Embarrassment and social phobia: the role of parasympathetic activation

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Abstract

The few studies on the psychophysiology of embarrassment have suggested involvement of parasympathetic activation. However, blushing, the hallmark of embarrassment and a prominent symptom in social phobia, is more likely to be produced by cervical sympathetic outflow. Hitherto, there has been no evidence of parasympathetic innervation of the facial blood vessels. In this study, a group of social phobics and control participants watched, together with a 2-person audience, a previously made videotape of themselves singing a children’s song. Self-report measures confirmed that this task induced embarrassment. While two measures of respiratory sinus arrhythmia (RSA) during the task did not indicate heightened parasympathetic tone, increased heart rate (HR) and skin conductance marked sympathetic activation. Thus, our data do not support the notion that an increase in parasympathetic activation plays a significant role in social phobia and embarrassment. Social anxiety and embarrassment both resulted in sympathetic activation.

Section snippets

Embarrassment and social phobia: the role of parasympathetic activation

Social phobia is defined as a marked and persistent fear of social or performance situations in which embarrassment may occur (DSM-IV, American Psychiatric Association, 1994). Astonishingly, only few researchers have tried to investigate embarrassment among social phobics directly. There are two main reasons to consider embarrassment as a promising avenue towards understanding social phobia. First, research has shown the profound impact of embarrassment on behavior. For example, embarrassment

Participants

Thirty social phobics (DSM-IV, American Psychiatric Association, 1994) were recruited by advertisements in local newspapers asking either for people with fear of blushing or with fear of speaking in front of other people. In addition, 14 controls were recruited by advertisements asking for people that usually enjoy social situations. Presence or absence of a diagnosis of social phobia was established with the Anxiety Disorder Interview Schedule (ADIS-IV, Di Nardo, Brown, & Barlow, 1994). Mean

Self-report measures

Since control participants reported almost no distress, variance in this group is much smaller than in the social phobic group. F-statistics are misleading when means are correlated with variances across cells of the design, and therefore, it was not possible to use MANOVAs to analyze differences between social phobics and controls or changes within subjects. Consequently, we employed Mann–Whitney U-tests to establish group differences in self-reported embarrassment and anxiety and paired t

Discussion

Our goal was to determine whether parasympathetic activation plays an important role in embarrassment in those who are socially phobic and in those who are not. We approached this by devising a task that we hoped would induce embarrassment in both groups, and in terms of self-reported embarrassment, we succeeded. As expected, embarrassment ratings in the control group were much lower than in social phobics (Table 2), and in social phobics ratings of anxiety were high as well. Embarrassment and

Acknowledgements

Alexander L. Gerlach, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, and Department of Psychology, Institute I, Psychological Assessment and Clinical Psychology, Westfalian Wilhelms University of Münster, Münster, Germany; Frank H. Wilhelm and Walton T. Roth, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine and Veterans Administration Health Care System, Palo Alto, CA. This research was supported by the

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