Why Do Some People Develop Social Anxiety Disorder While Others Do Not?
Ever since it was officially recognized as a disorder in 1980 by the American Psychiatric Association, scientists all over the world have been trying to identify and understand the causes of social anxiety.
Like for most psychological conditions, the majority of contemporary professionals agree upon the idea that SAD is caused by a combination of genetics as well as environmental and socioeconomic factors.
What this means is that there is hardly one specific root cause of social anxiety, but rather a variety of factors that can lead to a certain vulnerability that favors the development of it.
It is important to note that even a combination of most of these factors does not necessarily cause social anxiety in an individual.
A person might be equipped with “social anxiety genes“, have been raised by overly critical parents and have an insecure attachment style, but never really struggles with social anxiety and generally feels confident around others. Despite a certain vulnerability, SAD does not develop.
In contrast, others may be affected by only very few of these factors and develop social anxiety as a result.
For instance, this may be the case for an individual who is usually outgoing and sociable and suffers a traumatizing social experience. In this case, direct conditioning might cause the development of SAD in performance situations.
Explainer Video: What Predisposes a Person to Develop Social Anxiety?
The 10 Possible Causes of Social Anxiety Disorder
Once again, a single determining factor for the development of SAD does not exist. Rather, the possibility of social anxiety emerging increases as certain predispositions combine.
The following factors have been linked to SAD and are believed to be possible causes of social anxiety.
Although researchers have not been able to identify a specific “social anxiety gene”, familial links are very common among those with SAD.
Especially those with generalized social anxiety disorder often have several relatives who are diagnosed with SAD or who have very shy, socially inhibited temperaments.
Therefore, genes seem to play a role for some affected people (Spence & Rapee, 2016).
(2) Insecure Attachment Style
The psychologist John Bowlby famously coined the term “attachment style” (1969). It refers to the way we relate to others, especially on an emotional level and is formed in early childhood.
A secure bond between child and mother (or other primary caregiver) lays the foundations for secure emotional bonding for the rest of the child’s life and is an important factor for psychological health.
If the mother does not respond to the child’s needs adequately enough, an insecure attachment style may be the result.
Studies suggest that an insecure attachment style is a risk factor for the development of SAD (Bohlin, Hagekull, & Rydell, 2000; Muris, Mayer, & Meesters, 2000).
(3) Parents’ Shortcoming
Many people with SAD report having been raised by parents that were overprotective, controlling, insensitive, rejecting, or emotionally distant.
Overcontrolling and rejecting parenting styles have been linked to the development of social anxiety (Parker, 1979; Bruch & Heimberg, 1994; Rapee & Melville, 1997; Bögels, Van Oosten, Muris, & Smulders, 2001; Burgess, Rubin, Cheah, & Nelson, 2001; Schmidt, Polak, & Spooner, 2001; Wood, McLeod, Sigman, Hwang, & Chu, 2003; Higa-McMillan & Ebesutani, 2011).
Parents who overemphasize the opinion of others, socially isolate their children, or shame them frequently seem to be more frequent among SAD sufferers as well (Bruch, Heimberg, Berger, & Collins, 1989; Stravynski, Elie, & Franche, 1989).
(4) Traumatic Social Experience(s)
About half of all people with SAD report that a social faux-pas which they experienced as highly humiliating marked the beginning of their social anxiety (Öst, 1985).
A common anecdote frequently recounted by SAD sufferers is that of being teased, made fun of or being laughed at for failing to adequately respond to a task at school, such as reading out loud or giving a presentation.
Psychologists refer to this type of learning as direct conditioning. By experiencing a very uncomfortable social situation, the brain tries to protect the organism from having to experience it again by activating brain areas responsible for fear responses. This often happens when only thinking of a similar experience.
This is the brain’s in-built protective system at work, unfortunately it is little helpful in the case of SAD.
(5) Witnessing Others’ Traumatic Social Experiences
There have been some interesting findings with non-human primates that suggest that by simply observing another person having a traumatic social experience can we learn to be fearful of similar situations (Öst & Hughdahl, 1981; Mineka & Cook, 1988; Mineka & Cook, 1991).
Witnessing the negative social consequences of others’ social faux-pas, the brain can be conditioned to fear similar situations, even though it did not experience them directly. For people with socially anxious parents or siblings, this may be a relevant cause.
(6) Significant Negative Life Events
It has been found that people with SAD frequently report negative life events, such as moving various times during childhood, having been sexually abused, parents’ divorce, significant illness during childhood, psychopathology of a parent, and family conflicts (Kessler, Davis, & Kendler, 1997; Magee, 1999; Lieb et al., 2000; Bandelow et al., 2004).
It seems as if experiences of this type represent another predisposition which increases vulnerability to developing SAD.
(7) Social Skills Deficit
People with SAD frequently question their social competence, although an overwhelming number of studies has shown that most SAD sufferers clearly underestimate their social performance (Cartwright-Hatton, Hodges, & Porter, 2003; Cartwright-Hatton, Tschernitz, & Gomersall, 2005, Clark & Arkowitz, 1975; Norton & Hope, 2001; Rapee & Abbott, 2006; Rapee & Lim, 1992; Stopa & Clark, 1993; Voncken & Bögels, 2008). On a same note, the majority of people with SAD additionally overestimates the visibility of their anxiety.
Still, some people with social anxiety do seem to lack social skills (e.g., Alden & Mellings, 2004, Alden & Wallace, 1995; Baker & Edelmann, 2002).
In these cases, a vicious cycle may emerge which ultimately leads to the development of SAD, considering that a deficiency in social skills is likely to lead to negative social experiences, which increases social avoidance, which yet again impedes the improvement of social skills (Spence et al., 1999).
(8) Cognitive Biases (or: unfavorable ways of thinking)
Cognitive biases relate to the way we perceive the world around us. They are highly dependent on our beliefs, moods, and the way we think.
Imagine being asked to rate your well-being on a Friday afternoon. Now imagine the same thing, but on a Monday morning. Your answers are likely going to differ in some way, given that the world tends to look more colorful with the weekend coming up.
Just as your way of thinking affected your answers in the imaginary survey above, people with social anxiety are strongly influenced by the beliefs they hold about themselves, others and the world.
Additionally, an anxious and depressed emotional state are likely to affect the way people with SAD perceive their surroundings and themselves in social situations.
It has been suggested that cognitive biases can lead to the development of SAD (Alfano & Beidel, 2011).
However, it is not clear whether they should be seen as root causes of social anxiety, since they can also be interpreted as mere manifestations or symptoms of the disorder.
(9) Biological Vulnerabilities
Although there is not enough evidence to prove the existence of structural abnormalities in social anxiety disorder, there have been some interesting findings that suggest certain biological differences.
- People with SAD show a stronger cortisol response when performing in front of an audience (Condren, O’Neill, Ryan, Barrett, & Thakore, 2002).
- People with generalized SAD possibly exhibit low dopamine system activity (Schneier et al., 1994-1995).
- SAD seems to be associated with hypersensitive postsynaptic serotonin receptors (Tancer 1993; Tancer et al., 1994-1995).
- People with circumscribed SAD (also: the specific subtype) show a greater heart rate reactivity in public speaking tasks (Heimberg, Hope, et al., 1990; Hofmann, Newman, Ehlers, & Roth, 1995; Levin, Saoud, Strauman, & Gorman, 1993).
- Socially anxious people’s amygdala (also: the “fear center of the brain“) shows greater activation for certain stimuli (Birbaumer et al., 1998; Schwartz, Wright, Shin, Kagan, & Rauch, 2003; Stein, Goldin, Sareen, Eyler-Zorrilla, & Brown, 2002, Tillfors et al., 2001).
Just as with cognitive biases, it is not clear whether these neurobiological differences are causes of social anxiety or if they should rather be considered manifestations of SAD after its onset.
(10) Cultural Influences
Individualistic cultures, such as found in Northern America and most parts of Europe, value social confidence, and outgoing individuals tend to strive in these societies.
This leaves people with reserved and shy temperaments in a position in which they either adjust their personality to societal standards or suffer from the consequences of not fitting in.
The latter often include receiving lower wages, having fewer friends and romantic partners, and struggling with the sensation of being inadequate, among others (Alden & Taylor, 2004; Hart, Turk, Heimberg, & Liebowitz, 1999; Spokas & Cardaciotto, 2014).
For people with this type of temperament, the development of SAD can be a consequence (Brockveld et al., 2014).
In collectivist cultures, such as found in Eastern Asia, a shy and rather reserved temperament is often appreciated. Very extroverted and outgoing people are often seen as rude and disrespectful in these societies.
And indeed, when looking at the prevalence of SAD in countries such as Japan and China, the numbers tend to be lower compared to Western countries, such as the United States and Russia (Hofmann, Asnaani, & Hinton, 2011).
Societal expectations may influence what is seen as functional impairment, and therefore what is classified as a psychological disorder.
However, while SAD, defined as fear of negative evaluation and humiliation, is not as common in collectivist cultures, another type of social fears can often be found in these societies.
Especially in Japan, a fear of making other people feel uncomfortable has been well documented. It has been suggested that this phenomenon, referred to as Taijin Kyofusho, relates to cultural norms that value interdependence and social harmony (Rector, Kocovski, & Ryder, 2006).
While the culture an individual grows up in seems to have an influence on the chances of developing SAD, it is rather to be treated as a predisposing factor instead of a fixed cause. But as pointed out several times before, this accounts for all the causes of social anxiety listed on this page.
Another thing to keep in mind is that psychological issues are not always easy to generalize, as a person’s unique biological makeup and life experiences create a peculiar way of being in the world.
That is, not everybody reacts the same way when faced with a given situation. This is also true for the emotional processing of disturbing life events and explains why not everybody affected by the above vulnerabilities develops SAD.
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