New insights into recalled parental behavior in social anxiety disorder: A cluster analytic approach

• Published in: Journal of affective disorders 2024-10, Vol.363, p.662-670
• Main Authors: Rambau, Stefanie, Forstner, Andreas J., Geiser, Franziska, Schumacher, Johannes, Conrad, Rupert
• Format: Article
• Language: English
• Subjects: Adverse childhood experiences; Cluster analysis; Parental behavior; Social anxiety disorder; Subgroups; Temperament and Character Inventory
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2024.07.055

Social Anxiety Disorder (SAD) is a highly heterogeneous disorder. To enlighten its heterogeneity, this study focused on recalled parental behavior and aimed to empirically identify if there are subgroups of SAD based on recalled parental behavior by means of cluster analysis. Further, the study investigated whether those subgroups differed on clinical, trauma, and personality variables. This study included 505 individuals diagnosed with SAD and 98 adult controls who were asked to fill out the Parental Bonding Instrument (PBI), the Adverse Childhood Experiences Questionnaire (ACE), and the Temperament and Character Inventory (TCI). Cluster analysis determined whether there are meaningful SAD subgroups based on PBI. The clusters obtained were compared with each other and with the control group with regard to clinical, ACE, and TCI variables. The cluster analysis revealed two SAD clusters based on recalled parental behavior. SAD individuals in the first cluster (49.3 %) perceived their parents as intermediately caring, but not as overcontrolling. SAD individuals in the second cluster (50.7 %) perceived their parents as less caring and overcontrolling, reported more severe clinical symptoms and trauma, and had lower values in Self-Directedness and Cooperativeness. The present study is cross-sectional, therefore unable to confirm causal interpretations. Parenting is meaningful to enlighten the heterogeneity of SAD symptomatology and to specify treatment approaches as there are two meaningful subgroups in individuals with SAD corresponding to differences in clinical presentation, trauma, and personality. •Parental behavior is of great relevance for SAD and can uncover its heterogeneity.•Based on recalled parental behavior cluster analysis can identify two subgroups of SAD.•Subgroups account for 50.7 % and 49.3 % of 505 individuals with SAD.•Less care and overcontrol characterize the clinically more severe subgroup.•Subgroups differ significantly in character dimensions according to the TCI.