Post-traumatic stress disorder (PTSD) has become a global health issue, with prevalence rates ranging from 1.3% to 37.4%. As there is little current data on PTSD in Canada, an epidemiological study was conducted examining PTSD and related comorbid conditions. Modified versions of the Composite International Diagnostic Interview (CIDI) PTSD module, the depression, alcohol and substance abuse sections of the Mini International Neuropsychiatric Interview (MINI), as well as portions of the Childhood Trauma Questionnaire (CTQ) were combined, and administered via telephone interview in English or French. Random digit dialing was used to obtain a nationally representative sample of 2991, aged 18 years and above from across Canada. The prevalence rate of lifetime PTSD in Canada was estimated to be 9.2%, with a rate of current (1-month) PTSD of 2.4%. Traumatic exposure to at least one event sufficient to cause PTSD was reported by 76.1% of respondents. The most common forms of trauma resulting in PTSD included unexpected death of a loved one, sexual assault, and seeing someone badly injured or killed. In respondents meeting criteria for PTSD, the symptoms were chronic in nature, and associated with significant impairment and high rates of comorbidity. PTSD is a common psychiatric disorder in Canada. The results are surprising, given the comparably low rates of violent crime, a small military and few natural disasters. Potential implications of these findings are discussed.

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Background There is a paucity of data examining the prevalence and impact of childhood maltreatment in patients presenting with a primary diagnosis of social anxiety disorder (SAD). We thus examined the presence of a broad spectrum of childhood maltreatment, including physical, sexual, and emotional abuse and neglect, in treatment-seeking individuals with the generalized subtype of SAD (GSAD). We hypothesized that a history of childhood maltreatment would be associated with greater SAD symptom severity and poorer associated function. Methods One hundred and three participants with a primary diagnosis of GSAD (mean age 37±14; 70% male) completed the well-validated, self-rated Childhood Trauma Questionnaire (CTQ), as well as measures of SAD symptom severity and quality of life. Results Fully 70% (n = 72) of the GSAD sample met severity criteria for at least one type of childhood abuse or neglect as measured by the CTQ subscales using previously established thresholds. CTQ total score adjusted for age and gender was associated with greater SAD severity, and poorer quality of life, function, and resilience. Further, the number of types of maltreatment present had an additive effect, with specific associations for emotional abuse and neglect with SAD severity. Conclusions Despite the use of validated assessments, our findings are limited by the retrospective and subjective nature of self-report measures used to assess childhood maltreatment. Nonetheless, these data suggest a high rate of childhood maltreatment in individuals seeking treatment for GSAD, and the association of maltreatment with greater disorder severity suggests that screening is clinically prudent.

One of the most popular measures of social phobia is the Liebowitz Social Anxiety Scale (LSAS; Liebowitz, 1987). The LSAS is a 24-item semi-structured interview measure of fear and avoidance experienced in a range of social and performance situations. Recently, the LSAS has been modified to a self-report version (LSAS-SR) by several independent groups (Cox, Ross, Swinson, & Direnfeld, 1998; Fresco et al., 2001; Mancini, Van Ameringen, & Oakman, 1999). A self-report version offers ease of administration, but it may differ from the structured interview version in its psychometric properties. We conducted confirmatory factor analyses of the self-report version of the LSAS using data from a sample of 188 outpatients with anxiety disorders. The structure and psychometric properties of the LSAS-SR are highly similar to that of the LSAS and robust across groups of patients with a variety of primary anxiety disorders. We argue in favor of adopting the 4-factor model for the LSAS proposed by Safren et al. (1999) instead of the models implied by the scoring instructions for the LSAS.

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clinicaltrials.gov Identifier: NCT00182507.

Behavioral inhibition to the unfamiliar is a temperamental construct that refers to a characteristic propensity to react to both social and nonsocial novelty with inhibition. In contrast, shyness refers to feelings of discomfort in social situations but not nonsocial situations. Both shyness and behavioral inhibition are associated with anxiety disorders in children and adults. We compared the role of social and nonsocial inhibition in predicting anxiety disorder symptomatology. Patients (N = 225) at a university affiliated Anxiety Disorders Clinic completed several psychometric measures including the Retrospective Self-Report of Behavioral Inhibition (RSRI) and the Revised Shyness Scale. The RSRI has two replicable factors: social fears and general fearfulness. The social fears factor shows a stronger pattern of relationships to clinically relevant variables such as self-reports of symptomatology, social adjustment, and disability. Social, rather than nonsocial, fearfulness may account for the relationship between behavioral inhibition and anxiety disorder symptomatology.

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