(PS9-B50) Social Anxiety as a Predictor of Thwarted Belongingness and Perceived Burdensomeness: A Longitudinal Analysis

People with social anxiety difficulties are at an increased risk for the development and progression of suicidal ideation. The interpersonal psychological theory of suicidal behavior (IPTS) suggests that two social factors increase the risk for suicidal ideation: perceived burdensomeness (PB) and thwarted sense of belongingness (TB). Social anxiety is positively associated with both PB and TB above and beyond depressive symptoms. Given that PB and TB independently predict future suicidal ideation, identifying factors that contribute to increased PB and TB may be important to mitigating future suicide risk in social anxiety. People with elevated social anxiety tend to excessively worry about social rejection and hold negative self-views (e.g., make negative social comparisons). Moreover, past research suggests negative self-views and rejection concerns predict increased TB and PB. Extrapolating on these findings, social anxiety may longitudinally predict TB/PB via elevated social rejection concerns and negative self-views. No study to date has examined these processes longitudinally, thus precluding conclusions about temporality. The present study addressed this gap by leveraging a longitudinal design to examine: 1) if social anxiety prospectively predicts PB and TB above and beyond depressive symptoms, and 2) how rejection concerns and negative self-views (operationalized by a negative social comparison measure) contribute to these respective relationships (i.e., social anxiety-PB and social anxiety-TB). 

Community adults (N = 226; mean age = 35 years; 80% women, 20% men) with elevated social anxiety and/or depression completed measures of social anxiety and depression at baseline (T1) and measures of PB and TB at a one-month follow-up (T3). Between baseline and follow-up assessments, participants completed a 14-day diary study (T2) measuring daily concerns about rejection and social comparisons. Multiple regression analyses revealed that social anxiety (T1) predicted both PB and TB (T3) above and beyond depressive symptoms (T1). Mediation analyses revealed that concerns about rejection (T2) partially mediated the social anxiety–PB relationship, while negative social comparisons (T2) partially mediated the social anxiety–TB relationship. 

The present study adds longitudinal data to nascent work examining social anxiety and suicide risk within an IPTS framework. Study findings suggest that people with elevated social anxiety are at an increased risk for both TB and PB, irrespective of depressive symptoms. In line with cognitive frameworks of social anxiety, higher levels of social anxiety predicted concerns with rejection and engagement in negative social comparisons, which in turn, partially accounted for the social anxiety-PB/TB relationships. Negative self-views and rejection concerns may be important clinical targets to mitigate future suicide risk in those with elevated social anxiety.