Safety behaviours in social anxiety: an examination across adolescence

Abstract

Background Safety behaviours have been shown to be a key maintaining factor in Social Anxiety Disorder (SAD). In adults, a two-factor structure of safety behaviours reflecting ‘avoidance’ and ‘impression-management’ types has been identified. This has not yet been investigated in adolescents. Aims We set out to investigate the factor structure of safety behaviours in relation to adolescent social anxiety symptoms and SAD, the extent to which this varies by age, and then to examine the association between the derived factor scores and other social anxiety related phenomena. Method Questionnaire measures of social anxiety symptoms, cognitions and safety behaviours, peer relationship outcomes, general anxiety and depression were collected from a community sample of 584 younger (11–14 years) and 208 older (16–18 years) adolescents, and a clinical sample of 80 adolescents (11–18 years) with a primary diagnosis of SAD. Four hypotheses were investigated using exploratory and confirmatory factor analyses, regressions, correlations and path analyses. Results A two-factor structure reflecting ‘avoidance’ and ‘impression-management’ safety behaviours was supported in the community and clinical sample. Older adolescents were found to use ‘impression-management’ behaviours more than younger adolescents after controlling for overall safety behaviour score. Both types of safety behaviour were significantly positively associated with social anxiety symptoms and cognitions. Path analyses revealed-an indirect effect of social anxiety symptoms on peer victimisation, social satisfaction and friendship quality via ‘avoidance’, but not ‘impression-management’ safety behaviours. Conclusions Both ‘avoidance’ and ‘impression-management’ safety behaviours are associated with social anxiety symptoms and cognitions in youth, with age-related differences in their frequency. ‘Avoidance’ behaviours are specifically associated with negative outcomes for quality of peer relationships.