Reactivity to Social Stress in Subclinical Social Anxiety: Emotional Experience, Cognitive Appraisals, Behavior, and Physiology.

Liviu G Crişan,Mircea Miclea,Romana Vulturar,Andrei C Miu

doi:10.3389/fpsyt.2016.00005

Abstract

Recent research indicates that subclinical social anxiety is associated with dysfunctions at multiple psychological and biological levels, in a manner that seems reminiscent of social anxiety disorder (SAD). This study aimed to describe multidimensional responses to laboratory-induced social stress in an analog sample selected for social anxiety symptoms. State anxiety, cognitive biases related to negative social evaluation, speech anxiety behaviors, and cortisol reactivity were assessed in the Trier Social Stress Test (TSST). Results showed that social anxiety symptoms were associated with increased state anxiety, biased appraisals related to the probability and cost of negative social evaluations, behavioral changes in facial expression that were consistent with speech anxiety, and lower cortisol reactivity. In addition, multiple interrelations between responses in the TSST were found, with positive associations between subjective experience, cognitive appraisals, and observable behavior, as well as negative associations between each of the former two types of response and cortisol reactivity. These results show that in response to social stressors, subclinical social anxiety is associated with significant changes in emotional experience, cognitive appraisals, behaviors, and physiology that could parallel those previously found in SAD samples.

Highlights

Social anxiety disorder (SAD) is one of the most common psychiatric disorders, with a lifetime prevalence of 6.7% in Europe [1] and 12.1% in the USA [2]
The results of this study indicated that the severity of social anxiety symptoms was positively associated with self-reported state anxiety and biased appraisals related to negative social evaluation
Social anxiety symptoms correlated positively with several observable anxiety behaviors in the Trier Social Stress Test (TSST), but only the correlation with facial expression ratings remained significant after adjusting the alpha level for multiple comparisons

Summary

Introduction

Social anxiety disorder (SAD) is one of the most common psychiatric disorders, with a lifetime prevalence of 6.7% in Europe [1] and 12.1% in the USA [2]. Up to 20% of general population report subclinical levels of Social Stress Reactivity in Social Anxiety social anxiety symptoms, which can alter individual functioning in multiple life domains [10, 11] and quality of life [12]. Increased social anxiety is linked with dysfunctions at multiple levels [for review, see Ref. Social anxiety has been linked with increased self-focused attention [18] and negative interpretation biases [19] in social situations. Both SAD and subthreshold social anxiety may involve altered biological reactivity to social stress. Considering that it is a risk factor for health problems [e.g., Ref. [21]], impaired HPA reactivity may contribute to medical comorbidities of SAD [22]

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