“I Want to Be Alone, but I Don’t Want to Be Lonely”: Uncertainty Management Regarding Social Situations among College Students with Social Anxiety Disorder

ABSTRACT

Individuals with social anxiety disorder (iSAD) experience adverse outcomes in daily life due to the disorder (e.g., lower educational and work achievement compared to their healthy counterparts). They are prone to social isolation, even though they desire intimate interpersonal relationships. Yet, little research on iSAD is devoted to understanding in detail a) when they interpret social situations as social-anxiety-provoking, b) how this interpretation motivates their assessments of their efficacy and likely interaction outcomes, and c) how they choose specific information-seeking strategies in uncertain social situations. Leveraging the theory of motivated information management (TMIM) and the emotional systems (ES) model, we explored the lived experiences of iSAD. We conducted in-depth interviews (N = 27) and analyzed them using thematic analysis. iSAD perceived discrepancies in a) mutual goals, b) common ground, and c) self-image as social-anxiety-provoking. These interpretations motivated their assessments of a) socializing benefits, b) communication competency, and c) interactant partner’s amiability, which led to a mix of information-seeking decisions in social situations. Practical and theoretical implications for future research are discussed.

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No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1. While anxiety and fear are typical human responses, SAD involves extreme anxiety and fear that are pathological and not “adapted for” responses, which can persist over long periods (APA, 2013; WHO, 2018).

2. Roseman’s (2013) theory, and evidence in support of it, supports specific in-the-moment emotional appraisals (differentiating specific emotions, resulting from concurrent factors such as the cause of uncertainty or motive consistency) accompanied by an empirically-based “emotional syndrome” of component cues (phenomenological, expressive; behavioral, e-motivational goal), many of which afford observable micro-changes that can rapidly shift from moment to moment (e.g., micro movements such as stopping or moving toward).

3. Motive inconsistency (versus consistency) refers to the adaptive value of internal and external changes such that getting less (more) of it minimizes harm (maximizes benefits) (Roseman, 2013).

4. The interview protocol is available from the corresponding author upon request.

5. This process is highly similar to the processes used for qualitative interviews in initially designing a virtual reality intervention game for men who have sex with men (MSM). Analyzing the interviews successfully enabled instantiation of situations in virtual reality environments to which individual participants would respond as they did in everyday life (Miller et al., 2011). Ultimately, the results of the current study, along with additional formative research, can be used to design virtual reality environments that resemble the situational cues present when individuals with SAD experience social anxiety in everyday life, which can activate problematic response patterns that may be targeted for intervention change.

6. Here we use common ground to refer to both the construction of shared meaning but also the production of behavior that fits within shared cultural expectations.

7. For further discussion, see Miller, Jeong et al. (2019) and Miller, Shaikh et al. (2019).

8. An examination of our findings in light of Parks’s (1994) hierarchical model of communication skills also points to communicative competencies that may be helpful for iSAD in terms of training their communication skills. For instance, here are some of the communication competences suggested in Parks’s model that may be targeted for SAD interventions: (a) ability to satisfy personal goals in a given context without jeopardizing more important goals in other contexts, (b) ability to improvise plans of action when interaction is disrupted, and (c) ability to interpret one’s own actions and the actions of others from a variety of perspectives.

9. This is in line with work on virtual reality exposure therapy that has been regarded as an innovative method to improve psychological impairments (e.g., Rizzo & Koenig, 2017; Rizzo et al., 2019).

10. Comorbidities that our participants reported include general anxiety disorder, depression, bipolar disorder, attention deficit hyperactivity disorder, and post-traumatic stress disorder.

Additional information

Funding

This project was supported by the USC Graduate School and an Annenberg Doctoral Student Summer Research Fellowship.