(PS2-46) The Effect of Fear Generalization on Social Fear, Social Avoidance, Experiential Avoidance, and Functional Impairment Amongst Individuals with Social Anxiety Disorder

Social Anxiety Disorder (SAD) is characterized by a fear of negative social evaluation and often involves avoidance. This can take the form of social avoidance (i.e., avoiding feared social scenarios), or experiential avoidance, (i.e., avoiding aversive emotions). Both forms of avoidance can prolong clinical symptoms. Fear and avoidance can interact, such that when an individual’s fear generalizes to related stimuli (i.e., fear generalization), avoidance can further increase. Although fear generalization is a posited maintenance and risk factor for social anxiety, its relation to dimensional symptoms of social anxiety (i.e., social fear and avoidance) and subsequent impairment is underexplored. Thus, the present study explored whether fear generalization was related to dimensional symptoms of SAD by testing whether fear generalization predicted social fear, social avoidance, and experiential avoidance. Given that fear and avoidance have also been associated with elevated functional impairment, we explored whether fear generalization moderated the relationship between dimensional symptoms of social anxiety and functional impairment.

Participants (n = 128) were part of a multi-site project conducted at the Jewish Vocational Services in Detroit and Los Angeles, and met diagnostic criteria for SAD. Fear generalization was measured using self-reported ratings during a fear generalization task. Social fear and avoidance were measured using the Liebowitz Social Anxiety Scale. Experiential avoidance was measured using the Acceptance and Action Questionnaire. Functional impairment was measured using the Sheehan Disability Scale. Through a series of linear regressions we examined whether elevated fear generalization cross-sectionally predicted elevated social fear, social avoidance, and experiential avoidance. We then examined whether fear generalization moderated the effects of social fear, social avoidance, and experiential avoidance on functional impairment. 

Fear generalization did not significantly predict social fear (p = 0.61), social avoidance (p = 0.62) or experiential avoidance (p = 0.98). Fear generalization marginally moderated the relationship between social fear and functional impairment (p = .052), and social fear significantly predicted functional impairment (p < 0.001). Fear generalization significantly moderated the relationship between social avoidance and functional impairment (p = .02). Lastly, fear generalization did not significantly moderate the relationship between experiential avoidance and functional impairment (p=.13) but experiential avoidance did significantly predict functional impairment (p < .001).

Overall, individuals with higher social avoidance and fear generalization demonstrated greater impairment compared to those with high avoidance and low fear generalization. Furthermore, greater social fear and experiential avoidance both predicted greater impairment. Findings suggest that fear generalization may be a treatment target for SAD and highlights the value of dimensional symptom assessments. Future studies could test whether fear generalization leads to sustained social avoidance and functional impairment over time.