Psychosocial correlates of childhood anxiety disorders

OBJECTIVE: This study explored psychosocial and "environmental" correlates of childhood anxiety disorders. The study examined relationships among parental psychiatric symptomatology, perceived family environment, temperament, and self-competence in children with a DSM-III-R anxiety disorder. METHOD: A community sample of third through sixth graders was screened initially for symptoms of test anxiety. Those with high and low scores were administered the Anxiety Disorders Interview Schedule for Children. Three groups (childhood anxiety disorder, test-anxious only, and normal controls) were identified and compared on the psychosocial variables. RESULTS: Children with an anxiety disorder had greater impairment on the indices of perceived self-competence and temperamental flexibility than controls, with the test-anxious children showing intermediate, yet significant, levels of disturbance. There was a trend for children with an anxiety disorder to describe their families as less promoting of independence than the other groups. Finally, measures of parental psychiatric symptomatology revealed more obsessive-compulsive symptoms for the fathers of both the anxiety disorder and test-anxious children compared with controls. CONCLUSIONS: Results are consistent with previous findings suggesting the familial transmission of anxiety disorders and recent speculations regarding a relationship between behavioral inhibition, environmental control, and anxiety. Further research may isolate psychosocial and family environmental factors as instrumental treatment targets in the management of childhood anxiety disorders.     

Social phobia: A comparison of specific and generalized subtypes and avoidant personality disorder.

The validity of the social phobia subtype distinction was examined in a large sample of carefully diagnosed social phobics (N?=?89). Generalized and specific subtypes were diagnosed reliably, and the generalized subtype showed a consistent pattern of greater symptom severity than did the specific subtype. In addition, generalized social phobics with and without avoidant personality disorder were compared, and a difference was found for only 1 of 4 parameters. The results are discussed in terms of the validity of subtyping in social phobia and the diagnostic boundary between social phobia and avoidant personality disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of an abbreviated Social Phobia and Anxiety Inventory (SPAI) using item response theory: The SPAI-23.

An abbreviated version of the Social Phobia and Anxiety Inventory (SPAI) was developed using methods based in nonparametric item response theory. Participants included a nonclinical sample of 1,482 undergraduates (52% female, mean age = 19.4 years) as well as a clinical sample of 105 individuals (56% female, mean age = 36.4 years) diagnosed with either generalized (73%) or specific social phobia (27%). Twenty-three of the 45 SPAI items demonstrated good discrimination along the social anxiety continuum. In addition, option characteristic curves (OCCs) indicated that the SPAI's 7-point scale may generate errors in ranking individuals. Thus, options were collapsed to improve item performance. No gender differences emerged between any of the items' OCCs, suggesting that items function similarly among men and women. The abbreviated version also correlated highly with the original 45-item SPAI and exhibited similar patterns of correlations with measures of social anxiety. The SPAI-23 has considerable practical benefits, including a screening of both social and agoraphobic anxiety as well as decreased assessment and scoring time. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reliability and validity of the Social Phobia and Anxiety Inventory for adolescents.

Although social anxiety is known to be common among adolescents, there are no self-report measures with demonstrated reliability and validity for this population. The Social Phobia and Anxiety Inventory (SPAI) is a measure of social anxiety developed for adults. The purpose of this study was to determine the reliability and validity of the SPAI for adolescents. The sample consisted of 223 adolescents (aged 12–18 yrs) from both clinical and community sources. Confirmatory factor analysis established the validity of the 2 separate factors of Social Phobia and Agoraphobia. Reliability estimates by Cronbach alpha were acceptable for the SPAI subscales and total. The SPAI demonstrated good construct validity, showing statistically significant relationships with independent measures of social phobia and other anxiety variables. The results demonstrate that the SPAI is a reliable and valid measure of social phobia for adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An empirically derived inventory to measure social fears and anxiety: The Social Phobia and Anxiety Inventory.

The development, reliability, and discriminative ability of a new instrument to assess social phobia are presented. The Social Phobia and Anxiety Inventory (SPAI) is an empirically derived instrument incorporating responses from the cognitive, somatic, and behavioral dimensions of social fear. The SPAI high test–retest reliability and good internal consistency. The instrument appears to be sensitive to the entire continuum of socially anxious concerns and is capable of differentiating social phobics from normal controls as well as from other anxiety patients. The utility of this instrument for improved assessment of social phobia and anxiety and its use as an aid for treatment planning are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Situational determinants of social anxiety in clinic and nonclinic samples: Physiological and cognitive correlates.

Compared the level of physiological reactivity and frequency of negative cognitions in 26 nonclinic, socially anxious (SA) Ss (mean age 20.8 yrs), 17 clinic SA patients (mean age 40.8 yrs), and 26 nonsocially anxious (NSA) Ss (mean age 22.0 yrs) to investigate the consistency of cognitive and physiological reactivity in the assessment of social anxiety. A social interaction self-statement test served as the cognitive measure. Physiological reactivity was monitored continuously throughout Ss' completion of the following behavioral tasks: an unstructured interpersonal interaction with an opposite-sex confederate, a similar interaction with a same-sex confederate, and an impromptu talk on a topic selected by the S. The clinic and nonclinic samples of SA Ss differed significantly from the NSA Ss in level of physiological reactivity and type of cognition. There were no significant differences between the 2 anxious groups. The results indicate that both thoughts and physiological reactivity were influenced by situational parameters. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Panic disorder and agoraphobia with panic attacks: Covariation along the dimensions of panic and agoraphobic fear.

Tested the validity of the distinction made in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) between the diagnoses of "panic disorder" and "agoraphobia with panic attacks" by examining the pattern of covariation between panic symptoms and agoraphobic fear in a group of individuals presenting with panic attacks as a prominent symptom. Ss were 17 patients (mean age 34.4 yrs) who had been diagnosed as having panic disorder and 56 patients (mean age 36.4 yrs) diagnosed as having agoraphobia with panic attacks, and who had completed at the time of diagnosis both the Fear Survey Schedule and the SCL-90-R. Analyses of the panic-related items and the agoraphobia-related items of these 2 inventories revealed that irrespective of diagnosis, the degree of panic was highly correlated with the degree of agoraphobic fear. Although panic patients tended to experience more severe panic and milder agoraphobic fear than agoraphobics, the groups overlapped with respect to both kinds of symptoms. Findings are discussed in terms of whether panic disorder and agoraphobia should be classified as qualitatively distinct conditions. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathology in the offspring of anxiety disorders patients.

Children of patients with an anxiety disorders diagnosis were assessed with a battery of self-report inventories and a semistructured interview schedule. The performance of these children was compared with that of children of patients with a diagnosis of dysthymic disorder, children of normal parents, and normal school children. Children of anxiety disorders patients were found to be more anxious and fearful; to report more school difficulties, more worries about family members and themselves, and more somatic complaints; and to spend more time engaged in solitary activities than children in either of the two normal groups. In addition, they were found to be more than 7 times as likely to meet criteria for an anxiety disorder than the two normal groups and to be twice as likely to have an anxiety disorder than the children of dysthymics. The resultant implications for familial factors in anxiety disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social phobia: An analysis of possible developmental factors.

Sixty-eight individuals with specific or generalized social phobia and 25 normal controls were assessed for presence of a family history of anxiety, childhood shyness, traumatic conditioning experiences, neuroticism, and extraversion. Subtype differences emerged, including significantly greater neuroticism and a more frequent history of shyness in the generalized subtype. Those with the generalized subtype also had significantly lower extraversion scores, and those with the specific subtype had a significantly higher frequency of traumatic conditioning episodes. Together, traumatic conditioning and childhood shyness predicted the presence of social phobia, although other unidentified factors also appeared to be relevant. The results are discussed in terms of potentially different modes of onset for the subtypes of social phobia and the role of neuroticism and introversion in the development of the disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychophysiological assessment of anxious emotional states in children.

Elementary school children with clinically significant test anxiety, as determined by self-report and a clinical interview, were assessed for autonomic responses when engaged in two social-evaluative tasks: a timed vocabulary test and an oral reading session. The results indicated that as a group, test-anxious children had significantly higher heart rates during both tasks than did their non-test-anxious peers. The similarity in heart rate response patterns across the two conditions indicates that for at least some test-anxious children, fear of negative evaluation is not limited to a "test" situation but may also be evident in other social or evaluative settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)