Abstract
BackgroundThere is evidence for the relevance of attachment style and anger expression for the manifestation of social anxiety disorder (SAD).MethodIn a cross-sectional study 321 individuals with social anxiety disorder (41% men, age 38.8 ± 13.9) were compared with 94 healthy controls (37% men, age 35.8 ± 15.1) on several questionnaires (Attachment Styles Questionnaire, State Trait Anger Inventory, Social Phobia Inventory, Beck Depression Inventory).ResultsIndividuals with SAD showed moderate-sized reduced levels of secure and large-sized increased levels of fearful and preoccupied attachment style compared to healthy controls (all p < 0.001) as well as small-sized increased levels of trait anger (p = 0.03) and moderate-sized increased levels of anger-in (p < 0.001). Attachment style and anger regulation could predict 21% (R2 = 0.21, p < 0.001) of the extent of social anxiety (SPIN) in SAD; secure (β = − 0.196, p < 0.01) and preoccupied attachment style (β = 0.117, p < 0.05), as well as anger-in (β = 0.199, p < 0.01) were significant cross-sectional predictors. Further analysis revealed that the relationship between preoccupied attachment and social anxiety is partially mediated by anger-in.ConclusionStudy findings confirm the relevance of preoccupied attachment style and anger suppression for social anxiety. Disentangling the role of anger regulation in early attachment patterns has significant therapeutic implications in SAD.
Highlights
There is evidence for the relevance of attachment style and anger expression for the manifestation of social anxiety disorder (SAD)
The fearful attachment style, which is defined by a negative view of self and others and leads to an avoidance of close relationships as a means to protect oneself against anticipated rejection
Depressive symptomatology as measured by the Beck Depression Inventory (BDI) was significantly increased in the SAD sample
Summary
There is evidence for the relevance of attachment style and anger expression for the manifestation of social anxiety disorder (SAD). The fearful attachment style, which is defined by a negative view of self and others and leads to an avoidance of close relationships as a means to protect oneself against anticipated rejection. Against this backdrop there is growing evidence which suggests that attachment theory can be viewed as a theory of affect regulation, given that the regulation of emotions in the caregiver-child relationships lays the foundations for the self-regulation of emotions [8, 9] In line with this assumption several studies found a deficiency in the ability to regulate emotions in individuals with SAD [10,11,12,13]. In keeping with this assumption previous studies found higher levels of suppressed anger in SAD [15,16,17]
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