Abstract
Although social anxiety disorder (SAD) is most often diagnosed during adolescence, few investigations have examined the clinical presentation and daily functional impairment of this disorder exclusively in adolescents. Prior studies have demonstrated that some clinical features of SAD in adolescents are unique relative to younger children with the condition. Furthermore, quality of sleep, a robust predictor of anxiety problems and daily stress, has not been examined in socially anxious adolescents. In this investigation, social behavior and sleep were closely examined in adolescents with SAD (n = 16) and normal control adolescents (NC; n = 14). Participants completed a self-report measure and an actigraphy assessment of sleep. Social functioning was assessed via a brief speech and a social interaction task, during which heart rate and skin conductance were measured. Additionally, participants completed a daily social activity journal for 1 week. No differences were observed in objective or subjective quality of sleep. Adolescents with SAD reported greater distress during the analogue social tasks relative to NC adolescents. During the speech task, adolescents with SAD exhibited a trend toward greater speech latency and spoke significantly less than NC adolescents. Additionally, SAD participants manifested greater skin conductance during the speech task. During the social interaction, adolescents with SAD required significantly more confederate prompts to stimulate interaction. Finally, adolescents with SAD reported more frequent anxiety-provoking situations in their daily lives, including answering questions in class, assertive communication, and interacting with a group. The findings suggest that, although adolescents with SAD may not exhibit daily impaired sleep, the group does experience specific behavioral and physiological difficulties in social contexts regularly. Social skills training may be a critical component in therapeutic approaches for this group.
Highlights
Social fears are relatively common, as 24.1% of respondents in a recent U.S survey reported at least one lifetime social fear [1]
Similar findings were reported when heart rate reactivity was assessed among normal controls, subclinical socially anxious adolescents, and adolescents with Social anxiety disorder (SAD) [22]. These findings suggest that perceptions of increased physiological arousal produce significant distress among adolescents with SAD, though they may not experience actual increased physiological arousal in laboratory settings
Group differences were examined with multivariate analysis of variance on selected groups of dependent variables, followed by ANOVA when the overall MANOVA statistic was significant at p,.05.The correlations among variables targeted in each MANOVA were examined
Summary
Social fears are relatively common, as 24.1% of respondents in a recent U.S survey reported at least one lifetime social fear [1]. Social anxiety disorder (SAD) is typified by a pattern of excessive fear of social situations or performances in which an individual may be scrutinized by others [2]. The prevalence of SAD within the general population is among the highest of all the anxiety disorders. Recent estimates have placed its 12-month and lifetime prevalence at approximately 7% and 12% in community samples, respectively [7], and without treatment, the course of the disorder spans decades [8]. Within youth observed prevalence of SAD ranges from approximately 1% [12] to 5.4% [13] in community samples and even higher rates have been reported from clinical samples [14]
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