The latent structure of social anxiety disorder and the performance only specifier: a taxometric analysis

Social anxiety refers to fears of social interaction and/or performance situations. When social anxiety is accompanied by significant distress or impairment in one’s social life, work, or education, an individual is said to “have” Social Anxiety Disorder (SAD). Although social anxiety is a ubiquitous phenomenon, the current psychiatric diagnostic system (DSM-5) treats SAD as a distinct condition and individuals are often referred to as having or not having SAD. However, some evidence suggests that social anxiety may not be categorical; rather, social anxiety may be experienced by all humans in varying degrees, without a naturally occurring threshold that differentiates individuals as having or not having a social anxiety disorder.

This study examined whether the underlying structure of social anxiety is categorical (i.e., one has or does not have SAD) or dimensional (i.e., individuals vary in degree rather than type of social anxiety) by using the taxometric method, which consists of a set of statistical procedures designed to discern whether a construct is taxonic (i.e., consists of groups) or dimensional (i.e., occurs along a spectrum). Three taxometric procedures (MAXCOV, MAMBAC, and L-Mode) were applied to data collected from a large, nonclinical sample of 2,019 undergraduates. As predicted, the three procedures provided convergent evidence indicating that social anxiety is dimensional and occurs on a spectrum of severity. Further, although the DSM-5 requires clinicians to distinguish between individuals with “performance only” social anxiety versus those with more generalized social anxiety, taxometric analyses also indicated that there is not a naturally occurring distinction between these groups. Rather, individuals merely vary in severity of social anxiety and number of social situations that lead them to feel anxious.

The results of the present study are consistent with previous research and suggest that dividing individuals into groups of those who “have” versus “do not have” SAD is contraindicated. In addition, treatment programs should be aimed at reducing the impact that social fears have on one’s life rather than trying to cure SAD or change individuals from having to not having the disorder since failure to meet diagnostic criteria does not necessarily mean that an individual does not experience symptoms or impairment.

Read the full paper: Boyers, G. B., Broman-Fulks, J. J., Valentiner, D. P., McCraw, K., Curtin, L., & Michael, K. D. (2017). The latent structure of social anxiety disorder and the performance only specifier: a taxometric analysis. Cognitive Behaviour Therapy, 1-15. doi:10.1080/16506073.2017.1338310

Grace Boyers
Lead Author

 

Photo by: Toshiyuki Imai

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