The Nature and Extent of Social Anxiety and Avoidance in Patients with Chronic Pain

Abstract

The present study explored the nature and extent of social anxiety and avoidance, anxiety sensitivity, and pain-related anxiety and avoidance in 46 clinic-referred chronic pain patients, compared with a community-based group reporting pain (n = 66) and healthy controls (n = 57). The chronic pain patients consistently reported higher levels of social distress, social avoidance, fear of negative evaluation, anxiety sensitivity, and pain-related anxiety and avoidance as compared with controls. Group differences in social distress, social avoidance, fear of negative evaluation, pain-related cognitive anxiety, and fear of cognitive and emotional dyscontrol, remained stable when pain severity was controlled for. Anxiety sensitivity was strongly related to both social and pain-related fears. The source of these social fears is examined in relation to the elevated pain-related fear and anxiety sensitivity also exhibited by chronic pain patients, and implications for treatment and rehabilitation are discussed.