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Early identification and treatment of social anxiety disorder (SAD) is critical to prevent development of a chronic course of symptoms, persistent functional impairment, and progressive psychiatric comorbidity. A small but growing literature supports the effectiveness of cognitive behavior therapy (CBT) for anxiety disorders, including SAD, in adolescence. The present randomized controlled trial evaluated the efficacy of group vs. individual CBT for adolescents with generalized SAD in relation to an educational/supportive psychotherapy that did not contain specific CBT elements. All three treatments were associated with significant reductions in symptoms and functional impairment, and in improved social skills. No differences between treatments emerged on measures of symptoms, but the CBT conditions demonstrated greater gains on behavioral measures. The implications of the findings are discussed. KeywordsSocial anxiety disorder; adolescence; social phobia; cognitive behavior therapy Address correspondence to: James D. Herbert, Department of Psychology, Drexel University, Mail Stop 988, 245 N. 15 th Street, Philadelphia, PA 19102-1192 or via james.herbert@drexel.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptSocial anxiety disorder (SAD), also known as social phobia, is characterized by a marked and persistent fear and/or avoidance of social situations in which one fears being negatively evaluated by others or being subjected to embarrassment (American Psychiatric Association, 2000). SAD is divided into two subtypes: generalized and non-generalized. Individuals with generalized SAD experience anxiety across most social situations, whereas those with the non-generalized subtype fear a specific social or performance situation (Hofmann, Albano, Heimberg, Tracey, Chorpita, & Barlow, 1999). SAD is widely believed to be among the most prevalent of psychiatric conditions, although most individuals with the disorder are never identified and do not obtain treatment (Chavira, Stein, Bailey, & Stein 2004;Kessler et al., 1994). Without treatment, SAD tends to follow a chronic, unremitting course. Onset is typically in the early teens, with a mean onset of 15.5 years (Schneier, Johnson, Hornig, Liebowitz, & Weissman, 1992). Although the vast majority of research on SAD has focused on adults, the early onset, chronicity, high levels of comorbidity, and substantial distress and functional impairment associated with the disorder highlight the critical importance of effective early ass...

Epidemiological research serves a critical role in public mental health planning in the aftermath of disasters, particularly via estimation of the mental health burden and potential needs of affected communities. However, different measures are used across studies to assess mental health response, making cross-study comparison difficult. The National Women's Study Posttraumatic Stress Disorder module (NWS-PTSD) and PTSD Checklist (PCL) have been among the most widely used measures of PTSD in postdisaster research. Here, the authors used a sample of 233 New York City-area residents who were administered both the NWS-PTSD and PCL 4 months after the September 11, 2001 terrorist attacks. The PCL yielded higher prevalence estimates at the symptom, cluster, and diagnostic levels. Implications for the interpretation of epidemiological data are discussed.

This study aims to explore rates of bereavement-related mental health outcomes and diagnostic comorbidity along with the associations between mental health outcomes, perceived social support, knowledge of services, and service use among a diverse sample of 47 survivors 2 years post loss. Findings are consistent with prior studies in that homicide is associated with an overlapping of significant symptom presentation of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and complicated grief (CG). Lack of grief-specific social support was demonstrated to be associated with PTSD and MDD but not with CG. Although a significant number of survivors reported poor mental health outcomes, a limited number were using services.

Given the significant rates and deleterious consequences of childhood sexual abuse (CSA), identifying effective primary prevention approaches is a clear priority. There isa growing awareness that childcare professionals (e.g.,teachers, childcare personnel, clergy) are in a unique position to engage in prevention efforts due to high accessibility to children and expertise in child development. However, CSA prevention programs targeting childcare professionals have received insufficient attention. The goal of this study was toc on duct an independent multi-site controlled evaluation of an existing CSA prevention program, Stewards of Children, offered through both in-person and web-based formats. This study included 352 childcare professionals recruited from children’s advocacy centers across three states. Participants were randomly assigned to one of three conditions: (1) inperson training, (2) web-based training, or (3) waitlist control. Dependent variables included CSA knowledge, CSA attitudes,and self-reported CSA preventive behaviors. Results indicated that Stewards impacted knowledge, attitudes, and preventive behaviors. No differences were found between training modalities (i.e., in-person versus web-based) on knowledge and preventive behaviors. Results indicate that brief trainings for childcare professionals may impact CSA prevention efforts.

Background Each homicide leaves behind several friends and family members, or homicide survivors. However, limited information is available on the impact of homicide on adolescent survivors. The purpose of the current study was to identify the prevalence of homicide survivorship and to determine mental health outcomes within a sample of U.S. adolescent survivors. Methods A nationally representative sample of American adolescents (N=3,614) between the ages of 12–17 completed structured telephone interviews assessing homicide survivorship and mental health consequences including posttraumatic stress disorder (PTSD), depression, drug use, and alcohol abuse. Results Reported prevalence within this sample of losing a loved one to criminal homicide was 9%, losing a loved one to vehicular homicide was 7%, and losing a loved one to both types of homicide was 2%. Logistic regression analyses found that adolescents who reported being homicide survivors were significantly more likely to report depression, drug use, and alcohol abuse after controlling for demographic factors and other violence exposure. Conclusions If the results from this study are generalizable to the US population, roughly 1 in 5 American adolescents may be impacted by homicide. Further, adolescents exposed to such a loss are at increased risk for mental health sequalae. Results suggest that greater attention needs to be paid to address the needs of these often underserved victims.

The development and clinical trial of a 5-session behavioral intervention for complicated bereavement (CB) is presented. We conceptualized CB in terms of Major Depression (MDD) and Post-traumatic Stress Disorder (PTSD) and consequently applied treatment components of Behavioral Activation and Therapeutic Exposure (BA-TE). In order to assure standardization of treatment, control costs, and engage patients, a multi-media, multi-context format was adopted to address avoidance and withdrawal behaviors conceptualized as central pathogenic responses in CB. Participants (N = 26) were assessed before and after BA-TE treatment via structured clinical interview and standardized questionnaires in terms of PTSD, MDD, CB, and health concerns. The number of days since the death of the loved one was widely variable and served as a covariate for all outcome analyses. ANCOVAS revealed statistically significant improvement, irrespective of how many days since death had elapsed prior to initiation of intervention, on structured interviews and self-report measures for most outcome variables.