Influence of Comorbid Social Anxiety Disorder on Symptomatology and Social Functioning in Female Military Sexual Trauma Survivors with PTSD

Abstract Military sexual trauma (MST) is a common experience in veterans and associated with numerous negative outcomes, such as posttraumatic stress disorder (PTSD), diagnostic comorbidity, and impairments in multiple domains, including social functioning. Comorbid social anxiety disorder (SOC) may represent a particularly challenging presentation due to added difficulties with social functioning and treatment response. The present study investigated severity, emotion regulation, and perceived support and functioning of comorbid SOC in female MST survivors with PTSD. Participants were recruited for a randomized clinical trial that compared telehealth and in-person delivery of evidence-based psychotherapy for PTSD. Of the 112 participants with PTSD, 30 participants (27%) also met criteria for comorbid SOC on a diagnostic interview. Participants with comorbid PTSD-SOC endorsed poorer emotion regulation, less positive affect, and greater negative affect compared to participants with PTSD without SOC comorbidity. Participants with comorbid PTSD-SOC also were less likely to be involved in a romantic relationship and evidenced increased difficulties in sharing thoughts and feelings with family members and friends. Together, these findings suggest that SOC comorbidity in patients with MST-related PTSD is associated with increased impairments in emotion regulation and social functioning.