All by Myself: Loneliness in Social Anxiety Disorder

In the present study we examined loneliness among individuals with and without social anxiety disorder (SAD), contexts that may moderate the experience of loneliness, and the temporal relationship between loneliness and social anxiety. We examined 88 individuals (44 with SAD and 44 without SAD) and used experience sampling (ES) methods, comprising of real-time measurement of naturally occurring events and participants' emotional reactions to them during participants' daily lives over the course of 21 days. Hierarchical linear models indicated that individuals with SAD reported significantly more loneliness compared to individuals without SAD. We also found that characteristics of social situations (negativity, positivity, and meaningfulness) were all positively and significantly associated with loneliness among individuals with SAD. Thus, social situations that were experienced as more negative, more positive, and more meaningful all resulted in increased loneliness for individuals with SAD. We also found a significant Positivity 3 Meaningfulness interaction that indicated that the effect of positivity was attenuated when meaningfulness was high. Notably, none of these effects were found for individuals without SAD. Finally, we found that for individuals with SAD, both anxiety and loneliness predicted changes in each other and combined to form a deleterious cycle. However, evidence for such a cycle was not found for individuals without SAD. The role of loneliness in the psychopathology of SAD and its maintenance, as well as clinical implications are discussed.