Social Anxiety and Work: A Qualitative Investigation in a Low-Income, Minority Sample

Background/Purpose: Social anxiety disorder (SAD) is consistently associated with poor employment-related outcomes. However, our understanding of mechanisms through which SAD impacts employment is limited, and few studies examine employment experiences among racial minorities and economically disadvantaged individuals with SAD. This study employed qualitative methods to explore SAD’s impact on employment-related experiences among a majority African American, low-income sample seeking vocational services in a large Mid-western city.

Methods: Qualitative interviews were conducted for 12 vocational service-seeking individuals who met diagnostic criteria for SAD. Stratified purposive sampling was used to select participants based on sex and social anxiety severity. Interviews, focused on participant experiences with SAD and perceptions of SAD’s impact on work, were conducted by a masters-level social worker, audio recorded, and transcribed verbatim. Two investigators led thematic data analysis: one coded data in NVIVO, a qualitative software program, and one re-examined transcripts and codes for consistency. Axial coding grouped codes into meaningful themes and examined relationships among themes. The research team reviewed the data, confirming findings through group consensus.

Results: Thematic analysis identified two core themes: 1) Perceptions of SAD symptoms; and 2) Coping strategies to manage problems associated with SAD.

Perceptions of SAD symptoms: Participants described interactions between feelings of social anxiety, anger, and aggression in addition to symptoms typically reported by persons with SAD. This contrasts with perceptions of socially anxious persons as conflict avoidant and passive. Respondents also identified aggression as a strategy to keep people away and reduce future contacts with others.

         Participants perceived negative judgments from employers based on socio-economic status, appearance, and criminal histories. Some respondents felt there was little point in trying to seek employment, as employers would judge them on their limited work experience, low levels of educational attainment, or previous legal problems. This was especially true for respondents “marked” by criminal records, the street homeless “marked” by their appearance, and the under-educated “marked” by their communication style.

Coping Strategies to Manage Problems Associated with SAD: Participants reported utilizing a range of positive and negative coping strategies for work-related social anxiety. Respondents reported using self-talk and positive thinking to reduce fear and improve performance. Most respondents reported using self-styled relaxation strategies when confronted with challenging social situations. Interestingly, some respondents reported purposefully avoiding thoughts related to challenging situations or imagining they were elsewhere when in interpersonal situations. Additionally, respondents reported using prayer as a coping method. Beyond positive cognitive strategies, many respondents reported using substances to cope or “tune out” or acting in a particularly tough and threatening way to avoid social situations.

Conclusions and Implications: This is the first study qualitatively exploring SAD’s impact on employment and only known work investigating ways SAD affects the lives of disadvantaged, minority group members. Findings highlight the complex interplay between poverty, SAD, and employment. Results suggest an intersection between social circumstance, perceived treatment and history of actual discrimination, violence, and aggression that must be understood and addressed by clinicians seeking to help clients strike a balance between “mind-reading” distortions and realities of lived experiences.