November 21, 2022

Dear Colleagues,

The National Social Anxiety Center (NSAC) provides information about relevant and current research in service of disseminating and promoting evidence-based treatment. This month’s summary is written by Robert Yeilding, PsyD, representing NSAC Bixby Knolls, Long Beach, CA. He examines the article, Adolescent Safety Behaviors and Social Anxiety: Links to Psychosocial Impairments and Functioning with Unfamiliar Peer Confederates (Okuno et al., 2021).

Past studies have linked safety behaviors (avoiding eye contact, anticipatory rehearsal) in adults with social anxiety to impaired social functioning. The researchers of this study developed a novel approach to examine if prevalence of safety behaviors in adolescents also correlates with greater psychosocial impairments. They integrated multi-informant assessments (parents, adolescent, objective observer) to assess an adolescent’s safety behaviors and social anxiety symptoms. Then, they engaged the participants in a series of social interaction tasks such as an unstructured conversation with a study confederate, and an impromptu speech task. Finally, for each participant a group of trained observers rated the adolescent on the levels of social skills they displayed during the task.

Their findings showed evidence that adolescents who were evaluated to have high levels of social anxiety and safety behaviors displayed the lowest utilization of social skills when interacting with an unfamiliar peer, as well as higher levels of evaluative fears relative to those who showed less safety behaviors. These findings clearly link safety behaviors in adolescents with social anxiety with greater social difficulty. Furthermore, it has direct clinical relevance for exposure-based approaches that address such maladaptive safety behaviors as a target of change.

A question I have for my colleagues is what motivational strategies or specific experiments have you found to be effective with adolescents to help them commit to dropping their safety behaviors?

Okuno H, Rezeppa T, Raskin T, De Los Reyes A. Adolescent Safety Behaviors and Social Anxiety: Links to Psychosocial Impairments and Functioning with Unfamiliar Peer Confederates. Behavior Modification, November, 2022, Volume 45, Issue 6, pages 1314-1345. First published online, November 11, 2021.

Robert Yeilding, PsyD, A-CBT
Clinical Psychologist, CA
Diplomate of the Academy of Cognitive Therapy
NSAC Cochair
Representing NSAC Bixby Knolls, Long Beach (YCBT Services)