From Fear to Avoidance: Factors Associated with the Onset of Avoidance in People who Fear Social Situations

Abstract

Avoidance of social situations is a key factor in the maintenance of social anxiety disorder, with overt avoidance an important clinical indicator. This paper examines predictors of the transition from the initial experience of social fears to the development of overt avoidance behaviours. Using the 2007 Australian National Survey of Mental Health and Wellbeing, age, gender, DSM-IV diagnoses of other mental disorders and substance use were examined in discrete time survival models (n = 1,359). A majority of the sample reported overt avoidance within a year of initial social fears. Predictors of faster transitions to overt avoidance included fear of attending parties, entering a room or an older onset age. Predictors of slower transitions to overt avoidance included public performance fears and regular alcohol use. This study provides initial support for factors that may influence the transition from initial fear to overt avoidance in social anxiety disorder.