Cognitive distortions in patients with social anxiety disorder: Comparison of a clinical group and healthy controls

Abstract

Background and objective

Based on the cognitive model of social anxiety disorder (SAD), individuals who are anxious in social environments have some dysfunctional thoughts and beliefs regarding themselves and ways of others to judge their behaviors. A fundamental component of cognitive behavioral therapy is about noticing and changing cognitive distortions. The aims of our study were to analyze the differences in cognitive distortions between patients with SAD and a healthy control group, and examine the relationship between cognitive distortions and levels of anxiety and depression in patients with SAD.

Methods

One hundred two individuals from two samples, non-clinical and clinical with SAD, were included. Patients were evaluated using a socio-demographic data form, the Liebowitz Social Anxiety Scale, Cognitive Distortions Scale (CDS), State-Trait Anxiety Inventory, and Beck Depression Inventory after a diagnostic interview.

Results

There were significant differences between the patient and control group in terms of total CDS; most cognitive distortions were significantly higher in the patient group compared with the controls. The correlations between social anxiety, state and trait anxiety levels, depressive symptoms, and cognitive distortions were analyzed and significant correlations were found between the scales with a range of 0.316–0.676.

Conclusions

Patients with SAD had more cognitive distortions compared with the healthy controls. The comorbid depressive symptoms in SAD had effects on ‘mental filter, overgeneralization and personalization’ in social situations, and there was no specific cognitive distortion without depression. Cognitive distortions in these patients were more related to depression and trait anxiety levels than the severity of social anxiety.