Are Social and Communication Difficulties a Risk Factor for the Development of Social Anxiety?

Hannah Pickard,Fruhling Rijsdijk,Francesca Happé,William Mandy

doi:10.1016/j.jaac.2017.01.007

Abstract

ObjectiveSocial anxiety (SA) is a common condition associated with social and communication (SC) difficulties in typically developing young people, as well as those with autism spectrum disorder (ASD). Whether SC difficulties place children at risk for developing SA is unclear. Using a longitudinal design, the present study aimed to disentangle the relationship between SA symptoms and SC difficulties using a population-based sample of 9,491 children from the Avon Longitudinal Study of Parents and Children (ALSPAC).MethodParent-reported data on SC difficulties and SA symptoms were collected at ages 7, 10, and 13 years. A cross-lagged panel model was used to investigate the longitudinal stability and directional relationship between latent SC difficulties and SA constructs over time.ResultsMore SC difficulties were associated with greater SA symptoms at all ages. Earlier SC difficulties predicted a small but significant amount of variance in later SA symptoms. The reverse relationship from SA to SC difficulties was not observed. The relationship from SC difficulties to SA was strongest from age 7 to 10 years. No sex differences were observed.ConclusionThe evidence suggests that SC difficulties may be an important risk factor for the development of SA. These findings suggest the potential usefulness of incorporating social skills training alongside effective interventions to prevent or alleviate symptoms of SA in childhood.

Highlights

These findings suggest the potential usefulness of incorporating social skills training alongside effective interventions to prevent or alleviate symptoms of Social anxiety (SA) in childhood
Social anxiety (SA) disorder is characterized by an intense fear of social situations, which is often accompanied by the fear of being scrutinized by others.[1]
Anxiety-related fears are commonly driven by negative self-perceptions and a fear of being ridiculed by others, which can lead to increased social withdrawal and avoidance.[2]

Summary

Methods

Parent-reported data on SC difficulties and SA symptoms were collected at ages 7, 10, and 13 years. All participants were from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort, a population-based sample of children born in Bristol between 1991 and 1992. Following ALSPACs exclusion criteria for prorated scores, only children with 50% or more complete data on all measures of interest at all ages were included in the present study. Based on these exclusion criteria, 248 children (3%), 204 children (2.6%), and 226 children (3.2%) were excluded at ages 7, 10, and 13 years, respectively. Merging the three samples at ages 7 (n 1⁄4 7,900), 10 (n 1⁄4 7,519), and 13 (n 1⁄4 6,782) years, the final sample included 9,491 children (4,654 female) with data at one, two, or three time points. Compared to the original ALSPAC cohort not included in the current analyses, young people in our final sample were more likely to have a mother who was a homeowner (odds ratio [OR] 1⁄4 2.94, 95% CI 1⁄4 2.72, 3.19) and had completed higher education (OR 1⁄4 2.33, 95% CI 1⁄4 2.13, 2.55)

Results

Discussion

Conclusion