An interpersonal problem approach to the division of social phobia subtypes

In the DSM-IV, social phobia has been subdivided into a generalized and a n on-generalized subtype. Although a number of important quantitative distinc tions have been identified between the subtypes, most studies have failed t o find support for qualitative differences between them. The goal of the pr esent study was to determine whether the investigation of interpersonal pro blems in social phobia would lead to qualitatively different subgroups, sub groups that would provide additional nonoverlapping information to the DSM- IV classification. Thirty generalized socially phobic, 30 nongeneralized so cially phobic, and 30 nondisordered control participants were selected base d on dual structured interviews. All participants completed the Inventory o f Interpersonal Problems Circumplex Scales (HPC; Alden, Wiggins, & Pincus, 1990). Results showed that when social phobia subtypes were classified usin g the DSM-IV definition, the IIP-C reflected subgroup differences in global severity of interpersonal problems, with the generalized social phobia gro up evidencing the greatest difficulty. However, the subgroups could not be discriminated on core or central interpersonal problems. In contrast, when an interpersonal analysis of subtype classification was employed, two group s were formed, each with discriminating core unifying features suggesting q ualitatively different problematic reactions to interpersonal situations. O ne group evidenced interpersonal problems related to hostile, angry behavio r, whereas the other group exhibited problems related to friendly-submissiv e behavior. Interpersonally derived subtypes were unrelated to DSM-IV defin ed subtypes, depression, and Axis I or avoidant personality disorder comorb idity. The potential clinical relevance of an assessment of interpersonal d ysfunction to the treatment of social phobia is discussed.