3 - (SYM 34) The Nature and Accuracy of Worries in the Daily Social Lives of People with Social Anxiety

People with social anxiety (SA) spend considerable time worrying about what will happen if and when they socialize. Cognitive frameworks posit that these worries maintain anxiety and avoidance. Yet, we know little about the nature of these worries in everyday social interactions. Critically, the validity of these fears (i.e., how often the feared outcome occurs) is unclear, which has direct implications for targeting cognitive biases in cognitive-behavioral treatments.

Participants submitted 890 total EMA reports. When asked about their biggest fear, 15.4% of worries were about saying or doing something wrong, 14.4% about negative social judgment, 13.3% about upsetting someone, 13.1% about having an unpleasant or uncomfortable social experience, 7.4% about being rejected, 4.8% about saying or doing something “stupid”, and 4.8% about a social worry unrelated to the specific interaction. In addition, 10.6% of worries were non-social (worries that did not reference another individual or referred to an inanimate object), and 16.2% of reports did not contain a worry (e.g., “N/A”). Participants reported that these feared outcomes occurred in 33% of social interactions. In determining whether these fears were realized, participants most often used their own emotions (32.4%) or behaviors (31.2%) as their basis for judgment. They also used others’ behavior, either in response to something they did/said (18.2%) or independent of them (7.1%), changes in another person’s emotions (4.7%), and other (6.4%).

 Results suggest that people with SA frequently anticipate feared outcomes that do not occur, particularly those involving social judgment. This highlights the need for interventions that help individuals with SA assess the accuracy of their fears in social interactions. By focusing on how they determine whether feared outcomes occurred—often relying on subjective emotions or biased interpretations of behaviors—therapy can work to correct these cognitive distortions. Targeting these misjudgments in a person-centered, affirming approach can lead to more effective interventions that modify maladaptive beliefs and enhance social functioning.