The Relevance of Age of Onset to the Psychopathology of Social Phobia

Abstract

The present study aimed to examine the relevance of age of onset to the psychopathology of social phobia using a large clinical sample of 210 patients with social phobia. The two most common periods of onset were during adolescence (ages 14–17) and early childhood (prior to age 10). Structural regression modeling was used to test predictions that early onset social phobia would be associated with greater severity of the disorder, stronger current symptoms of depression and anxiety, greater functional impairment, and more pronounced levels of emotional disorder vulnerabilities (e.g., neuroticism/behavioral inhibition, extraversion, perceptions of control). Logistic regression was used to evaluate relationships between age of onset and the presence of acute and chronic stress at the time of onset. Results showed that earlier age of social phobia onset was associated with stronger current psychopathology, functional impairment, and emotional disorder vulnerabilities, and that later age of onset predicted the presence of an acutely stressful event around the time of disorder emergence. These results are discussed in regard to their clinical implications and congruence with prominent etiological models of the emotional disorders.

Persistence and remission of ADHD during adulthood: a 7-year clinical follow-up study

“…The other study did not find predictive effects for any co-morbidity (Kessler et al 2005). Another possible reason for the lack of association between social phobia and persistence in childhood ADHD is the fact that a significant fraction of cases of social phobia starts during or after adolescence (Rosellini et al 2013). Previous studies have suggested that both oppositional defiant disorder and social phobia may be related with a worse response to treatment as well as with some difficulty to engage in clinical interventions (Souery et al 2007;Stringaris & Goodman, 2009;).…”

Comparison of Early Maladaptive Schemas and Metacognitive Beliefs between the Students with Social Phobia and the ones with no Psychiatric Problems

“…Based on these studies, early maladaptive schema as a deeper cognitive variable affects social phobia through behavioral-cognitive variables (perception of others' negative assessment, negative selfassessment and behavioral inhibition). The main feature of social phobia is a distinguished and stable fear of social situations in which one might be confused and embarrassed because people with social phobia believe that their behaviors would socially have catastrophic consequences (22). In the past few decades, many theoretical models were represented to explain the mechanism underlying this distinguished fear of social situations in particular and social phobia in general, some of which emphasized the cognitive processes.…”

Adolescent Social Phobia in Clinical Services

“…Among anxiety disorders, SAD has one of the earliest onset and, without intervention, tends to follow a chronic course (Brown et al 2001 ;Burstein et al 2011 ;Juster and Heimberg 1995 ;Reich et al 1994 ;Rosellini et al 2013 ;Stein and Stein 2008 ). In fact, the median age of onset of SAD appears to be more accurately described as bimodal; in one large sample of individuals presenting for treatment, 21 % reported an age of onset before the age of 10, and 47.6 % reported an age of onset during adolescence/early adulthood (14-22) (Rosellini et al 2013 ).…”

“…In fact, the median age of onset of SAD appears to be more accurately described as bimodal; in one large sample of individuals presenting for treatment, 21 % reported an age of onset before the age of 10, and 47.6 % reported an age of onset during adolescence/early adulthood (14-22) (Rosellini et al 2013 ). Age of onset in the middle childhood years (10-14) or adult years (over 23) 1 is relatively rare (Rosellini et al 2013 ;Wittchen and Fehm 2003 2 ). For more details, please see Chap.…”

“…Developmental psychologists (and increasingly clinical psychologists) place a premium on developmental pathways, highlighting the various vulnerabilities, conditioning events, and maintaining factors underlying a disorder (Higa-McMillan and Ebesutani 2011 ;Vasey and Dadds 2001 ). Although age of onset during adolescence appears to be more strongly related to the presence of some acute stressor or stressors around the time the SAD developed, most researchers believe the individual's response to these stressors is strongly infl uenced by a variety of vulnerabilities produced by exposure to any number of risk factors (Rosellini et al 2013 ). It is also worth considering early factors in the onset of SAD because earlier age of onset predicts increases in symptom severity, autonomic arousal, depression, higher levels of neurotic temperament, and functional impairment (Rosellini et al 2013 : see Knappe et al Chap.…”