Current Trends in the Understanding and Treatment of Social Phobia in Youth

Abstract

Social phobia is a common psychiatric problem in children and adolescents that has recently gained serious attention in clinical practice and research. This article describes the clinical presentation of social phobia and reviews several emergent areas of related research to social phobia in children and adolescents. We begin with a summary of research regarding the developmental pathways of childhood social anxiety into social phobia, highlighting normative developmental factors, behavioral inhibition, pathophysiology, genetics, and parenting/environmental factors. This is followed by a critical review of findings from studies providing evidence for and against the existence of subtypes of social phobia. Common comorbid disorders and sequelae of social phobia in children and adolescents are discussed, bringing to attention the critical need for effective treatments, the current status of which is reviewed in the final section. In sum, this review demonstrates that through research in multiple disciplines, scientists are now developing a better understanding of the risk and protective factors of social phobia in children and adolescents, ultimately leading to improvements in primary prevention and intervention efforts for children at serious risk for long-term problems with education, employment, social relationships, and independent adult functioning.

Girls' and Mothers' Social Anxiety, Social Skills, and Loneliness: Associations After Accounting for Depressive Symptoms

“…As Velting and Albano (2001) noted, a moderate level of social fears and social anxiety is normative for children and necessary for optimal social functioning and development. Yet many youth have a social fear or excessive social anxiety that is associated with impaired functioning, despite not having social phobia (Essau, Conradt, & Petermann, 1999).…”

Elevated social anxiety among early maturing girls.

“…Social anxiety is characterized by an intense, pervasive fear of negative evaluation, or of acting in a manner that is potentially embarrassing while under the scrutiny of others. Elevated social anxiety can be differentiated from the diagnosis of social phobia/social anxiety disorder, which is characterized by a clinically-significant impairment in functioning [American Psychiatric Association (APA), 2000]; importantly, sub-clinical social phobia, or elevated social anxiety, also can be extremely distressing (Bruch, 1989; Storch, Masia-Warner, Crisp, & Klein, 2005), may lead to the development of clinical social phobia (La Greca & Moore Harrison, 2005; Velting & Albano, 2001), and has been linked to many of the comorbid problems associated with a formal diagnosis such as substance use and depression (Essau et al, 1999; Sonntag, Wittchen, Höfler, Kessler, & Stein, 2000). …”

Subjective versus objective behavioral ratings following two analogue tasks: A comparison of socially phobic and non-anxious adolescents

“…Furthermore, it is one of the most common psychiatric disorders in youth with prevalence rates estimated between three and four percent (Beidel et al, 1999). In addition, social phobia is associated with significant impairment in functioning as it often involves limitations in interpersonal relationships (Hersen & Last, 1990), limits adolescents' participation in social activities (Velting & Albano, 2001), and is related to an increased risk for depression ) and substance abuse (Clark, 1993). Finally, although a significant amount of research has been conducted with adult populations, a fair amount with child populations, very little research has focused exclusively on adolescents.…”