Temporal Dynamics of Social Anxiety and Depressive Symptoms: The Moderating Role of Cognitive Flexibility

Social anxiety (SA) and depressive symptoms frequently coexist, with the onset of SA typically preceding the onset of depression. Individuals experiencing SA-depression comorbidity exhibit increased functional impairments as compared to individuals without this comorbidity. Understanding the mechanisms that underlie the coexistence of SA and depressive symptoms can deepen our theoretical understanding regarding these conditions and contribute to depression prevention efforts. Recent theories suggest that low cognitive flexibility (CF) contributes to the development of depression and may play a role in the relationship between the disorders. However, empirical prospective findings are sparse. We examined whether CF moderates the link between SA and depressive symptoms in two independent preregistered studies: cross-sectional (n = 379) and longitudinal (n = 108, 2-year). Cross-sectionally, higher CF was linked to a weaker relationship between SA and depressive symptoms. Across time, among individuals with low CF at baseline, there was a positive association between SA at baseline and depressive symptoms 2 years later. No such association was found among individuals with high CF. These findings highlight the role of CF in the development of comorbid depressive symptoms among high SA individuals. It may contribute to the clinical prevention of depression through specific psychotherapeutic techniques targeted to enhance CF among SA patients. A preprint of this MS has previously been published.