Social anxiety disorder puts welfare recipients at risk for economic hardship

January 8, 2009

(PhysOrg.com) -- Women on welfare who suffer from social anxiety find it harder to work—and leave welfare—than women without the disorder, according to a new University of Michigan study.

Welfare recipients with social anxiety disorder worked only six of 12 months, compared with about nine months for those who did not suffer from this disorder or from major depression. By comparison, women with depression only worked about eight of 12 months.

Social anxiety disorder is a persistent fear of social or performance situations that might involve exposure to unfamiliar people or possible scrutiny by others. This condition, which often remains undetected and untreated, undermines a woman's ability to become self-sufficient and impedes efforts to reduce welfare costs through return-to-work programs, the U-M researchers said.

"Women with social anxiety disorder are at risk of extreme economic hardship," said Richard Tolman, a professor in the School of Social Work and the study's lead author. "These welfare recipients may lose benefits if they fail to enter the work force rapidly and if they exceed time limits for support."

Tolman and colleagues examined whether social anxiety disorder was an obstacle to successful employment among women receiving welfare. They analyzed data on 609 respondents who completed four annual interviews from the Women's Employment Study.

More than a third of the women cared for a child younger than age 2 and more than 60 percent lived in poverty in the month before the interview.

Interview questions included measures of social anxiety disorder, other mental health diagnoses, welfare and work status, and other variables.

"Very few of the women in this study received any help for a treatable problem that made it nearly impossible for them to get a job and get off of welfare," said Joseph Himle, an assistant professor in the Department of Psychiatry and School of Social Work.

The findings also highlight that other barriers—such as poor physical health of the women and their children, low educational attainment and inadequate transportation—remain a concern and are significant obstacles to work for women in this disadvantaged economic group. An accumulation of multiple barriers increases interference with work efforts, the researchers said.

"With unemployment growing rapidly in these tough economic times, people suffering from social anxiety disorder may be at even greater risk," said James Abelson, a professor of psychiatry. "Social fears may increase their risk of being laid off, and discomfort making phone calls or interviewing will greatly undermine efforts to find new employment."

In a follow-up study led by Himle, the research team is developing and testing a treatment program specifically designed for this disadvantaged population. The researchers hope to increase job success for those whose social anxiety has contributed to their lack of employment.

Since the study focused on women, the researchers do not know if the findings are relevant to low-income men, who are generally denied public welfare benefits in the United States.

The study's other authors are Deborah Bybee, research scientist, School of Social Work; Jody Hoffman of Ann Arbor Consultation Services; and Michelle Van Etten-Lee, adjunct assistant professor, Department of Psychology.

The findings appear in the current issue of Psychiatric Services.

Provided by University of Michigan