Examination of the relationship between attachment styles, separation anxiety and rejection sensitivity in social anxiety disorder

Social anxiety disorder is a significant mental health illness that causes marked functional impairment. This study hypothesizes that rejection sensitivity, insecure attachment, and separation anxiety will be higher in people with social anxiety disorder and that these factors will predict social anxiety disorder. The study included 57 patients diagnosed with social anxiety disorder and 59 healthy controls. All participants completed the Relationship Scales Questionnaire, Rejection Sensitivity Scale, and Adult Separation Anxiety Questionnaire, while the Liebowitz Social Anxiety Scale was additionally administered to the patient group. The mean secure attachment subscale score was lower in the patient group (p<0.001). The patient group had higher mean scores on the preoccupied, disengaged, and fearful attachment subscales (p<0.001). Total scores on the Rejection Sensitivity Scale and the Adult Separation Anxiety Questionnaire were higher in the patient group (p=0.036 and p<0.001, respectively). Moreover each one-unit increase in rejection sensitivity was associated with a 0.360-unit increase in the SF-anxiety score, while each one-unit increase in preoccupied attachment score led to a 0.755-unit increase in the SF-anxiety score. Each one-unit increase in preoccupied attachment was associated with a 1.446-unit increase in the SF-avoidant score, while each one-unit increase in fearful attachment resulted in a 0.898-unit increase in the SF-avoidant score. This study found that individuals with social anxiety disorder exhibit higher levels of rejection sensitivity, adult separation anxiety, and insecure attachment. Rejection sensitivity, adult separation anxiety, and insecure attachment styles were found to increase the severity of social anxiety disorder symptoms.