Safety Behaviors and Social Performance in Patients With Generalized Social Phobia

The cognitive model of social phobia (Clark & Wells, 1995) suggests that safety behaviors, besides preventing disconfirmation of dysfunctional beliefs, cause significant impairment in social performance. To test this hypothesis, the current study investigated the relationship between observer-rated social performance, self-rated safety behaviors, and anxiety in 20 generalized social phobics, 14 controls with anxiety, and 17 controls without anxiety in two experimental tasks: a conversation with a stooge and a brief speech. Compared to the control groups, socially phobic patients displayed higher anxiety levels, reported more safety behaviors, and did not perform as well as the control groups in both tasks. There was a nonsignificant tendency of socially phobic patients to display more negative thoughts than both control groups. Differences in heart rate responses were not significant. A path analysis revealed that safety behaviors partially mediated the relation between diagnostic group and social performance deficit in both tasks. The results highlight the importance of safety behaviors for social performance deficit in social phobia.