Interpersonal Subtypes in Social Phobia: Diagnostic and Treatment Implications

Abstract

Interpersonal assessment may provide a clinically useful way to identify subtypes of social phobia. In this study, we examined evidence for interpersonal subtypes in a sample of 77 socially phobic outpatients. A cluster analysis based on the dimensions of dominance and love on the Inventory of Interpersonal Problems-Circumplex Scales (Alden, Wiggins, Pincus, 1990) found 2 interpersonal subtypes of socially phobic patients. These subtypes did not differ on pretreatment global symptom severity as measured by the Brief Symptom Inventory (Derogatis, 1993) or diagnostic comorbidity but did exhibit differential responses to outpatient psychotherapy. Overall, friendly-submissive social phobia patients had significantly lower scores on measures of social anxiety and significantly higher scores on measures of well-being and satisfaction at posttreatment than cold-submissive social phobia patients. We discuss the results in terms of interpersonal theory and the clinical relevance of assessment of interpersonal functioning prior to beginning psychotherapy with socially phobic patients.

Interpersonal Problems Across Levels of the Psychopathology Hierarchy

“…However, when the individual diagnoses are heterogeneous, that dimension may fail to achieve interpersonal prototypicality. These findings are consistent with previous research on pathoplasticity in depressive and anxiety disorders (e.g., Cain et al, 2012Cain et al, , 2010.…”

“…Due to methodological and reporting limitations of many of these studies, conclusions regarding profile descriptors are difficult to draw. In general, these studies suggest that major depressive disorder has a nonassertive and socially avoidant style (Barrett and Barber, 2007;Dinger et al, 2015;Grosse Holtforth et al, 2014;Locke et al, 2016;Quilty et al, 2013;Stangier et al, 2006), social phobia has a nonassertive style (Cain et al, 2010;Kachin et al, 2001;Stangier et al, 2006), and generalized anxiety disorder has an exploitable style (Przeworski et al, 2011;Salzer et al, 2008Salzer et al, , 2011. These disorders also seem to have marked elevation.…”

Does Worrying Mean Caring Too Much? Interpersonal Prototypicality of Dimensional Worry Controlling for Social Anxiety and Depressive Symptoms

“…Second, our results do not dispute, but suggest a limit to, interpersonal pathoplasticity for some symptoms. Similar to how both the mean and standard deviation convey information about a distribution, it is useful to know that social anxiety is a submissive phenomenon on average (our findings) and that socially anxious individuals vary interpersonally (e.g., warm-submissive vs. cold-submissive; Cain et al, 2010). Third, our results may have implications for understanding individuals' emotional and social difficulties.…”

“…For example, the average problems of GAD patients were affiliative-submissive/submissive, but not prototypical and therefore not interpretable (Przeworski et al, 2011); however, four cluster analytically derived subgroups each had high nonspecific interpersonal distress (Alternative 1) as well as different differentiated and prototypical problems (Alternative 2). Similarly, heterogeneity has been shown in other GAD (Salzer, Pincus, Winkelbach, Leichsenring, & Leibing, 2011), social anxiety disorder (Cain et al, 2010;Kachin et al, 2001), and depressed (Cain et al, 2012;Simon, Cain, Wallner Samstag, Meehan, & Muran, 2015) and analogue depressed (Dawood, Thomas, Wright, & Hopwood, 2013) samples.…”

“…Measuring all combinations of these dimensions ensures that specific types of problems are not overlooked (e.g., trusting and forgiving too much reflects a combination of high affiliation and low dominance). IPC research has linked selfreported interpersonal problems of many types to the aforementioned symptoms (e.g., Cain, Pincus, & Grosse Holtforth, 2010;McEvoy et al, 2013;Przeworski et al, 2011).…”