Abstract

Purpose: Several studies have demonstrated that the measurement of salivary alpha-amylase (sAA) levels is a useful tool for evaluating the autonomic nervous system. Psychosocial stress increases the release of sAA as a useful marker for autonomic nervous system (ANS). To our knowledge, although some studies have evaluated sAA levels under psychosocial stress, no studies have investigated the changes in sAA activity that occur in junior high school students who are not attending school due to social anxiety disorder (SAD). We aimed to investigate the relationship between the sAA levels and psychiatric states of such patients. Methods: The study subjects consisted of SAD patients (n = 39) and healthy controls (n = 57). We used a portable hand-held monitor to measure the level of sAA and State-Trait Anxiety Index (STAI) to evaluate the psychiatric state. Results: The patients’ sAA activity was significantly higher than that of the controls (n = 57) (p p p p < 0.001) were detected between the patients and healthy controls. Conclusions: These results indicated that junior high school students with SAD exhibit a higher state of anxiety and high autonomic activity, probably due to changes in the sympathetic nervous system. As a result, junior high school students with SAD are expected to exhibit high levels of sAA accompanied by anxiety symptoms.

Highlights

  • Social anxiety disorder (SAD) is characterized by a recurrent and intensely anxious response to social situations in which the patient expects to be evaluated by others [1]

  • Some studies have evaluated salivary alpha-amylase (sAA) levels under psychosocial stress, no studies have investigated the changes in sAA activity that occur in junior high school students who are not attending school due to social anxiety disorder (SAD)

  • Significant differences in heart rate (HR) (76.10 ± 11.96 vs. 68.69 ± 10.61, respectively, p < 0.01) and State-Trait Anxiety Index (STAI) scores (49.35 ± 10.57 vs. 41.24 ± 8.59, respectively, p < 0.01; 55.69 ± 10.44 vs. 45.61 ± 9.36, respectively, p < 0.001) were detected between the patients and healthy controls. These results indicated that junior high school students with SAD exhibit a higher state of anxiety and high autonomic activity, probably due to changes in the sympathetic nervous system

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Summary

Introduction

Social anxiety disorder (SAD) is characterized by a recurrent and intensely anxious response to social situations in which the patient expects to be evaluated by others [1]. Patients with SAD experience more frequent anxiety and higher levels of anxiety in relation to social evaluative threat [2]. The incidence rates of the disorder are higher during childhood and adolescence (e.g., between 10 and 20 years of age) [3] and according to the DSM-5, the median age of onset of social anxiety disorder in the US is 13 years old, with 75% of those with social anxiety disorder experiencing the onset at a range of ages 8 - 15 (American Psychiatric Association, 2013). The DSM-5 cites the annual prevalence of social anxiety disorder as 7%, in both children and adults in the United States (American Psychiatric Association, 2013)

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