Is there a complex relation between social anxiety disorder, childhood traumatic experiences and dissociation?

Background: A possible relationship has been suggested between social anxiety and dissociation. Traumatic experiences, especially childhood abuse, play an important role in the aetiology of dissociation.

Aim: This study assesses childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with social anxiety disorder (SAD).

Method: The 94 psychotropic drug-naive patients participating in the study had to meet DSM-IV criteria for SAD. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), the Dissociation Questionnaire (DIS-Q), the Liebowitz Social Anxiety Scale (LSAS), and the Childhood Trauma Questionnaire (CTQ). Patients were divided into two groups using the DIS-Q, and the two groups were compared.

Results: The evaluation found evidence of at least one dissociative disorder in 31.91% of participating patients. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Average scores on LSAS and fear and avoidance sub-scale averages were significantly higher among the high DIS-Q group (p < .05). In a logistic regression taking average LSAS scores as the dependent variable, the five independent variables DIS-Q, CTQ-53 total score, emotional abuse, sexual abuse, and emotional neglect were associated with average LSAS scores among patients with SAD (p < .05).

Conclusions: It is concluded that, on detecting SAD symptoms during hospitalization, the clinician should not neglect underlying dissociative processes and traumatic experiences among these patients.