Many people dread being judged, whether at a job interview, in a classroom or at a party. For some, that worry grows into social anxiety that shapes their friendships, studies and careers. A large new review suggests that fear of other people’s negative opinions is moderately and consistently tied to social anxiety, though the strength of the link varies between cultures.

Researchers at Shanxi Medical University and partner institutions in China pooled the results of 143 studies in a systematic review and meta-analysis. The findings appear in BMC Psychology. Together the studies covered 146 independent samples and 80,285 participants.

The team searched major databases for work published between January 2010 and April 2025, and registered their plan in advance. Two reviewers selected the studies, extracted the data and rated their quality independently. Of the studies, 76 were in Chinese and 67 in English, and 37 were theses or dissertations rather than journal papers.

Fear of negative evaluation is the worry that others will judge a person unfavourably. Social anxiety is a persistent unease in situations where a person might be scrutinised, and in its severe form it becomes social anxiety disorder. A meta-analysis combines the results of many studies to give one overall estimate.

The pooled correlation between the two was 0.53, which counts as a moderate positive link. People who feared negative evaluation more strongly tended to report more social anxiety. Results differed a good deal from study to study, but removing any single study left the figure almost unchanged, and there was no sign of serious publication bias.

Age, gender and publication year did not explain the differences. Culture did, as the link was stronger in Western samples, at 0.59, than in Eastern samples, at 0.52. The measure used for social anxiety also made a difference, and the cultural gap shrank to borderline significance once the choice of measure was taken into account.

The participants had an average age of about 22, and just under 40 per cent were men. Most of the studies recruited adolescents and university students. Quality scores were high for both the cross-sectional studies and the nine that followed people over time.

The study has clear limits. Nearly all of the included studies measured people at one point in time, so the review cannot show that fear of judgement causes social anxiety. Many were conducted in China, the split between Eastern and Western cultures was broad, and a lot of the variation between studies remained unexplained.

The finding fits with long-standing psychological models in which fear of negative evaluation sits at the core of social anxiety, and with therapies that aim to loosen that fear. The review confirms the link on a much larger scale, while showing that culture and measurement can shape how strong it looks.