Friends with Benefits:
The Role of Behavioural Inhibition and Sensory Processing Sensitivity in the Relation of Friendship Quality and Adolescents’ Social Anxiety Symptoms
Masterscriptie Orthopedagogiek Pedagogische en Onderwijskundige Wetenschappen Universiteit van Amsterdam Student: S. Soudagar Begeleider: prof. dr. G.J. Overbeek Tweede beoordelaar: dr. P.H.O. Leijten Amsterdam, juli 2017
Abstract
Previous research suggests a link between best friendship quality and social anxiety
symptoms in adolescents. According to the differential susceptibility hypothesis, some people are more susceptible to both the negative outcomes that are associated with adverse
environments and the positive outcomes that are associated with supportive environments. This study examined whether adolescents’ behavioural inhibition and sensory processing sensitivity would mark their susceptibility to both positive and negative friendship qualities with regard to social anxiety symptoms. Questionnaires were administered to a sample of 305 adolescents between 11 and 16 years old (M = 13.6 years, SD = 0.9). Results of hierarchical regression analyses showed that, as expected, positive friendship qualities predicted lower levels of adolescents’ social anxiety symptoms. Also, we found that negative friendship qualities predicted more social anxiety symptoms, but only in adolescents with high levels of sensory processing sensitivity. No direct effects of negative friendship qualities, and no interaction effects with behavioural inhibition were found. Our findings do not support the idea of differential susceptibility, and are in line with the prevailing diathesis–stress view of psychopathology. The current findings support the emphasis on improving the interpersonal relationships of socially anxious adolescents.
Keywords: social anxiety, best friendship, differential susceptibility, behavioural inhibition, sensory processing sensitivity
De Vriendschapsbonus:
De Rol van Gedragsinhibitie en Sensorische Informatieverwerkingsgevoeligheid in de Relatie Tussen Vriendschapskwaliteit en Sociale Angst Symptomen bij Adolescenten
Samenvatting
Voorgaand onderzoek suggereert een link tussen de kwaliteit van de relatie met een beste vriend(in) en sociale angst symptomen bij adolescenten. Volgens de ‘differential
susceptibility’ hypothese zijn bepaalde mensen meer ontvankelijk voor zowel de negatieve uitkomsten die geassocieerd zijn met nadelige omstandigheden als de positieve uitkomsten die geassocieerd zijn met gunstige omstandigheden. Deze studie onderzocht of
gedragsinhibitie en sensorische informatieverwerkingsgevoeligheid de ontvankelijkheid van adolescenten voor sociale angst symptomen zou aangeven in de aanwezigheid van positieve en negatieve vriendschapskwaliteiten. Een steekproef van 305 adolescenten tussen de 11 en 16 jaar oud (M = 13.6 jaar, SD = 0.9) hebben vragenlijsten ingevuld. Uit de resultaten van hiërarchische regressie analyses bleek dat, zoals verwacht, positieve vriendschapskwaliteiten minder sociale angst symptomen voorspelden. Daarnaast bleek dat negatieve
vriendschapskwaliteiten meer sociale angst symptomen voorspelden, maar enkel bij
adolescenten met een hoge mate van sensorische informatieverwerkingsgevoeligheid. Geen directe effecten van negatieve vriendschapskwaliteiten, noch interactie–effecten met
gedragsinhibitie zijn gevonden. Onze bevindingen geven geen bewijs voor de differential susceptibility hypothese, en zijn in overeenstemming met het heersende diathese–stress beeld van psychopathologie. De huidige bevindingen ondersteunen de nadruk op het verbeteren van de interpersoonlijke relaties van sociaal angstige adolescenten.
Sleutelwoorden: sociale angst, beste vriendschap, differential susceptibility, gedragsinhibitie, sensorische informatieverwerkingsgevoeligheid
Friends with Benefits: The Role of Behavioural Inhibition and Sensory Processing Sensitivity in the Relation of Friendship Quality and Adolescents’ Social Anxiety Symptoms
We all care about what other people think of us, some more than others. Adolescence in particular is a time when other people’s (mostly peers’) opinions matter (Furman & Buhrmester, 1992). Feeling a bit nervous when meeting new classmates or when giving a class presentation is only natural. For some however, the anxiety that goes with feeling nervous is persistent in all kinds of social situations in which they are exposed to unfamiliar people or to possible scrutiny by others. Having trouble talking to unfamiliar people, being shy and worrying about being negatively evaluated by others are symptoms of social anxiety (Wong & Rapee, 2015). Social anxiety symptoms typically develop in late childhood or mid-adolescence (Rosellini, Rutter, Bourgeois, Emmert-Aronson, & Brown, 2013). Adolescents who develop social anxiety symptoms are at risk for numerous developmental difficulties. First, social anxiety symptoms are associated with social withdrawal, which can interfere with the development of successful relationships with peers (La Greca & Lopez, 1998). Second, adolescents with social anxiety symptoms are at risk for developing an actual social anxiety disorder, which can be extremely impairing in everyday life (Rao et al., 2007). Third, experiencing symptoms of social anxiety may lead to other serious problems, such as depression and substance use (Beesdo et al., 2007; Bucker et al., 2008). Taking these risks into account, it is important to know what factors predict social anxiety symptoms and what factors can protect adolescents against social anxiety symptoms.
The interpersonal theory of social anxiety states that relationships with significant others influence the way we perceive other people and social situations (Alden & Taylor, 2004). Research has proven that relationships with parents play a moderately important role in the development of social anxiety in children (for a meta-analysis see McLeod, Wood, & Weisz, 2007). During adolescence, however, peers become a more important source of social support (Furman & Buhrmester, 1992). Particularly, the quality of the relationship with a best friend seems to matter for adolescents’ psychosocial adjustment (Berndt, 1982). Previous research suggests a link between best friendship quality and social anxiety symptoms in adolescents (La Greca & Harisson, 2005; La Greca & Lopez, 1998). However, it is unknown for which adolescents the relationship between best friendship quality and social anxiety symptoms is especially strong. The literature suggests that behavioural inhibition, a tendency to experience negative emotions and avoidance behaviour when confronted with threats of punishment, and sensory processing sensitivity (SPS), a high sensitivity to subtle
environmental stimuli, are potential markers for the susceptibility of individuals to their environment (Aron, Aron, & Jagiellowicz, 2012; Carver & White, 1994). It is unknown whether behavioural inhibition and SPS mark adolescents’ susceptibility to the relationship quality with a best friend regarding social anxiety symptoms. To fill this gap, this study will investigate whether behavioural inhibition and/or SPS affect (i.e., moderate) the strength of the relation between best friendship quality and social anxiety symptoms in adolescents. Best Friendships and Social Anxiety
The interpersonal theory of psychopathology states that positive social relationships contribute to psychological well-being and that negative social relationships contribute to psychopathology (Kiesler, 1997). More specifically, interpersonal theory proposes that positive experiences with significant others shape positive beliefs and assumptions about self and others, which in turn contribute to positive interpretations and processing of social events. On the other hand, negative experiences with significant others shape negative beliefs and assumptions about self and others, which in turn contribute to negative interpretations and processing of social events (for a review see Alden & Taylor, 2004). Most research in support of an interpersonal theory of social anxiety has focused on relationships with parents
(McLeod et al., 2007). However, in adolescence, best friendships become an increasingly important part of adolescents’ interpersonal functioning, and serve several essential needs, such as companionship, emotional support, intimacy, and coping assistance (Berndt, 1982). In support of the interpersonal theory, having a supportive and intimate relationship with a best friend has been related to higher self-esteem, being more sociable, higher self-perceived social acceptance and less anxiety and depression (Berndt, 2004; Buhrmester, 1990; Keefe & Berndt, 1996). On the other hand, negative features in best friendships such as conflict, pressure and exclusion, have been related to problems with self-esteem (Keefe & Berndt, 1996).
One previous study found that adolescent girls who were more socially anxious had fewer best friends, and reported having less intimacy, companionship, and emotional support in best friendships than less socially anxious girls (La Greca & Lopez, 1998). No such relation was found for adolescent boys, however. This could be explained by the fact that adolescent girls usually perceive more intimacy in their friendships than boys. Thus, problems in these close friendships might lead to greater distress for girls than for boys (La Greca & Lopez, 1998). In another study, La Greca and Harrison (2005) found that adolescents (both boys and girls) who experienced more positive features in their best friendships (as measured
with the Network of Relationships Inventory; Furman & Buhrmester, 1985) reported less social anxiety symptoms, even when controlled for their general peer relations in terms of peer crowd affiliations and peer victimization. These results again suggest that a good quality friendship may protect adolescents against symptoms of social anxiety. On the other hand, adolescents who experienced more negative features in their best friendships (e.g., exclusion, pressure) reported more social anxiety symptoms (La Greca & Harrison, 2005). Taken together, previous research shows some evidence in support of an interpersonal theory for social anxiety symptoms in adolescents with regard to best friendship quality.
Differential Susceptibility: Behavioural Inhibition
For which adolescents might the relationship between best friendship quality and social anxiety symptoms be especially strong? According to the differential susceptibility hypothesis, some people are more susceptible than others to environmental influences, for better and for worse (Belsky & Pluess, 2009; Ellis, Boyce, Belsky, Bakermans-Kranenburg, & Van IJzendoorn, 2011). That is, some people may be more susceptible to both the negative outcomes that are associated with adverse environments and to the positive outcomes that are associated with supportive environments. People who are less susceptible to environmental influences are, in contrast, less affected by adverse and supportive environments. Individual differences in susceptibility are presumed to have a neurobiological basis (Ellis et al., 2011). The first evidence for differential susceptibility stated that a difficult temperament or high levels of negative emotionality (e.g., fear, inhibition) in early childhood not only serves as a risk factor for negative outcomes in the presence of adverse experiences, as was long
assumed, but also makes children more prone to benefit from supportive experiences (Belsky, 1997, 2005). Since then, numerous studies found evidence for this “for-better-and-for-worse” effect in young children with high levels of negative emotionality (Belsky, 2013). Although the theory states that differential susceptibility can occur during all developmental stages (Ellis et al., 2011), research on differential susceptibility has mostly focused on infancy and toddlerhood (Belsky & Pluess, 2009). Indeed, most developmentalists argue that human development is most susceptible to environmental influences in the early years of life, since plasticity is thought to be greatest when biological systems are being laid down (e.g., Ganzel & Morris, 2011). However, Belsky and Pluess (2013) argue from an evolutionary standpoint that this is not necessarily true for every individual, which makes it likely that some people are susceptible early in life, others later in life, others all the time, and still others more or less
never. Following this line of reasoning, individual differences in susceptibility could also be apparent in adolescence.
The marker that can be used to identify differential susceptibility, however, might differ depending on age (Belsky & Pluess, 2013). Adolescents with a predisposition for negative emotions are old enough to be aware of their tendency and to rearrange their life in a way to avoid such emotions (Carver & White, 1994). It is therefore argued that the experience of negative emotions (i.e., negative emotionality) is not a valid way to measure this
predisposition in adolescents and adults (Carver & White, 1994). Alternatively, adolescents’ tendency to experience negative emotions can be measured with the trait behavioural
inhibition. Levels of behavioural inhibition indicate an individuals’ sensitivity to experience negative emotions and display avoidance behaviour when confronted with cues for
punishment in a broad sense (Carver & White, 1994). Although negative emotionality in childhood has been investigated in a for-better-and-for-worse manner, behavioural inhibition is commonly investigated only as a risk factor for negative outcomes (for worse; Clauss & Blackford, 2012). Moreover, studies investigating adolescents’ behavioural inhibition in interaction with the environment are scarce. One study found a small interactive effect of behavioural inhibition (as measured with the Behavioral Inhibition Scale; Muris,
Merckelbach, Wessel, & Van de Ven, 1999) and attachment in adolescents aged 11 to 15 years old, in a way that insecurely attached adolescents experienced more anxiety symptoms, especially those with higher levels of behavioural inhibition (for worse; Van Brakel, Muris, Bögels, & Thomassen, 2006). The authors also found that, in a context of sensitive and responsive parenting (in such a way that caregiver and child were securely attached), adolescents with higher levels of behavioural inhibition benefitted more (e.g., experienced less anxiety symptoms) from a controlling parenting style than securely attached adolescents with lower levels of behavioural inhibition (for better; Van Brakel et al., 2006). Another study found that 8- to 13-year-olds with higher levels of behavioural inhibition (as measured with the Behavioral Inhibition Scale; Muris et al., 1999) who experienced higher levels of stress (as a result of daily hassles in family life, school, friendships, and play) showed increases in anxiety symptoms during a six-week interval relative to their peers with lower levels of behavioural inhibition (for worse; Brozina & Abela, 2006). The authors did not investigate a possible for-better effect.
As to why negative emotionality and possibly behavioural inhibition are markers for differential susceptibility, it is thought that these markers reflect a highly sensitive nervous
system that reacts strongly on environmental experiences (Aron et al., 2012; Ellis et al., 2011). This is in line with the view that differences in susceptibility are grounded in the biology of the nervous system (Ellis et al., 2011). If behavioural inhibition were to be such an indicator of a highly sensitive nervous system, it would be plausible that adolescents with higher levels of behavioural inhibition are not only more susceptible to adverse environments (e.g., unsecure attachment, stress or a negative best friendship quality), but also more
susceptible to supportive environments (e.g., a caring and controlling parenting environment or a positive best friendship quality).
Differential Susceptibility: Sensory Processing Sensitivity
Theory states that negative emotionality and possibly behavioural inhibition reflect a highly sensitive nervous system (Ellis et al., 2011), which relates to the trait of sensory processing sensitivity (SPS; Aron & Aron, 1997; Aron et al., 2012). SPS reflects a lower threshold for sensory information and a higher sensitivity to subtle stimuli (Aron et al., 2012). People with high levels of SPS tend to be more aware of information in their environment, and tend to process this information on a deeper and more complex level than people with low levels of SPS, which affects the way they think and feel. Because they process experiences more deeply, their development is believed to be more strongly affected by the environment. In terms of differential susceptibility, this would mean that people high on SPS thrive
exceptionally well in a supportive environment, but are more negatively affected in a less supportive environment (Aron et al., 2012).
Studies investigating SPS as a susceptibility marker are limited. One study found that in a sample of young adults, a problematic childrearing history predicted high levels of shyness and negative affectivity and the absence of a problematic childrearing history
predicted low levels of shyness and negative affectivity, but both relations were only valid in participants scoring high on SPS (Aron, Aron, & Davies, 2005). In search of a for-better-and-for-worse effect of SPS, another study found a small interactive effect of undergraduates’ SPS and parental care, where in the context of low parental care highly-sensitive students were significantly more depressed than non-highly sensitive students (for worse; Liss, Timmel, Baxley, & Killingsworth, 2005). The authors failed to find a for-better effect as in the context of high parental care there was no significant difference between highly sensitive and non-highly sensitive students. Only one study is available with regard to SPS in adolescence, as it shows that girls aged 11 to 12 years old with higher levels of SPS, compared to those with lower levels of SPS, benefitted more from an intervention aimed at reducing depression
(Pluess & Boniwell, 2015). Based on the theory of SPS and previous research findings, it could be that adolescents with higher levels of SPS benefit more from supportive
environments (e.g., a positive best friendship quality), but are more negatively affected by unsupportive environments (e.g., a negative friendship quality).
The Present Study
In this study, we will examine the role of behavioural inhibition and SPS in the relationship between best friendship quality and social anxiety symptoms in adolescents. We first hypothesize that best friendship quality predicts adolescents’ social anxiety symptoms. That is, positive friendship qualities predict less social anxiety symptoms and negative friendship qualities predict more social anxiety symptoms. Second, we hypothesize that adolescents with higher levels of behavioural inhibition are more affected—for better and for worse—by the relationship quality with a best friend with regard to social anxiety symptoms than adolescents with lower levels of behavioural inhibition. That is, in the context of a high level of positive friendship qualities, adolescents with higher levels of behavioural inhibition experience less social anxiety symptoms than adolescents with lower levels of behavioural inhibition. On the other hand, in the context of a high level of negative friendship qualities, adolescents with higher levels of behavioural inhibition experience more social anxiety symptoms than adolescents with lower levels of behavioural inhibition. Third, along the same line of reasoning we hypothesize that adolescents with higher levels of SPS are more
affected—for better and for worse—by the relationship quality with a best friend with regard to social anxiety symptoms than adolescents with lower levels of SPS.
Method Design and Procedure
This study is part of the first wave of the Dutch ADAPT (i.e., Adolescent
Development and Parent–child Transactions) longitudinal study. Firstly, we selected 222 high schools throughout the Netherlands that had participated in previous studies. These schools were approached to participate by sending them a letter introducing the research and making a follow-up phone call. After this first round, three schools decided to participate in the study (1.35 percent). Secondly, the research team, together with the school administrations, decided which and how many classes would be selected in each school. Thirdly, from March to May 2017, the questionnaires were administered to the adolescents by undergraduate students involved in our doctoral thesis programme. In one of the schools, we decided to let the
teachers administer the questionnaires as we were unable to settle on a date for our
undergraduate students to visit the school. The undergraduate students, and the teachers of the one school, were given instructions regarding the content of the questionnaire and the
administration procedure in a classroom situation. Adolescents filled in the questionnaire in their class during a regular lesson (45–50 min) at school. Both adolescents and parents were informed about the content and purpose of the study. Parents agreed in the participation of their children through passive consent (i.e., parents were given the opportunity to contact the school if they did not want their child participating in the study). Most parents agreed in the participation of their children. In most classes, a teacher was available to assist the
undergraduate in distributing the questionnaires among the students and keeping order. We explained to the adolescents they were not allowed to talk about their answers in the
questionnaires with other students and guaranteed that their information would not be shared with a third party (i.e., teachers or parents). After the data collection was completed, we sent each school a research report on the social development of all participating adolescents, without providing information that identified individual adolescents.
Participants
The participants of this study were 305 high school students. The sample consisted of 148 girls (53.2 percent) and 130 boys. Concerning the educational level, 200 students (66 percent) followed lower vocational education programmes, and 103 students (34 percent) were enrolled in middle or higher-level education programmes. Adolescents’ average age was 13.6 years (SD = 0.9; min–max = 11–16 years). About 70 percent of the adolescents were from an indigenous Dutch background, and most adolescents (78.1 percent) came from intact, two-parent families.
Measures
Relationship quality best friend. The relationship quality with a best friend was assessed with a Dutch adapted version of the Network of Relationships Inventory—Short Form (NRI; Furman & Buhrmester, 1985). The self-report measure consists of 24 items on a five-point Likert scale ranging from 1 (little or none) to 5 (the most). The NRI describes the relationship with a best friend in eight positive interaction features (e.g., “Does your best friend admire and respect you?”), six negative interaction features (e.g., “How often do you and your best friend disagree and quarrel with each other?), and relative power.Relative power is a separate factor and was not considered in the present study. Relationship quality scores were obtained for positive and negative friendship qualities separately. Cronbach’s
alphas for the eight positive interaction and six negative interaction items were .82 and .80, respectively, indicating high reliability. Support for the reliability and validity of the NRI has been found in previous research (Furman, 1996).
Behavioural inhibition. Behavioural inhibition was assessed with the Dutch version of the Behavioural Inhibition System and Behavioural Activation System (BIS/BAS) scales (Carver & White, 1994; Franken, Muris, & Rasin, 2005). Adolescents scored seven items with regard to their levels of behavioural inhibition (BIS scale). For instance, ‘Criticism or scolding hurts me quite a bit’ or ‘I worry about making mistakes’. All items were answered on a five-point Likert scale ranging from 1 (very true) to 5 (very false). Cronbach’s alpha was .69, indicating an acceptable reliability. Support for the factor structure, reliability, and convergent and divergent validity has been found in previous research (Jorm et al., 1998), also for the Dutch version (Franken et al., 2005; Yu, Branje, Keijsers, & Meeus, 2011).
Sensory processing sensitivity. Sensory processing sensitivity was assessed with the Dutch version of the High Sensitive Child Questionnaire—Short Version (Pluess, 2015), a modified version of the Highly Sensitive Person Scale for adults (Smolewska, McCabe, & Woody, 2006). This self-report measure consists of 12 items on a seven-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). Youth report on the extent to which they are sensitive to internal (e.g., pain, hunger) and external (e.g., light, noise) sensory information. For instance, ‘I find it unpleasant to have a lot going on at once’ or ‘Loud noises make me feel uncomfortable’. Cronbach’s alpha was .75, indicating good reliability. Studies have demonstrated that the Highly Sensitive Person Scale (adult version) is a valid and reliable measure of the construct of SPS (Smolewska et al., 2006).
Social anxiety symptoms. Social anxiety symptoms were assessed with the Dutch version of the Screen for Child Anxiety Related Emotional Disorders questionnaire (SCARED; Birmaher et al., 1997). This self-report measure consists of a Social Phobia subscale consisting of seven items on a three-point Likert scale ranging from 1 (not true) to 3 (very true). For instance, ‘It is hard for me to talk with people I don’t know well’ or ‘I am shy’. Because social anxiety symptoms also include a fear of possibly scrutiny by others (Wong & Rapee, 2015), two items of the Generalized Anxiety subscale were added. The two items were ‘I worry about other people liking me’ and ‘I worry about being as good as other kids’. Cronbach’s alpha for the Social Phobia subscale plus the two items of the Generalized Anxiety subscale was .86, indicating high reliability. Support for the reliability and validity of
the SCARED questionnaire has been found in numerous studies (Birmaher et al., 1999; Hale, Raaijmakers, Muris, & Meeus, 2005).
Data Analysis
First, we carried out descriptive analyses to establish the levels of study variables in the current sample. We conducted an independent-samples t test to compare the study variables in boys and girls. Further, we calculated Pearson correlations between the study variables to check for bivariate associations. We then conducted hierarchical regression analyses to determine the predictive value of positive and negative friendship qualities on adolescents’ social anxiety symptoms and the possible moderating effects of behavioural inhibition and SPS. First, we controlled for gender in the first step of the hierarchical
regression model. Second, main effects between the independent variables positive friendship qualities, negative friendship qualities, behavioural inhibition, SPS and the dependent variable social anxiety symptoms were tested in the second step. Third, we tested four interaction terms between positive and negative friendship qualities on one hand and behavioural
inhibition and SPS on the other hand. Specifically, in each interaction term the variables were centered and then multiplied and placed as a predictor for social anxiety symptoms in the third step of the regression model. If an interaction term significantly predicted adolescents’ social anxiety symptoms, the association between either positive or negative friendship
qualities and social anxiety symptoms was then further explored for high and low levels of the moderating variable (i.e., behavioural inhibition or SPS).
Results Descriptive Analyses
Prior to the main analyses, descriptive information was obtained for the main study variables. First, adolescents generally reported relatively low levels of social anxiety symptoms (M = 0.71, SD = 0.49), with girls reporting more symptoms than boys (see Table 1). Second, adolescents reported relatively high levels of positive friendship qualities (M = 3.05, SD = 0.61) and relatively low levels of negative friendship qualities (M = 0.77, SD = 0.73). Girls reported significantly more positive friendship qualities and less negative friendship qualities than boys. Third, adolescents reported relatively average levels of
behavioural inhibition (M = 1.42, SD = 0.58) and relatively average levels of SPS (M = 3.48, SD = 0.92). Girls reported significantly more behavioural inhibition and more SPS than boys (see Table 1).
Bivariate associations: Pearson correlations.
Table 2 features the Pearson correlations between the measures of positive and negative friendship qualities, behavioural inhibition, SPS and social anxiety symptoms. It shows that adolescents reporting higher levels of positive friendship qualities also reported lower levels of negative friendship qualities. Further, moderately strong associations between social anxiety symptoms and behavioural inhibition and between social anxiety symptoms and SPS indicated that adolescents reporting higher levels of social anxiety symptoms reported higher levels of behavioural inhibition and SPS. There was also a significant correlation between behavioural inhibition and SPS indicating that adolescents reporting higher levels of behavioural inhibition also reported higher levels of SPS. No significant correlations were found between positive or negative friendship qualities and social anxiety symptoms.
Hierarchical Regression Model Predicting Social Anxiety Symptoms
To evaluate the predictive value of positive and negative friendship qualities for adolescents’ social anxiety symptoms and possible moderating effects of behavioural inhibition and SPS, hierarchical regression analyses were conducted. As girls reported
significantly more social anxiety symptoms, the regression models were controlled for gender (model 1, see Table 3). In the second model, positive and negative friendship qualities,
behavioural inhibition and SPS were entered to study their main effects on adolescents’ social anxiety symptoms. Finally, to test if behavioural inhibition or SPS could act as a moderator, the interactions between positive and negative friendship qualities on the one hand and
behavioural inhibition and SPS on the other hand were added in the third model (see Table 3). Main effects.
As expected, positive friendship qualities significantly predicted adolescents’ social anxiety symptoms (see Table 3). Specifically, a higher level of positive friendship qualities predicted less social anxiety symptoms in adolescents. Negative friendship qualities, however, did not significantly predict adolescents’ social anxiety symptoms. Both behavioural
inhibition and SPS significantly predicted adolescents’ social anxiety symptoms. Specifically, a higher level of behavioural inhibition and a higher level of SPS predicted more social anxiety symptoms in adolescents.
Moderator effects.
Table 3 shows no significant interaction effect between behavioural inhibition and positive or negative friendship qualities. The interaction between negative friendship qualities
and SPS, however, did significantly predict adolescents’ social anxiety symptoms. To further explore the moderating effect of SPS on the relationship between negative friendship qualities and social anxiety symptoms, the sample was divided into two groups: low levels of SPS (below the mean) and high levels of SPS (above the mean). In the context of high levels of SPS adolescents’ negative friendship qualities were significantly correlated with their social anxiety symptoms (r = .21, p < .05). Meaning that in adolescents with high levels of SPS the more negative qualities in their best friendships, the more social anxiety symptoms they report. In the context of low levels of SPS adolescents’ negative friendship qualities were not significantly correlated with their social anxiety symptoms. Figure 1 shows the
unstandardized slopes for the relation between negative friendship qualities and social anxiety symptoms plotted at high and low levels of SPS.
Discussion
This study examined the role of behavioural inhibition and SPS in the relationship between best friendship quality and social anxiety symptoms in adolescents. The results showed that positive friendship qualities, but not negative friendship qualities, significantly predicted adolescents’ lower levels of social anxiety symptoms. Further, the results
demonstrated a significant interaction effect between negative friendship qualities and SPS. That is, a higher level of negative friendship qualities was associated with more social anxiety symptoms only in adolescents with high levels of SPS. No interaction effects between
positive or negative friendship qualities and behavioural inhibition were found.
First, as expected, more positive friendship qualities predicted less social anxiety symptoms in adolescents. These results are in line with the interpersonal theory of
psychopathology and suggest that maybe positive interactions with significant others shape positive beliefs about self and others, which in turn contribute to positive interpretations and processing of social events (i.e., less social anxiety symptoms; Kiesler, 1997). The results are also in line with previous research that showed that adolescents with more positive features in their best friendships reported less social anxiety symptoms (La Greca & Harrison, 2005). Secondly, as expected, we found an interaction effect between SPS and negative friendship qualities on adolescents’ social anxiety symptoms. Specifically, more negative friendship qualities were associated with more social anxiety symptoms only in adolescents with high levels of SPS. These results demonstrate a for-worse effect and are in line with the diathesis– stress model, which states that some people with certain biological, temperamental, or
behavioural characteristics (i.e., diathesis; SPS) are more vulnerable to the negative effects of adverse environments (i.e., stress; negative friendship qualities) than others without these characteristics (Zuckermann, 1999). The present results are also in line with previous research that showed SPS to be a vulnerability factor for other negative outcomes, such as depression and negative affectivity (Aron et al., 2005; Liss et al., 2005).
Negative friendship qualities on their own, however, did not predict adolescents’ social anxiety symptoms. These results contrast those from previous research that showed negative friendship features to predict a higher level of adolescents’ social anxiety symptoms (La Greca & Harrison, 2005; La Greca & Lopez, 1998). One explanation could be found in the concept of resilience. Resilience refers to the process of overcoming the negative effects of adverse experiences by the presence of promotive factors that reduce or avoid a negative outcome (Zimmerman et al., 2013). Relationships with parents or other caring adults have been identified as critical promotive factors for children and adolescents. Thus, it could be that adolescents who reported a high level of negative friendship qualities, overcame the negative effects (e.g., social anxiety symptoms) by experiencing a supportive relationship with their parents or with other adults. Another explanation could be that conflicts between best friends are not experienced as negative as conflicts with others (e.g., parents). As the relationship between friends is voluntarily, relatively equally distributed in power and potentially unstable (as there are lots of alternative friends to be found), it is argued that friends in conflict are relatively more focused on mitigation, because they are aware that power must be shared and beneficial conflict outcomes must be maintained if the friendship is to continue (Adams & Laursen, 2001). This could be the reason why negative friendship qualities in the present study did not predict a negative outcome such as social anxiety symptoms. A third explanation is a methodological one as the current sample reported relatively low levels of negative friendship qualities. Because of the relatively limited variance in this measure, it might have been harder to find a significant relationship with adolescents’ social anxiety symptoms.
Importantly, the present results did not support the idea of differential susceptibility. The fact that we did not find any differential susceptibility effects might be because the current sample consisted of relatively older children. Most research on differential
susceptibility that focused on temperament used infancy or toddlerhood samples (Belsky & Pluess, 2009). Although the theory states that differential susceptibility can occur during all developmental stages (Ellis et al., 2011), several scholars have argued that human
development is most susceptible to environmental influences in the early years of life, since plasticity is thought to be greatest when biological systems are being laid down (e.g., Boyce & Ellis, 2005; Ganzel & Morris, 2011). Following this reasoning, one might expect that, a canalization of sensitivity takes place during the first few years of life, inducing a
progressively diminishing plasticity.
The results of our analyses showed that both behavioural inhibition and SPS were strong predictors of adolescents’ social anxiety symptoms. Specifically, more behavioural inhibition and more SPS predicted more social anxiety symptoms. This raises the question whether behavioural inhibition and SPS are really different from social anxiety symptoms. It could be that social anxiety symptoms represent the more extreme end of the temperamental characteristics of behavioural inhibition and SPS. This is consistent with the spectrum hypothesis, stating that psychopathology may represent the extreme end of a continuously distributed personality trait (Shiner & Caspi, 2003). Evidence for the spectrum hypothesis has been found in cases of high functioning autism and attention-deficit hyperactivity disorder (Burrows, Usher, Schwartz, Mundy, & Henderson, 2016; De Pauw & Mervielde, 2011). This could also explain why negative friendship qualities only predicted social anxiety symptoms in adolescents with high levels of SPS, as SPS could be a precursor of social anxiety
symptoms. Following this line of reasoning, behavioural inhibition and SPS would not be suitable susceptibility markers as they would be a mild form of social anxiety symptoms.
The present results should be interpreted with the following cautions in mind. First, the study provided a one-time measure of adolescents’ best friendship qualities, behavioural inhibition, SPS and social anxiety symptoms. This means that the dynamic nature of the interrelations between these variables was not captured and that it is not possible to determine if friendship quality actually leads to social anxiety symptoms or the other way around. Second, we used a community sample of adolescents. Specifically, the adolescents in the current sample seemed to be doing well in terms of relatively high levels of positive friendship qualities and relatively low levels of negative friendship qualities and social anxiety symptoms. It is unknown to which extent the findings may generalize to adolescents who suffer from clinical levels of social anxiety–somewhat limiting the clinical relevance of the analyses. Third, other factors that are known to contribute to social anxiety symptoms, such as peer victimization (Siegel, La Greca, & Harrison, 2009), have not been included in the present study. This means that the current effects found could also be influenced by other factors. Notwithstanding these limitations, a great strength of the current study is that it takes
on a dimensional approach on social anxiety and does not focus solely on its clinical form (i.e., social anxiety disorder). It is argued, after all, that most mental disorders consist along a continuum with normality (Weems, 2008).
Overall, the current findings partially support the interpersonal theory of social anxiety. Future research could focus on different relationships (e.g., parents, general peer relations, best friendships) in order to compare the effect they have on adolescents’ social anxiety symptoms. Also, the current findings do not support the differential susceptibility hypothesis. Possibly, the current sample consisted of relatively old children, making them less susceptible to environmental influences (Boyce & Ellis, 2005). Future research could
investigate differential susceptibility across different age groups, to examine whether susceptibility changes with age. In addition, other traits could be examined as possible susceptibility markers. For instance, highly impulsive children or adolescents could be more susceptible to their environment because they are relatively sensitive to immediate rewards, making them react to their environment more strongly (Derryberry & Rothbart, 1997). Indeed, one study found that impulsivity made children more susceptible to harsh discipline (Leve, Kim, & Pears, 2005). Also, children or adolescents with high levels of effortful
control, the capacity to inhibit a dominant response in favour of a subdominant one, are better able to focus their attention on information in the environment (Derryberry & Rothbart, 1997), making them deeply process this information, which may make them more susceptible to the environment, as is thought to be the case with SPS (Aron et al., 2012). Furthermore, future research should take on a longitudinal approach, which is essential for understanding the direction of effects (i.e., positive friendship qualities lead to less social anxiety symptoms, or adolescents who are less socially anxious interact more positively with their friends) and to consider potential reciprocal influences. It is also suggested that future research on differential susceptibility takes into account other outcome measures, as the absence of social anxiety symptoms does not equal the presence of positive outcomes.
Taken together, this study shows that especially adolescents with high levels of SPS may be more vulnerable to negative best friendship qualities, which leads to more social anxiety symptoms. Our findings do not support the idea of differential susceptibility, and do support the prevailing diathesis–stress view of psychopathology. It could be, however, that SPS and behavioural inhibition are mild forms of social anxiety symptoms and represent precursors of substantial social anxiety problems. This study also shows that positive best friendship qualities are important to foster as they predict less social anxiety symptoms in
adolescents. Clinically, the current findings support the emphasis on improving the interpersonal relationships of socially anxious adolescents (e.g., Beidel & Turner, 1998). Furthermore, efforts to improve adolescents’ interpersonal functioning may be critical for preventing clinical levels of social anxiety. This study has demonstrated that in a good quality friendship, friends might come with benefits after all.
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Figure 1. Interaction of negative friendship qualities and SPS in predicting adolescents’ social anxiety symptoms. Unstandardized slopes at values above the mean (high), and values below the mean (low) are presented. Values depicted are Pearson correlations. SPS = sensory processing sensitivity.
* p < .05.
.21*
