A false sense of security: safety behaviors erode objective speech performance in individuals with social anxiety disorder.

In the current study, 55 participants with a diagnosis of generalized social anxiety disorder (SAD), 23 participants with a diagnosis of an anxiety disorder other than SAD with no comorbid SAD, and 50 healthy controls completed a speech task as well as self-reported measures of safety behavior use. Speeches were videotaped and coded for global and specific indicators of performance by two raters who were blind to participants' diagnostic status. Results suggested that the objective performance of people with SAD was poorer than that of both control groups, who did not differ from each other. Moreover, self-reported use of safety behaviors during the speech strongly mediated the relationship between diagnostic group and observers' performance ratings. These results are consistent with contemporary cognitive-behavioral and interpersonal models of SAD and suggest that socially anxious individuals' performance skills may be undermined by the use of safety behaviors. These data provide further support for recommendations from previous studies that the elimination of safety behaviors ought to be a priority in cognitive behavioral therapy for SAD.

Self-portrayal concerns and their relation to safety behaviors and negative affect in social anxiety disorder.

It has been proposed that self-portrayal concerns - fundamental worries that particular negative self-attributes will become exposed during social encounters and criticized by others - underlie the experience of social anxiety (SA) and drive associated avoidance and safety behaviors (Moscovitch, 2009). The development of the Negative Self Portrayal Scale (NSPS) to assess such concerns across the dimensions of social competence, signs of anxiety, and physical appearance has helped yield promising initial findings that support the basic tenets of Moscovitch's (2009) theoretical model in samples of undergraduate students (Moscovitch & Huyder, 2011). The present study investigated the nature of self-portrayal concerns and their relation to affect and behavior in a sample of 194 community-based participants consisting of (a) 62 individuals with a principal diagnosis of generalized SAD, either with (n = 35) or without (n = 27) an additional depressive disorder diagnosis, (b) 51 individuals with another principal anxiety disorder diagnosis, either with (n = 22) or without (n = 29) an additional diagnosis of SAD, and (c) 81 healthy controls. Participants completed trait questionnaires, daily diaries of naturalistic social encounters, and a laboratory-based speech task. Results demonstrated (a) that a diagnosis of SAD confers unique risk for elevated self-portrayal concerns, (b) that such concerns predict significant variance in safety behavior use across diverse contexts, and (c) that the use of safety behaviors mediates the relation between such concerns and the experience of heightened negative affect. Implications for case conceptualization and treatment of SAD are discussed.