Social anxiety disorder warps view of friendship

"Current treatments focus, in part, on helping people with social anxiety disorder see that they come across better than they expect they will," says Thomas Rodebaugh. "Our study suggests that's true for specific friendships as well." (Credit: iStockphoto)

People with social anxiety disorder tend to have trouble making friends—and to assume the friendships they have are not high quality.

The problem with this perception, according to new research, is that their friends don’t necessarily agree.

“People who are impaired by high social anxiety typically think they are coming across much worse than they really are,” says study coauthor Thomas Rodebaugh, associate professor of psychology at Washington University in St. Louis. “This new study suggests that the same is true in their friendships.”

The study, published this month in the Journal of Abnormal Psychology, finds that people with social anxiety disorder often overestimate how bad their relationships are with friends, when compared to what the friends say.

Much more than simple shyness, social anxiety disorder is a recognized psychiatric condition in which those struggling with the affliction often live in fear of meeting new people, passing up social invitations or work opportunities for fear of being rejected, embarrassed, or otherwise singled out as a failure.

By some estimates, 13 percent of people in Europe and the United States experience social anxiety disorder. The disorder ranges in severity, from less severe, yet impairing fears of a single situation (most often public speaking), to fears about interacting with people in general.

Friends disagree

Based on a battery of psychological tests designed to assess friendship quality, Rodebaugh’s study involved a group of 112 participants, each diagnosed as having or not having social anxiety disorder. Each participant brought along a friend from a non-romantic relationship who agreed to take part in the testing.


“People with social anxiety disorder report that their friendships are worse, but their friends didn’t see it the same way,” Rodebaugh says. “Their friends seem to say something more like: ‘It’s different, but not worse.'”

These misperceptions were stronger and more prevalent among younger study participants and in situations where the friendship was relatively new, researchers found.

“The friends of people with social anxiety disorder did seem to be aware that their friends were having trouble, and additionally saw the person with social anxiety disorder as less dominant in the friendship,” Rodebaugh says.

The findings could play an important role in helping people with social anxiety disorder understand that their friendships may not be as terrible as they might imagine. Helping people form friendships is important because many studies confirm that the lack of strong social networks can leave people vulnerable to a host of problems, including disease, depression, and even earlier mortality, Rodebaugh says.

The good news is that social anxiety disorder is treatable. Decades of research suggests that talk therapy, such as cognitive behavioral treatment, is as, or even more, effective than medications for long term treatment of the disorder.

“Current treatments focus, in part, on helping people with social anxiety disorder see that they come across better than they expect they will,” Rodebaugh says. “Our study suggests that’s true for specific friendships as well.”

The National Institute of Mental Health and the National Institutes of Health supported the study.

Source: Washington University in St. Louis