The nature and extent of social anxiety and avoidance in patients with chronic pain : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand

Abstract

The present study explored the nature and extent of social anxiety and avoidance in 46 clinic-referred chronic pain patients relative to a community-based group reporting pain (n = 66) and healthy controls (n = 57). These social fears were also investigated in relation to anxiety sensitivity (i.e., the propensity to fear anxiety-related somatic sensations; Reiss & McNally, 1985) and the elevated pain-related anxiety and avoidance commonly reported by patients with chronic pain. The clinic-referred chronic pain patients consistently reported higher social distress, social avoidance, and fear of negative evaluation as compared with controls. As expected, the clinic-referred chronic pain patients also reported higher levels of anxiety sensitivity and pain-related anxiety and avoidance as compared with controls. With the exception of cognitive anxiety about pain and fear of cognitive and emotional dyscontrol, these group differences disappeared when pain severity was controlled for. The social distress, social avoidance, and fear of negative evaluation reported by the clinic-referred chronic pain patients was consistently related to cognitive anxiety about pain, but not with other measures of pain-related anxiety or avoidance. As anticipated, anxiety sensitivity was strongly related to both social and pain-related fears. In relation to the present results, the potential source of these social fears and the possible role that negative affect and depression might have in the development of social anxiety and avoidance in chronic pain patients is discussed.