Individuals with social anxiety disorder have markedly different personality traits than others. Emotional instability and introversion are hallmarks, according to a new study from Uppsala University published in PLOS ONE.

"Social anxiety disorder seems to be a problem that is strongly intertwined with personality, but at the same time it shows great variation," says Professor Tomas Furmark from the Department of Psychology at Uppsala University, who led the study.

Researchers have long been looking for the connection between personality factors and the risk of developing psychiatric illnesses. In psychological science, personality is typically described using five well-established dimensions: neuroticism, also known as emotional instability; extraversion, which deals with how outgoing a person is; openness; agreeableness; and conscientiousness - the 'Big Five'.

A study from Uppsala University, now published in PLOS ONE, shows that personality is strongly intertwined with the diagnosis of social anxiety disorder, also called social phobia.

The study involved 265 individuals with the diagnosis. They filled out comprehensive personality instruments, including the revised NEO Personality Inventory (NEO-PI-R) and the Karolinska Scales of Personality (KSP). They were also compared with healthy control subjects and Swedish norm data. The results showed that individuals with social anxiety disorder had markedly different personality traits, in particular, high neuroticism and introversion, in other words, a tendency to be emotionally unstable and inward turning.

At the same time, the study showed that there was a great deal of variation in personality traits among the socially anxious individuals. Three personality groups could be distinguished, based on cluster analysis of the Big Five personality dimensions.

The first group, with prototypical social anxiety, was both highly anxious and introverted - which may be seen as the typical form of social anxiety disorder. However, these individuals accounted for only one-third (33 per cent) of the total patient sample.

Individuals in the second group (29 per cent), with introvert-conscientious social anxiety, were very introverted but more moderately anxious and also had high levels of conscientiousness.

Individuals in the third and largest group (38 per cent), with unstable-open social anxiety disorder, were anxious while having almost normal levels of extraversion. Comparisons with norm data also showed that these individuals scored high on the personality trait openness.

"It is possible that the causes of social anxiety differ for the three groups, for example, with regard to abnormalities in brain neurotransmitter levels and genetic factors. It may also be that different treatment efforts are needed for the different types of social anxiety disorder, but further studies are needed to clarify this," says Furmark.

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Ref; Costache M E, et al (2020); Higher- and Lower-order Personality Traits and Cluster Subtypes in Social Anxiety Disorder, PLOS ONE (open access) PONE-D-19-29839R1, https:/ / journals. plos. org/ plosone/ article?id= 10. 1371/ journal. pone. 0232187

For further information:

Tomas Furmark, Professor at Department of Psychology, Emotion Psychology, Uppsala University

Email: Tomas.Furmark@psyk.uu.se, Telephone: +46-18-471 2153

Abstract and method:

Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N=265) diagnosed with SAD in comparison to healthy controls (N=164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions.

Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables.

A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD.

Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables.

While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.

Previous studies (selection):

Patients' expectations influence the effectiveness of SSRI antidepressants (2019) https:/ / www. uu. se/ en/ news-media/ press-releases/ press-release/ ?id= 4032&typ= pm&lang= en

Antidepressants boost cognitive behavioural therapy for social anxiety (2016) https:/ / www. uu. se/ en/ news-media/ press-releases/ press-release/ ?id= 3336&typ= pm&lang= en