What explains social anxiety in adolescents with Social Anxiety Disorder and healthy controls? The applicability of the Clark and Wells’ model

Clark and Wells’ model for social anxiety proposed several maintenance factors for social anxiety (SA), which is assumed to exist in a continuum from normative to pathological levels (i.e., Social Anxiety Disorder – SAD). Based on these premises, we used a cross-sectional design to investigate pathways linking those maintenance factors to SA, in adolescents (Mage = 16.02, SD = .97) with SAD (n = 30) and healthy controls (n = 23), who filled in self-report questionnaires about those variables. Separate moderation models were tested using the same dependent variable (i.e., SA) and different independent variables (i.e., Negative Social Thoughts and Beliefs, Self-focused Attention, and Safety-seeking Behaviors); group was the moderating variable. All variables were significant predictors of SA, explaining between 80% (i.e., Self-focused Attention) and 83% (i.e., Safety-seeking Behaviors and Negative Social Thoughts and Beliefs) of its variance. Group was never a significant moderator. These results favor Clark and Wells’ model for explaining SA along its continuum. The pervasiveness of negative cognitions, safety-seeking behaviors, and self-focused attention in adolescents with SAD seems to contribute to a more disrupting experience of SA. As such, addressing these maintenance factors may be useful, as a preventive and remedial approach to SA in adolescence.