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Impact of Social Anxiety Disorder on Employment Among Women Receiving Welfare Benefits

Dr. Tolman, Dr. Himle, and Dr. Bybee are affiliated with the University of Michigan School of Social Work, 1080 S. University Ave., Ann Arbor, MI 48104 (e-mail: rtolman{at}umich.edu). Dr. Van Etten-Lee is with the Department of Psychology and Dr. Abelson is with the Department of Psychiatry, both at the University of Michigan, Ann Arbor. Dr. Hoffman is with Ann Arbor Consultation Services.

OBJECTIVE: Studies in clinical and community samples have documented that social anxiety disorder is common, disabling, and costly. It reduces educational attainment and job success, and thus it may undermine economic self-sufficiency. The authors examined whether social anxiety disorder was an obstacle to successful employment in a longitudinal epidemiological study of women receiving welfare in an urban Michigan county. The hypothesis that social anxiety disorder would predict reduced work attainment was examined. METHODS: Psychiatric diagnoses were established with the Composite International Diagnostic Interview-Short Form. The authors conducted a linear fixed-effects regression analysis for survey data with 609 respondents who completed at least the third wave of the Women's Employment Study in order to explore obstacles to employment among mothers on welfare. RESULTS: Analyses demonstrated that compared with respondents without social anxiety disorder, those with this disorder worked fewer months. The impact of social anxiety disorder was independent of and more striking than the effects of depression. CONCLUSIONS: By undermining efforts to obtain or maintain employment, social anxiety disorder poses a significant, unrecognized impediment to efforts to reduce welfare reliance and to help recipients achieve economic self-sufficiency. Because recipients may lose benefits if they fail to enter the workforce rapidly and if they exceed time limits for support, those with social anxiety disorder are at risk of extreme economic hardship. Improved access to effective treatments in this population could have significant public health and economic benefits.

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