KITCHENER -- People with social anxiety may experience more distress from wearing masks during and after the COVID-19 pandemic, a new study from the University of Waterloo found.

“The adverse effects of the COVID-19 pandemic on mental health outcomes, including anxiety and depression, have been well-documented,” co-author David Moscovitch said in a news release. “However, little is known about effects of increased mask-wearing on social interactions, social anxiety, or overall mental health."

The paper, which was written by researchers from the Department of Psychology and Centre for Mental Health Research and Treatment, said there may also be future implications for people who may not have experienced social anxiety in the past.

“It is also possible that many people who didn’t struggle with social anxiety before the pandemic may find themselves feeling more anxious than usual as we emerge out of the pandemic and into a more uncertain future — especially within social situations where our social skills are rusty and the new rules for social engagement are yet to be written," Moscovitch added.

Social anxiety is defined as negative self-perception and fear that someone's appearance or behaviour won't conform with social expectations and norms. Social anxiety disorder, an extreme manifestation, affects around 13 per cent of the population.

The study reviewed existing literature looking at three factors contributing to social anxiety associated with wearing masks: hypersensitivity to social norms, bias in the detection of social and emotional facial clues, and using self-concealment as a form of safety behaviour.

“We found that mask-wearing by people with social anxiety is likely to be influenced by their perception of social norms and expectations, which may or may not be consistent with public-health guidelines and can vary widely by region and context,” said Sidney Saint, the paper's lead author and an undergraduate psychology student.

According to the research, people with social anxiety may have trouble detecting ambiguous social cues, and are more likely to interpret them negatively. They also worry about sounding incomprehensible or awkward.

“We believe that both issues are likely to be magnified during interactions with masks,” Saint said.

The study looked at how masks can act as a type of self-concealment allowing people to "hide their self-perceived flaws." The researchers said people may be more motivated to wear masks for self-concealment.

“Due to their self-concealing function, masks may be difficult for some people to discard even when mask-wearing is no longer required by public health mandates,” Saint said.

People with social anxiety may also be more vulnerable during transition periods where mask-wearing exceptions are fluctuating or a personal choice, the study said.

The study is available online and will be published in “Anxiety, Stress & Coping.”