Efficient Screening for Impairments in Peer Functioning Among Mid-to-Late Adolescents Receiving Clinical Assessments for Social Anxiety

Abstract

Impairments in peer relations comprise a core feature of social anxiety, particularly among adolescents. Yet, these impairments may also stem from concerns that commonly co-occur with social anxiety, namely depressive symptoms and attention-deficit/hyperactivity disorder (ADHD) symptoms. Although peer-related impairments spike during adolescence, we know relatively little about efficiently screening for peer-related impairments that specifically index those impairments relevant to adolescent social anxiety. We recruited 89 adolescents (M = 14.5 years, 64% female, 65.1% African American) who varied on evaluation-seeking status (30 evaluation-seeking; 59 community control). On a preliminary phone screen, parents provided reports on three peer-related impairment items identified in prior work as particularly discriminative: number of friends, trouble making friends, and trouble keeping friends. Parents and adolescents completed survey measures of social anxiety and mental health concerns commonly linked to social anxiety (i.e., depressive symptoms, ADHD symptoms). Increased peer-related impairments were uniquely related to increased social anxiety, controlling for depressive symptoms and ADHD symptoms. Increased peer-related impairments also predicted increased risk for being above the clinical cut score on measures of social anxiety, depressive symptoms, and ADHD symptoms. The number of peer-related impairments significantly distinguished adolescents on evaluation-seeking status. Using a short list of three items assessing peer-related impairments (number of friends, trouble making friends, and trouble keeping friends) one can efficiently screen for peer-related impairments of specific relevance to adolescent social anxiety. These findings have important implications for leveraging efficient, evidence-based screening devices when clinically assessing adolescent social anxiety, particularly in low-resource mental health settings.