Candidate factors maintaining social anxiety in the context of psychotic experiences: a systematic review

Aunjitsakul, W., McGuire, N., McLeod, H. and Gumley, A. (2021) Candidate factors maintaining social anxiety in the context of psychotic experiences: a systematic review. Schizophrenia Bulletin, 47(5), pp. 1218-1242. (doi: 10.1093/schbul/sbab026) (PMID:33778868)

Abstract

Social anxiety is common in psychosis and associated with impaired functioning, poorer quality of life, and higher symptom severity. This study systematically reviewed factors maintaining social anxiety in people with attenuated, transient, or persistent psychotic experiences. Other correlates of social anxiety were also examined. MEDLINE, Embase, CENTRAL, and PsycINFO were searched for relevant literature up to October 19, 2020. Forty-eight articles were eligible for narrative synthesis: 38 cross-sectional studies, 8 prospective studies, 1 uncontrolled trial, and 1 qualitative study. From 12060 participants, the majority was general population (n = 8771), followed by psychosis samples (n = 2532) and those at high risk of psychosis (n = 757). The methodological quality and risk of bias were assessed using the Mixed Methods Appraisal Tool. Ninety percent of studies were rated as high to very-high quality. Poorer quality studies typically failed to adequately control for confounds and provided insufficient information on the measurement validity and reliability. Prominent psychological factors maintaining social anxiety included self-perceptions of stigma and shame. Common correlates of social anxiety included poorer functioning and lower quality of life. In conclusion, stigma and shame could be targeted as a causal mechanism in future interventional studies. The integration of findings from this review lead us to propose a new theoretical model to guide future intervention research.

• Item Type: Articles
• Additional Information: This study was conducted primarily by W.A. as part of a PhD program supervised by H.M. and A.G., under funding from Faculty of Medicine, Prince of Songkla University, Thailand.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McGuire, Nicola and McLeod, Professor Hamish and Aunjitsakul, Warut and Gumley, Professor Andrew
• Authors: Aunjitsakul, W., McGuire, N., McLeod, H., and Gumley, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Schizophrenia Bulletin
• Publisher: Oxford University Press
• ISSN: 0586-7614
• ISSN (Online): 1745-1701
• Published Online: 29 March 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Schizophrenia Bulletin 47(5): 1218-1242
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher