perception affected depersonalization through the single mediating role of intrusive rumination, fear of negative evaluation and the chain mediating role of intrusive rumination and fear of negative evaluation (ß=0.16, 0.17, 0.07, 95%CI: 0.15-0.20, 0.15-0.21, 0.03-0.09, P<0.05) . Conclusion: Workplace incivility perception directly or through the independent mediating effects of intrusive rumination or fear of negative evaluation, and the chain mediating effects of intrusive rumination and fear of negative evaluation influences the depersonalization of clinical nurses.

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OBJECTIVE: The study was conducted to determine patients' desire for being liked and the fear of negative evaluation before and after surgery. MATERIALS AND METHOD: The study was conducted quasi-experimentally using a one-group pretest-posttest (sixth month) design. The study population consisted of rhinoplasty patients hospitalized in the ear, nose, and throat service. The study was completed with 60 people. Participant information form, the desire for being liked scale, and the brief fear of negative evaluation scale were used as data collection tools. The data of the study were collected face-to-face between November 15, 2021, and March 15, 2023. FINDINGS: It was determined that the mean scores of the desire for being liked were 19.43 ± 7.44 in the pretest and 12.15 ± 4.76 in the posttest, and the difference between the measurements was highly significant. Furthermore, it was determined that the mean score of fear of negative evaluation was 27.78 ± 9.81 in the pretest and 17.72 ± 6.91 in the posttest, and the difference between the measurements was highly significant. It was observed that there was a high, statistically significant, and positive relationship between the pretest and posttest fear of negative evaluation and desire for being liked scores. CONCLUSION: Patients' desire for being liked and fear of negative evaluation, which were high before surgery, decreased significantly six months after surgery. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online instructions to authors www.springer.com/00266 .

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Fear of positive evaluation (FPE) and fear of negative evaluation (FNE), which play distinct and central roles in social anxiety (SA), are postulated to reflect conflicting forces in hierarchal group contexts. Yet, experimental studies testing these assumptions are scarce. We examined the impact of status positions on FPE, FNE, and SA using a novel manipulation, CyberStatus. Participants (N = 557) provided self-descriptive statements before being randomly assigned to high, intermediate, or low-status conditions. Next, they reported their emotions, status, and belongingness-related cognitions and adjusted their self-presentation. FPE was more strongly linked to self-presentation modifications in the high- compared to intermediate-status conditions and positively associated with perceived status in the low vs. intermediate conditions. Furthermore, FPE and SA were more linked to belongingness in low vs. intermediate status conditions while FNE demonstrated the reversed pattern. These findings support and expand the evolutionary perspective on evaluation fears and emphasize the importance of assessing the linkage between status and belongingness systems in SA.

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The Hierarchical Taxonomy of Internalizing Dimensions for Eating Disorders model positions eating disorder (ED) symptoms on an internalizing dimension alongside anxiety and mood symptoms. Symptom dimensions falling under the internalizing subfactors of distress (e.g., social anxiety) and fear/avoidance (e.g., panic, compulsions, checking) may differentially guide treatment. We examined relations between fear of negative evaluation and intolerance of uncertainty (core features of social anxiety and obsessive-compulsive disorder, respectively) and ED-related impairment and potential diagnostic differences. We hypothesized that: (a) fear of negative evaluation and intolerance of uncertainty would be related to ED-related impairment, (b) the relation between fear of negative evaluation and impairment would be strongest among individuals with "binge-eating syndromes" (i.e., bulimia nervosa [BN], binge-eating disorder [BED]), and (c) the relation between intolerance of uncertainty and impairment would be strongest among individuals with "weight-phobic syndromes" (i.e., anorexia nervosa [AN], BN, atypical AN). Participants (N = 236) included children/adolescents and adults evaluated for outpatient ED treatment. Participants completed questionnaires and semi-structured diagnostic interviews. Greater fear of negative evaluation and greater intolerance of uncertainty were related to greater clinical impairment, and the strength of these relations depended on ED diagnosis. Fear of negative evaluation was related to impairment among individuals with AN and atypical AN, and intolerance of uncertainty was related to impairment for individuals with AN, BN, and atypical AN. We identified fear of negative evaluation and intolerance of uncertainty as correlates of clinical impairment, highlighting the potential utility of developing treatments to target these internalizing constructs, especially for individuals with weight-phobic syndromes.

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Women Living with HIV (WLHIV) who use substances face stigma related to HIV and substance use (SU). The relationship between the intersection of these stigmas and adherence to antiretroviral therapy (ART), as well as the underlying mechanisms, remains poorly understood. This study aimed to examine the association between intersectional HIV and SU stigma and ART adherence, while also exploring the potential role of depression and fear of negative evaluation (FNE) by other people in explaining this association. We analyzed data from 409 WLHIV collected between April 2016 and April 2017, Using Multidimensional Latent Class Item Response Theory analysis. We identified five subgroups (i.e., latent classes [C]) of WLHIV with different combinations of experienced SU and HIV stigma levels: (C1) low HIV and SU stigma; (C2) moderate SU stigma; (C3) higher HIV and lower SU stigma; (C4) moderate HIV and high SU stigma; and (C5) high HIV and moderate SU stigma. Medication adherence differed significantly among these classes. Women in the class with moderate HIV and high SU stigma had lower adherence than other classes. A serial mediation analysis suggested that FNE and depression symptoms are mechanisms that contribute to explaining the differences in ART adherence among WLHIV who experience different combinations of intersectional HIV and SU stigma. We suggest that FNE is a key intervention target to attenuate the effect of intersectional stigma on depression symptoms and ART adherence, and ultimately improve health outcomes among WLHIV.

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Fear of negative evaluation and prosocial behavior have been identified as predictive factors influencing the development of loneliness in adolescence, representing typical factors in the cognitive and behavioral processes of re-affiliation. The elucidation of plausible direct and indirect pathways linking these pivotal factors to adolescents' loneliness need further exploration. This study aimed to investigate the direct and indirect relationships between the fear of negative evaluation, prosocial behavior, and adolescents' loneliness through the lens of developmental changes. A total of 533 adolescents (49.0% girls, Mage = 15.18 years, SD = 0.71) participated in this longitudinal study, assessed at three timepoints over a span of two years with 12-month intervals. Latent growth modeling uncovered direct associations between the developmental trajectories of both fear of negative evaluation and prosocial behavior with the developmental trajectory of adolescents' loneliness. The developmental trajectory of fear of negative evaluation exhibited an indirect association with the developmental trajectory of loneliness through the mediating role of prosocial behavior. These findings highlighted the roles of cognitive and behavioral re-affiliation processes, both independently and as mediators, in influencing adolescent loneliness, suggesting that interventions aimed at reducing fear of negative evaluation and promoting prosocial behavior could effectively mitigate adolescents' loneliness.

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