Social anxiety disorder, characterized by intense worries and fears about social situations, is highly prevalent and disabling if untreated.
By generating distress in interpersonal contexts and daily activities, social anxiety diminishes quality of life and limits academic and career potential. Socially anxious individuals are at risk for depression, substance abuse, and suicide if their condition persists without intervention.
Eres, R., Lim, M. H., & Bates, G. (2023). Loneliness and social anxiety in young adults: The moderating and mediating roles of emotion dysregulation, depression and social isolation risk. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12469
Key Points
- Loneliness predicts future social anxiety symptoms and is thought to be mediated by emotion dysregulation and depression.
- Social isolation risk moderates the relationships between loneliness, emotion dysregulation, depression, and social anxiety.
- Young adults with lower social isolation risk may be protected against poor mental health outcomes.
- Addressing deficits in emotion regulation and depressive symptoms may help reduce loneliness and social anxiety.
Rationale
Previous research shows loneliness is associated with anxiety, depression, and psychotic symptoms (Beutel et al., 2017; Badcock et al., 2015).
Loneliness also predicts future mental health issues, whereas the inverse does not hold true (Cacioppo et al., 2010; Lim et al., 2016).
Clinical trials demonstrate a bidirectional relationship between reductions in social anxiety and loneliness (O’Day et al., 2021). Social anxiety and depression are also interrelated (Fehm et al., 2008).
This study aimed to clarify the mechanisms linking loneliness, social anxiety, depression, and emotion dysregulation. Additionally, it examined how social isolation risk impacts these associations.
Method
This cross-sectional online survey measured loneliness, social isolation risk, social anxiety, depression, and emotion dysregulation in 1239 young adults (mean age 21.52 years, 77.2% female).
Sample
The sample comprised 1239 young adults recruited online, with a mean age of 21.52 years (SD = 2.32). The majority were female (77.2%).
Statistical Analysis
A moderated serial mediation model tested whether emotion dysregulation and depression mediate the loneliness-social anxiety link. Social isolation risk was examined as a moderator.
Results
The central finding was that loneliness predicted future social anxiety symptoms. Statistical analyses showed this relationship was explained (mediated) by both emotion dysregulation and depressive symptoms independently as well as in tandem.
Additionally, those with lower social isolation risk were protected from experiencing poorer mental health outcomes associated with loneliness.
Insight
By demonstrating loneliness precedes and contributes to social anxiety, these results bolster past longitudinal research suggesting a causal pathway.
The findings also highlight the mental health benefits of social bonds. Loneliness was less detrimental for those with more social connections. Thus, strengthening people’s social resources could mitigate anxiety/depression.
The mediating effects of dysfunctional emotion regulation and low mood further suggest targeting these areas in clinical efforts.
Teaching coping strategies and mood management techniques, for instance, through CBT, could help alleviate distress from loneliness that otherwise may escalate into social anxiety disorder.
Strengths
- The large sample size of 1239 participants ensures the results are powered to detect small effects and reduce the margin of error. This lends confidence to the reliability of the findings.
- Using established, validated measures of all constructs examines the research questions with rigor and precision. The survey instruments have been pre-tested and refined to accurately measure the variables of interest.
- The analyses unpack the underlying mechanisms linking loneliness and social anxiety via emotion dysregulation and depression. This sheds light on the processes through which these symptoms operate and mutually reinforce each other.
- Testing social isolation risk as a moderator provides a more nuanced understanding of how and under what conditions these relationships manifest. Exploring moderators reveals individual differences in resilience/vulnerability.
Limitations
- The cross-sectional design means causal inferences cannot be drawn regarding the directionality of effects. It remains unclear whether deficits in emotion regulation precipitate greater loneliness, for instance, or vice versa.
- Convenience sampling was used rather than random sampling, meaning those who opted in may possess certain traits that skew the results and restrict generalizability. Replication with more representative groups is warranted.
- As the sample comprised young adults predominantly, the findings may not extend to children, middle-aged groups or the elderly. The relationships examined may operate differently depending on factors associated with age/developmental stage.
Implications
The study underscores the profound importance of belongingness for young people’s wellbeing.
Interventions aimed at fostering social connectedness, such as peer support networks, mentoring programs, or group therapies, may help prevent isolation and subsequent psychopathology.
On an individual level, clinicians should screen for loneliness and tailor treatment plans to address any deficits in emotion control or negativity biases that perpetuate anxiety.
Building emotion regulation skills and targeting thought patterns through CBT, DBT, or positive psychology may relieve distress.
Regarding social resources, clinicians might help patients identify potential social supports and interpersonal sources of resilience.
Fostering meaningful bonds on campus, at work, in community or religious centers, or through shared interests can provide a buffer during distressing times.
References
Primary reference
Eres, R., Lim, M. H., & Bates, G. (2023). Loneliness and social anxiety in young adults: The moderating and mediating roles of emotion dysregulation, depression and social isolation risk. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12469
Other references
Badcock, J. C., Shah, S., Mackinnon, A., Stain, H. J., Galletly, C., Jablensky, A., & Morgan, V. A. (2015). Loneliness in psychotic disorders and its association with cognitive function and symptom profile. Schizophrenia Research, 169(1), 268–273. https://doi.org/10.1016/j.schres.2015.10.027
Beutel, M. E., Klein, E. M., Brähler, E., Reiner, I., Jünger, C., Michal, M., Wiltink, J., Wild, P. S., Münzel, T., Lackner, K. J., & Tibubos, A. N. (2017). Loneliness in the general population: Prevalence, determinants and relations to mental health. BMC Psychiatry, 17(1), 97. https://doi.org/10.1186/s12888-017-1262-x
Cacioppo, J. T., Hawkley, L. C., & Thisted, R. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging, 25(2), 453–463. https://doi.org/10.1037/a0017216
Eres, R., Postolovski, N., Thielking, M., & Lim, M. H. (2020). Loneliness, mental health, and social health indicators in LGBTQIA+ Australians. American Journal of Orthopsychiatry, 91(3), 358–366. https://doi.org/10.1037/ort0000531
Eres, R., Lim, M. H., Lanham, S., Jillard, C., & Bates, G. (2021). Loneliness and emotion regulation: Implications of having social anxiety disorder. Australian Journal of Psychology, 73(1), 46–56. https://doi.org/10.1080/00049530.2021.190449
Fehm, L., Beesdo, K., Jacobi, F., & Fiedler, A. (2008). Social anxiety disorder above and below the diagnostic threshold: Prevalence, comorbidity and impairment in the general population. Social Psychiatry and Psychiatric Epidemiology, 43(4), 257–265.
Lim, M. H., Eres, R., & Vasan, S. (2020). Understanding loneliness in the twenty-first century: An update on correlates, risk factors, and potential solutions. Social Psychiatry and Psychiatric Epidemiology, 55(7), 793–810. https://doi.org/10.1007/s00127-020-01889-7
O’Day, E. B., Butler, R. M., Morrison, A. S., Goldin, P. R., Gross, J. J., & Heimberg, R. G. (2021). Reductions in social anxiety during treatment predict lower levels of loneliness during follow-up among individuals with social anxiety disorder. Journal of Anxiety Disorders, 78, 102362. https://doi.org/10.1016/j/janxdis.2021.102362
Keep Learning
Here are some suggested Socratic discussion questions about this paper for a college class:
- What are some of the reasons why loneliness might specifically predict future social anxiety rather than depression or other mental health issues?
- Aside from fostering social connections, what practical steps could be taken to help young people struggling with emotion dysregulation or depressive mood?
- How might culture or gender impact social isolation risk and its effects on mental health?
- What longitudinal or experimental studies could help establish the causal relationships suggested by these findings?
- How could this research inform public health programs or policies aimed at supporting young people’s well-being?
