. 2021 Mar 29;47(5):1218–1242. doi: 10.1093/schbul/sbab026

Table 3.

Studies Addressing Correlated Factors of Social Anxiety in Psychotic Experiences Contexts

Citation	Design	Sample Characteristic (N)	Measurements 1. Diagnostic Criteria 2. Symptom Scales		Correlated Factors	Findings	Quality Criteria Met^a
			Psychosis	Social Anxiety
Nemoto et al⁵²	Prospective	SZ (118)	1. DSM-IV 2. PANSS, CGI-severity scale	2. LSAS	Quality of life - WHO-QOL26 Functioning - GAF - SFS Well-being - SWNS	Regarding a stepwise regression adjusted with demographic data, change in LSAS was significantly associated with change of the outcome models in predicting WHO- QOL26 (β = -0.01, P = .005, adjusted R² = 0.167), SFS (β = -0.33, P < .001, adjusted R² = 0.212) and SWNS (β = -0.25, P < .001, adjusted R² = 0.234).	4****
Kumazaki et al⁴⁷	Prospective	Total 36 SZ+Worsened^b LSAS (12) SZ+Stable LSAS (24)	1. ICD-10 2. PANSS	2. LSAS	Quality of life - WHO-QOL26 Functioning - GAF - SFS	WHO-QOL26 significantly predicted level of LSAS at follow-up (adjusted 0.85, P < .05, respectively) after controlling baseline of LSAS. PANSS, SFS and GAF were not significantly associated with development of social anxiety.	4****
Vrbova et al⁶²	Cross-sectional	Total 61 SZ (42) SZ+SAD (19)	1. ICD-10 2. PANSS, CGI	2. LSAS	Quality of life - Q-LES-Q Personality factors - TCI-R Hopelessness - ADHS	SZ+SAD reported lower level of Q-LES-Q (t = 4.863, P < .0001) and ADHS (t = 2.710, P < .01) than SZ. SZ+SAD revealed higher level of TCI-R harm avoidance and lower self-directed subscales (t = 4.203, P < .0001 and t = 4.447, P < .0001) than SZ.	5*****
Kwong et al⁹²	Cross-sectional	SZ (159)	1. DSM-IV 2. PANSS	2. LSAS	Quality of life - SF-36 MCS and PCS subscales	Total score of LSAS significantly correlated with SF-36 MCS (r/t^c = −0.484, P < .001) and PCS (r/t = −0.302, P < .001).	5*****
Lowengrub et al⁴⁸	Cross-sectional	Total 50 SZ (31) SZ+SAD (19)	1. ICD-10 2. PANSS, CGI	2. LSAS	Quality of life - SQLS	Total score of LSAS significantly correlated with SQLS (r = −.47, P < .01).	4****
Huppert et al⁴⁹	Cross-sectional	SZ (32)	2. PANSS, SAPS, SANS, IHS	1. DSM-IV, ADIS 2. SIAS, SPS	Quality of life - QOLI	Levels of QOLI significantly correlated with level of SPS (r = −.48, P < .01), SIAS (r = −.48, P < .01) and ADIS social phobia (r = −.42, P < .05).	4****
Blanchard et al⁴¹	Prospective	Total 52 SZ (37) NC (15)	1. DSM- III-R 2. BPRS	2. BFNE, IAS	Well-being - WB Social anhedonia - SAS	Amongst SZ, level of SAS positively correlated with level of IAS and BFNE (r = .64 and .48), while WB negatively correlated with level of IAS and BFNE (r = −.52 and −.48), all Ps < .005.	4****
Bipeta et al⁵⁰	Cross-sectional	Total 64 SZ (47) SZ+SAD (17)	1. ICD-10 2. PANSS	2. SIAS	Well-being - WHO-5 Functioning - GAF	SZ+SAD reported lower level of WHO-5 (t = 2.66, P = .01) and GAF (t = 2.1437, P = .036) than SZ.	4****
Romm et al⁷¹	Cross-sectional	Total 144 FEP (30) FEP+NonGSAD (46) FEP+GSAD (68)	1. DSM-IV 2. PANSS, IS	2. LSAS-SR	Quality of life - QOLI Functioning - GAF - Premorbid adjustment scale	FEP+GSAD reported lower level of premorbid social functioning, academic functioning, GAF and QOLI (F = 7.62 and 15.13, 12.51 and 10.91, all ps < 0.001) than FEP and FEP+NonGSAD.	5*****
El-Masry et al⁴⁴	Cross-sectional	Total 107 SZ (67) SZ+SAD (19) SAD (21)	1. DSM-IV 2. SAPS, SANS	2. LSAS	Quality of life - SF-36	SZ+SAD reported lower levels of SF-36 subscales: general health, vitality, social function, role-emotional and mental health than SZ, all ps < 0.05.	3***
Chudleigh et al⁴²	Cross-sectional	Total 60 FEP (20) At risk of psychosis (20) NC (20)	1. CAARMS 2. BPRS	2. BSPS	Functioning - SFS - WHODAS	Amongst FEP, level of SFS: performance and competence of independence subscales correlated with BSPS (r = −.52 and r = −.58), plus level of WHODAS: self-care and getting along with people subscales correlated with level of BSPS (r = .71 and r = .53). All all Ps < .01.	4****
Voges et al⁷⁶	Cross-sectional	SZ (60)	1. DSM-IV 2. PANSS	1. DSM-IV 2. SPAI	Functioning - SFS	SPAI significantly correlated with SFS (r = −.32, P < .001).	5*****
Pallanti et al¹⁰	Cross-sectional	Total 107 SZ (51) SZ+SAD (29) SAD (27)	1. DSM-IV 2. SAPS, SANS	1. DSM-IV 2. LSAS	Quality of life - SF-36 Functioning - SAS* Suicidality - Suicide behavior (by interview) and the number of lifetime suicide	SZ+SAD reported lower level of SAS* (F4.85, P < .04), higher number of suicide attempts (F5.19, P < .03) and lethality of suicide attempts (F34.14, P < .001) than SZ. SZ+SAD reported lower level of SF-36: general health, vitality, social functioning, role-emotional and mental health subscales (F1,78 = 8.71, 4.79, 25.41, 9.94 and 8.96; P < .01, P < .05, P < .001, P < .01 and P < .01, respectively) than SZ.	4****
Aikawa et al⁹⁰	Cross-sectional	Total 207 SZ (177) SZ+SAD (30)	1. DSM-IV 2. PANSS	1. MINI 2. LSAS	Functioning - SFS	Lower level of SFS, female, younger age of onset and longer untreated duration were associated with LSAS (β = -0.42, P < .001, adjusted R² = 0.255).	5*****
Lecomte et al⁷³	Cross-sectional	Total 47 SZ (25) SZ+SAD (22)	1. DSM- IV-TR	2. BSPS, SIAS	Functioning - SFS	SIAS was associated with SFS engaging in conversations subscales (β = -0.61, P < .001, adjusted R² = 0.35).	5*****
Cacciotti-Saija et al⁵¹	Cross-sectional	SZ (51)	1. DSM- IV-TR 2. SAPS, SANS	2. SIAS	Functioning - SFS	SIAS (β = -0.56, P < .001) and SANS (-0.37, P < .01) were associated with SFS (adjusted R² = 0.66).	4****
Khaliln et al⁵⁴	Cross-sectional	SZ (53)	1. ICD-9	2. U-Scale	Family factors - EMBU - AfS	Level of social anxiety (U-scale) positively correlated with a paternal rejection (P < .005), but not correlated with mother. Those with SZ who scored their key relatives as more critical and hostile attributed to themselves (Afs) reported higher scores on social anxiety dimensions: fear of failure and criticism (P < .01), social contact anxiety (P < .001), inability to refuse (P < .001) and decency (P < .01).	4****
Michail et al⁸⁶	Cross-sectional	Total 135 FEP (60) FEP+SAD (20) SAD (31) NC (24)	1. ICD-10 2. PANSS	1. ICD-10 2. SIAS, SPS	Family factors - MOPS Traumatic experiences - CTQ	FEP+SAD and SAD reported higher level of traumatic experiences (CTQ: emotional abuse (F1,97 = 4.8, P < .05) and sexual abuse (F1,97 = 3.7, P < .05)) and dysfunctional parental behaviors (MOPS: paternal indifference (F1,97 = 5.6, P < .05) and paternal abuse (F1,97 = 6.1, P < .05)) than FEP and NC.	5*****
Schutters et al⁵⁶	Prospective	General population (2548)	1. DIA-X⁄M- CIDI	1. DSM-IV	Personality factors - RSRI - TPQ	Regarding multinomial logistic regression analysis, people having comorbid paranoid with social phobia associated with RSRI behavioral inhibition and TPQ harm/avoidance (Relative Risk = 26.22 and 1.12, all ps < 0.001), when compared to those without a history of social phobia or paranoid symptoms.	4****
Park et al⁴⁰	Cross-sectional	Total 54 SZ (27) NC (27)	1. DSM- IV-TR 2. PANSS, SAS**	2. STAI trait anxiety	Anomalous experiences - SAS	SZ reported higher level of STAI than NC in happy condition (t = -5.00, df = 42.7, P < .01). Amongst SZ, STAI correlated with SAS** in happy (r = .56, P < .01) and angry conditions (r = .54, P < .01), and with SAS in happy condition (r = .38, P < .05).	2**
Jang et al³⁹	Cross-sectional	Total 30 SZ (15) NC (15)	2. PANSS	2. STAI state anxiety	Anomalous experiences	Virtual avatar could evoke level of STAI, showing positive correlation between the STAI and PANSS negative subscales: blunted affect (evoked by happy avatar: r = .549, P = .034; and neutral avatar: r = .536, P = .039); and passive/apathetic social withdrawal (happy avatar: r = .536, P = .039; and neutral avatar: r = .658, P = .008).	3***
Lysaker et al⁹⁵	Cross-sectional	Total 71 (All SZ) WCST impaired+no delusions (39) WCST impaired+delusions (11) WCST not impaired+no delusions (15) WCST not impaired+delusions (6)	1. DSM- III-R 2. PANSS	2. LSAS, STAI	Executive functionings - WCST	Patients having impaired cognitive flexibility with significant delusion group reported higher level of LSAS (F = 4.12, P < .05) than all other groups. Subgroup analysis showed this group reporting higher on LSAS particularly fear subscale (Fisher LSD P < .05).	5*****
Rietdijk et al⁵⁷	Prospective	General population (7076)	1. DSM- III-R 2. CIDI Psychosis section	2. CIDI Social anxiety section	Subclinical paranoia - CIDI Psychosis section	Of 489 subjects who did have lifetime subclinical paranoid symptoms but no lifetime social phobia at baseline, 23 subjects (4.7%) developed social phobia (OR = 4.07; 95% CI = 2.50–6.63; P < .001). The OR remained significant after controlling for neuroticism (OR = 2.62; 95% CI = 1.57–4.36; P < .001).	4****
Michail et al¹¹	Cross-sectional	Total 111 FEP (60) FEP+SAD (20) SAD (31)	1. ICD-10 2. PANSS, DoT	1. ICD-10 2. SIAS, SPS, BFNE	Persecutory threat - DoT	FEP+SAD (n = 9/20 (45%)) had higher number of express persecutory threat (DoT) than FEP alone (n = 7/60 (11.6%)), x²1 = 10.4, P < .01.	4****
Lysaker et al⁹⁴	Cross-sectional	SZ (143)	1. DSM-IV 2. PANSS	2. MAQ social anxiety	Hopelessness - BHS	MAQ social anxiety significantly correlated with BHS hope (r = −.44, P < .001).	5*****

Note: ADHS, Adult Dispositional Hope Scale; ADIS, Anxiety Disorders Interview Schedule for DSM-IV; AfS, Angehbrigen-Fragebogen fur Schizophrene patienten (assessing for patient’s attitude towards him); BHS, Beck Hopelessness Scale; BFNE, Brief Fear of Negative Evaluation scale; BPRS, Brief Psychiatric Rating Scale; BSPS, Brief Social Phobia Scale; CAARMS, Comprehensive Assessment of At Risk Mental State; CGI, Clinical Global Impression; CIDI, Composite International Diagnostic Interview; CTQ, Childhood Trauma Questionnaire; DIA-X/M-CIDI, Munich-CIDI (a modified CIDI version 1.2); DoT, Details of Threat questionnaire; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders 3rd edition Revision; DSM-IV, DSM 4th edition; DSM-IV-TR, DSM-IV Total Revision; EMBU, Egna Minnen av Barndoms Uppfostran (assessing for memories of parental behavior); FEP, First Episode Psychosis; GAF, Global Assessment of Functioning scale; GSAD, Generalized SAD; IAS, Interaction Anxiousness Scale; ICD-9, International Classification of Diseases 9th edition; ICD-10, ICD 10th edition; LSAS, Liebowitz Social Anxiety Scale; LSAS-SR, LSAS Self-Rating version; MAQ, Multidimensional Anxiety Questionnaire; MINI, Mini International Neuropsychiatric Interview; MOPS, Measure Of Parental Style; NC, Normal Control; PANSS, Positive and Negative Syndrome Scale; Q-LES-Q, Quality of Life Enjoyment and Satisfaction Questionnaire; QoL, Quality of Life; QOLI, Lehman Quality Of Life Interview; RSRI, Retrospective Self-Report of Inhibition; SAD, Social Anxiety Disorder; SANS, Scale for the Assessment of Negative Symptoms; SAPS, Scale for the Assessment of Positive Symptoms; SAS, Social Anhedonia Scale; SAS*, Social Adjustment Scale score; SAS**, Schizotypal Ambivalence Scale; SF-36, 36-tem Short Form health survey (Mental and Physical Component Summary (MCS and PCS)); SFS, Social Functioning Scale; SIAS, Social Interaction Anxiety Scale; SPAI, Social Phobia and Anxiety Inventory; SPS, Social Phobia Scale; SQLS, Schizophrenia Quality of Life Scale; STAI, State Trait Anxiety Inventory; SWNS, Subjective Well-being under Neuroleptic drug treatment Short form; SZ, SchiZophrenia spectrum disorder; TCI-R, Temperament and Character Inventory-Revised; TPQ, Tridimensional Personality Questionnaire; U-Scale, Unsicherheits-Fragebogen scale (assessing for social anxiety); WB, Well-Being scale; WCST, Wisconsin Card Sorting Test; WHO-5, World Health Organisation-5 Well-Being Index; WHODAS, WHO Disability Assessment Scale II; WHO-QOL26, WHO-Quality of Life 26

^a coring as number of quality criteria met; for example, 4**** means 4 criteria (of totally 5) of a study design were met.

^bworsened means an LSAS total score a ≥30% increase from baseline.

^cr/t means Pearson’s product-mean correlation analyzes and independent t-tests were performed to examine the relationships of SF-36 scores with continuous and categorical variables.