Elsevier

Journal of Anxiety Disorders

Volume 13, Issue 3, May–June 1999, Pages 271-292
Journal of Anxiety Disorders

Multimodal Comparisons of Social Phobia Subtypes and Avoidant Personality Disorder

https://doi.org/10.1016/S0887-6185(99)00004-3Get rights and content

Abstract

The purpose of the present study was to further clarify the behavioral, physiological, and verbal response of patients with circumscribed social (speech) phobia, generalized social phobia without avoidant personality disorder, and generalized social phobia with avoidant personality disorder. Patients completed a battery of verbal report instruments and participated in two behavioral assessment tests. Measures of avoidance/escape behavior, cardiac response, level of behavioral skill, state anxiety, and positive and negative self-statements during performance were collected. Significant differences across response domains were found between the circumscribed social phobia and the generalized groups. Most of the distinctions were between individuals with circumscribed social phobia and those with both generalized social phobia and avoidant personality disorder, with the former group having less overall psychopathology. In addition, there was substantial overlap of problems between generalized social phobia individuals with and without avoidant personality disorder. Implications for the conceptualization of social phobia are discussed in terms of the differences among social phobia subtypes.

Section snippets

Participants

Participants consisted of 41 outpatients (23 females) who presented at a university-based Psychological Services Center. The mean age of the sample was 30.4 years SD = 9.8; range, 18–53. Thirty-eight patients were Caucasian, 1 was Latino American, 1 was African American, and 1 was Asian American. Individuals who were included as subjects received a principal diagnosis of social phobia. Diagnoses were assigned according to DSM-III-R (American Psychiatric Association, 1987) criteria based on

Data Processing and Analysis

All 41 participants completed the initial verbal report assessment and had the opportunity to perform in the BATs; therefore, the analysis of initial verbal report data and avoidance/escape behavior included 41 participants. Ten participants, however, completely avoided (i.e., declined) the speech BAT (although none completely avoided the conversation BAT), and equipment failure occurred during one participant’s BAT performance. Thus, the analysis of psychophysiological, skill rating, and

Discussion

The present study utilized a comprehensive, multimodal, and multimethod assessment to compare the behavioral, cardiac, and verbal responses of patients with circumscribed speech phobia, generalized social phobia without APD, and generalized social phobia with APD. Overall, greater psychopathology was found in the generalized social phobia groups compared to the circumscribed speech phobia group. More differences, however, were seen between persons with circumscribed speech phobia and those with

Acknowledgements

This study was supported in part by an award from the Oklahoma Center for the Advancement of Science and Technology (OCAST no. HRO-023) to Daniel W. McNeil.

Some of these data were presented at the meetings of the Association for the Advancement of Behavior Therapy, Boston, MA (November, 1992), the Southwestern Psychological Association, Austin, TX (April, 1992), and Corpus Christi, TX (April, 1993). The present data are part of as a larger project; other current publications from it include

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    Martin L. Boone and Daniel W. McNeil are presently at West Virginia University, Morgantown, WV.

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    Carrie L. Masia is presently at Columbia University, New York, NY.

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    Cynthia L. Turk is presently at Temple University, Philadelphia, PA.

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    Leslie E. Carter is presently at Northwest Occupational Medicine Center, Portland, OR.

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    Barry J. Reis is presently at Minnesota State University, Mankato, MN.

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    Michael R. Lewin is presently at the University of California, San Bernadino, CA.

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