PATTERNS OF ANXIETY: AN ANALYSIS OF SOCIAL ANXIETIES*
BY JAMES J. DIXON, CECILY DE MONCHAUX
All neurotic symptoms and character traits
involve a disturbance in object-relationships.
But certain symptoms are predominantly
private, and their pain-producing qualities d o
not depend upon the immediate presence of
others. There is, however, a large group of
neurotic symptoms which includes the social
anxieties. These are anxieties which occur
when the person concerned is, or anticipates
being, in interaction with others. It follows
that the existence of these anxieties affects very
markedly not only the sufferer himself, but
also those who compose his social environ-
ment. Not only in their outcome do these
symptoms have sociological implications, but
in so far as they take their origin in part from
social interactions in the family, the question
of their aetiology poses sociological as well as
psychological problems.
As in our previous study (Dixon, de Mon-
chaux & Sandler, 1957) the first aim of this
research was the construction of a classifica-
tion of social anxieties, derived empirically
from an analysis of a sample of anxieties. This
classification, reached by means of statistical
techniques, is then capable of being examined
and interpreted theoretically.
THECLASSIFICATION OF SOCIAL ANXIETIES
The technique of analysing patients’ responses
to selected items of a comprehensive psy-
* This paper is the seventh of the Studies in
Psychopathology using a Self-Assessment Inven-
tory. It is the second of a series of papers which
includes work submitted by Dr Dixon for the
degree of Ph.D. in the University of London
(Dixon, 1955). The present research was carried
out jointly at the Tavistock Clinic under the
direction of Dr Sandler and at the Psychology
Department, University College, London, under
the supervision of Dr de Monchaux. Manuscript
received 10 January 1957.
AND JOSEPH SANDLER
chiatric inventory has been discussed else-
where (Sandler, 1954), and the value of this
approach in psychopathological research has
been shown in a number of studies (Sandler &
Pollock, 1954a-c; Kanter & Sandler, 1955;
Sandler & Rakoff, 1955).
Twenty-six of the items of the Tavistock
Self-Assessment Inventory refer to problems
which could be classified under the broad
heading of ‘social anxieties’. These items are
given in Table 1. It will be apparent that the
items chosen for classification in this study
relate to ‘public’ rather than tomore ‘intimate’
social situations. The responses (which could
be classified into ‘true’ or ‘false’) of 250
patients at the Tavistock Clinic, London, were
used as the basis of this investigation. This
group of patients, tested on admission, were
the same patients investigated in the previous
research in this series (Dixon, de Monchaux &
Sandler, 1957), and the results of the present
study will, in a later report, be related to the
classification of ‘phobic’ anxieties found
previously.
The twenty-six items were intercorrelated
using $-coefficients and were subjected to
a factor analysis by Thurstone’s centroid
method. This analysis yielded four factors,
including a strong general factor. As all the
factors after the first were bipolar factors,
involving the contrasting of three pairs of
opposing tendencies, it was felt that the results
could be more clearly ordered by modifying
the centroid analysis so that the factors con-
sisted of a general factor and group factors
(that is, corresponding to the main clusters of
items found upon detailed examination of the
centroid factors). The logic and arithmetic of
all these processes are given by Dixon (1955).
The results of the group factor analysis are
given in Table 2. For clearness of presentation,
the items are given according to the statistical
108 J. J. DIXON, CECILY D E MONCHAUX A N D J. SANDLER
groupings. Factor saturations are given in full order of their saturation with the factor are as
for the general factor, and are listed when over follows:
0.200 for the group factors. The general factor 21. I am frequently afraid I may look ridi-
G, accounted for 19.7 % of the variance of the culous or make a fool of myself.
items, while four group factors (As, B,, C, and 24. I am sometimes afraid of expressing
DJ accounted for 4.6,3.3,2.6 and 2.2 % of the myself in case I make a foolish mistake.
total variance respectively. 5 . I hate walking past a crowd of people.

Table 1
1 . I often have the fear that others might think me unintelligent or ignorant.
2. I sometimes get the sudden fear that my clothes are not properly done up.
3. I am afraid of being disliked by people.
4. I feel generally uncomfortable when eating or drinking in front of others.
5. I hate walking past a crowd of people.
6. I constantly seem to feel that I have offended someone.
7. If I come late to a meeting I would rather stand than take a front seat.
8. I feel uncomfortable in the company of a cripple or anyone with a physical defect.
9. I am often worried in case I might vomit or be sick in public.
10. I usually feel nervous when speaking to someone in authority.
11. I usually feel uncomfortable when with a crowd of people I do not know.
12. I feel uncomfortable when I am the centre of attention (e.g. when crossing a dance floor).
13. I sometimes worry that I may want to pass water at an inconvenient time.
14. I sometimes have the fear of fainting in public.
15. I am usually in doubt whether to greet someone I know only slightly.
16. I find it intolerable to be on bad terms with someone in authority.
17. If anything happens which tends to make me look foolish I tend to think about it for a long
time afterwards.
18. I always feel uncomfortable when I do not know what is expected of me.
19. I find it difficult to ask other people for information.
20. Talking to people about my personal feelings makes me acutely uncomfortable.
21. I am frequently afraid I may look ridiculous or make a fool of myself.
22. I am nervous about performing in front of people.
23. I feel very embarrassed if there is anything wrong with my clothes or appearance.
24. I am sometimes afraid of expressing myself in case I make a foolish mistake.
25. I often have the fear of passing wind or making involuntary body noises when other people
can hear.
26. I usually feel awkward with strangers.

11. I usually feel uncomfortable when with

General social anxiety
The general factor (G,) accounts for very
much more of the common-factor variance
than any of the group factors; indeed, for
more than all the group factors taken together.
Any psychological interpretation put upon the
group factors must be made against the back-
ground of this large general factor, which can
be called general social anxiety.
The items most highly saturated with G,, in
a crowd of people I d o not know.
1. I often have the fear that others might
think me unintelligent or ignorant.
12. I feel uncomfortable when I am the centre
of attention (e.g. when crossing a dance
floor).
18. I always feel uncomfortable when I do not
know what is expected of me.
10. I usually feel nervous when speaking to
someone in authority.
 SOCIAL ANXIETIES 109
These items, taken together, will tend to Contrasting these items with those possess-
indicate the level of any one patient’s general ing a high saturation with G,, it appears that
social anxiety. They sample, as it were, the a high ‘general social anxiety’ refers to appre-
most general trend in the whole set of repre- hensions about the performance. of social
sentative items. It is clear from Table 2, roles, apprehensions which refer to a whole
however, that these items may fall into other range of possible social situations. Those
groupings as well. What they have in common items which refer to relatively spec& occur-
is a high saturation with the general factor. rences have a low saturation with G,.
Table 2
Item G, A,
21 0.572 -
17 0.469 -
25 04-39 -
8 0.272 -
26 0.497 0.503
11 0-525 0.425
10 0.509 0.403
19 0-395 0.359
18 0.512 0.315
15 0.493 0.289
24 0.544 0.266
4 0-465 0.223 -
9 0.209 - -
14 0.123 - -
13 0.315 - -
16 0.283 - -
12 0.522 - 0.419
7 0.490 - 0.353
5 0.529 - 0.292
23 0-427 - 0.245
22 0.376 - 0.225
20 0403 - 0.205
1 0.523 - -
2 0.428 - -
3 0-416 - -
6 0-439 - -
The items which have a low saturation with
the general factor are : Social timidity (A8)
14. I sometimes have the fear of fainting in The items most highly saturated with A,, the
public. first of our group factors, are listed below:
9. I am often worried in case I might vomit
or be sick in public. 26. I usually feel awkward with strangers.
8. I feel uncomfortable in the company of 11. I usually feel uncomfortable when with
a cripple or anyone with a physical defect. a crowd of people I do not know.
16. I find it intolerable to be on bad terms 10. I usually feel nervous when speaking to
with someone in authority. someone in authority.
13. I sometimes worry that I may want to 19. I find it difficult to ask other people for
pass water at an inconvenient time. information.
110 J. J. DIXON, CECILY D E MONCHAUX A N D J. SANDLER
18. I always feel uncomfortablewhen I do not Fear of exhibitionism (C,)
know what is expected of me.
The six items which fall into this group,
15. I am usually in doubt whether to greet having the highest saturations with factor C,,
someone I know only slightly.
are as follows:
24; I am sometimes afraid of expressing my-
self in case I make a foolish mistake. 12. I feel uncomfortablewhen I am the centre
4. I feel generally uncomfortable when of attention (e.g. when crossing a dance
eating or drinking in front of others. floor).
7. If I come late to a meeting I would rather
These items all refer to social situations in stand than take a front seat.
which the subject is self-consciously afraid 5. I hate walking past a crowd of people.
that he will not know how to behave, especially 23. I feel very embarrassedif there is anything
in strange social surroundings. They refer to a wrong with my clothes or appearance.
type of social inhibition in which the accent is 22. I feel nervous about performing in front
not upon intrinsic inferiority, but rather on the of people.
fear of creating, in strangers or in authority 20. Talking to people about my personal
figures, an adverse impression. feelingsmakes me acutely uncomfortable.
We know, from everyday experience, that These items consistently refer to a fear of
this type of person feels most comfortable being noticed by others. More specifically,the
when in his own familiar social group, where factor appears to represent a fear of self dis-
he feels relatively secure in the judgement of play, for in most of the items in this group
his intimates. The factor suggests a feeling of there is an implication of the patient’s doing
social timidity as opposed to personal something which might draw the attention of
inferiority. others to him.

Fear of loss of control, especially Fear of revealing inferiority (0,)

bodily control (BJ
The items grouped together by factor B, are :
9. I am often worried in case I might vomit
or be sick in public.
14. I sometimes have the fear of fainting in
public.
13. I sometimes worry that I may want to
pass water at an inconvenient time.
16. I findit intolerableto be on bad terms with
someone in authority.
The first three items, having the highest
saturations with this factor, suggest that those
patients who show this factor pattern are
anxious lest they fail to retain control over
certain bodily functions. The fourth item,
which does not fit in with the other three, may
be associated with them by virtue of a fear of
The items which have the highest saturations
with factor 0,are:
1. I often have the fear that others might
think me unintelligent or ignorant.
2. I sometimes get the sudden fear that my
clothes are not properly done up.
3. I am afraid of being disliked by people.
6. I constantly seem to feel that I have
offended someone.
This factor is qualitatively different from the
other factors. The items refer to fears of being
judged critically by others. In this they stand in
contrast to the items listed under A,, items
which refer rather to subjective feelings of
discomfort, awkwardness or tension in the
presence of others.
DISCUSSION OF THE GROUP FACTORS

loss of control of aggressivefeelings. It is clear, Factor A,, which we have labelled social
however, that this last item does not appear timidity, brings together a group of items
very consistent with the first three. which refer to subjective feelings of discom-
 SOCIAL ANXIETIES 111
fort in certain social situations. All the items subject explicitly anticipates that he will be at
refer to feelings of tension and inhibition in fault or judged to be at fault. In short, he feels
social intercourse. If we compare A, with C, that he will misbehave or that others will
ffear of exhibitionism) we find that the latter disapprove of or dislike him.
also refers to subjective discomfort in public Group B, (fear of loss of control, especially
relationships, but in C, the striking common bodily control) contrasts however with D, in
feature is that the inhibitions are referred in that three of its four component items refer
every case to a situation in which the subject to social sins (vomiting, fainting or urinating
is explicitly the focus of attention, where his in public) in which involuntary loss of bodily
behaviour will be revealed and observed. control is predominantly feared. In group 0,
Given a situation in which he is revealed to Wear of revealing inferiority) the consequences
others, he anticipates danger. Psychoana- of voluntary behaviour are feared.
lytically, we would say that the focus of conflict From another viewpoint, it can be seen that
for those who are of type C, is an exhibitionistic A, and B, refer on the whole to fears of expres-
one. * Where type A, anticipates awkwardness sive acts, while in C, and 0,the emphasis is
and embarrassment in approaching any new upon the possibility of an adverse assessment
or unfamiliar social situation, those of type C, by others.
anticipate anxiety when the spotlight is turned
upon them. We may surmise that A, has his
IMPLICATIONS FOR DIAGNOSIS AND THERAPY
worst moment when he approaches a stranger,
but that C, experiences his when he is exposed Clearly, although there is a strong general
before a group. factor of social anxiety, we must differentiate
Groups A, and C, refer to two types of social between a number of types of social fear which
situation which provokes anxiety. In this they may mean very different things. Detailed
contrast with groups B, and D, in which the examination of the focus of anxiety may
* Factors which are hypothetical tests or throw light in particular upon the nature and
measures, i.e. those derived fromthe factor analysis development of the patient’s super-ego, and
of attributes or test-items, are at the same time upon his pattern of internalization and pro-
hypothetical persons or ‘types’. We might speak jection. Apparently slight differences in what
of a ‘verbal’factor derived from the factoranalysis is broadly termed ‘social inferiority feelings’,
of intelligence tests, and at the same time of a may be indicative of gross inner differences,
‘verbal’ type who exemplifies such a factor. In especially with respect to the development of
this discussion we can speak of ‘types’ A,, B,, C ,
paranoid illness.
and D , as well as of the corresponding groupings
In a followingpaper, the empiricalgroupings
of the original items. There is, in fact, a mathe-
matical identity between factors derived from presented here will be related to further data in
‘tests’ (e.g. the present twenty-six items) and order to amplify the present classification,
person ‘types’ derived from the factor analysis particularly in relation to psychopathological
of persons (Sandler, 1949, 1952). theory.
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