Social anxiety in children: Social skills deficit, or cognitive distortion?
Abstract
Background Treatments for childhood social anxiety have traditionally employed social skills training, based on the assumption that effected children have social skills deficits. Recent conceptualisations of social anxiety in adults have questioned this assumption, and have suggested that socially anxious individuals merely believe that they have skill deficits. A recent study using children provided preliminary confirmation of this for younger populations, and also suggested that beliefs about appearing nervous are of particular importance.Methods Two groups of children, aged 10-11 years (analogue high social anxiety/low social anxiety), participated in a conversation with an unfamiliar adult. They then rated their performance in a number of domains, after which independent observers also rated their performances.Results Independent observers were unable to distinguish between the low and high social anxiety groups. However, high socially anxious children rated themselves as appearing significantly less skilled than their low socially anxious counterparts. Notably, high socially anxious children rated themselves particularly poorly in terms of how nervous they looked.Conclusions Socially anxious children may not necessarily display social skill deficits. However, they may believe that they appear nervous during social encounters. Clinicians should consider using CBT techniques to address these concerns, rather than relying on social skill remediation.
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In Cartwright-Hatton et al.'s study, there was no statistical difference between volunteers' estimates of social skills of 10-11-year-old children with and without SAD.
“they found there was no statistical difference between volunteers’ estimates of social skills of people with and without SAD.”
From Shame or What Makes Irrational Social Anxiety Rational. (2025) · cites this paper as [15]
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Observer Perspective in Adolescence: The Relationship with Social Anxiety and Age
Hignett, E., & Cartwright‐Hatton, S. (2008) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465808004554 · Cited by 18 · see citing works
Tratamiento cognitivo-conductual para niños mexicanos con fobia social
Gil-Bernal, F. D. M. E., & Hernández‐Guzmán, L. (2009) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) · Cited by 18 · see citing works
Kley, H., Tuschen-Caffier, B., & Heinrichs, N. (2011) · Journal of Experimental Psychopathology · doi:10.5127/jep.014511 · Cited by 17 · see citing works
Perfectionistic Self‐Presentation and Psychopathology: A Systematic Review and Meta‐Analysis
Casale, S., Svicher, A., Fioravanti, G., Hewitt, P. L., Flett, G. L., & Pozza, A. (2024) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2966 · Cited by 20 · see citing works
Koo, H. J., Woo, S., Yang, E., & Kwon, J. H. (2015) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2014.0396 · Cited by 17 · see citing works
“However, other researchers have suggested that some socially anxious youths are able to make friends because their social anxiety may not stem primarily from the absence of adaptive social behavior or intimate relationships, but rather from social sensitivity and negative cognitions.(5,6) Furthermore, some authors(7,8…”
Henricks, L. A., Lange, W., Luijten, M., van den Berg, Y. H. M., Stoltz, S. E. M. J., Cillessen, A. H. N., & Becker, E. S. (2023) · Journal of Research on Adolescence · doi:10.1111/jora.12833 · Cited by 17 · see citing works
Associations Between Anxiety Symptoms and Child and Family Factors in Pediatric Obesity
Lim, C. S., Espil, F. M., Viana, A. G., & Janicke, D. M. (2015) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000225 · Cited by 16 · see citing works
Self-evaluation, social and cognitive performance in children with social phobia
Krämer, M., Schmitz, J., Heinrichs, N., & Tuschen‐Caffier, B. (2011) · Journal of Experimental Psychopathology · doi:10.5127/jep.0016311 · Cited by 16 · see citing works
Social Skills Deficits and Self-appraisal Biases in Children with Social Anxiety Disorder
Lau, N., Zhou, A. M., Yuan, A., Parigoris, R. M., Rosenberg, A. R., & Weisz, J. R. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-021-02194-w · Cited by 17 · see citing works
“…no worse than non-anxious controls on social interaction tasks when rated by external observers, but that self-ratings of performance were signi fi cantly lower for children with SAD than for non-anxious controls (Cartwright-Hatton et al., 2005; Krämer et al., 2011; Tuschen-Caf fi er et al., 2011).”
BackgroundResultBlöte, A. W., Poungjit, A., Miers, A. C., van Beek, Y., & Westenberg, P. M. (2015) · Journal of Experimental Psychopathology · doi:10.5127/jep.039713 · Cited by 15 · see citing works
“An adapted version (Miers et al., 2009) of the PQ-O (Cartwright-Hatton et al., 2003; 2005) was used in the SAND study to rate speaker behavior.”
BackgroundMethodInfluentialHabilidades sociais na agorafobia e fobia social
Levitan, M. N., Rangé, B., & Nardi, A. E. (2008) · Psicologia Teoria e Pesquisa · doi:10.1590/s0102-37722008000100011 · Cited by 15 · see citing works
Social anxiety and perceptions of likeability by peers in children
Baartmans, J. M. D., van Steensel, F. J. A., Mobach, L., Lansu, T. A. M., Bijsterbosch, G., Verpaalen, I. A. M., Rapee, R. M., Magson, N. R., Bögels, S. M., Rinck, M., et al. (2020) · British Journal of Developmental Psychology · doi:10.1111/bjdp.12324 · Cited by 15 · see citing works
Blöte, A. W., Miers, A. C., van den Bos, E., & Westenberg, P. M. (2018) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000310 · Cited by 14 · see citing works
“Other studies did not find differences in observer ratings between socially anxious and non-anxious groups (Cartwright-Hatton et al., 2005; Erath et al., 2007; Miers et al., 2009).”
MethodResult", & DAVID, O. A. (2019) · Journal of Evidence-Based Psychotherapies · doi:10.24193/jebp.2019.2.15 · Cited by 13 · see citing works
Psychosocial and pharmacological treatment for pediatric anxiety disorders
Fisher, P. H., Tobkes, J. L., Kotcher, L. B., & Masia‐Warner, C. (2006) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.6.11.1707 · Cited by 13 · see citing works
Centrality in children's best friend networks: The role of social behaviour
Betts, L. R., & Stiller, J. (2013) · British Journal of Developmental Psychology · doi:10.1111/bjdp.12020 · Cited by 12 · see citing works
Klein, A. M., Flokstra, E., van Niekerk, R. E., Klein, S., Rapee, R. M., Hudson, J. L., Bögels, S. M., Becker, E. S., & Rinck, M. (2018) · Child Psychiatry & Human Development · doi:10.1007/s10578-018-0804-x · Cited by 12 · see citing works
“Finally, because the published results are inconclusive as to whether socially anxious individuals behave differently from non-anxious individuals during anxiety-provoking situations [22, 42, 43], we decided to measure self-reported anxiety before and after the SST, instead of using a measure of actual behavior in thi…”
ResultFox, J. K., Ryan, J. L., Burch, J. M., & Halpern, L. F. (2021) · School Mental Health · doi:10.1007/s12310-021-09466-2 · Cited by 12 · see citing works
“Indeed, studies show that children with social anxiety experience social threat cognitions more frequently than their non-anxious peers during socially evaluative tasks (Cartwright-Hatton et al., 2005; Kley et al., 2012) and social interactions (Alfano et al.”
BackgroundStark, C., Groves, N. B., & Kofler, M. J. (2022) · British Journal of Clinical Psychology · doi:10.1111/bjc.12398 · Cited by 16 · see citing works
Social Skills Differences Between the Autism Spectrum Disorders
Kozlowski, A. M., Matson, J. L., & Belva, B. C. (2011) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-011-9260-2 · Cited by 12 · see citing works
Youth’s Responses to Peer Provocation: Links to Symptoms of Anxiety and Depression
Dirks, M. A., Treat, T. A., & Weersing, V. R. (2014) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-014-9406-5 · Cited by 12 · see citing works
Biased Self-Perception of Social Skills in Anxious Children: The Role of State Anxiety
Dodd, H. F., Hudson, J. L., Lyneham, H. J., Wuthrich, V. M., Morris, T. M., & Monier, L. (2011) · Journal of Experimental Psychopathology · doi:10.5127/jep.019211 · Cited by 11 · see citing works
Schäfer, J., Schmitz, J., & Tuschen‐Caffier, B. (2012) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000113 · Cited by 11 · see citing works
Klein, A. M., Liber, J. M., van Lang, N. D. J., Reichart, C. G., Nauta, M. H., van Widenfelt, B. M., & Utens, E. M. W. J. (2021) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-021-00824-x · Cited by 10 · see citing works
Lidle, L. R., & Schmitz, J. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-022-01383-y · Cited by 10 · see citing works
“…self-evaluation bias regarding gaze behavior in children diagnosed with SAD (Hypothesis 3b), that is, that only in the HC group—and not in children diagnosed with SAD—would self-ratings of gaze behavior correspond to objective measures of gaze behavior (number of fixations, dwell time; e.g., [20]).”
BackgroundInfluentialMelero, S., Morales, A., Espada, J. P., & Orgilés, M. (2021) · Behavior Modification · doi:10.1177/0145445521991098 · Cited by 10 · see citing works
Developing Social Competence Through a Resilience Model
Alvord, M. K., Rich, B. A., & Berghorst, L. H. (2014) · Plenum series on human exceptionality · doi:10.1007/978-1-4939-0542-3_15 · Cited by 11 · see citing works
Alkhathami, S. S. (2014) · University of Bedfordshire Repository (University of Bedfordshire) · Cited by 10 · see citing works
Mylett, M. L., Boucher, T. Q., Scheerer, N. E., & Iarocci, G. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-06012-8 · Cited by 9 · see citing works
- Authors
- Cartwright-Hatton, S., Tschernitz, N., & Gomersall, H.
- Affiliations
- University of Manchester (GB)
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2005-01
- Volume
- 43
- Issue
- 1
- Pages
- 131-141
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2130219743
- Cited by
- 177
- References
- 22
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 3 · 2023: 6 · 2022: 9 · 2021: 13 · 2020: 7 · 2019: 7 · 2018: 11 · 2017: 11 · 2016: 7 · 2015: 18 · 2014: 13 · 2013: 8 · 2012: 8
- FWCI
- 5.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- social skills deficits, cognitive distortions, social skills training, cognitive behavioral therapy
- MeSH terms
- Analysis of Variance, Anxiety Disorders, Child, Child Behavior, Cognition, Female, Humans, Interpersonal Relations, Male, Psychiatric Status Rating Scales, Surveys and Questionnaires, Self-Assessment, Self Concept, Observer Variation
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