The role of social isolation in social anxiety disorder: A systematic review and meta-analysis

• We systematically identified measures of social isolation that have been used in studies of social anxiety disorder.
• Simple measures of social isolation were relatively common, whereas more complex and higher quality measures were rarely used in multiple studies.
• Social isolation appears to be a substantial source of morbidity among those with social anxiety disorder.

IntroductionSocial isolation in the context of social anxiety disorder has not been closely examined. This study aimed to describe the role and measurement of social isolation in those with social anxiety disorder.MethodA systematic review and meta-analyses were conducted using a prospectively prepared protocol for search strategy, selection criteria, and data extraction. DerSimonian–Laird random effects models were used to calculate pooled estimates of effect.ResultsThirty-four studies, containing 20 formal instruments and four other measures of social isolation, were included. Most formal instruments were utilized in single studies, whereas simple structural measures (e.g., living alone) were used most frequently. The pooled score was 38.1 on the Loneliness and Social Dissatisfaction Questionnaire, 33.1 on the Liebowitz Social Anxiety Scale (avoidance subscale), and 21.1 on the Social Avoidance and Distress Scale.ConclusionsSocial isolation is common in social anxiety disorder but assessed by a heterogeneous mix of measures.