Temporal Dynamics of Social Anxiety and Depression: The Moderating Role of Cognitive Flexibility

Social anxiety (SA) and depressive symptoms are frequently comorbid, with the onset of SA typically preceding the onset of depression. Individuals experiencing SA-depression comorbidity exhibit increased clinical and functional impairments as compared to individuals without this comorbidity. Understanding the mechanisms that underlie this comorbidity can deepen our theoretical understanding regarding the co-occurrence of these conditions and contribute to depression prevention efforts. Recent theories suggest that low cognitive flexibility (CF) contributes to the development of depression and may play a role in the relationship between the disorders. However, empirical prospective findings are sparse. We examined whether CF moderates the link between SA and depressive symptoms in two independent pre-registered studies: cross-sectional (n=379) and longitudinal (n=108, two-year). Higher CF was linked to a weaker relationship between SA and depression. Across time, among individuals with low CF at baseline, there was a positive association between SA at baseline and depression two years later. No such association was found among individuals with high CF. These findings highlight the role of CF in the development of comorbid depression among high SA individuals. It may contribute to the clinical prevention of depression through specific psychotherapeutic techniques targeted to enhance CF among SA patients.