Sub-types of safety behaviours and their effects on social anxiety disorder.

Emily Gray,Esther T Beierl,David M Clark,Daimei Sasayama

doi:10.1371/journal.pone.0223165

Emily Gray, Esther T Beierl + Show 2 more

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https://doi.org/10.1371/journal.pone.0223165

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Abstract

Cognitive models suggest that social anxiety disorder (SAD) is maintained through the use of safety behaviours. Previous reports propose that these safety behaviours can be subdivided into two main categories: avoidance and impression management. Study 1 investigates whether certain safety behaviours are specific to SAD. The social behaviour questionnaire was administered to individuals with SAD (N = 106), post-traumatic stress disorder (N = 28) and non-patient controls (N = 59). A factor analysis (N = 164) replicated the previously reported avoidance and impression management subtypes. Scores for both subtypes were significantly higher in individuals with SAD than in individuals with post-traumatic stress disorder or non-patient controls. Study 2 investigated the causal role of such safety behaviours using an experimental design in a non-clinical population (N = 96). Pairs of participants each engaged in two conversations. In one of the conversations, a randomly selected participant performed either avoidance or impression management safety behaviours. In the other conversation, neither participant was instructed to use safety behaviours. Each participant rated their own anxiety and performance as well as rating the other person. Videos of the conversations were also rated. Both types of safety behaviour increased anxiety in the person performing the safety behaviour. The avoidance subtype also had broader effects on the other person that were largely absent from the impression management subtype. Taken together the studies provide support for the distinction between safety behaviour subtypes and have implications for the treatment of SAD.

Highlights

Social anxiety disorder (SAD) is a persistent fear of one or more social situations where embarrassment may occur and the anxiety is disproportional to the actual threat posed [1]
A oneway ANOVA showed a significant difference between the groups, with post-hoc comparisons indicating that patients with social anxiety disorder (SAD) score higher on the Fear of Negative Evaluation scale (FNE) than patients with post-traumatic stress disorder (PTSD) and that
It is possible that less familiar impression management strategies might have produced different results. These two studies help add to our understanding of the use and the effect of different safety behaviours in social anxiety disorder

Summary

Introduction

Social anxiety disorder (SAD) is a persistent fear of one or more social situations where embarrassment may occur and the anxiety is disproportional to the actual threat posed [1]. Individuals with SAD have distorted beliefs about how they are perceived by other people. People with SAD come across more positively than they think [2, 3]. It is a puzzle why social anxiety persists, as logically an individual should adjust their beliefs of how they come across to others in response to the positive reactions they get from others. One of the reasons why individuals are thought not to adjust to a more realistic appraisal of themselves is that any positive outcomes are attributed to the use of social safety behaviours, rather than being a sign that the individual is intrinsically acceptable to other people [4].

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