A Social Identity Approach to Social Anxiety

Abstract

Social anxiety disorder (SAD) is a common and disabling condition, with prevalence rates increasing since the COVID-19 pandemic. SAD is defined as a fear of negative evaluation, causing psychological distress and impairment as well as significant economic costs. There are a number of evidence-based therapies available for SAD, with cognitive behavioural therapy (CBT) recommended as the condition's frontline treatment. As such, the development and maintenance of social anxiety symptoms have been largely conceptualised through a cognitive behavioural lens. Yet, remission rates for CBT for SAD are lower than those of other anxiety disorders, and researchers have cited a need for alternative conceptualisations of the condition. In particular, there is a lack of theoretical work, and associated empirical evidence, outlining the role of social processes in social anxiety and how these interact with individualistic, cognitive behavioural processes. This thesis offers a social psychological analysis of social anxiety, using the social identity approach, and integrates this with current cognitive behavioural theorising. The social identity approach argues that people's group memberships, when internalised into their sense of self, form social identities. Social identities provide the individual with psychological resources like a sense of meaning, self-esteem, and social support, which, in turn, support health and well-being. In particular, having multiple social identities (termed multiple group memberships) has been found to be particularly beneficial. In this thesis I extend current social identity theorising and develop a novel social identity model of social anxiety (SIMSA) and test several of its propositions across three empirical studies. First, I demonstrate that those who maintained multiple group memberships over the initial phase of the COVID-19 pandemic (February to August 2020) had lower anxiety in anticipation of future feared social situations (August 2020) and, through this, lower social anxiety symptoms (October 2020). Second, I show that multiple group memberships are associated with lower social anxiety symptoms because they reduce self-focused attention, a maladaptive attentional process which maintains social anxiety. Finally, I present the first test of a social identity informed intervention, GROUPS 4 HEALTH, among a population with clinical levels of social anxiety. Here I demonstrate that the program is efficacious, with improvements in social anxiety, loneliness, depression, and well-being from baseline to 5-month follow-up. Further, I utilise participant interviews to determine the program's acceptability and feasibility. Together, my PhD findings have clear implications for clinical practice, for example, that efforts to boost people's social identities will likely improve their social anxiety symptoms. In addition, through the development of SIMSA I provide the groundwork for further theoretical integration between the social identity and cognitive behavioural literatures. Show more