The Cultural Shaping of Social Anxiety: Concerns About Causing Distress to Others in Han Chinese and Euro-Canadian Outpatients

Abstract

Given considerable evidence that culture profoundly shapes both normative social behaviors and psychopathology, we argue that social anxiety disorder cannot be properly understood in the absence of cultural context. In particular, there is evidence that Chinese cultural contexts foster concern for whether one is making other people uncomfortable. We examined these concerns in 175 Han Chinese depressed psychiatric outpatients in Changsha, China and 104 Euro-Canadian depressed psychiatric outpatients in Toronto, Canada. As anticipated, anxiety about causing discomfort to others was related to but distinct from social interaction anxiety, with a stronger relation in the Han Chinese sample. Also as anticipated, anxiety about causing discomfort to others was higher in the Han Chinese sample compared to the Euro-Canadian sample, especially in outpatients who acknowledged anxiety in social situations. These findings can be understood in light of research demonstrating that Chinese cultural contexts foster particular concerns for the maintenance of social harmony. We discuss implications of these findings for assessment and treatment of social anxiety disorder.

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