سرکوب خشم پس از رد تصور در میان افراد با اضطراب اجتماعی

Individuals experiencing high levels of social anxiety report frequent and intense anger. Yet, little is known about how they manage this emotion. Despite general tendencies towards anger suppression, subsets of individuals with social anxiety regulate anger through outward expression. In this study, we investigated rejection as an antecedent to anger, examined how and when individuals with high social anxiety suppress anger, and evaluated experiential avoidance (EA) as a moderator of the relationship between social anxiety and anger suppression. 170 undergraduate students described their responses to everyday social situations that were designed to elicit anger; several situations reflected instances of social rejection. Our results suggest that rejection was a potent source of anger for most people and that social anxiety predicted both anger and EA in response to imagined rejection. In addition, as evidence of a moderation model, individuals with low social anxiety and low EA reported the least anger suppression; no significant differences were found for individuals with high social anxiety. We discuss the implications for understanding the interface of social anxiety and anger.

Mounting evidence suggests that individuals with social anxiety vary on meaningful dimensions that influence frequency and intensity of distress and impact socio-emotional functioning (Hofmann, Heinrichs, & Moscovitch, 2004). One dimension appears to be how people experience and express anger. Anger is worthy of clinical attention due to its deleterious effects on health (Diamond, 1982, Rein et al., 1995 and Siegman, 1993) and social functioning (Deffenbacher et al., 1996, Hazaleus and Deffenbacher, 1986 and Tafrate et al., 2002). Yet, few studies have examined whether, why, and when social anxiety is related to anger. We sought to better understand anger experiences in individuals with social anxiety by experimentally inducing anger and examining how and when anger is over-regulated or suppressed. 1. Social anxiety and anger Social anxiety refers to a fear of being scrutinized or rejected in social or performance situations (American Psychiatric Association, 2000). Cognitive-behavioral theories explain that individuals with social anxiety engage in safety behaviors to minimize anxiety and limit information shared with others to reduce the likelihood of negative evaluation (Clark and Wells, 1995 and Rapee and Heimberg, 1997). Expressing strong emotions is a powerful way to convey information (Keltner & Haidt, 1999) while expressing anger also has the potential to generate conflict (Averill, 1983). Conflict increases the likelihood of scrutiny and rejection. As a result, individuals with social anxiety may experience anger as problematic and expend effort and energy to manage it (Kashdan, Breen, Terhar, & Afram, 2010). The seminal study of social anxiety and anger examined 234 people who met diagnostic criteria for Social Anxiety Disorder (SAD) (American Psychiatric Association, 2000) compared with people who did not meet criteria for any psychiatric diagnoses (Erwin, Heimberg, Schneier, & Leibowitz, 2003). Results suggest that people diagnosed with SAD reported more frequent and intense anger, greater anger in response to negative evaluation, poorer anger expression skills, and greater tendencies to suppress anger compared to those without SAD. The largest correlation (r = .49) occurred between social anxiety and anger suppression ( Erwin et al., 2003). In sum, people with excessive and impairing social anxiety experienced greater levels of anger, reported greater difficulty managing anger, and were more likely to suppress anger than people with less social anxiety. More recent studies extend these findings. One study examined anger among individuals diagnosed with different anxiety disorders and found that people diagnosed with SAD were less likely to express anger than people diagnosed with other anxiety disorders or no diagnosis (Moscovitch, McCabe, Antony, Rocca, & Swinson, 2007). In another study, experience sampling techniques were used to collect data on social anxiety and anger episodes from college students across 14 days (Kashdan & Collins, 2010). Results suggest that individuals with high social anxiety spent more time each day feeling angry and reported more anger episodes in both social and non-social situations compared to individuals with low social anxiety. Thus, there appears to be a strong relation between social anxiety and anger. Despite a tendency to do so, not all individuals with social anxiety habitually suppress emotions. One study presented evidence for differences in emotion and behavior management after examining interpersonal difficulties in people diagnosed with SAD (Kachin, Newman, & Pincus, 2001). The authors assessed differences in social problems in people with SAD and identified two distinct subsets of people with varying behavioral reactions to social threat. One group reported theoretically expected avoidant, unassertive, and submissive response styles while the other group reported less characteristic angry, hostile, and mistrusting interpersonal styles. After controlling for co-morbid psychopathology, the authors inferred that people with SAD do not uniformly respond to social situations and demonstrate greater variation in their behavior than theoretically assumed. These data offered preliminary evidence for a subgroup of individuals with social anxiety who exhibit aggressive, externalized behavior when confronted with threatening social situations and tend to express rather than suppress anger. Additional evidence was found in two studies that examined differences in appraisal patterns and novelty-seeking tendencies for risky social situations (Kashdan et al., 2008 and Kashdan and Hofmann, 2008). These studies used cluster-analytic techniques to identify subgroups of individuals with social anxiety characterized by distinct patterns of approach/avoidance appraisals for social activities and risk-taking behaviors. In these studies, individuals with social anxiety seemed torn between a desire to avoid threats and minimize rejection versus pursuing activities believed to be enjoyable or useful. For example, a subgroup of individuals with moderate social anxiety differed in appraisals of risk-taking behavior, reported more approach-oriented appraisals (e.g., aggression seen as an opportunity to increase social status, etc.), and greater anger expression over a three-month assessment period. Similar evidence for subgroups of people diagnosed with SAD emerged from the National Comorbidity Study-Replication data (Kashdan, McKnight, Richey, & Hofmann, 2009). Thus, there appears to be heterogeneity in how individuals with social anxiety respond to social threat and manage anger. 2. Social anxiety, anger, and rejection Despite increasing research, no study has examined anger antecedents and responses among individuals with social anxiety. In this section, we suggest that perceived rejection may provide a link between social anxiety and anger. Anger is a common human emotion that occurs most frequently in social situations (Averill, 1983). Social situations are replete with possibilities for interpersonal rewards (e.g., attention, intimacy) or unpleasant consequences (e.g., hurt feelings, rejection). Many anger researchers agree that frustration, or interference with important goals, and painful or unpleasant events (e.g., rejection) are common anger antecedents (Berkowitz, 1989, Berkowitz and Harmon-Jones, 2004, Buss, 1961 and Izard, 1977). Rejection might provoke anger in individuals with social anxiety to the extent that it is perceived as an aversive social event or an obstacle to satisfy the need to belong (Leary, Twenge, & Quinlivan, 2006). The need to belong is a strong human motivation to affiliate with and be accepted by others (Baumeister & Leary, 1995). Failure to meet this fundamental need is associated with emotional distress and poor social outcomes (Baumeister, Brewer, Tice, & Twenge, 2007). Rejection interferes with the need to belong by impeding the creation and maintenance of meaningful relationships. In addition, rejection is painful (Eisenberger et al., 2003, Leary et al., 1998 and MacDonald and Leary, 2005) and is associated with an increase in aversive emotions including anxiety, loneliness, and depression (Ayduk et al., 2001, Baumeister and Tice, 1990, Gardner et al., 2000, Gilbert and Miles, 2000 and Leary, 1990). The relation between rejection and anger may be particularly strong for individuals experiencing chronic and intense social anxiety. These individuals tend to report fewer social connections including friendships and romantic partners as well as diminished life satisfaction (Schneier et al., 1994). They also tend to interpret ambiguous social information as negative and would be more likely to perceive innocuous or ambiguous events as threatening (Amir, Foa, & Coles, 1998; Stopa & Clark, 2000). As such, individuals with social anxiety are more vulnerable to fluctuating perceptions of belongingness and may be more likely to experience anger in daily life. Due to the challenges posed by anger, individuals with social anxiety would be expected to expend personal resources to alter or avoid anger experiences. 3. Experiential avoidance as moderator Undoubtedly, individuals with social anxiety experience rejection as unpleasant. However, important variability may exist in how individuals experience and respond to rejection. Experiential avoidance (EA) refers to an unwillingness to experience negatively evaluated thoughts, emotions, physical sensations, and environmental events as well as attempts to alter these experiences even when doing so is counterproductive (Hayes, Strosahl, & Wilson, 1999). Differences in the willingness to experience aversive events or effort exerted to avoid those events may influence how and when individuals with social anxiety suppress anger after rejection. Cognitive-behavioral theories state that individuals experiencing social anxiety expend significant personal resources engaging in avoidance-based strategies (i.e., safety behaviors) to minimize the occurrence of unwanted social outcomes and aversive emotions (Clark and Wells, 1995 and Rapee and Heimberg, 1997). Emotion suppression is a common strategy used to hide, conceal, or control feelings of anxiety and anger (Gross & John, 2003). Thus, suppression is behavioral evidence of EA (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). Although individuals with social anxiety tend to suppress emotions, those who exhibit greater EA would be expected to engage in greater anger suppression compared to those less inclined to avoid unwanted emotions. Therefore, EA is hypothesized to moderate the relation between social anxiety and anger suppression by altering the strength of the relation for individuals experiencing different degrees of social anxiety. Yet, hiding and concealing emotions can be beneficial at time (e.g., suppressing anger at work rather than cursing at the boss). On the other hand, chonic and rigid suppression is harmful because it has paradoxical consequences (Feldner et al., 2003 and Wegner et al., 1987), depletes finite personal resources (Muraven & Baumeister, 2000), damages relationship rapport (Butler et al., 2003), impairs cognitive functioning (Richards & Gross, 1999), inhibits movement towards valued goals (e.g., expressing feelings to deepen a romantic relationship) and may produce more severe functional impairment (Eifert and Forsyth, 2005 and Hayes et al., 1999). Despite theoretical links, little is known about relations between social anxiety and EA. One cross-sectional study presented evidence of a positive correlation between social anxiety and EA in a university sample (Kashdan & Breen, 2007). Two daily diary studies found that EA accounts for how and when daily distress and positive experiences were associated with social anxiety (Kashdan & Steger, 2006) better than cognitive reappraisal (Kashdan, Barrios, Forsyth, & Steger, 2006). Albeit promising, more research is needed to understand relations between social anxiety, EA, and anger.