Rupert Conrad1, Andreas J Forstner2,3, Man-Long Chung4, Martin Mücke5, Franziska Geiser4, Johannes Schumacher2, Friederike Carnehl4. 1. Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany. rupert.conrad@ukbonn.de. 2. Center for Human Genetics, University of Marburg, Baldingerstraße, 35033, Marburg, Germany. 3. Institute of Human Genetics, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany. 4. Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany. 5. Center for Rare Diseases Bonn (ZSEB), University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Abstract
BACKGROUND: There is evidence for the relevance of attachment style and anger expression for the manifestation of social anxiety disorder (SAD). METHOD: In a cross-sectional study 321 individuals with social anxiety disorder (41% men, age 38.8 ± 13.9) were compared with 94 healthy controls (37% men, age 35.8 ± 15.1) on several questionnaires (Attachment Styles Questionnaire, State Trait Anger Inventory, Social Phobia Inventory, Beck Depression Inventory). RESULTS: Individuals with SAD showed moderate-sized reduced levels of secure and large-sized increased levels of fearful and preoccupied attachment style compared to healthy controls (all p < 0.001) as well as small-sized increased levels of trait anger (p = 0.03) and moderate-sized increased levels of anger-in (p < 0.001). Attachment style and anger regulation could predict 21% (R2 = 0.21, p < 0.001) of the extent of social anxiety (SPIN) in SAD; secure (β = - 0.196, p < 0.01) and preoccupied attachment style (β = 0.117, p < 0.05), as well as anger-in (β = 0.199, p < 0.01) were significant cross-sectional predictors. Further analysis revealed that the relationship between preoccupied attachment and social anxiety is partially mediated by anger-in. CONCLUSION: Study findings confirm the relevance of preoccupied attachment style and anger suppression for social anxiety. Disentangling the role of anger regulation in early attachment patterns has significant therapeutic implications in SAD.
BACKGROUND: There is evidence for the relevance of attachment style and anger expression for the manifestation of social anxiety disorder (SAD). METHOD: In a cross-sectional study 321 individuals with social anxiety disorder (41% men, age 38.8 ± 13.9) were compared with 94 healthy controls (37% men, age 35.8 ± 15.1) on several questionnaires (Attachment Styles Questionnaire, State Trait Anger Inventory, Social Phobia Inventory, Beck Depression Inventory). RESULTS: Individuals with SAD showed moderate-sized reduced levels of secure and large-sized increased levels of fearful and preoccupied attachment style compared to healthy controls (all p < 0.001) as well as small-sized increased levels of trait anger (p = 0.03) and moderate-sized increased levels of anger-in (p < 0.001). Attachment style and anger regulation could predict 21% (R2 = 0.21, p < 0.001) of the extent of social anxiety (SPIN) in SAD; secure (β = - 0.196, p < 0.01) and preoccupied attachment style (β = 0.117, p < 0.05), as well as anger-in (β = 0.199, p < 0.01) were significant cross-sectional predictors. Further analysis revealed that the relationship between preoccupied attachment and social anxiety is partially mediated by anger-in. CONCLUSION: Study findings confirm the relevance of preoccupied attachment style and anger suppression for social anxiety. Disentangling the role of anger regulation in early attachment patterns has significant therapeutic implications in SAD.