Social anxiety and dissociation: the moderating role of emotion regulation

Cook, Matthew A.; Newins, Amie R.

doi:10.1007/s11031-021-09875-5

Original Paper
Published: 13 March 2021

Social anxiety and dissociation: the moderating role of emotion regulation

Matthew A. Cook¹ &
Amie R. Newins¹

Motivation and Emotion volume 45, pages 345–353 (2021)Cite this article

966 Accesses
2 Citations
11 Altmetric
Metrics details

Abstract

Social anxiety is associated with dissociative experiences, which are thought to occur when coping or avoidance is unavailable, and distress is experienced. Emotion regulation difficulties maintain social anxiety. The current study examined the moderating effect of emotion regulation on social anxiety and dissociation. It was hypothesized that social anxiety would be positively associated with dissociation and that emotion regulation difficulties would moderate the relationship between social anxiety and dissociation such that the relationship would be stronger at higher levels of emotion regulation difficulties. College students aged 18 or older (n = 572) were recruited from a large public university. All participants completed measures of social anxiety, emotion regulation, and dissociation as part of a larger online study. Results supported both hypotheses. Future studies should investigate dissociative symptoms during times of acute stress or anxiety in social anxiety, how emotion regulation difficulties are associated with the genesis of dissociative symptoms, and how these variables are related in more diverse community samples.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

References

Aiken, L. S., West, S. G., & Reno, R. R. (1991). Multiple regression: Testing and interpreting interactions. Sage.
Google Scholar
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004
Article PubMed Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
Book Google Scholar
Baker, D., Hunter, E., Lawrence, E., Medford, N., Patel, M., Senior, C., Sierra, M., Lambert, M. V., Phillips, M. L., & David, A. S. (2003). Depersonalisation disorder: clinical features of 204 cases. The British Journal of Psychiatry, 182(5), 428–433.
Article PubMed Google Scholar
Beidel, D. C., & Turner, S. M. (2007). Shy children, phobic adults: Nature and treatment of social anxiety disorder (2nd ed.). American Psychological Association.
Book Google Scholar
Blevins, C. A., Weathers, F. W., & Mason, E. A. (2012). Construct validity of three depersonalization measures in trauma-exposed college students. Journal of Trauma and Dissociation, 13(5), 539–553. https://doi.org/10.1080/15299732.2012.678470
Article PubMed Google Scholar
Clark, D. M. (2001). A cognitive perspective on social phobia. In W. R. Crozier & L. E. Alden (Eds.), International handbook of social anxiety: Concepts, research and interventions relating to the self and shyness (pp. 405–430). John Wiley & Sons Ltd.
Google Scholar
Daros, A. R., Daniel, K. E., Meyer, M. J., Chow, P. I., Barnes, L. E., & Teachman, B. A. (2019). Impact of social anxiety and social context on college students’ emotion regulation strategy use: An experience sampling study. Motivation and Emotion, 43(5), 844–855.
Article Google Scholar
Dell, P. F., & O’Neil, J. A. (Eds.). (2009). Dissociation and the dissociative disorders: DSM-5 and beyond. Taylor & Francis Group LLC.
Google Scholar
Dixon, L. J., Tull, M. T., Lee, A. A., Kimbrel, N. A., & Grats, K. L. (2017). The role of emotion-driven impulse control difficulties in the relation between social anxiety and aggression. Journal of Clinical Psychology, 73(6), 722–732. https://doi.org/10.1002/jclp.22372
Article PubMed Google Scholar
Filho, A. S., Hetem, L. A., Ferrari, M. C., Trzesniak, C., Martín-Santos, R., Borduqui, T., de Lima, O. F., Loureiro, S. R., Busatto Filho, G., Zuardi, A. W., & Crippa, J. A. (2010). Social anxiety disorder: what are we losing with the current diagnostic criteria? Acta Psychiatrica Scandinavica, 121(3), 216–226. https://doi.org/10.1111/j.1600-0447.2009.01459.x
Article PubMed Google Scholar
Goldin, P. R., & Gross, J. J. (2010). Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion, 10(1), 83–91. https://doi.org/10.1037/a0018441
Article PubMed PubMed Central Google Scholar
Goldin, P. R., Manber-Ball, T., Werner, K., Heimberg, R., & Gross, J. J. (2009). Neural mechanisms of cognitive reappraisal of negative self-beliefs in social anxiety disorder. Biological Psychiatry, 66(12), 1091–1099. https://doi.org/10.1016/j.biopsych.2009.07.014
Article PubMed PubMed Central Google Scholar
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54.
Article Google Scholar
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299.
Article Google Scholar
Helbig-Lang, S., Rusch, S., & Lincoln, T. M. (2014). Emotion regulation difficulties in social anxiety disorder and their specific contributions to anxious responding. Journal of Clinical Psychology, 71(3), 241–249. https://doi.org/10.1002/jclp.22135
Article PubMed Google Scholar
Hermann, C., Ofer, J., & Flor, H. (2004). Covariation bias for ambiguous social stimuli in generalized social phobia. Journal of Abnormal Psychology, 113(4), 646–653. https://doi.org/10.1037/0021-843X.113.4.646
Article PubMed Google Scholar
Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 36(4), 193–209. https://doi.org/10.1080/16506070701421313
Article PubMed PubMed Central Google Scholar
Hofmann, S. G. (2005). Perception of control over anxiety mediates the relation between catastrophic thinking and social anxiety in social phobia. Behaviour Research and Therapy, 43(7), 885–895. https://doi.org/10.1016/j.brat.2004.07.002
Article PubMed Google Scholar
Hofmann, S. G., & Roth, W. T. (1996). Issues related to social anxiety among controls in social phobia research. Behavior Therapy, 27(1), 79–91.
Article Google Scholar
Hoyer, J., Braeuer, D., Crawcour, S., Klumbies, E., & Kirschbaum, C. (2013). Depersonalization/derealization during acute social stress in social phobia. Journal of Anxiety Disorders, 27(2), 178–187. https://doi.org/10.1016/j.janxdis.2013.01.002
Article PubMed Google Scholar
Kashdan, T. B., & Breen, W. E. (2008). Social anxiety and positive emotions: A prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable. Behavior Therapy, 39(1), 1–12. https://doi.org/10.1016/j.beth.2007.02.003
Article PubMed Google Scholar
Kashdan, T. B., & McKnight, P. E. (2010). The darker side of social anxiety: When aggressive impulsivity prevails over shy inhibition. Current Directions in Psychological Science, 19(1), 47–50. https://doi.org/10.1177/0963721409359280
Article Google Scholar
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(3), 169–184.
Article PubMed PubMed Central Google Scholar
Medford, N. (2012). Emotion and the unreal self: depersonalization disorder and de-affectualization. Emotion Review, 4(2), 139–144. https://doi.org/10.1177/1754073911430135
Article Google Scholar
Michelson, L. K., & Ray, W. J. (Eds.). (1996). Handbook of dissociation: Theoretical, empirical, and clinical perspectives. Plenum Press.
Google Scholar
Nicholls, J., Staiger, P. K., Williams, J. S., Richardson, B., & Kambouropoulos, N. (2014). When social anxiety co-occurs with substance use: Does an impulsive social anxiety subtype explain this unexpected relationship? Psychiatry Research, 220(3), 909–914. https://doi.org/10.1016/j.osychres.2014.08.040
Article PubMed Google Scholar
Noyes, R., Hoenk, P. R., Kuperman, S., & Slymen, D. J. (1977). Depersonalization in accident victims and psychiatric patients. Journal of Nervous and Mental Disease, 164(6), 401–407. https://doi.org/10.1097/00005053-197706000-00005
Article Google Scholar
Purdon, C., Antony, M., Monteiro, S., & Swinson, R. P. (2001). Social anxiety in college students. Journal of Anxiety Disorders, 15(3), 203–215. https://doi.org/10.1016/S0887-6185(01)00059-7
Article PubMed Google Scholar
Roberson-Nay, R., Strong, D. R., Nay, W. T., Beidel, D. C., & Turner, S. M. (2007). Development of an abbreviated social phobia and anxiety inventory (SPAI) using item response theory: The SPAI-23. Psychological Assessment, 19(1), 133–145. https://doi.org/10.1037/1040-3590.19.1.133
Article PubMed Google Scholar
Roth, M. (1959). The phobic anxiety-depersonalization syndrome. Proceedings of the Royal Society of Medicine, 52(8), 587–595.
Article PubMed PubMed Central Google Scholar
Ruscio, A. M., Brown, T. A., Chiu, W. T., Sareen, J., Stein, M. B., & Kessler, R. C. (2008). Social fears and social phobia in the USA: Results from the National Comorbidity Survey Replication. Psychological Medicine, 38(1), 15–28. https://doi.org/10.1017/S0033291707001699
Article PubMed Google Scholar
Schry, A. R., Roberson-Nay, R., & White, S. W. (2012). Measuring social anxiety in college students: A comprehensive evaluation of the psychometric properties of the SPAI-23. Psychological Assessment, 24(4), 846–854. https://doi.org/10.1037/a0027398
Article PubMed Google Scholar
Schweden, T. L., Pittig, A., Bräuer, D., Klumbies, E., Kirschbaum, C., & Hoyer, J. (2016). Reduction of depersonalization during social stress through cognitive therapy for social anxiety disorder: A randomized controlled trial. Journal of Anxiety Disorders, 43, 99–105. https://doi.org/10.1016/j.janxdis.2016.09.005
Article PubMed Google Scholar
Sierra, M., & Berrios, G. E. (2000). The Cambridge depersonalization scale: A new instrument for the measurement of depersonalization. Psychiatry Research, 93(2), 153–164. https://doi.org/10.1016/S0165-1781(00)00100-1
Article PubMed Google Scholar
Stein, M. B., Asmundson, G. J., & Chartier, M. (1994). Autonomic responsivity in generalized social phobia. Journal of Affective Disorders, 31(3), 211–221.
Article PubMed Google Scholar
Trueman, D. (1984). Depersonalization in a nonclinical population. The Journal of Psychology, 116(1), 107–112. https://doi.org/10.1080/00223980.1984.9923624
Article PubMed Google Scholar
Tutkun, H., Savas, H. A., Zoroglu, S. S., & Esgi, K. (2004). Relationship between alexithymia, dissociation and anxiety in psychiatric outpatients from Turkey. The Israel Journal of Psychiatry and Related Sciences, 41(2), 118–124.
PubMed Google Scholar

Download references

Funding

This study was not funded.

Author information

Authors and Affiliations

Department of Psychology, University of Central Florida, 4111 Pictor Lane, Orlando, FL, 32816, USA
Matthew A. Cook & Amie R. Newins

Authors

Matthew A. Cook
View author publications
You can also search for this author in PubMed Google Scholar
Amie R. Newins
View author publications
You can also search for this author in PubMed Google Scholar

Contributions

MC designed and conducted the original study, developed the hypotheses for this manuscript, conducted the statistical analyses, and wrote the initial drafts of the introduction and method, results, and discussion sections. ARN assisted in designing the original study and conducting the statistical analyses, and assisted with writing the introduction, method, results, and discussion sections. All authors contributed to and have approved the final manuscript.

Corresponding author

Correspondence to Matthew A. Cook.

Ethics declarations

Conflict of interest

All authors declare that they have no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Cook, M.A., Newins, A.R. Social anxiety and dissociation: the moderating role of emotion regulation. Motiv Emot 45, 345–353 (2021). https://doi.org/10.1007/s11031-021-09875-5

Download citation

Accepted: 26 February 2021
Published: 13 March 2021
Issue Date: June 2021
DOI: https://doi.org/10.1007/s11031-021-09875-5

Keywords

Social anxiety
Emotion regulation difficulties
Dissociation
Depersonalization
Derealization
Moderation