A worrying trend in social anxiety: to what degree are worry and its cognitive factors associated with youth Social Anxiety Disorder?

Background: Comorbidity between Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) is extremely common. This study investigated whether factors commonly associated with GAD, including worry, intolerance of uncertainty (IU), positive and negative beliefs about worry (PBW, NBW), negative problem orientation (NPO) and cognitive avoidance (CA) were associated with SAD severity, symptoms and overall functioning. Method: Participants included 126 youth aged 8–17 years (M=11.29, SD=2.67, Males n=50) with a primary diagnosis of SAD. Participants and a parent underwent a diagnostic interview and completed questionnaires at pre- and 12-week post assessment, and 6-month follow-up. Correlations and hierarchical multiple regression analyses were conducted. Results: Each of the cognitive variables, with the exception of PBW, was found to correlate with SAD symptoms, SAD severity and overall functioning. NPO emerged as an important predictor of SAD severity, self-reported ratings of SAD symptoms, and poorer levels of overall functioning. IU and worry also predicted self-rated SAD symptoms. Limitations: Measures were chosen on the basis of their sound psychometrics however some were yet to undergo rigorous testing with youth populations. The study design is cross-sectional, which restricts firm conclusions regarding causal and temporal associations between the variables. Conclusions: Findings from this study have implications for the specificity of GAD and SAD in youth. Further research is required to understand whether these cognitive variables play a maintaining role in youth SAD and the extent to which they might influence treatment

Do worry and its associated cognitive variables alter following CBT treatment in a youth population with Social Anxiety Disorder? Results from a randomized controlled trial

Social Anxiety Disorder (SAD) affects between 1 and 10% of children (Anderson, Williams, McGee, & Silva, 1989; Kashani & Orvaschel, 1990; Schneier, 2006), and in adolescents, has a lifetime prevalence ranging from 3.9%–13.7% (Fehm, Pelissolo, Furmark, & Wittchen, 2005; Kessler et al., 2005; Kessler et al., 2012; Ruscio et al., 2008). SAD confers significant deleterious consequences (Beesdo et al., 2007; Wittchen, Fuetsch et al., 1999; Wittchen, Stein, & Kessler, 1999), and if left untreated, tends to persist (Beesdo-Baum et al., 2012; Burstein et al., 2011; Kessler et al., 2012). It commonly co-occurs with other mood and anxiety disorders and is particularly comorbid with Generalized Anxiety Disorder (GAD), with research demonstrating that pure forms of either GAD or SAD are relatively rare (Walkup et al., 2008). Not only is SAD in youth prevalent, detrimental and persistent, but there are also less positive outcomes following CBT for those suffering with SAD compared to those afflicted with other anxiety disorders (Ginsburg et al., 2011; Hudson et al., 2015).Griffith Health, School of Applied PsychologyNo Full Tex

What’s the worry with social anxiety? Comparing cognitive processes in children with generalized anxiety disorder and social anxiety disorder

Social anxiety disorder (SAD) in children is often comorbid with generalized anxiety disorder (GAD). We investigated whether worry, intolerance of uncertainty, beliefs about worry, negative problem orientation and cognitive avoidance, that are typically associated with GAD, are present in children with SAD. Participants included 60 children (8–12 years), matched on age and gender. Groups included children: with primary GAD and without SAD (GAD); with primary SAD and without GAD (SAD); and without an anxiety disorder (NAD). GAD and SAD groups scored significantly higher than the NAD group on worry, intolerance of uncertainty, negative beliefs about worry and negative problem orientation, however, they did not score differently from each other. Only the GAD group scored significantly higher than the NAD group on cognitive avoidance. These findings further understanding of the structure of SAD and suggest that the high comorbidity between SAD and GAD may be due to similar underlying processes within the disorders

Generic versus disorder specific cognitive behavior therapy for social anxiety disorder in youth: a randomized controlled trial using internet delivery

The study examined whether the efficacy of cognitive behavioral treatment for Social Anxiety Disorder for children and adolescents is increased if intervention addresses specific cognitive and behavioral factors linked to the development and maintenance of SAD in young people, over and above the traditional generic CBT approach. Participants were 125 youth, aged 8e17 years, with a primary diagnosis of SAD, who were randomly assigned to generic CBT (CBT-GEN), social anxiety specific CBT (CBT SAD) or a wait list control (WLC). Intervention was delivered using a therapist-supported online program. After 12-weeks, participants who received treatment (CBT SAD or CBT-GEN) showed significantly greater reduction in social anxiety and post-event processing, and greater improvement in global functioning than the WLC but there was no significant difference between CBT-SAD and CBT-GEN on any outcome variable at 12-weeks or 6-month follow-up. Despite significant reductions in anxiety, the majority in both treatment conditions continued to meet diagnostic criteria for SAD at 6-month followup. Decreases in social anxiety were associated with decreases in post-event processing. Future research should continue to investigate disorder-specific interventions for SAD in young people, drawing on evidence regarding causal or maintaining factors, in order to enhance treatment outcomes for this debilitating condition