The Measurement of Reactions to Face Masks and the Relation to Social Anxiety

Introduction: Following a period of social isolation from the COVID-19 pandemic, social interactions may be particularly complicated for individuals with elevated levels of social anxiety. One potential implication relates to the use of face masks. Face masks have been used as an effective tool to prevent the transmission of COVID-19. However, for individuals with elevated social anxiety, face masks may be a form of avoidance and type of safety behavior and discontinued use of face masks may be associated with increases in social anxiety. In response to these possibilities, the purpose of this study was to develop a measure to assess potential anxiety-related reactions to face masks. Method: Participants were 564 nonreferred young adults who completed a measure developed for this study to assess behaviors and reactions to face masks (Reaction to Face Masks Questionnaire), including anxiety and avoidance behaviors. Measures of social anxiety, more general avoidance, and safety behaviors were also included. Results: Based on an exploratory factor analysis, a two-factor model was retained. Safety-Seeking and Avoidance (SSA) measures reductions in social anxiety derived from a feeling of safety when wearing a face mask, and Social Interference measures increases in social anxiety symptoms related to the interference/inhibition of social interactions related to wearing masks. Both subscales were found to be associated with general measures of social anxiety, more general avoidance, and safety behaviors; however, the correlations were more robust for the SSA subscale. Discussion: Based on the current findings, general social anxiety and common correlates of social anxiety, including safety-seeking behaviors, were found to be associated with face mask anxiety and avoidance. Implications for future research and potential clinical practice are discussed.