Social Anxiety in Psychosis: Towards a New Understanding of Affective Dysfunction

Review Article

Social Anxiety in Psychosis: Towards a New Understanding of Affective Dysfunction

Maria Michail ¹ and Max Birchwood ²
Affiliationss: ¹School of Psychology, University of Birmingham, UK and ²School of Psychology, University of Birmingham UK, Birmingham & Solihull Mental Health Foundation Trust


ABSTRACT

Affective disturbances are pervasive in psychosis. Social anxiety, in particular, is among the most commonly reported and disruptive affective symptoms in early psychosis exerting a significant impact on social disability. However, its nature, phenomenology, and relationship with positive symptoms are not well understood. It is not clear whether the emergence and maintenance of social anxiety in psychosis is simply driven by paranoia and persecutory beliefs. In this review, we examine the role of affect in psychosis and, more specifically, we investigate the relationship between social anxiety and psychotic symptoms. We argue that social anxiety is not simply a phenocopy of psychotic symptoms and clinical paranoia, and that the processes that underlie its development in psychosis warrant further investigation.

Keywords: affective dysfunction, social anxiety, psychosis, paranoia
Correspondence: Maria Michail, Frankland Building, School of Psychology, University of Birmingham, Edgbaston B15 2TT Birmingham UK. Tel: (0121) 414 2871; e‐mail: m.michail@bham.ac.uk