Shame and loneliness in social anxiety disorder: A comparison with panic disorder

Abstract

Shame and loneliness are two important emotions that have been suggested to play a maintaining role in social anxiety disorder (SAD). However, it is not clear whether emotional processes involving these emotions are predominantly experienced in SAD or shared with other anxiety disorders. In the present study we examined the temporal relationship between shame and loneliness on one hand and anxiety on the other among individuals with SAD and among individuals with panic disorder (PD). We used a daily diary design in which participants reported their emotional experiences every evening for 21 consecutive days. We found that individuals with SAD had higher levels of shame but not higher levels of loneliness compared to individuals with PD. We also found evidence for a bidirectional relationship among individuals with SAD, in which anxiety on a given day predicted shame and loneliness on the following day, and shame and loneliness on given day predicted anxiety on the following day. This relationship was not found for individuals with panic disorder. Our findings are consistent with a negative cycle of emotions that may play a role in SAD. Implications for emotional models of psychopathology and for treatment of SAD are discussed.