High Risk, High Reward: Daily Perceptions of Social Challenge and Performance in Social Anxiety Disorder.

摘要

Social Anxiety Disorder (SAD) is associated with significant impairment in social, occupational, and daily functioning, as well as subjective appraisals of life events as more negative and less positive. Individuals with SAD have difficulty engaging in social situations because their actions are predicated on minimizing the potential for rejection---a potential they perceive as not only possible, but likely. That is, individuals with SAD frequently perceive social situations as challenging, and their performance as subpar. Yet when individuals perceive themselves as succeeding in challenging situations, they typically report these situations as enjoyable and rewarding. This subjective experience of succeeding in a challenging situation has been studied as flow (Csikszentmihalyi, 1975/2000). Forty adults with SAD and 39 matched healthy controls completed a baseline assessment, along with daily and experience sampling entries for 14 days. Results were analyzed using three-level linear mixed effects models, with observations nested within days, nested within participants. Nested-model comparisons also ensured that increased complexity of the models explained significant variance over more parsimonious models. Results indicated that, although individuals with SAD experienced the same frequency of flow overall in their daily lives (probability=.19; &phis;=-0.01, p=.83), social experiences led to proportionally more flow in participants with SAD (probability=.20) than their healthy control counterparts (probability=.07; b=-1.39, se=0.63, t=2.21, p=0.02, OR=0.25). Moreover, several experiential variables predict the probability of flow during each situation, such as positive emotions and importance ascribed to the event. These results offer several suggestions for how individuals may benefit from seeking out challenging situations that offer maximal rewards. Clinical and research implications are also discussed.