Self-portrayal concerns and their relation to safety behaviors and negative affect in social anxiety disorder

• Self-portrayal concerns (SPCs) examined in people with social anxiety disorder (SAD) vs. clinical and healthy controls.
• SPCs measured via questionnaires, daily diaries of social encounters, and speech task.
• Diagnosis of SAD was uniquely associated with elevations in SPCs irrespective of secondary depression.
• SPCs about signs of anxiety, social competence, and physical appearance each uniquely predicted use of safety behaviors.
• Use of safety behaviors mediated the relation between self-portrayal concerns and negative affect.

It has been proposed that self-portrayal concerns – fundamental worries that particular negative self-attributes will become exposed during social encounters and criticized by others – underlie the experience of social anxiety (SA) and drive associated avoidance and safety behaviors ( Moscovitch, 2009). The development of the Negative Self Portrayal Scale (NSPS) to assess such concerns across the dimensions of social competence, signs of anxiety, and physical appearance has helped yield promising initial findings that support the basic tenets of Moscovitch's (2009) theoretical model in samples of undergraduate students (Moscovitch & Huyder, 2011). The present study investigated the nature of self-portrayal concerns and their relation to affect and behavior in a sample of 194 community-based participants consisting of (a) 62 individuals with a principal diagnosis of generalized SAD, either with (n = 35) or without (n = 27) an additional depressive disorder diagnosis, (b) 51 individuals with another principal anxiety disorder diagnosis, either with (n = 22) or without (n = 29) an additional diagnosis of SAD, and (c) 81 healthy controls. Participants completed trait questionnaires, daily diaries of naturalistic social encounters, and a laboratory-based speech task. Results demonstrated (a) that a diagnosis of SAD confers unique risk for elevated self-portrayal concerns, (b) that such concerns predict significant variance in safety behavior use across diverse contexts, and (c) that the use of safety behaviors mediates the relation between such concerns and the experience of heightened negative affect. Implications for case conceptualization and treatment of SAD are discussed.