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Sample records for comorbid social anxiety

  1. Social Anxiety Disorder and Mood Disorders Comorbidity

    Directory of Open Access Journals (Sweden)

    Zerrin Binbay

    2012-03-01

    Full Text Available Social Anxiety Disorder is a common disorder leading functional impairment. The comorbidity between mood disorders with social anxiety disorder is relatively common. This comorbidity impacts the clinical severity, resistance and functionality of patients. The systematic evaluation of the comorbidity in both patient groups should not be ignored and be carefully conducted. In general, social anxiety disorder starts at an earlier age than mood disorders and is reported to be predictor for subsequent major depression. The absence of comorbidity in patients with social anxiety disorder is a predictor of good response to treatment. In bipolar disorder patients with comorbid social anxiety disorder, there is an increased level of general psychopathology. Besides, they have poor outcome and increased risk of suicide. In this article, comorbidity between these two disorders has been evaluated in detail.

  2. Theory of mind in social anxiety disorder, depression, and comorbid conditions.

    Science.gov (United States)

    Washburn, Dustin; Wilson, Gillian; Roes, Meighen; Rnic, Katerina; Harkness, Kate Leslie

    2016-01-01

    Social anxiety disorder is characterized by marked interpersonal impairment, particularly when presenting with comorbid major depression. However, the foundational social-cognitive skills that underlie interpersonal impairment in comorbid and non-comorbid manifestations of SAD has to date received very little empirical investigation. In a sample of 119 young adults, the current study examined differences in theory of mind (ToM), defined as the ability to decode and reason about others' mental states, across four groups: (a) non-comorbid SAD; (b) non-comorbid Lifetime MDD; (c) comorbid SAD and Lifetime MDD; and (d) healthy control. The non-comorbid SAD group was significantly less accurate at decoding mental states than the non-comorbid MDD and control groups. Further, both the comorbid and non-comorbid SAD groups made significantly more 'excessive' ToM reasoning errors than the non-comorbid MDD group, suggesting a pattern of over-mentalizing. Findings are discussed in terms of their implications for understanding the social cognitive foundations of social anxiety. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Social anxiety and eating disorder comorbidity: The role of negative social evaluation fears

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    Levinson, Cheri A.; Rodebaugh, Thomas L.

    2011-01-01

    Social anxiety and eating disorders are highly comorbid. However, it is unknown how specific domains of social anxiety relate to disordered eating. We provide data on these relationships and investigate social appearance anxiety and fear of negative evaluation as potential vulnerabilities linking social anxiety with eating disorders. Specifically, we examined five domains of social anxiety: Social interaction anxiety, fear of scrutiny, fear of positive evaluation, fear of negative evaluation, and social appearance anxiety. Results indicated that social appearance anxiety predicted body dissatisfaction, bulimia symptoms, shape concern, weight concern, and eating concern over and above fear of scrutiny, social interaction anxiety, and fear of positive evaluation. Fear of negative evaluation uniquely predicted drive for thinness and restraint. Structural equation modeling supported a model in which social appearance anxiety and fear of negative evaluation are vulnerabilities for both social anxiety and eating disorder symptoms. Interventions that target these negative social evaluation fears may help prevent development of eating disorders. PMID:22177392

  4. Severity of anxiety in mental health versus addiction treatment settings when social anxiety and substance abuse are comorbid

    OpenAIRE

    Book, Sarah W.; Thomas, Suzanne E.; Smith, Joshua P.; Miller, Peter M.

    2012-01-01

    There is increasing interest in the co-occurrence of social anxiety and addiction. Each investigation has a specific vantage point, e.g. the effect social anxiety has in a population with addiction or that of addiction in a population with social anxiety, which could create unique findings. Among comorbid individuals, is social anxiety more severe in people seeking treatment for anxiety, as compared to those seeking treatment for addiction? This report compares social anxiety severity between...

  5. Severity of anxiety in mental health versus addiction treatment settings when social anxiety and substance abuse are comorbid.

    Science.gov (United States)

    Book, Sarah W; Thomas, Suzanne E; Smith, Joshua P; Miller, Peter M

    2012-10-01

    There is increasing interest in the co-occurrence of social anxiety and addiction. Each investigation has a specific vantage point, e.g., the effect social anxiety has in a population with addiction or that of addiction in a population with social anxiety, which could create unique findings. Among comorbid individuals, is social anxiety more severe in people seeking treatment for anxiety, as compared to those seeking treatment for addiction? This report compares social anxiety severity between subjects in two studies--one involving socially anxious individuals (n=38) seeking treatment for addictions; the other (n=41) subjects with social anxiety and an alcohol use disorder, seeking treatment for social anxiety. Baseline severity scores on the Liebowitz Social Anxiety Scale for social anxiety were compared between the groups. No significant differences were found. For both groups, social anxiety was largely in the severe range. The results suggest that clinicians should attend to social anxiety symptom severity in patients with co-occurring social anxiety and addiction, regardless of the condition for which treatment is sought. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. The effect of comorbid major depressive disorder or bipolar disorder on cognitive behavioral therapy for social anxiety disorder.

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    Fracalanza, Katie; McCabe, Randi E; Taylor, Valerie H; Antony, Martin M

    2014-06-01

    Major depressive disorder (MDD) and bipolar disorder (BD) commonly co-occur in individuals with social anxiety disorder (SAD), yet whether these comorbidities influence the outcomes of cognitive behavioral therapy (CBT) for SAD is unclear. The present study examined the degree to which individuals with SAD and comorbid MDD (SAD+MDD; n=76), comorbid BD (SAD+BD; n=19), a comorbid anxiety disorder (SAD+ANX; n=27), or no comorbid diagnoses (SAD+NCO; n=41) benefitted from CBT for SAD. Individuals were screened using the Structured Clinical Interview for DSM-IV and then completed the Social Phobia Inventory and the Depression Anxiety Stress Scales before and after 12-weeks of group CBT for SAD. At pretreatment the SAD+MDD and SAD+BD groups reported higher social anxiety symptoms than the SAD+ANX and SAD+NCO groups. All groups reported large and significant improvement in social anxiety with CBT. However, at posttreatment the SAD+MDD and SAD+BD groups continued to have higher social anxiety symptoms than the SAD+NCO group, and the SAD+ANX group did not differ in social anxiety symptoms from any group. The sample also showed small and statistically significant improvement in depressive symptoms with CBT for SAD. Information about medication was not collected in the present study, and we did not assess the long-term effects of CBT. Our results suggest that CBT for SAD is an effective treatment even in the presence of comorbid mood disorders in the short-term, although extending the course of treatment may be helpful for this population and should be investigated in future research. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Implicit Associations in Social Anxiety Disorder: The Effects of Comorbid Depression

    Science.gov (United States)

    Wong, Judy; Morrison, Amanda S.; Heimberg, Richard G.; Goldin, Philippe R.; Gross, James J.

    2014-01-01

    Implicit associations of the self to concepts like “calm” have been shown to be weaker in persons with social anxiety than in non-anxious healthy controls. However, other implicit self associations, such as those to acceptance or rejection, have been less studied in social anxiety, and none of this work has been conducted with clinical samples. Furthermore, the importance of depression in these relationships has not been well investigated. We addressed these issues by administering two Implicit Association Tests (IATs; Greenwald, McGhee, & Schwartz, 1998), one examining the implicit association of self/other to anxiety/calmness and the other examining the association of self/other to rejection/acceptance, to individuals with generalized social anxiety disorder (SAD, n = 85), individuals with generalized SAD and a current or past diagnosis of major depressive disorder or current dysthymic disorder (n = 47), and non-anxious, non-depressed healthy controls (n = 44). The SAD and SAD-depression groups showed weaker implicit self-calmness associations than healthy controls, with the comorbid group showing the weakest self-calmness associations. The SAD-depression group showed the weakest implicit self-acceptance associations; no difference was found between non-depressed individuals with SAD and healthy controls. Post hoc analyses revealed that differences appeared to be driven by those with current depression. The SAD-only and SAD-depression groups did not differ in self-reported (explicit) social anxiety. The implications of these findings for the understanding of SAD-depression comorbidity and for the treatment of SAD are considered. PMID:24983794

  8. Implicit associations in social anxiety disorder: the effects of comorbid depression.

    Science.gov (United States)

    Wong, Judy; Morrison, Amanda S; Heimberg, Richard G; Goldin, Philippe R; Gross, James J

    2014-08-01

    Implicit associations of the self to concepts like "calm" have been shown to be weaker in persons with social anxiety than in non-anxious healthy controls. However, other implicit self associations, such as those to acceptance or rejection, have been less studied in social anxiety, and none of this work has been conducted with clinical samples. Furthermore, the importance of depression in these relationships has not been well investigated. We addressed these issues by administering two Implicit Association Tests (IATs; Greenwald, McGhee, & Schwartz, 1998), one examining the implicit association of self/other to anxiety/calmness and the other examining the association of self/other to rejection/acceptance, to individuals with generalized social anxiety disorder (SAD, n=85), individuals with generalized SAD and a current or past diagnosis of major depressive disorder or current dysthymic disorder (n=47), and non-anxious, non-depressed healthy controls (n=44). The SAD and SAD-depression groups showed weaker implicit self-calmness associations than healthy controls, with the comorbid group showing the weakest self-calmness associations. The SAD-depression group showed the weakest implicit self-acceptance associations; no difference was found between non-depressed individuals with SAD and healthy controls. Post hoc analyses revealed that differences appeared to be driven by those with current depression. The SAD-only and SAD-depression groups did not differ in self-reported (explicit) social anxiety. The implications of these findings for the understanding of SAD-depression comorbidity and for the treatment of SAD are considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Internet treatment for social phobia reduces comorbidity.

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    Titov, Nickolai; Gibson, Matthew; Andrews, Gavin; McEvoy, Peter

    2009-08-01

    Social phobia can be treated by brief Internet-based cognitive behaviour therapy (CBT). Most people with social phobia, however, meet criteria for another mental disorder; this comorbidity is associated with significant disability, and cases of comorbidity may be more difficult to treat. The present study examined the impact of the Shyness programme, an Internet-based treatment programme for social phobia, on comorbid symptoms of depression and generalized anxiety disorder. Data from three randomized controlled trials using the Shyness programme to treat social phobia were reanalysed. The 211 subjects, all of whom met DSM-IV criteria for social phobia, were divided into four groups: (i) social phobia only; (ii) social phobia with elevated symptoms of depression; (iii) social phobia with elevated symptoms of generalized anxiety; and (iv) social phobia with elevated symptoms of both generalized anxiety and depression. The improvement in social phobia, depression and anxiety following Internet-based treatment for social phobia was measured. Improvement in social phobia was seen in all groups, whether comorbid or not. Significant improvements in comorbid symptoms of depression and generalized anxiety occurred even though the treatment was focused on the social phobia. Brief Internet-based CBT can reduce both the target disorder as well as comorbid symptoms. These findings are consistent with evidence that unified or transdiagnostic programmes may reduce the severity of comorbid disorders and symptoms, indicating an important direction for future research.

  10. The comparison of attentional control deficits in the three group of normal, with social anxiety disorder and with comorbidity (social anxiety disorder and depression) students of Lorestan University

    OpenAIRE

    Ghadampour E; Rezaei F; Hosseini Ramaghani NA; Moradi M

    2017-01-01

    Background and aims: One of the mechanisms that thought to underlie social anxiety disorder is dysfunction in attentional control. The current study was designed to compare attentional control deficits in the three group: normal, with social anxiety disorder and with comorbidity (social anxiety disorder and depression) students. Methods: The design of present study was causal-comparative. Statistical population of this study contained all normal female students, with social anxiety disorde...

  11. Vortioxetine versus placebo in major depressive disorder comorbid with social anxiety disorder.

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    Liebowitz, Michael R; Careri, Jason; Blatt, Kyra; Draine, Ann; Morita, Junko; Moran, Melissa; Hanover, Rita

    2017-12-01

    Major Depressive Disorder (MDD) and Social Anxiety Disorder (SAD) are highly comorbid, yet the combined condition has not been subject to any placebo-controlled treatment trials. This study reports a trial of vortioxetine, an antidepressant that has also shown benefit in Generalized Anxiety Disorder (GAD), in patients meeting DSM-5 criteria for both MDD and SAD. The study was a 12-week double-blind, placebo-controlled comparison of vortioxetine 10-20 mg/day or placebo administered on a 1:1 ratio. The study was designed to include 40 male or female outpatients aged 18-70 years. The primary endpoint was the "composite" Clinical Global Impression of Improvement (CGI-I) responder rate, factoring in improvement in both MDD and SAD features. Major secondary outcome measures were changes on the Montgomery Asberg Depression Rating Scale (MADRS) and Liebowitz Social Anxiety Scale (LSAS). On the composite CGI-I, 10 of 20 (50%) vortioxetine and six of 20 (30%) placebo-treated patients were rated as responders, a non-significant difference. However, vortioxetine-treated patients did show significantly greater improvement than those on placebo on both the MADRS (effect size 0.672) and LSAS (effect size 0.714). Efficacy in depression was seen before improvement in SAD. Adverse effects were similar to those previously reported. In this preliminary trial vortioxetine appears safe and effective for patients with MDD comorbid with SAD, with robust effect sizes on dimensional measures of both depression and social anxiety, but failure to separate from placebo on the primary outcome measure of composite responder rate. More studies of patients with comorbid conditions are needed, as this mirrors what is often seen in clinical practice. © 2017 Wiley Periodicals, Inc.

  12. Co-morbid anxiety disorders in bipolar disorder and major depression: familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder.

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    Goes, F S; McCusker, M G; Bienvenu, O J; Mackinnon, D F; Mondimore, F M; Schweizer, B; Depaulo, J R; Potash, J B

    2012-07-01

    Co-morbidity of mood and anxiety disorders is common and often associated with greater illness severity. This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees. The sample comprised 566 BP families with 1416 affected subjects and 675 MDD families with 1726 affected subjects. Clinical characteristics and familiality of panic disorder, social phobia, specific phobia and obsessive-compulsive disorder (OCD) were examined in BP and MDD pedigrees with multivariate modeling using generalized estimating equations. Co-morbidity between mood and anxiety disorders was associated with several markers of clinical severity, including earlier age of onset, greater number of depressive episodes and higher prevalence of attempted suicide, when compared with mood disorder without co-morbid anxiety. Familial aggregation was found with co-morbid panic and OCD in both BP and MDD pedigrees. Specific phobia showed familial aggregation in both MDD and BP families, although the findings in BP were just short of statistical significance after adjusting for other anxiety co-morbidities. We found no evidence for familiality of social phobia. Our findings suggest that co-morbidity of MDD and BP with specific anxiety disorders (OCD, panic disorder and specific phobia) is at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity.

  13. Social anxiety disorder in the Chinese military: prevalence, comorbidities, impairment, and treatment-seeking.

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    Wang, Huaning; Zhang, Ruiguo; Chen, Yunchun; Wang, Huaihai; Zhang, Yahong; Gan, Jingli; Zhang, Liyi; Tan, Qingrong

    2014-12-30

    The objective of this work is To investigate the prevalence, comorbidities, impairment, and treatment-seeking of social anxiety disorder in the Chinese military personnel. Military personnel (n=11,527) were surveyed from May to August 2007 using a multistage whole cohort probability sampling method. A Chinese version of the World Health Organization Composite International Diagnostic Interview (CIDI) was used for assessment, and a military-related socio-demographic questionnaire was used to describe the prevalence distribution. A unified survey was performed to investigate 11 different social situations. The short-form health survey was used to assess role impairment. The 12-month and lifetime prevalence rates of social anxiety disorder were 3.34% (95% CI: 3.25-3.42%) and 6.22% (95% CI: 6.11-6.32%), respectively. Social anxiety disorder was associated with increased odds of depression, substance abuse, panic attacks/disorder, and generalized anxiety disorder. Childhood foster, female, stressful life events, younger age, and being divorced/widowed increase the incidence of social anxiety disorder. Treatment-seeking was relatively rare. Social anxiety disorder is a common disorder in military personnel in China, and it is a risk factor for subsequent depressive illness, substance abuse and other mental disorder. Early detection and treatment of social anxiety disorder are important because of the low rate of treatment-seeking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Social anxiety disorder diagnostic criteria perform equally across age, comorbid diagnosis, and performance/interaction subtypes.

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    Crome, Erica; Baillie, Andrew

    2015-01-01

    The prevalence of social anxiety disorder (SAD) is frequently higher in younger age groups and people with other anxiety or mood disorders; however, it is unclear whether these groups have a higher risk for developing SAD or are simply more likely to endorse diagnostic criteria than other people with similar levels of social anxiety. Explicitly testing the assumption all people respond to structured diagnostic interviews in comparable ways (measurement invariance) is essential in ensuring systematic response biases do not create spurious group differences. This research aims to systematically test whether age, comorbidity status, or types of social fears affect responses to a structured diagnostic interview. Responses from 1755 participants in a large-scale survey of mental health in Australia screening into the social phobia/SAD section of the Composite International Diagnostic Interview were used. Three series of multigroup confirmatory factor analyses for categorical data systematically tested for increasingly strict levels of measurement invariance. Overall, patterns of responding to diagnostic criteria were comparable across the groups, supporting assumptions of measurement invariance. Establishment of invariance supports the interpretation of differences between age, comorbidity status, and types of social situations feared as genuine differences in experience as opposed to measurement biases.

  15. Comorbidity of Anxiety and Depression in Children and Adolescents: 20 Years After

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    Cummings, Colleen M.; Caporino, Nicole E.; Kendall, Philip C.

    2014-01-01

    Brady and Kendall (1992) concluded that although anxiety and depression in youth are meaningfully linked, there are important distinctions, and additional research was needed. Since then, studies of anxiety-depression comorbidity in youth have increased exponentially. Following a discussion of comorbidity, we review existing conceptual models and propose a multiple pathways model to anxiety-depression comorbidity. Pathway 1 describes youth with a diathesis for anxiety, with subsequent comorbid depression resulting from anxiety-related impairment. Pathway 2 refers to youth with a shared diathesis for anxiety and depression, who may experience both disorders simultaneously. Pathway 3 describes youth with a diathesis for depression, with subsequent comorbid anxiety resulting from depression-related impairment. Additionally, shared and stratified risk factors contribute to the development of the comorbid disorder, either by interacting with disorder-related impairment or by predicting the simultaneous development of the disorders. Our review addresses descriptive and developmental factors, gender differences, suicidality, assessments, and treatment-outcome research as they relate to comorbid anxiety and depression, and to our proposed pathways. Research since 1992 indicates that comorbidity varies depending on the specific anxiety disorder, with Pathway 1 describing youth with either social phobia or separation anxiety disorder and subsequent depression, Pathway 2 applying to youth with co-primary generalized anxiety disorder and depression, and Pathway 3 including depressed youth with subsequent social phobia. The need to test the proposed multiple pathways model and to examine (a) developmental change and (b) specific anxiety disorders is highlighted. PMID:24219155

  16. Generalized anxiety disorder: A comorbid disease.

    Science.gov (United States)

    Nutt, David; Argyropoulos, Spilos; Hood, Sean; Potokar, John

    2006-07-01

    Generalized anxiety disorder (GAD) frequently occurs comorbidly with other conditions, including depression and somatic complaints. Comorbid GAD sufferers have increased psychologic and social impairment, request additional treatment, and have an extended course and poorer outcome than those with GAD alone; therapy should alleviate both the psychic and somatic symptoms of GAD without negatively affecting the comorbid condition. The ideal treatment would provide relief from both GAD and the comorbid condition, reducing the need for polypharmacy. Physicians need suitable tools to assist them in the detection and monitoring of GAD patients-the GADI, a new, self-rating scale, may meet this requirement. Clinical data have shown that various neurobiologic irregularities (e.g., in the GABA and serotonin systems) are associated with the development of anxiety. Prescribing physicians must take into account these abnormalities when choosing a drug. Effective diagnosis and treatment should improve patients' quality of life and their prognosis for recovery.

  17. Generalized anxiety disorder: comorbidity, comparative biology and treatment.

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    Nutt, David J; Ballenger, James C; Sheehan, David; Wittchen, Hans-Ulrich

    2002-12-01

    Generalized anxiety disorder (GAD) is a severe and chronic anxiety disorder characterized by uncontrollable worrying and somatic anxiety (tension, insomnia and hypervigilance). It is a common condition, with lifetime prevalence rates for DSM-IV GAD in the general population of approx. 5-6% being reported. In addition, like other anxiety disorders, GAD also shows comorbidity with depression and most of the other anxiety disorders. This article reviews data on the prevalence of GAD, its comorbidity with depression, and its social and economic impact. Proposed neurobiological mechanisms for GAD are discussed, since an understanding of these may help in the development of future therapies. Finally, current pharmacological and non-pharmacological treatment options for GAD are reviewed, with particular attention being paid to published clinical-trial data.

  18. Adolescent Social Isolation as a Model of Heightened Vulnerability to Comorbid Alcoholism and Anxiety Disorders.

    Science.gov (United States)

    Butler, Tracy R; Karkhanis, Anushree N; Jones, Sara R; Weiner, Jeffrey L

    2016-06-01

    Individuals diagnosed with anxiety-related illnesses are at increased risk of developing alcoholism, exhibit a telescoped progression of this disease and fare worse in recovery, relative to alcoholics that do not suffer from a comorbid anxiety disorder. Similarly, preclinical evidence supports the notion that stress and anxiety represent major risk factors for the development of alcohol use disorder (AUD). Despite the importance of understanding the link between anxiety and alcoholism, much remains unknown about the neurobiological substrates underlying this relationship. One stumbling block has been the lack of animal models that reliably reproduce the spectrum of behaviors associated with increased vulnerability to these diseases. Here, we review the literature that has examined the behavioral and neurobiological outcomes of a simple rodent adolescent social isolation procedure and discuss its validity as a model of vulnerability to comorbid anxiety disorders and alcoholism. Recent studies have provided strong evidence that adolescent social isolation of male rats leads to the expression of a variety of behaviors linked with increased vulnerability to anxiety and/or AUD, including deficits in sensory gating and fear extinction, and increases in anxiety measures and ethanol drinking. Neurobiological studies are beginning to identify mesolimbic adaptations that may contribute to the behavioral phenotype engendered by this model. Some of these changes include increased excitability of ventral tegmental area dopamine neurons and pyramidal cells in the basolateral amygdala and significant alterations in baseline and stimulated catecholamine signaling. A growing body of evidence suggests that adolescent social isolation may represent a reliable rodent model of heightened vulnerability to anxiety disorders and alcoholism in male rats. These studies provide initial support for the face, construct, and predictive validity of this model and highlight its utility in

  19. Anxiety disorders: Psychiatric comorbidities and psychosocial ...

    African Journals Online (AJOL)

    Anxiety disorders: Psychiatric comorbidities and psychosocial stressors ... were present for 98.1% of patients and 36.9% had multiple anxiety disorders. ... and the comorbidity of anxiety and personality disorders should receive further attention.

  20. Social functioning in patients with depressive and anxiety disorders.

    Science.gov (United States)

    Saris, I M J; Aghajani, M; van der Werff, S J A; van der Wee, N J A; Penninx, B W J H

    2017-10-01

    Adaptive social functioning is severely impeded in depressive and anxiety disorders, even after remission. However, a comprehensive overview is still lacking. Using data from the Netherlands Study of Depression and Anxiety (NESDA), behavioural (network size, social activities, social support) and affective (loneliness, affiliation, perceived social disability) indicators of social functioning were analyzed in patients with anxiety (N = 540), depressive (N = 393), comorbid anxiety and depressive disorders ('comorbid', N = 748), remitted participants (N = 621), and healthy control subjects (N = 650). Analyses revealed an increasing trend of social dysfunction among patient groups, in patients with comorbid anxiety and depressive disorders, showing the most severe impairments, followed by depressed and anxious patients (P's social functioning indicators). Affective indicators showed the largest effect sizes (Cohen's d range from 0.13 to 1.76). We also found impairments in social functioning among remitted patients. Furthermore, perceived social disability among patients was predictive of still having a depressive and/or anxiety diagnosis 2 years later (P social functioning are impaired in patients with anxiety or depressive disorders and most in patients with comorbid disorders. After remission of affective psychopathology, residual impairments tend to remain, while social dysfunction in patients seems predictive of future psychopathology. © 2017The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

  1. Cognitive therapy for depressed adults with comorbid social phobia.

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    Smits, Jasper A J; Minhajuddin, Abu; Jarrett, Robin B

    2009-04-01

    Evidence suggests that comorbid depression influences the outcome of cognitive-behavioral treatment for patients presenting with social phobia. Little is known, however, about the influence of comorbid social phobia on the response to cognitive therapy (CT) for depression among adults presenting with recurrent major depressive disorder (MDD). These analyses seek to clarify this relationship. Patients (N=156) with recurrent DSM-IV MDD entered CT (20% also met DSM-IV criteria for social phobia). Every week during the course of CT, clinicians assessed depressive symptoms and patients completed self-report instruments measuring severity of depression and anxiety. At presentation, outpatients with comorbid social phobia reported greater levels of depressive symptoms and clinicians rated their impairment as more severe, compared to their counterparts without social phobia. Patients with or without comorbid social phobia did not differ significantly in (1) attrition rates; (2) response or sustained remission rates; (3) time to response or sustained remission; or (4) rate of improvement in symptoms of depression or anxiety. The lack of domain-specific measures limits inference with respect to the improvements in social anxiety that occur with CT of depression. These findings introduce the hypothesis that CT for depression may be flexible enough to treat the depressive symptoms of patients presenting with MDD who also suffer from social phobia.

  2. Using a hybrid model to investigate the comorbidity and symptom overlap between social phobia and the other anxiety disorders and unipolar mood disorders.

    Science.gov (United States)

    Gros, Daniel F; McCabe, Randi E; Antony, Martin M

    2013-11-30

    New hybrid models of psychopathology have been proposed that combine the current categorical approach with symptom dimensions that are common across various disorders. The present study investigated the new hybrid model of social anxiety in a large sample of participants with anxiety disorders and unipolar mood disorders to improve understanding of the comorbidity and symptom overlap between social phobia (SOC) and the other anxiety disorders and unipolar mood disorders. Six hundred and eighty two participants from a specialized outpatient clinic for anxiety treatment completed a semi-structured diagnostic interview and the Multidimensional Assessment of Social Anxiety (MASA). A hybrid model symptom profile was identified for SOC and compared with each of the other principal diagnoses. Significant group differences were identified on each of the MASA scales. Differences also were identified when common sets of comorbidities were compared within participants diagnosed with SOC. The findings demonstrated the influence of both the principal diagnosis of SOC and other anxiety disorders and unipolar mood disorders as well as the influence of comorbid diagnoses with SOC on the six symptom dimensions. These findings highlight the need to shift to transdiagnostic assessment and treatment practices that go beyond the disorder-specific focus of the current categorical diagnostic systems. Published by Elsevier Ireland Ltd.

  3. Comorbid anxiety disorders in late-life depression: results of a cohort study.

    Science.gov (United States)

    van der Veen, D C; van Zelst, W H; Schoevers, R A; Comijs, H C; Voshaar, R C Oude

    2015-07-01

    Comorbid anxiety disorders are common in late-life depression and negatively impact treatment outcome. This study aimed to examine personality characteristics as well as early and recent life-events as possible determinants of comorbid anxiety disorders in late-life depression, taking previously examined determinants into account. Using the Composite International Diagnostic Interview (CIDI 2.0), we established comorbid anxiety disorders (social phobia (SP), panic disorder (PD), generalized anxiety disorder (GAD), and agoraphobia (AGO)) in 350 patients (aged ≥60 years) suffering from a major depressive disorder according to DSM-IV-TR criteria within the past six months. Adjusted for age, sex, and level of education, we first examined previously identified determinants of anxious depression: depression severity, suicidality, partner status, loneliness, chronic diseases, and gait speed in multiple logistic regression models. Subsequently, associations were explored with the big five personality characteristics as well as early and recent life-events. First, multiple logistic regression analyses were conducted with the presence of any anxiety disorder (yes/no) as dependent variable, where after analyses were repeated for each anxiety disorder, separately. In our sample, the prevalence rate of comorbid anxiety disorders in late-life depression was 38.6%. Determinants of comorbid anxiety disorders were a lower age, female sex, less education, higher depression severity, early traumatization, neuroticism, extraversion, and conscientiousness. Nonetheless, determinants differed across the specific anxiety disorders and lumping all anxiety disorder together masked some determinants (education, personality). Our findings stress the need to examine determinants of comorbid anxiety disorder for specific anxiety disorders separately, enabling the development of targeted interventions within subgroups of depressed patients.

  4. Clinical characteristics and treatment outcomes of patients with major depressive disorder and comorbid anxiety disorders - results from a European multicenter study.

    Science.gov (United States)

    Dold, Markus; Bartova, Lucie; Souery, Daniel; Mendlewicz, Julien; Serretti, Alessandro; Porcelli, Stefano; Zohar, Joseph; Montgomery, Stuart; Kasper, Siegfried

    2017-08-01

    This naturalistic European multicenter study aimed to elucidate the association between major depressive disorder (MDD) and comorbid anxiety disorders. Demographic and clinical information of 1346 MDD patients were compared between those with and without concurrent anxiety disorders. The association between explanatory variables and the presence of comorbid anxiety disorders was examined using binary logistic regression analyses. 286 (21.2%) of the participants exhibited comorbid anxiety disorders, 10.8% generalized anxiety disorder (GAD), 8.3% panic disorder, 8.1% agoraphobia, and 3.3% social phobia. MDD patients with comorbid anxiety disorders were characterized by younger age (social phobia), outpatient status (agoraphobia), suicide risk (any anxiety disorder, panic disorder, agoraphobia, social phobia), higher depressive symptom severity (GAD), polypsychopharmacy (panic disorder, agoraphobia), and a higher proportion receiving augmentation treatment with benzodiazepines (any anxiety disorder, GAD, panic disorder, agoraphobia, social phobia) and pregabalin (any anxiety disorder, GAD, panic disorder). The results in terms of treatment response were conflicting (better response for panic disorder and poorer for GAD). The logistic regression analyses revealed younger age (any anxiety disorder, social phobia), outpatient status (agoraphobia), suicide risk (agoraphobia), severe depressive symptoms (any anxiety disorder, GAD, social phobia), poorer treatment response (GAD), and increased administration of benzodiazepines (any anxiety disorder, agoraphobia, social phobia) and pregabalin (any anxiety disorder, GAD, panic disorder) to be associated with comorbid anxiety disorders. Our findings suggest that the various anxiety disorders subtypes display divergent clinical characteristics and are associated with different variables. Especially comorbid GAD appears to be characterized by high symptom severity and poor treatment response. Copyright © 2017 Elsevier Ltd. All

  5. Does comorbidity predict poorer treatment outcome in pediatric anxiety disorders? An updated 10-year review

    DEFF Research Database (Denmark)

    Walczak, Monika Anna; Ollendick, Thomas H; Ryan, Sarah

    2018-01-01

    The aim of the present review was to provide an updated investigation of literature from the past ten years that examined the effects of comorbid problems on treatment outcomes, and/or explored if cognitive behavioral treatments (CBT) targeting anxiety disorders also affected comorbid disorders...... diagnoses, rather than grouping them together. Overall, our findings suggest that comorbid disorders may have a more negative impact on treatment outcomes than proposed in previous reviews, particularly in the cases of comorbid social anxiety and mood disorders. Furthermore, CBT for anxiety disorders...

  6. Social anxiety disorder and alcohol use disorder co-morbidity in the National Epidemiologic Survey on Alcohol and Related Conditions.

    Science.gov (United States)

    Schneier, F R; Foose, T E; Hasin, D S; Heimberg, R G; Liu, S-M; Grant, B F; Blanco, C

    2010-06-01

    To assess the prevalence and clinical impact of co-morbid social anxiety disorder (SAD) and alcohol use disorders (AUD, i.e. alcohol abuse and alcohol dependence) in a nationally representative sample of adults in the United States. Data came from a large representative sample of the US population. Face-to-face interviews of 43093 adults residing in households were conducted during 2001-2002. Diagnoses of mood, anxiety, alcohol and drug use disorders and personality disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV version. Lifetime prevalence of co-morbid AUD and SAD in the general population was 2.4%. SAD was associated with significantly increased rates of alcohol dependence [odds ratio (OR) 2.8] and alcohol abuse (OR 1.2). Among respondents with alcohol dependence, SAD was associated with significantly more mood, anxiety, psychotic and personality disorders. Among respondents with SAD, alcohol dependence and abuse were most strongly associated with more substance use disorders, pathological gambling and antisocial personality disorders. SAD occurred before alcohol dependence in 79.7% of co-morbid cases, but co-morbidity status did not influence age of onset for either disorder. Co-morbid SAD was associated with increased severity of alcohol dependence and abuse. Respondents with co-morbid SAD and alcohol dependence or abuse reported low rates of treatment-seeking. Co-morbid lifetime AUD and SAD is a prevalent dual diagnosis, associated with substantial rates of additional co-morbidity, but remaining largely untreated. Future research should clarify the etiology of this co-morbid presentation to better identify effective means of intervention.

  7. Attribution bias and social anxiety in schizophrenia

    Directory of Open Access Journals (Sweden)

    Amelie M. Achim

    2016-06-01

    Full Text Available Studies on attribution biases in schizophrenia have produced mixed results, whereas such biases have been more consistently reported in people with anxiety disorders. Anxiety comorbidities are frequent in schizophrenia, in particular social anxiety disorder, which could influence their patterns of attribution biases. The objective of the present study was thus to determine if individuals with schizophrenia and a comorbid social anxiety disorder (SZ+ show distinct attribution biases as compared with individuals with schizophrenia without social anxiety (SZ− and healthy controls. Attribution biases were assessed with the Internal, Personal, and Situational Attributions Questionnaire in 41 individual with schizophrenia and 41 healthy controls. Results revealed the lack of the normal externalizing bias in SZ+, whereas SZ− did not significantly differ from healthy controls on this dimension. The personalizing bias was not influenced by social anxiety but was in contrast linked with delusions, with a greater personalizing bias in individuals with current delusions. Future studies on attribution biases in schizophrenia should carefully document symptom presentation, including social anxiety.

  8. Drinking motives in alcohol use disorder patients with and without social anxiety disorder.

    Science.gov (United States)

    Cooper, R; Hildebrandt, S; Gerlach, A L

    2014-01-01

    The high comorbidity of alcohol use disorders (AUD) and social anxiety disorder (SAD) is often explained by excessive drinking in social situations to self-medicate social anxiety. Indeed, the motive to drink alcohol to lower social fears was found to be elevated in socially anxious persons. However, this social anxiety specific motive has not been directly investigated in primarily alcohol dependent individuals. We explored social anxiety, the motivation to drink alcohol in order to cope with social fears, and social anxiety as a consequence of drinking in AUD with and without comorbid SAD. Male AUD inpatients with (AUD+SAD group, N=23) and without comorbid SAD (N=37) completed a clinical interview and a questionnaire assessment. AUD+SAD patients reported higher levels of depression and an elevated motive to drink due to social anxiety but did not experience more social fears as a consequence of drinking. Previous results concerning alcohol drinking motives in order to relieve social fears could be replicated in a clinical AUD sample. Additionally, our findings suggest comorbid AUD+SAD patients to be more burdened regarding broader psychopathological symptoms. Thus, accessibility to SAD-specific screening and treatment procedures may be beneficial for primary AUD patients.

  9. Diagnostic comorbidity in adults with generalized anxiety disorder: impact of comorbidity on psychotherapy outcome and impact of psychotherapy on comorbid diagnoses.

    Science.gov (United States)

    Newman, Michelle G; Przeworski, Amy; Fisher, Aaron J; Borkovec, Thomas D

    2010-03-01

    The current study examined the impact of comorbidity on cognitive and behavioral therapies for generalized anxiety disorder (GAD) as well as the impact of these therapies on diagnoses comorbid to GAD. Seventy-six treatment-seeking adults with principal diagnoses of GAD received 14 sessions of therapy. Most (n=46; 60.5%) of the sample had at least one comorbid diagnosis. Although the presence of comorbid diagnoses was associated with greater severity of GAD symptoms at pretreatment, greater severity of comorbid major depression, simple phobia, and social phobia was associated with greater change in symptoms of GAD in response to treatment, with no effect on maintenance of gains during a 2-year follow-up. Further, psychotherapy for principal GAD led to a reduction in number of comorbid diagnoses and in severity of social phobia, simple phobia, and major depression at posttreatment. At 2-year follow-up severity of social and simple phobia remained below pretreatment levels, whereas severity of depression was no longer significantly below pretreatment levels. These results suggest that although people with comorbid disorders enter treatment with more severe GAD symptomatology, they demonstrate greater change, and therefore such comorbidity does not diminish the efficacy of cognitive and behavioral therapies for GAD. In addition, the impact of these treatments for GAD may generalize to reduced severity of simple phobia, social phobia, and major depression; however, gains in severity of major depression are not maintained. 2009. Published by Elsevier Ltd.

  10. Mechanisms of comorbidity, continuity, and discontinuity in anxiety-related disorders.

    Science.gov (United States)

    McNaughton, Neil; Corr, Philip J

    2016-11-01

    We discuss comorbidity, continuity, and discontinuity of anxiety-related disorders from the perspective of a two-dimensional neuropsychology of fear (threat avoidance) and anxiety (threat approach). Pharmacological dissection of the "neurotic" disorders justifies both a categorical division between fear and anxiety and a subdivision of each mapped to a hierarchy of neural modules that process different immediacies of threat. It is critical that each module can generate normal responses, symptoms of another syndrome, or syndromal responses. We discuss the resultant possibilities for comorbid dysfunction of these modules both with each other and with some disorders not usually classified as anxiety related. The simplest case is symptomatic fear/anxiety comorbidity, where dysfunction in one module results in excess activity in a second, otherwise normal, module to generate symptoms and apparent comorbidity. More complex is syndromal fear/anxiety comorbidity, where more than one module is concurrently dysfunctional. Yet more complex are syndromal comorbidities of anxiety that go beyond the two dimensional fear/anxiety systems: depression, substance use disorder, and attention-deficit/hyperactivity disorder. Our account of attention-deficit/hyperactivity disorder-anxiety comorbidity entails discussion of the neuropsychology of externalizing disorders to account for the lack of anxiety comorbidity in some of these. Finally, we link the neuropsychology of disorder to personality variation, and to the development of a biomarker of variation in the anxiety system among individuals that, if extreme, may provide a means of unambiguously identifying the first of a range of anxiety syndromes.

  11. Comparison of clinical and sociodemographic features of bipolar disorder patients with those of social anxiety disorder patients comorbid with bipolar disorder in Turkey

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    Tonguç D. Berkol

    2016-03-01

    Full Text Available Objectives: To assess the impact of social anxiety disorder (SAD comorbidity on the clinical features, illness severity, and response to mood stabilizers in bipolar disorder (BD patients. Methods: This retrospective study included bipolar patients that were treated at the Department of Psychiatry, Haseki Training and Research Hospital, Istanbul, Turkey in 2015, and who provided their informed consents for participation in this study. The study was conducted by assessing patient files retrospectively. Two hundred bipolar patients were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition axis-I (SCID-I in order to detect all possible comorbid psychiatric diagnoses. The sample was split according to the presence of SAD comorbidity and the groups were compared. Results: The SAD comorbidity was detected in 17.5% (35/200 of the BD patients. The SAD comorbid bipolar patients were more educated, had earlier onset of BD, lower number of manic episodes, and more severe episodes. There was no difference between groups in terms of total number of episodes, hospitalization, suicidality, being psychotic, treatment response to lithium and anticonvulsants. Conclusion: Social anxiety disorder comorbidity may be associated with more severe episodes and early onset of BD. However, SAD comorbidity may not be related to treatment response in bipolar patients.

  12. The anxiety disorders and suicidal ideation: accounting for co-morbidity via underlying personality traits.

    Science.gov (United States)

    Naragon-Gainey, K; Watson, D

    2011-07-01

    The anxiety disorders are robust correlates/predictors of suicidal ideation, but it is unclear whether (a) the anxiety disorders are specifically associated with suicidal ideation or (b) the association is due to co-morbidity with depression and other disorders. One means of modeling co-morbidity is through the personality traits neuroticism/negative emotionality (N/NE) and extraversion/positive emotionality (E/PE), which account for substantial shared variance among the internalizing disorders. The current study examines the association between the internalizing disorders and suicidal ideation, after controlling for co-morbidity via N/NE and E/PE. The sample consisted of 327 psychiatric out-patients. Multiple self-report and interview measures were collected for internalizing disorders [depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), social anxiety, panic and specific phobia] and suicidal ideation, as well as self-report measures for N/NE and E/PE. A model was hypothesized in which each disorder and suicidal ideation was regressed on N/NE, and depression and social anxiety were regressed on E/PE. Structural equation modeling (SEM) was used to examine the unique association of suicidality with each disorder, beyond shared variance with N/NE and E/PE. The hypothesized model was an acceptable fit to the data. Although zero-order analyses indicated that suicidal ideation was moderately to strongly correlated with all of the disorders, only depression and PTSD remained significantly associated with suicidal ideation in the SEM analyses. In a latent variable model that accounts for measurement error and a broad source of co-morbidity, only depression and PTSD were uniquely associated with suicidal ideation; panic, GAD, social anxiety and specific phobia were not.

  13. Treating Comorbid Anxiety and Aggression in Children

    Science.gov (United States)

    Levy, Karyn; Hunt, Caroline; Heriot, Sandra

    2007-01-01

    Objective: The aim of the study was to evaluate the effectiveness of an intervention that targeted both anxious and aggressive behaviors in children with anxiety disorders and comorbid aggression by parent report. Method: The effects of a cognitive-behavioral therapy intervention targeting comorbid anxiety and aggression problems were compared…

  14. Treating Comorbid Anxiety in Adolescents With ADHD Using a Cognitive Behavior Therapy Program Approach.

    Science.gov (United States)

    Houghton, Stephen; Alsalmi, Nadiyah; Tan, Carol; Taylor, Myra; Durkin, Kevin

    2017-11-01

    To evaluate an 8-week cognitive behavior therapy (CBT) treatment specifically designed for adolescents with ADHD and comorbid anxiety. Using a multiple baseline design, nine adolescents (13 years to 16 years 9 months) received a weekly CBT, which focused on four identified anxiety-arousing times. Participants self-recorded their levels of anxiety for each of the four times during baseline, intervention, and a maintenance phase. Anxiety was also assessed using the Multidimensional Anxiety Scale for Children (MASC). Paired samples t tests supported the success of the intervention. Interrupted time-series data for each participant revealed varying rates of success across the four times, however. The MASC data revealed significant reductions in Physical Symptoms of Anxiety, Social Anxiety, Separation Anxiety, Harm Avoidance, and Total Anxiety. The data demonstrate the efficacy of a CBT program for the treatment of comorbid anxiety in adolescents with ADHD.

  15. Distinctions between separation anxiety and social anxiety in children and adolescents

    NARCIS (Netherlands)

    Ferdinand, Robert F.; Bongers, Ilja L.; van der Ende, Jan; van Gastel, Willemijn; Tick, Nouchka; Utens, Elisabeth; Verhulst, Frank C.

    2006-01-01

    Separation anxiety and social phobia are intertwined to a considerable degree, and high comorbidity rates have been reported. The present study used latent class analysis (LCA) to investigate if classes of children and adolescents with-simultaneously-high rates of separation anxiety and low rates of

  16. Does relational dysfunction mediate the association between anxiety disorders and later depression? Testing an interpersonal model of comorbidity.

    Science.gov (United States)

    Starr, Lisa R; Hammen, Constance; Connolly, Nicole Phillips; Brennan, Patricia A

    2014-01-01

    Anxiety disorders tend to precede onset of comorbid depression. Several researchers have suggested a causal role for anxiety in promoting depressive episodes, but few studies have identified specific mechanisms. The current study proposes an interpersonal model of comorbidity, where anxiety disorders disrupt interpersonal functioning, which in turn elevates risk for depression. At age 15 (T1), 815 adolescents oversampled for maternal depression completed diagnostic interviews, social chronic stress interviews, and self-report measures. At age 20 (T2), participants repeated all measures and reported on self-perceived interpersonal problems. At approximately age 23 (T3), a subset of participants (n = 475) completed a self-report depressive symptoms measure. Consistent with other samples, anxiety disorders largely preceded depressive disorders. Low sociability and interpersonal oversensitivity mediated the association between T1 social anxiety disorder and later depression (including T2 depressive diagnosis and T3 depressive symptoms), controlling for baseline. Interpersonal oversensitivity and social chronic stress similarly mediated the association between generalized anxiety disorder before age 15 and later depression. Interpersonal dysfunction may be one mechanism through which anxiety disorders promote later depression, contributing to high comorbidity rates. © 2013 Wiley Periodicals, Inc.

  17. Clinical relevance of comorbidity in anxiety disorders : A report from the Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    Hofmeijer-Sevink, Mieke Klein; Batelaan, Neeltje M.; van Megen, Harold J. G. M.; Penninx, Brenda W.; Cath, Danielle C.; van den Hout, Marcel A.; van Balkom, Anton J. L. M.

    Background: To study the clinical relevance of type of comorbidity and number of comorbid disorders in anxiety disorders. Four groups were compared according to sociodemographic-, vulnerability- and clinical factors: single anxiety disorder, anxiety-anxiety comorbidity, anxiety-depressive

  18. Clinical relevance of comorbidity in anxiety disorders: A report from the Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    Klein Hofmeijer-Sevink, M.; Batelaan, N.M.; van Megen, H.J.G.M.; Penninx, B.W.J.H.; Cath, D.C.; van Hout, M.A.; van Balkom, A.J.L.M.

    2012-01-01

    Background: To study the clinical relevance of type of comorbidity and number of comorbid disorders in anxiety disorders. Four groups were compared according to sociodemographic-, vulnerability- and clinical factors: single anxiety disorder, anxiety-anxiety comorbidity, anxiety-depressive

  19. Comorbid social withdrawal (hikikomori) in outpatients with social anxiety disorder: clinical characteristics and treatment response in a case series.

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    Nagata, Toshihiko; Yamada, Hisashi; Teo, Alan R; Yoshimura, Chiho; Nakajima, Takenori; van Vliet, Irene

    2013-02-01

    Severe social withdrawal (called hikikomori, and defined as isolation lasting more than six months and not due to an apparent mental disorder) has drawn increasing public attention in Japan. It is unclear whether hikikomori is merely a symptom or syndrome of social withdrawal. To evaluate this phenomenon in relationship to social anxiety disorder (SAD), as few previous studies have. One hundred and forty-one consecutive patients with SAD diagnosed according to DSM-IV criteria by a semi-structured interview were treated with a combination of psychotherapy, pharmacotherapy and group activity. Twenty-seven (19%) SAD patients fulfilled the criteria for hikikomori, and these patients had earlier onset, more symptoms and less education than non-hikikomori SAD patients. Only 33% of hikikomori SAD patients spontaneously complained of SAD symptoms at first visit. There were no diagnostic differences between hikikomori and non-hikikomori SAD patients, except that comorbid obsessive-compulsive disorder was more frequent in hikikomori SAD patients. Functional impairment in 10 (37%) hikikomori SAD patients improved after several years of combination therapy. Hikikomori may serve as a proxy for a severe form of SAD. Patients with comorbid SAD and hikikomori have lower treatment response rates than those with SAD alone.

  20. Bipolar disorder with comorbid anxiety disorders: impact of comorbidity on treatment outcome in cognitive-behavioral therapy and psychoeducation

    OpenAIRE

    Hawke, Lisa D; Velyvis, Vytas; Parikh, Sagar V

    2013-01-01

    Background Comorbid anxiety disorders are extremely prevalent in bipolar disorder (BD) and have substantial impact on the course of illness. Limited evidence regarding treatment factors has led to a renewal of research efforts examining both the impact of treatments on comorbid anxiety and the impact of comorbid anxiety on treatments. The current study examines the impact of comorbid anxiety disorders on response to two psychosocial interventions for BD. Methods A sample of 204 patients with ...

  1. Quality of life in borderline patients comorbid with anxiety spectrum disorders – a cross-sectional study

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    Grambal A

    2016-08-01

    Full Text Available Ales Grambal,1 Jan Prasko,1 Dana Kamaradova,1 Klara Latalova,1 Michaela Holubova,1,2 Zuzana Sedláčková,3 Radovan Hruby4 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital, Olomouc, 2Department of Psychiatry, Hospital Liberec, Liberec, 3Department of Psychology, Faculty of Arts, Palacky University Olomouc, Olomouc, Czech Republic; 4Private Practice, Martin, Slovak Republic Introduction: Borderline personality disorder (BPD significantly reduces the quality of life (QoL in mental, social, and work domains. Patients with BPD often suffer from depressive anxiety symptoms. The purpose of this cross-sectional study was to compare the QoL and demographic and clinical factors of inpatients diagnosed with BPD and comorbid anxiety spectrum disorders, and healthy controls.Methods: Ninety-two hospitalized patients treated in the psychotherapeutic department and 40 healthy controls were included. Subjects were assessed by the Quality of Life Satisfaction and Enjoyment Questionnaire (Q-LES-Q, Dissociative Experiences Scale, Beck Depression Inventory (BDI-II, Beck Anxiety Inventory, Clinical Global Impression, demographic questionnaire, Sheehan Disability Scale (SDS, and Sheehan Anxiety Scale.Results: BPD patients suffered from comorbid anxiety disorders, panic disorder (18.5%, social phobia (20.7%, generalized anxiety disorder/mixed anxiety depression disorder (17.4%, adjustment disorder (22.8%, and posttraumatic stress disorder (8.7%; 19.6% patients had two or more anxiety disorder comorbidities. Patients score in Q-LES-Q (general was 36.24±9.21, which was significantly lower in comparison to controls (57.83±10.21 and similar in all domains (physical health, feelings, work, household, school/study, leisure, social activities. The subjective level of depression measured by BDI and SDS (social life and family subscales negatively correlated with all Q-LES-Q domains.Conclusion: Patients suffering

  2. Anxiety disorders: treatable regardless of the severity of comorbid alcohol dependence

    NARCIS (Netherlands)

    Schade, Annemiek; Marquenie, Loes A.; van Balkom, Anton J. L. M.; Koeter, Maarten W. J.; de Beurs, Edwin; van Dyck, Richard; van den Brink, Wim

    2007-01-01

    AIMS: Clinical and epidemiological research has shown that comorbidity is the rule rather than exception in the case of psychiatric disorders. Cognitive behavioral therapy (CBT) has been clearly demonstrated to be effective in treating anxiety and avoidance symptoms in patient samples of social

  3. Social phobia: diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment

    OpenAIRE

    Brunello, Nicoletta; den Boer, Johan A.; Judd, Lewis L.; Kasper, Siegfried; Kelsey, Jeffrey E.; Lader, Malcolm; Lecrubier, Yves; Lepine, Jean-Pierre; Lydiard, R. B.; Mendlewicz, Julien; Montgomery, Stuart A.; Racagni, Giorgio; Stein, Murray B.; Wittchen, Hans-Ulrich

    2013-01-01

    Social phobia is a common disorder associated with significant psychosocial impairment, representing a substantial public health problem largely determined by the high prevalence, and the lifelong chronicity. Social phobia starts in early childhood or adolescence and is often comorbid with depression, other anxiety disorders, alcohol and substance abuse or eating disorders. This cascade of comorbidity, usually secondary to social phobia, increases the disability associated with the condition....

  4. Contributions of cognitive inflexibility to eating disorder and social anxiety symptoms.

    Science.gov (United States)

    Arlt, Jean; Yiu, Angelina; Eneva, Kalina; Taylor Dryman, M; Heimberg, Richard G; Chen, Eunice Y

    2016-04-01

    Eating disorders and social anxiety are highly co-occurring. These disorders share fears of social evaluation, possibly maintained by similar cognitive content and styles, including an inability to adapt or flexibly respond to unexpected conditions. However, the role of cognitive inflexibility in eating disorders in relation to social anxiety has not been explored. In this study, the link between eating disorder symptoms and cognitive inflexibility, while accounting for social anxiety, is examined. Participants (N=461) were undergraduates who completed the Detail and Flexibility Questionnaire 12-item Cognitive Rigidity subscale, the Eating Disorders Diagnostic Scale, and the Social Interaction Anxiety Scale. Eating disorder symptoms and social anxiety were both positively correlated with cognitive inflexibility. After controlling for social anxiety, the relationship between eating disorder symptoms and cognitive inflexibility remained robust. Further examination of cognitive inflexibility in eating disorders and comorbid social anxiety in clinical samples is warranted. We suggest future directions for examining cognitive inflexibility as a trans-diagnostic construct important to eating disorders and frequently comorbid disorders, consistent with NIMH Research Domain Criteria. Copyright © 2015. Published by Elsevier Ltd.

  5. Social anxiety symptoms across diagnoses among outpatients attending a tertiary care mood and anxiety disorders service.

    Science.gov (United States)

    Graystone, H J; Garner, M J; Baldwin, D S

    2009-04-01

    Social phobia is a common, persistent and disabling anxiety disorder in which co-existing depressive symptoms are common. However the prevalence of social anxiety symptoms in patients with other mood and anxiety disorders is uncertain. In consecutive patients attending a tertiary referral mood and anxiety disorders service, depressive symptoms were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) and social anxiety symptoms by the Liebowitz Social Anxiety Scale (LSAS). The Clinical Global Impression of Severity (CGI-S) was completed following the appointment. 75 patients (48 women, 27 men; mean age 45.9 years) completed the study. 38 had a single diagnosis and 37 co-morbid diagnoses: 15 patients had bipolar disorder, 35 unipolar depressive disorder, 19 an anxiety disorder, and 6 other disorders. Independent samples t-tests and one-way between-subjects ANOVA revealed that the severity of social anxiety symptoms but not depressive symptoms was significantly greater in patients with co-morbid diagnoses (LSAS 73.7 vs 54.2, t(72)=2.44, pdepression or bipolar disorder (respectively; LSAS 78.8 vs 59.4 vs 50.0, F(2, 65)=3.13, p=.05; MADRS 22.2 vs 19.8 vs 17.5, F(2, 66)depression (R(2)=0.376, pdepressive and social anxiety symptoms across a range of diagnoses. Depressive and social anxiety symptoms were most severe but least well correlated among tertiary care outpatients with anxiety disorders, emphasising the need for comprehensive evaluation and treatment.

  6. Comorbid Social Anxiety Disorder in Adults with Autism Spectrum Disorder

    Science.gov (United States)

    Maddox, Brenna B.; White, Susan W.

    2015-01-01

    Social anxiety symptoms are common among cognitively unimpaired youth with autism spectrum disorder (ASD). Few studies have investigated the co-occurrence of social anxiety disorder (SAD) in adults with ASD, although identification may aid access to effective treatments and inform our scientific efforts to parse heterogeneity. In this preliminary…

  7. Comparison of behavioral profiles for anxiety-related comorbidities including ADHD and selective mutism in children.

    Science.gov (United States)

    Levin-Decanini, Tal; Connolly, Sucheta D; Simpson, David; Suarez, Liza; Jacob, Suma

    2013-09-01

    Elucidating differences in social-behavioral profiles of children with comorbid presentations, utilizing caregiver as well as teacher reports, will refine our understanding of how contextual symptoms vary across anxiety-related disorders. In our pediatric anxiety clinic, the most frequent diagnoses and comorbidities were mixed anxiety (MA; ≥ 1 anxiety disorder; N = 155), anxiety with comorbid attention-deficit hyperactivity disorder (MA/ADHD, N = 47) and selective mutism (SM, N = 48). Behavioral measures (CPRS, CTRS) were analyzed using multiple one-way multivariate analyses of covariance tests. Differences between the three diagnostic groups were examined using completed parent and teacher reports (N = 135, 46, and 48 for MA, MA/ADHD, and SM groups, respectively). Comparisons across the MA, MA/ADHD, and SM groups indicate a significant multivariate main effect of group for caregiver and teacher responses (P < 0.01). Caregivers reported that children with SM are similar in profile to those with MA, and both groups were significantly different from the MA/ADHD group. Teachers reported that children with SM had more problems with social behaviors than with the MA or MA/ADHD groups. Further comparison indicates a significant main effect of group (P < 0.001), such that children with SM have the greatest differences in behavior observed by teachers versus caregivers. Clinical profiles between MA/ADHD, MA, and SM groups varied, illustrating the importance of multi-rater assessment scales to capture subtle distinctions and to inform treatment planning given that comorbidities occur frequently in children who present with anxiety. © 2013 Wiley Periodicals, Inc.

  8. Suicide in late-life depression with and without comorbid anxiety disorders.

    Science.gov (United States)

    Oude Voshaar, Richard C; van der Veen, Date C; Hunt, Isabelle; Kapur, Nav

    2016-02-01

    Comorbid anxiety in depression increases the risk of suicidal ideation and behavior, although data on death by suicide are scarce. We compared characteristics of depressed elderly patients with and without anxiety disorders who died by suicide. From a 16-year clinical survey of all suicides in the UK (n = 25,128), we identified 1909 cases aged ≥60 years with a primary diagnosis of depression and no comorbidity other than anxiety disorders. Clinical characteristics of cases with (n = 333, 17.4%) and without (n = 1576) comorbid anxiety disorders were compared by logistic regression adjusted for demographic differences. Compared with cases without comorbid anxiety disorders, cases with comorbid anxiety disorders were more likely to have a duration of illness over 1 year (OR(1-5 years)  = 1.4 [95% CI: 1.0-1.9], p = 0.061; OR(≥5 years)  = 1.4 [95% CI: 1.6-2.8], p suicidal risks lower in those with comorbid anxiety disorders (OR = 0.6 [95% CI: 0.3-0.9], p = 0.011 and OR = 0.7 [95% CI: 0.6-1.0], p = 0.028, respectively). Among depressed suicide cases, a comorbid anxiety disorder was identified in one out of six cases and associated with a higher prevalence of several suicide risk factors. This is important, as the detection of anxiety disorders comorbid to depression seems rather low and even when recognized clinicians rated such individuals as at low suicide risk. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Childhood history of behavioral inhibition and comorbidity status in 256 adults with social phobia.

    Science.gov (United States)

    Rotge, Jean-Yves; Grabot, Denis; Aouizerate, Bruno; Pélissolo, Antoine; Lépine, Jean-Pierre; Tignol, Jean

    2011-03-01

    Behavioral inhibition (BI), a heritable temperament, predisposes one to an increased risk of social phobia. Recent investigations have reported that BI may also be a precursor to anxiety as well as depressive and alcohol-related disorders, which are frequently comorbid with social phobia. In the present study, we explored the relationship between BI and psychiatric disorders in 256 adults with a primary diagnosis of social phobia. BI severity was retrospectively assessed with the Retrospective Self-Report of Inhibition (RSRI). The severity of social phobia and the presence of comorbid diagnoses were evaluated with the Liebowitz Social Anxiety Scale (LSAS) and the Mini-International Neuropsychiatric Interview, respectively. The RSRI score was significantly and positively correlated with both the LSAS score and the occurrence of a major depressive disorder. No significant association was found with other anxiety and substance-related disorders. The assessment of BI was retrospective and self-reported. A childhood history of BI was associated with an increased risk of depressive comorbidity in social phobia. Copyright © 2010 Elsevier B.V. All rights reserved.

  10. Interpersonal Psychotherapy-Adolescent Skills Training: Anxiety Outcomes and Impact of Comorbidity

    Science.gov (United States)

    Young, Jami F.; Makover, Heather B.; Cohen, Joseph R.; Mufson, Laura; Gallop, Robert J.; Benas, Jessica S.

    2012-01-01

    Given the frequent comorbidity of anxiety and depression, it is important to study the effects of depression interventions on anxiety and the impact of comorbid anxiety on depression outcomes. This article reports on pooled anxiety and depression data from two randomized trials of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a…

  11. Distinctive and common neural underpinnings of major depression, social anxiety, and their comorbidity.

    Science.gov (United States)

    Hamilton, J Paul; Chen, Michael C; Waugh, Christian E; Joormann, Jutta; Gotlib, Ian H

    2015-04-01

    Assessing neural commonalities and differences among depression, anxiety and their comorbidity is critical in developing a more integrative clinical neuroscience and in evaluating currently debated categorical vs dimensional approaches to psychiatric classification. Therefore, in this study, we sought to identify patterns of anomalous neural responding to criticism and praise that are specific to and common among major depressive disorder (MDD), social anxiety disorder (SAD) and comorbid MDD-SAD. Adult females who met formal diagnostic criteria for MDD, SAD or MDD-SAD and psychiatrically healthy participants underwent functional magnetic resonance imaging as they listened to statements directing praise or criticism at them or at another person. MDD groups showed reduced responding to praise across a distributed cortical network, an effect potentially mediated by thalamic nuclei undergirding arousal-mediated attention. SAD groups showed heightened anterior insula and decreased default-mode network response to criticism. The MDD-SAD group uniquely showed reduced responding to praise in the dorsal anterior cingulate cortex. Finally, all groups with psychopathology showed heightened response to criticism in a region of the superior frontal gyrus implicated in attentional gating. The present results suggest novel neural models of anhedonia in MDD, vigilance-withdrawal behaviors in SAD, and poorer outcome in MDD-SAD. Importantly, in identifying unique and common neural substrates of MDD and SAD, these results support a formulation in which common neural components represent general risk factors for psychopathology that, due to factors that are present at illness onset, lead to distinct forms of psychopathology with unique neural signatures. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  12. One session treatment for specific phobias in children: Comorbid anxiety disorders and treatment outcome.

    Science.gov (United States)

    Ryan, Sarah M; Strege, Marlene V; Oar, Ella L; Ollendick, Thomas H

    2017-03-01

    One-Session Treatment (OST) for specific phobias has been shown to be effective in reducing phobia severity; however, the effect of different types of co-occurring anxiety disorders on OST outcomes is unknown. The present study examined (1) the effects of co-occurring generalized anxiety disorder (GAD), social anxiety disorder (SAD), or another non-targeted specific phobia (OSP) on the efficacy of OST for specific phobias, and (2) the effects of OST on these co-occurring disorders following treatment. Three groups of 18 youth (7-15 years) with a specific phobia and comorbid GAD, SAD, or OSP were matched on age, gender, and phobia type. Outcome measures included diagnostic status and severity, and clinician rated improvement. All groups demonstrated an improvement in their specific phobia following treatment. Treatment was equally effective regardless of co-occurring anxiety disorder. In addition, comorbid anxiety disorders improved following OST; however, this effect was not equal across groups. The SAD group showed poorer improvement in their comorbid disorder than the GAD group post-treatment. However, the SAD group continued to improve and this differential effect was not evident six-months following treatment. The current study sample was small, with insufficient power to detect small and medium effect sizes. Further, the sample only included a portion of individuals with primary GAD or SAD, which may have attenuated the findings. The current study demonstrated that co-occurring anxiety disorders did not interfere with phobia treatment. OST, despite targeting a single specific phobia type, significantly reduced comorbid symptomatology across multiple anxiety disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Differentiating Anxiety and Depression in Relation to the Social Functioning of Young Adolescents With ADHD.

    Science.gov (United States)

    Becker, Stephen P; Langberg, Joshua M; Evans, Steven W; Girio-Herrera, Erin; Vaughn, Aaron J

    2015-01-01

    The present study examined anxiety and depressive symptoms in relation to the social functioning of young adolescents with attention-deficit/hyperactivity disorder (ADHD) and builds upon prior work by incorporating youths' self-reports of internalizing symptoms and examining distinct anxiety and depression dimensions to increase specificity. Participants were 310 young adolescents (ages 10-14; 71% male, 78% Caucasian) diagnosed with ADHD. Youth provided ratings of anxiety/depression, and parents provided ratings of their own depression. Parents and youth both reported on youths' social skills and perceived social acceptance. Path analyses indicated that above and beyond child demographics, ADHD and oppositional defiant disorder symptom severity, and parents' own depression, self-reported social anxiety and anhedonia were both associated with lower youth-reported social skills and both parent- and youth-reported social acceptance. Negative self-evaluation was associated with poorer parent-reported social skills. Finally, harm avoidance was positively associated with both youth- and parent-reported social skills. A path analysis using comorbid diagnoses (rather than symptom dimensions) indicated that that having a comorbid disruptive behavior disorder or depression diagnosis (but not a comorbid anxiety diagnosis) was associated with poorer parent-reported social functioning. Results demonstrate that the relation between internalizing symptoms and social functioning among young adolescents with ADHD is nuanced, with social anxiety and anhedonia symptoms associated with lower social skills and social acceptance in contrast to harm avoidance being associated with higher ratings of social skills (and unrelated to social acceptance). In terms of comorbid diagnoses, depression is more clearly related than anxiety to poorer social functioning among young adolescents with ADHD. These results point to the importance of attending to specific facets of anxiety and depression in

  14. Group schema therapy versus group cognitive behavioral therapy for social anxiety disorder with comorbid avoidant personality disorder : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Baljé, A.; Greeven, A.; van Giezen, A.; Korrelboom, C.W.; Arntz, A.; Spinhoven, P.

    2016-01-01

    Background Social anxiety disorder (SAD) with comorbid avoidant personality disorder (APD) has a high prevalence and is associated with serious psychosocial problems and high societal costs. When patients suffer from both SAD and APD, the Dutch multidisciplinary guidelines for personality disorders

  15. Group schema therapy versus group cognitive behavioral therapy for social anxiety disorder with comorbid avoidant personality disorder : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Baljé, A.; Greeven, A.; van Giezen, A.; Korrelboom, K.; Arntz, A.; Spinhoven, P.

    2016-01-01

    BACKGROUND: Social anxiety disorder (SAD) with comorbid avoidant personality disorder (APD) has a high prevalence and is associated with serious psychosocial problems and high societal costs. When patients suffer from both SAD and APD, the Dutch multidisciplinary guidelines for personality disorders

  16. Examining the Panic Attack Specifier in Social Anxiety Disorder.

    Science.gov (United States)

    Allan, Nicholas P; Oglesby, Mary E; Short, Nicole A; Schmidt, Norman B

    2016-04-01

    Panic attacks (PAs) are characterized by overwhelming surges of fear and discomfort and are one of the most frequently occurring symptoms in psychiatric populations. The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (i.e. DSM-5) allows for a panic attack (PA) specifier for all disorders, including social anxiety disorder (SAD). However, there is little research examining differences between individuals diagnosed with SAD with the PA specifier versus individuals diagnosed with SAD without the PA specifier. The current study examined social anxiety, mood, anxiety, and anxiety sensitivity social concerns, a risk factor for social anxiety in SAD-diagnosed individuals without (N = 52) and with (N = 14) the PA specifier. The groups differed only in somatic symptoms of anxiety. Result of the current study provides preliminary evidence that the presence of the PA specifier in social anxiety does not result in elevated levels of comorbidity or a more severe presentation of social anxiety.

  17. Metacognitive therapy versus disorder-specific CBT for comorbid anxiety disorders: A randomized controlled trial.

    Science.gov (United States)

    Johnson, Sverre Urnes; Hoffart, Asle; Nordahl, Hans M; Wampold, Bruce E

    2017-08-01

    Few studies have compared the effects of Metacognitive therapy (MCT) and Cognitive behavioral therapy (CBT) for comorbid anxiety disorders. In the current study we compared CBT and MCT for heterogeneous anxiety disorders in a residential setting. Ninety patients with a primary diagnosis of Post Traumatic Stress Disorder, Social Phobia or Panic disorder, with and without Agoraphobia, were randomized to either CBT or MCT. Patients were assessed at pre-treatment, post-treatment and one-year follow-up. Primary outcome measures were Beck Anxiety Inventory and ADIS IV and secondary outcome measures were SCID II, Beck Depression Inventory, Penn State Worry Questionnaire, The Symptom Checklist-90 and the Inventory of Interpersonal Problems-64. Treatment fidelity was satisfactory and therapist credibility was equal in both treatments. There was a significant difference in the level of anxiety favouring MCT at post-treatment (d=0.7), but there were no differences at one-year follow-up, mainly due to a further improvement in the CBT group during the follow-up period. Both treatments were efficacious. No differences in effect on comorbid diagnoses and symptoms were found, but MCT produced larger change in personality problems. MCT seems to have a more rapid effect on anxiety symptoms, but there were no significant differences in the long term for patients with comorbid anxiety disorders. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Anxiety disorders: Psychiatric comorbidities and psychosocial ...

    African Journals Online (AJOL)

    2018-05-24

    May 24, 2018 ... psychiatric disorders, including other anxiety disorders, mood disorders, substance use disorders ... psychiatric comorbidities present among adults at a tertiary ..... clinical files as well as unclear handwriting and missing.

  19. Comorbidity of Anxiety-Depression among Australian University Students: Implications for Student Counsellors

    Science.gov (United States)

    Bitsika, Vicki; Sharpley, Christopher F.

    2012-01-01

    The incidence, factor structure and scale item differences in anxiety-depression comorbidity were investigated in a sample of Australian university students defined according to the presence of anxiety and/or depression. The incidence of anxiety-depression comorbidity was over 32%, about four times that for anxiety or depression alone.…

  20. Temperament clusters associate with anxiety disorder comorbidity in depression.

    Science.gov (United States)

    Paavonen, Vesa; Luoto, Kaisa; Lassila, Antero; Leinonen, Esa; Kampman, Olli

    2018-08-15

    Individual temperament is associated with psychiatric morbidity and could explain differences in psychiatric comorbidities. We investigated the association of temperament profile clusters with anxiety disorder comorbidity in patients with depression. We assessed the temperament of 204 specialized care-treated depressed patients with the Temperament and Character Inventory (TCI-R) and their diagnoses with the Mini International Neuropsychiatric Interview. Two-step cluster analysis was used for defining patients' temperament profiles and logistic regression analysis was used for predicting different anxiety disorders for various temperament profiles. Four temperament clusters were found: 1) Novelty seekers with highest Novelty Seeking scores (n = 56),2) Persistent with highest Persistence scores (n = 36), 3) Reserved with lowest Novelty Seeking scores (n = 66) and 4) Wearied with highest Harm avoidance, lowest Reward Dependence and lowest Persistence scores (n = 58). After adjusting for clinical variables, panic disorder and/or agoraphobia were predicted by Novelty seekers' temperament profile with odds ratio [OR] = 3.5 (95% confidence interval [CI] = 1.8 - 6.9, p < 0.001), social anxiety disorder was predicted by Wearied temperament profile with OR = 3.4 (95% CI = 1.6 - 7.5, p = 0.002), and generalized anxiety disorder was predicted by Reserved temperament profile with OR = 2.6 (95% CI = 1.2 - 5.3, p = 0.01). The patients' temperament profiles were assessed while displaying depressive symptoms, which may have affected results. Temperament clusters with unique dimensional profiles were specifically associated with different anxiety disorders in this study. These results suggest that TCI-R could offer a valuable dimensional method for predicting the risk of anxiety disorders in diverse depressed patients. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Do Comorbid Anxiety Disorders Moderate the Effects of Psychotherapy for Bipolar Disorder? Results From STEP-BD

    Science.gov (United States)

    Deckersbach, Thilo; Peters, Amy T.; Sylvia, Louisa; Urdahl, Anna; Magalhães, Pedro V.S.; Otto, Michael W.; Frank, Ellen; Miklowitz, David J.; Berk, Michael; Kinrys, Gustavo; Nierenberg, Andrew

    2013-01-01

    Objective At least 50% of individuals with bipolar disorder have a lifetime anxiety disorder. Individuals with both bipolar disorder and a co-occurring anxiety disorder experience longer illness duration, greater illness severity, and poorer treatment response. The study explored whether comorbid lifetime anxiety in bipolar patients moderates psychotherapy treatment outcome. Method In the Systematic Treatment Enhancement Program randomized controlled trial of psychotherapy for bipolar depression, participants received up to 30 sessions of intensive psychotherapy (family-focused therapy, interpersonal and social rhythm therapy, or cognitive-behavioral therapy) or collaborative care, a three-session comparison treatment, plus pharmacotherapy. Using the number needed to treat, we computed effect sizes to analyze the relationship between lifetime anxiety disorders and rates of recovery across treatment groups after 1 year. Results A total of 269 patients (113 women) with a comorbid lifetime anxiety disorder (N=177) or without a comorbid lifetime anxiety disorder (N=92) were included in the analysis. Participants with a lifetime anxiety disorder were more likely to recover with psychotherapy than with collaborative care (66% compared with 49% recovered over 1 year; number needed to treat=5.88, small to medium effect). For patients without a lifetime anxiety disorder, there was no difference between rates of recovery in psychotherapy compared with collaborative care (64% compared with 62% recovered; number needed to treat=50, small effect). Participants with one lifetime anxiety disorder were likely to benefit from intensive psychotherapy compared with collaborative care (84% compared with 53% recovered; number needed to treat=3.22, medium to large effect), whereas patients with multiple anxiety disorders exhibited no difference in response to the two treatments (54% compared with 46% recovered; number needed to treat=12.5, small effect). Conclusions Depressed patients

  2. Emotional reasoning and anxiety sensitivity: associations with social anxiety disorder in childhood.

    Science.gov (United States)

    Alkozei, Anna; Cooper, Peter J; Creswell, Cathy

    2014-01-01

    Two specific cognitive constructs that have been implicated in the development and maintenance of anxiety symptoms are anxiety sensitivity and emotional reasoning, both of which relate to the experience and meaning of physical symptoms of arousal or anxiety. The interpretation of physical symptoms has been particularly implicated in theories of social anxiety disorder, where internal physical symptoms are hypothesized to influence the individual's appraisals of the self as a social object. The current study compared 75 children on measures of anxiety sensitivity and emotional reasoning: 25 with social anxiety disorder, 25 with other anxiety disorders, and 25 nonanxious children (aged 7-12 years). Children with social anxiety disorder reported higher levels of anxiety sensitivity and were more likely than both other groups to view ambiguous situations as anxiety provoking, whether physical information was present or not. There were no group differences in the extent to which physical information altered children's interpretation of hypothetical scenarios. This study is the first to investigate emotional reasoning in clinically anxious children and therefore replication is needed. In addition, those in both anxious groups commonly had comorbid conditions and, consequently, specific conclusions about social anxiety disorder need to be treated with caution. The findings highlight cognitive characteristics that may be particularly pertinent in the context of social anxiety disorder in childhood and which may be potential targets for treatment. Furthermore, the findings suggest that strategies to modify these particular cognitive constructs may not be necessary in treatments of some other childhood anxiety disorders. © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Emotional reasoning and anxiety sensitivity: Associations with social anxiety disorder in childhood☆

    Science.gov (United States)

    Alkozei, Anna; Cooper, Peter J.; Creswell, Cathy

    2014-01-01

    Background Two specific cognitive constructs that have been implicated in the development and maintenance of anxiety symptoms are anxiety sensitivity and emotional reasoning, both of which relate to the experience and meaning of physical symptoms of arousal or anxiety. The interpretation of physical symptoms has been particularly implicated in theories of social anxiety disorder, where internal physical symptoms are hypothesized to influence the individual's appraisals of the self as a social object. Method The current study compared 75 children on measures of anxiety sensitivity and emotional reasoning: 25 with social anxiety disorder, 25 with other anxiety disorders, and 25 nonanxious children (aged 7–12 years). Results Children with social anxiety disorder reported higher levels of anxiety sensitivity and were more likely than both other groups to view ambiguous situations as anxiety provoking, whether physical information was present or not. There were no group differences in the extent to which physical information altered children's interpretation of hypothetical scenarios. Limitations This study is the first to investigate emotional reasoning in clinically anxious children and therefore replication is needed. In addition, those in both anxious groups commonly had comorbid conditions and, consequently, specific conclusions about social anxiety disorder need to be treated with caution. Conclusion The findings highlight cognitive characteristics that may be particularly pertinent in the context of social anxiety disorder in childhood and which may be potential targets for treatment. Furthermore, the findings suggest that strategies to modify these particular cognitive constructs may not be necessary in treatments of some other childhood anxiety disorders. PMID:24120086

  4. Prevalence of and associations between body dysmorphic concerns, obsessive beliefs and social anxiety.

    Science.gov (United States)

    Barahmand, Usha; Shahbazi, Zeynab

    2015-03-01

    Physical attractiveness has been of concern in different cultures and at different times. Physical attractiveness can influence one's thoughts and actions, and concerns regarding body image can be destructive, giving rise to psychological problems. The purpose of the present study was to determine the prevalence of body dysmorphic concerns, related sex differences and comorbidity with social anxiety and obsessive beliefs. Using a stratified and cluster sampling procedure, 1,200 males and females were randomly selected. Self-report measures on body image, social anxiety and obsessive beliefs were distributed of which 843 completed questionnaires (54.9% males and 45.1% females) were returned (return rate of 70.25%). Therefore, data pertaining to 463 males and 380 females ranging in age from 17 to 20 years with a mean age of 18.12 years (SD = 1.06) were analyzed. Findings suggest a prevalence rate of 19.1% for body dysmorphic disorder, 23.6% for social anxiety and 8.8% for obsessive beliefs. Both social anxiety and obsessive beliefs were found to be comorbid with body dysmorphic concerns. The percentage of individuals reporting comorbid social anxiety (12.9%) was greater than that of those reporting comorbid obsessive beliefs (6.4%). Males with body dysmorphic concerns reported more obsessive beliefs (8.2% versus 4.1%), while their female counterparts reported more social anxiety (23.4% versus 4.2%). In males, body image concerns appear to be more cognitive in quality, while in females, body image concerns seem more emotional in tone. As the measures used do not yield formal diagnoses, findings should be viewed with caution. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  5. Internet addiction is associated with social anxiety in young adults.

    Science.gov (United States)

    Weinstein, Aviv; Dorani, Dikla; Elhadif, Rotem; Bukovza, Yehely; Yarmulnik, Anastasya; Dannon, Pinhas

    2015-02-01

    Problematic Internet use or excessive Internet use is characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use, and Internet access that leads to impairment or distress. Cross-sectional studies on samples of patients reported high comorbidity of Internet addiction with psychiatric disorders, especially affective disorders (including depression), anxiety disorders (generalized anxiety disorder, social anxiety disorder), and attention-deficit/hyperactivity disorder. We have investigated the association between Internet addiction and social anxiety in 2 samples of 120 university students (60 males and 60 females in each sample). We found a correlation between Internet addiction and social anxiety in the 2 samples (r=0.411, Paddiction. Thirdly, we did not find a preference for social networks among participants with high levels of social anxiety. The results of the study support previous evidence for co-occurrence of Internet addiction and social anxiety, but further studies need to clarify this association.

  6. Comorbid Depressive Disorders in Anxiety-Disordered Youth: Demographic, Clinical, and Family Characteristics

    Science.gov (United States)

    O'Neil, Kelly A.; Podell, Jennifer L.; Benjamin, Courtney L.; Kendall, Philip C.

    2010-01-01

    Research indicates that depression and anxiety are highly comorbid in youth. Little is known, however, about the clinical and family characteristics of youth with principal anxiety disorders and comorbid depressive diagnoses. The present study examined the demographic, clinical, and family characteristics of 200 anxiety-disordered children and…

  7. Comorbidity of depression and anxiety in nursing home patients

    NARCIS (Netherlands)

    Smalbrugge, M.; Jongenelis, L.; Pot, A.M.; Beekman, A.T.F.; Eefsting, J.A.

    2005-01-01

    Objectives: To assess the occurrence and risk indicators of depression, anxiety, and comorbid anxiety and depression among nursing home patients and to determine whether depression and anxiety are best described in a dimensional or in a categorical classification system. Methods: DSM and

  8. Balance Treatment Ameliorates Anxiety and Increases Self-Esteem in Children with Comorbid Anxiety and Balance Disorder

    Science.gov (United States)

    Bart, Orit; Bar-Haim, Yair; Weizman, Einat; Levin, Moran; Sadeh, Avi; Mintz, Matti

    2009-01-01

    Comorbidity between balance and anxiety disorders in adult population is a well-studied clinical entity. Children might be particularly prone to develop balance-anxiety comorbidity, but surprisingly they are practically neglected in this field of research. The consequence is that children are treated for what seems to be the primary disorder…

  9. The role of social support in anxiety for persons with COPD.

    Science.gov (United States)

    Dinicola, Gia; Julian, Laura; Gregorich, Steven E; Blanc, Paul D; Katz, Patricia P

    2013-02-01

    This study examined the contribution of perceived social support to the presence of anxiety in persons with chronic obstructive pulmonary disease (COPD). A cross-sectional survey sample of 452 persons with COPD (61.3% female; 53.5% older than 65; 70.8% without a college degree or higher educational achievement, and 54.8% with household income of $40,000 or less) completed a telephone survey. Measures included the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A), 5 social support subscales from the Positive and Negative Social Exchanges (PANSE) Scale, a COPD Severity Score (CSS; a weighted algorithmic combination of symptoms and the need for various COPD medical interventions), and the Geriatric Depression Scale, Short Form (GDS-SF). Zero order correlations and a series of multiple regression analyses were calculated. Multiple regression analysis revealed that the receipt of instrumental support, feeling let down by the failure of others to provide needed help, and unsympathetic or insensitive behavior from others each positively predicted a higher level of patient anxiety in COPD patients, after controlling for demographic variables, smoking status, comorbid depression (GDS) and severity of illness (CSS). Additionally, the control variable of depression was the strongest predictor of anxiety, suggesting a high degree of co-morbidity in this sample. Anxiety and depression are serious co-morbid mental health concerns for persons with COPD. It is important to examine both positive and negative aspects of perceived social support for COPD patients and how they may impact or interact with these mental health concerns. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Screening efficiency of the self-report version of the Multidimensional Anxiety Scale for Children in a highly comorbid inpatient sample.

    Science.gov (United States)

    Skarphedinsson, Gudmundur; Villabø, Marianne A; Lauth, Bertrand

    2015-01-01

    The Multidimensional Anxiety Scale for Children (MASC) is a widely used self-report questionnaire for the assessment of anxiety symptoms in children and adolescents with well documented predictive validity of the total score and subscales in internalizing and mixed clinical samples. However, no data exist on the screening efficiency in an inpatient sample of adolescents. To examine the psychometric properties and screening efficiency of the MASC in a high comorbid inpatient sample. The current study used receiver operating characteristic (ROC) analyses to investigate the predictive value of the MASC total and subscale scores for the Schedule for Affective Disorders and Schizophrenia for School-age children-Present and Lifetime version (K-SADS-PL), DSM-IV diagnoses of generalized anxiety disorder (GAD), separation anxiety disorder (SAD) and social phobia (SoP) in a highly comorbid inpatient sample of adolescents (11-18 years). The MASC total score predicted any anxiety disorder (AD) and GAD moderately well. Physical symptoms predicted GAD moderately well. Social anxiety and separation anxiety/panic did not predict SoP or SAD, respectively. Physical symptoms and harm avoidance also predicted the presence of major depressive disorder. The findings support the utility of the MASC total score to predict the presence of any AD and GAD. However, the utility of the social anxiety and separation anxiety/panic subscales showed limited utility to predict the presence of SAD and SoP, respectively. The MASC has probably a more limited function in screening for AD among a highly comorbid inpatient sample of severely affected adolescents. Our results should be interpreted in the light of a small, mixed sample of inpatient adolescents.

  11. Associations of social phobia and general anxiety with alcohol and drug use in a community sample of adolescents.

    Science.gov (United States)

    Fröjd, Sari; Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Marttunen, Mauri

    2011-01-01

    This study explores whether associations between anxiety and alcohol and other substance use are already evident in middle adolescence, and whether general anxiety or symptoms of social phobia affect continuity of frequent alcohol use, frequent drunkenness and cannabis use. Data from the Adolescent Mental Health Cohort Study, a school-based Finnish survey among adolescents aged 15-16 years at baseline, was utilized to assess prevalence, incidence and continuity of symptoms of social phobia, general anxiety, frequent alcohol use, frequent drunkenness and cannabis use (which in this context was smoked 'hashish' of unknown constituency), and the associations between the substance use variables and the anxiety variables in 2-year follow-up. Anxiety preceded substance use while no reciprocal associations were observed. Depression mediated the associations between anxiety and substance use. Symptoms of social phobia did not elevate the incidence of substance use, but general anxiety did. Frequent drunkenness was less significantly associated with anxiety than the other two substance use variables. Co-morbid general anxiety increased the persistence of frequent alcohol use while co-morbid social phobia decreased its persistence. Continuity of frequent drunkenness and cannabis use were unaffected by co-morbid anxiety. General anxiety in middle adolescence places adolescents at risk for concurrent and subsequent substance use. The risk may, however, be associated with co-morbid depression. Social phobia in middle adolescence may protect from substance use. Adolescents with internalizing symptoms may need guidance in coping with the symptoms even if the symptoms do not fulfil the criteria of mood or anxiety disorder.

  12. Altered emotion regulation capacity in social phobia as a function of comorbidity.

    Science.gov (United States)

    Burklund, Lisa J; Craske, Michelle G; Taylor, Shelley E; Lieberman, Matthew D

    2015-02-01

    Social phobia (SP) has been associated with amygdala hyperreactivity to fear-relevant stimuli. However, little is known about the neural basis of SP individuals' capacity to downregulate their responses to such stimuli and how such regulation varies as a function of comorbid depression and anxiety. We completed an functional magnetic resonance imaging (fMRI) study wherein SP participants without comorbidity (n = 30), with comorbid depression (n = 18) and with comorbid anxiety (n = 19) and healthy controls (n = 15) were scanned while completing an affect labeling emotion regulation task. Individuals with SP as a whole exhibited a reversal of the pattern observed in healthy controls in that they showed upregulation of amygdala activity during affect labeling. However, subsequent analyses revealed a more complex picture based on comorbidity type. Although none of the SP subgroups showed the normative pattern of amygdala downregulation, it was those with comorbid depression specifically who showed significant upregulation. Effects could not be attributed to differences in task performance, amygdala reactivity or right ventral lateral prefrontal cortex (RVLPFC) engagement, but may stem from dysfunctional communication between amygdala and RVLPFC. Furthermore, the particularly altered emotion regulation seen in those with comorbid depression could not be fully explained by symptom severity or state anxiety. Results reveal altered emotion regulation in SP, especially when comorbid with depression. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  13. [Co-occurrence of anxiety and autism. The social error and allostatic load hypotheses].

    Science.gov (United States)

    Paula-Perez, Isabel

    2013-02-22

    INTRODUCTION. The concept of comorbidity in neurodevelopmental disorders like autism is sometimes ambiguous. The co-occurrence of anxiety and autism is clinically significant, yet it is not always easy to determine whether it is a 'real' comorbidity, where the two comorbid conditions are phenotypically and aetiologically identical to what that anxiety would mean in persons with a neurotypical development, whether it is an anxiety that has been phenotypically modified by the pathological processes of the autism spectrum disorders, thus resulting in a specific variant of these latter, or whether we are dealing with a false comorbidity resulting from rather inaccurate differential diagnoses. DEVELOPMENT. The article puts forward two hypotheses to explain this co-occurrence, which provide each other with feedback and are little more than our reflections on the scientific evidence we have available today, but expressed aloud. The first is the 'social error' hypothesis, which considers that the maladjustments in the social behaviour of persons with autism (which arises from alterations affecting the processes involved in social cognition) help to aggravate anxiety in autism. The second hypothesis, referring to allostatic load, holds that anxiety is a response to chronic stress, wear or exhaustion that is produced by the hyperactivation of certain structures in the limbic system. CONCLUSIONS. The prototypical manifestations of anxiety present in the person with autism are not always related with the same biopsychosocial variables as those observed in persons without autism. Evidence points to hyper-reactive flee-or-fight responses (hypervigilance) when the person finds him or herself outside their comfort zone, and supports the hypotheses of 'social error' and of decompensation of the allostatic mechanism that makes it possible to cope with stress.

  14. Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder

    OpenAIRE

    Book, Sarah W.; Thomas, Suzanne E.; Randall, Patrick K.; Randall, Carrie L.

    2007-01-01

    Patients with social anxiety disorder who are seen in clinical practice commonly have additional psychiatric comorbidity, including alcohol use disorders. The first line treatment for social anxiety disorder is selective-serotonin-reuptake-inhibitors (SSRIs), such as paroxetine. However, the efficacy of SSRIs has been determined with studies that excluded alcoholics. Forty two subjects with social anxiety and a co-occurring alcohol use disorder participated in a 16-week, double-blind, placebo...

  15. Comorbid anxiety disorders in late-life depression : results of a cohort study

    NARCIS (Netherlands)

    van der Veen, D.C.; van Zelst, W. H.; Schoevers, R. A.; Comijs, H. C.; Oude Voshaar, Richard

    Background: Comorbid anxiety disorders are common in late-life depression and negatively impact treatment outcome. This study aimed to examine personality characteristics as well as early and recent life-events as possible determinants of comorbid anxiety disorders in late-life depression, taking

  16. Comorbid anxiety disorders in late-life depression: results of a cohort study

    NARCIS (Netherlands)

    van Veen, D.; van Zelst, W.; Schoevers, R.; Comijs, H.; Oude Voshaar, R.

    2015-01-01

    Background: Comorbid anxiety disorders are common in late-life depression and negatively impact treatment outcome. This study aimed to examine personality characteristics as well as early and recent life-events as possible determinants of comorbid anxiety disorders in late-life depression, taking

  17. Mother-Reported and Children's Perceived Social and Academic Competence in Clinic-Referred Youth: Unique Relations to Depression and/or Social Anxiety and the Role of Self-perceptions.

    Science.gov (United States)

    Epkins, Catherine C; Seegan, Paige L

    2015-10-01

    Depression and social anxiety symptoms and disorders are highly comorbid, and are associated with low social acceptance and academic competence. Theoretical models of both depression and social anxiety highlight the saliency of negative self-perceptions. We examined whether children's self-perceptions of social acceptance and mother-reported youth social acceptance are independently and uniquely related to children's depression and social anxiety, both before and after controlling for comorbid symptoms. Similar questions were examined regarding academic competence. The sample was 110 clinic-referred youth aged 8-16 years (65 boys, 45 girls; M age = 11.15, SD = 2.57). In the social acceptance area, both youth self-perceptions and mother-perceptions had independent and unique relations to depression and social anxiety, before and after controlling for comorbid symptoms. In the academic domain, both youth self-perceptions and mother-perceptions had independent and unique relations to depression, before and after controlling for social anxiety; yet only youth self-perceptions were related to social anxiety, before, but not after controlling for depression. For depression, larger effect sizes were observed for children's perceived, versus mother-reported, social acceptance and academic competence. Bootstrapping and Sobel tests found youth self-perceptions of social acceptance mediated the relation between mothers' perceptions and each of youth depression and social anxiety; and perceived academic competence mediated the relation between mothers' perceptions and youth depression, both before and after controlling for social anxiety. We found similarities and differences in findings for depression and social anxiety. Theoretical and treatment implications are highlighted, and future research directions are discussed.

  18. Cognitive behavioural group treatment for social anxiety in schizophrenia.

    Science.gov (United States)

    Kingsep, Patrick; Nathan, Paula; Castle, David

    2003-09-01

    Anxiety symptoms reported by individuals with schizophrenia have been traditionally seen as symptoms associated with the principal disorder and therefore not requiring special attention. The primary aim of this paper is to therapeutically target social anxiety symptoms in individuals with schizophrenia in order to determine the effectiveness of the cognitive behavioural group treatment model as an intervention for social anxiety in this participant group. Thirty-three individuals with schizophrenia and co-morbid social anxiety were allocated to a group-based cognitive behaviour (CBGT) intervention or waitlist control (WLC). Baseline, completion and follow-up ratings consist of measures of social anxiety: the Brief Social Phobia Scale (BSPS), Brief Fear of Negative Evaluation scale (BFNE) and the Social Interaction Anxiety Scale (SIAS); measures of general psychopathology: the Calgary Depression Scale for Schizophrenia (CDSS) and Global Severity Index (GSI) from the Brief Symptom Inventory (BSI); and the Quality of Life, Enjoyment and Satisfaction Questionnaire (QLESQ). Pre- and post-treatment measures were subjected to statistical evaluation. All outcome measures displayed statistical improvement in the intervention group compared with no change in the control group. These treatment gains were maintained at follow-up. CBGT for social anxiety in schizophrenia was demonstrated to be effective as an adjunctive treatment for this population.

  19. Relationships Between Social Anxiety and Smoking-Specific Experiential Avoidance.

    Science.gov (United States)

    Watson, Noreen L; Heffner, Jaimee L; McClure, Jennifer B; Bricker, Jonathan B

    2017-01-01

    Although social anxiety is associated with higher prevalence of smoking and lower cessation rates, little is known about the underlying mechanisms of these relationships. Research suggests that socially anxious smokers have higher levels of smoking-specific experiential avoidance and are inclined to smoke to avoid internal smoking cues. However, it is unknown which types of internal smoking cues they avoid. Thus, this study aimed to address this gap in the literature. Participants (N = 450) were adult smokers from a group-based trial for smoking cessation. Bivariate correlations and hierarchical linear regression models examined relationships between baseline levels of social anxiety and acceptance of internal smoking cues-physical sensations, emotions, and cognitions. Social anxiety was associated with lower levels of acceptance of thoughts, sensations, and emotions that cue smoking. After controlling for levels of nicotine dependence, depression, generalized anxiety, and posttraumatic stress disorder, social anxiety still explained unique variability in overall acceptance of internal smoking cues and in acceptance of physical sensations and emotions that serve as smoking cues. Social anxiety no longer explained unique variability in acceptance of thoughts that trigger smoking. Smokers with high levels of social anxiety are less accepting of internal smoking cues. For physical and emotional cues, this effect was independent of level of dependence and mental health comorbidity. Results help explain why smokers with social anxiety are less likely to quit and can inform the development of targeted cessation treatments for smokers with social anxiety.

  20. Differential patterns of lifetime multiple anxiety disorder comorbidity between Latino adults with bipolar I and major depressive disorders.

    Science.gov (United States)

    Dilsaver, Steven C; Benazzi, Franco; Akiskal, Kareen K; Akiskal, Hagop S

    2008-01-01

    To determine the lifetime rates of panic disorder, obsessive-compulsive disorder (OCD), social phobia, and posttraumatic stress disorder (PTSD) among adult Latino patients with major depressive disorder (MDD) and bipolar disorder (BPD), and whether there are dose-response relationships between loading for comorbid anxiety disorders, the probability of having BPD, and attributes of severity of illness. In a public sector clinic for the indigent located in a semiclosed rural community, 187 consecutively presenting affectively ill Latino patients were evaluated by use of the Structured Clinical Interview for DSM-IV. Polarity and the lifetime prevalence of panic disorder, OCD, social phobia, and PTSD were determined. Logistic regression was used to test associations. Trends in positive predictive values (PPVs) and likelihood ratios were assessed to determine whether dose-response relationships existed between loading for comorbid anxiety disorders and the likelihood of having BPD as opposed to MDD, psychosis, suicidal ideation, and suicide attempts. Of 187 subjects, 118 (63.1%) had MDD and 69 (36.9%) had BPD. The odds ratio of a patient with BPD, relative to MDD, of having panic disorder was 4.6 (panxiety disorders. There was a dose-response relationship between loading for comorbid anxiety disorders and the likelihood of having had a suicide attempt (but not suicidal ideation). As previously reported by us for juvenile patients, Latino adults with BPD had a remarkably high risk of having each anxiety disorder relative to patients with MDD. The results indicate that the risk of having BPD, having a psychosis, and making a suicide attempt becomes increasingly great as the number of comorbid anxiety disorders increases. These data, which are consistent with the notion of anxious bipolarity, provide further support for a possible anxious diathesis in bipolar disorder.

  1. Psychiatric comorbidities among adolescents with and without anxiety disorders: a community study

    Directory of Open Access Journals (Sweden)

    Estácio Amaro da Silva Júnior

    2015-09-01

    Full Text Available ABSTRACT Objective To evaluate, in a community sample of adolescents, the presence of comorbidities in different anxiety disorders. Methods This is a cross-sectional study, initially composed of 2,457 adolescents, aged between 10-17 years old, from public schools of the area covered by the Basic Health Unit of a university hospital. We applied the Screen for Child Anxiety Related Emotional Disorders (SCARED to assess for anxiety disorders. Then, 138 positive cases in the screening were assessed for mental disorders through the Schedule for Affective Disorder and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL. Results Patients with anxiety disorders had more association with other anxiety disorders, as well as depression, and enuresis. The most common comorbidity described in our study was between generalized anxiety disorder and separation anxiety disorder (OR = 4.21, 95% CI 1.88, 9.58. Significant association was observed between other disorders such as enuresis and separation anxiety disorder (OR = 3.81, 95% CI 1.16, 12.49, as well as depression and generalized anxiety disorder (OR = 3.40; 95% CI 1.52, 7.61. Conclusion Our study showed a relevant presence of comorbidities adolescents with anxiety disorders, selected from a community sample, especially regarding other anxiety disorders. Nevertheless, further studies are needed to confirm our findings.

  2. Social anxiety symptoms in alcohol-dependent outpatients: prevalence, severity and predictors

    OpenAIRE

    Yoshimi, Nicoli Tamie; Campos, Luana Moraes; Simão, Maria Odete; Torresan, Ricardo Cezar; Torres, Albina Rodrigues

    2016-01-01

    ABSTRACT Objectives High rates of comorbidity between social anxiety disorder (SAD) and alcohol use disorders have been reported, but the predictors of this comorbidity are poorly known and most studies involve primary SAD samples. The aims were to estimate the prevalence and severity of SAD symptoms among alcohol-dependent patients and to investigate sociodemographic and clinical factors associated with SAD comorbidity, including suicidal behaviors. Methods A cross-sectional study with 5...

  3. Integrating Etiological Models of Social Anxiety and Depression in Youth: Evidence for a Cumulative Interpersonal Risk Model

    Science.gov (United States)

    Epkins, Catherine C.; Heckler, David R.

    2011-01-01

    Models of social anxiety and depression in youth have been developed separately, and they contain similar etiological influences. Given the high comorbidity of social anxiety and depression, we examine whether the posited etiological constructs are a correlate of, or a risk factor for, social anxiety and/or depression at the symptom level and the…

  4. Pharmacotherapy for anxiety and comorbid alcohol use disorders.

    Science.gov (United States)

    Ipser, Jonathan C; Wilson, Don; Akindipe, Taiwo O; Sager, Carli; Stein, Dan J

    2015-01-20

    anxiety disorders with comorbid alcohol use disorders. Trials assessing drugs administered for the treatment of drinking behaviour, such as naltrexone, disulfiram and acomprosate were not eligible for inclusion in this systematic review. A systematic review is a standardised evaluation of all research studies that address a particular clinical issue.Two review authors independently assessed RCTs for inclusion in the review, collated trial data and assessed trial quality. We contacted investigators to obtain missing data. We calculated categorical and continuous treatment effect estimates and their 95% confidence intervals (CI) for treatment using a random-effects model with effect-size variability expressed using Chi(2) and I(2) heterogeneity statistics. We included five placebo-controlled pharmacotherapy RCTs (with 290 participants) in the review. Most of the trials provided little information on how randomization was performed or on whether both participants and study personnel were blinded to the intervention. Two of the three trials reporting superiority of medication compared with placebo on anxiety symptom outcomes were industry funded. We regarded one trial as being at high risk of bias due to selective reporting.Study participants had Diagnostic and Statistical Manual (DSM) III- and DSM IV-diagnosed alcohol use disorders and post-traumatic stress disorder (two studies), social anxiety disorder (SAD; two studies) or generalized anxiety disorder (GAD; one study). Four trials assessed the efficacy of the selective serotonin re-uptake inhibitors (SSRIs: sertraline, paroxetine); one RCT investigated the efficacy of buspirone, a 5-hydroxytryptamine (5-HT) partial agonist. Treatment duration lasted between eight and 24 weeks. Overall, 70% of participants included in the review were male.There was very low quality evidence for an effect of paroxetine on global clinical response to treatment, as assessed by the Clinical Global Impressions - Improvement scale (CGI

  5. Minimal role of comorbid personality disorder on the quality of life in patients with anxiety spectrum disorders.

    Science.gov (United States)

    Kamaradova, Dana; Latalova, Klara; Prasko, Jan; Grambal, Ales; Sigmundova, Zuzana; Kasalova, Petra; Cakirpaloglu, Snezana

    2017-01-01

    There is no consensus on the definition of Quality of life (QoL). It is considered to be comprised of both psychological and somatical well-being. A variety of tools has been developed to measure subjective and objective (QoL). A number of factors, including demographical and medical may have an impact on QoL. The aim of our study was to compare the QoL in selected anxiety disorders and evaluate the influence of comorbid personality disorder. We evaluated data from 278 patients suffering from social phobia, panic disorder and/or agoraphobia, adjustment disorder, generalized anxiety disorder and obsessive-compulsive disorder. Personality disorders were diagnosed in 90 probands. The Quality of Life Enjoyment and Satisfaction (Q-LES-Q) was used to assess patients´perceived QoL. Up to our data there was no statistical difference in overall score of quality of life in selected anxiety disorders. The only significant difference between patients was found in subscale "household." Comorbid personality disorder had no influence on the overall score or any domain of Q-LES-Q. Our study proved that presence of anxiety disorder means a decrease in QoL. Particular anxiety disorders did not differ in overall scores of Q-LES-Q. Furthermore, comorbid personality disorder had no impact on quality of life of patients.

  6. Systematic Review of Cognitive-Behavioural Therapy for Social Anxiety Disorder in Psychosis.

    Science.gov (United States)

    Michail, Maria; Birchwood, Max; Tait, Lynda

    2017-04-25

    Social anxiety is highly prevalent among people with psychosis and linked with significant social disability and poorer prognosis. Although cognitive-behavioural therapy (CBT) has shown to be effective for the treatment of social anxiety in non-psychotic populations, there is a lack of evidence on the clinical effectiveness of CBT for the treatment of social anxiety when this is co-morbid in psychosis. A systematic review to summarise and critically appraise the literature on the effectiveness of CBT interventions for the treatment of social anxiety in psychosis. Two studies were included in the review assessing the effectiveness of group CBT for social anxiety in schizophrenia, both of poor methodological quality. Preliminary findings suggest that group-based CBT is effective in treating symptoms of social anxiety, depression and associated distress in people with schizophrenia. The evidence-base is not robust enough to provide clear implications for practice about the effectiveness of CBT for the treatment of social anxiety in psychosis. Future research should focus on methodologically rigorous randomised controlled trials with embedded process evaluation to assess the effectiveness of CBT interventions in targeting symptoms of social anxiety in psychosis and identify mechanisms of change.

  7. Brief CBT-I for insomnia comorbid with social phobia: A case study.

    Science.gov (United States)

    Tang, Nicole K Y

    2010-01-01

    Despite an obvious link between social anxiety and acute state of insomnia, chronic types of sleep disturbances in people with social phobia have so far received limited research/clinical attention. This case report aims to illustrate the possibility of rectifying sleep disturbances comorbid with social phobia, using a brief cognitive behaviour therapy for insomnia (CBT-I). Treatment involved five sessions of CBT-I provided individually on a weekly basis. Major treatment components included psychoeducation, sleep restriction therapy, stimulus control and cognitive restructuring. Treatment effects were assessed using sleep diary and questionnaires over the course of the treatment and at ~9 month follow-up. The results were encouraging with all targeted sleep parameters demonstrating improvements that met dual criteria for clinical significance. The gains were well maintained even at ~9 months after treatment. These improvements in sleep were accompanied by a reduction in sleep-related anxiety and dysfunctional beliefs and attitudes about sleep. Whilst the patient also reported a corresponding improvement in daytime functioning and general anxiety, no gains were observed in depression and social anxiety. These findings highlight the potential benefits of incorporating brief CBT-I into existing treatments for social phobia and encourage further research on the intricate relationship between sleep, mood and social anxiety.

  8. Anxiety Disorders in Old Age: Psychiatric Comorbidities, Quality of Life, and Prevalence According to Age, Gender, and Country.

    Science.gov (United States)

    Canuto, Alessandra; Weber, Kerstin; Baertschi, Marc; Andreas, Sylke; Volkert, Jana; Dehoust, Maria Christina; Sehner, Susanne; Suling, Anna; Wegscheider, Karl; Ausín, Berta; Crawford, Mike J; Da Ronch, Chiara; Grassi, Luigi; Hershkovitz, Yael; Muñoz, Manuel; Quirk, Alan; Rotenstein, Ora; Santos-Olmo, Ana Belén; Shalev, Arieh; Strehle, Jens; Wittchen, Hans-Ulrich; Schulz, Holger; Härter, Martin

    2018-02-01

    Previous estimates of the prevalence of anxiety disorders in late life vary greatly due to the lack of reliable diagnostic tools. This MentDis_ICF65+ study assessed 12-month prevalence rates of anxiety disorders and age- and gender-related differences in comorbidities, as well as impact on quality of life. The study used a cross-sectional multicenter survey. The study sample comprised 3,142 men and women aged 65 to 84 years, living in five European countries and Israel. Anxiety disorders were assessed using computer-assisted face-to-face interviews with an age-appropriate diagnostic interview (CIDI65+). The prevalence of anxiety disorders was 17.2%. Agoraphobia was the most frequent disorder (4.9%), followed by panic disorder (3.8%), animal phobia (3.5%), general anxiety disorder (3.1%), post-traumatic stress disorder (1.4%), social phobia (1.3%), and obsessive-compulsive disorder (0.8%). The prevalence rate of any anxiety disorder dropped by 40% to 47% in adults aged 75-84 years compared with those aged 65-74 years. Women were twice as likely to present with agoraphobia or general anxiety disorder as men. Only panic disorder and phobia were associated with comorbid major depression. The negative relationship with quality of life was limited to agoraphobia and generalized anxiety disorder. The age-appropriate CIDI65+ led to higher prevalence rates of anxiety disorders in the elderly, yet to weaker associations with comorbidities and impaired quality of life compared with previous studies. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  9. Cultural Aspects in Social Anxiety and Social Anxiety Disorder

    Science.gov (United States)

    Hofmann, Stefan G.; Asnaani, Anu; Hinton, Devon E.

    2010-01-01

    To examine cultural aspects in social anxiety and social anxiety disorder (SAD), we reviewed the literature on the prevalence rates, expressions, and treatments of social anxiety/SAD as they relate to culture, race, and ethnicity. We further reviewed factors that contribute to the differences in social anxiety/SAD between different cultures, including individualism/collectivism, perception of social norms, self-construal, gender roles, and gender role identification. Our review suggests that the prevalence and expression of social anxiety/SAD depends on the particular culture. Asian cultures typically show the lowest rates, whereas Russian and US samples show the highest rates, of SAD. Taijin kyofusho is discussed as a possible culture-specific expression of social anxiety, although the empirical evidence concerning the validity of this syndrome has been mixed. It is concluded that the individual's social concerns need to be examined in the context of the person's cultural, racial, and ethnic background in order to adequately assess the degree and expression of social anxiety and social anxiety disorder. This has direct relevance for the upcoming DSM-V. PMID:21132847

  10. Comorbidity of social anxiety disorder and antisocial personality disorder in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC).

    Science.gov (United States)

    Galbraith, Todd; Heimberg, Richard G; Wang, Shuai; Schneier, Franklin R; Blanco, Carlos

    2014-01-01

    Social anxiety disorder (SAD) and antisocial personality disorder (ASPD) are not often thought of as being comorbid. However, recent research suggests the existence of a SAD subtype with characteristics atypical of SAD but common to ASPD. Thus, we explored two competing hypotheses: (1) SAD and ASPD represent opposite ends of a single dimension, or (2) SAD and ASPD exist on two separate dimensions that may be positively correlated. Data were obtained from the National Epidemiological Survey on Alcohol and Related Conditions. SAD-ASPD was related to greater impairment and psychiatric comorbidity than either disorder alone. The SAD-ASPD group was also more likely to seek treatment for their SAD symptoms and to drink before/during antisocial acts than the SAD only group. The presence of SAD for individuals with ASPD (and vice versa) does not appear to provide any "protective benefits." SAD and ASPD appear to be two separate but correlated disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Comorbidity of Social Anxiety Disorder and Antisocial Personality Disorder in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC)

    Science.gov (United States)

    Galbraith, Todd; Heimberg, Richard G.; Wang, Shuai; Schneier, Franklin R.; Blanco, Carlos

    2013-01-01

    Social anxiety disorder (SAD) and antisocial personality disorder (ASPD) are not often thought of as being comorbid. However, recent research suggests the existence of a SAD subtype with characteristics atypical of SAD but common to ASPD. Thus, we explored two competing hypotheses: 1) SAD and ASPD represent opposite ends of a single dimension, or 2) SAD and ASPD exist on two separate dimensions that may be positively correlated. Data were obtained from the National Epidemiological Survey on Alcohol and Related Conditions. SAD-ASPD was related to greater impairment and psychiatric comorbidity than either disorder alone. The SAD-ASPD group was also more likely to seek treatment for their SAD symptoms and to drink before/during antisocial acts than the SAD only group. The presence of SAD for individuals with ASPD (and vice versa) does not appear to provide any “protective benefits.” SAD and ASPD appear to be two separate but correlated disorders. PMID:24384071

  12. Optogenetic insights on the relationship between anxiety-related behaviors and social deficits

    Science.gov (United States)

    Allsop, Stephen A.; Vander Weele, Caitlin M.; Wichmann, Romy; Tye, Kay M.

    2014-01-01

    Many psychiatric illnesses are characterized by deficits in the social domain. For example, there is a high rate of co-morbidity between autism spectrum disorders and anxiety disorders. However, the common neural circuit mechanisms by which social deficits and other psychiatric disease states, such as anxiety, are co-expressed remains unclear. Here, we review optogenetic investigations of neural circuits in animal models of anxiety-related behaviors and social behaviors and discuss the important role of the amygdala in mediating aspects of these behaviors. In particular, we focus on recent evidence that projections from the basolateral amygdala (BLA) to the ventral hippocampus (vHPC) modulate anxiety-related behaviors and also alter social interaction. Understanding how this circuit influences both social behavior and anxiety may provide a mechanistic explanation for the pathogenesis of social anxiety disorder, as well as the prevalence of patients co-diagnosed with autism spectrum disorders and anxiety disorders. Furthermore, elucidating how circuits that modulate social behavior also mediate other complex emotional states will lead to a better understanding of the underlying mechanisms by which social deficits are expressed in psychiatric disease. PMID:25076878

  13. Comorbidities, Social Impact, and Quality of Life in Tourette Syndrome.

    Science.gov (United States)

    Eapen, Valsamma; Cavanna, Andrea E; Robertson, Mary M

    2016-01-01

    Tourette syndrome (TS) is more than having motor and vocal tics, and this review will examine the varied comorbidities as well as the social impact and quality of life (QoL) in individuals with TS. The relationship between any individual and his/her environment is complex, and this is further exaggerated in the case of a person with TS. For example, tics may play a significant role in shaping the person's experiences, perceptions, and interactions with the environment. Furthermore, associated clinical features, comorbidities, and coexisting psychopathologies may compound or alter this relationship. In this regard, the common comorbidities include attention-deficit hyperactivity disorder and disruptive behaviors, obsessive compulsive disorder, and autism spectrum disorder, and coexistent problems include anxiety, depression, and low self-esteem, which can all lead to poorer psychosocial functioning and QoL. Thus, the symptoms of TS and the associated comorbid conditions may interact to result in a vicious cycle or a downward spiraling of negative experiences and poor QoL. The stigma and social maladjustment in TS and the social exclusion, bullying, and discrimination are considered to be caused in large part by misperceptions of the disorder by teachers, peers, and the wider community. Improved community and professional awareness about TS and related comorbidities and other psychopathologies as well as the provision of multidisciplinary services to meet the complex needs of this clinical population are critical. Future research to inform the risk and resilience factors for successful long-term outcomes is also warranted.

  14. Comorbid Anxiety Disorders and Personality Disorders%焦虑障碍与人格障碍的共病

    Institute of Scientific and Technical Information of China (English)

    黄建军; 柏晓利; 杨蕴萍

    2012-01-01

    目的:探讨焦虑障碍患者共病人格障碍的情况.方法:对127例符合DSM-IV轴I焦虑障碍的患者进行了DSM-IV轴II人格障碍的诊断评估,并进行汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、疾病严重程度(CGI-SI)、社会功能缺陷(SDSS)等评定.结果:①焦虑障碍与人格障碍的共病率为73.2%;②共病者焦虑障碍的发病年龄更早(P<0.01),焦虑障碍病程更长(P<0.05),疾病更加严重(P<0.01),其焦虑、抑郁水平更高(P<0.05;P<0.05),社会功能更差(P<0.01).结论:焦虑障碍与人格障碍有较高的共病率,焦虑障碍与人格障碍共病患者的临床特征更加复杂.%Objective: To get the prevalence rate of personality disorders in patients with anxiety disorders and to get the clinical features of these comorbid patients, the authors conducted a survey among a cohort of patients with anxiety disorder. Methods: Personality disorders of 127 patients meeting DSM-Ⅳcriteria of anxiety disorders were assessed by structured clinical interview for DSM-Ⅳ Axis Ⅱ, the Hamilton Anxiety Scale, the Hamilton Depression Scale, the Clinical Global Impression-Severity of Ⅰllness, and the Social Disability Screening Schedule. Results: The prevalence rate of personality disorders in patients with anxiety disorders was 73.2%. Compared with patients with anxiety disorders only, the patients with comorbid anxiety disorders and personality disorders had earlier age of onset of anxiety disorders (P<0.01), longer duration of anxiety disorder (P<0.05), greater severity of illness (P<0.01), worse impaired social function (P<0.01) and higher level of anxiety and depression (P<0.05; P<0.05). Conclusion: The prevalence rate of personality disorders in anxiety disorders is high in our research, and the clinical features of the comorbidity are complex.

  15. Cognitive-Behavior Therapy (CBT) for Panic Disorder: Relationship of Anxiety and Depression Comorbidity with Treatment Outcome

    OpenAIRE

    Allen, Laura B.; White, Kamila S.; Barlow, David H.; Shear, M. Katherine; Gorman, Jack M.; Woods, Scott W.

    2009-01-01

    Research evaluating the relationship of comorbidity to treatment outcome for panic disorder has produced mixed results. The current study examined the relationship of comorbid depression and anxiety to treatment outcome in a large-scale, multi-site clinical trial for cognitive-behavior therapy (CBT) for panic disorder. Comorbidity was associated with more severe panic disorder symptoms, although comorbid diagnoses were not associated with treatment response. Comorbid generalized anxiety disor...

  16. Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for Social Anxiety Disorder and comorbid disorders: A randomized controlled trial.

    Science.gov (United States)

    Dear, B F; Staples, L G; Terides, M D; Fogliati, V J; Sheehan, J; Johnston, L; Kayrouz, R; Dear, R; McEvoy, P M; Titov, N

    2016-08-01

    Disorder-specific (DS-CBT) and transdiagnostic (TD-CBT) cognitive behaviour therapy have both been used to treat social anxiety disorder (SAD). This study compared internet-delivered DS-CBT and TD-CBT for SAD across clinician-guided (CG-CBT) and self-guided (SG-CBT) formats. Participants with SAD (n=233) were randomly allocated to receive internet-delivered TD-CBT or DS-CBT and CG-CBT or SG-CBT. Large reductions in symptoms of SAD (Cohen's d≥1.01; avg. reduction≥30%) and moderate-to-large reductions in symptoms of comorbid depression (Cohen's d≥1.25; avg. reduction≥39%), generalised anxiety disorder (Cohen's d≥0.86; avg. reduction≥36%) and panic disorder (Cohen's d≥0.53; avg. reduction≥25%) were found immediately post-treatment and were maintained or further improved to 24-month follow-up. No marked differences were observed between TD-CBT and DS-CBT or CG-CBT and SG-CBT highlighting the potential of each for the treatment of SAD and comorbid disorders. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  17. Comorbid anxiety disorders alter the association between cardiovascular diseases and depression: the German National Health Interview and Examination Survey.

    Science.gov (United States)

    Tully, Phillip J; Baune, Bernhard T

    2014-05-01

    This study aims to examine whether specific anxiety disorder comorbidity alters the purported association between depression and specific cardiovascular diseases (CVDs). In 4,181 representative German participants of the general population, 12-month prevalence of psychiatric disorders was assessed through the Composite International Diagnostic Interview and CVDs by physician verified diagnosis. Adjusting for conventional risk factors logistic regression analyzed the association between CVDs (peripheral vascular disease (PVD), hypertension, cerebrovascular disease and heart disease) and combinations of comorbidity between depression and anxiety disorder types (panic disorder, specific phobia, social phobia and generalized anxiety). There were 770 cases of hypertension (18.4 %), 763 cases of cerebrovascular disease (18.2 %), 748 cases of PVD (17.9 %), and 1,087 cases of CVD (26.0 %). In adjusted analyses phobia comorbid with depression was associated with cerebrovascular disease (odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.04-2.50) as was panic disorder (OR 2.89; 95 % CI 1.47-5.69). PVD was significantly associated with panic disorder (adjusted OR 2.97; 95 % CI 1.55-5.69). Panic disorder was associated with CVDs (adjusted OR 2.28; 95 % CI 1.09-4.77) as was phobia (adjusted OR 1.35; 95 % CI 1.04-1.78). Classification of anxiety and depression according to comorbidity groups showed discrete effects for panic disorder and specific phobia with CVDs, independent from covariates and depression.

  18. Illness appraisals and self-esteem as correlates of anxiety and affective comorbid disorders in schizophrenia.

    Science.gov (United States)

    Karatzias, Thanos; Gumley, Andrew; Power, Kevin; O'Grady, Margaret

    2007-01-01

    Comorbidity of anxiety and affective disorders in people with a diagnosis of schizophrenia is common. This study investigated the hypothesis that greater negative beliefs about illness and lower self-esteem will be significantly associated with the presence of anxiety or affective comorbidity in a sample of persons (n = 138) diagnosed with schizophrenia. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; the Positive and Negative Syndrome Scale; the Global Assessment of Functioning Scale; the Personal Beliefs about Illness Questionnaire; and the Rosenberg Self-Esteem Scale were all completed for each participant. Of the total sample, 62 (44.9%) had a comorbid anxiety or affective disorder. Logistic regression revealed that those with a comorbid anxiety or affective disorder had significantly lower levels of functioning (Global Assessment of Functioning), more negative appraisals of entrapment in psychosis (Personal Beliefs about Illness Questionnaire), and lower levels of self-esteem (Rosenberg Self-Esteem Scale). Although further research is required, the strong association between personal beliefs about self and illness and comorbidity suggests that negative beliefs about psychotic experiences and self-esteem may be linked to the development and maintenance of anxiety and affective comorbid conditions among people with a diagnosis of schizophrenia or the like.

  19. Atomoxetine Treatment for Pediatric Patients with Attention-Deficit/Hyperactivity Disorder with Comorbid Anxiety Disorder

    Science.gov (United States)

    Geller, Daniel; Donnelly, Craig; Lopez, Frank; Rubin, Richard; Newcorn, Jeffrey; Sutton, Virginia; Bakken, Rosalie; Paczkowski, Martin; Kelsey, Douglas; Sumner, Calvin

    2007-01-01

    Objective: Research suggests 25% to 35% of children with attention-deficit/hyperactivity disorder (ADHD) have comorbid anxiety disorders. This double-blind study compared atomoxetine with placebo for treating pediatric ADHD with comorbid anxiety, as measured by the ADHD Rating Scale-IV-Parent Version: Investigator Administered and Scored…

  20. Comorbidity in Emetophobia (Specific Phobia of Vomiting).

    Science.gov (United States)

    Sykes, Mark; Boschen, Mark J; Conlon, Elizabeth G

    2016-07-01

    Emetophobia (fear of vomiting) is an anxiety disorder in which individuals report clinical levels of fear that they may vomit or be exposed to the vomit of others. The prevalence of comorbidity of emetophobia with other conditions has previously only been investigated using self-report instruments. Sixty-four adults with emetophobia participated in an online structured clinical diagnostic interview assessing the presence of emetophobia and other conditions. Higher comorbidity for depression, generalized anxiety disorder, panic disorder, social anxiety disorder and obsessive-compulsive disorder were found in participants compared with general population norms. Emetophobia is commonly comorbid with other anxiety and depressive disorders. Comorbidity rates, when assessed using a structured clinical interview, were lower than previously reported using self-report alone. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Emetophobia (specific phobia of vomiting) is a clinical fear of vomiting. Individuals with emetophobia show high comorbidity with other anxiety and mood disorders. The most common comorbid conditions were generalized anxiety disorder, panic disorder, hypochondriasis and obsessive-compulsive disorder. Clinicians should ensure that they assess for the presence of comorbid conditions when treating emetophobia. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness

    Science.gov (United States)

    McLean, Carmen P.; Asnaani, Anu; Litz, Brett T.; Hofmann, Stefan G.

    2011-01-01

    Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N = 20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women had higher rates of lifetime diagnosis for each of the anxiety disorders examined, except for social anxiety disorder which showed no gender difference in prevalence. No gender differences were observed in the age of onset and chronicity of the illness. However, women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Furthermore, anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extend also among Hispanic women. These results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men. PMID:21439576

  2. Social anxiety symptoms in alcohol-dependent outpatients: prevalence, severity and predictors

    Directory of Open Access Journals (Sweden)

    Nicoli Tamie Yoshimi

    2016-06-01

    Full Text Available ABSTRACT Objectives High rates of comorbidity between social anxiety disorder (SAD and alcohol use disorders have been reported, but the predictors of this comorbidity are poorly known and most studies involve primary SAD samples. The aims were to estimate the prevalence and severity of SAD symptoms among alcohol-dependent patients and to investigate sociodemographic and clinical factors associated with SAD comorbidity, including suicidal behaviors. Methods A cross-sectional study with 53 adults who were in treatment for alcohol dependence at a Brazilian public university outpatient service. Assessment instruments Social Phobia Inventory (SPIN, Short Alcohol Dependence Data and Beck Depression Inventory. Bivariate analyses between the categorical outcome (Probable SAD: SPIN ≥ 19 and explanatory variables were conducted. Correlates of SPIN total and subscales scores (dimensional outcomes were also investigated. Results The diagnosis and treatment of alcohol dependence occurred, on average, 30 years after the onset of alcohol use and 39.6% of the 53 patients (37 men and 16 women reported alleviation of social anxiety symptoms with alcohol use. Twenty-four (45.3% patients presented probable SAD. These patients differed from non-SAD alcohol-dependent individuals by having lower income and higher frequency of depression, suicidal ideation, suicide plans and attempts. The SPIN subscales mostly associated with suicidal behaviors were social inadequacy and social inferiority. Conclusions SAD symptoms are common among help-seeking alcohol-dependent individuals and should be directly investigated and treated, since depression and suicidality are associated with this comorbidity. Prospective studies are needed to assess the impact of SAD treatment on the clinical course of alcohol dependence.

  3. Anxiety Disorders Comorbidity in Iranian Patients with Mood Disorders and Its' Relationship with Suicidal Attempt

    Directory of Open Access Journals (Sweden)

    Amir Shabani

    2007-08-01

    Full Text Available     Objective: Several studies show co morbidity of anxiety disorders amongst patients with bipolar and unipolar disorders. It is associated with an intensification of symptoms, insufficient treatment response, non recovery, poor functional outcome and suicidality. The aim of this study was to show the frequency of anxiety disorders comorbidity and the relationship between comorbidity and suicide attempt in these patients.         Method: In a descriptive study, 152 patients with bipolar and unipolar disorders in a psychiatric center were assessed with SCID. Current and lifetime comorbidity in bipolar and unipolar patients were analyzed.         Results: One hundred fifty two subjects aged 18-60 years were included in the study and102 bipolar I, 11 bipolar II, and 39 unipolar patients were diagnosed.Co morbidity in each group was 21.2%, 11.5%, and 43.5%. Suicide attempt in patients with bipolar disorders and anxiety disorders comorbidity was significantly more than patients with bipolar disorders without co morbidity.     Conclusions: Significant proportions of patients with bipolar and unipolar disorder had co morbid anxiety disorders. Moreover, anxiety disorders comorbidity may be associated with more suicide attempt in bipolar patients,highlighting the need for greater clinical attention to anxiety in this population, particularly for enhanced clinical monitoring of suicidality. In addition, it is important to determine whether an effective treatment of anxiety symptoms can reduce suicidality.

  4. Influence of alcohol on social anxiety: an investigation of attentional, physiological and behavioral effects.

    Science.gov (United States)

    Stevens, Stephan; Cludius, Barbara; Bantin, Trisha; Hermann, Christiane; Gerlach, Alexander L

    2014-02-01

    Social anxiety disorder and alcohol use disorders are highly comorbid. It remains unclear, however, if and how alcohol influences attentional processes and physical symptoms in social anxiety. In a balanced-placebo-design, high and normally socially anxious participants gave a speech while performing a task, which simultaneously measures internal and external attention. Only high anxious participants showed a preferential processing of external probes, which was eliminated by alcohol or the mere expectation of drinking alcohol. Furthermore, alcohol reduced facial blushing as well as self-reported social anxiety during public speaking. Decreases in anxiety were significantly associated with a reduction of the external focus in the high anxious group. Understanding alcohol as a substance influencing cognitive processes as well as physiological symptoms of anxiety further contributes to our understanding of alcohol use as a safety behavior in social anxiety disorder. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. The influence of comorbid anxiety on the effectiveness of Cognitive Therapy and Interpersonal Psychotherapy for Major Depressive Disorder.

    Science.gov (United States)

    van Bronswijk, Suzanne C; Lemmens, Lotte H J M; Huibers, Marcus J H; Arntz, Arnoud; Peeters, Frenk P M L

    2018-05-01

    Anxious depression is an important subtype of Major Depressive Disorder (MDD) defined by both syndromal (anxiety disorders) and dimensional (anxiety symptoms) criteria. A debated question is how anxiety affects MDD treatment. This study examined the impact of comorbid anxiety disorders and symptoms on the effectiveness of and dropout during Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for MDD. Depressed individuals were randomized to CT (n = 76) or IPT (n = 75). Outcome was depression severity measured with the Beck Depression Inventory-II (BDI-II) at the start of each therapy session, post treatment, and monthly up to five months follow-up. Anxiety disorders were assessed with the Structured Clinical Interview for DSM-IV Axis I disorders, (phobic) anxiety symptoms were assessed with Brief Symptom Inventory subscales. Approximately one third of participants had a comorbid anxiety disorder. Comorbid anxiety disorders and anxiety symptoms were associated with less favorable depression change during IPT as compared to CT in the treatment phase, but not in the trial follow-up phase. Individuals with a comorbid anxiety disorder had significantly higher treatment dropout during both treatments. Not all therapists and participants were blind to the assessment of comorbid anxiety disorders and the assessments were performed by one rater. A preference for CT over IPT for MDD is justifiable when comorbid anxiety is present, although long-term differences are not established and replication of this finding is needed. Clinicians should be aware of the risk of dropout for depressed individuals with an anxiety disorder. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Disease management for co-morbid depression and anxiety in diabetes mellitus

    DEFF Research Database (Denmark)

    Stoop, Corinne H; Spek, Viola R M; Pop, Victor J M

    2011-01-01

    BACKGROUND: Depression and anxiety are common co-morbid health problems in patients with type 2 diabetes. Both depression and anxiety are associated with poor glycaemic control and increased risk of poor vascular outcomes and higher mortality rates. Results of previous studies have shown that in ...

  7. Suicide in late-life depression with and without comorbid anxiety disorders

    NARCIS (Netherlands)

    Oude Voshaar, Richard; Veen, D. C. van der; Hunt, I.; Kapur, N.

    OBJECTIVE: Comorbid anxiety in depression increases the risk of suicidal ideation and behavior, although data on death by suicide are scarce. We compared characteristics of depressed elderly patients with and without anxiety disorders who died by suicide. METHODS: From a 16-year clinical survey of

  8. Prevalence and co-morbidity among anxiety disorders in a national cohort of psychiatrically referred children and adolescents

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Hoeyer, Mette; Dyrborg, Jørgen

    2010-01-01

    The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from a data...... as routine to increase the precision in recognizing and reporting on childhood anxiety disorders.......The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from...... a database containing 83% of all youth referred from 2004 to 2007 (N=13,241). A prevalence of 5.7% of anxiety disorder was found in the sample. Homotypic co-morbidity was found in only 2.8%, whereas heterotypic co-morbidity was found in 42.9% of the cohort. A total of 73.6% had a principal anxiety disorder...

  9. Comorbidities, Social Impact, and Quality of Life in Tourette Syndrome

    Science.gov (United States)

    Eapen, Valsamma; Cavanna, Andrea E.; Robertson, Mary M.

    2016-01-01

    Tourette syndrome (TS) is more than having motor and vocal tics, and this review will examine the varied comorbidities as well as the social impact and quality of life (QoL) in individuals with TS. The relationship between any individual and his/her environment is complex, and this is further exaggerated in the case of a person with TS. For example, tics may play a significant role in shaping the person’s experiences, perceptions, and interactions with the environment. Furthermore, associated clinical features, comorbidities, and coexisting psychopathologies may compound or alter this relationship. In this regard, the common comorbidities include attention-deficit hyperactivity disorder and disruptive behaviors, obsessive compulsive disorder, and autism spectrum disorder, and coexistent problems include anxiety, depression, and low self-esteem, which can all lead to poorer psychosocial functioning and QoL. Thus, the symptoms of TS and the associated comorbid conditions may interact to result in a vicious cycle or a downward spiraling of negative experiences and poor QoL. The stigma and social maladjustment in TS and the social exclusion, bullying, and discrimination are considered to be caused in large part by misperceptions of the disorder by teachers, peers, and the wider community. Improved community and professional awareness about TS and related comorbidities and other psychopathologies as well as the provision of multidisciplinary services to meet the complex needs of this clinical population are critical. Future research to inform the risk and resilience factors for successful long-term outcomes is also warranted. PMID:27375503

  10. Attention bias for social threat in youth with tic disorders: Links with tic severity and social anxiety.

    Science.gov (United States)

    Pile, Victoria; Robinson, Sally; Topor, Marta; Hedderly, Tammy; Lau, Jennifer Y F

    2018-06-07

    Many individuals with Tourette syndrome and chronic tic disorders (TS/CTDs) report poor social functioning and comorbid social anxiety. Yet limited research has investigated the role of cognitive factors that highlight social threats in youth with TS/CTD, and whether these biases underlie tic severity and co-occurring social anxiety. This study examined whether selective attention to social threat is enhanced young people with TS/CTDs compared to healthy controls, and whether attention biases are associated with tic severity and social anxiety. Twenty seven young people with TS/CTDs and 25 matched control participants completed an experimental measure of attention bias toward/away from threat stimuli. A clinician-rated interview measuring tic severity/impairment (YGTSS Total Score) and questionnaire measures of social anxiety were completed by participants and their parents. Young people with TS/CTD showed an attention bias to social threat words (relative to benign words) compared to controls but no such bias for social threat faces. Attention bias for social threat words was associated with increasing YGTSS Total Score and parent-reported social anxiety in the TS/CTDs group. Mediation analysis revealed a significant indirect path between YGTSS Total Score and social anxiety, via attention to social threat. Tentatively, these associations appeared to be driven by impairment rather than tic severity scores. Preliminary data suggests that youth with TS/CTD have enhanced attention to threat, compared to controls, and this is associated with impairment and social anxiety. Attention to threat could offer a cognitive mechanism connecting impairment and social anxiety, and so be a valuable trans-diagnostic treatment target.

  11. Fearful imagery in social phobia: generalization, comorbidity, and physiological reactivity.

    Science.gov (United States)

    McTeague, Lisa M; Lang, Peter J; Laplante, Marie-Claude; Cuthbert, Bruce N; Strauss, Cyd C; Bradley, Margaret M

    2009-03-01

    Social phobia has been characterized as a disorder of exaggerated fear of social threat and heightened sensitivity to imagery of social failure. To assess the physiological basis of this description, social phobia patients (n=75) and demographically matched control participants (n=75) imagined neutral and fearful events while acoustic startle probes were occasionally presented and eye-blink responses (orbicularis occuli) recorded. Changes in heart rate, skin conductance level, and facial expressivity were also indexed. In addition to comparing control participants and social phobia patients, the influences of diagnostic subtype (circumscribed, generalized), comorbid depression, and chronicity were assessed. Patients exceeded control participants in startle reflex and autonomic responding during imagery of social threat, whereas the groups evinced commensurate reactivity to contents depicting commonly shared fears (survival threat). Individuals with circumscribed performance phobia were similar to control participants, with the exception of more robust reactions to idiographic, performance fear imagery. In contrast, generalized phobic patients were characterized by longer disorder chronicity and demonstrated heightened sensitivity to a broader range of fear contents. Those with generalized phobia plus comorbid depression showed attenuation of fear-potentiated startle and reported the most protracted social anxiety. Subtypes of social phobia can be objectively distinguished in patterns of physiological reactivity. Furthermore, subtypes vary systematically in chronicity and defensive engagement with the shortest disorder duration (circumscribed phobia) associated with the most robust and focal physiological reactivity, followed by broader defensive sensitivity in more chronic generalized phobia, and finally attenuation of the formerly exaggerated fear potentiation in the comorbidly depressed, the most chronic form.

  12. Social anxiety and Internet socialization in Indian undergraduate students: An exploratory study.

    Science.gov (United States)

    Honnekeri, Bianca S; Goel, Akhil; Umate, Maithili; Shah, Nilesh; De Sousa, Avinash

    2017-06-01

    Social Anxiety Disorder (SAD) is a globally prevalent, chronic, debilitating psychiatric disorder affecting youth. With comorbidities including major depression, substance abuse, lower educational and work attainment, and increased suicide risk, it has a significant public health burden. The objective of this study was to estimate the prevalence of SAD in urban Indian undergraduate students and to study their Facebook (FB) usage patterns. In this exploratory cross-sectional study, 316 undergraduate students were screened for social anxiety using validated instruments, Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS), and divided into two groups based on scores obtained. The groups were then compared with regards to behaviors and attitudes toward Facebook, obtained from a self-report questionnaire. SAD was estimated to be a significant, prevalent (7.8%) disorder in otherwise productive youth, and showed female preponderance. Higher specific social phobia scores were associated with the inability to reduce Facebook use, urges toward increasing use, spending more time thinking about Facebook, negative reactions to restricting use, and using it to forget one's problems. SAD was estimated to have a prevalence of 7.8% in our study, and was associated with stronger FB usage attitudes and patterns. We recommend that the relationship between social anxiety and Internet use be explored further, to study the possibility of Internet-based screening and intervention strategies having wider reach and appeal in socially anxious individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder.

    Science.gov (United States)

    White, Daniela; Tavakoli, Sason

    2015-08-01

    Repetitive transcranial magnetic stimulation (rTMS) has shown promising results in treating individuals with behavioral disorders such as major depressive disorder (MDD), posttraumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder. A number of applications of rTMS to different regions of the left and right prefrontal cortex have been used to treat these disorders, but no study of treatment for MDD with generalized anxiety disorder (GAD) has been conducted with application of rTMS to both the left and right prefrontal cortex. We hypothesized that applying low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) before applying it to the left DLPFC for the treatment of depression would be anxiolytic in patients with MDD with GAD. Thirteen adult patients with comorbid MDD and GAD received treatment with rTMS in an outpatient setting. The number of treatments ranged from 24 to 36 over 5 to 6 weeks. Response was defined as a ≥ 50% reduction in symptoms from baseline, and remission was defined as a score of anxiety symptoms on the 7-item Generalized Anxiety Disorder (GAD-7) scale and depressive symptoms on the 21-item Hamilton Rating Scale for Depression (HAM-D-21). At the end of the treatment period, for the GAD-7 scale, 11 out of 13 (84.6%) patients' anxiety symptoms were in remission, achieving a score of depressive symptoms. In this small pilot study of 13 patients with comorbid MDD and GAD, significant improvement in anxiety symptoms along with depressive symptoms was achieved in a majority of patients after bilateral rTMS application.

  14. Social anxiety disorder

    Science.gov (United States)

    Phobia - social; Anxiety disorder - social; Social phobia; SAD - social anxiety disorder ... People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in ...

  15. Exploring the role of the DSM-5 performance-only specifier in adolescents with social anxiety disorder.

    Science.gov (United States)

    Fuentes-Rodriguez, Gema; Garcia-Lopez, Luis-Joaquin; Garcia-Trujillo, Veronica

    2018-03-23

    The DSM-5 social anxiety disorder section has recently added the performance-only specifier for individuals whose anxiety is limited to speaking or performing in public. The impact of the DSM-5 performance-only specifier remains a neglected area. The sample comprised 44 healthy controls and 50 adolescents with a clinical diagnosis of SAD (20% met criteria for the performance-only specifier). Findings revealed that adolescents with the specifier had a later age of onset; lower levels of depression, social anxiety symptomatology and clinical severity; and a lesser degree of comorbidity relative to adolescents with SAD but excluding the performance-only specifier. Specifiers only evidenced higher (cognitive) social anxiety symptomatology compared to healthy controls. Results of this study also suggested that the performance-only specifier may correspond to a mild form of social anxiety disorder. Data also revealed that SAD exists on a continuum of severity among healthy controls, specifier participants, and those with both interactional and performance fears, which is consistent with a dimensional structure for SAD. Finally, findings suggested a unique comorbid pattern for specifiers and those adolescents with SAD but excluding the performance-only specifier. The implications of these findings for the etiology, assessment, classification, and treatment of social anxiety in youth are discussed. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Stepped care versus face-to-face cognitive behavior therapy for panic disorder and social anxiety disorder: Predictors and moderators of outcome.

    Science.gov (United States)

    Haug, Thomas; Nordgreen, Tine; Öst, Lars-Göran; Kvale, Gerd; Tangen, Tone; Andersson, Gerhard; Carlbring, Per; Heiervang, Einar R; Havik, Odd E

    2015-08-01

    To investigate predictors and moderators of treatment outcome by comparing immediate face-to-face cognitive behavioral therapy (FtF-CBT) to a Stepped Care treatment model comprising three steps: Psychoeducation, Internet-delivered CBT, and FtF-CBT for panic disorder (PD) and social anxiety disorder (SAD). Patients (N = 173) were recruited from nine public mental health out-patient clinics and randomized to immediate FtF-CBT or Stepped Care treatment. Characteristics related to social functioning, impairment from the anxiety disorder, and comorbidity was investigated as predictors and moderators by treatment format and diagnosis in multiple regression analyses. Lower social functioning, higher impairment from the anxiety disorder, and a comorbid cluster C personality disorder were associated with significantly less improvement, particularly among patients with PD. Furthermore, having a comorbid anxiety disorder was associated with a better treatment outcome among patients with PD but not patients with SAD. Patients with a comorbid depression had similar outcomes from the different treatments, but patients without comorbid depression had better outcomes from immediate FtF-CBT compared to guided self-help. In general, the same patient characteristics appear to be associated with the treatment outcome for CBT provided in low- and high-intensity formats when treated in public mental health care clinics. The findings suggest that patients with lower social functioning and higher impairment from their anxiety disorder benefit less from these treatments and may require more adapted and extensive treatment. CLINICALTRIALS.GOV: Identifier: NCT00619138. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Eating disorders with and without comorbid depression and anxiety: similarities and differences in a clinical sample of children and adolescents.

    Science.gov (United States)

    Hughes, Elizabeth K; Goldschmidt, Andrea B; Labuschagne, Zandre; Loeb, Katharine L; Sawyer, Susan M; Le Grange, Daniel

    2013-09-01

    This study aimed to describe and compare the demographic and clinical characteristics of children and adolescents with an eating disorder (ED) and comorbid depression or anxiety. Data were drawn from intake assessments of children and adolescents at a specialist ED clinic. Demographic characteristics (e.g. age and gender) and clinical characteristics (e.g. body mass, binge eating and purging) were compared between 217 ED participants without comorbidity, 32 with comorbid anxiety, 86 with comorbid depression and 36 with comorbid anxiety and depression. The groups with comorbid depression had more complex and severe presentations compared with those with an ED and no comorbid disorder and those with comorbid anxiety alone, especially in regard to binge eating, purging, dietary restraint and weight/shape concerns. Depression and anxiety were differentially related to clinical characteristics of EDs. The findings have implications for understanding the relations between these disorders and their potential to impact outcome of ED treatments. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

  18. Online social networking addiction among college students in Singapore: Comorbidity with behavioral addiction and affective disorder.

    Science.gov (United States)

    Tang, Catherine So-Kum; Koh, Yvaine Yee Woen

    2017-02-01

    This study aimed to determine the prevalence of addiction to social networking sites/platforms (SNS) and its comorbidity with other behavioral addiction and affective disorder among college students in Singapore. 1110 college students (age: M=21.46, SD=1.80) in Singapore completed measures assessing online social networking, unhealthy food intake and shopping addiction as well as depression, anxiety and mania. Descriptive analyses were conducted to investigate the prevalence and comorbidity of behavioral addiction and affective disorder. Chi-square tests were used to examine gender differences. The prevalence rates of SNS, food and shopping addiction were 29.5%, 4.7% and 9.3% respectively for the total sample. SNS addiction was found to co-occur with food addiction (3%), shopping addiction (5%), and both food and shopping addiction (1%). The comorbidity rates of SNS addiction and affective disorder were 21% for depression, 27.7% for anxiety, and 26.1% for mania. Compared with the total sample, students with SNS addiction reported higher comorbidity rates with other behavioral addiction and affective disorder. In general, females as compared to males reported higher comorbidity rates of SNS addiction and affective disorder. SNS addiction has a high prevalence rate among college students in Singapore. Students with SNS addiction were vulnerable to experience other behavior addiction as well as affective disorder, especially among females. Copyright © 2016. Published by Elsevier B.V.

  19. Evaluation of social anxiety, self-esteem, life quality in adolescents with acne vulgaris.

    Science.gov (United States)

    Unal, Dilek; Emiroğlu, Nazan; Cengiz, Fatma Pelin

    2016-08-05

    Acne vulgaris is a visible skin disease commonly seen in adolescence. As it affects the appearance, it is likely to bring stress to the adolescent's life regarding sensitivity about their appearance. The aim of the study was to investigate the social anxiety level, acne-specific life quality, and self-esteem among adolescents with acne vulgaris. In addition, we evaluated the relationship between these parameters, clinical severity, and sociodemographic data. One hundred and two adolescents with acne vulgaris, aged 12-17 years without any psychiatric or medical comorbidity were recruited. The control group consisted of 83 adolescents in the same age range, who had neither psychiatric disease nor acne. Sociodemographic form (SDF), Capa Social Phobia Scale for Children and Adolescents (CSPSCA), and Rosenberg Self-esteem Scale (RSES) were applied to both groups. Additionally, the severity of acne was determined with Global Acne Grading System (GAGS), and life quality of the patients was evaluated with Acne Quality of Life Scale (AQOL). There was no significant difference in social anxiety levels and self-esteem between the study and control groups. Life quality impairment and high social anxiety levels, as well as low self-esteem, were found to be associated regardless of the clinical severity. Clinicians should be aware of the psychiatric comorbidities when treating adolescents with acne vulgaris. Especially, low self-esteem and life quality impairment should warn clinicians to predict high social anxiety levels in adolescent acne patients.

  20. Co-morbidities, social impact and quality of life in Tourette syndrome

    Directory of Open Access Journals (Sweden)

    Valsamma eEapen

    2016-06-01

    Full Text Available Tourette Syndrome (TS is more than having motor and vocal tics, and this review will examine the varied co-morbidities as well as the social impact and Quality of Life (QoL in individuals with TS. The relationship between any individual and his/her environment is complex and this is further exaggerated in the case of a person with TS. For example, tics may play a significant role in shaping the person’s experiences, perceptions and interactions with the environment. Further, associated clinical features, co-morbidities and co-existing psychopathologies may compound or alter this relationship. The common co-morbidities in this regard include Attention Deficit Hyperactivity Disorder (ADHD and disruptive behaviours, Obsessive Compulsive Disorder (OCD and Autism Spectrum Disorder (ASD, and co-existent problems include anxiety, depression and low self esteem, which can all lead to poorer psychosocial functioning and QoL. Thus, the symptoms of TS and the associated co-morbid conditions may interact to result in a vicious cycle or a downward spiralling of negative experiences and poor QoL. The stigma and social maladjustment in TS and the social exclusion, bullying and discrimination is considered to be caused in large part by misperceptions of the disorder by teachers, peers, and the wider community. Improved community and professional awareness about TS and related co-morbidities & other psychopathologies as well as the provision of multidisciplinary services to meet the complex needs of this clinical population are critical. Future research to inform the risk and resilience factors for successful long term outcomes is also warranted.

  1. Conditioned Subjective Responses to Socially Relevant Stimuli in Social Anxiety Disorder and Subclinical Social Anxiety.

    Science.gov (United States)

    Tinoco-González, Daniella; Fullana, Miquel Angel; Torrents-Rodas, David; Bonillo, Albert; Vervliet, Bram; Pailhez, Guillem; Farré, Magí; Andión, Oscar; Perez, Víctor; Torrubia, Rafael

    2015-01-01

    Although enhanced fear conditioning has been implicated in the origins of social anxiety disorder (SAD), laboratory evidence in support of this association is limited. Using a paradigm employing socially relevant unconditioned stimuli, we conducted two separate studies to asses fear conditioning in individuals with SAD and non-clinical individuals with high social anxiety (subclinical social anxiety [SSA]). They were compared with age-matched and gender-matched individuals with another anxiety disorder (panic disorder with agoraphobia) and healthy controls (Study 1) and with individuals with low social anxiety (Study 2). Contrary to our expectations, in both studies, self-report measures (ratings of anxiety, unpleasantness and arousal to the conditioned stimuli) of fear conditioning failed to discriminate between SAD or SSA and the other participant groups. Our results suggest that enhanced fear conditioning does not play a major role in pathological social anxiety. We used a social conditioning paradigm to study fear conditioning in clinical and subclinical social anxiety. We found no evidence of enhanced fear conditioning in social anxiety individuals. Enhanced fear conditioning may not be a hallmark of pathological social anxiety. Copyright © 2014 John Wiley & Sons, Ltd.

  2. Neural sensitivity to social reward and punishment anticipation in Social Anxiety Disorder.

    Directory of Open Access Journals (Sweden)

    Henk eCremers

    2015-01-01

    Full Text Available An imbalance in the neural motivational system may underlie Social Anxiety Disorder (SAD. This study examines social reward and punishment anticipation in SAD, predicting a valence-specific effect: increased striatal activity for punishment avoidance compared to obtaining a reward. Individuals with SAD (n=20 and age, gender, and education case-matched controls (n=20 participated in a functional magnetic resonance imaging (fMRI study. During fMRI scanning, participants performed a Social Incentive Delay task to measure the anticipation of social reward and punishment. The left putamen (part of the striatum showed a valence-specific interaction with group after correcting for medication use and comorbidity. The control group showed a relatively stronger activation for reward vs. punishment trials, compared to the social anxiety group. However, post-hoc pairwise comparisons were not significant, indicating that the effect is driven by a relative difference. A connectivity analysis (Psychophysiological interaction further revealed a general salience effect: SAD patients showed decreased putamen-ACC connectivity compared to controls for both reward and punishment trials. Together these results suggest that the usual motivational preference for social reward is absent in SAD. In addition, cortical control processes during social incentive anticipation may be disrupted in SAD. These results provide initial evidence for altered striatal involvement in both valence-specific and valence nonspecific processing of social incentives, and stress the relevance of taking motivational processes into account when studying social anxiety.

  3. Social Exclusion Anxiety

    DEFF Research Database (Denmark)

    Søndergaard, Dorte Marie

    2017-01-01

    Social exclusion anxiety is a term which builds on a social-psychological concept of human beings as existentially dependent on social embeddedness. This entry explores the concept in relation to bullying among children, which is a widespread and serious problem in schools and institutions. Social...... exclusion anxiety and longing for belonging are both central aspects of the affects and processes that enact and challenge social groups. Social exclusion anxiety should not be confused with ‘social phobia’, which is a concept within clinical psychology that focuses on the individual and refers to a phobic...... psychological condition. Social exclusion anxiety instead points to a distributed affect which circulates and smolders in all social groups. This is the result of an ever-present risk of someone being judged unworthy to belong to, or deemed not a legitimate participant in, a social group. Such anxiety may...

  4. Comorbidity of Anxiety and Conduct Problems in Children: Implications for Clinical Research and Practice

    Science.gov (United States)

    Cunningham, Natoshia Raishevich; Ollendick, Thomas H.

    2010-01-01

    Given the relative lack of research on the comorbidity of anxiety disorders (ADs) and conduct problems (oppositional defiant disorder, conduct disorder) in youth, we examine this comorbidity from both basic and applied perspectives. First, we review the concept of comorbidity and provide a framework for understanding issues pertaining to…

  5. Predominantly Inattentive Type of ADHD is Associated With Social Anxiety Disorder.

    Science.gov (United States)

    Koyuncu, Ahmet; Ertekin, Erhan; Yüksel, Çağrı; Aslantaş Ertekin, Banu; Çelebi, Fahri; Binbay, Zerrin; Tükel, Raşit

    2015-10-01

    The aim of this study was to determine the frequency of childhood ADHD comorbidity in patients with social anxiety disorder (SAD), and the influence of this comorbidity on various demographic and clinical variables in SAD. A total of 130 patients with SAD were assessed with K-SADS-PL's (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version) behavioral disorders module to determine the childhood diagnosis of ADHD. Patients with or without a comorbid childhood ADHD were compared in terms of clinical characteristics and rating scores. The mean age at onset of SAD was lower, and lifetime major depressive disorder and bipolar disorder (BD) comorbidity were higher in the SAD-ADHD group than in the SAD-without ADHD group. We have found high ADHD comorbidity in patients with SAD. Presence of comorbid ADHD was associated with increased severity, functional impairment, and BD comorbidity. © 2014 SAGE Publications.

  6. Transdiagnostic Treatment of Bipolar Disorder and Comorbid Anxiety with the Unified Protocol: A Clinical Replication Series

    Science.gov (United States)

    Ellard, Kristen K.; Deckersbach, Thilo; Sylvia, Louisa G.; Nierenberg, Andrew A.; Barlow, David H.

    2012-01-01

    Bipolar disorder (BD) is a chronic, debilitating disorder with recurrent manic and depressive episodes. More than 75% of bipolar patients have a current or lifetime diagnosis of a comorbid anxiety disorder. Comorbid anxiety in BD is associated with greater illness severity, greater functional impairment, and poorer illness-related outcomes.…

  7. DSM-III-R generalized anxiety disorder in the National Comorbidity Survey.

    Science.gov (United States)

    Wittchen, H U; Zhao, S; Kessler, R C; Eaton, W W

    1994-05-01

    Nationally representative general population data are presented on the current, 12-month, and lifetime prevalence of DSM-III-R generalized anxiety disorder (GAD) as well as on risk factors, comorbidity, and related impairments. The data are from the National Comorbidity Survey, a large general population survey of persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States. DSM-III-R GAD was assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview. Generalized anxiety disorder was found to be a relatively rare current disorder with a current prevalence of 1.6% but was found to be a more frequent lifetime disorder affecting 5.1% of the US population aged 15 to 45 years. Generalized anxiety disorder was twice as common among women as among men. Multivariate logistic regression analysis showed that being older than 24 years, separated, widowed, divorced, unemployed, and a homemaker are significant correlates of GAD. Consistent with studies in treatment samples, we found that GAD was frequently associated with a wide spectrum of other mental disorders, with a lifetime comorbidity among 90.4% of the people who had a history of GAD. Contrary to the traditional view that GAD is a mild disorder, we found that the majority of people with GAD, whether they were comorbid or not, reported substantial interference with their life, a high degree of professional help seeking, and a high use of medication because of their GAD symptoms. Although lifetime GAD is highly comorbid, the proportion of current GAD that is not accompanied by any other current diagnosis is high enough to indicate that GAD should be considered an independent disorder rather than exclusively a residual or prodrome of other disorders.

  8. Excess costs of social anxiety disorder in Germany.

    Science.gov (United States)

    Dams, Judith; König, Hans-Helmut; Bleibler, Florian; Hoyer, Jürgen; Wiltink, Jörg; Beutel, Manfred E; Salzer, Simone; Herpertz, Stephan; Willutzki, Ulrike; Strauß, Bernhard; Leibing, Eric; Leichsenring, Falk; Konnopka, Alexander

    2017-04-15

    Social anxiety disorder is one of the most frequent mental disorders. It is often associated with mental comorbidities and causes a high economic burden. The aim of our analysis was to estimate the excess costs of patients with social anxiety disorder compared to persons without anxiety disorder in Germany. Excess costs of social anxiety disorder were determined by comparing two data sets. Patient data came from the SOPHO-NET study A1 (n=495), whereas data of persons without anxiety disorder originated from a representative phone survey (n=3213) of the general German population. Missing data were handled by "Multiple Imputation by Chained Equations". Both data sets were matched using "Entropy Balancing". Excess costs were calculated from a societal perspective for the year 2014 using general linear regression with a gamma distribution and log-link function. Analyses considered direct costs (in- and outpatient treatment, rehabilitation, and professional and informal care) and indirect costs due to absenteeism from work. Total six-month excess costs amounted to 451€ (95% CI: 199€-703€). Excess costs were mainly caused by indirect excess costs due to absenteeism from work of 317€ (95% CI: 172€-461€), whereas direct excess costs amounted to 134€ (95% CI: 110€-159€). Costs for medication, unemployment and disability pension was not evaluated. Social anxiety disorder was associated with statistically significant excess costs, in particular due to indirect costs. As patients in general are often unaware of their disorder or its severity, awareness should be strengthened. Prevention and early treatment might reduce long-term indirect costs. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Does comorbid anxiety counteract emotion recognition deficits in conduct disorder?

    Science.gov (United States)

    Short, Roxanna M L; Sonuga-Barke, Edmund J S; Adams, Wendy J; Fairchild, Graeme

    2016-08-01

    Previous research has reported altered emotion recognition in both conduct disorder (CD) and anxiety disorders (ADs) - but these effects appear to be of different kinds. Adolescents with CD often show a generalised pattern of deficits, while those with ADs show hypersensitivity to specific negative emotions. Although these conditions often cooccur, little is known regarding emotion recognition performance in comorbid CD+ADs. Here, we test the hypothesis that in the comorbid case, anxiety-related emotion hypersensitivity counteracts the emotion recognition deficits typically observed in CD. We compared facial emotion recognition across four groups of adolescents aged 12-18 years: those with CD alone (n = 28), ADs alone (n = 23), cooccurring CD+ADs (n = 20) and typically developing controls (n = 28). The emotion recognition task we used systematically manipulated the emotional intensity of facial expressions as well as fixation location (eye, nose or mouth region). Conduct disorder was associated with a generalised impairment in emotion recognition; however, this may have been modulated by group differences in IQ. AD was associated with increased sensitivity to low-intensity happiness, disgust and sadness. In general, the comorbid CD+ADs group performed similarly to typically developing controls. Although CD alone was associated with emotion recognition impairments, ADs and comorbid CD+ADs were associated with normal or enhanced emotion recognition performance. The presence of comorbid ADs appeared to counteract the effects of CD, suggesting a potentially protective role, although future research should examine the contribution of IQ and gender to these effects. © 2016 Association for Child and Adolescent Mental Health.

  10. Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment

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    Gimeno, Carmen; Dorado, Marisa Luisa; Roncero, Carlos; Szerman, Nestor; Vega, Pablo; Balanzá-Martínez, Vicent; Alvarez, F. Javier

    2017-01-01

    Patients with alcohol-use disorders (AUDs) have a high prevalence of anxiety disorders (AnxDs). “Co-occurring disorders” refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs), especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD–AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD–AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives. PMID:29018367

  11. Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment

    Directory of Open Access Journals (Sweden)

    Carmen Gimeno

    2017-09-01

    Full Text Available Patients with alcohol-use disorders (AUDs have a high prevalence of anxiety disorders (AnxDs. “Co-occurring disorders” refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs, especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD–AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD–AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives.

  12. Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder.

    Science.gov (United States)

    Langley, Audra K; Lewin, Adam B; Bergman, R Lindsey; Lee, Joyce C; Piacentini, John

    2010-08-01

    The present study examines the influence of diagnostic comorbidity on the demographic, psychiatric, and functional status of youth with a primary diagnosis of obsessive compulsive disorder (OCD). Two hundred and fifteen children (ages 5-17) referred to a university-based OCD specialty clinic were compared based on DSM-IV diagnostic profile: OCD without comorbid anxiety or externalizing disorder, OCD plus anxiety disorder, and OCD plus externalizing disorder. No age or gender differences were found across groups. Higher OCD severity was found for the OCD + ANX group, while the OCD + EXT group reported greater functional impairment than the other two groups. Lower family cohesion was reported by the OCD + EXT group compared to the OCD group and the OCD + ANX group reported higher family conflict compared to the OCD + EXT group. The OCD + ANX group had significantly lower rates of tic disorders while rates of depressive disorders did not differ among the three groups. The presence of comorbid anxiety and externalizing psychopathology are associated with greater symptom severity and functional and family impairment and underscores the importance of a better understanding of the relationship of OCD characteristics and associated disorders. Results and clinical implications are further discussed.

  13. Associations between comorbid anxiety, diabetes control, and overall medical burden in patients with serious mental illness and diabetes.

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    Bajor, Laura A; Gunzler, Douglas; Einstadter, Douglas; Thomas, Charles; McCormick, Richard; Perzynski, Adam T; Kanuch, Stephanie W; Cassidy, Kristin A; Dawson, Neal V; Sajatovic, Martha

    2015-01-01

    While previous work has demonstrated elevation of both comorbid anxiety disorders and diabetes mellitus type II in individuals with serious mental illness, little is known regarding the impact of comorbid anxiety on diabetes mellitus type II outcomes in serious mental illness populations. We analyzed baseline data from patients with serious mental illness and diabetes mellitus type II to examine relationships between comorbid anxiety, glucose control as measured by hemoglobin A1c score, and overall illness burden. Using baseline data from an ongoing prospective treatment study involving 157 individuals with serious mental illness and diabetes mellitus type II, we compared individuals with and without a comorbid anxiety disorder and compared hemoglobin A1c levels between these groups to assess the relationship between anxiety and management of diabetes mellitus type II. We conducted a similar analysis using cumulative number of anxiety diagnoses as a proxy for anxiety load. Finally, we searched for associations between anxiety and overall medical illness burden as measured by Charlson score. Anxiety disorders were seen in 33.1% (N=52) of individuals with serious mental illness and diabetes mellitus type II and were associated with increased severity of depressive symptoms and decreased function. Hemoglobin A1c levels were not significantly different in those with or without anxiety, and having multiple anxiety disorders was not associated with differences in diabetes mellitus type II control. However, depressive symptoms were significantly associated with higher hemoglobin A1c levels. Neither comorbid anxiety nor anxiety load was significantly associated with overall medical burden. One in three people with serious mental illness and diabetes mellitus type II had anxiety. Depressive symptoms were significantly associated with Hb1Ac levels while anxiety symptoms had no relation to hemoglobin A1c; this is consistent with previously published work. More studies are

  14. Individual correlates of self-stigma in patients with anxiety disorders with and without comorbidities

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    Ociskova M

    2015-07-01

    seems that the tendency to dissociate in stress increases the probability of development of self-stigma, and this relationship is entirely mediated by avoidance of harm. Conversely, self-directedness lowers the probability of occurrence of self-stigma, and this effect is partly mediated by hope.Conclusion: Patients with anxiety disorders accompanied with or without comorbid depressive or personality disorders may suffer from self-stigma. Individuals with greater sensitivity to rejection and other socially aversive stimuli are prone to the development of self-stigma. Other personality factors, such as hopeful thinking and self-acceptance serve as factors promoting resilience concerning self-stigma. Keywords: self-stigma, hope, Temperament and Character Inventory-Revised Version, clinical factors, demographic factors, anxiety disorders

  15. Comorbidity of schizophrenia and social phobia – impact on quality of life, hope, and personality traits: a cross sectional study

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    Vrbova K

    2017-08-01

    Full Text Available Kristyna Vrbova,1 Jan Prasko,1 Marie Ociskova,1 Michaela Holubova1,2 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 2Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic Objective: The purpose of the study was to explore whether the comorbidity of social phobia affects symptoms severity, positive and negative symptoms, self-stigma, hope, and quality of life in patients with schizophrenia spectrum disorders. Methods: This is a cross-sectional study in which all participants completed the Internalized Stigma of Mental Illness (ISMI scale, Adult Dispositional Hope Scale (ADHS, Liebowitz Social Anxiety Scale (LSAS, Beck Anxiety Inventory (BAI, Beck Depression Inventory-II (BDI-II, Positive and Negative Syndrome Scale (PANSS, Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q, Temperament and Character Inventory – Revised (TCI-R, and the demographic questionnaire. The disorder severity was assessed both by a psychiatrist (Clinical Global Impression Severity – the objective version [objCGI-S] scale and by the patients (Clinical Global Impression Severity – the subjective version [subjCGI-S] scale. The patients were in a stabilized state that did not require changes in the treatment. Diagnosis of schizophrenia, schizoaffective disorder, or delusional disorder was determined according to the International Classification of Diseases 10th Revision (ICD-10 research criteria. A structured interview by Mini International Neuropsychiatric Interview was used to confirm the diagnosis. Results: The study included 61 patients of both genders. Clinically, the patients with comorbid social phobia had the earlier onset of the illness, more severe current psychopathology, more intense anxiety (general and social, and higher severity of depressive symptoms. The patients with comorbid social phobia showed the significantly lower quality

  16. Predicting Response of ADHD Symptoms to Methylphenidate Treatment Based on Comorbid Anxiety

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    Blouin, Brittany; Maddeaux, Cindy; Stanley Firestone, Jill; van Stralen, Judy

    2010-01-01

    Objective: In this small pilot study, the association of comorbid anxiety with the treatment of ADHD is studied. Methods: Eighteen volunteers from a pediatric clinic are tested for ADHD and anxiety and assessed for behavioral and cognitive ADHD symptomology. Response to methylphenidate as treatment for ADHD symptoms is measured 2 to 3 weeks, and…

  17. Is Behavioral Regulation in Children with ADHD Aggravated by Comorbid Anxiety Disorder?

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    Sorensen, Lin; Plessen, Kerstin J.; Nicholas, Jude; Lundervold, Astri J.

    2011-01-01

    Background: The present study investigated the impact of coexisting anxiety disorder in children with ADHD on their ability to regulate behavior. Method: Parent reports on the Behavior Rating Inventory of Executive Function (BRIEF) in a comorbid group of children with ADHD and anxiety (n = 11) were compared to BRIEF reports in a group of children…

  18. Hemispheric Coherence in ASD with and without Comorbid ADHD and Anxiety

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    A. Saunders

    2016-01-01

    Full Text Available There is a growing body of evidence suggesting that altered brain connectivity may be a defining feature of disorders such as autism spectrum disorder (ASD, anxiety, and ADHD. This study investigated whether resting state functional connectivity, measured by 128-channel EEG oscillation coherence, differs between developmental disorders. Analyses were conducted separately on groups with and without comorbid conditions. Analyses revealed increased coherence across central electrodes over the primary motor cortex and decreased coherence in the frontal lobe networks in those with ASD compared to neurotypical controls. There was increased coherence in occipital lobe networks in the ADHD group compared to other groups. Symptoms of generalised anxiety were positively correlated with both frontal-occipital intrahemispheric (alpha only coherence and occipital interhemispheric coherence (alpha, approaching theta band. The patterns of coherence in the ASD pure group were different when comorbid conditions were included in the analyses, suggesting that aberrant coherence in the frontal and central areas of the brain is specifically associated with ASD. Our findings support the idea that comorbid conditions are additive, rather than being symptoms of the same disorder.

  19. Hemispheric Coherence in ASD with and without Comorbid ADHD and Anxiety.

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    Saunders, A; Kirk, I J; Waldie, K E

    2016-01-01

    There is a growing body of evidence suggesting that altered brain connectivity may be a defining feature of disorders such as autism spectrum disorder (ASD), anxiety, and ADHD. This study investigated whether resting state functional connectivity, measured by 128-channel EEG oscillation coherence, differs between developmental disorders. Analyses were conducted separately on groups with and without comorbid conditions. Analyses revealed increased coherence across central electrodes over the primary motor cortex and decreased coherence in the frontal lobe networks in those with ASD compared to neurotypical controls. There was increased coherence in occipital lobe networks in the ADHD group compared to other groups. Symptoms of generalised anxiety were positively correlated with both frontal-occipital intrahemispheric (alpha only) coherence and occipital interhemispheric coherence (alpha, approaching theta band). The patterns of coherence in the ASD pure group were different when comorbid conditions were included in the analyses, suggesting that aberrant coherence in the frontal and central areas of the brain is specifically associated with ASD. Our findings support the idea that comorbid conditions are additive, rather than being symptoms of the same disorder.

  20. Group schema therapy versus group cognitive behavioral therapy for social anxiety disorder with comorbid avoidant personality disorder: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Baljé, Astrid; Greeven, Anja; van Giezen, Anne; Korrelboom, Kees; Arntz, Arnoud; Spinhoven, Philip

    2016-10-08

    Social anxiety disorder (SAD) with comorbid avoidant personality disorder (APD) has a high prevalence and is associated with serious psychosocial problems and high societal costs. When patients suffer from both SAD and APD, the Dutch multidisciplinary guidelines for personality disorders advise offering prolonged cognitive behavioral therapy (CBT). Recently there is increasing evidence for the effectiveness of schema therapy (ST) for personality disorders such as borderline personality disorder and cluster C personality disorders. Since ST addresses underlying personality characteristics and maladaptive coping strategies developed in childhood, this treatment might be particularly effective for patients with SAD and comorbid APD. To our knowledge, there are no studies comparing CBT with ST in this particular group of patients. This superiority trial aims at comparing the effectiveness of these treatments. As an additional goal, predictors and underlying mechanisms of change will be explored. The design of the study is a multicentre two-group randomized controlled trial (RCT) in which the treatment effect of group cognitive behavioral therapy (GCBT) will be compared to that of group schema therapy (GST) in a semi-open group format. A total of 128 patients aged 18-65 years old will be enrolled. Patients will receive 30 sessions of GCBT or GST during a period of approximately 9 months. Primary outcome measures are the Liebowitz Social Anxiety Scale Self-Report (LSAS-SR) for social anxiety disorder and the newly developed Avoidant Personality Disorder Severity Index (AVPDSI) for avoidant personality disorder. Secondary outcome measures are the MINI section SAD, the SCID-II section APD, the Schema Mode Inventory (SMI-2), the Inventory of Depressive Symptomatology Self-Report (IDS-SR), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), the Difficulties in Emotion Regulation Scale (DERS), the Rosenberg Self-Esteem Scale (RSES) and the Acceptance and Action

  1. Social Skills as a Mediator between Anxiety Symptoms and Peer Interactions among Children and Adolescents

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    Motoca, Luci M.; Williams, Sandra; Silverman, Wendy K.

    2012-01-01

    Objective The present study used a cross-sectional design to examine the relations among youth anxiety symptoms, positive and negative peer interactions, and social skills. Also examined was the mediating role of social skills in the relations between youth anxiety symptoms and positive and negative peer interactions. Youth sex and age were examined as moderators. Method The sample consisted of 397 children and adolescents (M = 10.11 years; 53.4% boys; 74.8% Hispanic Latino) referred to an anxiety disorders clinic. Anxiety symptoms, positive and negative peer interactions, and social skills were assessed using youth and parent ratings. Results Structural equation modeling results indicated that for youth ratings only, youth anxiety symptoms were negatively related to positive peer interactions controlling for primary social phobia and comorbid depressive disorders. For both youth and parent ratings, youth anxiety symptoms were positively related to negative peer interactions and negatively related to social skills. Also for both youth and parent ratings, social skills mediated the relations between youth anxiety symptoms and positive and negative peer interactions. For parent ratings only, the effects of youth anxiety symptoms and social skills on peer interactions were significantly moderated by youth age. Youth sex was not a significant moderator using youth and parent ratings. Conclusions Findings suggest difficulties with social skills and peer interactions are problematic features of youth referred for anxiety problems. Findings highlight the need to improve understanding of anxiety symptoms, social skills, and peer interactions in this population. PMID:22471319

  2. Social skills as a mediator between anxiety symptoms and peer interactions among children and adolescents.

    Science.gov (United States)

    Motoca, Luci M; Williams, Sandra; Silverman, Wendy K

    2012-01-01

    The present study used a cross-sectional design to examine the relations among youth anxiety symptoms, positive and negative peer interactions, and social skills. Also examined was the mediating role of social skills in the relations between youth anxiety symptoms and positive and negative peer interactions. Youth sex and age were examined as moderators. The sample consisted of 397 children and adolescents (M = 10.11 years; 53.4% boys; 74.8% Hispanic Latino) referred to an anxiety disorders clinic. Anxiety symptoms, positive and negative peer interactions, and social skills were assessed using youth and parent ratings. Structural equation modeling results indicated that for youth ratings only, youth anxiety symptoms were negatively related to positive peer interactions controlling for primary social phobia and comorbid depressive disorders. For both youth and parent ratings, youth anxiety symptoms were positively related to negative peer interactions and negatively related to social skills. Also for both youth and parent ratings, social skills mediated the relations between youth anxiety symptoms and positive and negative peer interactions. For parent ratings only, the effects of youth anxiety symptoms and social skills on peer interactions were significantly moderated by youth age. Youth sex was not a significant moderator using youth and parent ratings. Findings suggest that difficulties with social skills and peer interactions are problematic features of youth referred for anxiety problems. Findings highlight the need to improve understanding of anxiety symptoms, social skills, and peer interactions in this population.

  3. Impact of depressive and anxiety disorder comorbidity on the clinical expression of obsessive-compulsive disorder.

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    Viswanath, Biju; Narayanaswamy, Janardhanan C; Rajkumar, Ravi Philip; Cherian, Anish V; Kandavel, Thennarasu; Math, Suresh Bada; Reddy, Y C Janardhan

    2012-08-01

    The identification of distinct subtypes based on comorbidity offers potential utility in understanding variations in the clinical expression of obsessive-compulsive disorder (OCD). Hence, we examined the hypothesis whether patients with OCD with major depressive disorder (MDD) or anxiety disorder comorbidity would differ from those without in terms of phenomenology. A total of 545 consecutive patients who consulted a specialty OCD clinic during the period 2004 to 2009 at a psychiatric hospital in India formed the sample. They were evaluated with the Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Mini International Neuropsychiatric Interview, and the Clinical Global Impression scale. Among 545 patients, 165 (30%) had current MDD, and 114 (21%) had current anxiety disorder comorbidity. Patients with OCD with MDD were mostly women who had a greater severity of OCD symptoms, more of obsessions (especially religious), greater occurrence of miscellaneous compulsions (need to confess or need to touch), higher suicidal risk, and past suicidal attempts. Patients with OCD with anxiety disorder had an earlier onset of illness that was associated with prior life events, less of compulsions, more of aggressive and hoarding obsessions, pathologic doubts, checking, and cognitive compulsions. Obsessive-compulsive disorder, when comorbid with MDD, is more severe and is associated with higher suicidal risk. On the other hand, anxiety disorder comorbidity seems to influence not so much the morbidity but the phenotypic expression of OCD. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Stigma, social anxiety, and illness severity in bipolar disorder: Implications for treatment.

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    Levy, Boaz; Tsoy, Elena; Brodt, Madeline; Petrosyan, Karen; Malloy, Mary

    2015-02-01

    Studies indicate that comorbid anxiety disorders predict a more severe course of illness in bipolar disorder (BD). The relatively high prevalence of social anxiety in BD points to the potential role that socio-cultural factors, such as stigma, play in exacerbating the progression of this disorder. Stigma creates social anxiety in affected individuals because it essentially forces them into a vulnerable social status that is marked by public disgrace. Although the etiology of debilitating social anxiety in BD may involve multiple factors, stigma deserves particular clinical attention because research in this area indicates that it is common and its internalization is associated with poor outcome. We conducted a literature review using search terms related to stigma, social anxiety, bipolar disorder, illness severity, and outcomes. The electronic databases searched included PsychINFO, PubMed, JSTOR, and EBSCOhost Academic Search Complete with limits set to include articles published in English. The literature indicates that internalized stigma often triggers the core psychological experiences of social anxiety and is highly correlated with clinical and functional outcome in BD. On a psychological level, internalized stigma and social anxiety can create distress that triggers symptoms of BD. From a biological perspective, stigma constitutes a chronic psychosocial stressor that may interact with the pathophysiology of BD in inflammatory ways. The connection between stigma and social anxiety, and their combined effects on people with BD, carries important implications for psychiatric care. To obtain an accurate clinical formulation, initial evaluations may seek to examine stigma-related experiences and determine their relationship to anxiety symptoms and psychosocial functioning. In addition, direct interventions for reducing the ill effects of stigma in BD deserve clinical attention, because they may carry the potential to enhance outcomes.

  5. Response to emotional expressions in generalized social phobia and generalized anxiety disorder: evidence for separate disorders.

    Science.gov (United States)

    Blair, Karina; Shaywitz, Jonathan; Smith, Bruce W; Rhodes, Rebecca; Geraci, Marilla; Jones, Matthew; McCaffrey, Daniel; Vythilingam, Meena; Finger, Elizabeth; Mondillo, Krystal; Jacobs, Madeline; Charney, Dennis S; Blair, R J R; Drevets, Wayne C; Pine, Daniel S

    2008-09-01

    Generalized social phobia involves fear/avoidance, specifically of social situations, whereas generalized anxiety disorder involves intrusive worry about diverse circumstances. It remains unclear the degree to which these two, often comorbid, conditions represent distinct disorders or alternative presentations of a single, core underlying pathology. Functional magnetic resonance imaging assessed the neural response to facial expressions in generalized social phobia and generalized anxiety disorder. Individuals matched on age, IQ, and gender with generalized social phobia without generalized anxiety disorder (N=17), generalized anxiety disorder (N=17), or no psychopathology (N=17) viewed neutral, fearful, and angry expressions while ostensibly making a simple gender judgment. The patients with generalized social phobia without generalized anxiety disorder showed increased activation to fearful relative to neutral expressions in several regions, including the amygdala, compared to healthy individuals. This increased amygdala response related to self-reported anxiety in patients with generalized social phobia without generalized anxiety disorder. In contrast, patients with generalized anxiety disorder showed significantly less activation to fearful relative to neutral faces compared to the healthy individuals. They did show significantly increased response to angry expressions relative to healthy individuals in a lateral region of the middle frontal gyrus. This increased lateral frontal response related to self-reported anxiety in patients with generalized anxiety disorder. These results suggest that neural circuitry dysfunctions differ in generalized social phobia and generalized anxiety disorder.

  6. Comorbidity of Anxiety Disorders and Substance Abusewith Bipolar Mood Disorders and Relationship with ClinicalCourse

    Directory of Open Access Journals (Sweden)

    Ali Reza Shafiee-Kandjani

    2009-12-01

    Full Text Available "n Objective: Patients with bipolar mood disorder constitute a relatively large number of individuals hospitalized in psychiatric hospitals. This disorder is highly co-morbid with other psychiatric disorders and may effect their clinical course. The goal of this study was to determine the co-occurrence rate of anxiety disorders and substance abuse with bipolar mood disorders and their impact on clinical course. "n Methods: 153 bipolar patients (type I were selected among the hospitalized patients at Razi Psychiatric Hospital in Tabriz, Iran, from September 2007 to October 2008 through convenience sampling method. The participants were evaluated by a structured clinical interview based on DSM-IV criteria (SCID, Hamilton Rating Scale for Depression (HRSD and Young Mania Rating Scale (YMRS. Results: Co-morbidity of anxiety disorders was 43% . Occurrence of anxiety disorders was 26% for obsessive-compulsive disorder, 24.8% for generalized anxiety disorder, 3.9% for phobia and 2% for panic disorder. Co-morbidity of substance abuse was 7.2% and the highest occurrence of substance abuse was 5.2% for alcoholism and 3.9% for opium. No significant difference was observed between the severity of disease and duration of hospitalization in bipolar patients with or without anxiety disorder. The severity of disease and duration of hospitalization in bipolar patients with substance abuse was higher compared to bipolar patients without substance abuse (P<0.05. "nConclusions: This study suggests that there is a high co-morbidity between anxiety disorders and substance abuse with bipolar disorder. Further, this study suggests that co-occurrence of substance abuse disorder with bipolar disorder increases the severity of the disease and duration of hospitalization.

  7. Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: implications for cardiovascular risk.

    Science.gov (United States)

    Kemp, Andrew H; Quintana, Daniel S; Felmingham, Kim L; Matthews, Slade; Jelinek, Herbert F

    2012-01-01

    There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction. To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal). A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use. HRV was calculated from electrocardiography under a standardized short-term resting state condition. HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size. Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.

  8. Cyber victimization by peers: Prospective associations with adolescent social anxiety and depressive symptoms.

    Science.gov (United States)

    Landoll, Ryan R; La Greca, Annette M; Lai, Betty S; Chan, Sherilynn F; Herge, Whitney M

    2015-07-01

    Peer victimization that occurs via electronic media, also termed cybervictimization, is a growing area of concern for adolescents. The current study evaluated the short-term prospective relationship between cybervictimization and adolescents' symptoms of social anxiety and depression over a six-week period. Participants were 839 high-school aged adolescents (14-18 years; 58% female; 73% Hispanic White), who completed measures of traditional peer victimization, cybervictimization, depression, and social anxiety at two time points. Findings supported the distinctiveness of cybervictimization as a unique form of peer victimization. Furthermore, only cybervictimization was associated with increased levels of depressive symptoms over time, and only relational victimization was associated with increased social anxiety over time, after controlling for the comorbidity of social anxiety and depression among youth. Cybervictimization appears to be a unique form of victimization that contributes to adolescents' depressive symptoms and may be important to target in clinical and preventive interventions for adolescent depression. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  9. Social phobia and depression: prevalence and comorbidity.

    Science.gov (United States)

    Ohayon, Maurice M; Schatzberg, Alan F

    2010-03-01

    Social phobia may seriously impair the functioning of affected individuals. It is frequently associated with other mental disorders. To estimate the co-occurrence of social phobia with major depressive disorder (MDD) and to analyze their interaction. Subjects were 18,980 individuals, aged 15 years or older, representative of the general population of the United Kingdom, Germany, Italy, Spain and Portugal, who were interviewed by telephone. DSM-IV diagnoses were made with the Sleep-EVAL system. The point prevalence for social phobia was 4.4% (95% confidence interval: 4.1-4.7%) of the sample. It was higher in women (odds ratio: 1.6) and decreased with age. MDDs were found in 19.5% of participants with social phobia. Co-occurrence of another anxiety disorder was high and increased when a MDD was present (65.2%). The odds of developing a major depressive episode 2 years after the appearance of the social phobia was of 5.74. Social phobia is highly prevalent in the general population. It increases the risk of developing a MDD and has a high comorbidity with other mental disorders. Social phobia is often present in the course of depression, more obviously during remission period of MDD. Physicians must explore and treat more systematically this frequent pathology. Copyright 2010 Elsevier Inc. All rights reserved.

  10. Social phobia in Finnish general adolescent population: prevalence, comorbidity, individual and family correlates, and service use.

    Science.gov (United States)

    Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Rantanen, Päivi; Marttunen, Mauri

    2009-01-01

    Few studies have investigated the epidemiology of social phobia (SP) among early to middle adolescents, at the time of suggested mean onset of the disorder. The objective of this study was to investigate the prevalence, comorbidity, individual and familial correlates, and service use associated with SP among Finnish 12-17-year-old adolescents in general population. A sample of 784 adolescents was screened with the Social Phobia Inventory, and a sub-sample (n=350) was interviewed with a semi-structured clinical interview to identify SP, sub-clinical SP (SSP), and a range of other axis I DSM-IV disorders. Individual and familial correlates, and service use associated with SP were also inquired. We found a 12-month prevalence of 3.2% for SP, and 4.6% for SSP. The prevalence rose and the gender ratio shifted to female preponderance as age increased. SP was frequently comorbid with other anxiety disorders (41%) and depressive disorders (41%). Adolescents with SP/SSP were impaired in their academic and global functioning, and reported more parental psychiatric treatment contacts. Two thirds (68%) of adolescents with SP reported having been bullied by peers. Only one fifth of adolescents with non-comorbid SP had been in contact with a mental health professional. We conclude that adolescent SP is a relatively frequent, undertreated and highly comorbid condition, associated with educational impairment, depression and anxiety in parents, and peer victimization. (c) 2009 Wiley-Liss, Inc.

  11. The role of social support in anxiety and depression among Parkinson's disease patients.

    Science.gov (United States)

    Ghorbani Saeedian, Radka; Nagyova, Iveta; Krokavcova, Martina; Skorvanek, Matej; Rosenberger, Jaroslav; Gdovinova, Zuzana; Groothoff, Johan W; van Dijk, Jitse P

    2014-01-01

    To explore how social support is associated with anxiety and depression in Parkinson's disease (PD) patients controlling for gender, disease duration and disease severity. The sample consisted of 124 patients (52.4% male; mean age 68.1 ± 8.4 years; mean disease duration 6.3 ± 5.5 years). Anxiety and depression were measured with the Hospital Anxiety and Depression Scale, social support with the Multidimensional Scale of Perceived Social Support and disease severity with the Unified Parkinson Disease Rating Scale. Data were analyzed using linear regression. Gender, disease duration, disease severity and social support explained 31% of the total variance in anxiety in younger PD patients but did not significantly contribute to the explanation of depression. In the older group, this model explained 41% of the variance in depression but did not significantly contribute to the explanation of anxiety. PD patients experience the positive influence of social support differently according to age. In the younger group, disease duration plays the primary role regarding anxiety. In the older group, poor social support especially from friends is associated with more depression after controlling for the relevant variables. Implications of Rehabilitation PD is a disease of older age with a neurodegenerative character and treatment should focus on increasing quality of life. Anxiety and depression are common co-morbidities in PD patients. The support network should also be screened regularly and involved in enhancing the quality of life.

  12. Social Anxiety Disorder

    Directory of Open Access Journals (Sweden)

    S Seedat

    2013-08-01

    Full Text Available According to epidemiological studies, rates of social anxiety disorder(SAD or social phobia range from 3% to 16% in the generalpopulation.[1,2]Social phobia and specific phobias have an earlier ageof onset than other anxiety disorders.

  13. Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients

    Directory of Open Access Journals (Sweden)

    Ociskova M

    2016-06-01

    Full Text Available Marie Ociskova, Jan Prasko, Klara Latalova, Dana Kamaradova, Ales Grambal Department of Psychiatry, Olomouc University Hospital, Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic Background: Anxiety disorders are a group of various mental syndromes that have been related with generally poor treatment response. Several psychological factors may improve or hinder treatment effectiveness. Hope has a direct impact on the effectiveness of psychotherapy. Also, dissociation is a significant factor influencing treatment efficiency in this group of disorders. Development of self-stigma could decrease treatment effectiveness, as well as several temperamental and character traits. The aim of this study was to explore a relationship between selected psychological factors and treatment efficacy in anxiety disorders. Subjects and methods: A total of 109 inpatients suffering from anxiety disorders with high frequency of comorbidity with depression and/or personality disorder were evaluated at the start of the treatment by the following scales: the Mini-International Neuropsychiatric Interview, the Internalized Stigma of Mental Illness scale, the Adult Dispositional Hope Scale, and the Temperament and Character Inventory – revised. The participants, who sought treatment for anxiety disorders, completed the following scales at the beginning and end of an inpatient-therapy program: Clinical Global Impression (objective and subjective the Beck Depression Inventory – second edition, the Beck Anxiety Inventory, and the Dissociative Experiences Scale. The treatment consisted of 25 group sessions and five individual sessions of cognitive behavioral therapy or psychodynamic therapy in combination with pharmacotherapy. There was no randomization to the type of group-therapy program. Results: Greater improvement in psychopathology, assessed by relative change in objective Clinical Global Impression score, was connected with low initial

  14. Social Anxiety among Chinese People.

    Science.gov (United States)

    Fan, Qianqian; Chang, Weining C

    2015-01-01

    The experience of social anxiety has largely been investigated among Western populations; much less is known about social anxiety in other cultures. Unlike the Western culture, the Chinese emphasize interdependence and harmony with social others. In addition, it is unclear if Western constructed instruments adequately capture culturally conditioned conceptualizations and manifestations of social anxiety that might be specific to the Chinese. The present study employed a sequence of qualitative and quantitative approaches to examine the assessment of social anxiety among the Chinese people. Interviews and focus group discussions with Chinese participants revealed that some items containing the experience of social anxiety among the Chinese are not present in existing Western measures. Factor analysis was employed to examine the factor structure of the more comprehensive scale. This approach revealed an "other concerned anxiety" factor that appears to be specific to the Chinese. Subsequent analysis found that the new factor-other concerned anxiety-functioned the same as other social anxiety factors in their association with risk factors of social anxiety, such as attachment, parenting, behavioral inhibition/activation, and attitude toward group. The implications of these findings for a more culturally sensitive assessment tool of social anxiety among the Chinese were discussed.

  15. Methylphenidate and comorbid anxiety disorder in children with both chronic multiple tic disorder and ADHD.

    Science.gov (United States)

    Gadow, Kenneth D; Nolan, Edith E

    2011-04-01

    To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD). Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial with rating scales and laboratory measures. The +ANX group obtained more severe parent, teacher, and child ratings of anxiety and more severe parent ratings of depression, tics, oppositional defiant disorder (ODD), and peer aggression than the -ANX group. Treatment with short-term MPH-IR was associated with improvement in ADHD, ODD, and peer aggression in the +ANX group. When controlling for ODD severity, there were no apparent group differences in therapeutic response to MPH-IR in children ±ANX. There was little evidence that MPH-IR contributed to improvement in anxiety or depression symptoms in the +ANX group. There was some indication that children with comorbid anxiety may differentially experience greater increase in systolic blood pressure (0.5 mg/kg of MPH-IR > placebo). Findings suggest that the co-occurrence of diagnosed CMTD+ADHD+ANX represents a particularly troublesome clinical phenotype, at least in the home setting. Comorbid anxiety disorder was not associated with a less favorable response to MPH-IR in children with ADHD+CMTD, but replication with larger samples is warranted before firm conclusions can be drawn about potential group differences.

  16. The effect of co-morbid depression and anxiety on the course and outcome of alcohol outpatient treatment

    DEFF Research Database (Denmark)

    Mellentin, Angelina Isabella; Nielsen, Bent; Stenager, Elsebeth

    2015-01-01

    Background: Studies examining the effect of alcohol treatment among patients with alcohol use disorders (AUD) and co-morbid depression and/or anxiety are few and show inconsistent, but mainly negative drinking outcomes. Aims: To describe the prevalence of anxiety and depression among Danish....... No difference was found between patients with and without co-morbidity. Conclusion: In contrast to the majority of prior studies, this study provides evidence that depression and anxiety do not have an effect on alcohol treatment. However, because of the naturalistic setting, a number of limitations should...

  17. Effects of Comorbid ADHD with Learning Disabilities on Anxiety, Depression, and Aggression in Adults

    Science.gov (United States)

    McGillivray, J. A.; Baker, K. L.

    2009-01-01

    Objective: ADHD and learning disabilities (LD) frequently coexist and there are indications that comorbidity may increase the risk of psychopathology. Method: The current study examined the gender distribution and frequency of comorbidity and its impact on the prevalence of symptoms of anxiety, depression, and aggression in a clinic sample of 80…

  18. Integrated care for comorbid alcohol dependence and anxiety and/or depressive disorder: study protocol for an assessor-blind, randomized controlled trial.

    Science.gov (United States)

    Morley, Kirsten C; Baillie, Andrew; Sannibale, Claudia; Teesson, Maree; Haber, Paul S

    2013-11-19

    A major barrier to successful treatment in alcohol dependence is psychiatric comorbidity. During treatment, the time to relapse is shorter, the drop-out rate is increased, and long-term alcohol consumption is greater for those with comorbid major depression or anxiety disorder than those with an alcohol use disorder with no comorbid mental disorder. The treatment of alcohol dependence and psychological disorders is often the responsibility of different services, and this can hinder the treatment process. Accordingly, there is a need for an effective integrated treatment for alcohol dependence and comorbid anxiety and/or depression. We aim to assess the effectiveness of a specialized, integrated intervention for alcohol dependence with comorbid anxiety and/or mood disorder using a randomized design in an outpatient hospital setting. Following a three-week stabilization period (abstinence or significantly reduced consumption), participants will undergo complete formal assessment for anxiety and depression. Those patients with a diagnosis of an anxiety and/or depressive disorder will be randomized to either 1) integrated intervention (cognitive behavioral therapy) for alcohol, anxiety, and/or depression; or 2) usual counseling care for alcohol problems. Patients will then be followed up at weeks 12, 16, and 24. The primary outcome measure is alcohol consumption (total abstinence, time to lapse, and time to relapse). Secondary outcome measures include changes in alcohol dependence severity, depression, or anxiety symptoms and changes in clinician-rated severity of anxiety and depression. The study findings will have potential implications for clinical practice by evaluating the implementation of specialized integrated treatment for comorbid anxiety and/or depression in an alcohol outpatient service. ClinicalTrials.gov Identifier: NCT01941693.

  19. Quality of life impairment in generalized anxiety disorder, social phobia, and panic disorder.

    Science.gov (United States)

    Barrera, Terri L; Norton, Peter J

    2009-12-01

    Interest in the assessment of quality of life in the anxiety disorders is growing. The present study examined quality of life impairments in individuals with generalized anxiety disorder (GAD), social phobia, and panic disorder. Results showed that individuals with these disorders reported less satisfaction with their quality of life than non-anxious adults in the community. However, the degree of quality of life impairment is similar across these three disorders. Additionally, comorbid depression, but not anxiety, was found to negatively impact quality of life in these individuals. Finally, diagnostic symptom severity was not found to influence quality of life, indicating that subjective measures of quality of life offer unique information on the effects of anxiety disorders.

  20. Interpretation bias and social anxiety: does interpretation bias mediate the relationship between trait social anxiety and state anxiety responses?

    Science.gov (United States)

    Chen, Junwen; Milne, Kirby; Dayman, Janet; Kemps, Eva

    2018-05-23

    Two studies aimed to examine whether high socially anxious individuals are more likely to negatively interpret ambiguous social scenarios and facial expressions compared to low socially anxious individuals. We also examined whether interpretation bias serves as a mediator of the relationship between trait social anxiety and state anxiety responses, in particular current state anxiety, bodily sensations, and perceived probability and cost of negative evaluation pertaining to a speech task. Study 1 used ambiguous social scenarios and Study 2 used ambiguous facial expressions as stimuli to objectively assess interpretation bias. Undergraduate students with high and low social anxiety completed measures of state anxiety responses at three time points: baseline, after the interpretation bias task, and after the preparation for an impromptu speech. Results showed that high socially anxious individuals were more likely to endorse threat interpretations for ambiguous social scenarios and to interpret ambiguous faces as negative than low socially anxious individuals. Furthermore, negative interpretations mediated the relationship between trait social anxiety and perceived probability of negative evaluation pertaining to the speech task in Study 1 but not Study 2. The present studies provide new insight into the role of interpretation bias in social anxiety.

  1. Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

    Science.gov (United States)

    Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

    2014-01-01

    This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

  2. The influence of comorbid anxiety on the effectiveness of Cognitive Therapy and Interpersonal Psychotherapy for Major Depressive Disorder

    NARCIS (Netherlands)

    van Bronswijk, Suzanne C.; Lemmens, Lotte H.J.M.; Huibers, Marcus J.H.; Arntz, Arnoud; Peeters, Frenk P.M.L.

    Background: Anxious depression is an important subtype of Major Depressive Disorder (MDD) defined by both syndromal (anxiety disorders) and dimensional (anxiety symptoms) criteria. A debated question is how anxiety affects MDD treatment. This study examined the impact of comorbid anxiety disorders

  3. Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. controls

    NARCIS (Netherlands)

    Hovens, J.G.F.M.; Wiersma, J.E.; Giltay, E.J.; van Oppen, P.C.; Spinhoven, P.; Penninx, B.W.J.H.; Zitman, F.G.

    2010-01-01

    Objective: To investigate the association between childhood life events, childhood trauma and the presence of anxiety, depressive or comorbid anxiety and depressive disorders in adulthood. Method: Data are from 1931 adult participants in the Netherlands Study of Depression and Anxiety (NESDA).

  4. Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. controls

    NARCIS (Netherlands)

    Hovens, J. G. F. M.; Wiersma, J. E.; Giltay, E. J.; van Oppen, P.; Spinhoven, P.; Penninx, B. W. J. H.; Zitman, F. G.

    Objective: To investigate the association between childhood life events, childhood trauma and the presence of anxiety, depressive or comorbid anxiety and depressive disorders in adulthood. Method: Data are from 1931 adult participants in the Netherlands Study of Depression and Anxiety (NESDA).

  5. Comorbidity of Depression and Anxiety: Association with Poor Quality of Life in Type 1 and 2 Diabetic Patients

    Science.gov (United States)

    de Ornelas Maia, Ana Claudia C.; Braga, Arthur de Azevedo; Paes, Flávia; Machado, Sergio; Carta, Mauro Giovanni; Nardi, Antonio Egidio; Silva, Adriana Cardoso

    2013-01-01

    Background: Diabetes is associates with depression and impairment in Quality of Life (QoL). Objective: The objective is to define the frequencies of depressive and anxiety symptoms in a sample of patients diagnosed with type 1 and 2 diabetes, the amount of impairment of QoL and the weight of depression and anxiety in determining the QoL in such of patients. Methods: A total of 210 patients were divided into two groups (type 1 and type 2). Patients completed the HADS and WHOQoL-bref. Results: Groups showed a high prevalence of anxiety (type 1 = 60%, type 2 = 43.8%) and depression (type 1 = 52.4%, type 2 = 38.1%), both measures were significantly higher (p < 0.05) in diabetes type 1 patients. Type 1 patients also showed a QoL in the overall assessment and the physical, psychological and social relations domains. In both Type 1 and 2 diabetes poor QoL was found associated by anxiety and depression comorbidity. Conclusion: In overall diabetes patients depression and anxiety seems to be a determinant of poor QoL. PMID:23935696

  6. Study of the moderating effect of parenting styles on the relationship between social anxiety and depressive symptomatology in adolescents

    Directory of Open Access Journals (Sweden)

    Eliana Silva

    2017-02-01

    Full Text Available Intruduction: The comorbidity between depression and social anxiety is high in adolescence. Parental emotion socialization behaviors have been associated with the development of social skills and depressive symptomatology. Objectives: This study aims to explore the moderating effect of parenting styles on the relationship between social anxiety and depression, to study the associations between them, and to analyze the relationship between parenting styles, social anxiety and depressive symptomatology in adolescents. Methods: The sample consisted of 122 parents and their children. Self-report instruments were used to assess social anxiety, depressive symptomatology and parenting styles. Results: It was found that social anxiety is significantly associated to depression and that the former has a predictive effect on the latter. The parenting styles revealed no significant associations with either depressive symptomatology or with social anxiety, but a moderating effect of explorer parenting style was found in the relationship between social anxiety (public performance and depressive symptomatology. Conclusions: The present investigation confirmed the existence of a significant association between social anxiety and depressive symptomatology in adolescence and suggests an effect of parental practices of emotional socialization in this relation, which, however, should be replicated in future research. It will also be important to study the effect of parenting styles on children's emotional regulation skills and their possible mediating effect on the relationship between social anxiety and depression.

  7. Negative autobiographical memories in social anxiety disorder: A comparison with panic disorder and healthy controls.

    Science.gov (United States)

    O'Toole, Mia Skytte; Watson, Lynn A; Rosenberg, Nicole K; Berntsen, Dorthe

    2016-03-01

    Empirical interest in mental imagery in social anxiety disorder (SAD) has grown over the past years but still little is known about the specificity to SAD. The present study therefore examines negative autobiographical memories in participants with social anxiety disorder (SAD), compared to patients with panic disorder (PD), and healthy controls (HCs). A total of 107 participants retrieved four memories cued by verbal phrases associated with either social anxiety (SA) or panic anxiety (PA), with two memories for each cue category. PA-cued memories were experienced with stronger imagery and as more traumatic. They were also rated as more central to identity than SA-cued memories, but not among participants with SAD, who perceived SA-cued memories as equally central to their identity. When between-group effects were detected, participants with anxiety disorders differed from HCs, but not from each other. Central limitations include reliance on self-report measures, comorbidity in the anxiety disorder groups, and lack of a neutrally cued memory comparison. The findings align with models of SAD suggesting that past negative social events play a central role in this disorder. Future research is suggested to further explore the function of negative memories, not only in SAD, but also in other anxiety disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Mindfulness Facets, Social Anxiety, and Drinking to Cope with Social Anxiety: Testing Mediators of Drinking Problems.

    Science.gov (United States)

    Clerkin, Elise M; Sarfan, Laurel D; Parsons, E Marie; Magee, Joshua C

    2017-02-01

    This cross-sectional study tested social anxiety symptoms, trait mindfulness, and drinking to cope with social anxiety as potential predictors and/or serial mediators of drinking problems. A community-based sample of individuals with co-occurring social anxiety symptoms and alcohol dependence were recruited. Participants ( N = 105) completed measures of social anxiety, drinking to cope with social anxiety, and alcohol use and problems. As well, participants completed the Five Facet Mindfulness Questionnaire , which assesses mindfulness facets of accepting without judgment, acting with awareness, not reacting to one's internal experiences, observing and attending to experiences, and labeling and describing. As predicted, the relationship between social anxiety symptoms and drinking problems was mediated by social anxiety coping motives across each of the models. Further, the relationship between specific mindfulness facets (acting with awareness, accepting without judgment, and describe) and drinking problems was serially mediated by social anxiety symptoms and drinking to cope with social anxiety. This research builds upon existing studies that have largely been conducted with college students to evaluate potential mediators driving drinking problems. Specifically, individuals who are less able to act with awareness, accept without judgment, and describe their internal experiences may experience heightened social anxiety and drinking to cope with that anxiety, which could ultimately result in greater alcohol-related problems.

  9. Identifying patterns of anxiety and depression in children with chromosome 22q11.2 deletion syndrome: comorbidity predicts behavioral difficulties and impaired functional communications.

    Science.gov (United States)

    Stephenson, David D; Beaton, Elliott A; Weems, Carl F; Angkustsiri, Kathleen; Simon, Tony J

    2015-01-01

    Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a complex genetic disorder with a variable clinical presentation that can include cardiac, neural, immunological, and psychological issues. Previous studies have measured elevated anxiety and depression in children with 22q11.2DS. Comorbity of anxiety and depression is well established in the pediatric literature but the nature of comorbidity patterns has not been empirically established in children with 22q11.2DS. Comorbidity of anxiety and depression has important implications for treatment and prognosis, and may be a marker of risk in this population of children at high-risk for developing schizophrenia. Participants were 131 boys and girls ages 8-14 with (n=76) and without (n=55) 22q11.2DS and their mothers. Children and mothers independently completed self- and parent-report measures of anxiety and depression. Mothers also completed measures of behavioral functioning including the Behavioral Assessment for Children, 2nd ed. (BASC-2). Cluster analyses were conducted to test if theoretically based groupings of anxiety and depression could be identified. We hypothesized four psychological profiles based on child- and mother-reports: low/no anxiety and low/no depression, higher depression and low/no anxiety, higher anxiety and no/low depression, and a comorbid profile of higher anxiety and higher depression. BASC-2 subscale scores were then compared across subgroups of children to determine if a comorbid profile would predict greater behavioral difficulties. In the full sample of children both with and without 22q11.2DS, cluster analyses of self and maternal reported anxiety and depression revealed the expected subgroups: (1) a group of children with higher anxiety/lower depression (anxious); (2) a group with primary depression (lower anxiety/higher depression (depressed)); (3) a comorbid group with higher anxiety/higher depression (comorbid); and, (4) a lowest anxiety/lowest depression group (NP). Mothers

  10. "Social Anxiety Disorder Carved at its Joints": evidence for the taxonicity of social anxiety disorder.

    Science.gov (United States)

    Weeks, Justin W; Carleton, R Nicholas; Asmundson, Gordon J G; McCabe, Randi E; Antony, Martin M

    2010-10-01

    Previous findings suggest that social anxiety disorder may be best characterized as having a dimensional latent structure (Kollman et al., 2006; Weeks et al., 2009). We attempted to extend previous taxometric investigations of social anxiety by examining the latent structure of social anxiety disorder symptoms in a large sample comprised of social anxiety disorder patients (i.e., putative taxon members) and community residents/undergraduate respondents (i.e., putative complement class members). MAXEIG and MAMBAC were performed with indicator sets drawn from a self-report measure of social anxiety symptoms, the Social Interaction Phobia Scale (Carleton et al., 2009). MAXEIG and MAMBAC analyses, as well as comparison analyses utilizing simulated taxonic and dimensional datasets, yielded converging evidence that social anxiety disorder has a taxonic latent structure. Moreover, 100% of the confirmed social anxiety disorder patients in our overall sample were correctly assigned to the identified taxon class, providing strong support for the external validity of the identified taxon; and k-means cluster analysis results corroborated our taxometric base-rate estimates. Implications regarding the conceptualization, diagnosis, and assessment of social anxiety disorder are discussed. Copyright 2010 Elsevier Ltd. All rights reserved.

  11. Mindfulness Facets, Social Anxiety, and Drinking to Cope with Social Anxiety: Testing Mediators of Drinking Problems

    OpenAIRE

    Clerkin, Elise M.; Sarfan, Laurel D.; Parsons, E. Marie; Magee, Joshua C.

    2016-01-01

    This cross-sectional study tested social anxiety symptoms, trait mindfulness, and drinking to cope with social anxiety as potential predictors and/or serial mediators of drinking problems. A community-based sample of individuals with co-occurring social anxiety symptoms and alcohol dependence were recruited. Participants (N = 105) completed measures of social anxiety, drinking to cope with social anxiety, and alcohol use and problems. As well, participants completed the Five Facet Mindfulness...

  12. Alcoholism and anxiety in bipolar illness : Differential lifetime anxiety comorbidity in bipolar I women with and without alcoholism

    NARCIS (Netherlands)

    Levander, Eric; Frye, Mark A.; McElroy, Susan; Suppes, Trisha; Grunze, Heinz; Nolen, Willem A.; Kupka, Ralph; Keck, Paul E.; Leverich, Gabriele S.; Altshuler, Lori L.; Hwang, Sun; Mintz, Jim; Post, Robert M.

    Introduction: This study was undertaken to evaluate the prevalence rate of anxiety comorbidity in bipolar subjects with and without alcohol use disorders (AUD). Methods: Bipolar men and women who entered the Stanley Foundation Bipolar Network (SFBN) underwent a Structured Clinical Interview for

  13. Is Behavioral Regulation in Children With ADHD Aggravated by Comorbid Anxiety Disorder?

    DEFF Research Database (Denmark)

    Sørensen, Lin; Plessen, Kerstin J; Nicholas, Jude

    2010-01-01

    compared to BRIEF reports in a group of children with a "pure" ADHD (n = 23), a "pure" anxiety (n = 24) and a group without any diagnosis (n = 104) in a 2 (ADHD vs. no ADHD) x 2 (anxiety vs. no anxiety) design. Results: The children with ADHD and anxiety disorder scored significantly higher on the Inhibit...... scale than children within the other three groups. Main effects of diagnosis appeared in ADHD children on the Inhibit, Emotional Control, and Working Memory scales, and on the Shift and Emotional Control scales in anxious children. Conclusion: The results indicate that a behavioral dysregulation in ADHD......Background: The present study investigated the impact of coexisting anxiety disorder in children with ADHD on their ability to regulate behavior. Method: Parent reports on the Behavior Rating Inventory of Executive Function (BRIEF) in a comorbid group of children with ADHD and anxiety (n = 11) were...

  14. Social Anxiety among Chinese People

    Directory of Open Access Journals (Sweden)

    Qianqian Fan

    2015-01-01

    Full Text Available The experience of social anxiety has largely been investigated among Western populations; much less is known about social anxiety in other cultures. Unlike the Western culture, the Chinese emphasize interdependence and harmony with social others. In addition, it is unclear if Western constructed instruments adequately capture culturally conditioned conceptualizations and manifestations of social anxiety that might be specific to the Chinese. The present study employed a sequence of qualitative and quantitative approaches to examine the assessment of social anxiety among the Chinese people. Interviews and focus group discussions with Chinese participants revealed that some items containing the experience of social anxiety among the Chinese are not present in existing Western measures. Factor analysis was employed to examine the factor structure of the more comprehensive scale. This approach revealed an “other concerned anxiety” factor that appears to be specific to the Chinese. Subsequent analysis found that the new factor—other concerned anxiety—functioned the same as other social anxiety factors in their association with risk factors of social anxiety, such as attachment, parenting, behavioral inhibition/activation, and attitude toward group. The implications of these findings for a more culturally sensitive assessment tool of social anxiety among the Chinese were discussed.

  15. Social Anxiety among Chinese People

    Science.gov (United States)

    Fan, Qianqian; Chang, Weining C.

    2015-01-01

    The experience of social anxiety has largely been investigated among Western populations; much less is known about social anxiety in other cultures. Unlike the Western culture, the Chinese emphasize interdependence and harmony with social others. In addition, it is unclear if Western constructed instruments adequately capture culturally conditioned conceptualizations and manifestations of social anxiety that might be specific to the Chinese. The present study employed a sequence of qualitative and quantitative approaches to examine the assessment of social anxiety among the Chinese people. Interviews and focus group discussions with Chinese participants revealed that some items containing the experience of social anxiety among the Chinese are not present in existing Western measures. Factor analysis was employed to examine the factor structure of the more comprehensive scale. This approach revealed an “other concerned anxiety” factor that appears to be specific to the Chinese. Subsequent analysis found that the new factor—other concerned anxiety—functioned the same as other social anxiety factors in their association with risk factors of social anxiety, such as attachment, parenting, behavioral inhibition/activation, and attitude toward group. The implications of these findings for a more culturally sensitive assessment tool of social anxiety among the Chinese were discussed. PMID:26380367

  16. Social communication deficits: Specific associations with Social Anxiety Disorder.

    Science.gov (United States)

    Halls, Georgia; Cooper, Peter J; Creswell, Cathy

    2015-02-01

    Social communication deficits are prevalent amongst children with anxiety disorders; however whether they are over-represented specifically among children with Social Anxiety Disorder has not been examined. This study set out to examine social communication deficits among children with Social Anxiety Disorder in comparison to children with other forms of anxiety disorder. Parents of 404 children with a diagnosed anxiety disorder completed the Social Communication Questionnaire (SCQ; Rutter, M., Bailey, A., Lord, C., 2003. The Social Communication Questionnaire - Manual. Western Psychological Services, Los Angeles, CA). Children with a diagnosis of Social Anxiety Disorder (n=262) and anxious children without Social Anxiety Disorder (n=142) were compared on SCQ total and subscale scores and the frequency of participants scoring above clinical cut-offs. Children with Social Anxiety Disorder scored significantly higher than anxious children without Social Anxiety Disorder on the SCQ total (t(352)=4.85, p<.001, d=.55, r=.27), Reciprocal Social Interaction (t(351)=4.73, p<.001, d=.55, r=.27), communication (t(344)=3.62, p<.001, d=.43, r=.21) and repetitive, restrictive and stereotyped behaviors subscales (t(353)=3.15, p=.002, d=.37, r=.18). Furthermore, children with Social Anxiety Disorder were three times more likely to score above clinical cut-offs. The participants were a relatively affluent group of predominantly non-minority status. The social communication difficulties measure relied on parental report which could be influenced by extraneous factors. Treatments for Social Anxiety Disorder may benefit from a specific focus on developing social communication skills. Future research using objective assessments of underlying social communication skills is required. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Genetic background contributes to the co-morbidity of anxiety and depression with audiogenic seizure propensity and responses to fluoxetine treatment.

    Science.gov (United States)

    Sarkisova, Karine Yu; Fedotova, Irina B; Surina, Natalia M; Nikolaev, Georgy M; Perepelkina, Olga V; Kostina, Zoya A; Poletaeva, Inga I

    2017-03-01

    Anxiety and depression are the most frequent comorbidities of different types of convulsive and non-convulsive epilepsies. Increased anxiety and depression-like phenotype have been described in the genetic absence epilepsy models as well as in models of limbic epilepsy and acquired seizure models, suggesting a neurobiological connection. However, whether anxiety and/or depression are comorbid to audiogenic epilepsy remains unclear. The aim of this study was to investigate whether anxiety or depression-like behavior can be found in rat strains with different susceptibility to audiogenic seizures (AS) and whether chronic fluoxetine treatment affects this co-morbidity. Behavior in the elevated plus-maze and the forced swimming test was studied in four strains: Wistar rats non-susceptible to AS; Krushinsky-Molodkina (KM) strain, selectively bred for AS propensity from outbred Wistar rats; and a selection lines bred for maximal AS expression (strain "4") and for a lack of AS (strain "0") from KM×Wistar F2 hybrids. Effects of chronic antidepressant treatment on AS and behavior were also evaluated. Anxiety and depression levels were higher in KM rats (with AS) compared with Wistar rats (without AS), indicating the comorbidity with AS. However, in strains "4" and "0" with contrasting AS expression, but with a genetic background close to KM rats, anxiety and depression were not as divergent as in KMs versus Wistars. Fluoxetine treatment exerted an antidepressant effect in all rat strains irrespective of its effect on AS. Genetic background contributes substantively to the co-morbidity of anxiety and depression with AS propensity. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Consensus statement on social anxiety disorder from the International Consensus Group on Depression and Anxiety.

    Science.gov (United States)

    Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Bobes, J; Beidel, D C; Ono, Y; Westenberg, H G

    1998-01-01

    The goal of this consensus statement is to provide primary care clinicians with a better understanding of management issues in social anxiety disorder (social phobia) and guide clinical practice with recommendations for appropriate pharmacotherapy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Other faculty invited by the chair were Julio Bobes, Deborah C. Beidel, Yukata Ono, and Herman G. M. Westenberg. The consensus statement is based on the 7 review papers published in this supplement and on the scientific literature relevant to the issues reviewed in these papers. The group met over a 2-day period. On day 1, the group discussed each review paper, and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. The consensus statement underlines the importance of recognizing social anxiety disorder and provides recommendations on how it may be distinguished from other anxiety disorders. It proposes definitions for response and remission and considers appropriate management strategies. Selective serotonin reuptake inhibitors are recommended as first-line therapy, and effective treatment should be continued for at least 12 months. Long-term treatment is indicated if symptoms are unresolved, the patient has a comorbid condition or a history of relapse, or there was an early onset of the disorder.

  19. [Social anxiety and self-esteem: Hungarian validation of the "Brief Fear of Negative Evaluation Scale - Straightforward Items"].

    Science.gov (United States)

    Perczel-Forintos, Dóra; Kresznerits, Szilvia

    2017-06-01

    Although social anxiety disorder (SAD) is the third most frequent emotional disorder with 13-15% prevalence rate, it remains unrecognized very often. Social phobia is associated with low self-esteem, high self-criticism and fear of negative evaluation by others. It shows high comorbidity with depression, alcoholism, drug addiction and eating disorders. To adapt the widely used "Fear of Negative Evaluation" (FNE) social phobia questionnaire. Anxiety and mood disorder patients (n = 255) completed the Fear of Negative Evaluation Scale (30, 12 and 8 item-versions) as well as social cognition, anxiety and self-esteem questionnaires. All the three versions of the FNE have strong internal validity (α>0.83) and moderate significant correlation with low self-esteem, negative social cognitions and anxiety. The short 8-item BFNE-S has the strongest disciminative value in differentiating patients with social phobia and with other emotional disorders. The Hungarian version of the BFNE-S is an effective tool for the quick recognition of social phobia. Orv Hetil. 2017; 158(22): 843-850.

  20. Symptoms of social anxiety, depression, and stress in parents of children with social anxiety disorder.

    Science.gov (United States)

    Halldorsson, Brynjar; Draisey, Jenny; Cooper, Peter; Creswell, Cathy

    2018-06-01

    It has been suggested that elevated maternal social anxiety may play a disorder-specific role in maintaining childhood social anxiety disorder (SAD), but few studies have examined whether mothers of children with SAD are more socially anxious than mothers of children with other anxiety disorders (ANX). This study set out to examine whether symptoms of social anxiety were more severe amongst mothers of 7-12 year old children presenting for treatment with SAD (n = 260) compared to those presenting with ANX (n = 138). In addition, we examined whether there were differences between these two groups in terms of maternal and paternal general anxiety, depression, and stress. Parents of 7-12 year old children referred for treatment of SAD or ANX completed self-report questionnaire measures of emotional symptoms. Compared to mothers of children with ANX, mothers of children with SAD reported significantly higher levels of social anxiety, general anxiety, and depression. In addition, fathers of children with SAD reported significantly higher levels of anxiety, stress, and depression than fathers of children with ANX. This study is one of the few existing studies that have examined mothers' and fathers' psychopathology across different childhood anxiety disorders. Compared to parents of children with ANX, parents of children with SAD may have poorer mental health which may inhibit optimum child treatment outcomes for children with SAD. Thus, targeting parental psychopathology may be particularly important in the treatment of childhood SAD. Consideration of parental psychopathology may be particularly important in the treatment of childhood social anxiety disorder. Mothers of children with social anxiety disorder are more socially anxious than mothers of children with other anxiety disorders Fathers of children with social anxiety disorder are more anxious and depressed than fathers of children with other anxiety disorders Participants were predominantly of high

  1. Adolescent Social Stress Increases Anxiety-like Behavior and Alters Synaptic Transmission, Without Influencing Nicotine Responses, in a Sex-Dependent Manner.

    Science.gov (United States)

    Caruso, Michael J; Crowley, Nicole A; Reiss, Dana E; Caulfield, Jasmine I; Luscher, Bernhard; Cavigelli, Sonia A; Kamens, Helen M

    2018-03-01

    Early-life stress is a risk factor for comorbid anxiety and nicotine use. Because little is known about the factors underlying this comorbidity, we investigated the effects of adolescent stress on anxiety-like behavior and nicotine responses within individual animals. Adolescent male and female C57BL/6J mice were exposed to chronic variable social stress (CVSS; repeated cycles of social isolation + social reorganization) or control conditions from postnatal days (PND) 25-59. Anxiety-like behavior and social avoidance were measured in the elevated plus-maze (PND 61-65) and social approach-avoidance test (Experiment 1: PND 140-144; Experiment 2: 95-97), respectively. Acute nicotine-induced locomotor, hypothermic, corticosterone responses, (Experiment 1: PND 56-59; Experiment 2: PND 65-70) and voluntary oral nicotine consumption (Experiment 1: PND 116-135; Experiment 2: 73-92) were also examined. Finally, we assessed prefrontal cortex (PFC) and nucleus accumbens (NAC) synaptic transmission (PND 64-80); brain regions that are implicated in anxiety and addiction. Mice exposed to adolescent CVSS displayed increased anxiety-like behavior relative to controls. Further, CVSS altered synaptic excitability in PFC and NAC neurons in a sex-specific manner. For males, CVSS decreased the amplitude and frequency of spontaneous excitatory postsynaptic currents in the PFC and NAC, respectively. In females, CVSS decreased the amplitude of spontaneous inhibitory postsynaptic currents in the NAC. Adolescent CVSS did not affect social avoidance or nicotine responses and anxiety-like behavior was not reliably associated with nicotine responses within individual animals. Taken together, complex interactions between PFC and NAC function may contribute to adolescent stress-induced anxiety-like behavior without influencing nicotine responses. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

  2. Social Anxiety and Social Support in Romantic Relationships.

    Science.gov (United States)

    Porter, Eliora; Chambless, Dianne L

    2017-05-01

    Little is known about the quality of socially anxious individuals' romantic relationships. In the present study, we examine associations between social anxiety and social support in such relationships. In Study 1, we collected self-report data on social anxiety symptoms and received, provided, and perceived social support from 343 undergraduates and their romantic partners. One year later couples were contacted to determine whether they were still in this relationship. Results indicated that men's social anxiety at Time 1 predicted higher rates of breakup at Time 2. Men's and women's perceived support, as well as men's provided support, were also significantly predictive of breakup. Social anxiety did not interact with any of the support variables to predict breakup. In Study 2, a subset of undergraduate couples with a partner high (n=27) or low (n=27) in social anxiety completed two 10-minute, lab-based, video-recorded social support tasks. Both partners rated their received or provided social support following the interaction, and trained observers also coded for support behaviors. Results showed that socially anxious individuals received less support from their partners during the interaction according to participant but not observer report. High and lower social anxiety couples did not differ in terms of the target's provision of support. Taken together, results suggest that social anxiety is associated with difficulties even in the context of established romantic relationships. Clinical implications are discussed. Copyright © 2016. Published by Elsevier Ltd.

  3. Correlations among Social Anxiety, Self-Esteem, Impulsivity, and Game Genre in Patients with Problematic Online Game Playing

    Science.gov (United States)

    Park, Jeong Ha; Han, Doug Hyun; Kim, Bung-Nyun; Cheong, Jae Hoon

    2016-01-01

    Objective Recent studies of online game addiction have suggested that social interaction and impulsivity are critical factors for the etiology and progress of online game addiction. We hypothesized that the genre of the online game is associated with impulsivity and sociality in individuals with online game addictions. Methods In total, 212 patients with problematic online game playing were divided into four groups by game genre: 1) massive multiplayer online role playing game (MMORPG), 2) real-time strategy (RTS), 3) first-person shooter (FPS), and 4) other. Their symptoms and characteristics were assessed using 8 scales and 2 tests to estimate self-esteem, impulsiveness, comorbidity, social interaction status, and cognitive function. Results The mean social anxiety score was highest in the MMORPG group and lowest in the FPS group. The mean self-esteem score was highest in the RTS group. Social anxiety score was positively correlated with Internet addiction score in the MMORPG group, and the self-esteem score was positively correlated with Internet addiction score in the RTS group. Conclusion The genre of online game was not associated with impulsivity, but social anxiety status varied significantly with game genre, and differences in social anxiety were especially pronounced in patients playing the MMORPG (highest social anxiety) and FPS (lowest social anxiety) game genres. In addition, self-esteem was highest in the RTS game genre. PMID:27247595

  4. Correlations among Social Anxiety, Self-Esteem, Impulsivity, and Game Genre in Patients with Problematic Online Game Playing.

    Science.gov (United States)

    Park, Jeong Ha; Han, Doug Hyun; Kim, Bung-Nyun; Cheong, Jae Hoon; Lee, Young-Sik

    2016-05-01

    Recent studies of online game addiction have suggested that social interaction and impulsivity are critical factors for the etiology and progress of online game addiction. We hypothesized that the genre of the online game is associated with impulsivity and sociality in individuals with online game addictions. In total, 212 patients with problematic online game playing were divided into four groups by game genre: 1) massive multiplayer online role playing game (MMORPG), 2) real-time strategy (RTS), 3) first-person shooter (FPS), and 4) other. Their symptoms and characteristics were assessed using 8 scales and 2 tests to estimate self-esteem, impulsiveness, comorbidity, social interaction status, and cognitive function. The mean social anxiety score was highest in the MMORPG group and lowest in the FPS group. The mean self-esteem score was highest in the RTS group. Social anxiety score was positively correlated with Internet addiction score in the MMORPG group, and the self-esteem score was positively correlated with Internet addiction score in the RTS group. The genre of online game was not associated with impulsivity, but social anxiety status varied significantly with game genre, and differences in social anxiety were especially pronounced in patients playing the MMORPG (highest social anxiety) and FPS (lowest social anxiety) game genres. In addition, self-esteem was highest in the RTS game genre.

  5. PSYCHOLOGICAL MECHANISMS OF SOCIAL ANXIETY AND SOCIAL ANXIETY DISORDER (SAD) IN ADOLESCENTS

    OpenAIRE

    Samoylova, Vera; Sagalakova, Olga

    2017-01-01

    Abstract: The cognitive model of social anxiety disorder is considered. Cognitive factors and linguistic features of the disorder are distinguished. The interconnections of such indicators as the quality of sleep, social behavior in everyday social situations, behavioral indices of social skills in social and performing tasks and physiological reactivity in adolescents are considered. It is shown that an accumulation of symptoms of social anxiety in the family leads to a disadaptive way of re...

  6. An experimental manipulation of social comparison in social anxiety.

    Science.gov (United States)

    Mitchell, Melissa A; Schmidt, Norman B

    2014-01-01

    Negative self-appraisal is thought to maintain social anxiety particularly when comparing oneself to others. Work on social comparison suggests that gender may moderate the effects of social comparison in social anxiety. Self-appraisals of the desirability of one's personality may be more important to women, whereas self-appraisal of signs of anxiety may be more important to men. Within each gender, those with high social anxiety are expected to report more negative self-appraisal when comparing themselves to someone else described as high achieving. This study is the first we are aware of that examined gender-based interactive effects after a social comparison manipulation. Participants read a bogus profile of a fellow student's adjustment to college. They were randomly assigned to read a profile suggesting that the fellow student was "high achieving" or more normative in his/her achievements. When comparing to a "high achieving" individual, men with high social anxiety reported the most negative self-appraisals of their signs of anxiety. In addition, greater social anxiety was associated with a poorer self-appraisal of personality only among men. The implications of the findings for conceptualizing the role of social comparison in social anxiety are discussed.

  7. An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol.

    Science.gov (United States)

    Baillie, Andrew J; Sannibale, Claudia; Stapinski, Lexine A; Teesson, Maree; Rapee, Ronald M; Haber, Paul S

    2013-07-30

    Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment. A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation. The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems. Australian New Zealand Clinical Trials Registry: ACTRN12608000228381.

  8. Methylphenidate and Comorbid Anxiety Disorder in Children with both Chronic Multiple Tic Disorder and ADHD

    Science.gov (United States)

    Gadow, Kenneth D.; Nolan, Edith E.

    2011-01-01

    Objective: To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD). Method: Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial…

  9. DSM-5 illness anxiety disorder and somatic symptom disorder: Comorbidity, correlates, and overlap with DSM-IV hypochondriasis.

    Science.gov (United States)

    Newby, Jill M; Hobbs, Megan J; Mahoney, Alison E J; Wong, Shiu Kelvin; Andrews, Gavin

    2017-10-01

    To investigate the reliability, validity and utility of DSM-5 illness anxiety disorder (IAD) and somatic symptom disorder (SSD), and explore their overlap with DSM-IV Hypochondriasis in a health anxious sample. Treatment-seeking patients with health anxiety (N=118) completed structured diagnostic interviews to assess DSM-IV Hypochondriasis, DSM-5 IAD, SSD, and comorbid mental disorders, and completed self-report measures of health anxiety, comorbid symptoms, cognitions and behaviours, and service utilization. IAD and SSD were more reliable diagnoses than Hypochondriasis (kappa estimates: IAD: 0.80, SSD: 0.92, Hypochondriasis: 0.60). 45% of patients were diagnosed with SSD, 47% with IAD, and 8% with comorbid IAD/SSD. Most patients with IAD fluctuated between seeking and avoiding care (61%), whereas care-seeking (25%) and care-avoidant subtypes were less common (14%). Half the sample met criteria for DSM-IV Hypochondriasis; of those, 56% met criteria for SSD criteria, 36% for IAD, and 8% for comorbid IAD/SSD. Compared to IAD, SSD was characterized by more severe health anxiety, somatic symptoms, depression, and higher health service use, and higher rates of major depressive disorder, panic disorder and agoraphobia. DSM-5 IAD and SSD classifications reliably detect more cases of clinically significant health anxiety than DSM-IV Hypochondriasis. The differences between IAD and SSD appear to be due to severity. Future research should explore the generalizability of these findings to other samples, and whether diagnostic status predicts treatment response and long-term outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness

    OpenAIRE

    McLean, Carmen P.; Asnaani, Anu; Litz, Brett T.; Hofmann, Stefan G.

    2011-01-01

    Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N = 20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women h...

  11. Are comorbid anxiety disorders a risk factor for suicide attempts in patients with mood disorders? A two-year prospective study.

    Science.gov (United States)

    Abreu, L N; Oquendo, M A; Galfavy, H; Burke, A; Grunebaum, M F; Sher, L; Sullivan, G M; Sublette, M E; Mann, J; Lafer, B

    2018-01-01

    Comorbid anxiety disorders have been considered a risk factor for suicidal behavior in patients with mood disorders, although results are controversial. The aim of this two-year prospective study was to determine if lifetime and current comorbid anxiety disorders at baseline were risk factors for suicide attempts during the two-year follow-up. We evaluated 667 patients with mood disorders (504 with major depression and 167 with bipolar disorder) divided in two groups: those with lifetime comorbid anxiety disorders (n=229) and those without (n=438). Assessments were performed at baseline and at 3, 12, and 24 months. Kaplan-Meier survival analysis and log-rank test were used to evaluate the relationship between anxiety disorders and suicide attempts. Cox proportional hazard regression was performed to investigate clinical and demographic variables that were associated with suicide attempts during follow-up. Of the initial sample of 667 patients, 480 had all three follow-up interviews. During the follow-up, 63 patients (13.1%) attempted suicide at least once. There was no significant difference in survival curves for patients with and without comorbid anxiety disorders (log-rank test=0.269; P=0.604). Female gender (HR=3.66, P=0.001), previous suicide attempts (HR=3.27, P=0.001) and higher scores in the Buss-Durkee Hostility Inventory (HR=1.05, P≤0.001) were associated with future suicide attempts. Our results suggest that comorbid anxiety disorders were not risk factors for suicide attempts. Further studies were needed to determine the role of anxiety disorders as risk factors for suicide attempts. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Preventing Adolescent Social Anxiety and Depression and Reducing Peer Victimization: Intervention Development and Open Trial

    Science.gov (United States)

    La Greca, Annette M.; Ehrenreich-May, Jill; Mufson, Laura; Chan, Sherilynn

    2016-01-01

    Background: Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the…

  13. Social Anxiety in University Students

    Science.gov (United States)

    Subasi, Guzin

    2005-01-01

    Social anxiety occurs when people feel doubtful about their particular impressions, real or imaginary, on others. Social anxiety, as denoted by its name, is a situation that arises in social settings as an outcome of interpersonal relationships. What lies in the basis of social anxiety is the fear of being evaluated by others as inadequate. Social…

  14. Personality disorders in heart failure patients requiring psychiatric management: comorbidity detections from a routine depression and anxiety screening protocol.

    Science.gov (United States)

    Tully, Phillip J; Selkow, Terina

    2014-12-30

    Several international guidelines recommend routine depression screening in cardiac disease populations. No previous study has determined the prevalence and comorbidities of personality disorders in patients presenting for psychiatric treatment after these screening initiatives. In the first stage 404 heart failure (HF) patients were routinely screened and 73 underwent structured interview when either of the following criteria were met: (a) Patient Health Questionnaire ≥10; (b) Generalized Anxiety Disorder Questionnaire ≥7); (c) Response to one item panic-screener. Or (d) Suicidality. Patients with personality disorders were compared to the positive-screen patients on psychiatric comorbidities. The most common personality disorders were avoidant (8.2%), borderline (6.8%) and obsessive compulsive (4.1%), other personality disorders were prevalent in less than patients. Personality disorder patients had significantly greater risk of major depression (risk ratio (RR) 1.2; 95% confidence interval (CI) 1.2-13.3), generalized anxiety disorder (RR 3.2; 95% CI 1.0-10.0), social phobia (RR 3.8; 95% CI 1.3-11.5) and alcohol abuse/dependence (RR 3.2; 95% 1.0-9.5). The findings that HF patients with personality disorders presented with complex psychiatric comorbidity suggest that pathways facilitating the integration of psychiatric services into cardiology settings are warranted when routine depression screening is in place. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Co-occurrence of social anxiety and depression symptoms in adolescence: differential links with implicit and explicit self-esteem?

    Science.gov (United States)

    de Jong, P J; Sportel, B E; de Hullu, E; Nauta, M H

    2012-03-01

    Social anxiety and depression often co-occur. As low self-esteem has been identified as a risk factor for both types of symptoms, it may help to explain their co-morbidity. Current dual process models of psychopathology differentiate between explicit and implicit self-esteem. Explicit self-esteem would reflect deliberate self-evaluative processes whereas implicit self-esteem would reflect simple associations in memory. Previous research suggests that low explicit self-esteem is involved in both social anxiety and depression whereas low implicit self-esteem is only involved in social anxiety. We tested whether the association between symptoms of social phobia and depression can indeed be explained by low explicit self-esteem, whereas low implicit self-esteem is only involved in social anxiety. Adolescents during the first stage of secondary education (n=1806) completed the Revised Child Anxiety and Depression Scale (RCADS) to measure symptoms of social anxiety and depression, the Rosenberg Self-Esteem Scale (RSES) to index explicit self-esteem and the Implicit Association Test (IAT) to measure implicit self-esteem. There was a strong association between symptoms of depression and social anxiety that could be largely explained by participants' explicit self-esteem. Only for girls did implicit self-esteem and the interaction between implicit and explicit self-esteem show small cumulative predictive validity for social anxiety, indicating that the association between low implicit self-esteem and social anxiety was most evident for girls with relatively low explicit self-esteem. Implicit self-esteem showed no significant predictive validity for depressive symptoms. The findings support the view that both shared and differential self-evaluative processes are involved in depression and social anxiety.

  16. A dimensional approach to determine common and specific neurofunctional markers for depression and social anxiety during emotional face processing.

    Science.gov (United States)

    Luo, Lizhu; Becker, Benjamin; Zheng, Xiaoxiao; Zhao, Zhiying; Xu, Xiaolei; Zhou, Feng; Wang, Jiaojian; Kou, Juan; Dai, Jing; Kendrick, Keith M

    2018-02-01

    Major depression disorder (MDD) and anxiety disorder are both prevalent and debilitating. High rates of comorbidity between MDD and social anxiety disorder (SAD) suggest common pathological pathways, including aberrant neural processing of interpersonal signals. In patient populations, the determination of common and distinct neurofunctional markers of MDD and SAD is often hampered by confounding factors, such as generally elevated anxiety levels and disorder-specific brain structural alterations. This study employed a dimensional disorder approach to map neurofunctional markers associated with levels of depression and social anxiety symptoms in a cohort of 91 healthy subjects using an emotional face processing paradigm. Examining linear associations between levels of depression and social anxiety, while controlling for trait anxiety revealed that both were associated with exaggerated dorsal striatal reactivity to fearful and sad expression faces respectively. Exploratory analysis revealed that depression scores were positively correlated with dorsal striatal functional connectivity during processing of fearful faces, whereas those of social anxiety showed a negative association during processing of sad faces. No linear relationships between levels of depression and social anxiety were observed during a facial-identity matching task or with brain structure. Together, the present findings indicate that dorsal striatal neurofunctional alterations might underlie aberrant interpersonal processing associated with both increased levels of depression and social anxiety. © 2017 Wiley Periodicals, Inc.

  17. Social Anxiety among Chinese People

    OpenAIRE

    Fan, Qianqian; Chang, Weining C.

    2015-01-01

    The experience of social anxiety has largely been investigated among Western populations; much less is known about social anxiety in other cultures. Unlike the Western culture, the Chinese emphasize interdependence and harmony with social others. In addition, it is unclear if Western constructed instruments adequately capture culturally conditioned conceptualizations and manifestations of social anxiety that might be specific to the Chinese. The present study employed a sequence of qualitativ...

  18. Disability and Comorbidity: Diagnoses and Symptoms Associated with Disability in a Clinical Population with Panic Disorder

    Directory of Open Access Journals (Sweden)

    Caroline A. Bonham

    2014-01-01

    Full Text Available Background. Anxiety disorders are associated with considerable disability in the domains of (1 work, (2 social, and (3 family and home interactions. Psychiatric comorbidity is also known to be associated with disability. Methods. Data from the Cross-National Collaborative Panic Study was used to identify rates of comorbid diagnoses, anxiety and depression symptom ratings, and Sheehan disability scale ratings from a clinical sample of 1165 adults with panic disorder. Results. Comorbid diagnoses of agoraphobia, major depression, and social phobia were associated with disability across the three domains of work, social, and family and home interactions. The symptom of agoraphobic avoidance makes the largest contribution to disability but there is no single symptom cluster that entirely predicts impairment and disability. Limitations. The findings about the relative contributions that comorbid diagnoses make to disability only apply to a population with panic disorder. Conclusions. Although panic disorder is not generally considered to be among the serious and persistent mental illnesses, when it is comorbid with other diagnoses, it is associated with considerable impairment. In particular, the presence of agoraphobic avoidance should alert the clinician to the likelihood of important functional impairment. When measuring the functional impact of comorbid anxiety disorders, both the categorical and the dimensional approaches to diagnosis make valuable contributions.

  19. Psychological treatment of depression and anxiety in patients with co-morbid personality disorder: A scoping study of trial evidence.

    Science.gov (United States)

    French, L R M; Turner, K M; Dawson, S; Moran, P

    2017-05-01

    It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Left hemisphere dysfunction during verbal dichotic listening tests in patients who have social phobia with or without comorbid depressive disorder.

    Science.gov (United States)

    Bruder, Gerard E; Schneier, Franklin R; Stewart, Jonathan W; McGrath, Patrick J; Quitkin, Frederic

    2004-01-01

    Behavioral, electrophysiological, and imaging studies have found evidence that anxiety disorders are associated with left hemisphere dysfunction or higher than normal activation of right hemisphere regions. Few studies, however, have examined hemispheric asymmetries of function in social phobia, and the influence of comorbidity with depressive disorders is unknown. The present study used dichotic listening tests to assess lateralized cognitive processing in patients with social phobia, depression, or comorbid social phobia and depression. The study used a two-by-two factorial design in which one factor was social phobia (present versus absent) and the second factor was depressive disorder (present versus absent). A total of 125 unmedicated patients with social phobia, depressive disorder, or comorbid social phobia and depressive disorder and 44 healthy comparison subjects were tested on dichotic fused-words, consonant-vowel syllable, and complex tone tests. Patients with social phobia with or without a comorbid depressive disorder had a smaller left hemisphere advantage for processing words and syllables, compared with subjects without social phobia, whereas no difference between groups was found in the right hemisphere advantage for processing complex tones. Depressed women had a larger left hemisphere advantage for processing words, compared with nondepressed women, but this difference was not seen among men. The results support the hypothesis that social phobia is associated with dysfunction of left hemisphere regions mediating verbal processing. Given the importance of verbal processes in social interactions, this dysfunction may contribute to the stress and difficulty experienced by patients with social phobia in social situations.

  1. Social Anxiety and Friendship Quality over Time.

    Science.gov (United States)

    Rodebaugh, Thomas L; Lim, Michelle H; Shumaker, Erik A; Levinson, Cheri A; Thompson, Tess

    2015-01-01

    High social anxiety in adults is associated with self-report of impaired friendship quality, but not necessarily with impairment reported by friends. Further, prospective prediction of social anxiety and friendship quality over time has not been tested among adults. We therefore examined friendship quality and social anxiety prospectively in 126 young adults (67 primary participants and 59 friends, aged 17-22 years); the primary participants were screened to be extreme groups to increase power and relevance to clinical samples (i.e., they were recruited based on having very high or very low social interaction anxiety). The prospective relationships between friendship quality and social anxiety were then tested using an Actor-Partner Interdependence Model. Friendship quality prospectively predicted social anxiety over time within each individual in the friendship, such that higher friendship quality at Time 1 predicted lower social anxiety approximately 6 months later at Time 2. Social anxiety did not predict friendship quality. Although the results support the view that social anxiety and friendship quality have an important causal relationship, the results run counter to the assumption that high social anxiety causes poor friendship quality. Interventions to increase friendship quality merit further consideration.

  2. Cultural differences in perceived social norms and social anxiety.

    Science.gov (United States)

    Heinrichs, Nina; Rapee, Ronald M; Alden, Lynn A; Bögels, Susan; Hofmann, Stefan G; Oh, Kyung Ja; Sakano, Yuji

    2006-08-01

    Cultural considerations in social anxiety are a rarely investigated topic although it seems likely that differences between countries in social norms may relate to the extent of social anxiety. The present study investigated individuals' personal and perceived cultural norms and their relation to social anxiety and fear of blushing. A total of 909 participants from eight countries completed vignettes describing social situations and evaluated the social acceptability of the behavior of the main actor both from their own, personal perspective as well as from a cultural viewpoint. Personal and cultural norms showed somewhat different patterns in comparison between types of countries (individualistic/collectivistic). According to reported cultural norms, collectivistic countries were more accepting toward socially reticent and withdrawn behaviors than was the case in individualistic countries. In contrast, there was no difference between individualistic and collectivistic countries on individuals' personal perspectives regarding socially withdrawn behavior. Collectivistic countries also reported greater levels of social anxiety and more fear of blushing than individualistic countries. Significant positive relations occurred between the extent to which attention-avoiding behaviors are accepted in a culture and the level of social anxiety or fear of blushing symptoms. These results provide initial evidence that social anxiety may be related to different cultural norms across countries.

  3. The association of quality of social relations, symptom severity and intelligence with anxiety in children with autism spectrum disorders.

    Science.gov (United States)

    Eussen, Mart L J M; Van Gool, Arthur R; Verheij, Fop; De Nijs, Pieter F A; Verhulst, Frank C; Greaves-Lord, Kirstin

    2013-11-01

    Limited quality of social relations, milder symptom severity and higher intelligence were shown to account for higher anxiety levels in autism spectrum disorders. The current study replicated and extended earlier findings by combining these three determinants of anxiety in autism spectrum disorders in one study. The sample consisted of 134 school-aged children with autism spectrum disorders, of whom 58 (43%) had a co-morbid anxiety disorder according to the Diagnostic Interview Schedule for Children-Parent version. In this sample, we tested associations between these determinants and anxiety univariately and multivariately to clarify the unique contribution of all determinants. Since we hypothesized that the association between limited quality of social relations and anxiety would be amplified by low symptom severity and/or high intelligence, we additionally tested for moderating effects. We found that higher anxiety levels were associated with a lower quality of social relations and lower symptom severity. In this mainly high-functioning sample, intelligence was not related to anxiety levels. No moderation effects were found. Since lower quality of social relations and lower symptom severity are associated with higher anxiety levels in children with autism spectrum disorders, therapeutic interventions aimed at reducing anxiety in autism spectrum disorders should pay attention to improving social relations, and presumably children with a lower symptom severity could benefit most from such interventions.

  4. Social Anxiety Disorder (Social Phobia)

    Science.gov (United States)

    ... enjoyment of life. Social anxiety disorder can cause: Low self-esteem Trouble being assertive Negative self-talk Hypersensitivity to criticism Poor social skills Isolation and difficult social relationships Low academic and employment achievement Substance abuse, such as ...

  5. Socialization of Social Anxiety in Adolescent Crowds

    Science.gov (United States)

    Van Zalk, Nejra; Van Zalk, Maarten Herman Walter; Kerr, Margaret

    2011-01-01

    In this study, we looked at whether social anxiety is socialized, or influenced by peers' social anxiety, more in some peer crowds than others. Adolescents in crowds with eye-catching appearances such as Goths and Punks (here termed "Radical"), were compared with three comparison groups. Using data from 796 adolescents (353 girls and 443 boys; M…

  6. Psychiatric comorbidities in patients with major depressive disorder

    Directory of Open Access Journals (Sweden)

    Thaipisuttikul P

    2014-11-01

    Full Text Available Papan Thaipisuttikul, Pichai Ittasakul, Punjaporn Waleeprakhon, Pattarabhorn Wisajun, Sudawan Jullagate Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Background: Psychiatric comorbidities are common in major depressive disorder (MDD. They may worsen outcome and cause economic burden. The primary objective was to examine the prevalence of psychiatric comorbidities in MDD. The secondary objectives were to compare the presence of comorbidities between currently active and past MDD, and between patients with and without suicidal risk.Methods: This was a cross-sectional study. A total of 250 patients with lifetime MDD and age ≥18 years were enrolled. The Mini International Neuropsychiatric Interview (MINI, Thai version, was used to confirm MDD diagnosis and classify comorbidities. MDD diagnosis was confirmed in 190, and 60 patients were excluded due to diagnosis of bipolar disorder.Results: Of the 190 MDD patients, 25.8% had current MDD and 74.2% had past MDD. Eighty percent were women. The mean age at enrollment was 50 years, and at MDD onset was 41 years. Most patients were married (53.2%, employed (54.8%, and had ≥12 years of education (66.9%. There were 67 patients (35.3% with one or more psychiatric comorbidities. Comorbidities included dysthymia (19.5%, any anxiety disorders (21.1% (panic disorder [6.8%], agoraphobia [5.8%], social phobia [3.7%], obsessive–compulsive disorder [OCD] [4.7%], generalized anxiety disorder [5.3%], and post-traumatic stress disorder [4.2%], alcohol dependence (0.5%, psychotic disorder (1.6%, antisocial personality (1.1%, and eating disorders (0%. Compared with past MDD, the current MDD group had significantly higher OCD (P<0.001, psychotic disorder (P=0.048, past panic disorder (P=0.017, and suicidal risk (P<0.001. Suicidal risk was found in 32.1% of patients. Patients with suicidal risk had more comorbid anxiety disorder of any type (P=0.019 and

  7. Once hurt, twice shy: Social pain contributes to social anxiety.

    Science.gov (United States)

    Fung, Klint; Alden, Lynn E

    2017-03-01

    Social rejection has been consistently linked to the development of social anxiety. However, mechanisms underlying the relation have been largely unexplored, which presents an obstacle to fully understanding the origins of social anxiety and to the development of effective prevention and treatment strategies. Two studies were conducted to test the hypothesis that the emotion of social pain following rejection promotes the development of social anxiety in subsequent situations. In Study 1, undergraduate participants were exposed to 2 social situations (Cyberball) 2 days apart. Participants who were rejected in the first situation reported higher social anxiety before and during the second situation relative to those who were included. This effect was fully mediated by initial social pain intensity. In Study 2, all participants were initially rejected. Using double-blinded drug administration, participants were randomly assigned to ingest acetaminophen to alleviate the social pain from rejection, or a sugar placebo. As predicted, the acetaminophen group reported lower social anxiety before and during the second situation. Approximately half of the effect was mediated by reduction in social pain. Notably, the immediate effect of acetaminophen was specific to social pain rather than social anxiety. Results were discussed in the context of literature on the etiology of social anxiety and social pain. Future directions were suggested. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Co-occurrence of social anxiety and depression symptoms in adolescence : differential links with implicit and explicit self-esteem?

    NARCIS (Netherlands)

    de Jong, P. J.; Sportel, B. E.; de Hullu, E.; Nauta, M. H.

    Background. Social anxiety and depression often co-occur. As low self-esteem has been identified as a risk factor for both types of symptoms, it may help to explain their co-morbidity. Current dual process models of psychopathology differentiate between explicit and implicit self-esteem. Explicit

  9. The comorbidity of anxiety and depressive symptoms in older adults with attention-deficit/hyperactivity disorder: A longitudinal study

    NARCIS (Netherlands)

    Michielsen, M.; Comijs, H.C.; Semeijn, E.J.; Beekman, A.T.F.; Deeg, D.J.H.; Kooij, J.J.S

    2013-01-01

    Background: Comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and depression and anxiety disorders in children and young to middle-aged adults has been well documented in the literature. Yet, it is still unknown whether this comorbidity persists into later life. The aim of this

  10. Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial.

    Science.gov (United States)

    Ellard, Kristen K; Bernstein, Emily E; Hearing, Casey; Baek, Ji Hyun; Sylvia, Louisa G; Nierenberg, Andrew A; Barlow, David H; Deckersbach, Thilo

    2017-09-01

    Comorbid anxiety in bipolar disorder (BD) is associated with greater illness severity, reduced treatment response, and greater impairment. Treating anxiety in the context of BD is crucial for improving illness course and outcomes. The current study examined the feasibility, acceptability and preliminary efficacy of the Unified Protocol (UP), a transdiagnostic cognitive behavioral therapy, as an adjunctive treatment to pharmacotherapy for BD and comorbid anxiety disorders. Twenty-nine patients with BD and at least one comorbid anxiety disorder were randomized to pharmacotherapy treatment-as-usual (TAU) or TAU with 18 sessions of the UP (UP+TAU). All patients completed assessments every four weeks to track symptoms, functioning, emotion regulation and temperament. Linear mixed-model regressions were conducted to track symptom changes over time and to examine the relationship between emotion-related variables and treatment response. Satisfaction ratings were equivalent for both treatment groups. Patients in the UP+TAU group evidenced significantly greater reductions over time in anxiety and depression symptoms (Cohen's d's>0.80). Baseline levels of neuroticism, perceived affective control, and emotion regulation ability predicted magnitude of symptom change for the UP+TAU group only. Greater change in perceived control of emotions and emotion regulation skills predicted greater change in anxiety related symptoms. This was a pilot feasibility and acceptability trial; results should be interpreted with caution. Treatment with the UP+TAU was rated high in patient satisfaction, and resulted in significantly greater improvement on indices of anxiety and depression relative to TAU. This suggests that the UP may be a feasible treatment approach for BD with comorbid anxiety. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Hemispheric Coherence in ASD with and without Comorbid ADHD and Anxiety

    OpenAIRE

    Saunders, A.; Kirk, I. J.; Waldie, K. E.

    2016-01-01

    There is a growing body of evidence suggesting that altered brain connectivity may be a defining feature of disorders such as autism spectrum disorder (ASD), anxiety, and ADHD. This study investigated whether resting state functional connectivity, measured by 128-channel EEG oscillation coherence, differs between developmental disorders. Analyses were conducted separately on groups with and without comorbid conditions. Analyses revealed increased coherence across central electrodes over the p...

  12. The Role of Cognitive Factors in Childhood Social Anxiety: Social Threat Thoughts and Social Skills Perception.

    Science.gov (United States)

    van Niekerk, Rianne E; Klein, Anke M; Allart-van Dam, Esther; Hudson, Jennifer L; Rinck, Mike; Hutschemaekers, Giel J M; Becker, Eni S

    2017-01-01

    Models of cognitive processing in anxiety disorders state that socially anxious children display several distorted cognitive processes that maintain their anxiety. The present study investigated the role of social threat thoughts and social skills perception in relation to childhood trait and state social anxiety. In total, 141 children varying in their levels of social anxiety performed a short speech task in front of a camera and filled out self-reports about their trait social anxiety, state anxiety, social skills perception and social threat thoughts. Results showed that social threat thoughts mediated the relationship between trait social anxiety and state anxiety after the speech task, even when controlling for baseline state anxiety. Furthermore, we found that children with higher trait anxiety and more social threat thoughts had a lower perception of their social skills, but did not display a social skills deficit. These results provide evidence for the applicability of the cognitive social anxiety model to children.

  13. The association between social phobia, social anxiety cognitions and paranoid symptoms.

    Science.gov (United States)

    Schutters, S I J; Dominguez, M-d-G; Knappe, S; Lieb, R; van Os, J; Schruers, K R J; Wittchen, H-U

    2012-03-01

    Previous research suggests high levels of comorbidity between social phobia and paranoid symptoms, although the nature of this association remains unclear. Data were derived from the Early Developmental Stages of Psychopathology study, a 10-year longitudinal study in a representative German community sample of 3021 participants aged 14-24 years at baseline. The Munich-Composite International Diagnostic Interview was used to assess social phobia and paranoid symptoms, along with data on social phobia features. Cross-sectional and longitudinal analyses were conducted. Differential associations with environmental risk factors and temperamental traits were investigated. Lifetime social phobia and paranoid symptoms were associated with each other cross-sectionally (OR = 1.80, 95% CI = 1.31-2.47). Lifetime paranoid symptoms were associated specifically with social anxiety cognitions. Lifetime cognitions of negative evaluation predicted later onset of paranoid symptoms, whereas onset of social phobia was predicted by cognitions of loss of control and fear/avoidance of social situations. Lifetime social phobia and paranoid symptoms shared temperamental traits of behavioural inhibition, but differed in environmental risks. The present study showed that paranoid symptoms and social phobia share similarities in cognitive profile and inhibited temperament. Avoidance appears to be important in the development of social phobia, whereas cannabis use and traumatic experiences may drive paranoid thinking in vulnerable individuals. © 2011 John Wiley & Sons A/S.

  14. Do Patient Characteristics Predict Outcome of Psychodynamic Psychotherapy for Social Anxiety Disorder?

    Directory of Open Access Journals (Sweden)

    Jörg Wiltink

    Full Text Available Little is known about patient characteristics as predictors for outcome in manualized short term psychodynamic psychotherapy (PDT. No study has addressed which patient variables predict outcome of PDT for social anxiety disorder.In the largest multicenter trial on psychotherapy of social anxiety (SA to date comparing cognitive therapy, PDT and wait list condition N = 230 patients were assigned to receive PDT, of which N = 166 completed treatment. Treatment outcome was assessed based on diverse parameters such as endstate functioning, remission, response, and drop-out. The relationship between patient characteristics (demographic variables, mental co-morbidity, personality, interpersonal problems and outcome was analysed using logistic and linear regressions.Pre-treatment SA predicted up to 39 percent of variance of outcome. Only few additional baseline characteristics predicted better treatment outcome (namely, lower comorbidity and interpersonal problems with a limited proportion of incremental variance (5.5 to 10 percent, while, e.g., shame, self-esteem or harm avoidance did not.We argue that the central importance of pre-treatment symptom severity for predicting outcomes should advocate alternative treatment strategies (e.g. longer treatments, combination of psychotherapy and medication in those who are most disturbed. Given the relatively small amount of variance explained by the other patient characteristics, process variables and patient-therapist interaction should additionally be taken into account in future research.Controlled-trials.com/ISRCTN53517394.

  15. Understanding migraine and psychiatric comorbidity.

    Science.gov (United States)

    Seng, Elizabeth K; Seng, Cynthia D

    2016-06-01

    This article describes recent trends in our understanding of the role of psychiatric disorders in the experience and treatment of migraine, and the role of migraine in the experience and treatment of psychiatric disorders. Although the majority of studies evaluating psychiatric comorbidity in migraine have focused on depression, anxiety, and bipolar disorders are highly associated with migraine and relevant for prognosis and treatment planning. Comorbid psychiatric disorders may be associated with poorer treatment response for some acute pharmacotherapies; however, people with comorbid migraine and mood or anxiety disorders can achieve large responses to preventive pharmacologic and behavioral therapies. Emerging research is developing and evaluating behavioral treatments designed to manage cooccurring migraine and mood or anxiety disorders. Stigma related to psychiatric disorders has been well characterized, and could exacerbate extant migraine-related stigma. Anxiety and mood disorders are prevalent in people with migraine, although not ubiquitous. Psychiatric comorbidity is associated with greater migraine symptoms and disability; however, people with comorbid depression or anxiety are amenable to preventive migraine treatment. Research regarding migraine treatment strategies optimized for people with comorbid psychiatric disorders is critical to advancing care and reducing stigma for this important subpopulation of people with migraine.

  16. Childhood adversities, bonding, and personality in social anxiety disorder with alcohol use disorder.

    Science.gov (United States)

    Rambau, Stefanie; Forstner, Andreas J; Wegener, Ingo; Mücke, Martin; Wissussek, Christine T S; Staufenbiel, Sabine M; Geiser, Franziska; Schumacher, Johannes; Conrad, Rupert

    2018-04-01

    Social anxiety disorder (SAD) is frequently associated with alcohol use disorders (abuse/dependence). However, there has been little research on the characteristics of this subgroup so far. In the current study we investigated individuals with SAD and comorbid alcohol use disorder (AUD) with regard to socialization experiences and personality. The sample comprised 410 individuals diagnosed with SAD by the Structured Clinical Interview of DSM-IV. 108 participants with comorbid AUD were compared to 302 participants without comorbid AUD concerning traumatic experiences during childhood and adolescence (Adverse Childhood Experiences Questionnaire; ACE), parental bonding (Parental Bonding Instrument; PBI), and personality (Temperament and Character Inventory; TCI). MANCOVA with covariates sex and depression displayed that individuals with SAD plus AUD reported significantly more traumatic events during childhood and adolescence, lower levels of maternal care, as well as lower cooperativeness. Our results highlight that adverse childhood experiences and unfavourable maternal bonding characterize individuals suffering from SAD plus AUD. These experiences might be reflected in a personality-based tendency to distance themselves from others, which corresponds to low scores on the character dimension cooperativeness. A deeper understanding of personality and specific socialization experiences is necessary to develop new treatment options in this clinically challenging subgroup. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Resting-state functional connectivity abnormalities in limbic and salience networks in social anxiety disorder without comorbidity

    NARCIS (Netherlands)

    Pannekoek, J. Nienke; Veer, Ilya M.; van Tol, Marie-Jose; van der Werff, Steven J. A.; Demenescu, Liliana R.; Aleman, Andre; Veltman, Dick J.; Zitman, Frans G.; Rombouts, Serge A. R. B.; van der Wee, Nic J. A.

    The neurobiology of social anxiety disorder (SAD) is not yet fully understood. Structural and functional neuroimaging studies in SAD have identified abnormalities in various brain areas, particularly the amygdala and elements of the salience network. This study is the first to examine resting-state

  18. Resting-state functional connectivity abnormalities in limbic and salience networks in social anxiety disorder without comorbidity

    NARCIS (Netherlands)

    Pannekoek, J.N.; Veer, I.M.; van Tol, M.J.; van der Werff, S.J.A.; Demenescu, L.R.; Aleman, A.; Veltman, D.J.; Zitman, F. G.; Rombouts, S.A.R.B.; van der Wee, N.J.A.

    2013-01-01

    The neurobiology of social anxiety disorder (SAD) is not yet fully understood. Structural and functional neuroimaging studies in SAD have identified abnormalities in various brain areas, particularly the amygdala and elements of the salience network. This study is the first to examine resting-state

  19. Relationship between anxiety, anxiety sensitivity and conduct disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

    Science.gov (United States)

    Bilgiç, Ayhan; Türkoğlu, Serhat; Ozcan, Ozlem; Tufan, Ali Evren; Yılmaz, Savaş; Yüksel, Tuğba

    2013-09-01

    Attention-deficit hyperactivity disorder (ADHD) is often comorbid with anxiety disorders and previous studies observed that anxiety could have an impact on the clinical course of ADHD and comorbid disruptive behavioral disorders (conduct disorders and oppositional-defiant disorders). Anxiety sensitivity (AS) is a different concept from anxiety per se and it is believed to represent the constitutionally based sensitivity of individuals to anxiety and anxiety symptoms. We aimed to assess the associations between anxiety, AS and symptoms of disruptive behavioral disorders (DBD) in a clinical sample of children and adolescents with ADHD. The sample consisted of 274 treatment naive children with ADHD aged 8-17 years. The severity of ADHD symptoms and comorbid DBD were assessed via parent rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Conners' Parent Rating Scale (CPRS), and Conners' Teacher Rating Scale (CTRS). AS and severity of anxiety symptoms of children were evaluated by self-report inventories. The association between anxiety, AS, and DBD was evaluated using structural equation modeling. Analyses revealed that AS social subscale scores negatively predicted symptoms of conduct disorder (CD) reported in T-DSM-IV-S. On the other hand, CD symptoms positively predicted severity of anxiety. No direct relationships were detected between anxiety, AS and oppositional-defiant behavior scores in any scales. These results may suggest a protective effect of AS social area on the development of conduct disorder in the presence of a diagnosis of ADHD, while the presence of symptoms of CD may be a vulnerability factor for the development of anxiety symptoms in children and adolescents with ADHD.

  20. Associations among comorbid anxiety, psychiatric symptomatology, and diabetic control in a population with serious mental illness and diabetes: Findings from an interventional randomized controlled trial.

    Science.gov (United States)

    Aftab, Awais; Bhat, Chetan; Gunzler, Douglas; Cassidy, Kristin; Thomas, Charles; McCormick, Richard; Dawson, Neal V; Sajatovic, Martha

    2018-05-01

    Objective Serious mental illness and type II diabetes mellitus have a high comorbidity, and both have a higher prevalence of anxiety disorders compared to the general population. Targeted Training in Illness Management is a group-based self-management training approach which targets serious mental illness and type II diabetes mellitus concurrently. This analysis examines data from a randomized controlled trial of Targeted Training in Illness Management intervention to examine the impact of comorbid anxiety on baseline psychiatric symptomatology and diabetic control, and on longitudinal treatment outcomes. Methods We conducted secondary analyses on data from a prospective, 60-week, randomized controlled trial testing Targeted Training in Illness Management versus treatment as usual in 200 individuals with serious mental illness and diabetes. Primary outcomes included measures related to serious mental illness symptoms, functional status, general health status, and diabetes control. Measures were compared between those participants with anxiety disorders versus those without anxiety at baseline as well as over time using linear mixed effects analyses. Results Forty seven percent of the participants had one or more anxiety disorders. At baseline, those with an anxiety diagnosis had higher illness severity, depressive, and other psychiatric symptomatology and disability. Diabetic control (HbA1c) was not significantly different at baseline. In the longitudinal analyses, no significant mean slope differences over time (group-by-time interaction effect) between those with anxiety diagnoses and those without in treatment as usual group were found for primary outcomes. Within the Targeted Training in Illness Management arm, those with anxiety disorders had significantly greater improvement in mental health functioning. Those with anxiety comorbidity in the Targeted Training in Illness Management group demonstrated significantly lower HbA1c levels compared to no anxiety

  1. Parental Involvement in CBT for Anxiety-Disordered Youth Revisited: Family CBT Outperforms Child CBT in the Long Term for Children With Comorbid ADHD Symptoms.

    Science.gov (United States)

    Maric, Marija; van Steensel, Francisca J A; Bögels, Susan M

    2018-03-01

    The objective of this study was to examine the efficacy of child cognitive-behavioral therapy (CCBT) versus family CBT (FCBT) in anxiety-disordered youth with high and low comorbid ADHD symptoms. Youth with anxiety disorders ( n = 123, aged 8-18) were classified in four groups according to (a) the type of CBT received (child vs. family) and (b) their comorbid ADHD symptoms, measured with the Child Behavior Checklist (CBCL) Attention Problems syndrome scale level (normal vs. [sub]clinical). Severity of anxiety disorders was assessed with Anxiety Disorders Interview Schedule-Child and Parent (ADIS-C/P) version and anxiety symptoms via a 71-item anxiety symptom questionnaire, the Screen for Child Anxiety and Related Emotional Disorders (SCARED-71), before and after CBT, and at 3 months and 1-year follow-ups. Based on the severity of anxiety disorders, children with high ADHD symptoms profit more from FCBT than CCBT in the long term. For children low on ADHD symptoms, and for anxiety symptoms and attention problems, no differences between CCBT and FCBT occurred. Family involvement seems a valuable addition to CBT for children with comorbid anxiety and ADHD symptoms.

  2. Reinforcement Sensitivity and Social Anxiety in Combat Veterans

    Science.gov (United States)

    Kimbrel, Nathan A.; Meyer, Eric C.; DeBeer, Bryann B.; Mitchell, John T.; Kimbrel, Azure D.; Nelson-Gray, Rosemery O.; Morissette, Sandra B.

    2017-01-01

    Objective The present study tested the hypothesis that low behavioral approach system (BAS) sensitivity is associated with social anxiety in combat veterans. Method Self-report measures of reinforcement sensitivity, combat exposure, social interaction anxiety, and social observation anxiety were administered to 197 Iraq/Afghanistan combat veterans. Results As expected, combat exposure, behavioral inhibition system (BIS) sensitivity, and fight-flight-freeze system (FFFS) sensitivity were positively associated with both social interaction anxiety and social observation anxiety. In contrast, BAS sensitivity was negatively associated with social interaction anxiety only. An analysis of the BAS subscales revealed that the Reward Responsiveness subscale was the only BAS subscale associated with social interaction anxiety. BAS-Reward Responsiveness was also associated with social observation anxiety. Conclusion The findings from the present research provide further evidence that low BAS sensitivity may be associated with social anxiety over and above the effects of BIS and FFFS sensitivity. PMID:28966424

  3. Social behavior and comorbidity in children with tics.

    Science.gov (United States)

    Pringsheim, Tamara; Hammer, Tracy

    2013-12-01

    To examine the characteristics of children with coexisting tics and autism spectrum disorder and determine if children with tics have deficits in social behavior. Descriptive study of children referred for tics over 18 months. Parents completed the Social Responsiveness Scale and the Social Communications Questionnaire; children screening positive on these measures were evaluated for autism spectrum disorder. Characteristics of children who were diagnosed with both disorders are described. Subscales scores on the Social Responsiveness Scale for children with tics without a comorbid autism spectrum disorder were compared. The relationship between a comorbid diagnosis of attention deficit hyperactivity disorder and autism spectrum disorder symptoms was explored using logistic and linear regression. One hundred and fourteen children were evaluated. Children with a tic disorder and autism spectrum disorder had significantly higher rates of comorbid attention deficit hyperactivity disorder (P = 0.005), rage attacks (P = 0.006), and oppositional defiant disorder (P = 0.007) than children without autism spectrum disorder. Mean tic severity and treatment rates did not differ between groups. Mean subscale scores on the Social Responsiveness Scale for children without autism spectrum disorders fell into the clinically significant range for autistic mannerisms only. All Social Responsiveness Scale scores were significantly increased by an attention deficit hyperactivity disorder diagnosis (P tics should be screened for autism spectrum disorders. There is a subgroup of children with multiple neuropsychiatric comorbidities who suffer from social dysfunction and autistic mannerisms outside of an autism spectrum disorder diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Social Anxiety in Children with Disabilities

    Science.gov (United States)

    Cowden, Peter A.

    2010-01-01

    Humans experience social anxiety to different degrees and in different areas. In school settings, this can be a barrier to learning. The school is a social place and to experience anxiety around peers can be challenging, especially if the student also has a learning disability. Social anxiety problems are often associated with learning…

  5. Social anxiety and social norms in individualistic and collectivistic countries.

    Science.gov (United States)

    Schreier, Sina-Simone; Heinrichs, Nina; Alden, Lynn; Rapee, Ronald M; Hofmann, Stefan G; Chen, Junwen; Oh, Kyung Ja; Bögels, Susan

    2010-12-01

    Social anxiety is assumed to be related to cultural norms across countries. Heinrichs et al. [2006: Behav Res Ther 44:1187-1197] compared individualistic and collectivistic countries and found higher social anxiety and more positive attitudes toward socially avoidant behaviors in collectivistic rather than in individualistic countries. However, the authors failed to include Latin American countries in the collectivistic group. To provide support for these earlier results within an extended sample of collectivistic countries, 478 undergraduate students from individualistic countries were compared with 388 undergraduate students from collectivistic countries (including East Asian and Latin American) via self-report of social anxiety and social vignettes assessing social norms. As expected, the results of Heinrichs et al. [2006: Behav Res Ther 44:1187-1197] were replicated for the individualistic and Asian countries, but not for Latin American countries. Latin American countries displayed the lowest social anxiety levels, whereas the collectivistic East Asian group displayed the highest. These findings indicate that while culture-mediated social norms affect social anxiety and might help to shed light on the etiology of social anxiety disorder, the dimension of individualism-collectivism may not fully capture the relevant norms. © 2010 Wiley-Liss, Inc.

  6. Social anxiety and social norms in individualistic and collectivistic countries

    Science.gov (United States)

    Schreier, Sina-Simone; Heinrichs, Nina; Alden, Lynn; Rapee, Ronald M.; Hofmann, Stefan G.; Chen, Junwen; Ja Oh, Kyung; Bögels, Susan

    2010-01-01

    Background Social anxiety is assumed to be related to cultural norms across countries. Heinrichs and colleagues [1] compared individualistic and collectivistic countries and found higher social anxiety and more positive attitudes toward socially avoidant behaviors in collectivistic than in individualistic countries. However, the authors failed to include Latin American countries in the collectivistic group. Methods To provide support for these earlier results within an extended sample of collectivistic countries, 478 undergraduate students from individualistic countries were compared with 388 undergraduate students from collectivistic countries (including East Asian and Latin American) via self report of social anxiety and social vignettes assessing social norms. Results As expected, the results of Heinrichs and colleagues [1] were replicated for the individualistic and Asian countries but not for Latin American countries. Latin American countries displayed the lowest social anxiety levels, whereas the collectivistic East Asian group displayed the highest. Conclusions These findings indicate that while culture-mediated social norms affect social anxiety and might help to shed light on the etiology of social anxiety disorder, the dimension of individualism-collectivism may not fully capture the relevant norms. PMID:21049538

  7. Interpersonal Subtypes Within Social Anxiety: The Identification of Distinct Social Features.

    Science.gov (United States)

    Cooper, Danielle; Anderson, Timothy

    2017-10-05

    Although social anxiety disorder is defined by anxiety-related symptoms, little research has focused on the interpersonal features of social anxiety. Prior studies (Cain, Pincus, & Grosse Holtforth, 2010; Kachin, Newman, & Pincus, 2001) identified distinct subgroups of socially anxious individuals' interpersonal circumplex problems that were blends of agency and communion, and yet inconsistencies remain. We predicted 2 distinct interpersonal subtypes would exist for individuals with high social anxiety, and that these social anxiety subtypes would differ on empathetic concern, paranoia, received peer victimization, perspective taking, and emotional suppression. From a sample of 175 undergraduate participants, 51 participants with high social anxiety were selected as above a clinical cutoff on the social phobia scale. Cluster analyses identified 2 interpersonal subtypes of socially anxious individuals: low hostility-high submissiveness (Cluster 1) and high hostility-high submissiveness (Cluster 2). Cluster 1 reported higher levels of empathetic concern, lower paranoia, less peer victimization, and lower emotional suppression compared to Cluster 2. There were no differences between subtypes on perspective taking or cognitive reappraisal. Findings are consistent with an interpersonal conceptualization of social anxiety, and provide evidence of distinct social features between these subtypes. Findings have implications for the etiology, classification, and treatment of social anxiety.

  8. Anxiety disorders, physical illnesses, and health care utilization in older male veterans with Parkinson disease and comorbid depression.

    Science.gov (United States)

    Qureshi, Salah U; Amspoker, Amber B; Calleo, Jessica S; Kunik, Mark E; Marsh, Laura

    2012-12-01

    This study examined the rates of anxiety and depressive disorders, physical illnesses, and health service use in male patients 55 years or older with a diagnosis of Parkinson disease who were seen at least twice at the 10 medical centers in the Veterans Affairs Healthcare Network of the South Central region of the United States. Of the 273 male patients diagnosed between October 1, 1997, and September 30, 2009, 62 (22.7%) had a depressive disorder. The overall prevalence of anxiety disorders was 12.8%; patients with comorbid depression had a 5-fold greater prevalence of anxiety disorders than those without depression (35.5% vs 6.2%, Pdepression also had increased prevalence of all physical illnesses examined and more outpatient clinic and mental health visits. Patients with Parkinson disease and comorbid depression are more likely to have anxiety disorders and several physical illnesses, to be using antipsychotic and dementia medicines, and to have increased health service utilization than those without depression.

  9. Anxiety and depression among adolescents with attention-deficit/hyperactivity disorder: The roles of behavioral temperamental traits, comorbid autism spectrum disorder, and bullying involvement

    Directory of Open Access Journals (Sweden)

    Huei-Fan Hu

    2016-02-01

    Full Text Available The aim of this study was to examine the associations of behavioral temperamental traits, comorbid autism spectrum disorder (ASD, and bullying involvement with anxiety and depression among adolescents with attention-deficit/hyperactivity disorder (ADHD in Taiwan. A total of 287 adolescents aged 11–18 years diagnosed with ADHD participated in this study. Their severities of anxiety and depression were assessed. Multiple regression analysis was used to examine the correlates of anxiety and depression. The results show that adolescents with ADHD who reported a higher behavioral inhibition system (BIS score, had comorbid ASD, and were bullying victims, reported more severe anxiety and depressive symptoms. Adolescents with ADHD who bullied others reported more severe depressive symptoms than those who did not bully. The results of this study indicated that behavioral temperamental traits on the BIS, comorbid ASD, and bullying involvement were significantly associated with anxiety and depression among the adolescents with ADHD.

  10. Social Anxiety Disorder: More Than Just Shyness

    Science.gov (United States)

    ... social anxiety disorder treated? Finding Help Reprints Share Social Anxiety Disorder: More Than Just Shyness Download PDF ... overcome your symptoms. What is it like having social anxiety disorder? “In school, I was always afraid ...

  11. Social Anxiety Scale for Adolescents (SAS-A): Measuring Social Anxiety among Finnish Adolescents

    Science.gov (United States)

    Ranta, Klaus; Junttila, Niina; Laakkonen, Eero; Uhmavaara, Anni; La Greca, Annette M.; Niemi, Paivi M.

    2012-01-01

    The aim of this study was to investigate symptoms of social anxiety and the psychometric properties of the "Social Anxiety Scale for Adolescents" (SAS-A) among Finnish adolescents, 13-16 years of age. Study 1 (n = 867) examined the distribution of SAS-A scores according to gender and age, and the internal consistency and factor structure…

  12. Assessment of social anxiety in first episode psychosis using the Liebowitz Social Anxiety scale as a self-report measure.

    Science.gov (United States)

    Romm, K L; Rossberg, J I; Berg, A O; Hansen, C F; Andreassen, O A; Melle, I

    2011-03-01

    Social anxiety is a common problem in psychotic disorders. The Liebowitz Social Anxiety Scale, Self-Rating version (LSAS-SR) is a widely used instrument to capture different aspects of social anxiety, but its psychometric properties have not been tested in this patient group. The aims of the present study were to evaluate the psychometric properties of the LSAS-SR in patients with first episode psychosis, to investigate whether it differentiated between active and passive social withdrawal and to test which clinical factors contributed to current level of social anxiety. A total of 144 first episode psychosis patients from the ongoing Thematically Organized Psychosis (TOP) study were included at the time of first treatment. Diagnoses were set according to the Structured Clinical Interview (SCID-1) for DSM-IV. A factor analysis was carried out and the relationship of social anxiety to psychotic and general symptomatology measured by the Positive and Negative Syndrome Scale (PANSS) was evaluated. Possible contributors to social anxiety were analyzed using multiple hierarchic regression analysis. The factor analysis identified three subscales: public performance, social interaction and observation. All three subscales showed satisfactory psychometric properties, acceptable convergent and discriminate properties, and confirmed previous findings in social anxiety samples. Self-esteem explained a significant amount of the variance in social anxiety, even after adjusting for the effects of delusions, suspiciousness and depression. The study shows that the LSAS-SR can be used in this patient group, that social anxiety is strongly related to both behavioral social avoidance and to self-esteem. The results support the use of this measure in assessment of social anxiety in both clinical settings and in research. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  13. Laughter perception in social anxiety.

    Science.gov (United States)

    Ritter, Jan; Brück, Carolin; Jacob, Heike; Wildgruber, Dirk; Kreifelts, Benjamin

    2015-01-01

    Laughter is a powerful signal of social acceptance or rejection while the fear of being embarrassed and humiliated is central in social anxiety (SA). This type of anxiety is associated with cognitive biases indicating increased sensitivity to social threat as well as with deficits in emotion regulation. Both are thought to be implicated in the maintenance of social anxiety. Using laughter as a novel stimulus, we investigated cognitive biases and their modulation through emotion regulation and cue ambiguity in individuals with varying degrees of SA (N = 60). A combination of a negative laughter interpretation bias and an attention bias away from joyful/social inclusive laughter in SA was observed. Both biases were not attributable to effects of general anxiety and were closely correlated with the concept of gelotophobia, the fear of being laughed at. Thus, our study demonstrates altered laughter perception in SA. Furthermore, it highlights the usefulness of laughter as a highly prevalent social signal for future research on the interrelations of interpretation and attention biases in SA and their modulation through emotion regulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Latent structure of the social anxiety scale and relations between social anxiety and irrational beliefs

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    Tovilović Snežana

    2004-01-01

    Full Text Available The research which was realized belongs to one of three research fields within framework of rational-emotional-behavioral therapy (REBT - to the theory of emotional disorders. It was undertaken with the aim to establish presence and nature of relations between social anxiety, treated as dimension and the construct of irrational beliefs from REBT theory. The research was carried out on the sample of 261 students of Novi Sad University, both genders, age 18 to 26. First of all, the latent structure of newly constructed Scale of Social Anxiety (SA of the author Tovilović S. was tested. SA scale was proved to be of satisfying reliability (α =0.92. Principal-component factor analysis was conducted under gathered data. Four factors of social anxiety, which explain 44,09% of total variance of the items of SA scale, were named: social-evaluation anxiety, inhibition in social-uncertain situations, low self-respect and hypersensitivity on rejection. The other test that was used is Scale of General Attitudes and Beliefs of the author Marić Z. Reliability of the sub-scale of irrational beliefs that was got on our sample is α =0.91 yet the subscale of rational beliefs is α =0.70. Canonical correlational analysis was conducted under manifest variables of both scales. Three pairs of statistically significant canonical factors were got, with correlations within the span between Rc=0.78 and Rc=0.64. We discussed nature of correlation between social anxiety and irrational beliefs in the light of REBT model of social phobia, REBT theory of emotional disorder, researches and model of social anxiety in wider, cognitive-behavioral framework.

  15. Neuroendocrine models of social anxiety disorder

    NARCIS (Netherlands)

    van Honk, Jack; Bos, Peter A.; Terburg, David; Heany, Sarah; Stein, Dan J.

    2015-01-01

    Social anxiety disorder (SAD) is a highly prevalent and disabling disorder with key behavioral traits of social fearfulness, social avoidance, and submissiveness. Here we argue that hormonal systems play a key role in mediating social anxiety, and so may be important in SAD. Hormonal alterations,

  16. Is the beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in The Netherlands study of depression and anxiety (NESDA

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    van der Feltz-Cornelis Christina M

    2011-07-01

    Full Text Available Abstract Background Appropriate management of anxiety disorders in primary care requires clinical assessment and monitoring of the severity of the anxiety. This study focuses on the Beck Anxiety Inventory (BAI as a severity indicator for anxiety in primary care patients with different anxiety disorders (social phobia, panic disorder with or without agoraphobia, agoraphobia or generalized anxiety disorder, depressive disorders or no disorder (controls. Methods Participants were 1601 primary care patients participating in the Netherlands Study of Depression and Anxiety (NESDA. Regression analyses were used to compare the mean BAI scores of the different diagnostic groups and to correct for age and gender. Results Patients with any anxiety disorder had a significantly higher mean score than the controls. A significantly higher score was found for patients with panic disorder and agoraphobia compared to patients with agoraphobia only or social phobia only. BAI scores in patients with an anxiety disorder with a co-morbid anxiety disorder and in patients with an anxiety disorder with a co-morbid depressive disorder were significantly higher than BAI scores in patients with an anxiety disorder alone or patients with a depressive disorder alone. Depressed and anxious patients did not differ significantly in their mean scores. Conclusions The results suggest that the BAI may be used as a severity indicator of anxiety in primary care patients with different anxiety disorders. However, because the instrument seems to reflect the severity of depression as well, it is not a suitable instrument to discriminate between anxiety and depression in a primary care population.

  17. Adolescent social isolation increases anxiety-like behavior and ethanol intake and impairs fear extinction in adulthood: Possible role of disrupted noradrenergic signaling.

    Science.gov (United States)

    Skelly, M J; Chappell, A E; Carter, E; Weiner, J L

    2015-10-01

    Alcohol use disorder, anxiety disorders, and post-traumatic stress disorder (PTSD) are highly comorbid, and exposure to chronic stress during adolescence may increase the incidence of these conditions in adulthood. Efforts to identify the common stress-related mechanisms driving these disorders have been hampered, in part, by a lack of reliable preclinical models that replicate their comorbid symptomatology. Prior work by us, and others, has shown that adolescent social isolation increases anxiety-like behaviors and voluntary ethanol consumption in adult male Long-Evans rats. Here we examined whether social isolation also produces deficiencies in extinction of conditioned fear, a hallmark symptom of PTSD. Additionally, as disrupted noradrenergic signaling may contribute to alcoholism, we examined the effect of anxiolytic medications that target noradrenergic signaling on ethanol intake following adolescent social isolation. Our results confirm and extend previous findings that adolescent social isolation increases anxiety-like behavior and enhances ethanol intake and preference in adulthood. Additionally, social isolation is associated with a significant deficit in the extinction of conditioned fear and a marked increase in the ability of noradrenergic therapeutics to decrease ethanol intake. These results suggest that adolescent social isolation not only leads to persistent increases in anxiety-like behaviors and ethanol consumption, but also disrupts fear extinction, and as such may be a useful preclinical model of stress-related psychopathology. Our data also suggest that disrupted noradrenergic signaling may contribute to escalated ethanol drinking following social isolation, thus further highlighting the potential utility of noradrenergic therapeutics in treating the deleterious behavioral sequelae associated with early life stress. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. A Comparison of Reinforcement Sensitivity Theory Measures: Unique Associations With Social Interaction Anxiety and Social Observation Anxiety.

    Science.gov (United States)

    Kramer, Sam L; Rodriguez, Benjamin F

    2018-07-01

    Evidence suggests that the behavior inhibition system (BIS) and fight-flight-freeze system play a role in the individual differences seen in social anxiety disorder; however, findings concerning the role of the behavior approach system (BAS) have been mixed. To date, the role of revised reinforcement sensitivity theory (RST) subsystems underlying social anxiety has been measured with scales designed for the original RST. This study examined how the BIS, BAS, and fight, flight, freeze components of the fight-flight-freeze system uniquely relate to social interaction anxiety and social observation anxiety using both a measure specifically designed for the revised RST and a commonly used original RST measure. Comparison of regression analyses with the Jackson-5 and the commonly used BIS/BAS Scales revealed important differences in the relationships between RST subsystems and social anxiety depending on how RST was assessed. Limitations and future directions for revised RST measurement are discussed.

  19. Predicting Comorbid Conditions and Trajectories using Social Health Records.

    Science.gov (United States)

    Ji, Xiang; Ae Chun, Soon; Geller, James

    2016-05-05

    Many patients suffer from comorbidity conditions, for example, obese patients often develop type-2 diabetes and hypertension. In the US, 80% of Medicare spending is for managing patients with these multiple coexisting conditions. Predicting potential comorbidity conditions for an individual patient can promote preventive care and reduce costs. Predicting possible comorbidity progression paths can provide important insights into population heath and aid with decisions in public health policies. Discovering the comorbidity relationships is complex and difficult, due to limited access to Electronic Health Records by privacy laws. In this paper, we present a collaborative comorbidity prediction method to predict likely comorbid conditions for individual patients, and a trajectory prediction graph model to reveal progression paths of comorbid conditions. Our prediction approaches utilize patient generated health reports on online social media, called Social Health Records (SHR). The experimental results based on one SHR source show that our method is able to predict future comorbid conditions for a patient with coverage values of 48% and 75% for a top-20 and a top-100 ranked list, respectively. For risk trajectory prediction, our approach is able to reveal each potential progression trajectory between any two conditions and infer the confidence of the future trajectory, given any observed condition. The predicted trajectories are validated with existing comorbidity relations from the medical literature.

  20. Autonomic arousal in childhood anxiety disorders: Associations with state anxiety and social anxiety disorder

    Science.gov (United States)

    Alkozei, Anna; Creswell, Cathy; Cooper, Peter J.; Allen, John J.B.

    2015-01-01

    Background Psychophysiological theories suggest that individuals with anxiety disorders may evidence inflexibility in their autonomic activity at rest and when responding to stressors. In addition, theories of social anxiety disorder, in particular, highlight the importance of physical symptoms. Research on autonomic activity in childhood (social) anxiety disorders, however, is scarce and has produced inconsistent findings, possibly because of methodological limitations. Method The present study aimed to account for limitations of previous studies and measured respiratory sinus arrhythmia (RSA) and heart rate (HR) using Actiheart heart rate monitors and software (Version 4) during rest and in response to a social and a non-social stressor in 60 anxious (30 socially anxious and 30 ‘other’ anxious), and 30 nonanxious sex-and age-matched 7–12 year olds. In addition, the effect of state anxiety during the tasks was explored. Results No group differences at rest or in response to stress were found. Importantly, however, with increases in state anxiety, all children, regardless of their anxiety diagnoses showed less autonomic responding (i.e., less change in HR and RSA from baseline in response to task) and took longer to recover once the stressor had passed. Limitations This study focused primarily on parasympathetic arousal and lacked measures of sympathetic arousal. Conclusion The findings suggest that childhood anxiety disorders may not be characterized by inflexible autonomic responding, and that previous findings to the contrary may have been the result of differences in subjective anxiety between anxious and nonanxious groups during the tasks, rather than a function of chronic autonomic dysregulation. PMID:25590763

  1. Treatment of Anxiety Disorders and Comorbid Alcohol Abuse with Buspirone in a Patient with Antidepressant-Induced Platelet Dysfunction: A Case Report

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    Mir Mazhar

    2013-01-01

    Full Text Available The risk of abnormal bleeding with serotonin reuptake inhibitors has been known, but there is insufficient evidence base to guide pharmacological treatment of anxiety in patients with underlying haematological conditions. The following case report is about a 50-year-old female with generalized anxiety disorder, social phobia, obsessive compulsive disorder, and alcohol abuse where pharmacological treatment of anxiety symptoms has been difficult as it would lead to bruising due to the patient’s underlying qualitative platelet dysfunction. Treatment with venlafaxine, citalopram, escitalopram, and clomipramine resulted in improvement and anxiety symptoms, as well as reduction in alcohol use, but pharmacological treatment has to be discontinued because of bruising and hematomas. In view of an active substance use disorder, benzodiazepines were avoided as a treatment option. The patient’s anxiety symptoms and comorbid alcohol abuse responded well to pharmacological treatment with buspirone which gradually titrated up to a dose of 30 mg BID. Patient was followed for around a six-month period while she was on buspirone before being discharged to family doctor’s care. Buspirone is unlikely to have a significant effect on platelet serotonin transponder and could be an effective alternative for pharmacological treatment of anxiety in patients with a bleeding diathesis.

  2. Measuring Social Anxiety in 11 Countries Development and Validation of the Social Anxiety Questionnaire for Adults

    NARCIS (Netherlands)

    Caballo, V.E.; Salazar, I.C.; Irurtia, M.J.; Arias, B.; Hofmann, S.G.

    2010-01-01

    This paper reports on two studies conducted to develop and validate a new self-report measure of social phobia/anxiety - the Social Anxiety Questionnaire for Adults (SAQ-A) (Cuestionario de ansiedad social para adultos, CASO-A). A diary-item recording procedure was used to generate the initial pool

  3. Effectiveness of reboxetine in treatment of outpatient children and adolescents with attention deficit-hyperactivity disorder with comorbid anxiety disorders.

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    Forough Riahi

    2013-12-01

    Full Text Available Some previous studies have reported that ADHD is often comorbid with anxiety disorders. The aim of the present study was to evaluate the effectiveness of reboxetine in treating outpatient children and adolescents with ADHD and comorbid anxiety disorders.In this open-label study, 25 outpatient children and adolescents, aged 6-16 years were selected by convenient sampling and underwent treatment with 4mg reboxetine for four weeks. Data were collected at baseline, two weeks and four weeks after the start of the medication using Conners' Parent Questionnaire, Hamilton's Rating Scale for Anxiety, Clinical Global Assessment Scale, Clinical Global Impression-Severity Scale and Side Effects Form. Data were analyzed using repeated measure, analyses of variance (ANOVA, Tukey post hoc test and paired t-test.There were significant reduction in the total score of ADHD (F = 31.441; P <0.001 at the end of the treatment compared to baseline (Table 1. The differences between T0 and T2 in the subscales of attention deficit, hyperactivity and confrontation (F = 20.691; P <0.001, F = 28.810; P < 0.001, and F = 17.463; P <0.001, respectively were also significant. Findings also indicated significant differences between T0 and T1 (P<0.01 and T1 and T2 (P<0.01 in all of the subscales except for confrontation. A significant improvement was observed in the severity of ADHD and anxiety disorders during different courses of the treatment (p<0.001. No significant changes were observed in systolic and diastolic blood pressure and pulse and weight of the patients during the study. The most common complications were headache and anorexia.The short-term treatment with reboxetine was effective in improving ADHD with comorbid anxiety disorders. Therefore, reboxetine could be used as a treatment option for ADHD in those children who experience comorbid anxiety disorders or in those who are non-responsive or intolerant to methylphenidate.

  4. Exposure-Focused Family-Based CBT for Youth With ASD and Comorbid Anxiety

    Science.gov (United States)

    2017-10-25

    Autism; Asperger's Syndrome; Pervasive Developmental Disorder Not Otherwise Specified; Generalized Anxiety Disorder; Social Phobia; Separation Anxiety Disorder; Obsessive-compulsive Disorder; Specific Phobia

  5. A Korean validation study of the Clinically Useful Anxiety Outcome Scale: Comorbidity and differentiation of anxiety and depressive disorders

    Science.gov (United States)

    Jeon, Sang Won; Ko, Young-Hoon; Yoon, Seoyoung; Pae, Chi-Un; Choi, Joonho; Kim, Jae-Min; Yoon, Ho-Kyoung; Lee, Hoseon; Patkar, Ashwin A.; Zimmerman, Mark

    2017-01-01

    Background This study aimed to evaluate the psychometric properties of the Korean version of the Clinically Useful Anxiety Outcome Scale (CUXOS) and to examine the current diagnostic comorbidity and differential severity of anxiety symptoms between major depressive disorder (MDD) and anxiety disorders. Methodology In total, 838 psychiatric outpatients were analyzed at their intake appointment. Diagnostic characteristics were examined using the structured clinical interview from the DSM-IV because the DSM5 was not available at the start of the study. The CUXOS score was measured and compared with that of 3 clinician rating scales and 4 self-report scales. Principal findings The CUXOS showed excellent results for internal consistency (Cronbach’s α = 0.90), test–retest reliability (r = 0.74), and discriminant and convergent validity. The CUXOS significantly discriminated between different levels of anxiety severity, and the measure was sensitive to change after treatment. Approximately 45% of patients with MDD were additionally diagnosed with anxiety disorders while 55% of patients with anxiety disorders additionally reported an MDD. There was a significant difference in CUXOS scores between diagnostic categories (MDD only, anxiety only, both disorders, and no MDD or anxiety disorder). The CUXOS scores differed significantly between all categories of depression (major, minor, and non-depression) except for the comparison between minor depression and non-depression groups. Conclusions The Korean version of the CUXOS is a reliable and valid measure of the severity of anxiety symptoms. The use of the CUXOS could broaden the understanding of coexisting and differentiating characteristics of anxiety and depression. PMID:28604808

  6. A Korean validation study of the Clinically Useful Anxiety Outcome Scale: Comorbidity and differentiation of anxiety and depressive disorders.

    Directory of Open Access Journals (Sweden)

    Sang Won Jeon

    Full Text Available This study aimed to evaluate the psychometric properties of the Korean version of the Clinically Useful Anxiety Outcome Scale (CUXOS and to examine the current diagnostic comorbidity and differential severity of anxiety symptoms between major depressive disorder (MDD and anxiety disorders.In total, 838 psychiatric outpatients were analyzed at their intake appointment. Diagnostic characteristics were examined using the structured clinical interview from the DSM-IV because the DSM5 was not available at the start of the study. The CUXOS score was measured and compared with that of 3 clinician rating scales and 4 self-report scales.The CUXOS showed excellent results for internal consistency (Cronbach's α = 0.90, test-retest reliability (r = 0.74, and discriminant and convergent validity. The CUXOS significantly discriminated between different levels of anxiety severity, and the measure was sensitive to change after treatment. Approximately 45% of patients with MDD were additionally diagnosed with anxiety disorders while 55% of patients with anxiety disorders additionally reported an MDD. There was a significant difference in CUXOS scores between diagnostic categories (MDD only, anxiety only, both disorders, and no MDD or anxiety disorder. The CUXOS scores differed significantly between all categories of depression (major, minor, and non-depression except for the comparison between minor depression and non-depression groups.The Korean version of the CUXOS is a reliable and valid measure of the severity of anxiety symptoms. The use of the CUXOS could broaden the understanding of coexisting and differentiating characteristics of anxiety and depression.

  7. Illusory correlation and social anxiety.

    NARCIS (Netherlands)

    de Jong, P.J.; Boegels, S.; Kindt, M.; Merckelbach, H.

    1998-01-01

    An illusory correlation (IC) experiment examined the presence of a phobia-relevant covariation bias in the context of social anxiety. 60 female college students (28 with low and 32 with high social anxiety) were shown a series of slides comprising pictures of angry, happy, and neutral faces which

  8. Not self-focused attention but negative beliefs affect poor social performance in social anxiety : An investigation of pathways in the social anxiety-social rejection relationship

    NARCIS (Netherlands)

    Voncken, Marisol J.; Dijk, Corine; de Jong, Peter J.; Roelofs, Jeffrey

    2010-01-01

    Patients with social anxiety disorder (SAD) not only fear negative evaluation but are indeed less likeable than people without SAD. Previous research shows social performance to mediate this social anxiety-social rejection relationship. This study studied two pathways hypothesized to lead to poor

  9. Not self-focused attention but negative beliefs affect poor social performance in social anxiety: an investigation of pathways in the social anxiety - social rejection relationship

    NARCIS (Netherlands)

    Voncken, M.J.; Dijk, C.; de Jong, P.J.; Roelofs, J.

    2010-01-01

    Patients with social anxiety disorder (SAD) not only fear negative evaluation but are indeed less likeable than people without SAD. Previous research shows social performance to mediate this social anxiety-social rejection relationship. This study studied two pathways hypothesized to lead to poor

  10. Reduced recruitment of orbitofrontal cortex to human social chemosensory cues in social anxiety.

    Science.gov (United States)

    Zhou, Wen; Hou, Ping; Zhou, Yuxiang; Chen, Denise

    2011-04-01

    Social anxiety refers to the prevalent and debilitating experience of fear and anxiety of being scrutinized in social situations. It originates from both learned (e.g. adverse social conditioning) and innate (e.g. shyness) factors. Research on social anxiety has traditionally focused on negative emotions induced by visual and auditory social cues in socially anxious clinical populations, and posits a dysfunctional orbitofrontal-amygdala circuit as a primary etiological mechanism. Yet as a trait, social anxiety is independent of one's specific emotional state. Here we probe the neural substrate of intrinsic social anxiety by employing a unique type of social stimuli, airborne human social chemosensory cues that are inherently social, ubiquitously present, and yet operating below verbal awareness. We show that the adopted social chemosensory cues were not perceived to be human-related, did not differentially bias self-report of anxiety or autonomic nervous system responses, yet individuals with elevated social anxiety demonstrated a reduced recruitment of the orbitofrontal cortex to social chemosensory cues. No reciprocal activity in the amygdala was observed. Our findings point to an intrinsic neural substrate underlying social anxiety that is not associated with prior adverse social conditioning, thereby providing the first neural evidence for the inherent social aspect of this enigmatic phenomenon. Copyright © 2010 Elsevier Inc. All rights reserved.

  11. Individual differences in social anxiety affect the salience of errors in social contexts.

    Science.gov (United States)

    Barker, Tyson V; Troller-Renfree, Sonya; Pine, Daniel S; Fox, Nathan A

    2015-12-01

    The error-related negativity (ERN) is an event-related potential that occurs approximately 50 ms after an erroneous response. The magnitude of the ERN is influenced by contextual factors, such as when errors are made during social evaluation. The ERN is also influenced by individual differences in anxiety, and it is elevated among anxious individuals. However, little research has examined how individual differences in anxiety interact with contextual factors to impact the ERN. Social anxiety involves fear and apprehension of social evaluation. In the present study, we explored how individual differences in social anxiety interact with social contexts to modulate the ERN. The ERN was measured in 43 young adults characterized as being either high or low in social anxiety, while they completed a flanker task in two contexts: alone and during social evaluation. The results revealed a significant interaction between social anxiety and context, such that the ERN was enhanced in a social relative to a nonsocial context only among highly socially anxious individuals. Furthermore, the degree of such enhancement significantly correlated with individual differences in social anxiety. These findings demonstrate that social anxiety is characterized by enhanced neural activity to errors in social-evaluative contexts.

  12. The relation between public speaking anxiety and social anxiety: a review.

    Science.gov (United States)

    Blöte, Anke W; Kint, Marcia J W; Miers, Anne C; Westenberg, P Michiel

    2009-04-01

    This article reviewed the literature on public speaking anxiety in the context of social phobia subtyping. In total, 18 empirical studies on subtype issues related to public speaking anxiety were analyzed. Results of the reviewed studies are discussed in relation to their research method, that is, whether it focused on qualitative or quantitative aspects of subtype differences and whether it used a clinical or community sample. Evidence supported the premise that public speaking anxiety is a distinct subtype, qualitatively and quantitatively different from other subtypes of social phobia. The significance of this finding for social phobia studies using speech tasks to assess participants' state anxiety and behavioral performance is discussed.

  13. Preventing Adolescent Social Anxiety and Depression and Reducing Peer Victimization: Intervention Development and Open Trial

    Science.gov (United States)

    La Greca, Annette M.; Ehrenreich-May, Jill; Mufson, Laura; Chan, Sherilynn

    2016-01-01

    Background Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the development and initial evaluation of a transdiagnostic school-based preventive intervention for adolescents with elevated symptoms of social anxiety and/or depression and elevated peer victimization. We modified Interpersonal Psychotherapy-Adolescent Skills Training for depression, incorporating strategies for dealing with social anxiety and peer victimization. Objective Our open trial assessed the feasibility, acceptability, and preliminary benefit of the modified program (called UTalk) for adolescents at risk for SAD or depression and who also reported peer victimization. Method Adolescents (N=14; 13–18 years; 79% girls; 86% Hispanic) were recruited and completed measures of peer victimization, social anxiety, and depression both pre- and post-intervention and provided ratings of treatment satisfaction. Independent evaluators (IEs) rated youths’ clinical severity. The intervention (3 individual and 10 group sessions) was conducted weekly during school. Results Regarding feasibility, 86% of the adolescents completed the intervention (M attendance=11.58 sessions). Satisfaction ratings were uniformly positive. Intention-to-treat analyses revealed significant declines in adolescent- and IE-rated social anxiety and depression and in reports of peer victimization. Additional secondary benefits were observed. Conclusions Although further evaluation is needed, the UTalk intervention appears feasible to administer in schools, with high satisfaction and preliminary benefit. Implications for research on the prevention of adolescent SAD and depression are discussed. PMID:27857509

  14. Social anxiety in three Western societies.

    NARCIS (Netherlands)

    Dam-Baggen, R.M.J. van; Kraaimaat, F.W.; Elal, G.

    2003-01-01

    The present study investigates whether empirical data support the notion that people in Western societies do not differ with regard to social anxiety. Social anxiety in Dutch students (N = 425) was compared with that experienced by students in the United States (N = 440) and Turkey (N = 349). Social

  15. Avoidant personality disorder in individuals with generalized social anxiety disorder: what does it add?

    Science.gov (United States)

    Marques, Luana; Porter, Eliora; Keshaviah, Aparna; Pollack, Mark H; Van Ameringen, Michael; Stein, Murray B; Simon, Naomi M

    2012-08-01

    Avoidant personality disorder (AvPD) has a high level of symptom overlap and comorbidity with generalized social anxiety disorder (GSAD). We examined whether the presence of comorbid AvPD adds significant clinically relevant information for individuals seeking treatment for GSAD. Results suggested that AvPD was significantly associated with poorer quality of life and greater disability in univariate, but not multivariate analyses. Endorsement of more AvPD symptoms was associated with increased disability, increased risk of intimacy, and lower social support, even after covariate adjustment. Specifically, AvPD item 3, hard to be "open" even with people you are close to, was most strongly correlated with quality of life and disability. A binary diagnosis of AvPD alone adds little beyond a marker of greater GSAD severity and depression among patients with GSAD, while a specific feature of AvPD not captured by the GSAD diagnosis, namely emotional guardedness, may be associated with greater impairment. Published by Elsevier Ltd.

  16. The exacerbation of depression, hostility, and social anxiety in the course of Internet addiction among adolescents: a prospective study.

    Science.gov (United States)

    Ko, Chih-Hung; Liu, Tai-Ling; Wang, Peng-Wei; Chen, Cheng-Sheng; Yen, Cheng-Fang; Yen, Ju-Yu

    2014-08-01

    In adolescent populations worldwide, Internet addiction is prevalent and is often comorbid with depression, hostility, and social anxiety of adolescents. This study aimed at evaluating the exacerbation of depression, hostility, and social anxiety in the course of getting addiction to Internet or remitting from Internet addiction among adolescents. This study recruited 2293 adolescents in grade 7 to assess their depression, hostility, social anxiety and Internet addiction. The same assessments were repeated one year later. The incidence group was defined as subjects classified as non-addicted in the first assessment and as addicted in the second assessment. The remission group was defined as subjects classified as addicted in the first assessment and as non-addicted in the second assessment. The incidence group exhibited increased depression and hostility more than the non-addiction group and the effect of on depression was stronger among adolescent girls. Further, the remission group showed decreased depression, hostility, and social anxiety more than the persistent addiction group. Depression and hostility worsen in the addiction process for the Internet among adolescents. Intervention of Internet addiction should be provided to prevent its negative effect on mental health. Depression, hostility, and social anxiety decreased in the process of remission. It suggested that the negative consequences could be reversed if Internet addiction could be remitted within a short duration. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Social anxiety and social norms in individualistic and collectivistic countries

    NARCIS (Netherlands)

    Schreier, S.S.; Heinrichs, N.; Alden, L.; Rapee, R.M.; Hofmann, S.G.; Chen, J.; Oh, K.Y.; Bogels, S.M.

    2010-01-01

    Background: Social anxiety is assumed to be related to cultural norms across countries. Heinrichs et al. [2006: Behav Res Ther 44:1187-1197] compared individualistic and collectivistic countries and found higher social anxiety and more positive attitudes toward socially avoidant behaviors in

  18. Feeling safe but appearing anxious: Differential effects of alcohol on anxiety and social performance in individuals with social anxiety disorder.

    Science.gov (United States)

    Stevens, Stephan; Cooper, Ruth; Bantin, Trisha; Hermann, Christiane; Gerlach, Alexander L

    2017-07-01

    Social anxiety disorder (SAD) and alcohol use disorders (AUD) co-occur frequently and there is preliminary evidence that alcohol might reduce social anxiety. It is, however, unclear which mechanisms contribute to the anxiety reducing effect, particularly regarding key aspects of social anxiety such as deficits in social performance. We compared self-rated and physiological measures of anxiety as well as self- and observer-rated social performance in a sample of 62 individuals with SAD and 60 nonanxious control participants during a speech task after receiving either alcohol, an alcohol-free placebo drink or orange juice. SAD patients reported more anxiety during the speech task than did control participants. Furthermore, SAD patients underestimated their performance in comparison to observer ratings. Alcohol reduced self-report anxiety only in SAD patients, while observers rated all participants as less competent when intoxicated. Although individuals with SAD experience a reduction in anxiety when drinking alcohol, simultaneous decreases in social performance might contribute to negative reactions from others and consequently increase the risk of further alcohol use to cope with these negative reactions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Social anxiety in the eating disorders: a systematic review and meta-analysis.

    Science.gov (United States)

    Kerr-Gaffney, Jess; Harrison, Amy; Tchanturia, Kate

    2018-04-10

    Social anxiety disorder is one of the most common comorbid conditions in eating disorders (EDs). The aim of the current review and meta-analysis is to provide a qualitative summary of what is known about social anxiety (SA) in EDs, as well as to compare levels of SA in those with EDs and healthy controls. Electronic databases were systematically searched for studies using self-report measures of SA in ED populations. In total, 38 studies were identified, 12 of which were included in the meta-analyses. For both anorexia nervosa (AN) and bulimia nervosa, there were significant differences between ED groups and HCs, with medium to large effect sizes. Findings from the qualitative review indicate that levels of SA are similar across the ED diagnoses, and SA improves with treatment in AN. In addition, high levels of SA are associated with more severe ED psychopathology, but not body mass index. These findings add to the wider literature on socio-emotional functioning in EDs, and may have implications for treatment strategies.

  20. Comorbid Depression and Anxiety in Childhood and Adolescent Anorexia Nervosa: Prevalence and Implications for Outcome

    Science.gov (United States)

    Hughes, Elizabeth K.

    2012-01-01

    Background: Comorbid conditions are common in individuals with anorexia nervosa (AN) and can raise issues for diagnosis, prognosis, and treatment planning. Methods: First, reported prevalence rates for depression and anxiety in children and adolescents with AN were reviewed. Diagnostic issues and current understanding of the temporal onset and…

  1. Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features.

    Science.gov (United States)

    Rush, A John; Zimmerman, Mark; Wisniewski, Stephen R; Fava, Maurizio; Hollon, Steven D; Warden, Diane; Biggs, Melanie M; Shores-Wilson, Kathy; Shelton, Richard C; Luther, James F; Thomas, Brandi; Trivedi, Madhukar H

    2005-07-01

    This study evaluated the clinical and sociodemographic features associated with various degrees of concurrent comorbidity in adult outpatients with nonpsychotic major depressive disorder (MDD). Outpatients enrolled in the STAR*D trial completed the Psychiatric Diagnostic Screening Questionnaire (PDSQ). An a priori 90% specificity threshold was set for PDSQ responses to ascertain the presence of 11 different concurrent DSM-IV Axis I disorders. Of 1376 outpatients, 38.2% had no concurrent comorbidities, while 25.6% suffered one, 16.1% suffered two, and 20.2% suffered three or more comorbid conditions. Altogether, 29.3% met threshold for social anxiety disorder, 20.8% for generalized anxiety disorder, 18.8% for posttraumatic stress disorder, 12.4% for bulimia, 11.9% for alcohol abuse/dependence, 13.4% for obsessive-compulsive disorder, 11.1% for panic disorder, 9.4% for agoraphobia, 7.3% for drug abuse/dependence, 3.7% for hypochondriasis, and 2.2% for somatoform disorder. Those with more concurrent Axis I conditions had earlier ages at first onset of MDD, longer histories of MDD, greater depressive symptom severity, more general medical comorbidity (even though they were younger than those with fewer comorbid conditions), poorer physical and mental function, health perceptions, and life satisfaction; and were more likely to be seen in primary care settings. Participants had to meet entry criteria for STAR*D. Ascertainment of comorbid conditions was not based on a structured interview. Concurrent Axis I conditions (most often anxiety disorders) are very common with MDD. Greater numbers of concurrent comorbid conditions were associated with increased severity, morbidity, and chronicity of their MDD.

  2. The Effects of Acceptance and Commitment Therapy on Man Smokers' Comorbid Depression and Anxiety Symptoms and Smoking Cessation: A Randomized Controlled Trial.

    Science.gov (United States)

    Davoudi, Mohammadreza; Omidi, Abdollah; Sehat, Mojtaba; Sepehrmanesh, Zahra

    2017-07-01

    Besides physical problems, cigarette smoking is associated with a high prevalence of comorbid depression and anxiety symptoms. One of the reasons behind high post-cessation smoking lapse and relapse rates is inattentiveness to these symptoms during the process of cessation. The aim of this study was to examine the effects of acceptance and commitment therapy (ACT) on male smokers' comorbid depression and anxiety symptoms and smoking cessation. This two-group pre-test-post-test randomized controlled trial was done on a random sample of seventy male smokers. Participants were randomly and evenly allocated to an intervention and a control group. Patients in these groups received either acceptance or commitment therapy or routine psychological counseling services include cognitive behavior therapy, respectively. Study data were collected through a demographic questionnaire, the Structural Clinical Interview (SCI) for Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV) disorders, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Micro Smokerlyzer carbon monoxide monitor. The SPSS software was employed to analyze the data. After the intervention, depression and anxiety scores and smoking cessation rate in the intervention group were respectively lower and higher than the control group (P < 0.050). ACT can significantly improve comorbid depression and anxiety symptoms and smoking cessation rate. Thus, it can be used to simultaneously manage depression, anxiety, and cigarette smoking.

  3. Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults.

    Science.gov (United States)

    Wuthrich, V M; Rapee, R M; Kangas, M; Perini, S

    2016-03-01

    Co-morbid anxiety and depression in older adults is associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments in older adults. However, there is a paucity of research focused on testing the efficacy of the co-morbid treatment of anxiety and depression in older adults using psychological interventions. Accordingly, the primary objective of the current study was to test the effects of a group cognitive behavior therapy (CBT) program in treating co-morbid anxiety and depression in a sample of older age adults. A total of 133 community-dwelling participants aged ⩾60 years (mean age = 67.35, s.d. = 5.44, male = 59) with both an anxiety disorder and unipolar mood disorder, as assessed on the Anxiety Disorder Interview Schedule (ADIS), were randomly allocated to an 11-week CBT group or discussion group. Participants with Mini-Mental State Examination scores <26 were excluded. Participants were assessed pre-treatment, post-treatment and at 6 months follow-up on the ADIS, a brief measure of well-being, Geriatric Anxiety Inventory and Geriatric Depression Scale. Both conditions resulted in significant improvements over time on all diagnostic, symptom and wellbeing measures. Significant group × time interaction effects emerged at post-treatment only for diagnostic severity of the primary disorder, mean severity of all anxiety disorders, mood disorders, and all disorders, and recovery rates on primary disorder. Group CBT produced faster and sustained improvements in anxiety and depression on diagnostic severity and recovery rates compared to an active control in older adults.

  4. Perception matters for clinical perfectionism and social anxiety.

    Science.gov (United States)

    Levinson, Cheri A; Rodebaugh, Thomas L; Shumaker, Erik A; Menatti, Andrew R; Weeks, Justin W; White, Emily K; Heimberg, Richard G; Warren, Cortney S; Blanco, Carlos; Schneier, Franklin; Liebowitz, Michael R

    2015-01-01

    Despite research documenting a relationship between social anxiety and perfectionism, very little research has examined the relationship between social anxiety and clinical perfectionism, defined as the combination of high personal standards and high maladaptive perfectionistic evaluative concern. In the current studies we examined whether clinical perfectionism predicted social anxiety in a large sample of undergraduates (N=602), in a clinical sample of participants diagnosed with social anxiety disorder (SAD; N=180), and by using a variance decomposition model of self- and informant-report of perfectionism (N=134). Using self-report, we found that an interaction of personal standards and evaluative concern predicted both social interaction anxiety and fear of scrutiny, but not in the theorized direction. Specifically, we found that self-report of low standards and high evaluative concern was associated with the highest levels of social anxiety, suggesting that when individuals with SAD hold low expectations for themselves combined with high concerns about evaluation, social anxiety symptoms may increase. Alternatively, when an informants' perspective was considered, and more consistent with the original theory, we found that the interaction of informant-only report of personal standards and shared-report (between both primary participant and informant) of concern over mistakes was associated with self-reported social anxiety, such that high concern over mistakes and high personal standards predicted the highest levels of social anxiety. Theoretical, clinical, and measurement implications for clinical perfectionism are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Differentiating among singular and comorbid obsessive-compulsive disorder and social phobia symptomology.

    Science.gov (United States)

    Rudy, Brittany M; May, Anna C; Whiting, Sara E; Davis, Thompson E; Jenkins, Whitney S; Reuther, Erin T

    2014-01-01

    Social phobia is a frequent co-occurring diagnosis with obsessive-compulsive disorder (OCD); however, co-occurring OCD in those with social phobia is less common. Genetic, environmental, and cognitive traits are common risk factors for anxiety disorders broadly. It is plausible that shared variables related to OCD and/or social phobia could provide insight into the co-occurrence of these two disorders. The current study explored differences in fear of negative evaluation (FNE) and perfectionism among four groups: those with (1) elevated social phobia symptoms, (2) elevated OCD symptoms, (3) elevated symptoms of OCD and social phobia, and those who were (4) asymptomatic as a control group. A non-clinical sample of 196 participants completed several online questionnaires about social phobia and OCD symptomology. Results identified three cognitive variables (i.e., FNE, total perfectionism, and concern over mistakes) as differential variables in comorbid symptom presentation of OCD and social phobia. A fourth variable (i.e., doubts about actions) was identified as a potential dual risk factor, and four subsequent variables (i.e., parental criticism, personal standards, parental expectations, and organization) were not implicated in differential symptom presentation. Given the different rates of OCD and social phobia co-occurrence, identification of differentiating variables could aid in better understanding of potential risk factors, which may enhance preventative and therapeutic techniques. Study implications, limitations, and future recommendations are discussed.

  6. [Effect of speech estimation on social anxiety].

    Science.gov (United States)

    Shirotsuki, Kentaro; Sasagawa, Satoko; Nomura, Shinobu

    2009-02-01

    This study investigates the effect of speech estimation on social anxiety to further understanding of this characteristic of Social Anxiety Disorder (SAD). In the first study, we developed the Speech Estimation Scale (SES) to assess negative estimation before giving a speech which has been reported to be the most fearful social situation in SAD. Undergraduate students (n = 306) completed a set of questionnaires, which consisted of the Short Fear of Negative Evaluation Scale (SFNE), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS), and the SES. Exploratory factor analysis showed an adequate one-factor structure with eight items. Further analysis indicated that the SES had good reliability and validity. In the second study, undergraduate students (n = 315) completed the SFNE, SIAS, SPS, SES, and the Self-reported Depression Scale (SDS). The results of path analysis showed that fear of negative evaluation from others (FNE) predicted social anxiety, and speech estimation mediated the relationship between FNE and social anxiety. These results suggest that speech estimation might maintain SAD symptoms, and could be used as a specific target for cognitive intervention in SAD.

  7. Role of Comorbid Depression and Co-Occurring Depressive Symptoms in Outcomes for Anxiety-Disordered Youth Treated with Cognitive-Behavioral Therapy

    Science.gov (United States)

    O'Neil, Kelly A.; Kendall, Philip C.

    2012-01-01

    This study examined the role of comorbid depressive disorders (major depressive disorder or dysthymic disorder) and co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7-14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety…

  8. Social Anxiety, Pain Catastrophizing and Return-To-Work Self-Efficacy in chronic pain: a cross-sectional study.

    Science.gov (United States)

    Thomtén, Johanna; Boersma, Katja; Flink, Ida; Tillfors, Maria

    2016-04-01

    Returning to work after periods of sick-leave due to chronic pain problems, involve a number of situations of interpersonal nature (e.g. meeting supervisors/insurance companies to adapt work setting to present functional level, receive help from colleagues, express pain, etc.). Since chronic pain has shown co-morbidity with social anxiety, it is of interest to investigate restraining factors in return to work among chronic pain sufferers from a social perspective. Catastrophizing is identified in both pain and social anxiety as a mechanism that might fuel a continuous bias in how situations are perceived (threat) and by hindering the development of functional behavior strategies. The presence of social anxiety in chronic pain patients might be seen as a stressor that limits the individuals' ability to effectively communicate pain-related needs to colleagues, and/or employers and therefore act as a hindering factor in return-to-work. Hence, the overall aim of this study was to examine the relationship between social anxiety, pain catastrophizing, and perceived ability to communicate pain-related needs to the work environment in a clinical pain population. The study employed a cross-sectional design and involved 247 individuals with chronic pain (82.3% women; M age =44 years). Measures included the Pain catastrophizing Scale, the Social Phobia Screening Questionnaire and the communication of pain-related needs-subscale of the Return-To-Work Self-efficacy Questionnaire. Analyzes were run to examine whether social anxiety moderated the relation between pain catastrophizing, and perceived ability to communicate pain-related needs while controlling for pain severity/interference and sick leave. Social anxiety and pain catastrophizing correlated positively with each other and negatively with perceived ability to communicate pain-related needs. No support was obtained for a moderating effect of social anxiety. However, social anxiety and pain interference were each

  9. Social anxiety and post-event processing among African-American individuals.

    Science.gov (United States)

    Buckner, Julia D; Dean, Kimberlye E

    2017-03-01

    Social anxiety is among the most prevalent psychiatric conditions, yet little attention has been paid to whether putative cognitive vulnerability factors related to social anxiety in predominantly White samples are related to social anxiety among historically underrepresented groups. We tested whether one such vulnerability factor, post-event processing (PEP; detailed review of social event that can increase state social anxiety) was related to social anxiety among African-American (AA; n = 127) persons, who comprise one of the largest underrepresented racial groups in the U.S. Secondarily, we tested whether AA participants differed from non-Hispanic White participants (n = 127) on PEP and social anxiety and whether race moderated the relation between PEP and social anxiety. Data were collected online among undergraduates. PEP was positively correlated with social anxiety among AA participants, even after controlling for depression and income, pr = .30, p = .001. AA and White participants did not differ on social anxiety or PEP, β = -1.57, 95% CI: -5.11, 1.96. The relation of PEP to social anxiety did not vary as a function of race, β = 0.00, 95% CI: -0.02, 0.02. PEP may be an important cognitive vulnerability factor related to social anxiety among AA persons suffering from social anxiety.

  10. Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review.

    Science.gov (United States)

    Cruz, Elisabeth Lima Dias da; Martins, Priscila Diniz de Carvalho; Diniz, Paula Rejane Beserra

    To identify the risk factors related to the association between social anxiety disorder and alcohol use in adolescents. The PICO research strategy was used to perform a systematic review in Medline, LILACS, Pubmed, IBECS and Cochrane Library databases. DeCS/MeSH: Phobic Disorders, Adolescent, Behavior, Ethanol, Risk Factors, and the Boolean operator "AND" were used. Inclusion criteria were: cross-sectional, prospective/retrospective cohort, and case-control studies, carried out in adolescents (10-19 years), original articles on social anxiety disorder and alcohol use published between 2010 and 2015. Studies that did not report the terms "anxiety disorder" and "alcohol use" in the title and abstract were excluded. 409 articles were retrieved; after the exclusion of 277 repeated articles, the following were eligible: 94 in MEDLINE, 68 in Pubmed, 12 in IBCS, and three in LILACS. Titles and abstracts were independently read by two examiners, which resulted in the selection of eight articles for the analysis. Risk factors associated to the two disorders were female gender, age, peer approval and affective problems for alcohol use, confrontation situations and/or compliance reasons, frequency of alcohol use, and secondary comorbidities, such as depression and generalized anxiety. It is necessary to assess the period of social anxiety disorders first symptom onset, as well as the risks for alcohol use in order to establish corrective intervention guidelines, especially for socially anxious students. Copyright © 2017. Published by Elsevier Editora Ltda.

  11. Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review

    Directory of Open Access Journals (Sweden)

    Elisabeth Lima Dias da Cruz

    Full Text Available Abstract Objective: To identify the risk factors related to the association between social anxiety disorder and alcohol use in adolescents. Source of data: The PICO research strategy was used to perform a systematic review in Medline, LILACS, Pubmed, IBECS and Cochrane Library databases. DeCS/MeSH: Phobic Disorders, Adolescent, Behavior, Ethanol, Risk Factors, and the Boolean operator “AND” were used. Inclusion criteria were: cross-sectional, prospective/retrospective cohort, and case-control studies, carried out in adolescents (10–19 years, original articles on social anxiety disorder and alcohol use published between 2010 and 2015. Studies that did not report the terms “anxiety disorder” and “alcohol use” in the title and abstract were excluded. Synthesis of data: 409 articles were retrieved; after the exclusion of 277 repeated articles, the following were eligible: 94 in MEDLINE, 68 in Pubmed, 12 in IBCS, and three in LILACS. Titles and abstracts were independently read by two examiners, which resulted in the selection of eight articles for the analysis. Risk factors associated to the two disorders were female gender, age, peer approval and affective problems for alcohol use, confrontation situations and/or compliance reasons, frequency of alcohol use, and secondary comorbidities, such as depression and generalized anxiety. Conclusions: It is necessary to assess the period of social anxiety disorders first symptom onset, as well as the risks for alcohol use in order to establish corrective intervention guidelines, especially for socially anxious students.

  12. Depression and anxiety in patients with COPD

    Directory of Open Access Journals (Sweden)

    Abebaw M. Yohannes

    2014-09-01

    Full Text Available Under-recognised and untreated depression and anxiety symptoms have deleterious effects on physical functioning and social interaction increasing fatigue and healthcare utilisation in patients with chronic obstructive pulmonary disease (COPD. Depression and anxiety are challenging to identify and treat because their symptoms often overlap with those of COPD. The cause(s of depression and anxiety symptoms are multifactorial and include behavioural, social and biological factors. Less than one-third of COPD patients with comorbid depression or anxiety symptoms are receiving appropriate treatment. Factors that contribute to the lack of provision of treatment are varied, they include patient perceived barriers, for example lack of knowledge and reluctance to receive antidepressant drug therapy; poor treatment compliance and lack of a standardised diagnostic approach; and scarcity of adequate resources for mental health treatment. The evidence for the efficacy of antidepressant drug therapy in patients with COPD with comorbid depression and anxiety is inconclusive. There are some promising findings regarding pulmonary rehabilitation, psychological therapy and the collaborative care model in reducing depression and anxiety symptoms in patients with COPD, but these findings are limited by short-term follow-up periods. Further work is required to examine the efficacy of these interventions in randomised controlled trials with larger samples and long-term follow-up.

  13. A comorbid anxiety disorder does not result in an excess risk of death among patients with a depressive disorder.

    Science.gov (United States)

    Laan, Wijnand; Termorshuizen, Fabian; Smeets, Hugo M; Boks, Marco P M; de Wit, Niek J; Geerlings, Mirjam I

    2011-12-01

    Several studies have demonstrated increased mortality associated with depression and with anxiety. Mortality due to comorbidity of two mental disorders may be even more increased. Therefore, we investigated the mortality among patients with depression, with anxiety and with both diagnoses. By linking the longitudinal Psychiatric Case Register Middle-Netherlands, which contains all patients of psychiatric services in the Utrecht region, to the death register of Statistics Netherlands, hazard ratio's of death were estimated overall and for different categories of death causes separately. We found an increased risk of death among patients with an anxiety disorder (N=6919): HR=1.45 (95%CI: 1.25-1.69), and among patients with a depression (N=14,778): HR=1.83, (95%CI: 1.72-1.95), compared to controls (N=103,824). The hazard ratios among both disorders combined (N=4260) were similar to those with only a depression: HR=1.91, (95% CI: 1.64-2.23). Among patients with a depression, mortality across all important disease-related categories of death causes (neoplasms, cardiovascular, respiratory, and other diseases) and due to suicide was increased, without an excess mortality in case of comorbid anxiety. The presented data are restricted to broad categories of patients in specialist services. No data on behavioral or intermediate factors were available. Although anxiety is associated with an increased risk of death, the presence of anxiety as comorbid disorder does not give an additional increase in the risk of death among patients with a depressive disorder. The increased mortality among patients with depression is not restricted to suicide and cardiovascular diseases, but associated with a broad range of death causes. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Self-verification and social anxiety: preference for negative social feedback and low social self-esteem.

    Science.gov (United States)

    Valentiner, David P; Skowronski, John J; McGrath, Patrick B; Smith, Sarah A; Renner, Kerry A

    2011-10-01

    A self-verification model of social anxiety views negative social self-esteem as a core feature of social anxiety. This core feature is proposed to be maintained through self-verification processes, such as by leading individuals with negative social self-esteem to prefer negative social feedback. This model is tested in two studies. In Study 1, questionnaires were administered to a college sample (N = 317). In Study 2, questionnaires were administered to anxiety disordered patients (N = 62) before and after treatment. Study 1 developed measures of preference for negative social feedback and social self-esteem, and provided evidence of their incremental validity in a college sample. Study 2 found that these two variables are not strongly related to fears of evaluation, are relatively unaffected by a treatment that targets such fears, and predict residual social anxiety following treatment. Overall, these studies provide preliminary evidence for a self-verification model of social anxiety.

  15. Increased error-related brain activity distinguishes generalized anxiety disorder with and without comorbid major depressive disorder.

    Science.gov (United States)

    Weinberg, Anna; Klein, Daniel N; Hajcak, Greg

    2012-11-01

    Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are so frequently comorbid that some have suggested that the 2 should be collapsed into a single overarching "distress" disorder. Yet there is also increasing evidence that the 2 categories are not redundant. Neurobehavioral markers that differentiate GAD and MDD would be helpful in ongoing efforts to refine classification schemes based on neurobiological measures. The error-related negativity (ERN) may be one such marker. The ERN is an event-related potential component presenting as a negative deflection approximately 50 ms following an erroneous response and reflects activity of the anterior cingulate cortex. There is evidence for an enhanced ERN in individuals with GAD, but the literature in MDD is mixed. The present study measured the ERN in 26 GAD, 23 comorbid GAD and MDD, and 36 control participants, all of whom were female and medication-free. Consistent with previous research, the GAD group was characterized by a larger ERN and an increased difference between error and correct trials than controls. No such enhancement was evident in the comorbid group, suggesting comorbid depression may moderate the relationship between the ERN and anxiety. The present study further suggests that the ERN is a potentially useful neurobiological marker for future studies that consider the pathophysiology of multiple disorders in order to construct or refine neurobiologically based diagnostic phenotypes. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  16. Social Anxiety and Post-Event Processing: The Impact of Race

    Science.gov (United States)

    Buckner, Julia D.; Dean, Kimberlye E.

    2016-01-01

    Background Social anxiety is among the most prevalent psychiatric conditions, yet little attention has been paid to whether putative cognitive vulnerability factors related to social anxiety in predominantly White samples are related to social anxiety among historically underrepresented groups. Design We tested whether one such vulnerability factor, post-event processing (PEP; detailed review of social event that can increase state social anxiety) was related to social anxiety among African American (AA; n=127) persons, who comprise one of the largest underrepresented racial groups in the U.S. Secondarily, we tested whether AA participants differed from non-Hispanic White participants (n=127) on PEP and social anxiety and whether race moderated the relation between PEP and social anxiety. Method Data were collected online among undergraduates. Results PEP was positively correlated with social anxiety among AA participants, even after controlling for depression and income, pr=.30, p=.001. AA and White participants did not differ on social anxiety or PEP, β=−1.57, 95% C.I.: −5.11, 1.96. The relation of PEP to social anxiety did not vary as a function of race, β=0.00, 95% C.I.: −0.02, 0.02. Conclusions PEP may be an important cognitive vulnerability factor related to social anxiety among AA persons suffering from social anxiety. PMID:27576610

  17. Validation of the Social Interaction Anxiety Scale and the Social Phobia Scale across the Anxiety Disorders.

    Science.gov (United States)

    Brown, Elissa J.; And Others

    1997-01-01

    The psychometric adequacy of the Social Interaction Scale and the Social Phobia Scale (both by R. P. Mattick and J. C. Clark, 1989) was studied with 165 patients with anxiety disorders and 21 people without anxiety. Results support the usefulness of the scales for screening and treatment design and evaluation. (SLD)

  18. Comorbidity between lifetime eating problems and mood and anxiety disorders: results from the Canadian Community Health Survey of Mental Health and Well-being.

    Science.gov (United States)

    Meng, Xiangfei; D'Arcy, Carl

    2015-03-01

    This study was to examine profiles of eating problems (EPs), mood and anxiety disorders and their comorbidities; explore risk patterns for these disorders; and document differences in health service utilization in a national population. Data were from the Canadian Community Health Survey of Mental Health and Well-being. The lifetime prevalence of EPs was 1.70% among Canadians, compared with 13.25% for mood disorder, 11.27% for anxiety disorder and 20.16% for any mood or anxiety disorder. Almost half of those with EPs also suffered with mood or anxiety disorders. A similar pattern in depressive symptoms was found among individuals with major depression and EPs, but individuals with EPs reported fewer symptoms. Factors associated with the comorbidity of EPs and mood and anxiety disorders were identified. Individuals with EPs reported more unmet needs. Patients with EPs should be concomitantly investigated for mood and anxiety disorders, as similar interventions may be effective for both. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  19. Social media use and anxiety in emerging adults.

    Science.gov (United States)

    Vannucci, Anna; Flannery, Kaitlin M; Ohannessian, Christine McCauley

    2017-01-01

    Social media use is central to the lives of emerging adults, but the implications of social media use on psychological adjustment are not well understood. The current study aimed to examine the impact of time spent using social media on anxiety symptoms and severity in emerging adults. Using a web-based recruitment technique, we collected survey information on social media use and anxiety symptoms and related impairment in a nationally representative sample of 563 emerging adults from the U.S. (18-22 years-old; 50.2% female; 63.3% Non-Hispanic White). Participants self-reported the amount of time they spent using various social media sites on an average day, and responded to anxiety questionnaires RESULTS: Hierarchical regression revealed that more time spent using social media was significantly associated with greater symptoms of dispositional anxiety (B=0.74, 95% CI=0.59-0.90, psocial media use was significantly associated with a greater likelihood of participants scoring above the anxiety severity clinical cut-off indicating a probable anxiety disorder (AOR=1.032, 95% CI=1.004-1.062, p=0.028). Study limitations include the cross-sectional design and reliance on self-report questionnaires. Given the ubiquity of social media among emerging adults, who are also at high risk for anxiety disorders, the positive association between social media use and anxiety has important implications for clinicians. Gaining a more nuanced understanding of this relationship will help to inform novel approaches to anxiety treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Culture of honour theory and social anxiety: Cross-regional and sex differences in relationships among honour-concerns, social anxiety and reactive aggression.

    Science.gov (United States)

    Howell, Ashley N; Buckner, Julia D; Weeks, Justin W

    2015-01-01

    Consistent with the "flight or fight" model of anxiety, social anxiety may incite withdrawal or attack; yet, it is unclear why some socially anxious individuals are vulnerable to aggress. It may be that culture impacts tendencies to "fight" or "flee" from social threat. Honour cultures, including the American South, permit or even promote aggression in response to honour-threats. Thus, social anxiety in the South may be more associated with aggression than in non-honour cultures. In the current sample, region moderated the relation between social anxiety and aggression; social anxiety related positively to reactive (but not proactive) aggression among Southerners (n = 285), but not Midwesterners (n = 258). Participant sex further moderated the relationship, such that it was significant only for Southern women. Also, for Southerners, prototypically masculine honour-concerns mediated the relationship between social anxiety and reactive aggression. Cultural factors may play key roles in aggressive behaviour among some socially anxious individuals.

  1. Depression and Anxiety among Transitioning Adolescents and College Students with ADHD, Dyslexia, or Comorbid ADHD/Dyslexia

    Science.gov (United States)

    Nelson, Jason M.; Gregg, Noel

    2012-01-01

    Objective: To investigate depressive and anxious symptomatology among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. Method: Transitioning adolescents and college students with these disorders along with a non-ADHD/dyslexia college sample completed self-report measures of depression and anxiety.…

  2. [Distorted cognition of bodily sensations in subtypes of social anxiety].

    Science.gov (United States)

    Kanai, Yoshihiro; Sasaki, Shoko; Iwanaga, Makoto; Seiwa, Hidetoshi

    2010-02-01

    The purpose of this study was to investigate the relationship between subtypes of social anxiety and distorted cognition of bodily sensations. The package of questionnaires including the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) was administered to 582 undergraduate students. To identify subtypes of social anxiety, cluster analysis was conducted using scores of the SPS and SIAS. Five clusters were identified and labeled as follows: Generalized type characterized by intense anxiety in most social situations, Non-anxious type characterized by low anxiety levels in social situations, Averaged type whose anxiety levels are averaged, Interaction anxiety type who feels anxiety mainly in social interaction situations, and Performance anxiety type who feels anxiety mainly in performance situations. Results of an ANOVA indicated that individuals with interaction type fear the negative evaluation from others regarding their bodily sensations whereas individuals with performance type overestimate the visibility of their bodily sensations to others. Differences in salient aspects of cognitive distortion among social anxiety subtypes may show necessity to select intervention techniques in consideration of subtypes.

  3. Psychological factors of social anxiety in Russian adolescents

    Directory of Open Access Journals (Sweden)

    Tatiana S. Pavlova

    2017-06-01

    Full Text Available Background. Social anxiety is one of the most common and disturbing conditions of childhood and adolescence. It is defined as an excessive fear of embarrassment or humiliation in social performance situations. Recent studies have identified a number of psychological factors that could explain the maintenance of the condition. Objective. The objective of this study was to investigate psychological factors of social anxiety in adolescents with a multifactor psychosocial model. Design: The study population comprised 183 Russian-speaking adolescents from Moscow secondary schools, ranging in age from 12 to 16 years. Self-report measures were used to access social anxiety, symptoms of depression, gender role identification, perfectionism, hostility, family emotional communications, and social support. Results. The results indicate that social anxiety was positively correlated with symptoms of depression and suicidal thoughts. No quantitative differences in social anxiety between girls and boys were found, while masculinity and undifferentiated gender identification had a strong association with social anxiety. A positive correlation was found between “concern over mistakes” (fear of making a mistake and being negatively compared with peers and “overdoing” (spending too much time doing homework and too little or none communicating with peers, using the Child Perfectionism Questionnaire (CPQ subscales and Social Anxiety and Distress Scale (SADS total score. Positive correlations were found between social anxiety and suppression of emotions and outward well-being subscales, as well in as the Family Emotional Communication (FEC total score. It is not common to discuss emotions and feelings; it is difficult to share negative experiences; and it is important for the families of socially anxious adolescents to put up a good front. Analysis revealed significant negative correlations between the SADS total score (as well its subscales and the Social

  4. Social anxiety disorder and stuttering: current status and future directions.

    Science.gov (United States)

    Iverach, Lisa; Rapee, Ronald M

    2014-06-01

    Anxiety is one of the most widely observed and extensively studied psychological concomitants of stuttering. Research conducted prior to the turn of the century produced evidence of heightened anxiety in people who stutter, yet findings were inconsistent and ambiguous. Failure to detect a clear and systematic relationship between anxiety and stuttering was attributed to methodological flaws, including use of small sample sizes and unidimensional measures of anxiety. More recent research, however, has generated far less equivocal findings when using social anxiety questionnaires and psychiatric diagnostic assessments in larger samples of people who stutter. In particular, a growing body of research has demonstrated an alarmingly high rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a prevalent and chronic anxiety disorder characterised by significant fear of humiliation, embarrassment, and negative evaluation in social or performance-based situations. In light of the debilitating nature of social anxiety disorder, and the impact of stuttering on quality of life and personal functioning, collaboration between speech pathologists and psychologists is required to develop and implement comprehensive assessment and treatment programmes for social anxiety among people who stutter. This comprehensive approach has the potential to improve quality of life and engagement in everyday activities for people who stutter. Determining the prevalence of social anxiety disorder among children and adolescents who stutter is a critical line of future research. Further studies are also required to confirm the efficacy of Cognitive Behaviour Therapy in treating social anxiety disorder in stuttering. The reader will be able to: (a) describe the nature and course of social anxiety disorder; (b) outline previous research regarding anxiety and stuttering, including features of social anxiety disorder; (c) summarise research findings regarding the

  5. Social Anxiety and Adolescents' Friendships: The Role of Social Withdrawal

    Science.gov (United States)

    Biggs, Bridget K.; Vernberg, Eric M.; Wu, Yelena P.

    2012-01-01

    Research indicates social anxiety is associated with lower friendship quality, but little is known about the underlying mechanisms. This 2-month longitudinal study examined social withdrawal as a mediator of the social anxiety-friendship quality link in a sample of 214 adolescents (M[subscript age] = 13.1 years, SD = 0.73) that included an…

  6. University students' understanding of social anxiety disorder.

    OpenAIRE

    Miyake, Yoshie; Okamoto, Yuri; Jinnin, Ran; Yashiki, Hisako; Uchino, Teiji; Isobe, Noriko; Takata, Jun; Kojima, Nanae; Nihonmatsu, Misato; Yokosaki, Yasuyuki; Hiyama, Toru; Yoshihara, Masaharu

    2014-01-01

    Social anxiety disorder is an important cause of psychosocial morbidity in adolescents and young adults. Problems in adolescents and young adults with social anxiety disorder would be a topic in recent years in campus mental health. We examined the opinion of social anxiety disorder on university students. We found that many students felt anxiety in various social scenes, and some students were worried about their anxiety. Most of the students understood the importance of mental treatment for...

  7. Still lonely: Social adjustment of youth with and without social anxiety disorder following cognitive behavioral therapy.

    Science.gov (United States)

    Suveg, Cynthia; Kingery, Julie Newman; Davis, Molly; Jones, Anna; Whitehead, Monica; Jacob, Marni L

    2017-12-01

    Social experiences are an integral part of normative development for youth and social functioning difficulties are related to poor outcomes. Youth with anxiety disorders, and particularly social anxiety disorder, experience difficulties across many aspects of social functioning that may place them at risk for maladjustment. The goal of this paper was to compare social experiences of youth across anxiety diagnoses and examine whether treatment is helpful in improving social functioning. Ninety-two children (age 7-12 years; 58% male; 87.0% White) with a primary diagnosis of generalized anxiety disorder, separation anxiety disorder, and/or social anxiety disorder participated in cognitive behavioral therapy. At both pre- and post-treatment, children with social anxiety disorder self-reported greater loneliness than youth without social anxiety disorder, though levels of peer victimization and receipt of prosocial behavior were similar across groups. Parents reported greater social problems for youth with social anxiety disorder compared to those without social anxiety disorder. All youth experienced improved social functioning following treatment per child- and parent-reports. The results call for an increased focus on the social experiences of youth with anxiety disorders, and particularly loneliness, for children with social anxiety disorder. The results document ways that evidenced-based practice can improve social functioning for youth with anxiety disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Social Anxiety Disorders and Alcohol Abuse

    Science.gov (United States)

    ... social anxiety disorder Follow Us Facebook Twitter RSS YouTube Advertisement Find A Therapist Search our directory of ADAA mental health professional members who specialize in anxiety, depression and co-occurring disorders. Understand the Facts Anxiety ...

  9. Social Anxiety and Aggression in Behaviorally Disordered Children.

    Science.gov (United States)

    Gonzalez, Ketty P.; And Others

    1996-01-01

    Thirty-nine boys in classes for students with behavioral disturbances were given questionnaires on trait anxiety, social anxiety, empathy, depression, and self-esteem, while teachers rated their aggression. Results showed that anxiety and empathy scores were not correlated with aggression, while social anxiety was positively correlated with trait…

  10. Social support and performance anxiety of college music students.

    Science.gov (United States)

    Schneider, Erin; Chesky, Kris

    2011-09-01

    This study characterized perceived social support and performance anxiety of college music students, compared characteristics to those of non-music majors, and explored the relationships between social support and performance anxiety. Subjects (n = 609) completed a questionnaire that included demographics, the Multidimensional Scale of Perceived Social Support (MSPSS), and visual analog scale measures of performance anxiety. Results showed that music majors perceived significantly lower levels of social support from significant others when compared to non-music majors. Perceived social support was significantly correlated with measures of performance anxiety. Students with greater perceived social support reported less frequent anxiety and lower levels of impact of anxiety on ability to perform. These findings may have practical implications for schools of music and conservatories.

  11. The social ties that bind: social anxiety and academic achievement across the university years.

    Science.gov (United States)

    Brook, Christina A; Willoughby, Teena

    2015-05-01

    Given that engagement and integration in university/college are considered key to successful academic achievement, the identifying features of social anxiety, including fear of negative evaluation and distress and avoidance of new or all social situations, may be particularly disadvantageous in the social and evaluative contexts that are integral to university/college life. Thus, the purpose of this study was to examine the direct effects of social anxiety on academic achievement, as well as investigate an indirect mechanism through which social anxiety might impact on academic achievement, namely, the formation of new social ties in university. The participants were 942 (71.7 % female; M = 19 years at Time 1) students enrolled in a mid-sized university in Southern Ontario, Canada. Students completed annual assessments of social anxiety, social ties, and academic achievement for three consecutive years. The results from an autoregressive cross-lag path analysis indicated that social anxiety had a significant and negative direct relationship with academic achievement. Moreover, the negative indirect effect of social anxiety on academic achievement through social ties was significant, as was the opposing direction of effects (i.e., the indirect effect of academic achievement on social anxiety through social ties). These findings highlight the critical role that social ties appear to play in successful academic outcomes and in alleviating the effects of social anxiety during university/college.

  12. The interaction of Matrix Reasoning and Social Motivation as predictors of Separation anxiety in boys with Autism Spectrum Disorder.

    Science.gov (United States)

    Bitsika, Vicki; Sharpley, Christopher F

    2018-06-01

    It has been suggested that higher cognitive functioning based in the pre-frontal cortex is implicated in the ability of people with Autism Spectrum Disorder (ASD) to understand and communicate in social situations. Low motivation to engage in social interaction may also be influential in this process. Although both of these factors have been argued to influence the levels of comorbid anxiety in young people with ASD, no detailed examination of those relationships has been reported to date. A sample of 90 boys with ASD (aged 6 to 12 yr) and 29 of their non-ASD peers, matched for age and IQ, completed tests of cognitive function and anxiety. Only one form of anxiety-fear of being separated from their parents- was significantly associated with cognitive function, at the Full Scale IQ and Matrix Reasoning levels, plus motivation to engage in social interactions, and only for the ASD boys. These data represent a complex interaction between the neurobiological aspects of ASD, fluid reasoning, social motivation, and Separation Anxiety in boys with ASD. As such, they bring a new perspective to understanding and treating anxious behaviour in these boys. Copyright © 2018 ISDN. Published by Elsevier Ltd. All rights reserved.

  13. Social anxiety in children

    Directory of Open Access Journals (Sweden)

    Avakyan, Tamara V.

    2014-03-01

    Full Text Available Results of research on social anxiety in orphaned children are presented in this article. The goal of this study was to identify the relationship between depressive states, anxiety states, characteristics of the situation at school, and fear of social evaluation in orphaned children. The differences in these parameters between orphaned children and children living with their families were also studied. The sample consisted of 123 teenagers. The main group comprised 57 orphans from an orphanage near the Moscow region, aged 10 to 16 years old. The control group comprised 66 students from a general school, aged 10 to 15 years old, and all living with their families. Differences were found in the parameters studied. The orphans were characterized by higher levels of social and general anxiety. On the one hand, they strove for the attention and approval of adults, but, on the other hand, they were more worried than their peers who lived with their families about the impression they made on others. They were afraid of receiving a negative evaluation.

  14. Social Anxiety and Social Adaptation among Adolescents at Three Age Levels

    Science.gov (United States)

    Peleg, Ora

    2012-01-01

    The aim of the study was to examine the relationship between social anxiety and social adaptation among adolescents. This is the first study to research these parameters among three age groups: early, middle and late adolescence. On the whole, a negative relation was found between social anxiety and social adaptation. Specifically, for adolescents…

  15. Psychiatric aspects of pediatric epilepsy: Focus on anxiety disorder

    Directory of Open Access Journals (Sweden)

    Sujita Kumar Kar

    2015-01-01

    Full Text Available Psychiatric co-morbidities are commonly seen with pediatric epilepsy, which can be in the form of cognitive deficits like - inattention and intellectual disability, motor disturbances like - hyperactivity, emotional disturbances like - depression and anxiety disorders and behavioral problems like - impulsivity, aggression and even psychotic behavior. Anxiety disorders like - Obsessive compulsive disorder, posttraumatic stress disorder, social phobia, separation anxiety disorder, agoraphobia and panic attacks are commonly seen with pediatric epilepsy. Presence of co-morbid anxiety disorder in pediatric epilepsy is responsible for scholastic decline, peer maladjustment and poor quality of life. Management of anxiety disorders in children with epilepsy is always a challenge. Until, there is no general consensus regarding management of anxiety disorders in pediatric epilepsy. Despite its enormous impact on an individual′s life, this area has not been addressed adequately through clinical research. This review focuses on psychiatric aspects of pediatric epilepsy with specific emphasis on anxiety disorders.

  16. Behavioral Relaxation Training for Parkinson's Disease Related Dyskinesia and Comorbid Social Anxiety

    Science.gov (United States)

    Lundervold, Duane A.; Pahwa, Rajesh; Lyons, Kelly E.

    2013-01-01

    Effects of brief Behavioral Relaxation Training (BRT) on anxiety and dyskinesia of a 57-year-old female, with an 11-year history of Parkinson's disease (PD) and 18-months post-deep brain stimulation of the subthalamic nucleus, were evaluated. Multiple process and outcome measures were used including the Clinical Anxiety Scale (CAS), Subjective…

  17. A mixed methods survey of social anxiety, anxiety, depression and wig use in alopecia.

    Science.gov (United States)

    Montgomery, Kerry; White, Caroline; Thompson, Andrew

    2017-05-04

    This study aimed to examine levels of social anxiety, anxiety and depression reported by people with alopecia as a result of a dermatological condition and associations with wig use. The study also sought to report on experiences of wearing wigs in social situations and the relationship with social confidence. A cross-sectional survey was sent by email to the Alopecia UK charity mailing list and advertised on social media. Inclusion criteria were a diagnosis of alopecia, aged 13 or above and sufficient English to complete the survey. Exclusion criteria included experiencing hair loss as a result of chemotherapy treatment or psychological disorder. Participants (n=338) were predominantly female (97.3%), Caucasian (93.5%) and aged between 35 and 54 years (49.4%) with a diagnosis of alopecia areata (82.6%). The Social Phobia Inventory measured symptoms of social anxiety, and the Hospital Anxiety and Depression Scale was used to measure symptoms of anxiety and depression. Survey questions were designed to measure the use of wigs. Open-ended questions enabled participants to comment on their experiences of wearing wigs. Clinically significant levels of social anxiety (47.5%), anxiety (35.5%) and depression (29%) were reported. Participants who reported worries about not wearing a wig reported significantly higher levels of depression: t(103)=3.40, p≤0.001; anxiety: t(109)=4.80, p≤0.001; and social anxiety: t(294)=3.89, p≤0.001. Wearing wigs was reported as increasing social confidence; however, the concealment it afforded was also reported as both reducing fear of negative evaluation and maintaining anxiety. Overall, 46% of participants reported that wearing a wig had a positive impact on their everyday life with negative experiences related to fears of the wig being noticed. Psychological interventions alongside wig provision would be beneficial for people living with alopecia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  18. Admixture analysis of the diagnostic subtypes of social anxiety disorder: implications for the DSM-V.

    Science.gov (United States)

    Aderka, Idan M; Nickerson, Angela; Hofmann, Stefan G

    2012-06-01

    Much controversy exists regarding diagnostic subtypes of social anxiety disorder (SAD). The present study used admixture analysis to examine whether individuals with generalized and nongeneralized SAD belong to the same or different populations of origin. This can inform diagnostic subtyping of SAD in the forthcoming DSM-V. Treatment-seeking individuals with generalized SAD (n = 154) and nongeneralized SAD (n = 48) completed a battery of questionnaires. Based on participants' responses to the Liebowitz Social Anxiety Scale (LSAS), we estimated log likelihood and chi-square goodness-of-fit for models with 1, 2, 3, or 4 populations of origin, and compared models using forward stepwise estimation and maximum likelihood ratio tests. Admixture analyses suggested that the two diagnostic subtypes of SAD belong to the same underlying population of origin. In addition, observable differences in depression, general anxiety, and comorbidity were no longer significant when controlling for social anxiety severity. Our sample was recruited in the U.S. and was a treatment-seeking sample. Future studies should examine whether our results generalize to different cultures, and community samples. Support for qualitative differences between SAD subtypes was not found. Rather, our findings support the notion that the diagnostic subtypes of SAD differ quantitatively, and that SAD exists on a continuum of severity. This finding informs diagnostic subtyping of SAD in the forthcoming DSM-V. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Psychometric properties of the Social Interaction Anxiety Scale and separation criterion between Spanish youths with and without subtypes of social anxiety.

    Science.gov (United States)

    Zubeidat, Ihab; Salinas, José María; Sierra, Juan Carlos; Fernández-Parra, Antonio

    2007-01-01

    In this study, we analyzed the reliability and validity of the Social Interaction Anxiety Scale (SIAS) and propose a separation criterion between youths with specific and generalized social anxiety and youths without social anxiety. A sample of 1012 Spanish youths attending school completed the SIAS, the Liebowitz Social Anxiety Scale, the Social Avoidance and Distress Scale, the Fear of Negative Evaluation Scale, the Youth Self-Report for Ages 11-18 and the Minnesota Multiphasic Personality Inventory-Adolescent. The factor analysis suggests the existence of three factors in the SIAS, the first two of which explain most of the variance of the construct assessed. Internal consistency is adequate in the first two factors. The SIAS features an adequate theoretical validity with the scores of different variables related to social interaction. Analysis of the criterion scores yields three groups pertaining to three clearly differentiated clusters. In the third cluster, two of social anxiety groups - specific and generalized - have been identified by means of a quantitative separation criterion.

  20. Reactivity to Social Stress in Subclinical Social Anxiety: Emotional Experience, Cognitive Appraisals, Behavior, and Physiology

    OpenAIRE

    Crişan, Liviu G.; Vulturar, Romana; Miclea, Mircea; Miu, Andrei C.

    2016-01-01

    Recent research indicates that subclinical social anxiety is associated with dysfunctions at multiple psychological and biological levels, in a manner that seems reminiscent of social anxiety disorder (SAD). This study aimed to describe multidimensional responses to laboratory-induced social stress in an analog sample selected for social anxiety symptoms. State anxiety, cognitive biases related to negative social evaluation, speech anxiety behaviors, and cortisol reactivity were assessed in t...

  1. Testing the Bivalent Fear of Evaluation Model of Social Anxiety: The Relationship between Fear of Positive Evaluation, Social Anxiety, and Perfectionism.

    Science.gov (United States)

    Yap, Keong; Gibbs, Amy L; Francis, Andrew J P; Schuster, Sharynn E

    2016-01-01

    The Bivalent Fear of Evaluation (BFOE) model of social anxiety proposes that fear of negative evaluation (FNE) and fear of positive evaluation (FPE) play distinct roles in social anxiety. Research is however lacking in terms of how FPE is related to perfectionism and how these constructs interact to predict social anxiety. Participants were 382 individuals from the general community and included an oversampling of individuals with social anxiety. Measures of FPE, FNE, perfectionism, and social anxiety were administered. Results were mostly consistent with the predictions made by the BFOE model and showed that accounting for confounding variables, FPE correlated negatively with high standards but positively with maladaptive perfectionism. FNE was also positively correlated with maladaptive perfectionism, but there was no significant relationship between FNE and high standards. Also consistent with BFOE model, both FNE and FPE significantly moderated the relationship between maladaptive perfectionism and social anxiety with the relationship strengthened at high levels of FPE and FNE. These findings provide additional support for the BFOE model and implications are discussed.

  2. Marijuana-related problems and social anxiety: the role of marijuana behaviors in social situations.

    Science.gov (United States)

    Buckner, Julia D; Heimberg, Richard G; Matthews, Russell A; Silgado, Jose

    2012-03-01

    Individuals with elevated social anxiety appear particularly vulnerable to marijuana-related problems. In fact, individuals with social anxiety may be more likely to experience marijuana-related impairment than individuals with other types of anxiety. It is therefore important to determine whether constructs particularly relevant to socially anxious individuals play a role in the expression of marijuana-related problems in this vulnerable population. Given that both social avoidance and using marijuana to cope with negative affect broadly have been found to play a role in marijuana-related problems, the current study utilized a new measure designed to simultaneously assess social avoidance and using marijuana to cope in situations previously identified as anxiety-provoking among those with elevated social anxiety. The Marijuana Use to Cope with Social Anxiety Scale (MCSAS) assessed behaviors regarding 24 social situations: marijuana use to cope in social situations (MCSAS-Cope) and avoidance of social situations if marijuana was unavailable. In Study 1, we found preliminary support for the convergent and discriminant validity and internal consistency of the MCSAS scales. In Study 2, we examined if MCSAS scores were related to marijuana problems among those with (n = 44) and without (n = 44) clinically elevated social anxiety. Individuals with clinically meaningful social anxiety were more likely to use marijuana to cope in social situations and to avoid social situations if marijuana was unavailable. Of importance, MCSAS-Cope uniquely mediated the relationship between social anxiety group status and marijuana-related problems. Results highlight the importance of contextual factors in assessing marijuana-related behaviors among high-risk populations. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  3. Lower subjective quality of life and the development of social anxiety symptoms after the discharge of elderly patients with remitted schizophrenia: a 5-year longitudinal study.

    Science.gov (United States)

    Kumazaki, Hirokazu; Kobayashi, Hiroyuki; Niimura, Hidehito; Kobayashi, Yasushi; Ito, Shinya; Nemoto, Takahiro; Sakuma, Kei; Kashima, Haruo; Mizuno, Masafumi

    2012-10-01

    Remitted schizophrenic patients living in the community often encounter difficulties in their daily lives, possibly leading to the development of social anxiety symptoms. Although several studies have reported the significance of social anxiety as a comorbidity in patients with schizophrenia, few longitudinal data are available on the development of social anxiety symptoms in patients with remitted schizophrenia, especially in association with the process of "deinstitutionalization." The aims of this study were to assess the social anxiety symptoms in remitted outpatients with schizophrenia and to examine whether the development of social anxiety symptoms was associated with psychotic symptoms, social functioning, or subjective quality of life. Fifty-six people with schizophrenia who were discharged through a deinstitutionalization project were enrolled in this longitudinal study and prospectively assessed with regard to their symptoms, social functioning, and subjective quality of life. The severity of social anxiety symptoms was measured using the Liebowitz Social Anxiety Scale (LSAS). Global/Social functioning and subjective quality of life were evaluated using the Global Assessment of Functioning Scale, the Social Functioning Scale, and the World Health Organization-Quality of Life 26 (WHO-QOL26). Thirty-six patients completed the reassessment at the end of the 5-year follow-up period. The mean LSAS total score worsened over time, whereas other symptoms improved from the baseline. The mean WHO-QOL26 score in the worsened LSAS group was significantly lower than that in the stable LSAS group. At baseline, WHO-QOL26 scores were associated with an increase in the severity of social anxiety symptoms. In community-dwelling patients with remitted schizophrenia, a lower subjective quality of life might lead to the development of social anxiety symptoms, both concurrently and prospectively. To achieve a complete functional recovery, additional interventions for social

  4. Development of the two forms of social anxiety in adolescence

    Directory of Open Access Journals (Sweden)

    Melita Puklek Levpušček

    2004-09-01

    Full Text Available In the last decade studies of social anxiety have focused on research of social anxiety in childhood and adolescence. They showed that social anxiety was related to negative self-perceptions and lower social adaptation. The research question not yet answered considers the developmental trend of social anxiety in various periods of adolescence. In the study we proposed that at least social anxiety in its cognitive form (i.e., worries and fear of negative social evaluation would decrease from early to late adolescence. We were also interested in personal characteristics that predict prolongation of social anxiety in late adolescence. The initial sample consisted of 325 early, middle and late adolescents to whom measures of social anxiety, self-consciousness and self-perceptions were administered. Two well-known aspects of social anxiety were measured: fear of negative social evaluation and social tension and inhibition. Early and middle adolescents were retested two years later at their transition to middle and late adolescence, respectively. Results from the first and the second assessment indicated that late adolescence is a time when the cognitive form of social anxiety in both adolescent males and females decreased. Social tension and inhibition showed a decrease only in adolescent females. Adolescent females reported more fear of negative social evaluation than males. Lower appraisal of one's own global and social competence and prolonged self-preoccupations were identified as characteristics of socially anxious late adolescents.

  5. Reactivity to Social Stress in Subclinical Social Anxiety: Emotional Experience, Cognitive Appraisals, Behavior, and Physiology

    Science.gov (United States)

    Crişan, Liviu G.; Vulturar, Romana; Miclea, Mircea; Miu, Andrei C.

    2016-01-01

    Recent research indicates that subclinical social anxiety is associated with dysfunctions at multiple psychological and biological levels, in a manner that seems reminiscent of social anxiety disorder (SAD). This study aimed to describe multidimensional responses to laboratory-induced social stress in an analog sample selected for social anxiety symptoms. State anxiety, cognitive biases related to negative social evaluation, speech anxiety behaviors, and cortisol reactivity were assessed in the Trier Social Stress Test (TSST). Results showed that social anxiety symptoms were associated with increased state anxiety, biased appraisals related to the probability and cost of negative social evaluations, behavioral changes in facial expression that were consistent with speech anxiety, and lower cortisol reactivity. In addition, multiple interrelations between responses in the TSST were found, with positive associations between subjective experience, cognitive appraisals, and observable behavior, as well as negative associations between each of the former two types of response and cortisol reactivity. These results show that in response to social stressors, subclinical social anxiety is associated with significant changes in emotional experience, cognitive appraisals, behaviors, and physiology that could parallel those previously found in SAD samples. PMID:26858658

  6. Fermented foods, neuroticism, and social anxiety: An interaction model.

    Science.gov (United States)

    Hilimire, Matthew R; DeVylder, Jordan E; Forestell, Catherine A

    2015-08-15

    Animal models and clinical trials in humans suggest that probiotics can have an anxiolytic effect. However, no studies have examined the relationship between probiotics and social anxiety. Here we employ a cross-sectional approach to determine whether consumption of fermented foods likely to contain probiotics interacts with neuroticism to predict social anxiety symptoms. A sample of young adults (N=710, 445 female) completed self-report measures of fermented food consumption, neuroticism, and social anxiety. An interaction model, controlling for demographics, general consumption of healthful foods, and exercise frequency, showed that exercise frequency, neuroticism, and fermented food consumption significantly and independently predicted social anxiety. Moreover, fermented food consumption also interacted with neuroticism in predicting social anxiety. Specifically, for those high in neuroticism, higher frequency of fermented food consumption was associated with fewer symptoms of social anxiety. Taken together with previous studies, the results suggest that fermented foods that contain probiotics may have a protective effect against social anxiety symptoms for those at higher genetic risk, as indexed by trait neuroticism. While additional research is necessary to determine the direction of causality, these results suggest that consumption of fermented foods that contain probiotics may serve as a low-risk intervention for reducing social anxiety. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Effects of the medial or basolateral amygdala upon social anxiety and social recognition in mice.

    Science.gov (United States)

    Wang, Yu; Zhao, Shanshan; Liu, Xu; Fu, Qunying

    2014-01-01

    Though social anxiety and social recognition have been studied extensively, the roles of the medial or basolateral amygdala in the control of social anxiety and social recognition remain to be determined. This study investigated the effects of excitotoxic bilateral medial or basolateral amygdala lesions upon social anxiety and social recognition in-mice. Animals at 9 weeks of age were given bilateral medial or basolateral amygdala lesions via infusion of N-methyl- D-aspartate and then were used for behavioral tests: anxiety-related tests (including open-field test, light-dark test, and elevated-plus maze test), social behavior test in a novel environment, social recognition test, and flavor recognition test. Medial or basolateral amygdala-lesioned mice showed lower levels of anxiety and increased social behaviors in a novel environment. Destruction of the medial or basolateral amygdala neurons impaired social recognition but not flavor recognition. The medial or basolateral amygdala is involved in the control of anxiety-related behavior (social anxiety and social behaviors) in mice. Moreover, both the medial and the basolateral amygdala are essential for social recognition but not flavor recognition in mice.

  8. Measuring online interpretations and attributions of social situations: Links with adolescent social anxiety.

    Science.gov (United States)

    Haller, Simone P W; Raeder, Sophie M; Scerif, Gaia; Cohen Kadosh, Kathrin; Lau, Jennifer Y F

    2016-03-01

    We evaluated the utility of a novel, picture-based tool to measure how adolescents interpret and attribute cause to social exchanges and whether biases in these processes relate to social anxiety. Briefly presented ambiguous visual social scenes, each containing a photograph of the adolescent as the protagonist, were followed by three possible interpretations (positive, negative, neutral/unrelated) and two possible causal attributions (internal, external) to which participants responded. Ninety-five adolescents aged 14 to 17 recruited from mainstream schools, with varying levels of social anxiety rated the likelihood of positive, negative and unrelated interpretations before selecting the single interpretation they deemed as most likely. This was followed by a question prompting them to decide between an internal or external causal attribution for the interpreted event. Across scenarios, adolescents with higher levels of social anxiety rated negative interpretations as more likely and positive interpretations as less likely compared to lower socially anxious adolescents. Higher socially anxious adolescents were also more likely to select internal attributions to negative and less likely to select internal attributions for positive events than adolescents with lower levels of social anxiety. Adolescents with higher social anxiety display cognitive biases in interpretation and attribution. This tool is suitable for measuring cognitive biases of complex visual-social cues in youth populations with social anxiety and simulates the demands of daily social experiences more closely. As we did not measure depressive symptoms, we cannot be sure that biases linked to social anxiety are not due to concurrent low mood. Copyright © 2015. Published by Elsevier Ltd.

  9. A Contextual Approach to Experiential Avoidance and Social Anxiety: Evidence from an Experimental Interaction and Daily Interactions of People with Social Anxiety Disorder

    Science.gov (United States)

    Kashdan, Todd B.; Goodman, Fallon R.; Machell, Kyla A.; Kleiman, Evan M.; Monfort, Samuel S.; Ciarrochi, Joseph; Nezlek, John B.

    2014-01-01

    Experiential avoidance, the tendency to avoid internal, unwanted thoughts and feelings, is hypothesized to be a risk factor for social anxiety. Existing studies of experiential avoidance rely on trait measures with minimal contextual consideration. In two studies, we examined the association between experiential avoidance and anxiety within real-world social interactions. In the first study, we examined the effect of experiential avoidance on social anxiety in everyday life. For two weeks, 37 participants with Social Anxiety Disorder [SAD] and 38 healthy controls provided reports of experiential avoidance and social anxiety symptoms during face-to-face social interactions. Results showed that momentary experiential avoidance was positively related to anxiety symptoms during social interactions and this effect was stronger among people with SAD. People low in EA showed greater sensitivity to the level of situational threat than high EA people. In the second study, we facilitated an initial encounter between strangers. Unlike Study 1, we experimentally created a social situation where there was either an opportunity for intimacy (self-disclosure conversation) or no such opportunity (small-talk conversation). Results showed that greater experiential avoidance during the self-disclosure conversation temporally preceded increases in social anxiety for the remainder of the interaction; no such effect was found in the small-talk conversation. Our findings provide insight into the association between experiential avoidance on social anxiety in laboratory and naturalistic settings, and demonstrate that the effect of EA depends upon level of social threat and opportunity. PMID:24749634

  10. Social functioning in youth with anxiety disorders: association with anxiety severity and outcomes from cognitive-behavioral therapy.

    Science.gov (United States)

    Settipani, Cara A; Kendall, Philip C

    2013-02-01

    Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer social functioning was associated with more severe anxiety. Among youth who received cognitive-behavioral therapy (n = 111), significant associations were found between parent-reported social competence and both absence of principal anxiety disorder and lower anxiety severity at posttreatment and 1-year follow-up, controlling for the severity of the child's principal anxiety disorder at pretreatment. Findings support a relationship between anxiety severity and social difficulties, and suggest the importance of social competence for a favorable treatment response.

  11. Comorbidity and risk indicators for alcohol use disorders among persons with anxiety and/or depressive disorders Findings from the Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    Boschloo, L.; Vogelzangs, N.; Smit, J.H.; van den Brink, W.; Veltman, D.J.; Beekman, A.T.F.; Penninx, B.W.J.H.

    2011-01-01

    Introduction: This study examines comorbidity of alcohol abuse and alcohol dependence as well as its risk indicators among anxious and/or depressed persons, also considering temporal sequencing of disorders. Methods: Baseline data from the Netherlands Study of Depression and Anxiety (NESDA) were

  12. Comorbidity and risk indicators for alcohol use disorders among persons with anxiety and/or depressive disorders: findings from the Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    Boschloo, Lynn; Vogelzangs, Nicole; Smit, Johannes H.; van den Brink, Wim; Veltman, Dick J.; Beekman, Aartjan T. F.; Penninx, Brenda W. J. H.

    2011-01-01

    This study examines comorbidity of alcohol abuse and alcohol dependence as well as its risk indicators among anxious and/or depressed persons, also considering temporal sequencing of disorders. Baseline data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 2329

  13. Allelic Variation of Risk for Anxiety Symptoms Moderates the Relation Between Adolescent Safety Behaviors and Social Anxiety Symptoms

    Science.gov (United States)

    Thomas, Sarah A.; Weeks, Justin W.; Dougherty, Lea R.; Lipton, Melanie F.; Daruwala, Samantha E.; Kline, Kathryn

    2015-01-01

    Social anxiety often develops in adolescence, and precedes the onset of depression and substance use disorders. The link between social anxiety and use of behaviors to minimize distress in social situations (i.e., safety behaviors) is strong and for some patients, this link poses difficulty for engaging in, and benefiting from, exposure-based treatment. Yet, little is known about whether individual differences may moderate links between social anxiety and safety behaviors, namely variations in genetic alleles germane to anxiety. We examined the relation between adolescent social anxiety and expressions of safety behaviors, and whether allelic variation for anxiety moderates this relation. Adolescents (n=75; ages 14–17) were recruited from two larger studies investigating measurement of family relationships or adolescent social anxiety. Adolescents completed self-report measures about social anxiety symptoms and use of safety behaviors. They also provided saliva samples to assess allelic variations for anxiety from two genetic polymorphisms (BDNF rs6265; TAQ1A rs1800497). Controlling for adolescent age and gender, we observed a significant interaction between social anxiety symptoms and allelic variation (β=0.37, t=2.41, p=.02). Specifically, adolescents carrying allelic variations for anxiety evidenced a statistically significant and relatively strong positive relation between social anxiety symptoms and safety behaviors (β=0.73), whereas adolescents not carrying allelic variation evidenced a statistically non-significant and relatively weak relation (β=0.22). These findings have important implications for treating adolescent social anxiety, in that we identified an individual difference variable that can be used to identify people who evidence a particularly strong link between use of safety behaviors and expressing social anxiety. PMID:26692635

  14. Self-Reported Acceptance of Social Anxiety Symptoms: Development and Validation of the Social Anxiety-Acceptance and Action Questionnaire

    Science.gov (United States)

    MacKenzie, Meagan B.; Kocovski, Nancy L.

    2010-01-01

    Mindfulness and acceptance-based interventions have been used in social anxiety treatments with initial success. Further research requires the psychometrically sound measurement of mechanisms of change associated with these treatments. This research was conducted to develop and evaluate such a measure, the Social Anxiety-Acceptance and Action…

  15. Effectiveness of “Task Concentration Training” in Reducing the Anxiety Symptoms in Individuals with Social Anxiety Disorder

    Directory of Open Access Journals (Sweden)

    K. Golmohammadi

    2017-01-01

    Full Text Available Aims: As a common disorder, the social anxiety disorder is characterized by the persistent fear of social situations and severe physical and mental reactions. Its prevalence and effect being noticed, different psychotherapy methods were raised to reduce or annihilate it. The aim of the study was to determine the effectiveness of task-concentration training technics on the social anxiety symptom reduction in persons with social anxiety. Materials & Methods: In the controlled pretest-posttest quasi-experimental study, 20 students with social anxiety disorder were studied in Shahed University in 2014-15 academic year. The subjects, selected via stepwise cluster sampling method, were randomly divided into two groups including control and experimental (task concentration training groups. Data was collected using the social anxiety questionnaire and the structured clinical interview. Five one-hour task-concentration treatment sessions were conducted in experimental group. Data was analyzed by SPSS 16 software using independent T test. Findings: The mean scores of social anxiety and its sub-scales were not significantly different in experimental and control groups at the pretest stage (p>0.05. Nevertheless, the pretest-posttest differences of the scores of social anxiety and its subscales including avoidance, fear, and physiologic discomfort between the groups were significant (p<0.05. Conclusion: The task-concentration training techniques reduce the social anxiety symptoms in persons with social anxiety disorders.

  16. Digital Media, Anxiety, and Depression in Children.

    Science.gov (United States)

    Hoge, Elizabeth; Bickham, David; Cantor, Joanne

    2017-11-01

    There are growing concerns about the impact of digital technologies on children's emotional well-being, particularly regarding fear, anxiety, and depression. The 2 mental health categories of anxiety and depression will be discussed together because there is significant symptom overlap and comorbidity. Early research has explored the impact of traditional media (eg, television, movies) on children's acute fears, which can result in anxieties and related sleep disturbances that are difficult to remedy. More recent research deals with the interactive nature of newer media, especially social media, and their impacts on anxiety and depression. Key topics of inquiry include the following: anxiety and depression associated with technology-based negative social comparison, anxiety resulting from lack of emotion-regulation skills because of substituted digital media use, social anxiety from avoidance of social interaction because of substituted digital media use, anxiety because of worries about being inadequately connected, and anxiety, depression, and suicide as the result of cyberbullying and related behavior. A growing body of research confirms the relationship between digital media and depression. Although there is evidence that greater electronic media use is associated with depressive symptoms, there is also evidence that the social nature of digital communication may be harnessed in some situations to improve mood and to promote health-enhancing strategies. Much more research is needed to explore these possibilities. Copyright © 2017 by the American Academy of Pediatrics.

  17. The Double Meaning of Online Social Space: Three-Way Interactions Among Social Anxiety, Online Social Behavior, and Offline Social Behavior.

    Science.gov (United States)

    Koo, Hoon Jung; Woo, Sungbum; Yang, Eunjoo; Kwon, Jung Hye

    2015-09-01

    The present study aimed to investigate how online and offline social behavior interact with each other ultimately to affect the well-being of socially anxious adolescents. Based on previous studies, it was assumed that there might be three-way interactive effects among online social behavior, offline social behavior, and social anxiety regarding the relationship with well-being. To measure social anxiety, online and offline social behavior, and mental well-being, self-report questionnaires such as the Korean-Social Avoidance and Distress Scale, Korean version of the Relational Maintenance Behavior Questionnaire, and Korean version of Mental Health Continuum Short Form were administered to 656 Korean adolescents. Hierarchical regression analysis revealed that the three-way interaction of online social behavior, offline social behavior, and social anxiety was indeed significant. First, online social behavior was associated with lower well-being of adolescents with higher social anxiety under conditions of low engagement in offline social behavior. In contrast, a higher level of online social behavior predicted greater well-being for individuals with high social anxiety under conditions of more engagement in offline social behavior. Second, online social behavior was not significantly related to well-being in youths with low social anxiety under conditions of both high and low engagement in offline social behavior. Implications and limitations of this study were discussed.

  18. Parental social anxiety disorder prospectively predicts toddlers' fear/avoidance in a social referencing paradigm

    OpenAIRE

    Aktar, E.; Majdandžić, M.; De, Vente W.; Bögels, S.M.

    2014-01-01

    Background: Anxiety runs in families. Observational learning of anxious behavior from parents with anxiety disorders plays an important role in the intergenerational transmission of anxiety. We investigated the link between parental anxiety (parental lifetime anxiety disorders and expressed parental anxiety) and toddler fear/avoidance during social referencing (SR) situations. Method: Toddlers (N = 117) participated with both parents (with lifetime social anxiety disorder, other nonsocial anx...

  19. Factors associated with social anxiety disorder in a group

    Science.gov (United States)

    Özşahin, Akatlı Kürşad; Altıntaş, Ebru

    2018-04-30

    Background/aim: Mental disorders may accompany obesity. This study aims to evaluate the association between social anxiety disorder (SAD) and obesity and the risk factors for SAD in obese female patients. Materials and methods: A total of 114 obese patients and 110 healthy controls were included. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI I-II), and Liebowitz Social Anxiety Scale (LSAS) were administered to assess anxiety, depression, and social anxiety levels. Scale scores were analyzed statistically. Results: The rate of SAD in obese female patients was found to be 8.8%. Anxiety, depression, and social anxiety levels were significantly higher in the obesity group compared to the control group (P < 0.05). According to linear regression analyses, a significant association between LSAS anxiety level and age, prior surgery, social support, history of being teased, BDI, and BAI was found. Conclusion: The present study shows that many factors are related to obesity and SAD in obese female patients. The clinical implications of these findings should be considered. Interventions for these factors may help prevent SAD in obese female patients.

  20. Girls' and Mothers' Social Anxiety, Social Skills, and Loneliness: Associations after Accounting for Depressive Symptoms

    Science.gov (United States)

    Stednitz, Jayme N.; Epkins, Catherine C.

    2006-01-01

    This study examined, in 102 mother-daughter dyads, whether (a) girls' social skills and loneliness are related to girls' social anxiety, after adjusting for girls' depressive symptoms, and (b) mothers' social functioning (social anxiety, social skills, and loneliness) is related to girls' social anxiety, after accounting for girls' social…

  1. A retrospective study on the impact of comorbid depression or anxiety on healthcare resource use and costs among diabetic neuropathy patients

    Directory of Open Access Journals (Sweden)

    Bao Yanjun

    2009-06-01

    Full Text Available Abstract Background Diabetic neuropathy (DN is a common complication of diabetes that has significant economic burden, especially for patients with comorbid depression or anxiety. This study examines and quantifies factors associated with healthcare costs among patients diagnosed with diabetic neuropathy (DN with or without a comorbid diagnosis of depression or anxiety (DA using retrospective administrative claims data. No study has examined the differences in economic outcomes depending on the presence of comorbid DA disorders. Methods Over-age-18 individuals with 1+ diagnosis of DN in 2005 were selected. The first observed DN claim was considered the "index date." All individuals had a 12-month pre-index and follow-up period. For both under-age-65 commercially insured and over-age-65 individuals with employer-sponsored Medicare supplemental insurance, we constructed 2 subgroups for individuals with DA (DN-DA or without (DN-only. Patients' clinical characteristics over pre-index period were compared. Multivariate regressions were performed to assess whether DN-DA patients had higher utilization of healthcare resources and costs than DN-only patients, controlling for demographic and clinical characteristics. Results We identified 16,831 DN-only and 1,699 DN-DA patients in the Medicare supplemental cohort, as well as 17,205 and 3,105 in the commercially insured. DN-DA patients had higher prevalence of diabetes-related comorbidities for cardiovascular disease, cerebrovascular/peripheral vascular disease, nephropathy, obesity, and hypoglycemic events than DN-only patients (all p Conclusion These findings indicate that the healthcare costs were significantly higher for DN patients with depression or anxiety relative to those without such comorbid disorders.

  2. A functionalist perspective on social anxiety and avoidant personality disorder.

    Science.gov (United States)

    Lafreniere, Peter

    2009-01-01

    A developmental-evolutionary perspective is used to synthesize basic research from the neurosciences, ethology, genetics, and developmental psychology into a unified framework for understanding the nature and origins of social anxiety and avoidant personality disorder. Evidence is presented that social anxiety disorder (social phobia) and avoidant personality disorder may be alternate conceptualizations of the same disorder because they have virtually the same symptoms and genetic basis, and respond to the same pharmacologic and psychotherapeutic interventions. A functionalist perspective on social anxiety is formulated to (a) explain the origins of normative states of anxiety, (b) outline developmental pathways in the transition from normative anxiety to social anxiety and avoidant personality disorders, and (c) account for the processes leading to gender-differentiated patterns of anxiety-related disorders after puberty.

  3. Combined Oral Contraceptive Pill Initiation in a Patient With Major Depressive Disorder, Premenstrual Dysphoric Disorder, Social Anxiety, Panic Disorder, and Histrionic Personality Disorder.

    Science.gov (United States)

    Roi, Cody; Conrad, Erich J

    2017-01-01

    Comorbid psychiatric conditions present an added layer of challenge in managing patients, as each condition and associated set of symptoms exacerbate the complexity of the overall presentation. Premenopausal women may be at particular risk for inadequate care, as their comorbid conditions may present overlapping symptoms and mask independent premenstrual symptoms. The prevalence of premenstrual dysphoric disorder and associated conditions can be as high as 8% in women of reproductive age. Recognizing and assessing premenstrual symptoms that are comorbid with other psychiatric conditions can help contribute to a comprehensive treatment strategy and potentially improve the treatment response for the comorbid conditions. Combined oral contraceptive pills (COCPs) have been approved for premenstrual conditions and should be considered by the psychiatrist as an available treatment option. A 34-year-old Caucasian female patient with comorbid major depressive disorder, premenstrual dysphoric disorder, social anxiety, panic disorder, and histrionic personality disorder, with persistent suicidal ideation and distress intolerance, was treated with norgestimate-ethinyl estradiol with improvement in mood, anxiety, and menstrual cramping and with associated diminished suicidal ideation and improved distress tolerance. In this case, Beck Depression Inventory and Beck Anxiety Inventory scores, as well as self- and peer-reported functionality, all suggested improvement in symptoms following the introduction of COCPs. The neurohormonal contribution to psychiatric conditions continues to be studied and is becoming increasingly important. An understanding of the presence and etiology of premenstrual symptoms should be part of a comprehensive psychiatric assessment of female patients, and consideration of COCPs in the treatment plan adds a potentially potent option for symptom mitigation and remission.

  4. Autistic Traits and Symptoms of Social Anxiety are Differentially Related to Attention to Others' Eyes in Social Anxiety Disorder.

    Science.gov (United States)

    Kleberg, Johan Lundin; Högström, Jens; Nord, Martina; Bölte, Sven; Serlachius, Eva; Falck-Ytter, Terje

    2017-12-01

    Autism spectrum disorder (ASD) and social anxiety disorder (SAD) have partly overlapping symptoms. Gaze avoidance has been linked to both SAD and ASD, but little is known about differences in social attention between the two conditions. We studied eye movements in a group of treatment-seeking adolescents with SAD (N = 25), assessing SAD and ASD dimensionally. The results indicated a double dissociation between two measures of social attention and the two symptom dimensions. Controlling for social anxiety, elevated autistic traits were associated with delayed orienting to eyes presented among distractors. In contrast, elevated social anxiety levels were associated with faster orienting away from the eyes, when controlling for autistic traits. This distinction deepens our understanding of ASD and SAD.

  5. Social anxiety experiences and responses of university students

    Directory of Open Access Journals (Sweden)

    Behiye Akacan

    2015-09-01

    Full Text Available The aim of this study is to examine the responses of university students in social anxiety situations in order to create a psychological counselling program with a structured group based on Cognitive Behavioural and Existential Approaches. These responses involve the behaviour and thoughts of the university students in situations where they experience or anticipate social anxiety. The semi-structured interview form developed by the researchers was used in the study during the face-to-face interviews with fifty-one 4th year students from the Guidance and Psychological Counselling (GPC and Pre-School Teaching (PST departments. The scope of the interview form includes the situations where 1 students experience social anxiety in the school setting and their thoughts and behaviours regarding these situations, 2 the situations where they anticipate social anxiety in their future profession, and 3 the situations where they experience social anxiety in their daily lives. Our aim was to collect data from these areas. The data collected were analysed through content analysis. The findings of the study revealed that the thoughts regarding the social anxiety situations of the final year students studying in Guidance and Psychological Counselling and Pre-School Teaching departments are generally negative and their behaviour usually presents as desertion or avoidance.

  6. Beyond Behaviour: Is Social Anxiety Low in Williams Syndrome?

    Science.gov (United States)

    Dodd, Helen F.; Schniering, Carolyn A.; Porter, Melanie A.

    2009-01-01

    Individuals with Williams syndrome (WS) exhibit striking social behaviour that may be indicative of abnormally low social anxiety. The present research aimed to determine whether social anxiety is unusually low in WS and to replicate previous findings of increased generalised anxiety in WS using both parent and self report. Fifteen individuals…

  7. Gaze perception in social anxiety and social anxiety disorder

    Directory of Open Access Journals (Sweden)

    Lars eSchulze

    2013-12-01

    Full Text Available Clinical observations suggest abnormal gaze perception to be an important indicator of social anxiety disorder (SAD. Experimental research has yet paid relatively little attention to the study of gaze perception in SAD. In this article we first discuss gaze perception in healthy human beings before reviewing self-referential and threat-related biases of gaze perception in clinical and non-clinical socially anxious samples. Relative to controls, socially anxious individuals exhibit an enhanced self-directed perception of gaze directions and demonstrate a pronounced fear of direct eye contact, though findings are less consistent regarding the avoidance of mutual gaze in SAD. Prospects for future research and clinical implications are discussed.

  8. Continual training of attentional bias in social anxiety.

    Science.gov (United States)

    Li, Songwei; Tan, Jieqing; Qian, Mingyi; Liu, Xinghua

    2008-08-01

    Using the dot-probe paradigm, it has been shown that high social anxiety is associated with an attentional bias toward negative information. In the present study, individuals with high social anxiety were divided into two groups randomly. One group was the attentional bias training group (Group T), and the other was the control group (Group C). For Group T, 7 days' continuous training of attentional bias was conducted using the dot-probe paradigm to make socially anxious individuals focus more on positive face pictures. The results showed that the training was effective in changing attentional bias in Group T. Scores of the Social Interaction Anxiety Scale (SIAS) in Group T were reduced compared to Group C, while the scores of Social Phobia Scale (SPS) and scores of Negative Evaluation Scale (FNE) showed no difference between the two groups, which suggested a limited reduction of social anxiety.

  9. Gender Dysphoria and Social Anxiety: An Exploratory Study in Spain.

    Science.gov (United States)

    Bergero-Miguel, Trinidad; García-Encinas, María A; Villena-Jimena, Amelia; Pérez-Costillas, Lucía; Sánchez-Álvarez, Nicolás; de Diego-Otero, Yolanda; Guzman-Parra, Jose

    2016-08-01

    Social anxiety in gender dysphoria is still under investigation. To determine the prevalence and associated factors of social anxiety in a sample of individuals with gender dysphoria. A cross-sectional design was used in a clinical sample attending a public gender identity unit in Spain. The sample consisted of 210 individuals (48% trans female and 52% trans male). Mini-International Neuropsychiatric Interview (MINI) for diagnosis of social anxiety disorder, Structured Clinical Interview, Exposure to Violence Questionnaire (EVQ), Beck Depression Inventory (BDI-II), and Functional Social Support Questionnaire (Duke-UNC-11). Of the total sample, 31.4% had social anxiety disorder. Social anxiety disorder was highly correlated with age (r = -0.181; CI = 0.061-0.264; P = .009) and depression (r = 0.345; CI = 0.213-0.468; P social anxiety disorder. This study highlights the necessity of implementing actions to prevent and treat social anxiety in this high-risk population. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  10. Comorbidity, age of onset and suicidality in obsessive-compulsive disorder (OCD): An international collaboration.

    Science.gov (United States)

    Brakoulias, V; Starcevic, V; Belloch, A; Brown, C; Ferrao, Y A; Fontenelle, L F; Lochner, C; Marazziti, D; Matsunaga, H; Miguel, E C; Reddy, Y C J; do Rosario, M C; Shavitt, R G; Shyam Sundar, A; Stein, D J; Torres, A R; Viswasam, K

    2017-07-01

    To collate data from multiple obsessive-compulsive disorder (OCD) treatment centers across seven countries and five continents, and to report findings in relation to OCD comorbidity, age of onset of OCD and comorbid disorders, and suicidality, in a large clinical and ethnically diverse sample, with the aim of investigating cultural variation and the utility of the psychiatric diagnostic classification of obsessive-compulsive and related disorders. Researchers in the field of OCD were invited to contribute summary statistics on current and lifetime psychiatric comorbidity, age of onset of OCD and comorbid disorders and suicidality in their patients with OCD. Data from 3711 adult patients with primary OCD came from Brazil (n=955), India (n=802), Italy (n=750), South Africa (n=565), Japan (n=322), Australia (n=219), and Spain (n=98). The most common current comorbid disorders were major depressive disorder (28.4%; n=1055), obsessive-compulsive personality disorder (24.5%, n=478), generalized anxiety disorder (19.3%, n=716), specific phobia (19.2%, n=714) and social phobia (18.5%, n=686). Major depression was also the most commonly co-occurring lifetime diagnosis, with a rate of 50.5% (n=1874). OCD generally had an age of onset in late adolescence (mean=17.9years, SD=1.9). Social phobia, specific phobia and body dysmorphic disorder also had an early age of onset. Co-occurring major depressive disorder, generalized anxiety disorder and psychotic disorders tended to have a later age of onset than OCD. Suicidal ideation within the last month was reported by 6.4% (n=200) of patients with OCD and 9.0% (n=314) reported a lifetime history of suicide attempt. In this large cross-continental study, comorbidity in OCD was common. The high rates of comorbid major depression and anxiety disorders emphasize the need for clinicians to assess and monitor for these disorders. Earlier ages of onset of OCD, specific phobia and social phobia may indicate some relatedness between these

  11. Criticism in the Romantic Relationships of Individuals With Social Anxiety.

    Science.gov (United States)

    Porter, Eliora; Chambless, Dianne L; Keefe, John R

    2017-07-01

    Social anxiety is associated with difficulties in intimate relationships. Because fear of negative evaluation is a cardinal feature of social anxiety disorder, perceived criticism and upset due to criticism from partners may play a significant role in socially anxious individuals' intimate relationships. In the present study, we examine associations between social anxiety and perceived, observed, and expressed criticism in interactions with romantic partners. In Study 1, we collected self-report data from 343 undergraduates and their romantic partners on social anxiety symptoms, perceived and expressed criticism, and upset due to criticism. One year later couples reported whether they were still in this relationship. Results showed that social anxiety was associated with being more critical of one's partner, and among women, being more upset by criticism from a partner. Social anxiety was not related to perceived criticism, nor did criticism variables predict relationship status at Time 2. In Study 2, undergraduate couples with a partner high (n = 26) or low (n = 26) in social anxiety completed a 10-minute, video-recorded problem-solving task. Both partners rated their perceived and expressed criticism and upset due to criticism following the interaction, and observers coded interactions for criticism. Results indicated that social anxiety was not significantly related to any of the criticism variables, but post hoc analyses cast doubts upon the external validity of the problem-solving task. Results are discussed in light of known difficulties with intimacy among individuals with social anxiety. Copyright © 2016. Published by Elsevier Ltd.

  12. Studying autism in rodent models: reconciling endophenotypes with comorbidities.

    Directory of Open Access Journals (Sweden)

    Andrew eArgyropoulos

    2013-07-01

    Full Text Available Autism spectrum disorder (ASD patients commonly exhibit a variety of comorbid traits including seizures, anxiety, aggressive behavior, gastrointestinal problems, motor deficits, abnormal sensory processing and sleep disturbances for which the cause is unknown. These features impact negatively on daily life and can exaggerate the effects of the core diagnostic traits (social communication deficits and repetitive behaviors. Studying endophenotypes relevant to both core and comorbid features of ASD in rodent models can provide insight into biological mechanisms underlying these disorders. Here we review the characterization of endophenotypes in a selection of environmental, genetic and behavioural rodent models of ASD. In addition to exhibiting core ASD-like behaviours, each of these animal models display one or more endophenotypes relevant to comorbid features including altered sensory processing, seizure susceptibility, anxiety-like behaviour and disturbed motor functions, suggesting that these traits are indicators of altered biological pathways in ASD. However, the study of behaviours paralleling comorbid traits in animal models of ASD is an emerging field and further research is needed to assess altered gastrointestinal function, aggression and disorders of sleep onset across models. Future studies should include investigation of these endophenotypes in order to advance our understanding of the etiology of this complex disorder.

  13. Avoidant personality disorder as a social anxiety phenotype: risk factors, associations and treatment.

    Science.gov (United States)

    Lampe, Lisa

    2016-01-01

    This article identifies research trends and synthesizes information from recent studies of avoidant personality disorder (AVPD). AVPD and social anxiety disorder (SAD) share genetic vulnerability, but may have distinct environmental risk factors that shape qualitative differences. Negative self-concept, shame proneness, and interpersonal hypersensitivity are characteristic of AVPD and may be predisposed to by heritable traits of high negative affectivity and low positive affectivity, and experiences of neglectful or emotionless parents. The interpersonal difficulties of AVPD may be associated with both anxious and avoidant attachment. Most individuals with AVPD do not also meet criteria for SAD. Integrative treatments incorporating cognitive behavioral strategies effective in SAD but also targeting shame aversion and avoidance may be most helpful for AVPD. Therapy adapted to both anxious attachment, associated with heightened interpersonal sensitivity and distress, and avoidant attachment, associated with experiential avoidance, may be optimal, though this is yet to be tested. Effective treatment of AVPD may enhance the outcome of comorbid conditions. More research is needed which compares three social anxiety groups (SAD alone, AVPD alone, and SAD plus AVPD) to further explore these disorders which are highly related, but which may have differences that are clinically relevant for individuals.

  14. The Relationships between Social Class, Listening Test Anxiety and Test Scores

    OpenAIRE

    Omid Talebi Rezaabadi

    2016-01-01

    This study investigated the relationships between the social anxiety, social class and listening-test anxiety of students learning English as a foreign language. The aims of the study were to examine the relationship between listening-test anxiety and listening-test performance. The data were collected using an adapted Foreign Language Listening Anxiety Scale and a newly developed Foreign Language Social Anxiety Scale. The potential correlation between social anxiety and listening-test perfor...

  15. Post-event processing in social anxiety.

    Science.gov (United States)

    Dannahy, Laura; Stopa, Lusia

    2007-06-01

    Clark and Wells' [1995. A cognitive model of social phobia. In: R. Heimberg, M. Liebowitz, D.A. Hope, & F.R. Schneier (Eds.) Social phobia: Diagnosis, assessment and treatment (pp. 69-93). New York: Guildford Press.] cognitive model of social phobia proposes that following a social event, individuals with social phobia will engage in post-event processing, during which they conduct a detailed review of the event. This study investigated the relationship between self-appraisals of performance and post-event processing in individuals high and low in social anxiety. Participants appraised their performance immediately after a conversation with an unknown individual and prior to an anticipated second conversation task 1 week later. The frequency and valence of post-event processing during the week following the conversation was also assessed. The study also explored differences in the metacognitive processes of high and low socially anxious participants. The high socially anxious group experienced more anxiety, predicted worse performance, underestimated their actual performance, and engaged in more post-event processing than low socially anxious participants. The degree of negative post-event processing was linked to the extent of social anxiety and negative appraisals of performance, both immediately after the conversation task and 1 week later. Differences were also observed in some metacognitive processes. The results are discussed in relation to current theory and previous research.

  16. Comorbidity in youth with specific phobias: Impact of comorbidity on treatment outcome and the impact of treatment on comorbid disorders.

    Science.gov (United States)

    Ollendick, Thomas H; Ost, Lars-Göran; Reuterskiöld, Lena; Costa, Natalie

    2010-09-01

    The purpose of the present study was twofold. In an analysis of data from an existing randomized control trial of brief cognitive behavioral treatment on specific phobias (One-Session Treatment, OST; Ollendick et al., 2009), we examined 1) the effect of comorbid specific phobias and other anxiety disorders on treatment outcomes, and 2) the effect of treatment of the specific phobia on these co-occurring disorders. These relations were explored in 100 youth presenting with animal, natural environment, situational, and "other" types of phobia. Youth were reliably diagnosed with the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent versions (Silverman & Albano, 1996). Clinician severity ratings at post-treatment and 6-month follow-up were examined as were parent and child treatment outcome satisfaction measures. Results indicated that the presence of comorbid phobias or anxiety disorders did not affect treatment outcomes; moreover, treatment of the targeted specific phobias led to significant reductions in the clinical severity of other co-occurring specific phobias and related anxiety disorders. These findings speak to the generalization of the effects of this time-limited treatment approach. Implications for treatment of principal and comorbid disorders are discussed, and possible mechanisms for these effects are commented upon. 2010 Elsevier Ltd. All rights reserved.

  17. Familial Accumulation of Social Anxiety Symptoms and Maladaptive Emotion Regulation.

    Directory of Open Access Journals (Sweden)

    Julia Asbrand

    Full Text Available Social anxiety is thought to be strongly related to maladaptive emotion regulation (ER. As social anxiety symptoms accumulate in families, we hypothesize that maladaptive ER is also more prevalent in families with anxious children. Thus, we analyze differences in emotion regulation of both child and mother in relation to social anxiety, as well as both their ER strategies in dealing with anxiety. Further, a positive relation between child and maternal ER strategies is assumed.Children (aged 9 to 13 years with social, anxiety disorder (SAD; n = 25 and healthy controls (HC, n = 26 as well as their mothers completed several measures of social anxiety and trait ER strategies towards anxiety. As ER of children is still in development, age is considered as covariate.SAD children and their mothers reported more maladaptive ER strategies than HC dyads. Maternal maladaptive ER was related negatively to child adaptive ER which was further moderated by the child's age.Maladaptive ER strategies seem to contribute to the exacerbation of social anxiety in both mother and child. Mothers reporting maladaptive ER may have difficulties supporting their child in coping with social anxiety while simultaneously also experiencing heightened levels of anxiety. Deeper understanding of interactional processes between mothers and children during development can assist the comprehension of factors maintaining SAD. Implications for future research and possible consequences for interventions are discussed.

  18. Familial Accumulation of Social Anxiety Symptoms and Maladaptive Emotion Regulation.

    Science.gov (United States)

    Asbrand, Julia; Svaldi, Jennifer; Krämer, Martina; Breuninger, Christoph; Tuschen-Caffier, Brunna

    2016-01-01

    Social anxiety is thought to be strongly related to maladaptive emotion regulation (ER). As social anxiety symptoms accumulate in families, we hypothesize that maladaptive ER is also more prevalent in families with anxious children. Thus, we analyze differences in emotion regulation of both child and mother in relation to social anxiety, as well as both their ER strategies in dealing with anxiety. Further, a positive relation between child and maternal ER strategies is assumed. Children (aged 9 to 13 years) with social, anxiety disorder (SAD; n = 25) and healthy controls (HC, n = 26) as well as their mothers completed several measures of social anxiety and trait ER strategies towards anxiety. As ER of children is still in development, age is considered as covariate. SAD children and their mothers reported more maladaptive ER strategies than HC dyads. Maternal maladaptive ER was related negatively to child adaptive ER which was further moderated by the child's age. Maladaptive ER strategies seem to contribute to the exacerbation of social anxiety in both mother and child. Mothers reporting maladaptive ER may have difficulties supporting their child in coping with social anxiety while simultaneously also experiencing heightened levels of anxiety. Deeper understanding of interactional processes between mothers and children during development can assist the comprehension of factors maintaining SAD. Implications for future research and possible consequences for interventions are discussed.

  19. Assessment of Social Anxiety and Its Correlates among ...

    African Journals Online (AJOL)

    Statistical analysis, using Regression Analysis and Four-Way ANOVA, revealed that while some factors predicted social anxiety (such as dating anxiety and fear of negative evaluation); Self esteem, Social maladjustment and assertiveness did not. Also demographic variables did not have any significant effect on social ...

  20. Factors associated with social interaction anxiety among Chinese adolescents.

    Science.gov (United States)

    Peng, Z W; Lam, L T; Jin, J

    2011-12-01

    To investigate potential risk factors for social anxiety, particularly social interaction anxiety among the Chinese adolescents. A cross-sectional health survey was conducted in Guangzhou city of the Guangdong Province where high school students aged 13 to 18 years were recruited. The sample was selected from all high schools in the city using a 2-stage random cluster sampling technique. Social interaction anxiety was assessed using the Social Interaction Anxiety Scale. Information collected in the survey included: demographics, self-perception on school performance, relationship with teachers and peers, satisfaction with self-image, achievements, and parenting style of the mother. The parent-child relationship, specifically the relationship between respondents and their mothers, was assessed using the mother attachment subscale of the Inventory of Parent and Peer Attachment. Self-esteem was assessed using the Rosenberg Self-Esteem Scale. The multiple linear regression technique was applied to investigate associations between selected potential risk factors and social interaction anxiety, with adjustments for cluster sampling. Lower family income, lower self-esteem, and hostility were significantly associated with social interaction anxiety among adolescents. Variables identified as risk factors of anxiety disorder in the literature, such as gender, were not associated with social interaction anxiety in this sample. These results were consistent with those of other studies conducted mainly in the United States and Europe. Regarding non-significant results related to gender, they need viewing in the context of parenting styles of Chinese mothers.

  1. Social Anxiety and Cannabis Use: An Analysis from Ecological Momentary Assessment

    Science.gov (United States)

    Buckner, Julia D.; Crosby, Ross D.; Wonderlich, Stephen A.; Schmidt, Norman B.

    2011-01-01

    Individuals with elevated social anxiety appear especially vulnerable to cannabis-related problems, yet little is known about the antecedents of cannabis-related behaviors among this high-risk population. The present study used ecological momentary assessment (EMA) to examine the relations among social anxiety, cannabis craving, state anxiety, situational variables, and cannabis use in the natural environment during ad-lib cannabis use episodes. Participants were 49 current cannabis users. During the two-week EMA period, social anxiety significantly interacted with cannabis craving to predict cannabis use both cross-sectionally and prospectively. Specifically, individuals with higher social anxiety and craving were most likely to use cannabis. There was a significant social anxiety X state anxiety X others’ use interaction such that when others were using cannabis, those with elevations in both trait social anxiety and state anxiety were the most likely to use cannabis. PMID:22246109

  2. Training implicit social anxiety associations: an experimental intervention.

    Science.gov (United States)

    Clerkin, Elise M; Teachman, Bethany A

    2010-04-01

    The current study investigates an experimental anxiety reduction intervention among a highly socially anxious sample (N=108; n=36 per Condition; 80 women). Using a conditioning paradigm, our goal was to modify implicit social anxiety associations to directly test the premise from cognitive models that biased cognitive processing may be causally related to anxious responding. Participants were trained to preferentially process non-threatening information through repeated pairings of self-relevant stimuli and faces indicating positive social feedback. As expected, participants in this positive training condition (relative to our two control conditions) displayed less negative implicit associations following training, and were more likely to complete an impromptu speech (though they did not report less anxiety during the speech). These findings offer partial support for cognitive models and indicate that implicit associations are not only correlated with social anxiety, they may be causally related to anxiety reduction as well. (c) 2010 Elsevier Ltd. All rights reserved.

  3. Reconsidering Co-Morbid Traits in Explanatory Models of High Dental Anxiety Using a Comparison of Psychiatric and Normal Patient Samples

    DEFF Research Database (Denmark)

    Moore, Rod; Jensen, Christina Gundlev; Andersen, Line Bæk

    2016-01-01

    Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic...... as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention. Dental Anxiety, Psychiatry, Case Comparison, Co...

  4. How smartphone usage correlates with social anxiety and loneliness.

    Science.gov (United States)

    Gao, Yusong; Li, Ang; Zhu, Tingshao; Liu, Xiaoqian; Liu, Xingyun

    2016-01-01

    Early detection of social anxiety and loneliness might be useful to prevent substantial impairment in personal relationships. Understanding the way people use smartphones can be beneficial for implementing an early detection of social anxiety and loneliness. This paper examines different types of smartphone usage and their relationships with people with different individual levels of social anxiety or loneliness. A total of 127 Android smartphone volunteers participated in this study, all of which have agreed to install an application (MobileSens) on their smartphones, which can record user's smartphone usage behaviors and upload the data into the server. They were instructed to complete an online survey, including the Interaction Anxiousness Scale (IAS) and the University of California Los Angeles Loneliness Scale (UCLA-LS). We then separated participants into three groups (high, middle and low) based on their scores of IAS and UCLA-LS, respectively. Finally, we acquired digital records of smartphone usage from MobileSens and examined the differences in 105 types of smartphone usage behaviors between high-score and low-score group of IAS/UCLA-LS. Individuals with different scores on social anxiety or loneliness might use smartphones in different ways. For social anxiety, compared with users in low-score group, users in high-score group had less number of phone calls (incoming and outgoing) (Mann-Whitney U = 282.50∼409.00, p social media (RenRen) (Mann-Whitney >U = 388.50, p social anxiety or loneliness receive less incoming calls and use healthy applications more frequently, but they do not show differences in outgoing-call-related features. Individuals with higher levels of social anxiety also receive less SMSs and use camera apps less frequently, while lonely individuals tend to use system, beautify, browser and social media (RenRen) apps more frequently. This paper finds that there exists certain correlation among smartphone usage and social anxiety and

  5. Social inference and social anxiety: evidence of a fear-congruent self-referential learning bias.

    Science.gov (United States)

    Button, Katherine S; Browning, Michael; Munafò, Marcus R; Lewis, Glyn

    2012-12-01

    Fears of negative evaluation characterise social anxiety, and preferential processing of fear-relevant information is implicated in maintaining symptoms. Little is known, however, about the relationship between social anxiety and the process of inferring negative evaluation. The ability to use social information to learn what others think about one, referred to here as self-referential learning, is fundamental for effective social interaction. The aim of this research was to examine whether social anxiety is associated with self-referential learning. 102 Females with either high (n = 52) or low (n = 50) self-reported social anxiety completed a novel probabilistic social learning task. Using trial and error, the task required participants to learn two self-referential rules, 'I am liked' and 'I am disliked'. Participants across the sample were better at learning the positive rule 'I am liked' than the negative rule 'I am disliked', β = -6.4, 95% CI [-8.0, -4.7], p learning positive self-referential information was strongest in the lowest socially anxious and was abolished in the most symptomatic participants. Relative to the low group, the high anxiety group were better at learning they were disliked and worse at learning they were liked, social anxiety by rule interaction β = 3.6; 95% CI [+0.3, +7.0], p = 0.03. The specificity of the results to self-referential processing requires further research. Healthy individuals show a robust preference for learning that they are liked relative to disliked. This positive self-referential bias is reduced in social anxiety in a way that would be expected to exacerbate anxiety symptoms. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Prevalence of anxiety and depressive symptoms in men with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    K Pankhurst

    2005-09-01

    Full Text Available Objectives. To determine the prevalence of anxiety and depressive symptoms in men presenting to a sexual dysfunction clinic in Bloemfontein with erectile dysfunction (ED; to determine the relationship, if any, between age and mood/anxiety symptoms in such patients; and to make clinicians aware of the co-morbidity of anxiety/mood symptoms and ED. Methods. An observational analytical study was undertaken of 100 consecutive male patients of all ages presenting with ED (with a score less than 20 on the 5-item intensity scale for ED. Age, race, marital and employment status were noted as well as social habits including smoking and alcohol use. The presence of known medical conditions and surgical procedures was ascertained. All current prescription medication was recorded. Panic disorder, obsessive-compulsive disorder, generalised anxiety disorder and social phobia were rated using the Mini International Neuropsychiatric Interview, while the Hamilton Rating Scale for Depression was used to rate depressive symptoms. Results. Thirty-three per cent of respondents had depressive symptoms, and of this group 36% had a co-morbid anxiety disorder. In total, 21% of patients had an anxiety disorder. Anxiety disorders were more common with moderate to severe ED. No anxiety disorders occurred in patients with mild ED. The majority of participants suffering from severe ED were evenly spread in age from 30 to 69 years. Participants suffering from moderate to severe ED were more likely to have medical conditions, most notably hypertension. Conclusion. The results of this study suggest that men suffering from ED are likely to have a co-morbid psychiatric disorder (42%, with the prevalence of depressive symptoms (33% and anxiety disorders (21% being higher than in the general population. Significant concomitant medical conditions (most notably hypertension were more common in men with moderate to severe ED.

  7. Social anxiety in online and real-life interaction and their associated factors.

    Science.gov (United States)

    Yen, Ju-Yu; Yen, Cheng-Fang; Chen, Cheng-Sheng; Wang, Peng-Wei; Chang, Yi-Hsin; Ko, Chih-Hung

    2012-01-01

    Social anxiety was compared between online and real-life interaction in a sample of 2,348 college students. Severity of social anxiety in both real-life and online interaction was tested for associations with depression, Internet addiction, Internet activity type (gaming versus chatting), and scores on Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) scales. The results showed that social anxiety was lower when interacting online than when interacting offline. Depression, Internet addiction, and high BIS and BAS scores were associated with high social anxiety. The social anxiety decreased more in online interaction among subjects with high social anxiety, depression, BIS, and BAS. This result suggests that the Internet has good potential as an alternative medium for delivering interventions for social anxiety. Further, the effect of BIS on social anxiety is decreased in online interaction. More attention should be paid for BIS when the treatment for social anxiety is delivered online.

  8. Peer conflict avoidance: associations with loneliness, social anxiety, and social avoidance.

    Science.gov (United States)

    Johnson, H D; LaVoie, J C; Spenceri, M C; Mahoney-Wernli, M A

    2001-02-01

    Failure to resolve peer conflict is associated with children's reports of loneliness, social anxiety, and social avoidance. Although these relationships are well established, researchers have not examined the association between the avoidance of peer conflict and various adjustment characteristics. The current study examined the association between avoidance of conflict and measures of loneliness, social anxiety, and social avoidance for 59 pupils in Grade 4 (31 boys and 28 girls) and 47 in Grade 8 (22 boys and 25 girls). Volunteers indicated that conflict avoidance based on autonomy, e.g., independence issues, and interpersonal issues, e.g., closeness and cohesion, was associated with scores on loneliness for boys and girls, respectively. Conflict avoidance for emotional and physical well-being and fear of punishment was associated with increased reports of loneliness and social anxiety for children in Grade 4.

  9. Cannabis Use Behaviors and Social Anxiety: The Roles of Perceived Descriptive and Injunctive Social Norms

    Science.gov (United States)

    Ecker, Anthony H.; Buckner, Julia D.

    2014-01-01

    Objective: Individuals with greater social anxiety are particularly vulnerable to cannabis-related impairment. Descriptive norms (beliefs about others’ use) and injunctive norms (beliefs regarding others’ approval of risky use) may be particularly relevant to cannabis-related behaviors among socially anxious persons if they use cannabis for fear of evaluation for deviating from what they believe to be normative behaviors. Yet, little research has examined the impact of these social norms on the relationships between social anxiety and cannabis use behaviors. Method: The current study investigated whether the relationships of social anxiety to cannabis use and use-related problems varied as a function of social norms. The sample comprised 230 (63.0% female) current cannabis-using undergraduates. Results: Injunctive norms (regarding parents, not friends) moderated the relationship between social anxiety and cannabis-related problem severity. Post hoc probing indicated that among participants with higher (but not lower) social anxiety, those with greater norm endorsement reported the most severe impairment. Injunctive norms (parents) also moderated the relationship between social anxiety and cannabis use frequency such that those with higher social anxiety and lower norm endorsement used cannabis less frequently. Descriptive norms did not moderate the relationship between social anxiety and cannabis use frequency. Conclusions: Socially anxious cannabis users appear to be especially influenced by beliefs regarding parents’ approval of risky cannabis use. Results underscore the importance of considering reference groups and the specific types of norms in understanding factors related to cannabis use behaviors among this vulnerable population. PMID:24411799

  10. Differentiating Emotions Across Contexts: Comparing Adults with and without Social Anxiety Disorder Using Random, Social Interaction, and Daily Experience Sampling

    Science.gov (United States)

    Kashdan, Todd B.; Farmer, Antonina S.

    2014-01-01

    The ability to recognize and label emotional experiences has been associated with well-being and adaptive functioning. This skill is particularly important in social situations, as emotions provide information about the state of relationships and help guide interpersonal decisions, such as whether to disclose personal information. Given the interpersonal difficulties linked to social anxiety disorder (SAD), deficient negative emotion differentiation may contribute to impairment in this population. We hypothesized that people with SAD would exhibit less negative emotion differentiation in daily life, and these differences would translate to impairment in social functioning. We recruited 43 people diagnosed with generalized SAD and 43 healthy adults to describe the emotions they experienced over 14 days. Participants received palmtop computers for responding to random prompts and describing naturalistic social interactions; to complete end-of-day diary entries, they used a secure online website. We calculated intraclass correlation coefficients to capture the degree of differentiation of negative and positive emotions for each context (random moments, face-to-face social interactions, and end-of-day reflections). Compared to healthy controls, the SAD group exhibited less negative (but not positive) emotion differentiation during random prompts, social interactions, and (at trend level) end-of-day assessments. These differences could not be explained by emotion intensity or variability over the 14 days, or to comorbid depression or anxiety disorders. Our findings suggest that people with generalized SAD have deficits in clarifying specific negative emotions felt at a given point of time. These deficits may contribute to difficulties with effective emotion regulation and healthy social relationship functioning. PMID:24512246

  11. Differentiating emotions across contexts: comparing adults with and without social anxiety disorder using random, social interaction, and daily experience sampling.

    Science.gov (United States)

    Kashdan, Todd B; Farmer, Antonina S

    2014-06-01

    The ability to recognize and label emotional experiences has been associated with well-being and adaptive functioning. This skill is particularly important in social situations, as emotions provide information about the state of relationships and help guide interpersonal decisions, such as whether to disclose personal information. Given the interpersonal difficulties linked to social anxiety disorder (SAD), deficient negative emotion differentiation may contribute to impairment in this population. We hypothesized that people with SAD would exhibit less negative emotion differentiation in daily life, and these differences would translate to impairment in social functioning. We recruited 43 people diagnosed with generalized SAD and 43 healthy adults to describe the emotions they experienced over 14 days. Participants received palmtop computers for responding to random prompts and describing naturalistic social interactions; to complete end-of-day diary entries, they used a secure online website. We calculated intraclass correlation coefficients to capture the degree of differentiation of negative and positive emotions for each context (random moments, face-to-face social interactions, and end-of-day reflections). Compared to healthy controls, the SAD group exhibited less negative (but not positive) emotion differentiation during random prompts, social interactions, and (at trend level) end-of-day assessments. These differences could not be explained by emotion intensity or variability over the 14 days, or to comorbid depression or anxiety disorders. Our findings suggest that people with generalized SAD have deficits in clarifying specific negative emotions felt at a given point of time. These deficits may contribute to difficulties with effective emotion regulation and healthy social relationship functioning.

  12. How smartphone usage correlates with social anxiety and loneliness

    Directory of Open Access Journals (Sweden)

    Yusong Gao

    2016-07-01

    Full Text Available Introduction: Early detection of social anxiety and loneliness might be useful to prevent substantial impairment in personal relationships. Understanding the way people use smartphones can be beneficial for implementing an early detection of social anxiety and loneliness. This paper examines different types of smartphone usage and their relationships with people with different individual levels of social anxiety or loneliness. Methods: A total of 127 Android smartphone volunteers participated in this study, all of which have agreed to install an application (MobileSens on their smartphones, which can record user’s smartphone usage behaviors and upload the data into the server. They were instructed to complete an online survey, including the Interaction Anxiousness Scale (IAS and the University of California Los Angeles Loneliness Scale (UCLA-LS. We then separated participants into three groups (high, middle and low based on their scores of IAS and UCLA-LS, respectively. Finally, we acquired digital records of smartphone usage from MobileSens and examined the differences in 105 types of smartphone usage behaviors between high-score and low-score group of IAS/UCLA-LS. Results: Individuals with different scores on social anxiety or loneliness might use smartphones in different ways. For social anxiety, compared with users in low-score group, users in high-score group had less number of phone calls (incoming and outgoing (Mann-Whitney U = 282.50∼409.00, p U = 388.50, p < 0.01. Discussion: The results show that individuals with social anxiety or loneliness receive less incoming calls and use healthy applications more frequently, but they do not show differences in outgoing-call-related features. Individuals with higher levels of social anxiety also receive less SMSs and use camera apps less frequently, while lonely individuals tend to use system, beautify, browser and social media (RenRen apps more frequently. Conclusion: This paper finds that

  13. How smartphone usage correlates with social anxiety and loneliness

    Science.gov (United States)

    Liu, Xiaoqian; Liu, Xingyun

    2016-01-01

    Introduction: Early detection of social anxiety and loneliness might be useful to prevent substantial impairment in personal relationships. Understanding the way people use smartphones can be beneficial for implementing an early detection of social anxiety and loneliness. This paper examines different types of smartphone usage and their relationships with people with different individual levels of social anxiety or loneliness. Methods: A total of 127 Android smartphone volunteers participated in this study, all of which have agreed to install an application (MobileSens) on their smartphones, which can record user’s smartphone usage behaviors and upload the data into the server. They were instructed to complete an online survey, including the Interaction Anxiousness Scale (IAS) and the University of California Los Angeles Loneliness Scale (UCLA-LS). We then separated participants into three groups (high, middle and low) based on their scores of IAS and UCLA-LS, respectively. Finally, we acquired digital records of smartphone usage from MobileSens and examined the differences in 105 types of smartphone usage behaviors between high-score and low-score group of IAS/UCLA-LS. Results: Individuals with different scores on social anxiety or loneliness might use smartphones in different ways. For social anxiety, compared with users in low-score group, users in high-score group had less number of phone calls (incoming and outgoing) (Mann-Whitney U = 282.50∼409.00, p U = 388.50, p < 0.01). Discussion: The results show that individuals with social anxiety or loneliness receive less incoming calls and use healthy applications more frequently, but they do not show differences in outgoing-call-related features. Individuals with higher levels of social anxiety also receive less SMSs and use camera apps less frequently, while lonely individuals tend to use system, beautify, browser and social media (RenRen) apps more frequently. Conclusion: This paper finds that there exists

  14. [Symptoms of depression in children and adolescents in relation to psychiatric comorbidities].

    Science.gov (United States)

    Baji, Ildikó; Gádoros, Júlia; Kiss, Enikô; Mayer, László; Kovács, Eszter; Benák, István; Vetró, Agnes

    2012-01-01

    The lifetime prevalence of MDD before adolescence is 4-5%, while the symptoms concern 13-20% of the adolescents. In the development of suicidal behaviour the most important risk factors are the use of psychoactive drugs and smoking. Psychiatric comorbidities are aggravating significantly the major depression. The comorbidities are high among major depression, anxiety and disruptive disorders. We examined 649 children being in a depressive episode diagnosed by ISCA-D semi-structured interview, 45,9% of them were girls, and 54,1% were boys, the mean age was 11,7 years ( SD=2,00). The participants were enrolled into three groups according to their comorbidities: group with only depression without comorbidities, group with anxiety comorbidity, and group with disruptive comorbidity. We compared the three groups according to the frequency of their depressive symptoms. Anxiety comorbidities increase the incidence of depressive symptoms. Among the criteria symptoms irritability where the most frequent symptom independently from the comorbidities, the depressed mood is the most frequent within the anxiety group, while anhedonia occurred with a moderate frequency in each groups. In the anxiety group the vegetative symptoms, while in the disruptive group the psychomotor agitation and the feeling of worthlessness are the most frequent symptoms. Comorbidities are increasing the incidence of the suicide symptoms. The incidence of impaired decision making was high in each group, the comorbidities didn't influence it's frequency. Among depressed boys irritability and feelings of worthlessness (low self-esteem) increase the presence of externalisation comorbidity. Among depressed girls guilt was significantly more frequent in the anxiety comorbidity group, and concentration problems are the most typical symptoms in the clear MDD group, without comorbidities.

  15. The moderating role of attachment anxiety on social network site use intensity and social capital.

    Science.gov (United States)

    Liu, Haihua; Shi, Junqi; Liu, Yihao; Sheng, Zitong

    2013-02-01

    This study examined the moderating role of attachment anxiety on the relationship between intensity of social network site use and bridging, bonding, and maintained social capital. Data from 322 undergraduate Chinese students were collected. Hierarchical regression analyses showed positive relationships between online intensity of social network site use and the three types of social capital. Moreover, attachment anxiety moderated the effect of intensity of social network site use on social capital. Specifically, for students with lower attachment anxiety, the relationships between intensity of social network site use and bonding and bridging social capital were stronger than those with higher attachment anxiety. The result suggested that social network sites cannot improve highly anxiously attached individuals' social capital effectively; they may need more face-to-face communications.

  16. Reduced optimism and a heightened neural response to everyday worries are specific to generalized anxiety disorder, and not seen in social anxiety.

    Science.gov (United States)

    Blair, K S; Otero, M; Teng, C; Geraci, M; Ernst, M; Blair, R J R; Pine, D S; Grillon, C

    2017-07-01

    Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are co-morbid and associated with similar neural disruptions during emotion regulation. In contrast, the lack of optimism examined here may be specific to GAD and could prove an important biomarker for that disorder. Unmedicated individuals with GAD (n = 18) and age-, intelligence quotient- and gender-matched SAD (n = 18) and healthy (n = 18) comparison individuals were scanned while contemplating likelihoods of high- and low-impact negative (e.g. heart attack; heartburn) or positive (e.g. winning lottery; hug) events occurring to themselves in the future. As expected, healthy subjects showed significant optimistic bias (OB); they considered themselves significantly less likely to experience future negative but significantly more likely to experience future positive events relative to others (p optimism and increased worry about everyday events in GAD. Consistent with this possibility, patients with SAD did not show such dysfunction. Future studies should consider if this dysfunction represents a biomarker for GAD.

  17. Specificity of emotion regulation deficits in social anxiety: an internet study.

    Science.gov (United States)

    Rusch, Silke; Westermann, Stefan; Lincoln, Tania M

    2012-09-01

    There is evidence for an association between social anxiety and emotion regulation difficulties. This study investigates that emotion regulation difficulties are specific to two domains of social anxiety. An explorative study was conducted to examine the associations between emotion regulation facets and social anxiety in the normal population. N= 149 healthy volunteers participated in an internet-based survey. Emotion regulation deficits were measured by the Difficulties in Emotion Regulation Scale which consists of six subscales. Social anxiety was measured by the Social Phobia Scale and the Social Interaction Anxiety Scale. Hierarchical regression analyses showed that anxiety of interactive social situations is associated with non-acceptance of negative emotions, impulse control difficulties, and lack of functional emotion regulation strategies over and above the impact of age and general psychopathology. In contrast, anxiety of being observed by others was not specifically associated with emotion regulation strategies. The results support the hypothesis that specific emotion regulation deficits are relevant to specific aspects of social anxiety. Implications for further research and therapy are discussed. © 2011 The British Psychological Society.

  18. [College students social anxiety associated with stress and mental health].

    Science.gov (United States)

    Chen, Xuefeng; Wang, Zhen; Gao, Jing; Hu, Weipeng

    2007-03-01

    To explore the mediator effects of social anxiety on college students' life stress and mental health. 1430 college students were tested by revised Adolescent Self-Rating Life Events Check List (ASLEC), General Health Questionnaire (GHQ12) and social anxiety scale chose from Self-Consciousness Scale. 1. Social anxiety was the mediator variable between stress and mental health. 2. Female students were easily suffered from higher losing stress and human relationship stress in comparision with male. 3. Non-only child Students got a higher score in social anxiety and lower GHQ in comparision with only child. It may be helpful to improve the stress management and mental health of college students by testing and intervening their social anxiety perception.

  19. Social Anxiety in Online and Real-Life Interaction and Their Associated Factors

    Science.gov (United States)

    Yen, Ju-Yu; Yen, Cheng-Fang; Chen, Cheng-Sheng; Wang, Peng-Wei; Chang, Yi-Hsin

    2012-01-01

    Abstract Social anxiety was compared between online and real-life interaction in a sample of 2,348 college students. Severity of social anxiety in both real-life and online interaction was tested for associations with depression, Internet addiction, Internet activity type (gaming versus chatting), and scores on Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) scales. The results showed that social anxiety was lower when interacting online than when interacting offline. Depression, Internet addiction, and high BIS and BAS scores were associated with high social anxiety. The social anxiety decreased more in online interaction among subjects with high social anxiety, depression, BIS, and BAS. This result suggests that the Internet has good potential as an alternative medium for delivering interventions for social anxiety. Further, the effect of BIS on social anxiety is decreased in online interaction. More attention should be paid for BIS when the treatment for social anxiety is delivered online. PMID:22175853

  20. A comparison of unemployed job-seekers with and without social anxiety

    Science.gov (United States)

    Himle, Joseph A; Weaver, Addie; Bybee, Deborah; O'Donnell, Lisa; Vlnka, Sarah; Laviolette, Wayne; Steinberger, Edward; Zipora, Golenberg; Levine, Debra Siegel

    2014-01-01

    Objective Literature consistently demonstrates that social anxiety disorder has substantial negative impacts on occupational functioning. However, to date, no identified empirical work has focused on understanding the specific nature of vocational problems among persons with social anxiety disorder. This study examines the association between employment-related factors (i.e., barriers to employment; skills related to employment; and job aspirations) and social anxiety among a sample of adults seeking vocational rehabilitation services. Methods Data from intake assessments, including a screen for social anxiety disorder, of 265 low-income, unemployed adults who initiated vocational rehabilitation services in urban Michigan was examined to assess differences in barriers to employment, employment skills, job aspirations, and demographic characteristics among participants who screened positive for social anxiety disorder compared to those who did not. Bivariate and multiple logistic regression analyses were performed. Results Multiple logistic regression analysis revealed that greater perceived experience and skill barriers to employment, fewer skills related to social-type occupations, and less education were significantly associated with social anxiety, after adjusting for other factors. Bivariate analysis also suggested that participants who screened positive for social anxiety disorder were significantly less likely to aspire to social jobs. Conclusions Employment-related factors likely impacting occupational functioning were significantly different between persons with and without social anxiety problems. Identifying these differences in employment barriers, skills, and job aspirations offer potentially important functional targets for psychosocial interventions aimed at social anxiety disorder and suggest the need for vocational service professionals to assess and address social anxiety among their clients. PMID:24733524

  1. Creating Inclusive School Environments: Recommendations for the Management of Neurobehavioural Comorbidities in Children with Epilepsy

    Science.gov (United States)

    MacKinnon, Cheryl; Roberts, Jillian; Wylie, Jaimie

    2016-01-01

    The neurobehavioural comorbidities associated with childhood epilepsy present significant physical challenges (i.e., excessive fatigue, memory impairment, headaches, visual impairments), emotional challenges (i.e., depression, anxiety), behavioural challenges (i.e., inattentiveness, distractibility, aggression), and social challenges (i.e., peer…

  2. [Relationship of Anxiety and Depression in the Development of Mixed Anxiety/Depression Disorder. An Experimental Study of Comorbidity Mechanisms (Review)].

    Science.gov (United States)

    Galyamina, A G; Kovalenko, I L; Smagin, D A; Kudryavtseva, N N

    2016-01-01

    As clinical practice and experimental studies show, symptoms of depression and anxiety often accompany each other. It is well known that combination of anxiety and depression in patients is treated more slowly, requires large doses of drugs, increases the likelihood of suicide and often leads to relapse. Furthermore, antidepressants and anxiolytics exert its therapeutic effect in limited cases even in monopolar anxiety or depression state. In this review of literature and our own data the relationship of anxiety and depression is analyzed. It has been shown with using the model of mixed anxiety/depression disorder caused by chronic social defeat stress, that the anxiety and depression are changed under the influence of psychotropic drugs independently.

  3. The aldehyde dehydrogenase 2 polymorphisms on neuropsychological performance in bipolar II disorder with or without comorbid anxiety disorder.

    Science.gov (United States)

    Lu, Ru-Band; Chang, Yun-Hsuan; Wang, Tzu-Yun; Lee, Sheng-Yu; Chen, Po See; Yang, Yen Kuang

    2018-01-01

    Anxiety disorders (ADs), the most common comorbid illnesses with bipolar disorder (BP) has been reported to associate with dopamine system. Dopamine, metabolized to 3,4-dihydroxyphenylacetic acid (DOPAC) by aldehyde dehydrogenase 2 (ALDH2), and the distribution of the ALDH2*1/*1, and ALDH2*1/*2+ALDH*2/*2 alleles in the Han Chinese general population is relatively equal. The association between dopamine metabolic enzymes and cognitive performance in patients with bipolar II disorder (BP-II) comorbid with AD is unclear. This study proposed to explore the role of ALDH2 polymorphisms on neuropsychological performance between BP-II comorbid with or without AD. One hundred ninety-seven BP-II patients with and without a comorbid AD were recruited and compared with 130 healthy controls (HCs). A polymerase chain reaction and a restriction fragment length polymorphism analysis were used to determine genotypes for ALDH2, and study participants underwent neuropsychological tests. An interaction between AD comorbidity and the ALDH2 polymorphisms was found in different domain of cognitive dysfunction in the BP-II patients. The ALDH2 polymorphisms might have different effects on the neuropsychological performance of BP-II patients with and without comorbid AD.

  4. Social anxiety and cardiovascular responses to active coping conditions

    Directory of Open Access Journals (Sweden)

    MARGIT GRAMER

    2006-03-01

    Full Text Available This study assessed the influence of trait social anxiety on cardiovascular, emotional and behavioral responses to active performance situations representing social and cognitive demands. Thirty-six male and thirty-six female students categorized as either high or low in trait social anxiety performed a mental arithmetic task and two interpersonal tasks requiring persuasive behavior: Preparation and Performance of a Speech, Role-played Interpersonal Interactions. The cardiovascular effects of social anxiety varied over experimental stressors and appear to reflect differences in effort or task engagement rather than differential affective experiences. During Role-played Interactions high socially anxious subjects displayed lower increases in systolic blood pressure compared to low anxious participants. This effect was partially mediated by behavioral indicators of social competence and suggests a more inhibited coping approach of socially anxious participants. Findings for Mental Arithmetic were in the opposite direction, high socially anxious subjects displayed greater heart rate effects. In the absence of group differences in state anxiety this effect might result from stronger audience effects on effort or task motivation in socially anxious participants. These findings strengthen the view that active performance situations elicit cardiovascular effects that are largely attributable to differences in task engagement. The data also indicate the importance of considering situational factors in social anxiety research.

  5. Alexithymia, emotion processing and social anxiety in adults with ADHD.

    Science.gov (United States)

    Edel, M-A; Rudel, A; Hubert, C; Scheele, D; Brüne, M; Juckel, G; Assion, Hans-Jörg

    2010-09-24

    given sparse research on the issue, this study sought to shed light upon the interactions of alexithymia, emotion processing, and social anxiety in adults with attention-deficit hyperactivity disorder (ADHD). 73 German adults with ADHD according to DSM-IV diagnostic criteria participated. We used the Toronto Alexithymia Scale (TAS-20) to assess alexithymia, the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) to assess different features of social anxiety, and we applied the German "Experience of Emotions Scalerdquor; (SEE) to measure emotion processing. 40% of the sample were found to meet the DSM-IV criteria of social anxiety disorder, and about 22% were highly alexithymic according to a TAS-20 total score ≥ 61; however, the mean TAS-20 total score of 50.94 ± 9.3 was not much higher than in community samples. Alexithymic traits emerged to be closely linked to emotion processing problems, particularly 'difficulty accepting own emotions', and to social anxiety features. our findings suggest interactions of alexithymia, emotion processing dysfunction, and social anxiety in adults with ADHD, which may entail the therapeutic implication to thoroughly instruct these patients to identify, accept, communicate, and regulate their emotions to aid reducing interaction anxiety.

  6. Integrated psychological treatment for substance use and co-morbid anxiety or depression vs. treatment for substance use alone

    DEFF Research Database (Denmark)

    Hesse, Morten

    2009-01-01

    Background There is a growing consensus in favour of integrated treatment of substance use disorders and co-morbid conditions, such as depression or anxiety. However, up till now no systematic reviews have been published. Methods Based on a systematic search of MedLine and PsychInfo, 10 trials of...

  7. Gender matters: the relationship between social anxiety and alcohol-related consequences.

    Science.gov (United States)

    Schry, Amie R; Norberg, Melissa M; Maddox, Brenna B; White, Susan W

    2014-01-01

    Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. In the present study, 573 undergraduate students (M(age) = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences.

  8. Disordered gambling and co-morbidity of psychiatric disorders among college students: an examination of problem drinking, anxiety and depression.

    Science.gov (United States)

    Martin, Ryan J; Usdan, Stuart; Cremeens, Jennifer; Vail-Smith, Karen

    2014-06-01

    We assessed the occurrence of co-morbid psychiatric disorders (i.e., problem drinking, anxiety, and depression) among college students who met the threshold for disordered gambling. The participants included a large sample of undergraduate students (n = 1,430) who were enrolled in an introductory health course at a large, southeastern university in Spring 2011 and completed an online assessment that included scales to assess disordered gambling, problem drinking, anxiety, and depression. We calculated screening scores, computed prevalence rates for each disorder, and calculated Pearson correlations and Chi square tests to examine correlations and co-morbid relationships between the four disorders. Analyses indicated that all disorders were significantly associated (p students who experience disordered gambling (and other psychiatric disorders) are at increased risk of experiencing co-occurring disorders, it might be useful for college health professionals to concurrently screen and intervene for co-occurring disorders.

  9. Anxiety and depressive symptoms and medical illness among adults with anxiety disorders.

    Science.gov (United States)

    Niles, Andrea N; Dour, Halina J; Stanton, Annette L; Roy-Byrne, Peter P; Stein, Murray B; Sullivan, Greer; Sherbourne, Cathy D; Rose, Raphael D; Craske, Michelle G

    2015-02-01

    Anxiety is linked to a number of medical conditions, yet few studies have examined how symptom severity relates to medical comorbidity. The current study assessed associations between severity of anxiety and depression and the presence of medical conditions in adults diagnosed with anxiety disorders. Nine-hundred eighty-nine patients diagnosed with panic, generalized anxiety, social anxiety, and posttraumatic stress disorders reported on the severity of anxiety and depressive symptoms and on diagnoses of 11 medical conditions. Severity of anxiety and depressive symptoms was strongly associated with having more medical conditions over and above control variables, and the association was as strong as that between BMI and disease. Odds of having asthma, heart disease, back problems, ulcer, migraine headache and eyesight difficulties also increased as anxiety and depressive symptom severity increased. Anxiety symptoms were independently associated with ulcer, whereas depressive symptoms were independently associated with heart disease, migraine, and eyesight difficulties. These findings add to a growing body of research linking anxiety disorders with physical health problems and indicate that anxiety and depressive symptoms deserve greater attention in their association with disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. How smartphone usage correlates with social anxiety and loneliness

    OpenAIRE

    Yusong Gao; Ang Li; Tingshao Zhu; Xiaoqian Liu; Xingyun Liu

    2016-01-01

    Introduction: Early detection of social anxiety and loneliness might be useful to prevent substantial impairment in personal relationships. Understanding the way people use smartphones can be beneficial for implementing an early detection of social anxiety and loneliness. This paper examines different types of smartphone usage and their relationships with people with different individual levels of social anxiety or loneliness. Methods: A total of 127 Android smartphone volunteers participated...

  11. Type D personality is associated with social anxiety in the general population.

    Science.gov (United States)

    Kupper, Nina; Denollet, Johan

    2014-06-01

    Research on the emotional processes associated with Type D personality is important for its further conceptualization. We examined the associations of Type D personality with social and general anxiety symptoms in a large community sample. The aim of the current study was to disentangle the associations of Type D personality and its components with social anxiety and general anxiety in a large sample from the general population. A random sample of 2,475 adults from the general population filled out questionnaires to assess Type D personality (DS-14), social anxiety (SIAS(10), SPS(11), BFNE-II), and general anxiety (HADS-A, GAD-7). Type D individuals were characterized by increased levels of both social and general anxiety. The social inhibition (SI) component of Type D personality was most strongly associated with social interaction anxiety (r = .63), while negative affectivity (NA) was strongly associated with general anxiety (GAD-7: r = .70; HADS-A: r = .66). Within social anxiety, SI was more strongly associated with facets of social interaction anxiety than with social phobia. Multiple regression analysis showed that the synergistic interaction of NA and SI was a predictor of social anxiety (SIAS(10): β = .32, p < .0005; SPS(11): β = .27, p < .0005; BFNE-II: β = .11, p = .007) independent of demographics and the scores on the individual Type D components. This interaction was not a significant predictor of general anxiety. Logistic regression using the dichotomous Type D classification demonstrated a 9.1-fold (95%CI, 7.0-11.8) increased odds of a score in the highest quartile of social interaction anxiety and a 7.6-fold (95%CI, 5.8-9.8) increased odds of high social phobia. Odds ratios for clinically relevant levels of general anxiety were 8.3 (95%CI, 5.5-12.5) for GAD-7 and 6.5 (95%CI, 3.4-12.6) for HADS-A. In the general population, Type D individuals were characterized by both social and general anxiety. The SI component of Type D is strongly associated

  12. Attachment style and oxytocin receptor gene variation interact in influencing social anxiety.

    Science.gov (United States)

    Notzon, S; Domschke, K; Holitschke, K; Ziegler, C; Arolt, V; Pauli, P; Reif, A; Deckert, J; Zwanzger, P

    2016-01-01

    Social anxiety has been suggested to be promoted by an insecure attachment style. Oxytocin is discussed as a mediator of trust and social bonding as well as a modulator of social anxiety. Applying a gene-environment (G × E) interaction approach, in the present pilot study the main and interactive effects of attachment styles and oxytocin receptor (OXTR) gene variation were probed in a combined risk factor model of social anxiety in healthy probands. Participants (N = 388; 219 females, 169 males; age 24.7 ± 4.7 years) were assessed for anxiety in social situations (Social Phobia and Anxiety Inventory) depending on attachment style (Adult Attachment Scale, AAS) and OXTR rs53576 A/G genotype. A less secure attachment style was significantly associated with higher social anxiety. This association was partly modulated by OXTR genotype, with a stronger negative influence of a less secure attachment style on social anxiety in A allele carriers as compared to GG homozygotes. The present pilot data point to a strong association of less secure attachment and social anxiety as well as to a gene-environment interaction effect of OXTR rs53576 genotype and attachment style on social anxiety possibly constituting a targetable combined risk marker of social anxiety disorder.

  13. Elevated Social Anxiety among Early Maturing Girls

    Science.gov (United States)

    Blumenthal, Heidemarie; Leen-Feldner, Ellen W.; Babson, Kimberly A.; Gahr, Jessica L.; Trainor, Casey D.; Frala, Jamie L.

    2011-01-01

    Adolescence is a key period in terms of the development of anxiety psychopathology. An emerging literature suggests that early pubertal maturation is associated with enhanced vulnerability for anxiety symptomatology, although few studies have examined this association with regard to social anxiety. Accordingly, the current study was designed to…

  14. Animal models of social anxiety disorder and their validity criteria.

    Science.gov (United States)

    Réus, Gislaine Z; Dos Santos, Maria Augusta B; Abelaira, Helena M; Quevedo, João

    2014-09-26

    Anxiety disorders pose one of the largest threats to global mental health, and they predominantly emerge early in life. Social anxiety disorder, also known as social phobia, is the most common of all anxiety disorders. Moreover, it has severe consequences and is a disabling disorder that can cause an individual to be unable to perform the tasks of daily life. Social anxiety disorder is associated with the subsequent development of major depression and other mental diseases, as well as increased substance abuse. Although some neurobiological alterations have been found to be associated with social anxiety disorder, little is known about this disorder. Animal models are useful tools for the investigation of this disorder, as well as for finding new pharmacological targets for treatment. Thus, this review will highlight the main animal models of anxiety associated with social phobia. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. College drinking problems and social anxiety: The importance of drinking context.

    Science.gov (United States)

    Terlecki, Meredith A; Ecker, Anthony H; Buckner, Julia D

    2014-06-01

    Social anxiety more than quadruples the risk of developing an alcohol use disorder, yet it is inconsistently linked to heavy alcohol use. Elucidation of the relation between social anxiety and alcohol use is an important next step in treating and preventing risky drinking. College students routinely face potentially anxiety-provoking social situations (e.g., meeting new people) and socially anxious undergraduates are especially vulnerable to alcohol-related impairment. Drinking to cope with social anxiety is thought to reinforce alcohol use, yet research on coping-motivated drinking among socially anxious students has yielded inconsistent findings. Further, undergraduate drinking varies by drinking context, yet the role of context in drinking behaviors among socially anxious individuals remains unclear. The current study sought to examine the relationship of social anxiety and drinking quantity in specific drinking contexts among undergraduates (N = 611). We also evaluated whether relevant drinking contexts mediated the relationship between social anxiety and alcohol-related problems. Clinically elevated social anxiety was related to heavier consumption in negative emotion (e.g., feeling sad or angry) and personal/intimate (e.g., before sexual intercourse) contexts, but not social/convivial contexts (e.g., parties, bars). Quantity of alcohol consumed in negative emotion and personal/intimate contexts mediated the relationship between social anxiety and drinking problem severity. Drinking in personal/intimate contexts demonstrated a unique mediational role. Findings suggest that heavy drinking in particular contexts (especially personal/intimate and negative emotion) may play an important role in drinking problems among socially anxious individuals.

  16. Familial correlates of social anxiety in children and adolescents.

    Science.gov (United States)

    Bögels, S M; van Oosten, A; Muris, P; Smulders, D

    2001-03-01

    Retrospective studies suggest a relationship between parental rearing practices and social phobia. The present study investigated whether socially anxious children perceive their current parental rearing as rejecting, overprotective, and lacking emotional warmth, and as emphasizing the importance of other's opinion, and de-emphasizing social initiatives and family sociability. Furthermore, we examined whether parents of socially anxious children report to rely on such rearing practices, and suffer themselves from social fears. A regression analysis as well as extreme group comparisons were applied. Little support was found for the presumed role of the assessed family rearing aspects in the development of social anxiety in children. Solely family sociability (children's and mothers' report) and children's perception of overprotection of the mother predicted social anxiety in the regression analysis. Given the influence of the mentioned rearing practices, social anxiety of the mother still significantly predicted social anxiety of the child. In the extreme group comparisons, differences in the expected direction were found between socially anxious and normal children on parental rejection, emotional warmth, and family sociability. However, the lack of differences between socially anxious and clinical control children suggests that these variables do not form a specific pathway to social fears.

  17. Social Anxiety in Cornelia de Lange Syndrome

    Science.gov (United States)

    Richards, Caroline; Moss, Jo; O'Farrell, Laura; Kaur, Gurmeash; Oliver, Chris

    2009-01-01

    In this study we assessed the behavioral presentation of social anxiety in Cornelia de Lange syndrome (CdLS) using a contrast group of Cri du Chat syndrome (CdCS). Behaviors indicative of social anxiety were recorded in twelve children with CdLS (mean age = 11.00; SD = 5.15) and twelve children with CdCS (8.20; SD = 2.86) during social…

  18. Social phobia and avoidant personality disorder: are they separate diagnostic entities or do they reflect a spectrum of social anxiety?

    Science.gov (United States)

    Tillfors, Maria; Ekselius, Lisa

    2009-01-01

    The Axis I disorder social phobia and the Axis II disorder avoidant personality disorder were first introduced in the DSM nomenclature in 1980. Since then a major nosological theme in research has concerned whether or not social phobia and avoidant personality disorder represent distinct clinical categories. Our main aim was to summarize both the current situation regarding this conceptual debate, as well as what we still do not know. In the present review we describe the evolution of these disorders as they have been addressed over time, from their introduction in the DSM-III system to their current descriptions in the DSM-IV. Thereafter, earlier empirical literature concerning this conceptual debate is evaluated, with the main focus on comorbidity between social phobia and avoidant personality disorder. The PsycINFO and PubMed electronic databases were searched for studies, and complementary searches of references in articles and books were conducted. To conclude, the studies summarized provide support for the view that social phobia and avoidant personality disorder are more than arbitrary cutoffs along a continuum of social anxiety.

  19. Gender matters: the relationship between social anxiety and alcohol-related consequences.

    Directory of Open Access Journals (Sweden)

    Amie R Schry

    Full Text Available BACKGROUND AND OBJECTIVES: Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. METHODS: In the present study, 573 undergraduate students (M(age = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role. Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. RESULTS: After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. DISCUSSION AND CONCLUSIONS: These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. SCIENTIFIC SIGNIFICANCE: This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences.

  20. Gender Matters: The Relationship between Social Anxiety and Alcohol-Related Consequences

    Science.gov (United States)

    Schry, Amie R.; Norberg, Melissa M.; Maddox, Brenna B.; White, Susan W.

    2014-01-01

    Background and Objectives Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. Methods In the present study, 573 undergraduate students (M age = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. Results After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. Discussion and Conclusions These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. Scientific Significance This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences. PMID:25541722

  1. Alexithymia, emotion processing and social anxiety in adults with ADHD

    Directory of Open Access Journals (Sweden)

    Edel M-A

    2010-09-01

    Full Text Available Abstract Objective Given sparse research on the issue, this study sought to shed light upon the interactions of alexithymia, emotion processing, and social anxiety in adults with attention-deficit hyperactivity disorder (ADHD. Subjects and methods 73 German adults with ADHD according to DSM-IV diagnostic criteria participated. We used the Toronto Alexithymia Scale (TAS-20 to assess alexithymia, the Social Phobia Scale (SPS and the Social Interaction Anxiety Scale (SIAS to assess different features of social anxiety, and we applied the German 'Experience of Emotions Scale' (SEE to measure emotion processing. Results 40% of the sample were found to meet the DSM-IV criteria of social anxiety disorder, and about 22% were highly alexithymic according to a TAS-20 total score ≥ 61; however, the mean TAS-20 total score of 50.94 ± 9.3 was not much higher than in community samples. Alexithymic traits emerged to be closely linked to emotion processing problems, particularly 'difficulty accepting own emotions', and to social anxiety features. Discussion/conclusion Our findings suggest interactions of alexithymia, emotion processing dysfunction, and social anxiety in adults with ADHD, which may entail the therapeutic implication to thoroughly instruct these patients to identify, accept, communicate, and regulate their emotions to aid reducing interaction anxiety.

  2. Social anxiety questionnaire (SAQ): Development and preliminary validation.

    Science.gov (United States)

    Łakuta, Patryk

    2018-05-30

    The Social Anxiety Questionnaire (SAQ) was designed to assess five dimensions of social anxiety as posited by the Clark and Wells' (1995; Clark, 2001) cognitive model. The development of the SAQ involved generation of an item pool, followed by a verification of content validity and the theorized factor structure (Study 1). The final version of the SAQ was then assessed for reliability, temporal stability (test re-test reliability), and construct, criterion-related, and contrasted-group validity (Study 2, 3, and 4). Following a systematic process, the results provide support for the SAQ as reliable, and both theoretically and empirically valid measure. A five-factor structure of the SAQ verified and replicated through confirmatory factor analyses reflect five dimensions of social anxiety: negative self-processing; self-focused attention and self-monitoring; safety behaviours; somatic and cognitive symptoms; and anticipatory and post-event rumination. Results suggest that the SAQ possesses good psychometric properties, while recognizing that additional validation is a required future research direction. It is important to replicate these findings in diverse populations, including a large clinical sample. The SAQ is a promising measure that supports social anxiety as a multidimensional construct, and the foundational role of self-focused cognitive processes in generation and maintenance of social anxiety symptoms. The findings make a significant contribution to the literature, moreover, the SAQ is a first instrument that offers to assess all, proposed by the Clark-Wells model, specific cognitive-affective, physiological, attitudinal, and attention processes related to social anxiety. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Relations among Social Anxiety, Eye Contact Avoidance, State Anxiety, and Perception of Interaction Performance during a Live Conversation.

    Science.gov (United States)

    Howell, Ashley N; Zibulsky, Devin A; Srivastav, Akanksha; Weeks, Justin W

    2016-01-01

    There is building evidence that highly socially anxious (HSA) individuals frequently avoid making eye contact, which may contribute to less meaningful social interactions and maintenance of social anxiety symptoms. However, research to date is lacking in ecological validity due to the usage of either static or pre-recorded facial stimuli or subjective coding of eye contact. The current study examined the relationships among trait social anxiety, eye contact avoidance, state anxiety, and participants' self-perceptions of interaction performance during a live, four-minute conversation with a confederate via webcam, and while being covertly eye-tracked. Participants included undergraduate women who conversed with same-sex confederates. Results indicated that trait social anxiety was inversely related to eye contact duration and frequency averaged across the four minutes, and positively related to state social anxiety and negative self-ratings. In addition, greater anticipatory state anxiety was associated with reduced eye contact throughout the first minute of the conversation. Eye contact was not related to post-task state anxiety or self-perception of poor performance; although, trends emerged in which these relations may be positive for HSA individuals. The current findings provide enhanced support for the notion that eye contact avoidance is an important feature of social anxiety.

  4. Social phobia as a comorbid condition in sex offenders with paraphilia or impulse control disorder.

    Science.gov (United States)

    Hoyer, J; Kunst, H; Schmidt, A

    2001-07-01

    Studies on the prevalence of social anxiety in sex offenders show mixed results. This may be due to social anxiety being heightened only in diagnostic subgroups of sex offenders, namely in paraphiliacs. In study 1, 72 mentally disordered sexual delinquents and 30 controls were screened for social anxiety with the Social Interaction Anxiety Scale and the Social Phobia Scale by Mattick and Clarke (German versions). In study 2, 55 mentally disordered sexual delinquents were diagnosed with a structured clinical interview. In both studies, sex offenders were categorized as either paraphilic or impulse control disordered (without paraphilia) according to research criteria. Study 1 showed markedly heightened scores for social anxiety in paraphiliacs, particularly for social interaction anxiety. Study 2 found a high lifetime and point prevalence of social phobia in paraphiliacs for which corroborating evidence was again found in questionnaire results. Implications for further research, diagnostic procedures, and therapy are discussed.

  5. Social anxiety and the cortisol response to social evaluation in children and adolescents.

    Science.gov (United States)

    van den Bos, Esther; Tops, Mattie; Westenberg, P Michiel

    2017-04-01

    Contradictory findings have been reported on the relation between social anxiety and the cortisol response to social evaluation in youth. The present longitudinal study aimed to clarify this relation by taking pubertal development into account. Data were collected in two waves, two years apart, for a community sample of 196 participants, aged 8-17 years at Time 1. Pubertal development and social anxiety were assessed with self-report questionnaires. Salivary cortisol was obtained before and after participants completed the Leiden Public Speaking Task. Data were analyzed using regression analysis with clustered bootstrap. The dependent variable was the cortisol area under the curve. Social anxiety and pubertal development scores were decomposed into between- and within-participants components. Between participants, the relation between social anxiety and the cortisol response to public speaking varied with pubertal development: socially anxious individuals showed higher responses at low levels of pubertal development, but lower responses at high levels of pubertal development. Within participants, an increase in social anxiety over time was associated with a lower cortisol response. The results are in line with the suggestion that the responses of socially anxious individuals change from elevated in childhood to attenuated in adolescence and adulthood. Attenuation of the cortisol response is explained by theories proposing that the stress response changes with the duration of the stressor. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Indirect Comorbidity in Childhood and Adolescence

    Directory of Open Access Journals (Sweden)

    William eCopeland

    2013-11-01

    Full Text Available Objective: Comorbidity between psychiatric disorders is common, but pairwise associations between two disorders may be explained by the presence of other diagnoses that are associated with both disorders or indirect comorbidity. Method: Comorbidities of common childhood psychiatric disorders were tested in three community samples of children ages 6 to 17 (8931 observations of 2965 subjects. Psychiatric disorder status in all three samples was assessed with the Child and Adolescent Psychiatric Assessment. Indirect comorbidity was defined as A-B associations that decreased from significance to nonsignificance after adjusting for other disorders. Results: All tested childhood psychiatric disorders were positively associated in bivariate analyses. After adjusting for comorbidities, many ssociations involving a behavioral disorder and an emotional disorder were attenuated suggesting indirect comorbidity. Generalized anxiety and depressive disorders displayed a very high level of overlap (adjusted OR=37.9. All analyses were rerun with depressive disorders grouped with generalized anxiety disorder in a single distress disorders category. In these revised models, all associations between and emotional disorder and a behavior disorder met our criteria for indirect comorbidity except for the association of oppositional defiant disorder with distress disorders (OR=11.3. Follow-up analyses suggested that the indirect associations were primarily accounted for by oppositional defiant disorder and the distress disorder category. There was little evidence of either sex differences or differences by developmental period Conclusions: After accounting for the overlap between depressive disorders with generalized anxiety disorder, direct comorbidity between emotional and behavioral disorders was uncommon. When there was evidence of indirect comorbidity, ODD and distress disorders were the key intermediary diagnoses accounting for the apparent associations.

  7. Mother-Child Attachment and Social Anxiety Symptoms in Middle Childhood

    Science.gov (United States)

    Brumariu, Laura E.; Kerns, Kathryn A.

    2008-01-01

    Literature suggests that parent-child attachment and anxiety symptoms are related. One purpose of the present study was to assess whether attachment patterns relate differentially to social anxiety aspects (fear of negative evaluation, social anxiety and distress in new situations, and generalized anxiety and distress). The second purpose was to…

  8. Recovery From Comorbidity

    Directory of Open Access Journals (Sweden)

    Mathew Carter

    2013-11-01

    Full Text Available Comorbidity among mood, anxiety, and alcohol disorders is common and burdensome, affecting individuals, families, and public health. A systematic and integrative review of the literature across disciplines and research methodologies was performed. Supradisciplinary approaches were applied to the review and the ensuing critical appraisal. Definitions, measurement, and estimation are controversial and inconstant. Recovery from comorbidity cannot be easily extricated from a sociocultural milieu. Methodological challenges in quantitative and qualitative research and across disciplines are many and are discussed. The evidence supporting current treatments is sparse and short-term, and modalities operating in isolation typically fail. People easily fall into the cracks between mental health and addiction services. Clinicians feel untrained and consumers bear the brunt of this: Judgmental and moralistic interactions persist and comorbidity is unrecognized in high-risk populations. Competing historical paradigms of mental illness and addiction present a barrier to progress and reductionism is an impediment to care and an obstacle to the integration and interpretation of research. What matters to consumers is challenging to quantify but worth considering: Finding employment, safe housing, and meaning are crucial to recovery. Complex social networks and peer support in recovery are important but poorly understood. The focus on modalities of limited evidence or generalizability persists in literature and practice. We need to consider different combinations of comorbidity, transitions as opposed to dichotomies of use or illness, and explore the long-term view and emic perspectives.

  9. Psychological treatment of social anxiety disorder improves body dysmorphic concerns.

    Science.gov (United States)

    Fang, Angela; Sawyer, Alice T; Aderka, Idan M; Hofmann, Stefan G

    2013-10-01

    Social anxiety disorder and body dysmorphic disorder are considered nosologically distinct disorders. In contrast, some cognitive models suggest that social anxiety disorder and body dysmorphic disorder share similar cognitive maintenance factors. The aim of this study was to examine the effects of psychological treatments for social anxiety disorder on body dysmorphic disorder concerns. In Study 1, we found that 12 weekly group sessions of cognitive-behavioral therapy led to significant decreases in body dysmorphic symptom severity. In Study 2, we found that an attention retraining intervention for social anxiety disorder was associated with a reduction in body dysmorphic concerns, compared to a placebo control condition. These findings support the notion that psychological treatments for individuals with primary social anxiety disorder improve co-occurring body dysmorphic disorder symptoms. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. High visual working memory capacity in trait social anxiety.

    Science.gov (United States)

    Moriya, Jun; Sugiura, Yoshinori

    2012-01-01

    Working memory capacity is one of the most important cognitive functions influencing individual traits, such as attentional control, fluid intelligence, and also psychopathological traits. Previous research suggests that anxiety is associated with impaired cognitive function, and studies have shown low verbal working memory capacity in individuals with high trait anxiety. However, the relationship between trait anxiety and visual working memory capacity is still unclear. Considering that people allocate visual attention more widely to detect danger under threat, visual working memory capacity might be higher in anxious people. In the present study, we show that visual working memory capacity increases as trait social anxiety increases by using a change detection task. When the demand to inhibit distractors increased, however, high visual working memory capacity diminished in individuals with social anxiety, and instead, impaired filtering of distractors was predicted by trait social anxiety. State anxiety was not correlated with visual working memory capacity. These results indicate that socially anxious people could potentially hold a large amount of information in working memory. However, because of an impaired cognitive function, they could not inhibit goal-irrelevant distractors and their performance decreased under highly demanding conditions.

  11. Social Support and Social Anxiety in Use and Perceptions of Online Mental Health Resources: Exploring Social Compensation and Enhancement.

    Science.gov (United States)

    Ruppel, Erin K; McKinley, Christopher J

    2015-08-01

    This study used the frameworks of social compensation and social enhancement to examine how social anxiety and social support were related to college students' (N=443) use and perceptions of online mental health resources (Web sites and online support groups). Potential interactions between social support and social anxiety were also examined. Consistent with the social compensation hypothesis, perceived usefulness of Web sites was positively associated with social support. Perceived usefulness of online support groups was positively associated with social support when participants reported average or high, but not low, social anxiety. In contrast, previous use of Web sites was consistent with the social compensation hypothesis. Participants who reported less social support were more likely to have used a Web site for a mental or emotional problem. These findings suggest that college students' use and perceptions of online mental health resources vary as a function of social support and social anxiety, and that patterns suggestive of social compensation and social enhancement depend on whether perceptions or actual use of resources are examined. Combined with the significant interaction between social support and social anxiety on perceived usefulness of online support groups, these findings highlight the potential complexity of social compensation and enhancement phenomena.

  12. Schizophrenia, Obsessive Covert Mental Rituals and Social Anxiety: Case Report

    Science.gov (United States)

    Tully, Phillip J.; Edwards, Christopher J.

    2009-01-01

    This case study reports the outcomes of cognitive therapy for social anxiety in a 45-year-old man with a 27-year history of paranoid schizophrenia. The intervention targeted the overlapping and interrelated symptoms of social anxiety and delusional beliefs. After 11 sessions of treatment, the patient showed no improvement in social anxiety,…

  13. Anxiety sensitivity and subjective social status in relation to anxiety and depressive symptoms and disorders among Latinos in primary care.

    Science.gov (United States)

    Zvolensky, Michael J; Bakhshaie, Jafar; Garza, Monica; Valdivieso, Jeanette; Ortiz, Mayra; Bogiaizian, Daniel; Robles, Zuzuky; Vujanovic, Anka

    2015-05-01

    The present investigation examined the interactive effects of anxiety sensitivity and subjective social status in relation to anxiety and depressive symptoms and psychopathology among 143 Latinos (85.7% female; Mage=39.0, SD=10.9; 97.2% used Spanish as their first language) who attended a community-based primary healthcare clinic. Results indicated that the interaction between anxiety sensitivity and subjective social status was significantly associated with number of mood and anxiety disorders, panic, social anxiety, and depressive symptoms. The form of the significant interactions indicated that individuals reporting co-occurring higher levels of anxiety sensitivity and lower levels of subjective social status evidenced the greatest levels of psychopathology and panic, social anxiety, and depressive symptoms. The present findings suggest that there is merit in focusing further scientific attention on the interplay between anxiety sensitivity and subjective social status in regard to understanding, and thus, better intervening to reduce anxiety/depressive vulnerability among Latinos in primary care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Impact of comorbid depression or anxiety on patterns of treatment and economic outcomes among patients with diabetic peripheral neuropathic pain.

    Science.gov (United States)

    Boulanger, Luke; Zhao, Yang; Foster, Talia S; Fraser, Kimberly; Bledsoe, Stacey L; Russell, Mason W

    2009-07-01

    The objective of this retrospective analysis was to assess the correlation of comorbid depression and/or anxiety to patterns of treatment, healthcare utilization, and associated costs among diabetic peripheral neuropathic pain (DPNP) patients, employing a large US administrative claims database. Patients under age 65 with commercial insurance and patients aged 65 and older with employer-sponsored Medicare supplemental insurance were selected for the study if they had at least one diagnosis of DPNP in 2005. The first observed DPNP claim was considered the 'index date.' All individuals had a 12-month pre-index and 12-month follow-up period. For both populations, two subgroups were constructed for individuals with depression and/or anxiety (DPNP-DA cohort) or without these disorders (DPNP-only cohort). Patients' demographic characteristics, clinical characteristics, and medication use were compared over the pre-index period. Healthcare expenditures and resource utilization were measured for the post-index period. Two-part models were used to examine the impact of comorbid depression and/or anxiety on healthcare utilization and costs, controlling for demographic and clinical characteristics. The study identified 11,854 DPNP-only and 1512 DPNP-DA patients in the Medicare supplemental cohort, and 11,685 and 2728 in the commercially insured cohort. Compared to DPNP-only patients over the follow-up period, a significantly higher percentage of DPNP-DA patients were dispensed pain and DPNP-related medication. All components of healthcare utilization, except home healthcare visits and physician office visits, were more likely to be provided to DPNP-DA patients versus the DPNP-only cohort (all p bias between study cohorts, mis-identification of DPNP and/or depression, and inability to assess indirect costs as well as use and cost of over-the-counter medications. These findings indicate that the healthcare costs were significantly higher for DPNP patients comorbid with

  15. Benign paroxysmal positional vertigo and comorbid conditions.

    Science.gov (United States)

    Cohen, Helen S; Kimball, Kay T; Stewart, Michael G

    2004-01-01

    To determine the prevalence of comorbid disease in patients with benign paroxysmal positional vertigo (BPPV) and the relationship of comorbid disease to symptoms of vertigo, disequilibrium, and anxiety. Patients who had posterior semicircular canal BPPV and who had been referred for vestibular rehabilitation at a tertiary care center completed a health status questionnaire and the Vertigo Symptom Scale, answered questions about level of vertigo, and were tested on computerized dynamic posturography. Subjects had high rates of diabetes, mild head trauma, and probable sinus disease. Balance was generally impaired, worse in diabetics and subjects with significant vestibular weakness. Subjects who smoked or had had mild head trauma had higher levels of anxiety. Comorbid conditions, particularly diabetes, mild head trauma, and sinus disease, are unusually prevalent in BPPV patients. Message: Patients with comorbid disease are at risk for having increased vertigo, anxiety, and disequilibrium compared to other patients. Copyright 2004 S. Karger AG, Basel

  16. Effectiveness of “Task Concentration Training” in Reducing the Anxiety Symptoms in Individuals with Social Anxiety Disorder

    OpenAIRE

    K. Golmohammadi; M.R. Shairi; M.A. Asghari Moghaddam

    2017-01-01

    Aims: As a common disorder, the social anxiety disorder is characterized by the persistent fear of social situations and severe physical and mental reactions. Its prevalence and effect being noticed, different psychotherapy methods were raised to reduce or annihilate it. The aim of the study was to determine the effectiveness of task-concentration training technics on the social anxiety symptom reduction in persons with social anxiety. Materials & Methods: In the controlled pretest-postte...

  17. Development, standardization and validation of social anxiety scale ...

    African Journals Online (AJOL)

    Little attention has been given to social anxiety in Nigeria despite its debilitating effects on the sufferers. The objective of this study was to develop, standardize and validate an instrument (Social Anxiety Scale) with high coefficients of Cronbach Alpha Internal Consistency Split-half reliability and construct validity.

  18. : Translated Scales in French: Social Anxiety and Taijin Kyofusho

    OpenAIRE

    Lacroix , Franca; Zhou , Biru

    2015-01-01

    This document contains 6 in-house translated scales (in French) that are related to social anxiety and Taijin Kyofusho. These translated scales are: Self Construal Scale (30 items), Brief Fear of Negative Evaluation Scale (12 items), Social Interaction Anxiety Scale (20 items), Social Anxiety - Causing Discomfort to Others (26 items), Taijin Kyofusho Scale (31 items), Modified version of Taijin Kyofusho Questionnaire (40 items).; Ce document contient la traduction en français de 6 échelles de...

  19. Social anxiety disorder: A critical overview of neurocognitive research

    NARCIS (Netherlands)

    Cremers, H.R.; Roelofs, K.

    2016-01-01

    Social anxiety is a common disorder characterized by a persistent and excessive fear of one or more social or performance situations. Behavioral inhibition is one of the early indicators of social anxiety, which later in life may advance into a certain personality structure (low extraversion and

  20. Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder.

    Science.gov (United States)

    Beesdo, Katja; Pine, Daniel S; Lieb, Roselind; Wittchen, Hans-Ulrich

    2010-01-01

    Controversy surrounds the diagnostic categorization of generalized anxiety disorder (GAD). To examine the incidence, comorbidity, and risk patterns for anxiety and depressive disorders and to test whether developmental features of GAD more strongly support a view of this condition as a depressive as opposed to an anxiety disorder. Face-to-face, 10-year prospective longitudinal and family study with as many as 4 assessment waves. The DSM-IV Munich Composite International Diagnostic Interview was administered by clinically trained interviewers. Munich, Germany. A community sample of 3021 individuals aged 14 to 24 years at baseline and 21 to 34 years at last follow-up. Cumulative incidence of GAD, other anxiety disorders (specific phobias, social phobia, agoraphobia, and panic disorder), and depressive disorders (major depressive disorder, and dysthymia). Longitudinal associations between GAD and depressive disorders are not stronger than those between GAD and anxiety disorders or between other anxiety and depressive disorders. Survival analyses reveal that the factors associated with GAD overlap more strongly with those specific to anxiety disorders than those specific to depressive disorders. In addition, GAD differs from anxiety and depressive disorders with regard to family climate and personality profiles. Anxiety and depressive disorders appear to differ with regard to risk constellations and temporal longitudinal patterns, and GAD is a heterogeneous disorder that is, overall, more closely related to other anxiety disorders than to depressive disorders. More work is needed to elucidate the potentially unique aspects of pathways and mechanisms involved in the etiopathogenesis of GAD. Grouping GAD with depressive disorders, as suggested by cross-sectional features and diagnostic comorbidity patterns, minimizes the importance of longitudinal data on risk factors and symptom trajectories.

  1. Examining the interrelationships between social anxiety, smoking to cope, and cigarette craving.

    Science.gov (United States)

    Watson, Noreen L; VanderVeen, Joseph W; Cohen, Lee M; DeMarree, Kenneth G; Morrell, Holly E R

    2012-08-01

    Smokers with symptoms of social anxiety often report smoking as a way to cope with negative affect. These individuals have lower success rates when attempting cessation compared with the general population. However, there is a paucity of research examining the role of social anxiety in nicotine dependence. The present study explored the relationships between symptoms of social anxiety, smoking to cope with these symptoms during social situations (STC), and cigarette craving. Thirty-eight participants completed measures of social anxiety and STC at baseline. Cigarette craving was subsequently assessed pre and post exposure to smoking-related images during periods of nicotine satiation and deprivation. Regression analyses revealed that greater symptoms of social anxiety predicted the frequency of STC behaviors and the number of cigarettes participants thought they would need in order to feel more comfortable in social situations. Symptoms of social anxiety and several behaviors associated with STC (e.g., avoiding social situations in which smoking is not permitted) predicted increases in craving during nicotine deprivation, but not satiation. These findings suggest that symptoms of social anxiety and STC behaviors may play a role in the maintenance of smoking behaviors. Further, targeting symptoms of social anxiety within the context of smoking cessation treatment may be particularly helpful and may improve the rates of smoking cessation among individuals with symptoms of social anxiety. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Social anxiety in physical activity participation in patients with mental illness: a cross-sectional multicenter study.

    Science.gov (United States)

    De Herdt, Amber; Knapen, Jan; Vancampfort, Davy; De Hert, Marc; Brunner, Emanuel; Probst, Michel

    2013-08-01

    Social anxiety (SA) is a frequent comorbid condition in patients with mental illness. However, no data exist regarding SA in physical activity (PA) situations. The aim of the present study was to measure the level of self-reported SA in PA participation in patients with mental illness compared to healthy controls. Six hundred ninety-three patients with mental illness and 2,888 controls aged between 18 and 65 years completed the Physical Activity and Sport Anxiety Scale (PASAS). Group and gender differences in PASAS scores were tested by ANOVA and Scheffé's post hoc test. After controlling for gender (P mental illness reported higher levels of SA in PA situations compared to healthy control subjects. Health professionals should consider SA when trying to improve outcome and adherence of patients with mental illness to PA interventions. © 2013 Wiley Periodicals, Inc.

  3. Linking Social Anxiety with Social Competence in Early Adolescence: Physiological and Coping Moderators.

    Science.gov (United States)

    Kaeppler, Alexander K; Erath, Stephen A

    2017-02-01

    Despite relatively universal feelings of discomfort in social situations, there is considerable evidence for diversity in the social behaviors and peer experiences of socially anxious youth. However, to date, very little research has been conducted with the aim of identifying factors that differentiate socially anxious youth who are more socially competent from those who are less socially competent. The present study addresses this gap in the literature by examining whether physiological and cognitive coping responses to social stress moderate the association between social anxiety and social competence. Participants were a community sample of 123 fifth and sixth graders (Mage = 12.03). Social anxiety was measured globally and in the context of a lab-based peer evaluation situation, and social competence was assessed via teacher-reports. Physiological (i.e., skin conductance level reactivity, SCLR, and respiratory sinus arrhythmia reactivity, RSAR) and coping (i.e., disengaged) responses to social stressors were also assessed. Results indicated that SCLR and disengaged coping with peer victimization moderated associations linking global and context-specific social anxiety with social competence, such that social anxiety was associated with lower social competence at lower levels of SCLR and higher levels of disengaged coping with peer victimization. Thus, whether socially anxious preadolescents exhibit more or less competent social behavior may depend, in part, on how they respond to peer-evaluative stress. Inflexible physiological responses and disengaged coping responses may undermine social competence, whereas engaged responses may counteract socially anxious preadolescents' tendency to withdraw from social interactions or focus primarily on threat cues.

  4. Amygdalar volumetric correlates of social anxiety in offspring of parents with bipolar disorder.

    Science.gov (United States)

    Park, Min-Hyeon; Garrett, Amy; Boucher, Spencer; Howe, Meghan; Sanders, Erica; Kim, Eunjoo; Singh, Manpreet; Chang, Kiki

    2015-11-30

    The prevalence of social anxiety disorder is high in offspring of parents with bipolar disorder (BD) and anxiety may be a significant risk factor in these youth for developing BD. We compared social anxiety symptoms between BD offspring with mood symptoms (high-risk group for developing BD I or II: HR) and healthy controls (HC). We also explored the correlations between the amygdalar volumes and social anxiety symptoms in the HR group with high social anxiety scores (HRHSA) due to the potential involvement of the amygdala in the pathophysiology of both BD and social anxiety. Youth participating in the study included 29h and 17HC of comparable age and gender. To assess social anxiety symptoms, we used the Multidimensional Anxiety Scale for Children (MASC) social anxiety subscale. The HR group's MASC social anxiety score was significantly higher than that of the HC group. Among the 29h, 17 subjects (58.6%) showed high social anxiety and they were classified as the HRHSA group. No significant difference was observed in amygdalar volume between the HRHSA and HC groups. However, there were significant negative correlations between amydalar volumes and MASC social anxiety score in the HRHSA group. These findings have implications for the link between amygdalar structure and both anxiety and mood control. This link may serve to implicate high social anxiety as a risk marker for future BD development. Copyright © 2015. Published by Elsevier Ireland Ltd.

  5. Cognitive indicators of social anxiety in youth: a structural equation analysis.

    Science.gov (United States)

    Rudy, Brittany M; Davis, Thompson E; Matthews, Russell A

    2014-01-01

    Previous studies have demonstrated significant relationships among various cognitive variables such as negative cognition, self-efficacy, and social anxiety. Unfortunately, few studies focus on the role of cognition among youth, and researchers often fail to use domain-specific measures when examining cognitive variables. Therefore, the purpose of the present study was to examine domain-specific cognitive variables (i.e., socially oriented negative self-referent cognition and social self-efficacy) and their relationships to social anxiety in children and adolescents using structural equation modeling techniques. A community sample of children and adolescents (n=245; 55.9% female; 83.3% Caucasian, 9.4% African American, 2% Asian, 2% Hispanic, 2% "other," and 1.2% not reported) completed questionnaires assessing social cognition and social anxiety symptomology. Three latent variables were created to examine the constructs of socially oriented negative self-referent cognition (as measured by the SONAS scale), social self-efficacy (as measured by the SEQSS-C), and social anxiety (as measured by the SPAI-C and the Brief SA). The resulting measurement model of latent variables fit the data well. Additionally, consistent with the study hypothesis, results indicated that social self-efficacy likely mediates the relationship between socially oriented negative self-referent cognition and social anxiety, and socially oriented negative self-referent cognition yields significant direct and indirect effects on social anxiety. These findings indicate that socially oriented negative cognitions are associated with youth's beliefs about social abilities and the experience of social anxiety. Future directions for research and study limitations, including use of cross-sectional data, are discussed. © 2013.

  6. A mixed methods survey of social anxiety, anxiety, depression and wig use in alopecia

    OpenAIRE

    Montgomery, K.; White, C.; Thompson, A. R.

    2017-01-01

    Objectives This study aimed to examine levels of social anxiety, anxiety and depression reported by people with alopecia as a result of a dermatological condition and associations with wig use. The study also sought to report on experiences of wearing wigs in social situations and the relationship with social confidence.\\ud \\ud Design A cross-sectional survey was sent by email to the Alopecia UK charity mailing list and advertised on social media.\\ud \\ud Participants Inclusion criteria were a...

  7. Early trauma, attachment experiences and comorbidities in schizophrenia

    Directory of Open Access Journals (Sweden)

    Thalita Gabínio

    2018-04-01

    Full Text Available Abstract Objective To evaluate attachment patterns in subjects with schizophrenia and their relationships to early traumatic events, psychotic symptoms and comorbidities. Methods Twenty patients diagnosed with schizophrenia according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5 underwent retrospective symptom assessment and careful assessment of the number and manner of childhood caregiver changes. The Diagnostic Interview for Psychosis and Affective Disorders (DI-PAD was used to assess symptoms related to schizophrenia (positive and negative symptoms, depression and mania. Anxiety disorder comorbidities were assessed by the Liebowitz Social Anxiety Scale (LSAS, Yale-Brown Obsessions and Compulsions Scale (Y-BOCS and Panic and Schizophrenia Interview (PaSI. Experience in Close Relationships – Relationship Structures (ECR-RS and Early Trauma Inventory Self Report-Short Form (ETISR-SF were used to assess attachment patterns and traumatic history, respectively. Results Moderate and significant correlations between attachment patterns and early trauma showed that greater severity of anxious attachment was predicted by a higher frequency of total early traumas (Spearman ρ = 0.446, p = 0.04, mainly general traumas (ρ = 0.526, p = 0.017; including parental illness and separation, as well as natural disaster and serious accidents. Among the correlations between early trauma and comorbid symptoms, panic attacks occurring before the onset of schizophrenia showed significant and positive correlations with ETISR-SF total scores and the sexual trauma subscale. Conclusion Children with an unstable early emotional life are more vulnerable to the development of psychopathology, such as panic anxiety symptoms. Traumatic events may also predict later schizophrenia.

  8. Specificity of dysfunctional thinking in children with symptoms of social anxiety, separation anxiety and generalised anxiety

    NARCIS (Netherlands)

    Bogels, S.M.; Snieder, N.; Kindt, M.

    2003-01-01

    The present study investigated whether children with high symptom levels of either social phobia (SP), separation anxiety disorder (SAD), or generalised anxiety disorder (GAD) are characterised by a specific set of dysfunctional interpretations that are consistent with the cognitive model of their

  9. Cognitive bias modification of interpretation in children with social anxiety disorder.

    Science.gov (United States)

    Orchard, Faith; Apetroaia, Adela; Clarke, Kiri; Creswell, Cathy

    2017-01-01

    Negative (or a lack of positive) interpretation of ambiguous social situations has been hypothesised to maintain social anxiety disorder in children, yet there is currently limited evidence to support this. Cognitive Bias Modification of Interpretation (CBM-I) provides a means to explore the causal influence of interpretation bias on social anxiety disorder, and has been associated with a reduction in social anxiety symptoms in adults. Seven to twelve year old children with a diagnosis of social anxiety disorder completed CBM-I training, adapted from materials designed for socially anxious children in the community, or no training. Effects on interpretation bias and social anxiety were assessed. The adapted CBM-I training was not associated with significant changes in benign or negative interpretation. Unsurprisingly given the lack of successful interpretation training, there were no significant changes in child or parent reported social anxiety symptoms, clinician-rated severity or diagnoses and change in interpretation was not significantly associated with change in social anxiety. These findings contrast with some studies with community populations although it is possible that more intensive CBM-I training is required to fully test this hypothesis among clinical groups. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. A Multivariate Genetic Analysis of Specific Phobia, Separation Anxiety and Social Phobia in Early Childhood

    Science.gov (United States)

    Eley, Thalia C.; Rijsdijk, Fruhling V.; Perrin, Sean; O'Connor, Thomas G.; Bolton, Derek

    2008-01-01

    Background: Comorbidity amongst anxiety disorders is very common in children as in adults and leads to considerable distress and impairment, yet is poorly understood. Multivariate genetic analyses can shed light on the origins of this comorbidity by revealing whether genetic or environmental risks for one disorder also influence another. We…

  11. Social Anxiety, Reasons for Drinking, and College Students

    Science.gov (United States)

    Norberg, Melissa M.; Norton, Alice R.; Olivier, Jake; Zvolensky, Michael J.

    2010-01-01

    Recent research suggests that social anxiety may be associated with higher rates of alcohol problems in women, yet may be associated with lower levels of drinking in men. The current study investigated putative mechanisms that may underlie potential gender differences in the social anxiety-alcohol relationship. One hundred and eighteen college…

  12. Social Anxiety as a Predictor of Dating Aggression

    Science.gov (United States)

    Hanby, Michelle S. R.; Fales, Jessica; Nangle, Douglas W.; Serwik, Agnieszka K.; Hedrich, Uriah J.

    2012-01-01

    By far, most research on the behavior of socially anxious individuals has focused on the "flight" rather than the "fight" response described in the traditional conceptualization of anxiety. More recently, however, there has been some speculation and emerging evidence suggesting that social anxiety and aggression may be related. The present study…

  13. A Neurobehavioral Mechanism Linking Behaviorally Inhibited Temperament and Later Adolescent Social Anxiety.

    Science.gov (United States)

    Buzzell, George A; Troller-Renfree, Sonya V; Barker, Tyson V; Bowman, Lindsay C; Chronis-Tuscano, Andrea; Henderson, Heather A; Kagan, Jerome; Pine, Daniel S; Fox, Nathan A

    2017-12-01

    Behavioral inhibition (BI) is a temperament identified in early childhood that is a risk factor for later social anxiety. However, mechanisms underlying the development of social anxiety remain unclear. To better understand the emergence of social anxiety, longitudinal studies investigating changes at behavioral neural levels are needed. BI was assessed in the laboratory at 2 and 3 years of age (N = 268). Children returned at 12 years, and an electroencephalogram was recorded while children performed a flanker task under 2 conditions: once while believing they were being observed by peers and once while not being observed. This methodology isolated changes in error monitoring (error-related negativity) and behavior (post-error reaction time slowing) as a function of social context. At 12 years, current social anxiety symptoms and lifetime diagnoses of social anxiety were obtained. Childhood BI prospectively predicted social-specific error-related negativity increases and social anxiety symptoms in adolescence; these symptoms directly related to clinical diagnoses. Serial mediation analysis showed that social error-related negativity changes explained relations between BI and social anxiety symptoms (n = 107) and diagnosis (n = 92), but only insofar as social context also led to increased post-error reaction time slowing (a measure of error preoccupation); this model was not significantly related to generalized anxiety. Results extend prior work on socially induced changes in error monitoring and error preoccupation. These measures could index a neurobehavioral mechanism linking BI to adolescent social anxiety symptoms and diagnosis. This mechanism could relate more strongly to social than to generalized anxiety in the peri-adolescent period. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. All rights reserved.

  14. The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia?

    Directory of Open Access Journals (Sweden)

    Myriam Rudaz

    Full Text Available Theories of anxiety disorders and phobias have ascribed a critical role to avoidance behavior in explaining the persistence of fear and anxiety, but knowledge about the role of avoidance behavior in the maintenance of anxiety in social anxiety disorder relative to specific phobia is lacking. This study examined the extent to which avoidance behavior moderates the relationship between general anxiety at baseline and 18 months later in women with a diagnosed social anxiety disorder (n = 91 and women with a diagnosed specific phobia (n = 130 at baseline. Circumscribed avoidance of social and specific situations were clinician-rated using the Anxiety Disorders Interview Schedule-Lifetime (ADIS-IV-L, and general anxiety was measured using the Beck Anxiety Inventory (BAI. Moderated regression analyses revealed that (a general anxiety at baseline predicted general anxiety at follow-up in both women with a specific phobia and women with a social anxiety disorder and (b avoidance behavior moderated this relationship in women with a specific phobia but not in women with a social anxiety disorder. Specifically, high avoidance behavior was found to amplify the effect between general anxiety at baseline and follow-up in specific phobia. Reasons for the absence of a similar moderating effect of avoidance behavior within social anxiety disorder are discussed.

  15. The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia?

    Science.gov (United States)

    Rudaz, Myriam; Ledermann, Thomas; Margraf, Jürgen; Becker, Eni S.; Craske, Michelle G.

    2017-01-01

    Theories of anxiety disorders and phobias have ascribed a critical role to avoidance behavior in explaining the persistence of fear and anxiety, but knowledge about the role of avoidance behavior in the maintenance of anxiety in social anxiety disorder relative to specific phobia is lacking. This study examined the extent to which avoidance behavior moderates the relationship between general anxiety at baseline and 18 months later in women with a diagnosed social anxiety disorder (n = 91) and women with a diagnosed specific phobia (n = 130) at baseline. Circumscribed avoidance of social and specific situations were clinician-rated using the Anxiety Disorders Interview Schedule-Lifetime (ADIS-IV-L), and general anxiety was measured using the Beck Anxiety Inventory (BAI). Moderated regression analyses revealed that (a) general anxiety at baseline predicted general anxiety at follow-up in both women with a specific phobia and women with a social anxiety disorder and (b) avoidance behavior moderated this relationship in women with a specific phobia but not in women with a social anxiety disorder. Specifically, high avoidance behavior was found to amplify the effect between general anxiety at baseline and follow-up in specific phobia. Reasons for the absence of a similar moderating effect of avoidance behavior within social anxiety disorder are discussed. PMID:28671977

  16. The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia?

    Science.gov (United States)

    Rudaz, Myriam; Ledermann, Thomas; Margraf, Jürgen; Becker, Eni S; Craske, Michelle G

    2017-01-01

    Theories of anxiety disorders and phobias have ascribed a critical role to avoidance behavior in explaining the persistence of fear and anxiety, but knowledge about the role of avoidance behavior in the maintenance of anxiety in social anxiety disorder relative to specific phobia is lacking. This study examined the extent to which avoidance behavior moderates the relationship between general anxiety at baseline and 18 months later in women with a diagnosed social anxiety disorder (n = 91) and women with a diagnosed specific phobia (n = 130) at baseline. Circumscribed avoidance of social and specific situations were clinician-rated using the Anxiety Disorders Interview Schedule-Lifetime (ADIS-IV-L), and general anxiety was measured using the Beck Anxiety Inventory (BAI). Moderated regression analyses revealed that (a) general anxiety at baseline predicted general anxiety at follow-up in both women with a specific phobia and women with a social anxiety disorder and (b) avoidance behavior moderated this relationship in women with a specific phobia but not in women with a social anxiety disorder. Specifically, high avoidance behavior was found to amplify the effect between general anxiety at baseline and follow-up in specific phobia. Reasons for the absence of a similar moderating effect of avoidance behavior within social anxiety disorder are discussed.

  17. Antisocial personality disorder and anxiety disorder: a diagnostic variant?

    Science.gov (United States)

    Coid, Jeremy; Ullrich, Simone

    2010-06-01

    Antisocial personality disorder (ASPD) with co-morbid anxiety disorder may be a variant of ASPD with different etiology and treatment requirements. We investigated diagnostic co-morbidity, ASPD criteria, and anxiety/affective symptoms of ASPD/anxiety disorder. Weighted analyses were carried out using survey data from a representative British household sample. ASPD/anxiety disorder demonstrated differing patterns of antisocial criteria, co-morbidity with clinical syndromes, psychotic symptoms, and other personality disorders compared to ASPD alone. ASPD criteria demonstrated specific associations with CIS-R scores of anxiety and affective symptoms. Findings suggest ASPD/anxiety disorder is a variant of ASPD, determined by symptoms of anxiety. Although co-morbid anxiety and affective symptoms are the same as in anxiety disorder alone, associations with psychotic symptoms require further investigation. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Processing bias in children with separation anxiety disorder, social phobia and generalised anxiety disorder

    NARCIS (Netherlands)

    Kindt, M.; Bögels, S.M.; Morren, M.

    2003-01-01

    The present study examined processing bias in children suffering from anxiety disorders. Processing bias was assessed using of the emotional Stroop task in clinically referred children with separation anxiety disorder (SAD), social phobia (SP), and/or generalised anxiety disorder (GAD) and normal

  19. Bipolar Disorder and Obsessive Compulsive Disorder Comorbidity

    Directory of Open Access Journals (Sweden)

    Necla Keskin

    2014-08-01

    Full Text Available The comorbidity of bipolar disorder and anxiety disorders is a well known concept. Obsessive-compulsive disorder is the most commonly seen comorbid anxiety disorder in bipolar patients. Some genetic variants, neurotransmitters especially serotonergic systems and second-messenger systems are thought to be responsible for its etiology. Bipolar disorder alters the clinical aspects of obsessive compulsive disorder and is associated with poorer outcome. The determination of comorbidity between bipolar disorder and obsessive compulsive disorder is quite important for appropriate clinical management and treatment. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 429-437

  20. Gender Differences in ADHD Subtype Comorbidity

    Science.gov (United States)

    Levy, Florence; Hay, David A.; Bennett, Kellie S.; McStephen, Michael

    2005-01-01

    Objective: To examine gender differences in attention-deficit/hyperactivity disorder ("ADHD") symptom comorbidity with "oppositional defiant disorder", "conduct disorder", "separation anxiety disorder", "generalized anxiety disorder", speech therapy, and remedial reading in children. Method: From…

  1. In Systemic Sclerosis, Anxiety and Depression Assessed by Hospital Anxiety Depression Scale Are Independently Associated with Disability and Psychological Factors

    Directory of Open Access Journals (Sweden)

    Angela Del Rosso

    2013-01-01

    Full Text Available Background. Anxious and depressive symptoms are frequent in Systemic Sclerosis (SSc. Our objective is to assess their prevalence and association with district and global disability and psychological variables. Methods. 119 SSc patients were assessed by Hospital Anxiety Depression Scale (HADS. Clinical depression and anxiety were defined for HADS score cutoff ≥8. Patients were assessed for psychological symptoms (RSES, COPE-NIV, hand (HAMIS, CHFDS, fist closure, and hand opening and face disability (MHISS, mouth opening, global disability, and fatigue (HAQ, FACIT. Results. Both depression and anxiety in SSc are 36%. Depressive patients with comorbid anxiety have higher HADS-D score than patients with depression only (. HADS-A and -D are positively correlated with global disability, hands and mouth disability, fatigue, self-esteem and avoidance coping strategy, and, only HADS-A, also with social support (. By multiple regression, HADS-D is independently associated with FACIT-F (, RSES (, and MHISS total score (, together explaining 50% of variance. HADS-A is independently associated with RSES (, COPE-NIV SA (, COPE-NIV SS (, FACIT-F (, and MHISS mouth opening (, explaining 41% of variance. Conclusions. In SSc depression and anxiety correlate to local and global disabilities and psychological characteristics. Depressive patients with comorbid anxiety have higher level of depressive symptoms.

  2. Refining and validating the Social Interaction Anxiety Scale and the Social Phobia Scale.

    Science.gov (United States)

    Carleton, R Nicholas; Collimore, Kelsey C; Asmundson, Gordon J G; McCabe, Randi E; Rowa, Karen; Antony, Martin M

    2009-01-01

    The Social Interaction Anxiety Scale and Social Phobia Scale are companion measures for assessing symptoms of social anxiety and social phobia. The scales have good reliability and validity across several samples, however, exploratory and confirmatory factor analyses have yielded solutions comprising substantially different item content and factor structures. These discrepancies are likely the result of analyzing items from each scale separately or simultaneously. The current investigation sets out to assess items from those scales, both simultaneously and separately, using exploratory and confirmatory factor analyses in an effort to resolve the factor structure. Participants consisted of a clinical sample (n 5353; 54% women) and an undergraduate sample (n 5317; 75% women) who completed the Social Interaction Anxiety Scale and Social Phobia Scale, along with additional fear-related measures to assess convergent and discriminant validity. A three-factor solution with a reduced set of items was found to be most stable, irrespective of whether the items from each scale are assessed together or separately. Items from the Social Interaction Anxiety Scale represented one factor, whereas items from the Social Phobia Scale represented two other factors. Initial support for scale and factor validity, along with implications and recommendations for future research, is provided. (c) 2009 Wiley-Liss, Inc.

  3. Social anxiety impacts willingness to participate in addiction treatment.

    Science.gov (United States)

    Book, Sarah W; Thomas, Suzanne E; Dempsey, Jared P; Randall, Patrick K; Randall, Carrie L

    2009-05-01

    Individuals with social anxiety have difficulty participating in group settings. Although it makes intuitive sense that social anxiety could present a challenge in addiction treatment settings, which often involve small groups and encouragement to participate in self-help groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), to our knowledge no study has yet assessed the impact of shyness on the treatment experience. Assessment surveys were given to 110 individuals seeking intensive outpatient substance abuse treatment at three community treatment programs. Established cut-offs for presence of clinically-significant social anxiety indicated a prevalence of 37%. Controlling for depression and worry, social anxiety was a unique predictor of endorsement that shyness interfered with willingness to talk to a therapist, speak up in group therapy, attend AA/NA, and ask somebody to be a sponsor. Socially anxious substance abusers were 4-8 times more likely to endorse that shyness interfered with addiction treatment activities. These findings have clinical and research implications.

  4. Loneliness over time: The crucial role of social anxiety.

    Science.gov (United States)

    Lim, Michelle H; Rodebaugh, Thomas L; Zyphur, Michael J; Gleeson, John F M

    2016-07-01

    Loneliness is known to be associated with multiple adverse physical outcomes, including higher mortality and morbidity risk. However, the impact of loneliness on mental health is less well researched, with most studies assessing how loneliness relates to depressive symptoms alone. We hypothesized that 2 mental health symptoms that relate to the fear of others-social anxiety and paranoia-would contribute to loneliness. We examined how loneliness relates to social anxiety, paranoia, and depression symptoms in a general community sample aged 18-87 years old (N = 1,010). We administered online measures over 3 time points across a 6-month period. In a cross-lagged structural equation model controlling for trait levels and prior states, our results indicated that earlier loneliness positively predicted future states of social anxiety, paranoia, and depression. However, in the same model, earlier social anxiety was the only predictor of future loneliness. These results suggest that loneliness may be a potential antecedent to emerging mental health symptoms and that identifying and treating co-occurring social anxiety symptoms may reduce the severity of loneliness. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  5. Parental and Peer Predictors of Social Anxiety in Youth

    Science.gov (United States)

    Festa, Candice C.; Ginsburg, Golda S.

    2011-01-01

    The aim of the current study was to extend etiological models of social anxiety in youth by examining the relative importance of parental (i.e., parental anxiety, rejection, and overcontrol) and peer factors (i.e., social acceptance, social support, and friendship quality). Sixty-three youth (ages 7-12; 52% male) and their parents participated in…

  6. Social Anxiety and Sociometric Nomination in Spanish Students of Compulsory Secondary Education.

    Science.gov (United States)

    Delgado, Beatriz; Inglés, Cándido J; Aparisi, David; García-Fernández, José M

    2016-07-18

    Adolescents with social anxiety can manifest great interference in their relationship with classmates and other peers, as well as in their school performance. The aim of this study was to analyze the sociometric nominations and assessment of students with high social anxiety by their peers and teachers, and to determine whether these assessments differ significantly between evaluators (peers vs. teachers), in a sample of 2022 (51.1% male) Spanish adolescents aged between 12 and 16 years. Social anxiety was assessed using the Social Phobia and Anxiety Inventory questionnaire. Sociometric identification and assessment of various educational aspects of the students was performed through the Socio program and Teacher assessment scales, respectively. Results show that students with high social anxiety were nominated by peers as popular, rejected and neglected with the same frequency and proportionately less nominated as leaders, friendly, cooperative, and quarrelsome students than those without high social anxiety (d .97). Finally, peers significantly nominated students with high social anxiety more as leaders, cooperative, quarrelsome, obedient and good students than their teachers (d social anxiety are valued and nominated by their peers and teachers differently.

  7. The Effect of Social Anxiety on Urge and Craving among Smokers with and without Anxiety Disorders

    Science.gov (United States)

    Kimbrel, Nathan A.; Morissette, Sandra B.; Gulliver, Suzy B.; Langdon, Kirsten J.; Zvolensky, Michael J.

    2014-01-01

    Background Despite the often social nature of smoking, relatively little research has been conducted on the relationship between smoking and social anxiety disorder (SAD). Method Participants (N = 99) included 34 smokers without current mental health disorders, 37 smokers with SAD, and 28 smokers who met criteria for other anxiety disorder diagnoses (e.g., panic disorder or generalized anxiety disorder, but not SAD). Nicotine and placebo patches were administered to participants in a counterbalanced manner across two assessment days. Urge and craving were assessed before and after a 5-hour nicotine absorption/deprivation period. Results Compared to smokers without current mental health disorders, smokers with SAD did not report greater nicotine dependence, but did endorse greater motivation to use nicotine to avoid negative outcomes. In addition, after controlling for demographic variables, smoking characteristics, pre-deprivation urge and craving, and other anxiety/depression symptoms, social anxiety symptoms uniquely predicted urge and craving in the placebo patch condition; however, social anxiety had no influence on urge and craving in the nicotine patch condition. Conclusions These findings suggest that one potential reason that smokers with SAD may have worse cessation outcomes is that they may experience higher levels of craving and urge to smoke during quit attempts. Thus, during a quit attempt, particularly in the absence of nicotine replacement therapy, smokers with SAD are likely to benefit from additional treatment aimed at managing or reducing their social anxiety symptoms. PMID:24331637

  8. Post-event Processing Predicts Impaired Cortisol Recovery Following Social Stressor: The Moderating Role of Social Anxiety.

    Science.gov (United States)

    Maeda, Shunta; Sato, Tomoya; Shimada, Hironori; Tsumura, Hideki

    2017-01-01

    There is growing evidence that individuals with social anxiety show impaired cortisol recovery after experiencing social evaluative stressors. Yet, little is known regarding the cognitive processes underlying such impaired cortisol recovery. The present study examined the effect of post-event processing (PEP), referred to as repetitive thinking about social situations, on cortisol recovery following a social stressor. Forty-two non-clinical university students (23 women, 19 men, mean age = 22.0 ± 2.0 years) completed the Trier Social Stress Test (TSST), followed by a thought sampling procedure which assessed the frequency of PEP reflecting the TSST. A growth curve model showed PEP and social anxiety interactively predicted cortisol recovery. In particular, PEP predicted impaired cortisol recovery in those with low levels of social anxiety but not in those with high levels of social anxiety, which contradicted the initial hypothesis. These findings suggest that PEP is differentially associated with cortisol recovery depending on levels of social anxiety. The possible mechanisms underlying these findings were discussed in terms of protective inhibition framework.

  9. Exercise dependence, social physique anxiety, and social support in experienced and inexperienced bodybuilders and weightlifters

    Science.gov (United States)

    Hurst, R.; Hale, B.; Smith, D.; Collins, D.

    2000-01-01

    Objectives—To investigate psychological correlates of exercise dependence in experienced and inexperienced bodybuilders and weightlifters. Secondary objectives included measuring social physique anxiety, bodybuilding identity, and social support among bodybuilders and weightlifters. Methods—Thirty five experienced bodybuilders, 31 inexperienced bodybuilders, and 23 weightlifters completed the bodybuilding dependence scale, a bodybuilding version of the athletic identity measurement scale, the social physique anxiety scale, and an adapted version of the social support survey-clinical form. Results—A between subjects multivariate analysis of variance was calculated on the scores of the three groups of lifters for the four questionnaires. Univariate F tests and follow up tests indicated that experienced bodybuilders scored significantly higher than inexperienced bodybuilders and weightlifters on bodybuilding dependence (pbodybuilding identity (pbodybuilders exhibit more exercise dependence, show greater social support behaviour, and experience less social physique anxiety than inexperienced bodybuilders and weightlifters. Key Words: bodybuilding; exercise dependence; social physical anxiety; social support; athletic identity PMID:11131230

  10. A false sense of security: safety behaviors erode objective speech performance in individuals with social anxiety disorder.

    Science.gov (United States)

    Rowa, Karen; Paulitzki, Jeffrey R; Ierullo, Maria D; Chiang, Brenda; Antony, Martin M; McCabe, Randi E; Moscovitch, David A

    2015-05-01

    In the current study, 55 participants with a diagnosis of generalized social anxiety disorder (SAD), 23 participants with a diagnosis of an anxiety disorder other than SAD with no comorbid SAD, and 50 healthy controls completed a speech task as well as self-reported measures of safety behavior use. Speeches were videotaped and coded for global and specific indicators of performance by two raters who were blind to participants' diagnostic status. Results suggested that the objective performance of people with SAD was poorer than that of both control groups, who did not differ from each other. Moreover, self-reported use of safety behaviors during the speech strongly mediated the relationship between diagnostic group and observers' performance ratings. These results are consistent with contemporary cognitive-behavioral and interpersonal models of SAD and suggest that socially anxious individuals' performance skills may be undermined by the use of safety behaviors. These data provide further support for recommendations from previous studies that the elimination of safety behaviors ought to be a priority in cognitive behavioral therapy for SAD. Copyright © 2014. Published by Elsevier Ltd.

  11. Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial.

    Science.gov (United States)

    Kampmann, Isabel L; Emmelkamp, Paul M G; Hartanto, Dwi; Brinkman, Willem-Paul; Zijlstra, Bonne J H; Morina, Nexhmedin

    2016-02-01

    This randomized controlled trial investigated the efficacy of a stand-alone virtual reality exposure intervention comprising verbal interaction with virtual humans to target heterogeneous social fears in participants with social anxiety disorder. Sixty participants (Mage = 36.9 years; 63.3% women) diagnosed with social anxiety disorder were randomly assigned to individual virtual reality exposure therapy (VRET), individual in vivo exposure therapy (iVET), or waiting-list. Multilevel regression analyses revealed that both treatment groups improved from pre-to postassessment on social anxiety symptoms, speech duration, perceived stress, and avoidant personality disorder related beliefs when compared to the waiting-list. Participants receiving iVET, but not VRET, improved on fear of negative evaluation, speech performance, general anxiety, depression, and quality of life relative to those on waiting-list. The iVET condition was further superior to the VRET condition regarding decreases in social anxiety symptoms at post- and follow-up assessments, and avoidant personality disorder related beliefs at follow-up. At follow-up, all improvements were significant for iVET. For VRET, only the effect for perceived stress was significant. VRET containing extensive verbal interaction without any cognitive components can effectively reduce complaints of generalized social anxiety disorder. Future technological and psychological improvements of virtual social interactions might further enhance the efficacy of VRET for social anxiety disorder. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Evaluating and treating anxiety disorders in medical settings.

    OpenAIRE

    Ball S; Goddard A; Shekhar A

    2002-01-01

    Anxiety disorders and medical illness present to the primary care physician as a common comorbidity. This article aims to review the literature on the prevalence of anxiety disorders in patients presenting to primary care physicians; to address the key issues in assessing the comorbid condition; and to discuss psychological and pharmacological treatment options for patients with a comorbid anxiety disorder and medical illness. Anxiety disorders are highly prevalent within the primary care pop...

  13. Implicit and Explicit Self-Esteem in Current, Remitted, Recovered, and Comorbid Depression and Anxiety Disorders: The NESDA Study

    Science.gov (United States)

    van Tuijl, Lonneke A.; Glashouwer, Klaske A.; Bockting, Claudi L. H.; Tendeiro, Jorge N.; Penninx, Brenda W. J. H.; de Jong, Peter J.

    2016-01-01

    Background Dual processing models of psychopathology emphasize the relevance of differentiating between deliberative self-evaluative processes (explicit self-esteem; ESE) and automatically-elicited affective self-associations (implicit self-esteem; ISE). It has been proposed that both low ESE and ISE would be involved in major depressive disorder (MDD) and anxiety disorders (AD). Further, it has been hypothesized that MDD and AD may result in a low ISE “scar” that may contribute to recurrence after remission. However, the available evidence provides no straightforward support for the relevance of low ISE in MDD/AD, and studies testing the relevance of discrepant SE even showed that especially high ISE combined with low ESE is predictive of the development of internalizing symptoms. However, these earlier findings have been limited by small sample sizes, poorly defined groups in terms of comorbidity and phase of the disorders, and by using inadequate indices of discrepant SE. Therefore, this study tested further the proposed role of ISE and discrepant SE in a large-scale study allowing for stricter differentiation between groups and phase of disorder. Method In the context of the Netherlands Study of Depression and Anxiety (NESDA), we selected participants with current MDD (n = 60), AD (n = 111), and comorbid MDD/AD (n = 71), remitted MDD (n = 41), AD (n = 29), and comorbid MDD/AD (n = 14), recovered MDD (n = 136) and AD (n = 98), and never MDD or AD controls (n = 382). The Implicit Association Test was used to index ISE and the Rosenberg Self-Esteem Scale indexed ESE. Results Controls reported higher ESE than all other groups, and current comorbid MDD/AD had lower ESE than all other clinical groups. ISE was only lower than controls in current comorbid AD/MDD. Discrepant self-esteem (difference between ISE and ESE) was not associated with disorder status once controlling for ESE. Limitations Cross-sectional design limits causal inferences. Conclusion Findings

  14. Implicit and Explicit Self-Esteem in Current, Remitted, Recovered, and Comorbid Depression and Anxiety Disorders: The NESDA Study.

    Directory of Open Access Journals (Sweden)

    Lonneke A van Tuijl

    Full Text Available Dual processing models of psychopathology emphasize the relevance of differentiating between deliberative self-evaluative processes (explicit self-esteem; ESE and automatically-elicited affective self-associations (implicit self-esteem; ISE. It has been proposed that both low ESE and ISE would be involved in major depressive disorder (MDD and anxiety disorders (AD. Further, it has been hypothesized that MDD and AD may result in a low ISE "scar" that may contribute to recurrence after remission. However, the available evidence provides no straightforward support for the relevance of low ISE in MDD/AD, and studies testing the relevance of discrepant SE even showed that especially high ISE combined with low ESE is predictive of the development of internalizing symptoms. However, these earlier findings have been limited by small sample sizes, poorly defined groups in terms of comorbidity and phase of the disorders, and by using inadequate indices of discrepant SE. Therefore, this study tested further the proposed role of ISE and discrepant SE in a large-scale study allowing for stricter differentiation between groups and phase of disorder.In the context of the Netherlands Study of Depression and Anxiety (NESDA, we selected participants with current MDD (n = 60, AD (n = 111, and comorbid MDD/AD (n = 71, remitted MDD (n = 41, AD (n = 29, and comorbid MDD/AD (n = 14, recovered MDD (n = 136 and AD (n = 98, and never MDD or AD controls (n = 382. The Implicit Association Test was used to index ISE and the Rosenberg Self-Esteem Scale indexed ESE.Controls reported higher ESE than all other groups, and current comorbid MDD/AD had lower ESE than all other clinical groups. ISE was only lower than controls in current comorbid AD/MDD. Discrepant self-esteem (difference between ISE and ESE was not associated with disorder status once controlling for ESE.Cross-sectional design limits causal inferences.Findings suggest a prominent role for ESE in MDD and AD, while

  15. Implicit and Explicit Self-Esteem in Current, Remitted, Recovered, and Comorbid Depression and Anxiety Disorders: The NESDA Study.

    Science.gov (United States)

    van Tuijl, Lonneke A; Glashouwer, Klaske A; Bockting, Claudi L H; Tendeiro, Jorge N; Penninx, Brenda W J H; de Jong, Peter J

    2016-01-01

    Dual processing models of psychopathology emphasize the relevance of differentiating between deliberative self-evaluative processes (explicit self-esteem; ESE) and automatically-elicited affective self-associations (implicit self-esteem; ISE). It has been proposed that both low ESE and ISE would be involved in major depressive disorder (MDD) and anxiety disorders (AD). Further, it has been hypothesized that MDD and AD may result in a low ISE "scar" that may contribute to recurrence after remission. However, the available evidence provides no straightforward support for the relevance of low ISE in MDD/AD, and studies testing the relevance of discrepant SE even showed that especially high ISE combined with low ESE is predictive of the development of internalizing symptoms. However, these earlier findings have been limited by small sample sizes, poorly defined groups in terms of comorbidity and phase of the disorders, and by using inadequate indices of discrepant SE. Therefore, this study tested further the proposed role of ISE and discrepant SE in a large-scale study allowing for stricter differentiation between groups and phase of disorder. In the context of the Netherlands Study of Depression and Anxiety (NESDA), we selected participants with current MDD (n = 60), AD (n = 111), and comorbid MDD/AD (n = 71), remitted MDD (n = 41), AD (n = 29), and comorbid MDD/AD (n = 14), recovered MDD (n = 136) and AD (n = 98), and never MDD or AD controls (n = 382). The Implicit Association Test was used to index ISE and the Rosenberg Self-Esteem Scale indexed ESE. Controls reported higher ESE than all other groups, and current comorbid MDD/AD had lower ESE than all other clinical groups. ISE was only lower than controls in current comorbid AD/MDD. Discrepant self-esteem (difference between ISE and ESE) was not associated with disorder status once controlling for ESE. Cross-sectional design limits causal inferences. Findings suggest a prominent role for ESE in MDD and AD, while

  16. Social phobia : diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment

    NARCIS (Netherlands)

    Brunello, N; den Boer, JA; Judd, LL; Kasper, S; Kelsey, JE; Lader, M; Lecrubier, Y; Lepine, JP; Lydiard, RB; Mendlewicz, J; Montgomery, SA; Racagni, G; Stein, MB; Wittchen, HU

    2000-01-01

    Social phobia is a common disorder associated with significant psychosocial impairment, representing a substantial public health problem largely determined by the high prevalence, and the lifelong chronicity. Social phobia starts in early childhood or adolescence and is often comorbid with

  17. Evaluating and treating anxiety disorders in medical settings.

    Directory of Open Access Journals (Sweden)

    Ball S

    2002-10-01

    Full Text Available Anxiety disorders and medical illness present to the primary care physician as a common comorbidity. This article aims to review the literature on the prevalence of anxiety disorders in patients presenting to primary care physicians; to address the key issues in assessing the comorbid condition; and to discuss psychological and pharmacological treatment options for patients with a comorbid anxiety disorder and medical illness. Anxiety disorders are highly prevalent within the primary care population, and these disorders significantly impact the patient′s course and outcome. Fortunately, primary care physicians have a variety of effective cognitive, behavioral and pharmacological interventions available for managing these patients with comorbid anxiety and medical illnesses.

  18. Social impressions while drinking account for the relationship between alcohol-related problems and social anxiety.

    Science.gov (United States)

    Buckner, Julia D; Matthews, Russell A

    2012-04-01

    Individuals with elevated social anxiety appear particularly vulnerable to experiencing alcohol-related problems; yet we know little about factors that may account for this relationship. One possibility is that socially anxious individuals hold beliefs about the impressions they make on others while drinking and these beliefs play an important role in their drinking behaviors. The present study used exploratory factor analysis among participants with clinically elevated social anxiety (n=166) to develop a measure, the Social Impressions while Drinking Scale (SIDS), to assess beliefs regarding others' impressions of drinking behaviors that may be particularly relevant to socially anxious individuals. A valuations scale was also developed to assess the importance of each belief. Empirically-derived subscales were identified with adequate reliability. Among socially anxious participants, the Gregarious and Sexual Facilitation subscales were uniquely related to drinking problems and frequency respectively. Individuals with clinically meaningful social anxiety achieved higher scores on all SIDS subscales compared to those with lower social anxiety (n=166). Several SIDS scales mediated the relations between social anxiety group status and drinking problems (Interaction Fears, Observation Fears, Aggression, Gregariousness). Results highlight the importance of examining beliefs specific to high-risk populations in assessing their alcohol-related behaviors. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Neural mechanisms of proactive and reactive cognitive control in social anxiety.

    Science.gov (United States)

    Schmid, Petra C; Kleiman, Tali; Amodio, David M

    2015-09-01

    Social anxiety--the fear of social embarrassment and negative evaluation by others--ranks among people's worst fears, and it is often thought to impair task performance. We investigated the neurocognitive processes through which trait social anxiety relates to task performance, proposing a model of the joint contributions of reactive control, theoretically associated with conflict monitoring and activity of the dorsal anterior cingulate cortex (dACC), and proactive control, theoretically associated with top-down regulation and activity of the dorsolateral prefrontal cortex (dlPFC). Participants varying in their degree of trait social anxiety completed the Eriksen flanker task while electroencephalography (EEG) was recorded. Task-related left dlPFC activity was indexed by relative left prefrontal EEG (inverse alpha), and conflict-related dACC activity was indexed by the N2r component of the event-related potential. Stronger activity in both regions predicted better response control, and greater social anxiety was associated with worse response control. Furthermore, for all participants, greater left prefrontal EEG activity predicted better behavioral control, but for high social anxiety participants only, greater N2r responses also predicted behavioral control. This pattern suggests that low social anxiety individuals engaged a proactive control process, driven by dlPFC activity, whereas high social anxiety individuals relied additionally on a reactive control process, driven by conflict-related dACC activity. These findings support a model of control that involves different patterns of interplay between proactive and reactive strategies and may help to explain self-regulatory impairments in social anxiety. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Gaining Insight into Adolescent Vulnerability for Social Anxiety from Developmental Cognitive Neuroscience

    OpenAIRE

    Caouette, Justin D.; Guyer, Amanda E.

    2013-01-01

    Social anxiety disorder (SAD) markedly impairs daily functioning. For adolescents, SAD can constrain typical development precisely when social experiences broaden, peers’ opinions are highly salient, and social approval is actively sought. Individuals with extreme, impairing social anxiety fear evaluation from others, avoid social interactions, and interpret ambiguous social cues as threatening. Yet some degree of social anxiety can be normative and non-impairing. Furthermore, a temperament o...

  1. Marijuana Effect Expectancies: Relations to Social Anxiety and Marijuana Use Problems

    OpenAIRE

    Buckner, Julia D.; Schmidt, Norman B.

    2008-01-01

    High social anxiety is related to marijuana problems, yet the nature of this relation remains unclear. We examined relations between marijuana effect expectancies, social anxiety, and marijuana among undergraduates (N=337). Social anxiety was related positively to negative expectancies and negatively to Tension Reduction Expectancies. Among socially anxious individuals, greater belief that marijuana produces cognitive/behavioral impairment was associated with greater marijuana use rates. Nega...

  2. Predictors of social anxiety in an opioid dependent sample and a control sample.

    Science.gov (United States)

    Shand, Fiona L; Degenhardt, Louisa; Nelson, Elliot C; Mattick, Richard P

    2010-01-01

    Compared to other mental health problems, social anxiety is under-acknowledged amongst opioid dependent populations. This study aimed to assess levels of social anxiety and identify its predictors in an opioid dependent sample and a matched control group. Opioid dependent participants (n=1385) and controls (n=417) completed the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS) and a diagnostic interview. Regression analyses were used to test a range of predictors of social anxiety. Opioid dependent cases had higher mean scores on both scales compared to controls. Predictors of social anxiety centred on emotional rejection in childhood, either by parents or peers. For opioid dependent cases, but not controls, lifetime non-opioid substance dependence (cannabis, sedatives, and tobacco) was associated with higher levels of social anxiety. However, much of the variance in social anxiety remains unexplained for this population.

  3. More than a face: A unified theoretical perspective on nonverbal social cue processing in social anxiety

    Directory of Open Access Journals (Sweden)

    Eva eGilboa-Schechtman

    2013-12-01

    Full Text Available Processing of nonverbal social cues (NVSCs is essential to interpersonal functioning and is particularly relevant to models of social anxiety. This article provides a review of the literature on NVSC processing from the perspective of social rank and affiliation biobehavioral systems, based on functional analysis of human sociality. We examine the potential of this framework for integrating cognitive, interpersonal, and evolutionary accounts of social anxiety. We argue that NVSCs are uniquely suited to rapid and effective conveyance of emotional, motivational, and trait information and that various channels are differentially effective in transmitting such information. First, we review studies on perception of NVSCs through face, voice, and body. We begin with studies that utilized information processing or imaging paradigms to assess NVSC perception. This research demonstrated that social anxiety is associated with biased attention to, and interpretation of, emotional facial expressions and emotional prosody. Findings regarding body and posture remain scarce. Next, we review studies on NVSC expression, which pinpointed links between social anxiety and disturbances in eye gaze, facial expressivity, and vocal properties of spontaneous and planned speech. Again, links between social anxiety and posture were understudied. Although cognitive, interpersonal, and evolutionary theories have described different pathways to social anxiety, all three models focus on interrelations among cognition, subjective experience, and social behavior. NVSC processing and production comprise the juncture where these theories intersect. In light of the conceptualizations emerging from the review, we highlight several directions for future research including focus on NVSCs as indexing reactions to changes in belongingness and social rank, the moderating role of gender, and the therapeutic opportunities offered by embodied cognition to treat social anxiety.

  4. More than a face: a unified theoretical perspective on nonverbal social cue processing in social anxiety

    Science.gov (United States)

    Gilboa-Schechtman, Eva; Shachar-Lavie, Iris

    2013-01-01

    Processing of nonverbal social cues (NVSCs) is essential to interpersonal functioning and is particularly relevant to models of social anxiety. This article provides a review of the literature on NVSC processing from the perspective of social rank and affiliation biobehavioral systems (ABSs), based on functional analysis of human sociality. We examine the potential of this framework for integrating cognitive, interpersonal, and evolutionary accounts of social anxiety. We argue that NVSCs are uniquely suited to rapid and effective conveyance of emotional, motivational, and trait information and that various channels are differentially effective in transmitting such information. First, we review studies on perception of NVSCs through face, voice, and body. We begin with studies that utilized information processing or imaging paradigms to assess NVSC perception. This research demonstrated that social anxiety is associated with biased attention to, and interpretation of, emotional facial expressions (EFEs) and emotional prosody. Findings regarding body and posture remain scarce. Next, we review studies on NVSC expression, which pinpointed links between social anxiety and disturbances in eye gaze, facial expressivity, and vocal properties of spontaneous and planned speech. Again, links between social anxiety and posture were understudied. Although cognitive, interpersonal, and evolutionary theories have described different pathways to social anxiety, all three models focus on interrelations among cognition, subjective experience, and social behavior. NVSC processing and production comprise the juncture where these theories intersect. In light of the conceptualizations emerging from the review, we highlight several directions for future research including focus on NVSCs as indexing reactions to changes in belongingness and social rank, the moderating role of gender, and the therapeutic opportunities offered by embodied cognition to treat social anxiety. PMID:24427129

  5. Mediation of Changes in Anxiety and Depression During Treatment of Social Phobia

    Science.gov (United States)

    Moscovitch, David A.; Stefan G. Hofmann, Michael K.; Suvak, Michael K.; In-Albon, Tina

    2005-01-01

    To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive- behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated…

  6. Women's anxiety about social and exercise settings.

    Science.gov (United States)

    Walton, Vicki R; Finkenberg, Mel E

    2002-04-01

    This study involved a comparison of social physique anxiety, assessed through the application of a modified version of the Social Physique Anxiety Scale, with 28 women who were new members exercising at all-female facilities compared to 43 new female members exercising at coeducational facilities. Analyses indicated there were no significant differences in means between the groups. The scores of women attending all-female facilities were significantly more influenced by the sex of members when choosing a facility.

  7. Cannabis-Related Problems and Social Anxiety: The Mediational Role of Post-Event Processing.

    Science.gov (United States)

    Ecker, Anthony H; Buckner, Julia D

    2018-01-02

    Cannabis is the most commonly used illicit drug in the US, and is associated with a range of psychological, social, and physical health-related problems. Individuals who endorse elevated levels of social anxiety are especially at risk for experiencing cannabis-related problems, including cannabis use disorder, despite not using cannabis more often than those with more normative social anxiety. Identification of mechanisms that underlie the relationship between social anxiety and cannabis-related problems may inform treatment and prevention efforts. Post-event processing (PEP, i.e., cognitively reviewing past social interactions/performances) is a social anxiety-related phenomenon that may be one such mechanism. The current study sought to test PEP as a mediator of the relationship between social anxiety and cannabis-related problems, adjusting for cannabis use frequency. Cannabis-using (past 3-month) undergraduate students recruited in 2015 (N = 244; 76.2% female; 74.2% Non-Hispanic Caucasian) completed an online survey of cannabis use, cannabis-related problems, social anxiety, and PEP. Bootstrap estimate of the indirect effect of social anxiety through PEP was significant, suggesting PEP is a mediator of the social anxiety-cannabis-related problems relationship. Conclusions/Importance: Treatment and prevention efforts may benefit from targeting PEP among individuals with elevated social anxiety and cannabis-related problems.

  8. Psychometric Properties of the Liebowitz Social Anxiety Scale in a Longitudinal Study of Latinos with Anxiety Disorders

    Science.gov (United States)

    Beard, Courtney; Rodriguez, Benjamin F.; Weisberg, Risa B.; Perry, Ashley; Keller, Martin B.

    2012-01-01

    The Liebowitz Social Anxiety Scale (LSAS) is one of the most commonly used measures of social anxiety symptoms. To date, no study has examined its psychometric properties in a Latino sample. The authors examined the reliability, temporal stability, and convergent validity of the LSAS in 73 Latinos diagnosed with an anxiety disorder. The original…

  9. Social Anxiety in Childhood: Bridging Developmental and Clinical Perspectives

    Science.gov (United States)

    Gazelle, Heidi; Rubin, Kenneth H.

    2010-01-01

    In this introductory chapter, guided by developmental psychopathology and developmental science as overarching integrative theoretical frameworks, the authors define three constructs related to social anxiety in childhood (behavioral inhibition, anxious solitude/withdrawal, and social anxiety disorder) and analyze commonalities and differences in…

  10. Social anxiety, acute social stress, and reward parameters interact to predict risky decision-making among adolescents.

    Science.gov (United States)

    Richards, Jessica M; Patel, Nilam; Daniele-Zegarelli, Teresa; MacPherson, Laura; Lejuez, C W; Ernst, Monique

    2015-01-01

    Risk-taking behavior increases during adolescence, leading to potentially disastrous consequences. Social anxiety emerges in adolescence and may compound risk-taking propensity, particularly during stress and when reward potential is high. However, the manner in which social anxiety, stress, and reward parameters interact to impact adolescent risk-taking is unclear. To clarify this question, a community sample of 35 adolescents (15-18yo), characterized as having high or low social anxiety, participated in a study over two separate days, during each of which they were exposed to either a social stress or a control condition, while performing a risky decision-making task. The task manipulated, orthogonally, reward magnitude and probability across trials. Three findings emerged. First, reward magnitude had a greater impact on the rate of risky decisions in high social anxiety (HSA) than low social anxiety (LSA) adolescents. Second, reaction times (RTs) were similar during the social stress and the control conditions for the HSA group, whereas the LSA group's RTs differed between conditions. Third, HSA adolescents showed the longest RTs on the most negative trials. These findings suggest that risk-taking in adolescents is modulated by context and reward parameters differentially as a function of social anxiety. Published by Elsevier Ltd.

  11. Social Anxiety, Acute Social Stress, and Reward Parameters Interact to Predict Risky Decision-Making among Adolescents

    Science.gov (United States)

    Richards, Jessica M.; Patel, Nilam; Daniele, Teresa; MacPherson, Laura; Lejuez, C.W.; Ernst, Monique

    2014-01-01

    Risk-taking behavior increases during adolescence, leading to potentially disastrous consequences. Social anxiety emerges in adolescence and may compound risk-taking propensity, particularly during stress and when reward potential is high. However, the manner in which social anxiety, stress, and reward parameters interact to impact adolescent risk-taking is unclear. To clarify this question, a community sample of 35 adolescents (15 to 18 yo), characterized as having high or low social anxiety, participated in a 2-day study, during each of which they were exposed to either a social stress or a control condition, while performing a risky decision-making task. The task manipulated, orthogonally, reward magnitude and probability across trials. Three findings emerged. First, reward magnitude had a greater impact on the rate of risky decisions in high social anxiety (HSA) than low social anxiety (LSA) adolescents. Second, reaction times (RTs) were similar during the social stress and the control conditions for the HSA group, whereas the LSA group’s RTs differed between conditions. Third, HSA adolescents showed the longest RTs on the most negative trials. These findings suggest that risk-taking in adolescents is modulated by context and reward parameters differentially as a function of social anxiety. PMID:25465884

  12. Social and academic functioning in adolescents with anxiety disorders: A systematic review.

    Science.gov (United States)

    de Lijster, Jasmijn M; Dieleman, Gwen C; Utens, Elisabeth M W J; Dierckx, Bram; Wierenga, Milou; Verhulst, Frank C; Legerstee, Jeroen S

    2018-04-01

    Anxiety disorders are highly prevalent during adolescence. Although literature points out that anxiety symptoms are related to problems in social and academic functioning, the extent of these problems among adolescents with clinical anxiety disorders has not been systematically reviewed before. Electronic databases were searched up to October 2017, with keywords representing anxiety disorders, adolescents, and social or academic functioning. The inclusion criteria were studies with a sample of adolescents (10-19 years) with anxiety disorders that provided data regarding their social or academic functioning. 3431 studies were examined, of which 19 met the inclusion criteria. Adolescents with anxiety disorders had a lower social competence relative to their healthy peers. They reported more negativity within interpersonal relationships, higher levels of loneliness, and victimization. Most adolescents with anxiety disorders felt impaired at school, however, findings of their average school results, compared to peers, were mixed. In addition, they had a higher risk for school refusal and entered higher education less often. Impairments in social and academic functioning differed across type and the number of anxiety disorders. Most studies examined social phobia or anxiety disorders in general and methodological approaches varied widely between studies. This systematic review indicates that adolescents with anxiety disorders experience a range of significant problems in both social and academic functioning. These findings suggest that the assessment and treatment of anxiety disorders in adolescence should focus on improving functioning across domains. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Compensatory deficits following rejection: the role of social anxiety in disrupting affiliative behavior.

    Science.gov (United States)

    Mallott, Michael A; Maner, Jon K; DeWall, Nathan; Schmidt, Norman B

    2009-01-01

    Managing perceived or actual social rejection is an important facet of meeting basic needs for affiliation. Social anxiety disorder (SAD) is characterized by significant distress and debilitation relating to affiliation and recent work suggests higher levels of social anxiety symptoms may adversely affect responses to social rejection. This study examined emotional and behavioral responding to a social rejection stressor to explore whether social anxiety moderates the effects of social rejection on prosocial compensatory behaviors. Individuals (N=37) evaluated on social anxiety symptoms were assigned to either a social rejection condition or control condition. Consistent with expectation, rejection promoted renewed interest in connecting with sources of positive social interaction among participants low in social anxiety. Participants with higher levels of social anxiety, however, failed to react to rejection in a positive or prosocial manner and exhibited some evidence of negative social responses. Such differential compensatory responding could have important implications for the genesis, maintenance, and treatment of SAD.

  14. Incorporating social anxiety into a model of college student problematic drinking

    OpenAIRE

    Ham, Lindsay S.; Hope, Debra A.

    2005-01-01

    College problem drinking and social anxiety are significant public health concerns with highly negative consequences. College students are faced with a variety of novel social situations and situations encouraging alcohol consumption. The current study involved developing a path model of college problem drinking, including social anxiety, in 316 college students referred to an alcohol intervention due to a campus alcohol violation. Contrary to hypotheses, social anxiety generally had an inver...

  15. Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: a study of the online assessment and diagnostic system within a web-based population.

    Science.gov (United States)

    Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

    2015-02-26

    While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Comorbidities of

  16. Mother-Child Attachment and Social Anxiety Symptoms in Middle Childhood

    OpenAIRE

    Brumariu, Laura E.; Kerns, Kathryn A.

    2008-01-01

    Literature suggests that parent-child attachment and anxiety symptoms are related. One purpose of the present study was to assess whether attachment patterns relate differentially to social anxiety aspects (fear of negative evaluation, social anxiety and distress in new situations, and generalized anxiety and distress). The second purpose was to investigate these links both longitudinally and concurrently in middle childhood. Children in grades 3 and 5 (N = 74) completed measures of secure, a...

  17. The Comorbidity of ADHD in the General Population of Saudi Arabian School-Age Children

    Science.gov (United States)

    Alqahtani, Mohammed M.

    2010-01-01

    Objective: To investigate comorbidity of oppositional-defiant disorder (ODD), conduct disorder (CD), anxiety, and depression and to investigate the impaired social and academic developments among children with ADHD in primary school settings in Saudi Arabia. Method: Data for the purpose of this study are obtained from parent and teachers of 652…

  18. Treating Social Anxiety in Adolescents: Ten Group Therapy Lesson Plans

    Science.gov (United States)

    Mazur-Elmer, Alison; McBride, Dawn

    2009-01-01

    This project provides a comprehensive overview of the research literature on social anxiety disorder (SAD) in adolescents and concludes by offering a set of 10 group therapy lesson plans for SAD that therapists can use in their practice. The overview includes a description of social anxiety disorder and highlights various theories of anxiety. The…

  19. Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: Incidence, clinical correlates, and behavioral treatment response.

    Science.gov (United States)

    Storch, Eric A; Zavrou, Sophia; Collier, Amanda B; Ung, Danielle; Arnold, Elysse B; Mutch, P Jane; Lewin, Adam B; Murphy, Tanya K

    2015-08-01

    Anxiety symptoms are common in youth with autism spectrum disorders (ASD) and directly associated with symptom severity and functional impairment. Family accommodation occurs frequently among individuals with obsessive-compulsive and anxiety disorders; to date, no data exist on the nature and correlates of family accommodation in youth with ASD and anxiety, as well as its relationship to cognitive-behavioral therapy outcome. Forty children with ASD and a comorbid anxiety disorder participated. Clinicians administered measures of ASD and anxiety disorder caseness, anxiety symptom severity, and family accommodation; parents completed questionnaires assessing social responsiveness, internalizing and externalizing behaviors, and functional impairment. A subsample of youth (n = 24) completed a course of cognitive-behavioral therapy. Family accommodation was common and positively correlated with anxiety symptom severity, but not functional impairment, general internalizing symptoms, externalizing behavior, or social responsiveness. Family accommodation decreased following cognitive-behavioral therapy with decreases in family accommodation being associated with decreases in anxiety levels. Treatment responders reported lower family accommodation frequency and lower parent impact relative to non-responders. Clinical implications of this study in assessing and psychotherapeutically treating youth with ASD and comorbid anxiety are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Comorbidity variation in patients with obsessive-compulsive disorder according to symptom dimensions: Results from a large multicentre clinical sample.

    Science.gov (United States)

    Torres, Albina R; Fontenelle, Leonardo F; Shavitt, Roseli G; Ferrão, Ygor A; do Rosário, Maria Conceição; Storch, Eric A; Miguel, Euripedes C

    2016-01-15

    Obsessive-compulsive disorder (OCD) has a heterogeneous and complex phenomenological picture, characterized by different symptom dimensions and comorbid psychiatric disorders, which frequently co-occur or are replaced by others over the illness course. To date, very few studies have investigated the associations between specific OCD symptom dimensions and comorbid disorders. Cross-sectional, multicenter clinical study with 1001 well-characterized OCD patients recruited within the Brazilian Research Consortium on Obsessive-Compulsive and Related Disorders. The primary instruments were the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS) and the Structured Clinical Interview for DSM-IV Axis I Disorders. Bivariate analyses between symptom dimensions and comorbidities were followed by logistic regression. The most common comorbidities among participants (56.8% females) were major depression (56.4%), social phobia (34.6%), generalized anxiety disorder (34.3%), and specific phobia (31.4%). The aggressive dimension was independently associated with posttraumatic stress disorder (PTSD), separation anxiety disorder, any impulse-control disorder and skin picking; the sexual-religious dimension was associated with mood disorders, panic disorder/agoraphobia, social phobia, separation anxiety disorder, non-paraphilic sexual disorder, any somatoform disorder, body dysmorphic disorder and tic disorders; the contamination-cleaning dimension was related to hypochondriasis; and the hoarding dimension was associated with depressive disorders, specific phobia, PTSD, impulse control disorders (compulsive buying, skin picking, internet use), ADHD and tic disorders. The symmetry-ordering dimension was not independently associated with any comorbidity. Cross-sectional design; participants from only tertiary mental health services; personality disorders not investigated. Different OCD dimensions presented some specific associations with comorbid disorders, which may influence

  1. The correlates and consequences of early appearing social anxiety in young children.

    Science.gov (United States)

    Weeks, Murray; Coplan, Robert J; Kingsbury, Adam

    2009-10-01

    Social anxiety is the fear of social situations and being negatively evaluated by others. Most previous studies of childhood social anxiety have employed clinical samples of children aged 10 years and older. The current study explored the correlates of social anxiety in an unselected sample of young children. Participants were n=178 elementary school children in grade 2 (aged 7-8 years). Children were individually administered the Social Anxiety Scale for Children-Revised (SASC-R), as well as measures of socio-emotional adjustment. Teachers completed measures of children's socio-emotional problems and school adjustment. Results indicated that social anxiety was positively associated with self-reported loneliness, school avoidance, and internalizing coping, and negatively related to school liking. However, social anxiety was mostly unrelated to teacher-rated outcomes. Findings are discussed in terms of use of the SASC-R for this type of population and reasons for the disparity between child and teacher reports of adjustment outcomes.

  2. Social anxiety and emotion regulation flexibility

    DEFF Research Database (Denmark)

    O'Toole, Mia S.; Zachariae, Robert; Mennin, Douglas S.

    2017-01-01

    Abstract BACKGROUND AND OBJECTIVES: Individuals with social anxiety disorder have often been considered inflexible in their emotion regulation. The aim of this study was to investigate emotion regulation flexibility in socially anxious individuals in response to two contextual factors, namely...... different levels of emotion intensity and emotion type. METHODS: A daily diary approach was employed, investigating emotion regulation (i.e., experiential avoidance, expressive suppression and cognitive reappraisal) in college students scoring high (N = 62; HSA) and low (N = 52; LSA) on social anxiety....... RESULTS: Results revealed that HSAs were found to use more experiential avoidance than LSAs, especially at higher levels of negative intensity. The use of this emotion regulation strategy appeared to be driven by guilt, nervousness, and sadness. There were no between-group differences concerning the other...

  3. The relation between social support, anxiety and distress symptoms and maternal fetal attachment.

    Science.gov (United States)

    Hopkins, Joyce; Miller, Jennifer L; Butler, Kristina; Gibson, Lynda; Hedrick, Laura; Boyle, Deborah Anne

    2018-05-04

    The aims of this study were to: (1) examine the relation between social support, trait anxiety, symptoms of maternal distress (including stress, depression and anxiety) and maternal-fetal attachment; and (2) to determine if social support buffers the relation between trait anxiety, symptoms of distress and maternal-fetal attachment. Ninety-four pregnant women completed five self-report questions. Two hierarchical regression analyses were conducted to examine the influence of trait anxiety, symptoms of distress, and social support on two factors of maternal-fetal attachment, quality and intensity/frequency. In the first model with the dependent measure as the maternal-fetal attachment quality score, trait anxiety (β = -.24, p social support (β = .30, p social support (β = .32, p social support is high, the relation between anxiety and maternal-fetal attachment intensity/frequency is attenuated. This study demonstrates that prenatal attachment is related to trait anxiety and social support. These findings suggest that interventions to decrease anxiety and increase social support could enhance maternal-fetal attachment.

  4. College Drinking Problems and Social Anxiety: The Importance of Drinking Context

    OpenAIRE

    Terlecki, Meredith A.; Ecker, Anthony H.; Buckner, Julia D.

    2014-01-01

    Social anxiety more than quadruples the risk of developing an alcohol use disorder, yet it is inconsistently linked to heavy alcohol use. Elucidation of the relation between social anxiety and alcohol use is an important next step in treating and preventing risky drinking. College students routinely face potentially anxiety-provoking social situations (e.g., meeting new people) and socially anxious undergraduates are especially vulnerable to alcohol-related impairment. Drinking to cope with s...

  5. Social anxiety and perception of early parenting among American, Chinese American, and social phobic samples.

    Science.gov (United States)

    Leung, A W; Heimberg, R G; Holt, C S; Bruch, M A

    1994-01-01

    Emotionally distant and controlling child-rearing attitudes have been reported to characterize the parents of American or western European social phobics in previous research. However, the notion that these parental attitudes may be associated with social anxiety only in some cultures has not been investigated. The present study examined social anxiety among American social phobics and American and Chinese/Chinese American volunteer samples and how it may relate to their parents' child-rearing attitudes. Multivariate analyses of variance revealed overall group differences. Both volunteer samples reported lower levels of anxiety than social phobics. Parents of Chinese/Chinese Americans and social phobics were reported to be similar in their (1) isolation of children from social activities; (2) over-emphasis of others' opinions; and (3) use of shame tactics for discipline (more so than American volunteers' parents). However, parents of nonsocial phobics were more likely to attend family social activities than social phobics' parents. Overall, the association between a reported parenting style emphasizing others' opinions and shame tactics and social anxiety in their adult children was more evident in both American samples than among Chinese/Chinese Americans.

  6. Social anxiety and training in neurolinguistic programming.

    Science.gov (United States)

    Konefal, J; Duncan, R C

    1998-12-01

    The Liebowitz Social Phobia Scale measured the effect of training on social anxiety responses of 28 adults prior to and following a 21-day residential training, and at 6 mo. follow-up. Significant reductions posttraining and at follow-up were evident in the mean self-reported global scale scores on fear and avoidance behavior in social situations. The item scores, aggregated to reflect the situational domains of formal and informal speaking, being observed by others, and assertion, showed significant and continuing reduction from posttraining through follow-up. These findings are consistent with the hypothesis that this training may be associated with reduced responses to social anxiety, but as there was no formal control group, pretest scores from another study were used. Interpretation is limited.

  7. Is there any influence of personality disorder on the short term intensive group cognitive behavioral therapy of social phobia?

    Science.gov (United States)

    Vyskocilova, Jana; Prasko, Jan; Novak, Tomas; Pohlova, Libuse

    2011-03-01

    The treatment of personality disorder is repeatedly reported as less successful than the treatment of patients without personality disorder. Most clinicians believe that anxiety disorder in tandem with a personality disorder often leads to longer treatment, worsens the prognosis, and thus increases treatment costs. Our study was designed to compare the short-term effectiveness of therapy in patients suffering from social phobia with and without personality disorder. The specific aim of the study was to assess the efficacy of a 6 week therapeutic program designed for social phobia (SSRIs and CBT) in patients suffering from social phobia with comorbid personality disorder (17 patients) and social phobia without comorbid personality disorder (18 patients). The patients were regularly assessed in weeks 0, 2, 4 and 6 using the CGI (Clinical Global Improvement) for severity, LSAS (Liebowitz Social Anxiety Scale), and in self-assessments BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory). Patients in both groups improved their scores in most of the assessment instruments used. A combination of CBT and pharmacotherapy proved to be the most effective treatment for patients suffering with social phobia with or without comorbid personality disorder. Treatment efficacy in patients with social phobia without personality disorder was significantly better than in the group with social phobia comorbid with personality disorder for CGI and specific inventory for social phobia - LSAS. The scores on the subjective depression inventory (BDI) also showed significantly greater decrease over the treatment in the group without personality disorder. The treatment effect between groups did not differ in subjective general anxiety scales BAI. Our study showed that patients suffering from social phobia and comorbid personality disorder showed a smaller decrease in specific social phobia symptomatology during treatment compared than patients with social phobia without personality

  8. Negative autobiographical memories in social anxiety disorder

    DEFF Research Database (Denmark)

    OToole, Mia Skytte; Watson, Lynn Ann; Rosenberg, Nicole

    2016-01-01

    (SAD), compared to patients with panic disorder (PD), and healthy controls (HCs). METHODS: A total of 107 participants retrieved four memories cued by verbal phrases associated with either social anxiety (SA) or panic anxiety (PA), with two memories for each cue category. RESULTS: PA-cued memories were...

  9. A cost of illness study of children with high-functioning autism spectrum disorders and comorbid anxiety disorders as compared to clinically anxious and typically developing children

    NARCIS (Netherlands)

    van Steensel, F.J.A.; Dirksen, C.D.; Bögels, S.M.

    2013-01-01

    The study’s aim was to estimate the societal costs of children with high-functioning ASD and comorbid anxiety disorder(s) (ASD + AD-group; n = 73), and to compare these costs to children with anxiety disorders (AD-group; n = 34), and typically developing children (controls; n = 87). Mean total costs

  10. Kindergarteners' self-reported social inhibition and observed social reticence: moderation by adult-reported social inhibition and social anxiety disorder symptoms.

    Science.gov (United States)

    Kiel, Elizabeth J; Buss, Kristin A; Molitor, Joseph G

    2015-04-01

    Prevention of later anxiety problems would best be accomplished by identifying at-risk children early in development. For example, children who develop Social Anxiety Disorder (SAD) may show social withdrawal in the form of social inhibition (i.e., shyness with unfamiliar adults and peers) at school entry. Although the use of children's perceptions of their own social inhibition would provide insight into early risk, the utility of young children's self-reports remains unclear. The current study examined whether children deemed more extreme on social inhibition or social anxiety by adult report provided self-report of social inhibition that related to observed social reticence in the laboratory. Participants included 85 kindergarten children (36 female, 49 male), their parents, and their teachers. Moderation analyses revealed that children's self-reported social inhibition related significantly to observed social reticence under the conditions of high parent-reported social inhibition, high teacher-reported social inhibition, and high SAD symptoms. These results suggest that the most inhibited children are aware of their behavior and can report it in a meaningfully way as young as kindergarten age.

  11. Facial Affect Recognition and Social Anxiety in Preschool Children

    Science.gov (United States)

    Ale, Chelsea M.; Chorney, Daniel B.; Brice, Chad S.; Morris, Tracy L.

    2010-01-01

    Research relating anxiety and facial affect recognition has focused mostly on school-aged children and adults and has yielded mixed results. The current study sought to demonstrate an association among behavioural inhibition and parent-reported social anxiety, shyness, social withdrawal and facial affect recognition performance in 30 children,…

  12. Racial-Ethnic Differences in Social Anxiety among College Students

    Science.gov (United States)

    LeSure-Lester, G. Evelyn; King, Nancy

    2004-01-01

    The present study investigated racial-ethnic differences in social anxiety among college students in two-year colleges. The sample consisted of 189 Asian American, African American, White American, and Hispanic American students from two colleges in the Southeast. Participants completed a questionnaire measure of social anxiety. The results…

  13. Social anxiety and alcohol use across the university years: Adaptive and maladaptive groups.

    Science.gov (United States)

    Brook, Christina A; Willoughby, Teena

    2016-05-01

    University/college can be a challenging time as students face developmental tasks such as building new social networks and achieving academically. Social anxiety may be disadvantageous in this setting given that social situations often include drinking and individuals with social anxiety tend to self-medicate through alcohol use. However, findings are mixed as to whether the association between social anxiety and alcohol use is positive or negative. To clarify the nature of this association, we used a person-centered longitudinal analysis to identify student groups based on levels of social anxiety symptoms and alcohol consumption. Undergraduates (N = 1132, 70.5% female, Mage = 19.06 at Time 1) enrolled in university completed a survey assessing social anxiety and alcohol use over 3 years, and psychosocial functioning and emotion coping behaviors at Time 1. Two out of 5 groups were identified with higher levels of social anxiety, 1 with moderately low alcohol use, and the other with moderately high alcohol use. Both groups reported higher levels of general anxiety, depressive symptoms, behavioral inhibition, emotional reactivity, daily hassles, and lower levels of social ties at Time 1 than the 3 groups with lower levels of social anxiety. Furthermore, the social anxiety-alcohol use group reported significantly lower academic grades and was more likely to endorse problematic emotion coping behaviors (e.g., self-injury) than the social anxiety-low alcohol use group. These results not only help explain the mixed findings in the literature but indicate that 1 group of socially anxious students may be particularly vulnerable to negative adjustment difficulties. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. The impact of comorbid post-traumatic stress disorder in patients with major depressive disorder on clinical features, pharmacological treatment strategies, and treatment outcomes - Results from a cross-sectional European multicenter study.

    Science.gov (United States)

    Dold, Markus; Bartova, Lucie; Kautzky, Alexander; Souery, Daniel; Mendlewicz, Julien; Serretti, Alessandro; Porcelli, Stefano; Zohar, Joseph; Montgomery, Stuart; Kasper, Siegfried

    2017-07-01

    This international, multicenter, cross-sectional study comprising 1346 adult in- and outpatients with major depressive disorder (MDD) investigated the association between MDD as primary diagnosis and comorbid post-traumatic stress disorder (PTSD). In a cross-sectional data collection process, the presence of comorbid PTSD was determined by the Mini International Neuropsychiatric Interview (MINI) and the patients' socio-demographic, clinical, psychopharmacological, and response information were obtained. Clinical features between MDD with and without concurrent PTSD were compared using descriptive statistics, analyses of covariance (ANCOVA), and binary logistic regression analyses. 1.49% of the MDD patients suffered from comorbid PTSD. Significantly more MDD + comorbid PTSD patients exhibited atypical features, comorbid anxiety disorders (any comorbid anxiety disorder, panic disorder, agoraphobia, and social phobia), comorbid bulimia nervosa, current suicide risk, and augmentation treatment with low-dose antipsychotic drugs. In the binary logistic regression analyses, the presence of atypical features (odds ratio (OR) = 4.49, 95%CI:1.01-20.12; p≤.05), any comorbid anxiety disorder (OR = 3.89, 95%CI:1.60-9.44; p = .003), comorbid panic disorder (OR = 6.45, 95%CI:2.52-16.51; p = .001), comorbid agoraphobia (OR = 6.51, 95%CI:2.54-16.68; p≤.001), comorbid social phobia (OR = 6.16, 95%CI:1.71-22.17; p≤.001), comorbid bulimia nervosa (OR = 10.39, 95%CI:1.21-88.64; p = .03), current suicide risk (OR = 3.58, 95%CI:1.30-9.91; p = .01), and augmentation with low-potency antipsychotics (OR = 6.66, 95%CI:2.50-17.77; pdisorders, and (3.) the increased suicide risk due to concurrent PTSD. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

  15. Social Networking Sites, Depression, and Anxiety: A Systematic Review

    Science.gov (United States)

    Kern, Margaret L; Rickard, Nikki S

    2016-01-01

    Background Social networking sites (SNSs) have become a pervasive part of modern culture, which may also affect mental health. Objective The aim of this systematic review was to identify and summarize research examining depression and anxiety in the context of SNSs. It also aimed to identify studies that complement the assessment of mental illness with measures of well-being and examine moderators and mediators that add to the complexity of this environment. Methods A multidatabase search was performed. Papers published between January 2005 and June 2016 relevant to mental illness (depression and anxiety only) were extracted and reviewed. Results Positive interactions, social support, and social connectedness on SNSs were consistently related to lower levels of depression and anxiety, whereas negative interaction and social comparisons on SNSs were related to higher levels of depression and anxiety. SNS use related to less loneliness and greater self-esteem and life satisfaction. Findings were mixed for frequency of SNS use and number of SNS friends. Different patterns in the way individuals with depression and individuals with social anxiety engage with SNSs are beginning to emerge. Conclusions The systematic review revealed many mixed findings between depression, anxiety, and SNS use. Methodology has predominantly focused on self-report cross-sectional approaches; future research will benefit from leveraging real-time SNS data over time. The evidence suggests that SNS use correlates with mental illness and well-being; however, whether this effect is beneficial or detrimental depends at least partly on the quality of social factors in the SNS environment. Understanding these relationships will lead to better utilization of SNSs in their potential to positively influence mental health. PMID:27881357

  16. Adverse consequences of student drinking: the role of sex, social anxiety, drinking motives.

    Science.gov (United States)

    Norberg, Melissa M; Olivier, Jake; Alperstein, Dion M; Zvolensky, Michael J; Norton, Alice R

    2011-08-01

    This study examined whether biological sex, social anxiety, and drinking motives relate differently to distinct types of alcohol-related consequences using Poisson regression. One hundred eighteen college students completed self-report measures assessing drinking motives and social anxiety and an interview assessing alcohol consumption and consequences. Highly socially anxious women were particularly apt to experience adverse role functioning consequences, while men were particularly apt to experience physical consequences. Although highly socially anxious women reported more personal consequences than did women with low to moderate social anxiety, men with low to moderate social anxiety reported experiencing more social and personal consequences than did women with low to moderate social anxiety. When taking into consideration the above associations, coping motives were statistically associated with social consequences and marginally related to personal consequences, while enhancement motives were significantly associated with physical consequences. Targeting these factors may lead to effective interventions for individuals with co-occurring social anxiety and drinking problems. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. The influence of exercise identity and social physique anxiety on exercise dependence.

    Science.gov (United States)

    Cook, Brian; Karr, Trisha M; Zunker, Christie; Mitchell, James E; Thompson, Ron; Sherman, Roberta; Erickson, Ann; Cao, Li; Crosby, Ross D

    2015-09-01

    Previous research has identified exercise identity and social physique anxiety as two independent factors that are associated with exercise dependence. The purpose of our study was to investigate the unique and interactive effect of these two known correlates of exercise dependence in a sample of 1,766 female runners. Regression analyses tested the main effects of exercise identity and social physique anxiety on exercise dependence. An interaction term was calculated to examine the potential moderating effect of social physique anxiety on the exercise identity and exercise dependence relationship. Results indicate a main effect for exercise identity and social physique anxiety on exercise dependence; and the interaction of these factors explained exercise dependence scores beyond the independent effects. Thus, social physique anxiety acted as a moderator in the exercise identity and exercise dependence relationship. Our results indicate that individuals who strongly identify themselves as an exerciser and also endorse a high degree of social physique anxiety may be at risk for developing exercise dependence. Our study supports previous research which has examined factors that may contribute to the development of exercise dependence and also suggests a previously unknown moderating relationship for social physique anxiety on exercise dependence.

  18. Skills for social and academic success: a school-based intervention for social anxiety disorder in adolescents.

    Science.gov (United States)

    Fisher, Paige H; Masia-Warner, Carrie; Klein, Rachel G

    2004-12-01

    This paper describes Skills for Academic and Social Success (SASS), a cognitive-behavioral, school-based intervention for adolescents with social anxiety disorder. Clinic-based treatment studies for socially anxious youth are reviewed, and a strong rationale for transporting empirically-based interventions into schools, such as SASS, is provided. The SASS program consists of 12, 40-min group sessions that emphasize social skills and in-vivo exposure. In addition to group sessions, students are seen individually at least twice and participate in 4 weekend social events with prosocial peers from their high schools. Meetings with teachers provide information about social anxiety and facilitate classroom exposures for socially anxious participants. Parents attend 2 psychoeducational meetings about social anxiety, its treatment, and approaches for managing their child's anxiety. Initial findings regarding the program's effectiveness are presented. We conclude by discussing the challenges involved in implementing treatment protocols in schools and provide suggestions to address these issues.

  19. Irritability and Anxiety Severity Among Youth With Anxiety

    Science.gov (United States)

    Cornacchio, Danielle; Crum, Kathleen I.; Coxe, Stefany; Pincus, Donna B.; Comer, Jonathan S.

    2015-01-01

    Objective Most research on irritability and child psychopathology has focused on depressive disorders, bipolar disorder, and/or oppositional defiant disorder (ODD). Less is known about relationships between child anxiety and irritability and moderators of such associations. Method Structural equation modeling (SEM) examined associations between anxiety severity and irritability in a large sample of treatment-seeking youth with anxiety disorders (N=663, ages 7–19 years, M=12.25), after accounting for comorbid depressive disorders and ODD. Additional analyses examined whether associations were moderated by child gender, age, and generalized anxiety disorder (GAD) status. Results There was a direct link between child anxiety and irritability even after accounting for comorbid depressive disorders and ODD. Links between child anxiety and irritability were robust across child gender and age. Further, relationships between child anxiety and irritability were comparable across youth with and without GAD, suggesting that the anxiety–irritability link is relevant across child anxiety disorders and not circumscribed to youth with GAD. Conclusion Findings add to an increasing body of evidence linking child irritability to a range of internalizing and externalizing psychopathologies, and suggest that child anxiety assessment should systematically incorporate irritability evaluations. Further, youth in clinical settings displaying irritability should be assessed for the presence of anxiety. Moreover, treatments for childhood anxiety may do well to incorporate new treatment modules as needed that specifically target problems of irritability. PMID:26703910

  20. Attentional control mediates the effect of social anxiety on positive affect☆

    Science.gov (United States)

    Morrison, Amanda S.; Heimberg, Richard G.

    2015-01-01

    The goal of the present studies was to examine whether attentional control, a self-regulatory attentional mechanism, mediates the effect of social anxiety on positive affect. We tested this mediation in two studies using undergraduate students selected to represent a broad range of severity of social anxiety. Self-report assessments of social anxiety, attentional control, and positive affect were collected in a cross-sectional design (Study 1) and in a longitudinal design with three assessment points (Study 2). Results of both studies supported the hypothesized mediational model. Specifically, social anxiety was inversely related to attentional control, which itself positively predicted positive affect. This mediation remained significant even when statistically controlling for the effects of depression. Additionally, the hypothesized model provided superior model fit to theoretically-grounded equivalent models in both studies. Implications of these findings for understanding diminished positive affect in social anxiety are discussed. PMID:23254261

  1. Measurement Invariance of the Social Phobia and Anxiety Inventory

    Science.gov (United States)

    Bunnell, Brian E.; Joseph, Dana L.; Beidel, Deborah C.

    2012-01-01

    The Social Phobia and Anxiety Inventory (SPAI) is a commonly used self-report measure of social phobia that has demonstrated adequate reliability, convergent validity, discriminant validity, and criterion-related validity. However, research has yet to address whether this measure functions equivalently in (a) individuals with and without a diagnosis of social phobia and (b) males and females. Evaluating measurement equivalence is necessary in order to determine that the construct of social anxiety is conceptually understood invariantly across these populations. The results of the current investigation, using a series of nested factorial models proposed by Vandenberg and Lance (2000), provide evidence for strong equivalence across 420 individuals with and without diagnoses of social anxiety disorder and across male and female samples. Accordingly, these results provide psychometric justification for comparison of SPAI scores across the symptom continuum and sexes. PMID:23247204

  2. Relationships among depression, anxiety, anxiety sensitivity, and perceived social support in adolescents with conversion disorder.

    Science.gov (United States)

    Yılmaz, Savaş; Bilgiç, Ayhan; Akça, Ömer Faruk; Türkoğlu, Serhat; Hergüner, Sabri

    2016-01-01

    This study aimed to assess the relationships of depression, anxiety, anxiety sensitivity, and perceived social support with conversion symptoms in adolescents with conversion disorder (CD). Fifty outpatients, aged 8-18 years, who had been diagnosed with CD and members of a control group were assessed using the psychological questionnaires. Compared with controls, adolescents with CD scored higher on the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI) total, CASI physical and cognitive subscales, and Multidimensional Scale of Perceived Social Support family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the Somatoform Dissociation Questionnaire (SDQ) scores and that CDI and CASI total scores predicted the Children's Somatization Inventory (CSI) scores of subjects. This study suggest that adolescents with CD had poor psychosocial well-being, and depression, global anxiety sensitivity and anxiety sensitivity cognitive concerns are related to conversion symptoms.

  3. The factor structure of the Social Interaction Anxiety Scale and the Social Phobia Scale.

    Science.gov (United States)

    Heidenreich, Thomas; Schermelleh-Engel, Karin; Schramm, Elisabeth; Hofmann, Stefan G; Stangier, Ulrich

    2011-05-01

    The Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS) are two compendium measures that have become some of the most popular self-report scales of social anxiety. Despite their popularity, it remains unclear whether it is necessary to maintain two separate scales of social anxiety. The primary objective of the present study was to examine the factor analytic structure of both measures to determine the factorial validity of each scale. For this purpose, we administered both scales to 577 patients at the beginning of outpatient treatment. Analyzing both scales simultaneously, a CFA with two correlated factors showed a better fit to the data than a single factor model. An additional EFA with an oblique rotation on all 40 items using the WLSMV estimator further supported the two factor solution. These results suggest that the SIAS and SPS measure similar, but not identical facets of social anxiety. Thus, our findings provide support to retain the SIAS and SPS as two separate scales. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Biased Perception and Interpretation of Bodily Anxiety Symptoms in Childhood Social Anxiety

    Science.gov (United States)

    Schmitz, Julian; Blechert, Jens; Kramer, Martina; Asbrand, Julia; Tuschen-Caffier, Brunna

    2012-01-01

    Cognitive models of social phobia (SP) and empirical evidence in adults suggest that affected individuals overestimate arousal symptoms such as heart rate (HR) during social stress and worry about their visibility in public. To date, little is known about these aspects in childhood social anxiety, an important precursor of the disorder. We…

  5. The Effects of Social Anxiety and State Anxiety on Visual Attention: Testing the Vigilance-Avoidance Hypothesis.

    Science.gov (United States)

    Singh, J Suzanne; Capozzoli, Michelle C; Dodd, Michael D; Hope, Debra A

    2015-01-01

    A growing theoretical and research literature suggests that trait and state social anxiety can predict attentional patterns in the presence of emotional stimuli. The current study adds to this literature by examining the effects of state anxiety on visual attention and testing the vigilance-avoidance hypothesis, using a method of continuous visual attentional assessment. Participants were 91 undergraduate college students with high or low trait fear of negative evaluation (FNE), a core aspect of social anxiety, who were randomly assigned to either a high or low state anxiety condition. Participants engaged in a free view task in which pairs of emotional facial stimuli were presented and eye movements were continuously monitored. Overall, participants with high FNE avoided angry stimuli and participants with high state anxiety attended to positive stimuli. Participants with high state anxiety and high FNE were avoidant of angry faces, whereas participants with low state and low FNE exhibited a bias toward angry faces. The study provided partial support for the vigilance-avoidance hypothesis. The findings add to the mixed results in the literature that suggest that both positive and negative emotional stimuli may be important in understanding the complex attention patterns associated with social anxiety. Clinical implications and suggestions for future research are discussed.

  6. Attenuated positive psychotic symptoms and social anxiety: Along a psychotic continuum or different constructs?

    Science.gov (United States)

    Cooper, Shanna; Klugman, Joshua; Heimberg, Richard G; Anglin, Deidre M; Ellman, Lauren M

    2016-01-30

    Social anxiety commonly occurs across the course of schizophrenia, including in the premorbid and prodromal phases of psychotic disorders. Some have posited that social anxiety may exist on a continuum with paranoia; however, empirical data are lacking. The study aim was to determine whether attenuated positive psychotic symptoms are related to social anxiety. Young adults (N=1378) were administered the Prodromal Questionnaire (PQ), which measures attenuated positive psychotic symptoms (APPS), and the Social Phobia Scale (SPS), which measures a subset of social anxiety symptoms. Confirmatory factor analyses were conducted to address the extent to which social anxiety and APPS tap distinct dimensions. Confirmatory factor analyses support the existence of a separate social anxiety factor scale and four separate, though interrelated, APPS factor domains (unusual thought content, paranoia/suspiciousness, disorganized thinking, and perceptual abnormalities). Additionally, social anxiety was significantly, but not differently related to each APPS domain, although the magnitude was reduced between social anxiety and distressing APPS. The current study suggests that social anxiety and attenuated positive psychotic symptoms are separable constructs, but are significantly associated with each other. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. The Reverse of Social Anxiety Is Not Always the Opposite: The Reverse-Scored Items of the Social Interaction Anxiety Scale Do Not Belong

    Science.gov (United States)

    Rodebaugh, Thomas L.; Woods, Carol M.; Heimberg, Richard G.

    2007-01-01

    Although well-used and empirically supported, the Social Interaction Anxiety Scale (SIAS) has a questionable factor structure and includes reverse-scored items with questionable utility. Here, using samples of undergraduates and a sample of clients with social anxiety disorder, we extend previous work that opened the question of whether the…

  8. A study of phenomenology, psychiatric co-morbidities, social and adaptive functioning in children and adolescents with OCD.

    Science.gov (United States)

    Agarwal, Vivek; Yaduvanshi, Rakesh; Arya, Amit; Gupta, Pawan Kumar; Sitholey, Prabhat

    2016-08-01

    To study the phenomenology, social, adaptive and global functioning of children and adolescents with OCD. Studies have shown varying prevalence of paediatric OCD ranging from 1% to 4%. Childhood-onset OCD have some important differences in sex distribution, presentation, co-morbidities and insight. 25 subjects (6 to ≤18 years) with a DSM-IV-TR diagnosis of OCD were included in this study. Subjects were evaluated using K-SADS-PL, Children's Y-BOCS, HoNOSCA, C-GAS and VABS-II. The mean age of the sample was 14.9±2.2 years. Obsession of contamination was commonest (68%) followed by aggressive obsession (60%); commonest compulsions were washing and cleaning (72%) followed by checking (56%). Most distressing obsessions were obsession of doubt about their decision (28%), having horrible thoughts about their family being hurt (20%) and thought that something terrible is going to happen and it will be their fault (16%). Most subjects rate spending far too much time in washing hands (60%) as most distressing compulsion, followed by rewriting and checking compulsions (both 12%). 76% subjects have co-morbid psychiatric diagnosis. Anxiety disorders (24%), depression (16%), and dissociative disorder (16%) were common co-morbidities. Mean C-GAS score of the sample was 53.2±9.9. 44% of subjects had below average adaptive functioning. The study shows that, most frequent obsessions and compulsions may be different from most distressing ones and this finding might have clinical implication. Most of the children and adolescent with OCD have co-morbidities. Children also had problems in adaptive functioning. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Social anxiety and self-protective communication style in close relationships.

    Science.gov (United States)

    Cuming, Samantha; Rapee, Ronald M

    2010-02-01

    People with higher social anxiety tend to reveal less information about themselves in interactions with strangers, and this appears to be part of a self-protective strategy adopted in situations in which the risk of negative evaluation is judged to be particularly high. This research examined whether a similar style of communication may be adopted by people with higher social anxiety in their close relationships, and whether it may be associated with decrements in the quality (support, depth, conflict) of these relationships. Over 300 people from the community completed a series of online questionnaires measuring social anxiety and depression, and disclosure in and quality of their close friendships and romantic relationships. After controlling for levels of depression, social anxiety was associated with a paucity of disclosure in both romantic relationships and close friendships in females, but not males. There was an indirect association between higher social anxiety and lower relationship quality (lower support, with a trend towards greater conflict) via lower self-disclosure in women's romantic relationships, but not their close friendships. Addressing disclosure in the context of close relationships may assist socially anxious women to develop more fulfilling and harmonious close relationships. Copyright 2009 Elsevier Ltd. All rights reserved.

  10. Hooked on Facebook: The Role of Social Anxiety and Need for Social Assurance in Problematic Use of Facebook.

    Science.gov (United States)

    Lee-Won, Roselyn J; Herzog, Leo; Park, Sung Gwan

    2015-10-01

    There is a growing concern that excessive and uncontrolled use of Facebook not only interferes with performance at school or work but also poses threats to physical and psychological well-being. The present research investigated how two individual difference variables--social anxiety and need for social assurance--affect problematic use of Facebook. Drawing on the basic premises of the social skill model of problematic Internet use, we hypothesized that social anxiety and need for social assurance would be positively correlated with problematic use of Facebook. Furthermore, it was predicted that need for social assurance would moderate the relationship between social anxiety and problematic use. A cross-sectional online survey was conducted with a college student sample in the United States (N=243) to test the proposed hypotheses. Results showed that both social anxiety and need for social assurance had a significant positive association with problematic use of Facebook. More importantly, the data demonstrated that need for social assurance served as a significant moderator of the relationship between social anxiety and problematic Facebook use. The positive association between social anxiety and problematic Facebook use was significant only for Facebook users with medium to high levels of need for social assurance but not for those with a low level of need for social assurance. Theoretical and practical implications of these findings were discussed.

  11. Self-referential and anxiety-relevant information processing in subclinical social anxiety: an fMRI study.

    Science.gov (United States)

    Abraham, Anna; Kaufmann, Carolin; Redlich, Ronny; Hermann, Andrea; Stark, Rudolf; Stevens, Stephan; Hermann, Christiane

    2013-03-01

    The fear of negative evaluation is one of the hallmark features of social anxiety. Behavioral evidence thus far largely supports cognitive models which postulate that information processing biases in the face of socially relevant information are a key factor underlying this widespread phobia. So far only one neuroimaging study has explicitly focused on the fear of negative evaluation in social anxiety where the brain responses of social phobics were compared to healthy participants during the processing of self-referential relative to other-referential criticism, praise or neutral information. Only self-referential criticism led to stronger activations in emotion-relevant regions of the brain, such as the amygdala and medial prefrontal cortices (mPFC), in the social phobics. The objective of the current study was to determine whether these findings could be extended to subclinical social anxiety. In doing so, the specificity of this self-referential bias was also examined by including both social and non-social (physical illness-related) threat information as well as a highly health anxious control group in the experimental paradigm. The fMRI findings indicated that the processing of emotional stimuli was accompanied by activations in the amygdala and the ventral mPFC, while self-referential processing was associated with activity in regions such as the mPFC, posterior cingulate and temporal poles. Despite the validation of the paradigm, the results revealed that the previously reported behavioral and brain biases associated with social phobia could not be unequivocally extended to subclinical social anxiety. The divergence between the findings is explored in detail with reference to paradigm differences and conceptual issues.

  12. Shame and guilt in social anxiety disorder: effects of cognitive behavior therapy and association with social anxiety and depressive symptoms.

    Directory of Open Access Journals (Sweden)

    Erik Hedman

    Full Text Available Social anxiety disorder (SAD, characterized by fear of being scrutinized by others, has features that that are closely linked to the concept of shame. Despite this, it remains to be investigated whether shame is elevated in persons with SAD, and if cognitive behavior therapy (CBT for SAD could reduce shame experience. In the present study, we focused on internal shame, i.e. the type of shame that pertains to how we judge ourselves. Although guilt is distinctly different from shame, we also viewed it as important to investigate its role in SAD as the two emotions are highly correlated. The aim of this study was to investigate: (I if persons with SAD differ from healthy controls on shame and guilt, (II if shame, guilt, depressive symptoms, and social anxiety are associated in persons with SAD, and (III if CBT can reduce internal shame in patients with SAD. Firstly, we conducted a case-control study comparing a sample with SAD (n = 67 with two samples of healthy controls, a main sample (n = 72 and a replication sample (n = 22. Secondly, all participants with SAD were treated with CBT and shame, measured with the Test of Self-Conscious affect, was assessed before and after treatment. The results showed that shame was elevated in person with SAD compared to the control replication sample, but not to the main control sample. In addition, shame, social anxiety, and depressive symptoms were significantly associated among participants with SAD. After CBT, participants with SAD had significantly reduced their shame (Cohen's d = 0.44. Guilt was unrelated to social anxiety. We conclude that shame and social anxiety are associated and that it is likely that persons with SAD are more prone to experience shame than persons without SAD. Also, CBT is associated with shame reduction in the treatment of SAD.

  13. Shame and guilt in social anxiety disorder: effects of cognitive behavior therapy and association with social anxiety and depressive symptoms.

    Science.gov (United States)

    Hedman, Erik; Ström, Peter; Stünkel, Angela; Mörtberg, Ewa

    2013-01-01

    Social anxiety disorder (SAD), characterized by fear of being scrutinized by others, has features that that are closely linked to the concept of shame. Despite this, it remains to be investigated whether shame is elevated in persons with SAD, and if cognitive behavior therapy (CBT) for SAD could reduce shame experience. In the present study, we focused on internal shame, i.e. the type of shame that pertains to how we judge ourselves. Although guilt is distinctly different from shame, we also viewed it as important to investigate its role in SAD as the two emotions are highly correlated. The aim of this study was to investigate: (I) if persons with SAD differ from healthy controls on shame and guilt, (II) if shame, guilt, depressive symptoms, and social anxiety are associated in persons with SAD, and (III) if CBT can reduce internal shame in patients with SAD. Firstly, we conducted a case-control study comparing a sample with SAD (n = 67) with two samples of healthy controls, a main sample (n = 72) and a replication sample (n = 22). Secondly, all participants with SAD were treated with CBT and shame, measured with the Test of Self-Conscious affect, was assessed before and after treatment. The results showed that shame was elevated in person with SAD compared to the control replication sample, but not to the main control sample. In addition, shame, social anxiety, and depressive symptoms were significantly associated among participants with SAD. After CBT, participants with SAD had significantly reduced their shame (Cohen's d = 0.44). Guilt was unrelated to social anxiety. We conclude that shame and social anxiety are associated and that it is likely that persons with SAD are more prone to experience shame than persons without SAD. Also, CBT is associated with shame reduction in the treatment of SAD.

  14. Shame and Guilt in Social Anxiety Disorder: Effects of Cognitive Behavior Therapy and Association with Social Anxiety and Depressive Symptoms

    Science.gov (United States)

    Hedman, Erik; Ström, Peter; Stünkel, Angela; Mörtberg, Ewa

    2013-01-01

    Social anxiety disorder (SAD), characterized by fear of being scrutinized by others, has features that that are closely linked to the concept of shame. Despite this, it remains to be investigated whether shame is elevated in persons with SAD, and if cognitive behavior therapy (CBT) for SAD could reduce shame experience. In the present study, we focused on internal shame, i.e. the type of shame that pertains to how we judge ourselves. Although guilt is distinctly different from shame, we also viewed it as important to investigate its role in SAD as the two emotions are highly correlated. The aim of this study was to investigate: (I) if persons with SAD differ from healthy controls on shame and guilt, (II) if shame, guilt, depressive symptoms, and social anxiety are associated in persons with SAD, and (III) if CBT can reduce internal shame in patients with SAD. Firstly, we conducted a case-control study comparing a sample with SAD (n = 67) with two samples of healthy controls, a main sample (n = 72) and a replication sample (n = 22). Secondly, all participants with SAD were treated with CBT and shame, measured with the Test of Self-Conscious affect, was assessed before and after treatment. The results showed that shame was elevated in person with SAD compared to the control replication sample, but not to the main control sample. In addition, shame, social anxiety, and depressive symptoms were significantly associated among participants with SAD. After CBT, participants with SAD had significantly reduced their shame (Cohen's d = 0.44). Guilt was unrelated to social anxiety. We conclude that shame and social anxiety are associated and that it is likely that persons with SAD are more prone to experience shame than persons without SAD. Also, CBT is associated with shame reduction in the treatment of SAD. PMID:23620782

  15. Mental symptoms and comorbid behaviours among Inuit in Greenland: the role of household crowding and household social structure

    DEFF Research Database (Denmark)

    Riva, Mylène; Larsen, Christina Viskum Lytken; Bjerregaard, Peter

    on 3108 Inuit aged 18 years and older are from the Inuit Health in Transition Survey. Dependent variables considered were: feelings of depression and of anxiety; binge drinking; harmful drinking; and use of marijuana. Household crowding was measured by the number of people in the house, and the social...... with higher risk of reporting feeling anxious (OR: 1.05; 95%CI: 1.00-1.09) or depressed (OR: 1.05; 95%CI: 1.02-1.09), but with lower risks of heavy drinking (OR: 0.89; 95%CI: 0.82-0.98), use of marijuana (OR: 0.85; 95%CI: 0.77-0.94), and marginally (p... marijuana (OR: 1.34; 95%CI: 0.98-1.81), but not of harmful drinking, were significantly higher in households composed only of adults. Although similar patterns of associations are observed, household crowding and the social structure of the household appear to influence women’s mental symptoms and comorbid...

  16. Social Anxiety, Acute Social Stress, and Reward Parameters Interact to Predict Risky Decision-Making among Adolescents

    OpenAIRE

    Richards, Jessica M.; Patel, Nilam; Daniele, Teresa; MacPherson, Laura; Lejuez, C.W.; Ernst, Monique

    2014-01-01

    Risk-taking behavior increases during adolescence, leading to potentially disastrous consequences. Social anxiety emerges in adolescence and may compound risk-taking propensity, particularly during stress and when reward potential is high. However, the manner in which social anxiety, stress, and reward parameters interact to impact adolescent risk-taking is unclear. To clarify this question, a community sample of 35 adolescents (15 to 18 yo), characterized as having high or low social anxiety...

  17. Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation

    OpenAIRE

    Khdour, Hussain Y.; Abushalbaq, Oday M.; Mughrabi, Ibrahim T.; Imam, Aya F.; Gluck, Mark A.; Herzallah, Mohammad M.; Moustafa, Ahmed A.

    2016-01-01

    Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of me...

  18. Investigating the Role of Interpersonal Sensitivity, Anger, and Perfectionism in Social Anxiety.

    Science.gov (United States)

    Mohammadian, Youkhabeh; Mahaki, Behzad; Dehghani, Mahmoud; Vahid, Mohammadkazem Atef; Lavasani, Fahimeh Fathali

    2018-01-01

    The investigation of personality characteristics and emotional experiences of the people suffering from anxiety disorders is one of the most important issues which are considered by researchers and clinicians. Perfectionism, sensitivity to interpersonal rejection, and anger are personality traits related to social anxiety. In social anxiety disorder, it has also been focused on anger as a personality characteristic and as an emotional condition. The main purpose of this work is to investigate the role of these variables in predicting social anxiety among a nonclinical group of Iranian students. In this cross-sectional study, 131 students completed the self-report version of Liebowitz Social Anxiety Scale Self-Report version (LSAS-SR), Frost Multidimensional Perfectionism Scale (FMPS), Interpersonal Sensitivity Measure (IPSM), and State and Trait Anger Expression Inventory. Multiple linear regressions were conducted to examine the concurrent associations between perfectionism, interpersonal sensitivity and quality of emotional experience, and expression of anger with severity of self-report social anxiety. Greater levels of FMPS total were significantly associated with a greater level of LSAS total, fear, and avoidance of social and functional situations ( P = 0.022, P = 0.024, and P = 0.006). Moreover, a significant positive correlation between IPSM total ( P = 0.015) with fear and also between anger expression index ( P = 0.009) with avoidance subscale were found. In accordance to the previous researches, we found that perfectionism, interpersonal sensitivity, anger experience, and anger expression skills are related to social anxiety. How these personality traits are related to fear and avoidance of social situations and their concurrent effects on predicting social anxiety were discussed.

  19. Gaining Insight into Adolescent Vulnerability for Social Anxiety from Developmental Cognitive Neuroscience

    Science.gov (United States)

    Caouette, Justin D.; Guyer, Amanda E.

    2013-01-01

    Social anxiety disorder (SAD) markedly impairs daily functioning. For adolescents, SAD can constrain typical development precisely when social experiences broaden, peers’ opinions are highly salient, and social approval is actively sought. Individuals with extreme, impairing social anxiety fear evaluation from others, avoid social interactions, and interpret ambiguous social cues as threatening. Yet some degree of social anxiety can be normative and non-impairing. Furthermore, a temperament of behavioral inhibition increases risk for SAD for some, but not all adolescents with this temperament. One fruitful approach taken to understand the mechanisms of social anxiety has been to use neuroimaging to link affect and cognition with neural networks implicated in the neurodevelopmental social reorientation of adolescence. Although initial neuroimaging studies of adolescent SAD and risk for SAD underscored the role of fear-processing circuits (e.g., the amygdala and ventral prefrontal cortex), recent work has expanded these circuits to include reward-processing structures in the basal ganglia. A growing focus on reward-related neural circuitry holds promise for innovative translational research needed to differentiate impairing from normative social anxiety and for novel ways to treat adolescent SAD that focus on both social avoidance and social approach. PMID:24239049

  20. Gaining insight into adolescent vulnerability for social anxiety from developmental cognitive neuroscience

    Directory of Open Access Journals (Sweden)

    Justin D. Caouette

    2014-04-01

    Full Text Available Social anxiety disorder (SAD markedly impairs daily functioning. For adolescents, SAD can constrain typical development precisely when social experiences broaden, peers’ opinions are highly salient, and social approval is actively sought. Individuals with extreme, impairing social anxiety fear evaluation from others, avoid social interactions, and interpret ambiguous social cues as threatening. Yet some degree of social anxiety can be normative and non-impairing. Furthermore, a temperament of behavioral inhibition increases risk for SAD for some, but not all adolescents with this temperament. One fruitful approach taken to understand the mechanisms of social anxiety has been to use neuroimaging to link affect and cognition with neural networks implicated in the neurodevelopmental social reorientation of adolescence. Although initial neuroimaging studies of adolescent SAD and risk for SAD underscored the role of fear-processing circuits (e.g., the amygdala and ventral prefrontal cortex, recent work has expanded these circuits to include reward-processing structures in the basal ganglia. A growing focus on reward-related neural circuitry holds promise for innovative translational research needed to differentiate impairing from normative social anxiety and for novel ways to treat adolescent SAD that focus on both social avoidance and social approach.