Embarrassability refers to an individual's general susceptibility to becoming embarrassed and is closely linked to another personality characteristic known as fear of negative evaluation. To find out if panic disorder patients with and without agoraphobia differ in terms of embarrassability and fear of negative evaluation 100 patients with a DSM-III-R diagnosis of panic disorder with agoraphobia, 30 patients with a DSM-III-R diagnosis of uncomplicated panic disorder and 80 controls were administered the Embarrassability Scale and the 12-item version of the Fear of Negative Evaluation Scale. Depressive mood in the clinical group was assessed with the help of the Beck Depression Inventory. Comparisons between these three groups, between patients with mild, moderate, and severe phobic avoidance and between male and female subjects were carried out. Patients with agoraphobic avoidance showed significantly higher scores on both scales than patients with uncomplicated panic disorder and controls and women generally showed higher embarrassability scores than men. We conclude that heightened embarrassability is an important characteristic of patients suffering from panic disorder with agoraphobia.
Embarrassment is generally regarded as a form of social anxiety closely related to shyness, audience anxiety and shame (Schlenker & Leary, 1982). Goffman (1955) conceptualized embarrassment as an event that occurs when events damage the public identity an individual wishes to claim. In a recently published study on the nature of embarrassability Miller (1995) suggested that embarrassment typically is a reaction to a known public predicament, often an adverse event, without the person having done anything wrong personally, thus differentiating embarrassment from shyness, which results from anticipation and fear of failures. Embarrassability refers to an individual's general susceptibility to becoming embarrassed and is closely linked to another personality characteristic known as fear of negative evaluation. People who have high fear of negative evaluation scores are particularly likely to fear that others may think poorly of them. Highly embarrassable people tend to score higher than less embarrassable people in fear of negative evaluation (Edelmann, 1985).
Sociophobic traits have been shown to be not uncommon in patients suffering from anxiety disorders, especially from panic disorder with agoraphobia. Telch, Brouillard, Telch, Agras and Taylor (1989) found that panic disorder patients without avoidance and panic disorder patients with marked avoidance showed relatively similar levels of concern about the physical consequences of a panic attack, whereas the avoidant group reported significantly more concerns related to social ridicule and loss of control. However the authors state that they cannot rule out the possibility that this difference might be a consequence of agoraphobia. A similar finding was reported by Pollard and Cox (1988), who have found higher levels of social-evaluative anxiety in agoraphobics than in patients with uncomplicated panic disorder. The authors have proposed that hypersensitivity to the opinions of others might predispose a person to respond to panic attacks with phobic avoidance. Amering et al. (1997) have investigated the contextual variables of the first panic attack and the person's reactions to it and have proposed that a feeling of embarrassment as a reaction to the first panic attack could be a contributing factor to the development of agoraphobia.
While there exists some literature on fear of negative evaluation and embarrassability in normal individuals (Monfries & Kafer, 1994; Winton, Clark, & Edelmann, 1995; Kocovski & Endler, 2000; Crozier & Russel, 1992; Miller, 1995; Singelis, Bond, Sharkey, & Lai, 1999), our study is the first to explore these constructs in patients suffering from a psychiatric disorder. The aim of the investigation was to compare patients suffering from panic disorder with and without agoraphobia in the dimensions of embarrassability and fear of negative evaluation. Our hypothesis was that patients who had developed agoraphobia would show higher embarrassability and fear of negative evaluation scores than patients suffering from uncomplicated panic disorder and controls.
