Social Anxiety Among Sexual Minority Individuals: A Systematic Review

Abstract

ABSTRACT Social anxiety is a prominent psychological concern within sexual minority populations. We systematically reviewed the related empirical literature in order to 1) describe the characteristics of studies assessing social anxiety among sexual minority individuals; 2) compare social anxiety levels across sexual orientation subgroups; 3) synthesise bivariate and multivariate associations related to social anxiety, and collate qualitative findings pertaining to social anxiety, among sexual minority populations; 4) identify psychological interventions that have been empirically tested to reduce social anxiety symptoms in sexual minority individuals. A search strategy was implemented across six databases, and 61 papers representing 46 unique studies were identified for inclusion. The vast majority of studies were cross-sectional, based in the USA, and more focused on sexual minority men than women. No included studies were qualitative in nature. Across studies, sexual minority individuals consistently appear at a higher risk for social anxiety symptoms than heterosexuals. Subgroup analyses within sexual minority subgroups are scarce; however, tentative evidence suggests that bisexual individuals are at greater risk for high social anxiety symptoms than gay/lesbian individuals. Minority stress processes, general social processes (e.g. social support), other internalising mental health symptoms, among other variables hold significant associations with social anxiety across the included studies. Empirical studies testing the efficacy of psychological interventions in this area are markedly lacking. Future studies should employ more diverse methodologies (i.e. experimental, longitudinal, and qualitative) to further elucidate the determinants and experience of social anxiety among sexual minority individuals and interventions to address them.