The Role of Fear of Positive Evaluation in Social Anxiety: A Systematic Review and Meta-Analysis

Social anxiety disorder (SAD) is often associated with fear of negative evaluation (FNE). More recently, fear of positive evaluation (FPE) has increasingly been recognized as a fear domain of SAD in which individuals are sensitive to positive appraisal and find social competition and conflict threatening. The relationships between FNE, FPE, and social anxiety symptoms were systematically reviewed and meta-analyzed, with 147 studies eligible for inclusion. It was found that considering both FNE and FPE together accounted for up to 9% more of additional variance in social anxiety symptoms than FNE alone, with large effect sizes between the means of FPE and FNE. It is recommended that research, diagnosis, and treatment account for the unique contribution of the FPE fear domain to better address social anxiety symptoms. Public Health Significance Statement Fear of positive evaluation is increasingly being recognised as a fear domain in Social Anxiety Disorder. Fear of positive evaluation explains additional unique variance in social anxiety symptoms not accounted for by fear of negative evaluation. Socially anxious individuals also report significantly higher levels of fear of positive evaluation.