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1、附錄3Is Social Anxiety Associated With Both Interpersonal Avoidance and Interpersonal Dependence?We tested the hypothesis that social anxiety is associated with both interpersonal avoidance and interpersonal dependency.Specifically,we predicted that dependence would be evident in developmentally salie

2、nt close relationships upon which socially anxious people may rely.One hundred sixty-eight young people undergoing the transition to adulthood completed self-report measures of anxiety and interpersonal patterns.Results indicated that both dependent and avoidant interpersonal styles in romantic rela

3、tionships,but not other relationships,were uniquely associated with social anxiety.These results remained when controlling for depressive symptoms,anxiety sensitivity,and trait anxiety.Our findings illustrate that social anxiety is not characterized solely by interpersonal avoidance as current conce

4、ptualizations suggest.Implications for models and treatment of social anxiety are discussed.Social anxiety,defined as either a diagnosable disorder or as elevated levels of anxiety about social scrutiny,has been characterized by the avoidance of social situations due to fear of negative evaluation,a

5、nd in line with this,research supports the presence of avoidant styles of interacting among socially anxious people(e.g.Alden,Bieling,&Meleshko,1995;Alden&Phillips,1990;Dow,Bigland,&Glaser,1985;Leary,Knight,&Johnson,1987;Leary&Kowalski,1995).However,another line of research sugge

6、sts that social anxiety is characterized by a dependent style of relating to others.For example,socially anxious people often have higher levels of interpersonal dependency than individuals with other types of anxiety related problems(e.g.,Alnaes&Torgersen,1988;Bornstein,1995;Overholser,1997).In

7、terpersonal dependency is characterized by thoughts,feelings,and behaviors revolving around the need to associate closely with other people(Hirschfeld et al.,1977),which is seemingly contradictory to the characteristics of socially anxious people.Hence,the present study was designed to examine the a

8、ssociation between social anxiety,interpersonal avoidance,and interpersonal dependency.Specifically,we examined the extent to which social anxiety among young people was associated with each of these two seemingly contradictory interpersonal styles.There has been a dearth of research in the literatu

9、re examining the interpersonal styles of socially anxious people.The few studies that do exist have reported that socially anxious people exhibit inhibited social behavior,shyness,lack of assertion in group conversations,and feelings of inadequacy while in social situations(e.g.,Alden et al.,1995;Al

10、den&Phillips,1990;Gotlib&Meltzer,1987;Leary et al.,1987;Libet&Lewinsohn,1973),all of which are associated with an avoidant interpersonal style.Theoretically,the fearful or avoidant interpersonal styles of socially anxious people can be attributed to feelings of inadequacy,self-criticism,

11、and fear of negative evaluation and abandonment.However,these same attributes have been associated with interpersonal styles that reflect dependency,ranging from general personality orientations to severe personality disorders.For example,sociotropy,which is a personality style characterized by depe

12、ndence on others and a need for involvement in relationships,has been theorized to result from low self-esteem,self-criticism,and fear of rejection from others(e.g.,Beck,1983;Blatt,Quinlan,Chevron,McDonald,&Zuroff,1982;Ouimette,Klein,Anderson,&Riso,1994;Robins&Luten,1991;Zuroff&Mongr

13、ain,1987).Similarly,dependent personality disorder is characterized by feelings of inadequacy and fears of abandonment(American Psychiatric Association,1994).As such,socially anxious people potentially could exhibit dependent styles as well as avoidant ones.In fact,social anxiety is associated with

14、traits of dependent and avoidant personality disorders(e.g.,Alnaes&Torgersen,1988;Bornstein,1995;Johnson,Turner,Beidel,&Lydiard,1995;Turner,Beidel,&Townsley,1992).Furthermore,avoidant and dependent personality traits often cooccur(e.g.,Trull,Widiger,&Frances,1987).Thus,it would be im

15、portant to sort out the extent to which and the conditions under which socially anxious people engage in dependent styles of relating in addition to avoidant styles.In order to examine the extent to which social anxiety is associated with both interpersonal dependency and avoidance,we examined the a

16、ttachment patterns of young people ranging in social anxiety severity.There are two patterns of attachment that appear to have implications for social anxiety:preoccupied and fearful avoidant.The fearful avoidant pattern of attachment is characterized by an avoidant interpersonal style in which peop

17、le avoid intimacy with others due to fear of rejection.This is exactly what current theories of social anxiety would predict regarding interpersonal behavior(e.g.,Hazen&Stein,1995;Liebowitz,Gorman,Fyer,&Klein,1985;Rapee,1995).The preoccupied pattern is characterized by a dependent interperso

18、nal style in which people are excessively dependent on relationships for emotional and tangible support.Although this may seem inconsistent with a socially anxious style,both of these patterns of attachment are elicited and exacerbated by a negative evaluation of the self(Bartholomew,1990;Bartholome

19、w&Horowtiz,1991),which is prominent among socially anxious people.In addition,dimensions underlying these patterns are associated with social anxiety(e.g.,Eng,Heimberg,Hart,Schneier,&Liebowitz,2001;Mickelson,Kessler,&Shaver,1997).Therefore,we predicted that social anxiety would be associ

20、ated with both fearful and preoccupied attachment patterns.In addition,we were interested in the conditions under which the above assoavoid social situations,due to their heightened levels of fear and anxiety while interacting with others.The most commonly feared social situations among socially anx

21、ious people tend to be social gatherings,performance situations,such as public speaking,and meeting new people(e.g.,Holt,Heimberg,Hope,&Liebowitz,1992;Turner et al.,1992).However,all of these social situations typically involve interactions with strangers or acquaintances,rather than interaction

22、s in close relationships.Hence,although socially anxious people typically avoid interactions with strangers or nonclose others,the extent to which socially anxious people avoid interactions with close others is unclear.Indeed,there is evidence that anxious people instead depend on close relationship

23、s to help them feel better in anxiety provoking situations.For example,Carter,Hollon,Carson,and Shelton(1995)found that among agoraphobics,anxiety can be pacified somewhat if a close other is present.Generalizing from these findings,it may be that the anxiety experienced in social situations will be

24、 assuaged if the socially anxious person can depend on a close other for emotional support.A socially anxious person may not have the intense fear of embarrassment or negative evaluation if they have the support of a close other in what they perceive to be a frightening social situation.Hence,we pre

25、dicted that socially anxious people would exhibit a dependent(i.e.,preoccupied),in addition to an avoidant(i.e.,fearful)style in close relationships.We also were interested in whether this would be true across all close relationships.Different close relationships are salient across different ages an

26、d developmental phases.As such,socially anxious people may exhibit dependence only in those relationships that are most close,safe,and salient.To examine this possibility,we selected a sample of young people,with varying levels of social anxiety,who were undergoing the transition to adulthooda time

27、during which their interpersonal worlds shift.During this transition,peers become more salient and closer as people move away(physically and psychologically)from their parents.Similarly,during this time,attachment functions are transferred from parents to peers and ultimately to romantic partners(e.

28、g.,Fraley&Davis,1997;Hazan&Shaver,1987;1994).Hence,we predicted that dependency(preoccupation)would be more evident in romantic relationships than parental relationships given the importance of peer relationships in this age group.We also selected a sample transitioning to adulthood because

29、of the advantage it confers in studying social anxiety.Research indicates that the average age of onset of social anxiety is the mid-to-late teens(e.g.,Mannuzza,Fryer,Leibowitz,&Klein,1990).Hence,we are capturing people early in this process,which allows for greater understanding of interpersona

30、l factors during the genesis of social anxiety problems.In addition,all participants were in college,a time during which they are faced with many situations involving meeting new people,public speaking,and talking to authority(e.g.,professors).These situations tend to be particularly difficult for s

31、ocially anxious people,as they evoke strong concerns about negative evaluation and potential failure(e.g.,Alden&Wallace,1995;Kocovoski&Endler,2000;Rapee,Sanderson,&Barlow,1988).Hence,the choice of a young sample was designed to capture participants during a time of transition when issues

32、 involving social presentation,interpersonal relationships,and anxiety appear to be prominent.To summarize,this study tested the hypothesis that social anxiety is associated with both avoidant and dependent interpersonal patterns in close relationships.Furthermore,we predicted that dependence would

33、be most evident in peer relationships(romantic relationships)than in parental relationships as peer relationships take on a greater importance than parental relationships during young adulthood.Finally,because research has indicated a similarity in interpersonal styles among people with social anxie

34、ty and depressive symptoms,we controlled for depressive symptoms.Research also has indicated an association between other anxiety symptoms and avoidant interpersonal styles(e.g.,Mavissakalian,Hamann,Haidar,&De Groot,1995),and an association between social anxiety and other anxiety symptoms such

35、as anxiety sensitivity and generalized anxiety.Therefore,we controlled for these symptoms in order to examine the unique associations between social anxiety and the two interpersonal styles.ParticipantsParticipants were 168 students(80 males,88 females)enrolled in Introductory Psychology during the

36、fall semester of 1999 and spring semester of 2000 at SUNY Buffalo.As part of a larger study(see Davila&Beck,2002),students were selected on the basis of their scores on the Anxiety Sensitivity Index(ASI;Reis,Peterson,Gursky,&McNally,1986).The ASI has been shown to serve as a risk factor for

37、the development of clinically significant symptoms of anxiety(Maller&Reis,1992;Schmidt,Larew,&Jackson,1999).All Introductory Psychology students completed the ASI during mass testing procedures.Their scores were screened by the investigators,using the norms set forth by McNally and colleague

38、s(Holloway&McNally,1987),and students were categorized into three groups:(1)high ASI(females scoring 30 and higher,males scoring 23 and higher);(2)low ASI(females scoring 10 or lower,males scoring 7 or lower;and(3)moderate ASI(scores falling in between).Project staff,who were unaware of ASI stat

39、us,then called and recruited an equal number of high,moderate,and low ASI males and females to participate in the study. The participants had an average age of 18.72(SD=1.05).Procedure and MeasuresAs part of a larger study,participants completed a packet of questionnaires containing an assessment of

40、 attachment patterns,depressive and anxiety symptoms,and anxiety sensitivity.The participants received course credit for participating in the study.RESULTSZero-order correlations,means,and standard deviations of all variables are presented in Table I.Social anxiety was correlated with both a preoccu

41、pied and an avoidant attachment pattern,suggesting that social anxiety is not associated with an avoidant interpersonal style only.Additionally,the preoccupied and fearful attachment patterns were correlated within relationships.That is,preoccupied partner was correlated with fearful partner,preoccu

42、pied mother was correlated with fearful mother,and preoccupied father was correlated with fearful father.Moreover,depressive symptom and anxiety variables were correlated as expected based on previous research in this domain(e.g.Mineka,Watson,&Clark,1998).Is Social Anxiety Associated With Preocc

43、upied and Fearful Patterns of Attachment?A series of hierarchical multiple regression analyses were conducted predicting social anxiety.Fearful attachment scores were entered first,followed by preoccupied scores in order to examine whether a dependent(preoccupied)style was associated with social anx

44、iety over and above the association with a fearful avoidant style.Analyses were conducted separately for mother,father,and romantic partner.As shown in Table II,consistent with our predictions,in romantic relationships,the preoccupied style accounted for significant variance in social anxiety over a

45、nd above that accounted for by the fearful style;although,as the betas from the final step of the analysis show,both fearful and preoccupied styles in romantic relationships were uniquely associated with social anxiety.However,for relationship with mother,only the fearful style was associated with s

46、ocial anxiety.For relationship with father,neither style was significantly associated with social anxiety.Is Social Anxiety Associated With Preoccupied and Fearful Attachment Patterns When Controlling for Depressive Symptoms,Anxiety Sensitivity,and Trait Anxiety?Because we wanted to examine whether

47、there was a unique association between social anxiety and the two interpersonal styles,hierarchical regression analyses were conducted as described above,except the symptom measures were entered first in the analysis.Separate analyses were conducted for each symptom measure and for each type of rela

48、tionship(i.e.,romantic partner,mother,father),resulting in nine analyses.As shown in Table III,for romantic relationship with partner,the association between social anxiety and a preoccupied interpersonal style remained significant when controlling for depressive symptoms,anxiety sensitivity,and tra

49、it anxiety(analyses 1,2,and 3).Additionally,the association between social anxiety and fearful interpersonal style remained significant when controlling for depressive symptoms.For relationship with mother,the association between social anxiety and a fearful interpersonal style remained significant

50、when controlling for anxiety sensitivity and depressive symptoms(analysis 5 and 7).However,the association became nonsignificant when controlling for trait anxiety(analysis 6).Finally,for relationship with father,as before there was not a significant association between social anxiety and either of

51、the two interpersonal styles when controlling for depressive symptoms,trait anxiety,and anxiety sensitivity.7Supplementary AnalysesAlthough not the focus of our study,there were a number of associations that emerged that warranted attention because they diverged from typical findings in the anxiety

52、literature.Specifically,as shown in Table I,anxiety sensitivity was strongly associated with depressive symptoms,trait anxiety,and social anxiety.This is notable given that some research suggests that anxiety sensitivity is specifically associated with certain types of anxiety(e.g.,panic disorder;Ta

53、ylor,1999).To further explore this,we compared the strength of the correlations using procedures outlined by Meng,Rosenthal,and Rubin(1992).The association between anxiety sensitivity and social anxiety was significantly stronger than that between anxiety sensitivity and trait anxiety(z=3.28,p<.0

54、1).The association between anxiety sensitivity and depressive symptoms was also significantly stronger than that between anxiety sensitivity and trait anxiety(z=6.04,p<.01).However,the association between anxiety sensitivity and social anxiety was not significantly different from that between anx

55、iety sensitivity and depressive symptoms(z=1.41,ns).In another set of analyses,when we examined partial correlations,anxiety sensitivity retained its association with depressive symptoms,social anxiety,and trait anxiety,when controlling for each of the others.Therefore,our results do not support spe

56、cificity.Instead,our findings are consistent with the comorbidity that is typically observed among various anxiety and depressive symptoms.DISCUSSIONThe purpose of this study was to examine associations between social anxiety and two seemingly contradictory interpersonal styles:avoidance and depende

57、nce.Although social anxiety typically is characterized by interpersonal avoidance,we predicted that social anxiety also would be associated with interpersonal dependence when studied in the context of close relationships.Moreover,we predicted that this is most likely to be true in close relationship

58、s that are developmentally salient.Our sample was undergoing the transition to adulthood,a time when peer and romantic relationships typically take on greater significance than family relationships(Fraley&Davis,1997;Hazan&Shaver,1987;1994).Hence,we expected the greatest levels of dependence

59、to be reported with regard to romantic relationships.Results supported these predictions.First,at the zero-order level,social anxiety was associated with avoidant(fearful)and dependent(preoccupied)interpersonal styles in relationships with mother,father,and romantic partners,suggesting that social a

60、nxiety is not characterized by avoidance alone,at least in the context of close relationships.This is consistent with prior research linking social anxiety to a dependent interpersonal style(e.g.,Alnaes&Torgersen,1988;Bornstein,1995;Overholser,1997).Second,even when controlling for the association between avoidance and dependence,both had a unique association with social anxiety when assesse

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