Invited Symposium: Development of Social Phobia



Materials & Methods


Discussion & Conclusion



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Toward an Improved Nosology of Social Phobia: Dimensional or Latent Class?

Contact Person: Jonathan M Oakman (jmoakman@watarts.uwaterloo.ca)

Discussion and Conclusion

The results of our data analysis suggest that shyness is a dimensional (continuous) trait, while social anxiety has a typological component to its variance. It is tempting to think of shyness as being primarily about fear of social evaluation while social anxiety combines both fear of social evaluation and fear of strangers. This conception would fit neatly with the contention of Asendorpf2 that adult social anxiety is the final common pathway of these two types of inhibition. Furthermore, this conception would suggest that it is fear of strangers that contributes the typological source of variance (as self-conscious shyness seems dimensional), fitting neatly with the typological implications of the construct of behavioural inhibition.

While these ideas have some support in our data, it is important to point out that this may be an oversimplification of the available evidence. The shyness measure of Cheek and Buss12 contains items that clearly measure the construct of fearful shyness (e.g. "I feel tense when I'm with people I don't know well."), other items that clearly measure the construct of self-conscious shyness (e.g. "I feel nervous when speaking to someone in authority," "I am more shy with members of the opposite sex"), and other items that are not clearly reflective of either type of shyness (e.g. "I am socially somewhat awkward"). Likewise, the LSAS, which assesses responses to a range of anxiety producing social situations, also includes items that measure both types of shyness. For example, fearful shyness is represented in items such as "Meeting strangers" while self-conscious shyness is represented in items such as "Entering a room when others are already seated." In order to identify what construct is contributing a typological source of variance it may be informative to conduct a more fine-grained analysis at the item level.

The MAXCOV data analytic technique operates on a set of item data, looking at the covariance of pairs of items in turn across an ability dimension created by summing the other items. Item data is bootstrapped (in the non-resampling sense of the word) by culling the item set to focus on the set of items that seem to best detect the typology41. The LSAS is a survey of anxiety producing situations where each item is rated on fear or anxiety experienced in the situation, and avoidance of the situation. In our sample, ratings of fear and avoidance were so highly correlated (r = .92) as to make the distinction meaningless. The set of items that best detect the typological source of variance in the LSAS scores are the following:

3. Eating in public places.

9. Writing while being observed.

11. Talking with people you don't know very well.

13. Urinating in a public bathroom.

19. Looking at people you don't know very well in the eyes.

Three of these items (3, 9, 13) appear to measure an extreme form of self-conscious shyness. The person is being observed, but the situation is barely classifiable as social; there is little in the way of an interaction going on. Interestingly, item 19 "looking at people you don't know very well in the eyes" shows an atypical pattern of factor loadings in factor analyses of the LSAS. The pattern of loadings of item 19 (in 3, 4, and 5-factor solutions) is most similar to the pattern of item 1 ("Telephone in public") and item 13 ("Urinating in a public bathroom"), both being scrutiny fears like eating or writing while being observed. Item analysis suggests that the typological source of variance in the LSAS may be due to a set of items measuring scrutiny fears, a construct that is not well-covered by the Cheek and Buss shyness scale.

This particular set of items may seem to be measuring nongeneralized social phobia. Nongeneralized (discrete or specific) social phobia refers to social fear that occurs in only one social context or in a limited domain of social behaviour. This intuition is contradicted by the observation that there were no patients with nongeneralized social phobia in our sample. These intense scrutiny fears occur in the context of more general social anxiety in the patients with social phobia in our sample. Our interpretation of these results is that scrutiny fear is separable from fearful shyness and self-conscious shyness, and that it may be typological in character.

Marks35 notes that fear of being looked at is common in the animal kingdom. Simply staring at young chicks is apparently enough to release tonic immobility18. Perhaps fear of being observed is based on the evolutionary remnants of a predator defense system where staring eyes may be a prepotent fear stimulus. (Interestingly, Dimberg and Öhman14 demonstrated that the direction of facial stimuli was important in a conditioning paradigm study of social fear). In contrast, other social fears may be based on basic systems guiding social behaviour such as the agonic group living system proposed by Gilbert22,59. If we adopt this psychobiological account of social anxiety, we would expect different social fears to be based on somewhat different defense systems that are the legacy of our evolutionary ancestors.

Implications for the nosology of social phobia.

Many researchers seem to favour the abandonment of a DSM-IV-like categorical classification system for social phobia47,57,61,62. Converging evidence suggests that our nosology of social phobia be reformulated to be consistent with a contemporary understanding of social anxiety. Provisionally we might proceed by focusing on the two main types of shyness and their additive prediction of social anxiety. Although there are at least two competing theoretical formulations about how best to describe the two types of shyness3, there is agreement concerning the importance of maintaining a distinction between early developing and late developing shyness. We would like to add a third type of social inhibition to this set. Fear of being observed may be a separable source of variance in social anxiety. It seems to be based on a latent typology, and according to some perspectives59 it may be based on a predator defense system in contrast to other social fears that seem based on systems regulating social behaviour.

Implications for further research.

Results of this study suggest that shyness is a dimensional trait, while there may be a source of typological variance in the social anxiety reported by social phobia. This source of variance may be related to the fear of being observed that has long been recognized, but that is often under-emphasized. Our results await conceptual replication with a measure of scrutiny fear. Similar analyses (and appropriate control simulations) need to be conducted on measures of fearful shyness and self-conscious shyness.

While many researchers emphasize the distinction between early and late developing shyness in their theorizing, progress in research is limited by the lack of measures that reflect theoretical notions of the distinction between the two types of shyness. Such measures would need to explicitly focus on the contextual determinants of these different types of shyness and measure them in a more or less pure way.

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Oakman, JM; Van Ameringen, M; Mancini, C; Farvolden, P; (1998). Toward an Improved Nosology of Social Phobia: Dimensional or Latent Class?. Presented at INABIS '98 - 5th Internet World Congress on Biomedical Sciences at McMaster University, Canada, Dec 7-16th. Invited Symposium. Available at URL http://www.mcmaster.ca/inabis98/ameringen/oakman0804/index.html
© 1998 Author(s) Hold Copyright