Background: This study explored affect organisation in patients diagnosed with social anxiety disorder (SAD) using qualitative methodology. Building on the affect consciousness model, participants were asked about aspects of affect integration in nine discrete or basic affects. The nine discrete affects were interest/excitement, enjoyment/joy, fear/panic, anger/rage, shame/humiliation, sadness/despair, envy/jealousy, guilt/remorse, and tenderness/care. The aspects of affect integration were scenes, awareness, tolerance, non-verbal expression, and conceptual expression. The primary affective problem (i.e. the nuclear script) was sought identified for each participant, and patterns of maladaptive affect organisation across the participants were searched for. This study expands on previous research investigating emotion regulation in individuals with SAD.
Methods: The data material used in this study was obtained from the Norwegian Multisite Study on the Process and Outcome of Psychotherapy. Seven outpatients diagnosed with SAD were interviewed with the Affect Consciousness Interview (ACI) before the start of psychotherapy. The interviews were transcribed and were subject to thematic analysis: First, the primary affective problem for each participant was established on the basis of the ACI using a predefined procedure for nuclear script identification. Second, based on the preceding within-case analysis, patterns of maladaptive affect organisation across the participants were searched for.
Results: Five major themes were identified in the analysis. First, all participants appeared to experience overwhelming or near-overwhelming shame and fear in social situations. Second, the majority of the participants seemed to experience generalized and overwhelming feelings of guilt. Third, there appeared to be a disturbance in self-assertiveness across the participants, as witnessed in anger and interest. Fourth, the communication of vulnerability and tenderness seemed to be disturbed across the participants. And finally, the majority of the participants appeared to experience paralyzing sadness because of perceptions of social deficits in themselves and social rejection.
Conclusion: Several significant patterns of maladaptive affect organisation were found across the group of patients diagnosed with SAD. These patterns of maladaptive affect organisation concern both discrete affects (e.g., sadness, anger, and shame) and aspects of affect integration (e.g., awareness and conceptual expression). Several of the patterns correspond to previously known characteristics of people with SAD. Although preliminary, these findings seem to be promising, and to suggest that more research should be directed towards exploring the role of discrete affects and aspects of affect integration in SAD and other psychopathological conditions.