Social anxiety and coping strategies in the eating disorders

Studies of social phobia in the eating disorders have demonstrated high comorbidity with both anorexia and bulimia nervosa. This study examined levels of social anxiety across different types of eating disorders, and determined the association of such anxiety with specific forms of emotional regulation. One hundred fourteen females who met DSM-IV criteria for an eating disorder and a comparison group of 50 nonclinical women completed three self-report questionnaires, which measured bulimic behaviours, dissociation, and social anxiety. The clinical groups reported higher levels of social anxiety than the nonclinical group. In both the nonclinical individuals and the bulimia nervosa patients, social anxiety was found to be associated with higher levels of bulimic psychopathology. By contrast, social anxiety in the restrictive anorexic group was linked to higher levels of dissociation. The present findings highlight the clinical importance of addressing social anxiety in eating-disordered individuals, and suggestions are made for the treatment of different forms of emotional regulation in such cases. Implications for future research are also discussed.