A systematic review of visual avoidance of faces in socially anxious individuals: Influence of severity, type of social situation, and development. (March 2020)

• Record Type: Journal Article
• Authors: Chen, Jiemiao; van den Bos, Esther; Westenberg, P. Michiel
• Is Part Of: Journal of anxiety disorders. Volume 70(2020:Mar.)
• Publication Date: 2020-03
• Subjects: Social anxiety -- Gaze behavior -- Avoidance -- Face -- Eyes; Anxiety -- Periodicals; Anxiety Disorders -- Periodicals; Angoisse -- Périodiques; Electronic journals; 616.8522
• DOI: 10.1016/j.janxdis.2020.102193
• Languages: English
• ISSNs: 0887-6185

Abstract

Highlights: Adults with SAD exhibit remarkably consistent visual avoidance of faces across various social situations. Adults with High Social Anxiety tend to aovid faces in naturalistic social situations but not in facial-viewing tasks. Individuals with shyness or fear of negative evaluation do not consistently avoid faces in facial-viewing tasks. Preliminary evidence suggests that visual avoidance of faces in socially anxious individuals emerges during adolescence. Abstract: Although visual avoidance of faces is a hallmark feature of social anxiety disorder (SAD) on clinical and theoretical grounds, empirical support is equivocal. This review aims to clarify under which conditions socially anxious individuals display visual avoidance of faces. Through a systematic search in Web of Science and PubMed up to March 2019 we identified 61 publications that met the inclusion criteria. We discuss the influence of three factors on the extent to which socially anxious individuals avoid looking at faces: (a) severity of social anxiety symptoms (diagnosed SAD versus High Social Anxiety levels in community samples [HSA] or related characteristics [Shyness, Fear of Negative Evaluation]), (b) three types of social situation (computer facial-viewing tasks, speaking tasks, social interactions), and (c) development (age-group). Adults with SAD exhibit visual avoidance across all three types of social situations, whereas adults with HSA exhibit visual avoidance in speaking and interaction tasks but not in facial-viewing tasks. The relatively few studies with children and adolescents suggest that visual avoidance emerges during adolescence. The findings are discussed in the context of cognitive-behavioral and skills-deficit models. Suggestions for future research include the need for developmental studies and more fine-grained analyses of specific areas of the face.