Social anxiety is associated with alterations in heart rate but not gaze in a real social interaction

Much of our current understanding of social anxiety rests on the use of simplistic stimulation material in laboratory settings. Latest technological developments now allow the investigation of eye movements and physiological measures during real interactions with adequate recording quality. Considering the wealth of conflicting findings on gaze behavior in social anxiety, the current study aimed at unraveling the mechanisms contributing to differential gaze patterns in a naturalistic setting in the general population and in social anxiety. We introduced participants with differing social anxiety symptoms to a waiting room situation while recording heart rate and electrodermal activity using mobile sensors and eye movements using mobile eye-tracking glasses. We observed fewer fixations on the head of the confederate in the initial waiting phase of the experiment. These head fixations increased when the confederate was involved in a phone call and head fixations were most pronounced during the actual conversation. In opposition to gaze-avoidance models of social anxiety, we did not observe any correlations between social anxiety and visual attention. Social anxiety was, however, associated with elevated heart rate throughout the entire experiment suggesting that physiological hyperactivity constitutes a cardinal feature of the disorder.