Trait Social Anxiety and Cardiovascular Responses to Acute Stress: The Mediating Effects of Perceived Hostility and Rejection in Interpersonal Relationships

The current study aimed to (1) examine the association between trait social anxiety and cardiovascular reactivity and recovery to an initial psychological stress exposure, as well as cardiovascular response adaptation to repeated acute stress, and (2) determine whether self-reported perceptions of negative social relationships mediate the association between social anxiety and cardiovascular stress responses. The current study employed a quasi-experimental observational design, whereby participants (n = 137) completed a standardized cardiovascular stress adaptation protocol with systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) monitored throughout. Participants ( M age = 19.54, SD = 1.53, ages 18 -26) included healthy young adults who were free from cardiovascular conditions. A total 72 (52.6 %) participants were women, 63 (46 %) were men, and 2 (1.5 %) were non-binary. Participants also completed measures assessing trait social anxiety (Social Interaction Anxiety Scale) and self-reported perceptions of negative social relationships which measures perceived hostility and rejection from one’s social network (NIH Social Distress Scale). The results indicated that greater perceptions of hostility from others significantly mediated the association between trait social anxiety and both diminished HR reactivity, B = -.03, 95% CI [-.070, -.001], and poorer HR recovery, B = .03, 95% CI [-.07, -.001] to acute psychological stress. Given that both blunted HR reactivity and poorer HR recovery have been associated with future health outcomes, these findings may suggest a potential psychophysiological pathway linking social anxiety and negative social relationships to adverse cardiovascular health outcomes.