Research Article
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The Link Between Anxiety Sensitivity and Social Anxiety Symptoms: Cognitive Flexibility as a Mediating Factor

Year 2025, Volume: 9 Issue: 1, 64 - 71, 01.04.2025

Abstract

Aim: The purpose of this study was to explore the relationship between symptoms of social anxiety and anxiety sensitivity, as well as the role of cognitive flexibility as a mediator.

Methods: A total of 552 people between the ages of 18-35, with no history of psychiatric follow-up and treatment, were included in the study. A sociodemographic data form, the Liebowitz Social Anxiety Scale, Anxiety Sensitivity Index-3 and Cognitive Flexibility Inventory were applied to the participants.

Results: It was determined that social anxiety scores were significantly higher in female participants (86.11 ± 23.50) compared to male participants (79.43 ± 26.10) (p < 0.001). There was a positive relationship between social anxiety symptoms and anxiety sensitivity and its subscales (p < 0.001) and a negative relationship with cognitive flexibility (p < 0.001). According to the mediation analysis results, cognitive flexibility mediates 13% of the total effect of anxiety sensitivity on social anxiety symptoms.

Conclusion: The findings of the study draw attention to the strong relationship between social anxiety symptoms and anxiety sensitivity and show that cognitive flexibility may be an important mediating mechanism in this process. Accordingly, it is thought that interventions aimed at increasing cognitive flexibility in the treatment of social anxiety may be useful.

References

  • 1. Stein MB, Kean YM. Disability and quality of life in social phobia: epidemiologic findings. Am J Psychiatry. 2000;157(10):1606-13. DOI: 10.1176/appi.ajp.157.10.1606.
  • 2. Kelly-Turner K, Radomsky A. The fear of losing control in social anxiety: An experimental approach. Cognit Ther Res. 2020;44:834-45. DOI: 10.1007/s10608-020-10104-5.
  • 3. Taylor S. Anxiety sensitivity: Theory, research and treatment of the fear of anxiety. Routledge; 2014. DOI: 10.4324/9781410603326.
  • 4. Wheaton MG, Deacon BJ, McGrath PB, Berman NC, Abramowitz JS. Dimensions of anxiety sensitivity in the anxiety disorders: Evaluation of the ASI-3. J Anxiety Disord. 2012;26(3):401-8. DOI: 10.1016/j.janxdis.2012.01.002.
  • 5. Zvolensky MJ, Goodie JL, Ruggiero KJ, Black AL, Larkin KT, Taylor BK, et al. Perceived stress and anxiety sensitivity in the prediction of anxiety-related responding: A multichallenge evaluation. Anxiety Stress Coping. 2002;15(3):211-29. DOI: 10.1080/1061580021000020699.
  • 6. Troy AS, Shallcross AJ, Mauss IB. A person-by-situation approach to emotion regulation: Cognitive reappraisal can either help or hurt, depending on the context. Psychol Sci. 2013;24(12):2505-14. DOI: 10.1177/0956797613496434.
  • 7. Anderson ER, Hope DA. The relationship among social phobia, objective and perceived physiological reactivity and anxiety sensitivity in an adolescent population. J Anxiety Disord. 2009;23(1):18-26. DOI: 10.1016/j.janxdis.2008.03.011.
  • 8. Mărcuş O, Stanciu O, MacLeod C, Liebregts H, Visu-Petra L. A FISTful of emotion: Individual differences in trait anxiety and cognitive-affective flexibility during preadolescence. J Abnorm Child Psychol. 2016;44(7):1231-42. DOI: 10.1007/s10802-015-0110-z.
  • 9. Mantar A, Yemez B, Alkin T. The validity and reliability of the Turkish version of the anxiety sensitivity index-3. Turk Psikiyatri Derg. 2010;21(3):225-34. PMID: 20818510.
  • 10. Soykan Ç, Özgüven HD, Gençöz T. Liebowitz social anxiety scale: the Turkish version. Psychol Rep. 2003; 93(3 Pt 2): 1059-1069. DOI: 10.2466/pr0.2003.93.3f.1059.
  • 11. Gulum IV, Dağ I. The Turkish adaptation, validity and reliability study of the Repetitive Thinking Questionnaire and the Cognitive Flexibility Inventory. Anadolu Psikiyatri Derg. 2012;13(3):216-23
  • 12. Grant DM, Beck JG, Davila J. Does anxiety sensitivity predict symptoms of panic, depression and social anxiety? Behav Res Ther. 2007;45(9):2247-55. DOI: 10.1016/j.brat.2007.02.008.
  • 13. Thibodeau MA, Gómez-Pérez L, Asmundson GJ. Objective and perceived arousal during performance of tasks with elements of social threat: The influence of anxiety sensitivity. J Behav Ther Exp Psychiatry. 2012;43(3):967-74. DOI: 10.1016/j.jbtep.2012.03.001.
  • 14. Farhane-Medina NZ, Luque B, Tabernero C, Castillo-Mayén R. Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review. Sci Prog. 2022;105(4):00368504221135469. DOI: 10.1177/00368504221135469.
  • 15. Schmidt NB, Mitchell MA, Richey JA. Anxiety sensitivity as an incremental predictor of later anxiety symptoms and syndromes. Compr Psychiatry. 2008;49(4):407-12. DOI: 10.1016/j.comppsych.2007.12.004.
  • 16. Rector NA, Szacun-Shimizu K, Leybman M. Anxiety sensitivity within the anxiety disorders: Disorder-specific sensitivities and depression comorbidity. Behav Res Ther. 2007;45(8):1967-75. DOI: 10.1016/j.brat.2006.09.017.
  • 17. Belcher J, Peters L. Relationship between anxiety sensitivity subscales and social fears. Aust J Psychol. 2009;61(3):128-35. DOI: 10.1080/00049530802239318.
  • 18. Rodriguez BF, Bruce SE, Pagano ME, Spencer MA, Keller MB. Factor structure and stability of the Anxiety Sensitivity Index in a longitudinal study of anxiety disorder patients. Behav Res Ther. 2004;42(1):79-91. DOI: 10.1016/S0005-7967(03)00074-3.
  • 19. Ölmez SB, Ataoğlu A. The relationships among impulsivity, anxiety sensitivity and severity of social anxiety disorder. Turk J Clin Psychiatry. 2019;22:7-15. DOI: 10.5505/kpd.2018.47560.
  • 20. Johnson AR, Bank SR, Summers M, Hyett MP, Erceg‐Hurn DM, Kyron MJ, et al. A longitudinal assessment of the bivalent fear of evaluation model with social interaction anxiety in social anxiety disorder. Depress Anxiety. 2020;37(12):1253-60. DOI: 10.1002/da.23099.
  • 21. Liang CW. Attentional control deficits in social anxiety: Investigating inhibition and shifting functions using a mixed antisaccade paradigm. J Behav Ther Exp Psychiatry. 2018;60:46-52. DOI: 10.1016/j.jbtep.2018.03.004.
  • 22. Arlt J, Yiu A, Eneva K, Dryman MT, Heimberg RG, Chen EY. Contributions of cognitive inflexibility to eating disorder and social anxiety symptoms. Eat Behav. 2016;21:30-2. DOI: 10.1016/j.eatbeh.2015.12.008.
  • 23. Kuru E, Safak Y, Özdemir İ, Tulacı RG, Özdel K, et al. Cognitive distortions in patients with social anxiety disorder: Comparison of a clinical group and healthy controls. Eur J Psychiatry. 2018;32(2):97-104. DOI: 10.1016/j.ejpsy.2017.08.004.
  • 24. Everaert J, Bronstein MV, Castro AA, Cannon TD, Joormann J. When negative interpretations persist, positive emotions don’t! Inflexible negative interpretations encourage depression and social anxiety by dampening positive emotions. Behav Res Ther. 2020;124:103510. DOI: 10.1016/j.brat.2019.103510.
  • 25. Gotlib IH, Joormann J. Cognition and depression: current status and future directions. Annu Rev Clin Psychol. 2010;6(1):285-312. DOI: 10.1146/annurev.clinpsy.121208.131305.

Anksiyete Duyarlılığı ve Sosyal Anksiyete Semptomları Arasındaki Bağlantı: Aracı Faktör Olarak Bilişsel Esneklik

Year 2025, Volume: 9 Issue: 1, 64 - 71, 01.04.2025

Abstract

Amaç: Bu çalışmanın amacı, sosyal anksiyete belirtileri ile anksiyete duyarlılığı arasındaki ilişkiyi ve bilişsel esnekliğin aracı rolünü araştırmaktır.

Yöntem: Çalışmaya psikiyatrik takip ve tedavi öyküsü olmayan, 18-35 yaş aralığında toplam 552 kişi dahil edildi. Katılımcılara sosyodemografik veri formu, Liebowitz Sosyal Anksiyete Ölçeği, Anksiyete Duyarlılığı İndeksi-3 ve Bilişsel Esneklik Envanteri uygulandı.

Bulgular: Kadın katılımcılarda sosyal anksiyete puanlarının (86.11 ± 23.50) erkeklere kıyasla (79.43 ± 26.10) anlamlı derecede yüksek olduğu belirlenmiştir (p < 0.001).Sosyal anksiyete belirtileri ile anksiyete duyarlılığı ve alt ölçekleri arasında pozitif (p < 0.001), bilişsel esneklik (p < 0.001) ile negatif ilişki bulunmuştur. Aracılık analizi sonuçlarına göre, bilişsel esneklik, anksiyete duyarlılığının sosyal anksiyete belirtileri üzerindeki toplam etkisinin %13’üne aracılık etmektedir.

Sonuç: Çalışmanın bulguları, sosyal anksiyete belirtileri ile anksiyete duyarlılığı arasındaki güçlü ilişkiye dikkat çekmekte ve bilişsel esnekliğin bu süreçte önemli bir aracı mekanizma olabileceğini göstermektedir. Bu doğrultuda, sosyal anksiyete tedavisinde bilişsel esnekliği artırmaya yönelik müdahalelerin faydalı olabileceği düşünülmektedir.

References

  • 1. Stein MB, Kean YM. Disability and quality of life in social phobia: epidemiologic findings. Am J Psychiatry. 2000;157(10):1606-13. DOI: 10.1176/appi.ajp.157.10.1606.
  • 2. Kelly-Turner K, Radomsky A. The fear of losing control in social anxiety: An experimental approach. Cognit Ther Res. 2020;44:834-45. DOI: 10.1007/s10608-020-10104-5.
  • 3. Taylor S. Anxiety sensitivity: Theory, research and treatment of the fear of anxiety. Routledge; 2014. DOI: 10.4324/9781410603326.
  • 4. Wheaton MG, Deacon BJ, McGrath PB, Berman NC, Abramowitz JS. Dimensions of anxiety sensitivity in the anxiety disorders: Evaluation of the ASI-3. J Anxiety Disord. 2012;26(3):401-8. DOI: 10.1016/j.janxdis.2012.01.002.
  • 5. Zvolensky MJ, Goodie JL, Ruggiero KJ, Black AL, Larkin KT, Taylor BK, et al. Perceived stress and anxiety sensitivity in the prediction of anxiety-related responding: A multichallenge evaluation. Anxiety Stress Coping. 2002;15(3):211-29. DOI: 10.1080/1061580021000020699.
  • 6. Troy AS, Shallcross AJ, Mauss IB. A person-by-situation approach to emotion regulation: Cognitive reappraisal can either help or hurt, depending on the context. Psychol Sci. 2013;24(12):2505-14. DOI: 10.1177/0956797613496434.
  • 7. Anderson ER, Hope DA. The relationship among social phobia, objective and perceived physiological reactivity and anxiety sensitivity in an adolescent population. J Anxiety Disord. 2009;23(1):18-26. DOI: 10.1016/j.janxdis.2008.03.011.
  • 8. Mărcuş O, Stanciu O, MacLeod C, Liebregts H, Visu-Petra L. A FISTful of emotion: Individual differences in trait anxiety and cognitive-affective flexibility during preadolescence. J Abnorm Child Psychol. 2016;44(7):1231-42. DOI: 10.1007/s10802-015-0110-z.
  • 9. Mantar A, Yemez B, Alkin T. The validity and reliability of the Turkish version of the anxiety sensitivity index-3. Turk Psikiyatri Derg. 2010;21(3):225-34. PMID: 20818510.
  • 10. Soykan Ç, Özgüven HD, Gençöz T. Liebowitz social anxiety scale: the Turkish version. Psychol Rep. 2003; 93(3 Pt 2): 1059-1069. DOI: 10.2466/pr0.2003.93.3f.1059.
  • 11. Gulum IV, Dağ I. The Turkish adaptation, validity and reliability study of the Repetitive Thinking Questionnaire and the Cognitive Flexibility Inventory. Anadolu Psikiyatri Derg. 2012;13(3):216-23
  • 12. Grant DM, Beck JG, Davila J. Does anxiety sensitivity predict symptoms of panic, depression and social anxiety? Behav Res Ther. 2007;45(9):2247-55. DOI: 10.1016/j.brat.2007.02.008.
  • 13. Thibodeau MA, Gómez-Pérez L, Asmundson GJ. Objective and perceived arousal during performance of tasks with elements of social threat: The influence of anxiety sensitivity. J Behav Ther Exp Psychiatry. 2012;43(3):967-74. DOI: 10.1016/j.jbtep.2012.03.001.
  • 14. Farhane-Medina NZ, Luque B, Tabernero C, Castillo-Mayén R. Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review. Sci Prog. 2022;105(4):00368504221135469. DOI: 10.1177/00368504221135469.
  • 15. Schmidt NB, Mitchell MA, Richey JA. Anxiety sensitivity as an incremental predictor of later anxiety symptoms and syndromes. Compr Psychiatry. 2008;49(4):407-12. DOI: 10.1016/j.comppsych.2007.12.004.
  • 16. Rector NA, Szacun-Shimizu K, Leybman M. Anxiety sensitivity within the anxiety disorders: Disorder-specific sensitivities and depression comorbidity. Behav Res Ther. 2007;45(8):1967-75. DOI: 10.1016/j.brat.2006.09.017.
  • 17. Belcher J, Peters L. Relationship between anxiety sensitivity subscales and social fears. Aust J Psychol. 2009;61(3):128-35. DOI: 10.1080/00049530802239318.
  • 18. Rodriguez BF, Bruce SE, Pagano ME, Spencer MA, Keller MB. Factor structure and stability of the Anxiety Sensitivity Index in a longitudinal study of anxiety disorder patients. Behav Res Ther. 2004;42(1):79-91. DOI: 10.1016/S0005-7967(03)00074-3.
  • 19. Ölmez SB, Ataoğlu A. The relationships among impulsivity, anxiety sensitivity and severity of social anxiety disorder. Turk J Clin Psychiatry. 2019;22:7-15. DOI: 10.5505/kpd.2018.47560.
  • 20. Johnson AR, Bank SR, Summers M, Hyett MP, Erceg‐Hurn DM, Kyron MJ, et al. A longitudinal assessment of the bivalent fear of evaluation model with social interaction anxiety in social anxiety disorder. Depress Anxiety. 2020;37(12):1253-60. DOI: 10.1002/da.23099.
  • 21. Liang CW. Attentional control deficits in social anxiety: Investigating inhibition and shifting functions using a mixed antisaccade paradigm. J Behav Ther Exp Psychiatry. 2018;60:46-52. DOI: 10.1016/j.jbtep.2018.03.004.
  • 22. Arlt J, Yiu A, Eneva K, Dryman MT, Heimberg RG, Chen EY. Contributions of cognitive inflexibility to eating disorder and social anxiety symptoms. Eat Behav. 2016;21:30-2. DOI: 10.1016/j.eatbeh.2015.12.008.
  • 23. Kuru E, Safak Y, Özdemir İ, Tulacı RG, Özdel K, et al. Cognitive distortions in patients with social anxiety disorder: Comparison of a clinical group and healthy controls. Eur J Psychiatry. 2018;32(2):97-104. DOI: 10.1016/j.ejpsy.2017.08.004.
  • 24. Everaert J, Bronstein MV, Castro AA, Cannon TD, Joormann J. When negative interpretations persist, positive emotions don’t! Inflexible negative interpretations encourage depression and social anxiety by dampening positive emotions. Behav Res Ther. 2020;124:103510. DOI: 10.1016/j.brat.2019.103510.
  • 25. Gotlib IH, Joormann J. Cognition and depression: current status and future directions. Annu Rev Clin Psychol. 2010;6(1):285-312. DOI: 10.1146/annurev.clinpsy.121208.131305.
There are 25 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Research Article
Authors

Çağla Özdemir 0000-0002-9766-1918

Merve Akkuş 0000-0003-3046-2815

Publication Date April 1, 2025
Submission Date January 23, 2025
Acceptance Date February 15, 2025
Published in Issue Year 2025 Volume: 9 Issue: 1

Cite

Vancouver Özdemir Ç, Akkuş M. The Link Between Anxiety Sensitivity and Social Anxiety Symptoms: Cognitive Flexibility as a Mediating Factor. Acta Med. Alanya. 2025;9(1):64-71.

9705

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