Social Anxiety, Loneliness, and the Moderating Role of Emotion Regulation

Background: Loneliness is a universal experience that is particularly relevant to social anxiety. However, research has not examined loneliness among treatment-seeking individuals with social anxiety disorder (SAD) or assessed whether mal-adaptive or adaptive emotion regulation strategies moderate the relationship between social anxiety and loneliness. Methods: We examined the baseline scores of individuals with SAD (n = 121) who sought treatment as part of a waitlist-controlled trial of cognitive behavioral group therapy versus mindfulness-based stress reduction. Healthy controls (n = 38) were also examined. Results: Individuals with SAD exhibited greater social anxiety (SA), greater loneliness, more frequent expressive suppression (ES), and less frequent cognitive reappraisal (CR) than controls. Hierarchical multiple regressions indicated that emotion regulation variables moderated the relationship between social anxiety and loneliness. At lower CR and higher ES, there was a positive relationship between social anxiety and loneliness. At higher CR and lower ES, there was unexpectedly a stronger positive relationship between social anxiety and loneliness. Higher SA was associated with higher loneliness regardless of emotion regulation strategy, whereas lower SA was associated with more moderate and lower levels of loneliness dependent on level of ER strategy. Discussion: Implications for understanding the prevalence and burden of loneliness among individuals with SAD, the role of emotion regulation in the relationship between social anxiety and loneliness, and directions for future research are discussed.