Theories of paruresis
While several theories have been proposed for paruresis (e.g., biopsychosocial, cognitive, behavioural, and cognitive-behavioural), the research underpinning most of them is limited. At this time, the cognitive-behavioural theory of paruresis (which is based within a biopsychosocial model which purports that paruresis is due to biological, psychological, and social factors) is the most widely accepted.
According to this model paruresis is due to the interaction of unhelpful thinking patterns (e.g., thoughts about being negatively evaluated by others) and behaviour (avoidance of restrooms leading to increasing levels of anxiety). Further, supporting evidence for the theory that paruresis is due to cognitive-behavioural processes is the finding that paruresis shares similar psychosocial processes underpinning social anxiety disorder.