People with a diagnosis of social anxiety disorder find social situations nerve wracking, from mixing with friends to speaking in public. A number of explanations have been proposed for why they feel this way, including that they are pre-occupied with creating the right impression. A new study makes a related but distinct claim, which is that people with social anxiety are overly concerned with social hierarchy, and struggle with what’s called the affiliative side of relationships. In simple terms this means they tend to perceive social situations as competitive, judging themselves as having low rank compared with other people, and they also have difficulty forming close relationships.
Ora Weisman and her colleagues made their claims after surveying 42 social anxiety disorder clients at a public clinic in Israel and 47 community controls. Potential recruits to the client group were excluded if they had depression, schizophrenia or an addiction problem. Comparing the two groups, the researchers found that the clients with social anxiety tended to report more submissive behaviour (e.g. agreeing to being wrong, even when knowing they were right), saw themselves as having low social rank, were more sensitive to rejection, had less closeness to their friends, and avoided getting too attached to romantic partners.
A second study was similar to the first, except this time the researchers compared clients with a joint diagnosis of social anxiety and depression against clients with an anxiety diagnosis other than social anxiety (e.g. panic disorder, generalised anxiety disorder) plus depression. Once again, it was the social anxiety group who scored higher on submissive behaviour, avoidance of attachment, lower perceived social rank and greater rejection sensitivity. Together both studies suggest that social anxiety is associated with these characteristics above and beyond the influence of depression.
Limitations of the study include its reliance on self-report and the fact that clients weren’t followed up over time. This means it’s difficult to tell if the measured characteristics (such as perceiving oneself as having low social rank) are a cause or a consequence of social anxiety.
Weisman and her team said their findings have treatment implications. Therapists should include techniques that focus on negative self-perception, they advised, including the use of video-feedback, and ways to overcome submissive behaviours. This work could extend to reducing the frequency of emotions such as shame and humiliation, they said, which may contribute to clients downplaying their social status. Also the affiliation side should be addressed too, Weisman’s group said: “…issues such as sharing and self-disclosure can help achieve intimacy and closeness with others and reduce social anxiety.”
O Weisman, I Aderka, S Marom, H Hermesh, and E Gilboa-Schechtman (2011). Social rank and affiliation in social anxiety disorder. Behaviour Research and Therapy DOI: 10.1016/j.brat.2011.03.010