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Social Anxiety Disorder in Swedish Adolescents: Prevalence, Victimization & Development
Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Human beings are social creatures. Accordingly, fear of social situations can be severely disabling. Social anxiety disorder (SAD) is characterized by excessive fear of negative evaluation in social or performance situations. SAD has an early onset and often goes undetected an untreated. Descriptive studies on non‐clinical samples are required in order to find ways to prevent SAD and associated consequences. This thesis aimed at examining epidemiological variables of SAD in adolescence which is the critical period for onset of SAD. More exactly, issues of detection and prevalence, victimization and developmental course were addressed.

Data was collected in four different community samples, using cross‐sectional and longitudinal designs. In the first study (n=169), psychometric evaluation of a screening questionnaire for use with adolescents was conducted. The second study (n=2128) investigated prevalence of SAD in students in grade 6‐8 (age 12‐14 years). In the third study (n=3211), the association between SAD and victimization in high‐school students (aged 17) was investigated. Finally, in the fourth study (n=350), longitudinal associations between social anxiety and depressive symptoms were investigated, with 4 waves of data from grade 7 to grade 11.

Self‐reported SAD was found among 4.4% of students in grade 6‐8 and among 10.6% of high‐school students. Females reported SAD to a significantly higher degree than males in all age groups. Experiences of peer victimization, maltreatment and sexual victimization were significantly more common in those reporting SAD than in non‐cases. Social anxiety was stable over adolescence. Further, peer victimization in grade 7 predicted social anxiety that mediated subsequent depressive symptoms. In conclusion, self‐reported SAD is common in Swedish adolescents and especially in girls and older adolescents. Social anxiety is stable over adolescence and correlated with depressive symptoms over course. The high prevalence rates, stable course and mediation of depressive symptoms call for early detection and prevention of social anxiety. The relationship between victimization and SAD needs to be investigated further in controlled prospective studies on children and adolescents.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2010. , 78 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1185
Keyword [en]
Social anxiety disorder, adolescents, prevalence, victimization, peer victimization, developmental course
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-57938ISBN: 978-91-7393-388-9 (print)OAI: oai:DiVA.org:liu-57938DiVA: diva2:329270
Public defence
2010-05-21, Berzeliussalen, Universitetssjukhuset, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Opponent
Available from: 2010-07-09 Created: 2010-07-09 Last updated: 2017-07-07Bibliographically approved
List of papers
1. Evaluation of the psychometric properties of a modified version of the Social Phobia Screening Questionnaire for use in adolescents.
Open this publication in new window or tab >>Evaluation of the psychometric properties of a modified version of the Social Phobia Screening Questionnaire for use in adolescents.
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2009 (English)In: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, E-ISSN 1753-2000, Vol. 3, no 1, 36- p.Article in journal (Refereed) Published
Abstract [en]

ABSTRACT: BACKGROUND: Social phobia (social anxiety disorder - SAD) is a rather common but often undetected and undertreated psychiatric condition in youths. Screening of SAD in young individuals in community samples is thus important in preventing negative outcomes. The present study is the first report on the psychometric properties of the Social Phobia Screening Questionnaire for Children and adolescents (SPSQ-C). METHODS: The SPSQ-C was administered to a community sample of high-school students. Test-retest reliability over three weeks was evaluated (n = 127) and internal consistency was calculated for items measuring level of fear in eight social situations. To measure concurrent validity, subjects who reported SAD on at least one occasion and randomly selected non-cases were blindly interviewed with the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I), as gold standard (n = 51). RESULTS: A moderate test-retest reliability, r = .60 (P < .01), and a satisfactory alpha coefficient of .78 was found. Values of sensitivity and specificity were 71% and 86% respectively, and area under the curve (AUC) was .79. Positive likelihood ratio (LR+) showed that a positive screening result was five times more likely to be correct than to reflect a non-case. Negative likelihood ratio (LR -) was .34. In addition, positive predictive value was 45% and negative predictive value was 95%. The prevalence of self-reported SAD was found to be 7.2% at the first assessment. CONCLUSION: The SPSQ-C is a short and psychometrically sound questionnaire for screening of SAD in adolescents, with the advantage of being based on the DSM-IV criteria.

Place, publisher, year, edition, pages
BioMed Central, 2009
National Category
Psychiatry
Identifiers
urn:nbn:se:liu:diva-53087 (URN)10.1186/1753-2000-3-36 (DOI)19906313 (PubMedID)
Note

Original Publication: Malin Green-Landell, Andreas Björklind, Maria Tillfors, Tomas Furmark, Carl Göran Svedin and Gerhard Andersson, Evaluation of the psychometric properties of a modified version of the Social Phobia Screening Questionnaire for use in adolescents., 2009, Child and adolescent psychiatry and mental health, (3), 1, 36. http://dx.doi.org/10.1186/1753-2000-3-36 Licensee: BioMed Central http://www.biomedcentral.com/ Postprint available at: Linköping University Electronic Press http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-53087

Available from: 2010-01-15 Created: 2010-01-15 Last updated: 2017-12-12Bibliographically approved
2. Social phobia in Swedish adolescents: Prevalence and gender differences
Open this publication in new window or tab >>Social phobia in Swedish adolescents: Prevalence and gender differences
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2009 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 44, no 1, 1-7 p.Article in journal (Refereed) Published
Abstract [en]

Background The aim of this study was to investigate the prevalence of self-reported social phobia in a community sample of Swedish adolescents in junior high school, at the risk-period for developing social phobia. Of particular interest was to investigate gender differences in prevalence across ages. Prevalence of sub-threshold social phobia was also studied. Methods Students in grades 6-8 (aged 12-14) from seventeen schools in five Swedish municipalities were screened by means of a self-report questionnaire, the social phobia screening questionnaire-for children (SPSQ-C). Results Data from a sample of 2,128 students were analysed and showed a point-prevalence rate of 4.4% (95% CI 3.5-5.2) and a significant gender difference (6.6% girls vs. 1.8% boys, P < 0.001). No significant differences in prevalence of probable cases emerged across the ages. At sub-threshold level, marked social fear of at least one social situation was reported by 13.8% of the total group. "Speaking in front of class and "calling someone unfamiliar on the phone were the most feared social situations. In the social phobia group, 91.4% reported impairment in the school-domain due to their social fear. Conclusion Social phobia is a common psychiatric condition in Swedish adolescents, especially in girls. As impairment in the school-domain is reported to a high degree, professionals and teachers need to recognize social phobia in adolescents so that help in overcoming the difficulties can be offered.

Keyword
prevalence, social phobia, adolescents, gender
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18017 (URN)10.1007/s00127-008-0400-7 (DOI)
Available from: 2009-05-04 Created: 2009-05-04 Last updated: 2017-12-13
3. Social anxiety disorder and victimization in a community sample of adolescents
Open this publication in new window or tab >>Social anxiety disorder and victimization in a community sample of adolescents
2011 (English)In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 34, no 3, 569-577 p.Article in journal (Refereed) Published
Abstract [en]

Despite high prevalence rates of social anxiety disorder (SAD) and high rates of victimization in adolescents, studies on the relationship between these phenomena are missing. In the present study we report associations between SAD and multiple victimization experiences in a community sample of adolescents. A cross-sectional study was conducted on 3211 Swedish high-school students. The prevalence rate of self-reported SAD was 10.6% (n=340). Significantly higher rates of lifetime victimization was found in subjects with self-reported SAD compared to non-cases, on the total score on the Juvenile Victimization Questionnaire, and on the subscales maltreatment, sexual victimization and victimization from peer/siblings. Different results emerged due to gender. In females, maltreatment and sexual victimization was associated with an increased risk of SAD and, in males sexual victimization increased the risk of reporting SAD. Further studies are needed to elaborate developmental models on SAD and to add to modification of prevention- and treatment interventions.

Place, publisher, year, edition, pages
Elsevier, 2011
Keyword
Social anxiety disorder, Adolescents, Victimization, Gender
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-57936 (URN)10.1016/j.adolescence.2010.03.007 (DOI)20416944 (PubMedID)
Available from: 2010-07-09 Created: 2010-07-09 Last updated: 2017-12-12
4. Longitudinal associations between social anxiety, depressive symptoms and peer victimization in adolescence: A prospective community study
Open this publication in new window or tab >>Longitudinal associations between social anxiety, depressive symptoms and peer victimization in adolescence: A prospective community study
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Self-reported social anxiety, depressive symptoms and peer victimization was investigated in 350 students in grade 7 and then in grade 8, 9 and 11. Using latent growth modeling, social anxiety was found to be stable over time and to have a time-invariant association with depressive symptoms. Further, social anxiety predicted subsequent depressive symptoms but not vice versa. Support was found for a meditational model. That is, peer victimization in grade 7 was related to higher level of social anxiety, which in turn was associated with more depressive symptoms in grade 8, 9 and 11. The development of social anxiety and depression symptomatology among adolescents can thus be described as one sequential longitudinal process initiated by peer victimization.

Keyword
Social anxiety, adolescents, developmental course, depressive symptoms, peer victimization, latent growth modeling
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-57937 (URN)
Available from: 2010-07-09 Created: 2010-07-09 Last updated: 2014-11-28Bibliographically approved

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