Self and friend's differing views of social anxiety disorder's effects on friendships

Conflicting patterns of cardiovascular reactivity, self-report, and behavior associated with social anxiety during a conversation with a close friend

Social anxiety (SA) is characterized by anxious symptomology and fear during social situations, but recent work suggests that SA may not necessarily be associated with negative interpersonal and intrapersonal outcomes in support contexts. The current research investigates the discrepancies between self-perceptions, behavior, and physiological responses associated with SA in social support conversations with close friends. Specifically, we examined the associations between SA and positive and negative affect, perceptions of demands and resources, and responsiveness. Additionally, we used the biopsychosocial model of challenge and threat to understand the physiological responses associated with SA. Participants (79.9% White, 9.8% Black or African American, 10.3% Multiple races or other; 78.7% Female), totaling 172 undergraduate friend dyads, completed self-report measures and had physiological responses recorded while they discussed a problem unrelated to the friendship. Trained coders rated responsive behaviors exhibited during the conversation. Results revealed that greater SA was associated with greater negative perceptions of social interactions (greater negative affect, fewer perceived resources, and greater perceived demands). However, cardiovascular reactivity and behavioral responses within the conversation, as well as perceptions of partners' behavior after the conversation, contrasted with these negative perceptions. Indeed, greater SA was associated with greater sympathetic arousal (indicative of greater task engagement), but not with greater challenge or threat, and SA was not associated with perceived partner responsiveness or responsive behaviors. These results add to the growing body of research that suggests people with greater SA show inconsistencies between their conscious appraisals of social situations and their physiological responses.

Vulnerabilities in social anxiety: Integrating intra- and interpersonal perspectives

What are the major vulnerabilities in people with social anxiety? What are the most promising directions for translational research pertaining to this condition? The present paper provides an integrative summary of basic and applied translational research on social anxiety, emphasizing vulnerability factors. It is divided into two subsections: intrapersonal and interpersonal. The intrapersonal section synthesizes research relating to (a) self-representations and self-referential processes; (b) emotions and their regulation; and (c) cognitive biases: attention, interpretation and judgment, and memory. The interpersonal section summarizes findings regarding the systems of (a) approach and avoidance, (b) affiliation and social rank, and their implications for interpersonal impairments. Our review suggests that the science of social anxiety and, more generally, psychopathology may be advanced by examining processes and their underlying content within broad psychological systems. Increased interaction between basic and applied researchers to diversify and elaborate different perspectives on social anxiety is necessary for progress.

Experiences of Friendships for Individuals on the Autism Spectrum: A Scoping Review

Friendships are vital to mental health and well-being. Understanding autistic individuals’ lived experiences of friendship is necessary to support friendship development. A scoping review exploring autistic individuals’ experiences of friendship was undertaken to understand their perspectives of friendship. Electronic database and manual reference searches identified twenty-two studies exploring autistic perspectives of friendship. Results were synthesised using a meta-ethnographic approach across the lifespan. Findings highlight the common and unique experiences of friendship among autistic individuals. While autistic individuals defined friendship based on homophily and propinquity, similar to non-autistic individuals, unique challenges including friendship insecurity, monotropism and efforts to conform to neurotypical social norms, leading to anxiety, were experienced by autistic individuals.

The prevalence of depression, anxiety and associated factors among adults with living human immunodeficiency virus in University Malaya Medical Centre

BACKGROUND

This study estimates prevalence of depression and anxiety among adults living with Human Immunodeficiency Virus (HIV) in University Malaya Medical Centre (UMMC) and determines its associated factors.

METHODS

This cross-sectional study was conducted between August 2020 and January 2021, in the Infectious Disease clinic and ward. One hundred ninety-one patients were recruited via convenience sampling. Patients' sociodemographic were obtained, followed by Depression, Anxiety, Stress Scale -21 (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS), and M.I.N.I. international neuropsychiatric interview (M.I.N.I.) The cut off DASS-21 point for depression is ≥5, for anxiety, ≥ 4. Mann-Whitney U and Chi square test were used to analyse the association between variables, and logistic regression to find predictability.

RESULTS

Of the 191 participants, 89.5% outpatient, mean age 40 years (SD 0.742), 91.1% male, 65.4% single, 71.2% working, 46.1% Malaysian Chinese, 59.8% non- heterosexual, mean 6 years of being HIV positive; mean CD4 count 449/μL; mean viral load 116,690 (median = 20). 85.9% were taking antiretroviral therapy. The prevalence of depression was 35.1% (n = 67); anxiety was 42.9% (n = 82). Regression analysis revealed anxiety and stress increased odds of depression by 3.8 times (p = .001) and 12 times (p < .001) respectively. Those 40 years old and younger had 2.3 times odds of anxiety (p = .048). Increased social support from friends increased odds of anxiety by 1.7 times (p = .018). Depression and stress increased odds of anxiety by 4.4 times (p = .001) and 3.7 times (p = .008) respectively.

CONCLUSIONS

Depression and anxiety among people with HIV is often under-recognised. Early identification and treatment of the mental illness is warranted. Screening with DASS-21 is useful to detect depression in patients with HIV.

Utilizing the Child Behavior Checklist (CBCL) as an Autism Spectrum Disorder Preliminary Screener and Outcome Measure for the PEERS® Intervention for Autistic Adolescents

Exploration of potential preliminary screeners, and examination of social intervention outcomes for effects on comorbid symptoms is imperative. The Child Behavior Checklist (CBCL; Achenbach & Rescorla, Achenbach and Rescorla, Manual for the ASEBA school-age forms & profiles, University of Vermont, Research Center for Children, Youth & Families, 2001) provides a potential ASD screener and intervention outcome evaluation. This study had two aims: (1) to examine CBCL scales scores as a potential ASD screener; (2) to investigate PEERS® outcomes via the CBCL for Autistic adolescents. Results indicated elevated scores on four CBCL scales in the ASD groups, contrasted to a typically-developing group. Furthermore, decreases in the two CBCL scales for adolescents that received the intervention were found. Findings support prior research indicating a unique CBCL elevation pattern as a potential screener for ASD, and provide additional support for the efficaciousness of PEERS®.

Social Anxiety Disorder and Social Support Behavior in Friendships

Relationship quality is a strong predictor of health outcomes, and individuals with social anxiety disorder (SAD) report increased interpersonal impairment. However, there are few studies testing the effect of SAD on friendships and it is thus unclear whether there are behavioral differences that distinguish friendships in which a target individual has SAD from friendships in which the target individual does not have SAD. We tested for differences in the provision and receipt of support behaviors as a function of having a SAD diagnosis and accounting for comorbid depressive symptoms. Participants with SAD (n = 90) and their friends engaged in support conversations that were coded using the Social Support Interaction Coding System. Structural equation modeling revealed some differences between participants and friends when accounting for depression. Specifically, friends of participants with SAD and comorbid depression engaged in fewer positive helper behaviors than the friends of participants who did not have SAD or comorbid depression. Additionally, dyads in which the primary participant had SAD engaged in more off-task behaviors. Results suggest that SAD does not result in global interpersonal impairment, but that receipt of positive support behaviors from friends may differ as a function of SAD and comorbid depression. Interpersonal interventions aimed at increasing adaptive friendships and aspects of CBT that target subtle avoidance (e.g., safety behaviors) may be useful in facilitating more satisfactory relationships for these individuals.

The Fear of Being Laughed at, Social Anxiety, and Paranoid Ideation: A Multilevel Confirmatory Factor Analysis of Multitrait-Multimethod Data

The GELOPH-15 is a self-report measure that assesses individual differences in the fear of being laughed at (i.e., gelotophobia), a relatively understudied but important trait that is closely related to social anxiety. Using a multitrait-multimethod (MTMM) approach, the convergent and discriminant validity of the GELOPH-15 scale was examined based on 217 self- and 651 peer ratings (of three close acquaintances per target) of the traits gelotophobia, social anxiety, and paranoid ideation. Participants completed the Spanish versions of the GELOPH-15, the Social Interaction Anxiety Scale, and the Paranoia Scale. Applying MTMM models of multilevel confirmatory factor analyses (ML-CFA-MTMM) revealed relatively high associations between the self- and peer ratings, supporting the convergent validity of the GELOPH-15. Discriminant validity analyses confirmed the expected relationship patterns of gelotophobia with social anxiety and paranoid ideation (i.e., strong, but not perfect associations). The results showed that the ML-CFA-MTMM models might be a useful tool for analyzing the convergent and discriminant validity based on self- and peer ratings.

Interpersonal problems in social anxiety disorder across different relational contexts

People with social anxiety disorder (SAD) frequently report interpersonal problems across various domains; however, it is unclear whether these problems are observable by others or represent negatively biased self-report. We assessed the interpersonal problems of people with and without SAD using self-report, friend, and romantic partner report. We hypothesized that SAD diagnosis would predict self-reported problems across multiple interpersonal domains, but restricted domains of informant report. Additionally, we hypothesized that diagnosis would predict discrepancy between self and informant report either in the form of a bias toward reporting more problems or in the form of lack of concordance between self and informant reporters. Using structural equation and multilevel models, we found evidence for differences between people with and without SAD in terms of domains of impairment observed by self and informants as well as differences in correspondence across relationship types. Results highlight the utility of multi-informant assessment of SAD.

Facial Affect and Interpersonal Affiliation: Displays of Emotion During Relationship Formation in Social Anxiety Disorder

Social anxiety disorder (SAD) often involves difficulty developing relationships. Facial expressions are important in relationship formation, but data are limited regarding facial display production among persons with SAD during social interaction. The current study compared facial displays of individuals diagnosed with SAD (n=41) to control participants (n=24) as they interacted with a confederate; confederates and observers then rated their desire for future interaction with participants. Automated software used the Facial Action Coding System (FACS; Ekman & Friesen, 1978) to classify displays. During portions of the interaction that involved listening to partners, the SAD group smiled less frequently and less intensely than controls, and lower smiling was associated with others' lower desire for future interaction with participants. Diminished positive facial affect in response to interaction partners may disrupt relationship formation in SAD and may serve as an effective treatment target.

Self- and other-perceptions of interpersonal problems: Effects of generalized anxiety, social anxiety, and depression

Despite attention on overlap and distinction between generalized anxiety disorder (GAD), social anxiety disorder (SAD), and major depressive disorder (MDD), interpersonal specificity (distinct, prototypical interpersonal features) between the disorders has been understudied. There is emerging evidence for such specificity (e.g., Erickson et al., 2016), but most studies relied on self-report, and not all studies controlled for shared variance between the disorders, complicating interpretation of findings. The present study extended the literature by examining unique interpersonal correlates of GAD, SAD, and MDD symptoms on self- and informant-report, and how self-informant agreement (both mean-level and correlation) in perception of interpersonal affiliation, dominance, and distress varied as a function of the symptoms. 369 college-aged participants (43% with clinical-level symptoms for at least one of the disorders (GAD, SAD, MDD), 57% non-disordered) and up to three of their significant others rated participants' interpersonal problems (interpersonal behaviors that were difficult to engage in or engaged in excessively). We found evidence for exploitable tendencies in GAD, socially avoidant and nonassertive tendencies in SAD, and coldness in MDD based on self-report, but not on informant-report. Although self-other correlation was positive across outcomes, participants endorsed higher affiliation and interpersonal distress and lower dominance relative to informants. GAD, SAD, and MDD symptoms showed distinct moderating effects on these self-informant discrepancies. GAD symptoms predicted over-endorsing affiliation, SAD predicted under-endorsing dominance and affiliation, and MDD predicted no discrepancies in affiliation and dominance. The results speak to potential differentiation of the disorders based on distinct patterns of self-other discrepancy in interpersonal perceptions.

Does centrality in a cross-sectional network suggest intervention targets for social anxiety disorder?

OBJECTIVE

Network analysis allows us to identify the most interconnected (i.e., central) symptoms, and multiple authors have suggested that these symptoms might be important treatment targets. This is because change in central symptoms (relative to others) should have greater impact on change in all other symptoms. It has been argued that networks derived from cross-sectional data may help identify such important symptoms. We tested this hypothesis in social anxiety disorder.

METHOD

We first estimated a state-of-the-art regularized partial correlation network based on participants with social anxiety disorder (n = 910) to determine which symptoms were more central. Next, we tested whether change in these central symptoms were indeed more related to overall symptom change in a separate dataset of participants with social anxiety disorder who underwent a variety of treatments (n = 244). We also tested whether relatively superficial item properties (infrequency of endorsement and variance of items) might account for any effects shown for central symptoms.

RESULTS

Centrality indices successfully predicted how strongly changes in items correlated with change in the remainder of the items. Findings were limited to the measure used in the network and did not generalize to three other measures related to social anxiety severity. In contrast, infrequency of endorsement showed associations across all measures.

CONCLUSIONS

The transfer of recently published results from cross-sectional network analyses to treatment data is unlikely to be straightforward. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Social Anxiety, Depression and Close Relationship: Intra and Inter-Personal Perceptions of Social-Rank and Affiliation

The present study investigated the associations between social anxiety (SA) and depression on the one hand, and intra- and interpersonal perceptions within a friendship relationship on the other. Evolutionary theories suggest that SA is associated with impairment in the social-rank system. Recent studies suggest that depression is associated with impairment in the affiliation system. We examined whether these impairments are manifested in the positivity and accuracy of (a) self-perception; (b) meta-perception (beliefs about how the other perceives the self); and (c) other-perception (evaluations of the friend). Pairs of same-sex friends (n = 50) completed rankings pertaining to these perceptions on general, social-rank, and affiliation traits. Higher levels of SA were associated with lower self-perception positivity, lower meta-perception positivity, and lower accuracy in the social-rank domain. Moreover, higher levels of SA were associated with perceiving the friend as higher on social-rank, regardless of the friend's self-rated traits. Higher levels of depression were associated with lower affiliation and social-rank self-perception positivity, and with lower accuracy in the domain of affiliation. Our findings broaden current conceptualizations of SA and depression and highlight the importance of understanding these disorders through the lens of interpersonal relationships.

Social anxiety and eating disorder comorbidity and underlying vulnerabilities: Using network analysis to conceptualize comorbidity

OBJECTIVE

Eating disorders (EDs) and social anxiety disorder (SAD) are highly co-occurring. This comorbidity is extremely relevant, given that individuals with comorbid ED-SAD are less likely to seek and/or benefit from ED treatment.

METHOD

We used network analysis to conceptualize ED-SAD comorbidity in a sample of 2,215 participants with a primary diagnosis of ED, SAD, or no known diagnosis. We used novel network analyses methods to select symptoms for our models, identify potential illness pathways (i.e., bridge symptoms) between disorders and underlying vulnerabilities (e.g., perfectionism, social appearance anxiety), and to compare across sample types (e.g., clinical vs. nonclinical). We also tested several novel network analyses methods aimed at the following methodological concerns: (a) topological concerns (i.e., which items should be included in NA models), (b) how to use empirical indices to quantify bridge symptoms and (c) what differences in networks across samples mean.

RESULTS

We found that difficulty with drinking beverages and eating in public were bridge symptoms between ED and SAD. We also found that feeling nervous about one's appearance was a bridge symptom.

CONCLUSIONS

We identified public eating and drinking as bridge symptoms between EDs and SAD. Future research is needed to test if interventions focused on public eating and drinking might decrease symptoms of both EDs and SAD. Researchers can use this study (code provided) as an exemplar for how to use network analysis, as well as to use network analysis to conceptualize ED comorbidity and compare network structure and density across samples.

The behavioral economics of social anxiety disorder reveal a robust effect for interpersonal traits

Recent evidence suggests that reduced generosity among individuals with social anxiety disorder (SAD) in behavioral economic tasks may result from constraint in changing behavior according to interpersonal contingencies. That is, people with SAD may be slower to be more generous when the situation warrants. Conversely, more global effects on generosity may be related to interpersonal vindictiveness, a dimension only somewhat related to SAD. A total of 133 participants, 73 with the generalized form of SAD, completed self-report instruments and a behavioral economic task with simulated interpersonal (friend, romantic partner, stranger) interactions. In a separate visit, friends (n = 88) also came to the lab and rated participants on vindictiveness. Interpersonal vindictiveness was associated with reduced initial and overall giving to simulated friends. SAD predicted a lack of increased giving to a simulated friend, and attenuated an increase in giving to simulated known versus unknown players compared to participants without SAD. Friend-reported vindictiveness predicted in the same direction as diagnosis. However, the findings for SAD were less robust than those for vindictiveness. SAD is perhaps weakly related to behavioral constraint in economic tasks that simulate interpersonal interactions, whereas vindictiveness is strongly related to lower overall generosity as well as (via friend report) behavioral constraint. Further study is needed to better characterize the construct of vindictiveness. Our findings dovetail with the suggestion that SAD is related to impairment in the proposed affiliation and attachment system, but further suggest that direct study of that system may be more fruitful than focusing on disorders.

Social Anxiety and Social Support in Romantic Relationships

Little is known about the quality of socially anxious individuals' romantic relationships. In the present study, we examine associations between social anxiety and social support in such relationships. In Study 1, we collected self-report data on social anxiety symptoms and received, provided, and perceived social support from 343 undergraduates and their romantic partners. One year later couples were contacted to determine whether they were still in this relationship. Results indicated that men's social anxiety at Time 1 predicted higher rates of breakup at Time 2. Men's and women's perceived support, as well as men's provided support, were also significantly predictive of breakup. Social anxiety did not interact with any of the support variables to predict breakup. In Study 2, a subset of undergraduate couples with a partner high (n=27) or low (n=27) in social anxiety completed two 10-minute, lab-based, video-recorded social support tasks. Both partners rated their received or provided social support following the interaction, and trained observers also coded for support behaviors. Results showed that socially anxious individuals received less support from their partners during the interaction according to participant but not observer report. High and lower social anxiety couples did not differ in terms of the target's provision of support. Taken together, results suggest that social anxiety is associated with difficulties even in the context of established romantic relationships. Clinical implications are discussed.

The structure of vulnerabilities for social anxiety disorder

Social anxiety disorder symptoms are generally proposed to be related to broad temperamental vulnerabilities (e.g., a low level of approach and high level of avoidance temperament), specific psychological vulnerabilities (e.g., fears of negative and positive evaluation), and additional disorders (e.g., major depressive disorder). However, existing tests of such a model have either not considered depressive symptoms or relied on samples of undergraduates. We examined these and related questions via a latent variable model in a large dataset (N=2253) that combined participants across a variety of studies. The model had adequate fit in the whole sample, and good fit in a subsample in which more participants completed the depression measure. The model indicated that low level of approach and high level of avoidance temperament contributed to fears of evaluation and social anxiety symptoms, and that fears of evaluation additionally contributed independently to social anxiety symptoms. The relationship between social anxiety and depressive symptoms was entirely accounted for by these vulnerabilities: Depressive symptoms were only predicted by avoidance temperament.

Social Anxiety and Social Surrogacy in College Roommate Relationships

The social surrogate hypothesis proposes that people with higher social anxiety (HSA) recruit others to accompany them into social situations. We tested this hypothesis with college roommates using both hypothetical (Study 1) and retrospective (Study 2) measures, while assessing roommate's perceptions of recruitment and how social surrogacy might influence liking between roommates. Across two studies, we found that HSA participants were less likely to enter social situations alone (i.e. higher conditional entry); however, HSA was related to recruitment only when participants considered hypothetical scenarios, not when recruitment was assessed globally or retrospectively. There was little evidence that HSA participants’ roommates were aware of these behaviours, although there was preliminary evidence that less social anxiety might increase liking when roommates perceived more conditional entry. We also found preliminary evidence that social anxiety may be negatively related to liking when participants were less likely to recruit an alternate surrogate if their roommate was unavailable. Taken together, these preliminary findings emphasize the importance of studying the surrogacy process from an interpersonal/dyadic perspective and using methods that will differentiate between anticipated (which may be assessed by hypothetical scenarios) and enacted recruitment behaviours. Copyright © 2017 European Association of Personality Psychology

The Core Extrusion Schema–Revised

Cognitive behavioral models of social anxiety disorder (SAD) suggest that fear of negative evaluation is a core fear or vulnerability for SAD. However, why negative evaluation is feared is not fully understood. It is possible that core beliefs contribute to the relationship between fear of negative evaluation and SAD. One of these beliefs may be a core extrusion schema: a constellation of beliefs that one’s true self will be rejected by others and therefore one should hide one’s true self. In the current study ( N = 699), we extended research on the Core Extrusion Schema and created a shortened and revised version of the measure called the Core Extrusion Schema–Revised. The Core Extrusion Schema–Revised demonstrated good factor fit for its two subscales (Hidden Self and Rejection of the True Self) and was invariant across gender and ethnicity. The Hidden Self subscale demonstrated excellent incremental validity within the full sample as well as in participants diagnosed with generalized SAD. Specifically, the Hidden Self subscale may help explain severity of social interaction anxiety. This measure could be used with individuals diagnosed with generalized SAD to design exposures targeting these core beliefs.

Exploring linguistic correlates of social anxiety in romantic stories

The current study used computerized linguistic analysis of stories about either going on a date or taking a walk down a street to examine linguistic correlates of social anxiety in a sample of undergraduate students. In general, linguistic analysis revealed associations of social anxiety with several linguistic variables, including negative emotion, affect, and anxiety words. Participants higher in social anxiety wrote fewer affect words. The relationship between social anxiety and anxiety words depended on gender, whereas the relationship between social anxiety and negative emotion words depended on both gender and the nature of primes (supraliminal vs. subliminal) received. Overall, our findings highlight the potential utility and benefits of using linguistic analysis as another source of information about how individuals higher in social anxiety process romantic stimuli.

The effects of social anxiety on interpersonal evaluations of warmth and dominance

Social anxiety disorder is associated with interpersonal dysfunction, but it is not clear why people with the disorder feel unsatisfied with their relationships. One possibility is that higher social anxiety could lead to changes in sensitivity to interpersonal traits. We examined whether social anxiety moderates the types of interpersonal evaluations people make regarding warmth and dominance. We developed vignettes in which central characters systematically varied in dominance and warmth and asked two samples of participants (undergraduate students, n=176, and online workers, n=403) to rate their willingness to interact with, and the social desirability of, these characters. Participants in general reported stronger desire to interact with warmer and less dominant characters, and rated warmer and more dominant characters as being more socially desirable. People with higher social anxiety exhibited greater tolerance for colder and more submissive characters on both rated dimensions. The perceived similarity of the characters accounted for the bulk of these effects. Participants indicated a higher desire to interact with characters more similar to themselves, and people with higher social anxiety were more likely to rate submissive and cold characters as being like themselves. The results have implications for clinical interventions for social anxiety disorder.

Self-reported social skills impairment explains elevated autistic traits in individuals with generalized social anxiety disorder

Screening for autism in individuals with generalized social anxiety disorder (GSAD) is complicated by symptom overlap between GSAD and autism spectrum disorder (ASD). We examined the prevalence of self-reported autistic traits within a sample of participants with a diagnosis of GSAD (n=37) compared to individuals without a GSAD diagnosis (NOSAD; n=26). Of the GSAD sample participants, 70.84% self-reported autistic traits above a cut-off of 65 on the Autism Quotient-Short (AQ-S) and reported significantly more autistic traits on 3 of 5 AQ-S subscales compared to the NOSAD group. Diagnosis uniquely predicted variation in the social skills subscale above and beyond the other subscales and other predictors. Furthermore, variation in the social skills subscale largely explained group differences on the other subscales. Our results suggest caution in utilizing measures like the AQ-S with clinical populations characterized by social difficulties such as individuals with a GSAD diagnosis.

Predicting short-term positive affect in individuals with social anxiety disorder: The role of selected personality traits and emotion regulation strategies

Recently, research has provided support for a moderate, inverse relationship between social anxiety and dispositional positive affect. However, the dynamics of this relationship remain poorly understood. The present study evaluates whether certain personality traits and emotion regulation variables predict short-term positive affect for individuals with social anxiety disorder and healthy controls. Positive affect as measured by two self-report instruments was assessed before and after two tasks in which the participant conversed with either a friend or a romantic partner. Tests of models examining the hypothesized prospective predictors revealed that the paths did not differ significantly across diagnostic group and both groups showed the hypothesized patterns of endorsement for the emotion regulation variables. Further, a variable reflecting difficulty redirecting oneself when distressed prospectively predicted one measure of positive affect. Additional research is needed to explore further the role of emotion regulation strategies on positive emotions for individuals higher in social anxiety.

Social Anxiety and Friendship Quality over Time

High social anxiety in adults is associated with self-report of impaired friendship quality, but not necessarily with impairment reported by friends. Further, prospective prediction of social anxiety and friendship quality over time has not been tested among adults. We therefore examined friendship quality and social anxiety prospectively in 126 young adults (67 primary participants and 59 friends, aged 17-22 years); the primary participants were screened to be extreme groups to increase power and relevance to clinical samples (i.e., they were recruited based on having very high or very low social interaction anxiety). The prospective relationships between friendship quality and social anxiety were then tested using an Actor-Partner Interdependence Model. Friendship quality prospectively predicted social anxiety over time within each individual in the friendship, such that higher friendship quality at Time 1 predicted lower social anxiety approximately 6 months later at Time 2. Social anxiety did not predict friendship quality. Although the results support the view that social anxiety and friendship quality have an important causal relationship, the results run counter to the assumption that high social anxiety causes poor friendship quality. Interventions to increase friendship quality merit further consideration.