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Cross-cultural network structures of social anxiety, body dysmorphic, and major depressive disorder symptoms in individualistic vs. collectivistic societies: A comparison between American, German, and Japanese populations.

Shota Noda,Chantal Kasch,Cameron E. Lindsay,Stefan G. Hofmann

Published 2025 in Journal of Anxiety Disorders

ABSTRACT

Social anxiety disorder (SAD), body dysmorphic disorder (BDD), and major depressive disorder (MDD) are highly comorbid, which may be influenced by cultural variables associated with individualism vs. collectivism with particular emphasis on shame. This study investigated the network structures comprising symptoms of SAD, BDD, MDD, and shame across three countries typically associated with either a high tendency of collectivism (Japan), a high tendency of individualism (USA), or in between (Germany). Participants included 319 Japanese, 440 US Americans, and 308 Germans from the general populations of their respective countries, who completed questionnaires assessing the aforementioned symptoms as well as individualistic and collectivistic tendencies. Psychometric network analyses were conducted using Gaussian Graphical Models to separately examine the network structures of (a) individualistic and collectivistic tendencies and (b) symptoms of SAD, BDD, MDD, and shame. A Network Comparison Test (NCT) was used to assess the overall consistency of these networks across countries. The NCT revealed significant cross-cultural differences in the network structures of individualistic and collectivistic tendencies across countries, as well as in the networks of symptoms of SAD, BDD, MDD, and shame between Japan and Germany and between Japan and the USA. Although certain central symptoms were shared across all countries, others differed. These findings underscore the coexistence of cultural homogeneity and heterogeneity in the manifestation and organization of SAD, BDD, and MDD symptoms, emphasizing the importance of culturally sensitive, targeted interventions.

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