Epidemiology of social phobia in Andalusia.

INTRODUCTION: Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian general population sample. MATERIAL AND METHODS: We used a random representative sample previously identified via standard stratification procedures. Thus, a final sample of 4507 participants were included (response rate 83.7%). Interviewees were thoroughly assessed on sociodemographic, clinical and psychosocial factors, including: exposures to threatening life events (TLEs), childhood abuse, personality disorder and traits (neuroticism, impulsivity, paranoia), global functioning, physical health and toxics consumption. SAD diagnosis was ascertained using the Mini International Neuropsychiatric Interview. Both, pooled prevalences (with 95% confidence intervals) and risk correlates for SAD were estimated using binary logistic regression. RESULTS: Estimated prevalence for SAD was 1.1% (95% CI=0.8-1.4). Having a SAD diagnosis was independently and significantly associated with younger age, poorer global functioning, higher neuroticism and paranoia personality traits, having suffered childhood abuse and exposure to previous TLEs. Furthermore, SAD was significantly associated with comorbid personality disorder, major depression, panic disorder and alcohol abuse. CONCLUSIONS: Among this large Andalusian population sample, the prevalence of SAD and its associated factors are relatively similar to previously reported international studies, although no population study had previously reported such a strong association with paranoia.

Social anxiety and psychological distress among polycystic ovarian syndrome patient's in Pakistan.

OBJECTIVE: To examine the fear of negative evaluation as a predictor, and to explore the association of social anxiety with psychological correlates among women with polycystic ovaries. Methods: The cross-sectional study was conducted from August 2020 to November 2021 after approval form the University of Central Punjab, Lahore, Pakistan, and comprised unmarried women aged 18-26 diagnosed with polycystic ovary syndrome. The sample was raised from different clinics and hospitals based in Lahore and Gujranwala cities. The sample was divided into obese, hirsutism and acne vulgaris groups. Data was collected using a demographic proforma along with standardised Derriford Appearance Scale, Brief Fear of Negative Evaluation Scale, University of California, Los Angeles, Loneliness Scale and the Social Interaction Anxiety Scale. Data was analysed using SPSS 24. RESULTS: Of the 180 patients, 60(33.3%) were in each of the 3 groups. The overall mean age was 21.4+/-2.27 years. A significant association of fear of negative evaluation was found with appearance distress, social anxiety and loneliness (p<0.05). The fear of negative evaluation and appearance distress also significantly predicted loneliness in the subjects (p<0.01). The obese group scored significantly higher in terms of fear of negative evaluation and social anxiety compared to the other groups (p<0.05). Conclusion: Women with polycystic ovaries were found to be suffering from adverse psychological outcomes and social anxiety.

Cannabis use and social anxiety disorder in emerging adulthood: Results from a nationally representative sample.

Cannabis use and social anxiety disorder (SAD) are prevalent during emerging adulthood. Previous work has demonstrated that SAD is related to cannabis use in adults; however, less is known about what correlates relate to this association in emerging adults. A subsample of individuals ages 18-25 years old from the NESARC-III (N = 5194) was used to (a) evaluate the association between cannabis use and SAD and (b) examine what correlates may be associated with cannabis use and SAD in emerging adulthood. Weighted cross-tabulations assessed sociodemographics and lifetime psychiatric disorder prevalence estimates among the emerging adult sample. Multinomial logistic regressions examined associations between sociodemographics and psychiatric disorders and four groups (i.e., no cannabis use or SAD; cannabis use only; SAD only; cannabis use + SAD). The prevalence of co-occurring cannabis use and SAD was 1.10%. Being White, a part-time student, or not a student were associated with increased odds of having co-occurring cannabis use + SAD (OR range: 2.26-3.09). Significant associations also emerged between major depressive disorder, bipolar I disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder and co-occurring cannabis use + SAD (AOR range: 3.03-19.05). Results of this study may have implications for better identifying and screening emerging adults who are at risk of co-occurring cannabis use and SAD.

Associations of generalized anxiety and social anxiety with perceived difficulties in school in the adolescent general population.

INTRODUCTION: Generalized anxiety disorder (GAD), marked by excessive worry, and social anxiety disorder (SAD) are among the clinically most important anxiety disorders in the adolescent population. This study aimed to explore the associations between perceived difficulties in school and heightened levels of self-reported noncomorbid and comorbid GAD and SAD symptoms. METHODS: Survey data of 37,905 Finnish upper secondary school students with a mean age of 17.33 years (SD = 0.63) were obtained from the School Health Promotion study, implemented in April and May 2015 in Finland. Exploratory factor analysis was used to determine indicators of academic and social difficulties in school. Logistic regression analysis was conducted to examine multivariate associations between anxiety symptoms and difficulties in the school. The anxiety symptom thresholds were based on the seven-item Generalized Anxiety Disorder Scale (≥10 points) for GAD-related symptoms and the Mini-SPIN (≥6 points) for SAD-related symptoms. RESULTS: Self-reported generalized anxiety and social anxiety were both significantly associated with various perceived difficulties in school among this adolescent general population sample. Noncomorbid and comorbid GAD and SAD symptoms were both associated with an increased risk of academic and social difficulties, even when controlling for school performance. Comorbid symptoms were associated with significantly higher rates of social difficulties than noncomorbid symptoms of GAD or SAD. Furthermore, GAD symptoms were associated with a high risk for academic difficulties, irrespective of comorbidity. CONCLUSIONS: Excessive worry, a defining feature of GAD, is central to school-related impairments among adolescents. The present study highlights the importance of school-based interventions for anxious adolescents. Interventions to improve adolescents'; school functioning should account for the interference of pathological worry related to GAD.

Social anxiety disorder in adolescents who stutter: A risk for school refusal.

BACKGROUND: Stuttering is a childhood-onset fluency disorder. Part of the counseling for middle and high school students with persistent stuttering is related to school refusal. Anxiety disorders are known to contribute to school refusal. However, it is not known whether social anxiety disorder (SAD) is a factor in school refusal among adolescents who stutter. METHODS: In our first study, we examined the relationship between school refusal and SAD in 84 middle and high school students who stutter; 26% of the 84 students were in the school refusal group and the remaining 74% were in the school attendance group. The second study examined whether SAD was associated with 10 factors related to speech and stuttering frequency using the Japanese version of the Liebowitz Social Anxiety Scale for Children and Adolescents to determine the presence of SAD. Of the 84 students in the first study, 40 participated in the second study. RESULTS: The school refusal group of adolescents who stutter had significantly higher rates of SAD than the school attendance group. Fifty percent of adolescents who stutter met the criteria for SAD. Moreover, adolescents who stutter with SAD had significantly higher scores on the items "When speaking in public, do you experience tremors in your limbs?" and "After you stutter, do you have negative thoughts about yourself?" than the adolescents who stutter without SAD. CONCLUSIONS: When examining adolescents who stutter, checking for comorbid SAD may lead to better support. Moreover, noticing their repetitive negative thinking, nervousness, and trembling during speech may help to resolve SAD.

Olfactory Reference Syndrome: Its Relationship to Comorbidity of Social Anxiety Disorder and Obsessive-Compulsive Disorder.

ABSTRACT: Olfactory reference syndrome (ORS) is known to have the clinical features of both obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD). However, there has been no clear explanation as to why ORS has the characteristics of two different disorders. In the present study, the comorbidity rates of ORS in patients with SAD (without OCD, n = 83), ORS in patients with OCD (without SAD, n = 42), and patients with SAD and OCD comorbidity (n = 17) were compared. Of all 142 patients studied, 11 were diagnosed with ORS. The comorbidity rate of ORS in comorbid SAD/OCD group was significantly higher than those in both SAD and OCD groups. Logistic regression analysis of 100 cases of SAD and selected 69 cases of generalized SAD showed that the risk of ORS was significantly higher in patients with OCD and bulimia nervosa. Of 59 cases with OCD, the risk of ORS was significantly higher in patients with SAD. The results of the present study suggest that the comorbidity of SAD and OCD most likely explains the development of ORS.

Prevalence and correlates of cannabis use among individuals with DSM-5 social anxiety disorder: Findings from a nationally representative sample.

Cannabis use disorder (CUD) and frequency of use are highly related to social anxiety disorder (SAD). With updates to diagnostic criteria of psychiatric disorders and recent changes in cannabis laws, the present study sought to explore the relationships between cannabis use, CUD, and social anxiety in a large nationally representative sample of individuals with lifetime (N = 1255) and past-year SAD (N = 980). Notably, we found that at the symptom level, at least weekly cannabis use was significantly related to fear or avoidance of social situations interfering with relationships in both samples. Weekly + cannabis use and CUD were significantly associated with lifetime SAD symptom severity, but only weekly + cannabis use was related to SAD severity in the past-year sample. We also found that weekly + cannabis use but not CUD was related to greater odds of seeking treatment for SAD and suicide attempt history. Overall, these data provide an updated examination of cannabis use and SAD using DSM-5 criteria and a large nationally representative sample and also highlight the importance of weekly + cannabis use as a marker of severity and suicide risk in individuals with SAD.

Social anxiety disorder is a risk factor for alcohol use problems in the National Comorbidity Surveys.

BACKGROUND: According to the self-medication and biopsychosocial models, individuals with social anxiety disorder (SAD) are at increased risk of developing an alcohol use disorder (AUD) as alcohol represents a maladaptive coping mechanism for some sufferers of SAD. The SAD-to-AUD causation was earlier supported in Norwegian longitudinal twin data and later questioned using longitudinal data from the USA. METHODS: We re-analyzed partly the same USA-based data (National Comorbidity Surveys, n = 5001), conducting theoretical and simulation analyses on different formulations of temporality and using real-data Logistic regression analysis to investigate whether baseline SAD was associated with AUD at the follow-up. RESULTS: Upon proper analysis of temporality, SAD preceded AUD. Specifically, SAD was the only one of the seven anxiety disorders that predicted 10-year later AUD after adjusting for all other anxiety disorders and AUD at the baseline (odds ratio was 1.70% and 95% confidence interval 1.12-2.57). SAD was also associated with incident AUD (OR = 1.64, 95% CI = 1.14-2.37). We provide formal, simulation-based, and data-based arguments on how certain flawed models of incidence attenuate the temporal association. CONCLUSIONS: We demonstrated temporality and specificity in SAD-to-AUD association, which are considered signs of causation. We further identified and discussed problems in previous statistical analyses with different conclusions. Our findings add support for models positing causal effects of SAD on AUD, such as the self-medication and biopsychosocial models. The available evidence suggests that treating SAD should incur better chances of preventing AUD compared to treating other anxiety disorders, which lack comparable evidence on causation.

Social phobia of Ethiopian students: meta-analysis and systematic review.

BACKGROUND: Social anxiety disorder is defined as the fear of social situations, incorporating situations that involve contact with strangers. People highly fear embarrassing themselves which includes situations like social gatherings, oral presentations, and meeting new people. People with social phobia have nonspecific fears of practicing vague or, performing specific tasks like eating or speaking in front of others. In people with social anxiety disorder, worry can arise from both the circumstance itself and embarrassment from others, for students, social phobia is an overwhelming fear of speaking in front of others or giving presentations in class. The prevalence of social phobia among different studies in Ethiopia was inconsistent and inconclusive therefore, this study showed the cumulative burden of social phobia among students in Ethiopia. METHOD: Observational studies published on social phobia and associated factors among students in Ethiopia were included in this study based on the criteria after independent selection by two authors. Data were extracted by Microsoft Excel spreadsheet to be exported to Stata version 11 for further analysis. The random-effect model was used to estimate the pooled effect size of social phobia and its effect on the previous studies with 95% confidence intervals. Funnel plots analysis and Egger regression tests were conducted to detect the presence of publication bias. Sub-group analysis and sensitivity analysis were done. RESULT: A total of 2878 study participants from seven studies were included in this meta-analysis and systematic review. The pooled prevalence of social phobia among students in Ethiopia was 26.81% with a 95% CI (22.31-31.30). The pooled effect size of social phobia in Oromia, Amhara, and SNNPs regions was 24.76%, 24.76%, and 29.47%, respectively. According to the subgroup analysis, university, and college/high school students were 28.05% and 25.34% respectively. Being female [AOR = 2.11 (95% CI 1.72-2.60)], having poor social support [AOR = 2.38 (95% CI 1.54-3.70)], substance use [AOR = 2.25 (95% CI 1.54-3.30)], single parent [AOR = 5.18 (95% CI 3.30-8.12)], and rural residence [AOR = 2.29 (95% CI 1.91-2.75)] were significantly associated in this meta-analysis in Ethiopia. CONCLUSION: The pooled prevalence of social phobia in this meta-analysis and systematic review was high (26.81%) among students therefore, the educational bureau needs to work on decreasing the burden of social phobia to raise the academic achievement and creativity of the students. In therapeutic advice like exposure to presentations, family members take the responsibility for the students' therapy and expose them to various social interactions.

Childhood maltreatment and non-suicidal self-injury among Chinese college students: The moderating roles of social phobia and perceived family economic status.

BACKGROUND: Non-suicidal self-injury is a heavy burden on affected college students with rippling effects throughout their lives. Childhood maltreatment is strongly associated with non-suicidal self-injury among college students. However, it remains unclear whether perceived family economic status and social phobia exert significant moderating effects on the relationship between childhood maltreatment and non-suicidal self-injury. OBJECTIVE: This study aimed to identify the perceived family economic status and social phobia moderating the association between childhood maltreatment and non-suicidal self-injury. PARTICIPANTS AND SETTING: This study used data (N = 5297) from two local medical colleges in Anhui province, China. METHODS: Respondents completed questionnaires on childhood maltreatment, non-suicidal self-injury, social phobia and perceived family economic status online. Data were analyzed using Spearman's correlation followed by multiple moderation models. RESULTS: The association between childhood maltreatment and non-suicidal self-injury was moderated by social phobia (ß = 0.03, p < 0.05) and perceived family economic status (ß = -0.30, p < 0.05). When considered together, both factors were found to play synergistic roles in the association between childhood maltreatment and non-suicidal self-injury in college students (ß = 0.08, p < 0.001). CONCLUSION: Our findings highlight that experience of childhood maltreatment, elevated social phobia, and low perceived family economic status increase the risk of non-suicidal self-injury. Future researches are recommended to conduct interventions from a more holistic perspective and integrate perceived family economic status as a relevant factor along with social phobia in coping with non-suicidal self-injury in college students.

Demographic and clinical correlates of social anxiety disorder among US veterans: findings from the NESARC-III study.

PURPOSE: Social anxiety disorder (SAD) is among the most highly prevalent and debilitating psychiatric disorders within the US population, but SAD has gone relatively unnoticed within the US veteran population. Preliminary research has demonstrated that SAD is related to decreased mental and physical functioning as well as posttraumatic stress disorder (PTSD) and depression among veterans. METHODS: The present study investigated SAD and its relationship with demographic factors, psychiatric disorders, suicidality, treatment seeking, and social support among veterans. Multivariate survey weighted logistic regression analyses were conducted to observe these associations utilizing data from National Epidemiologic Survey on Alcohol and Related Conditions which contained data on 3119 veterans. RESULTS: SAD was found to be strongly related to PTSD and other anxiety disorder, and these disorders were related to increased treatment seeking for SAD. Further, SAD was associated with lifetime suicide attempts and decreased perceived social support in multivariate models adjusting for demographic factors and psychiatric comorbidities. CONCLUSION: This study highlights the relationships of SAD among veterans by demonstrating its associations with other psychiatric disorders, treatment seeking, suicide attempts, and social support. A deeper understanding of the impact of SAD within the veteran population will inform future prevention and treatment efforts.

The Prevalence of Adolescent Social Fears and Social Anxiety Disorder in School Contexts.

Social fears arise when fearing to be judged in social events. When these fears are intense, persistent, and debilitating, the individual may suffer from social anxiety disorder (SAD), which has its most frequent onset during adolescence and tends to be chronic. Still, evidence on the prevalence of social fears and SAD in adolescence is scarce. This study analyzed the prevalence of social fears and of SAD in Portuguese adolescents. Of the initial sample (n = 1495), 26% presented with intense self-reported social fears. Of those, 53.9% accepted to be further assessed for diagnosis, resulting in a point-estimate prevalence of adolescent SAD of 9.4%; this is slightly higher than previously found. Social performance was the most feared social event. Of the adolescents with SAD, 12.9% were receiving psychological intervention, 12.1% refused intervention, and 92 (65.7%) accepted intervention. Findings confirm SAD as a highly prevalent mental disorder among adolescents, particularly girls, and additionally, that most of these adolescents did not seek treatment but are willing to receive help if made available. Hence, schools should be invested not only in identifying vulnerable adolescents but also in providing diverse intervention options, tailored to their needs, and directing them to successful developmental trajectories.

[Social Anxiety Disorder - an Update]. / Die soziale Angststörung ­ ein Update.

It can happen that one behaves in a supposedly embarrassing or insufficient manner; however, short-term feelings such as shame or self-doubt usually remain without significance. However, if there is excessive and persistent fear or significant avoidance behaviour, it may be a case of social anxiety disorder (SAS). This article provides an overview of the current status of the aetiology, diagnosis and therapy of SAS.

Correlates of treatment seeking in individuals with social anxiety disorder: Findings from a nationally representative sample.

Despite the availability of well-established and efficacious treatments for social anxiety disorder, most socially anxious individuals do not seek treatment and those who do often suffer for years before seeking treatment. A more comprehensive understanding of the factors related to treatment seeking for social anxiety disorder is needed. This study utilized the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a large representative U.S. adult sample, to examine the relationships between treatment seeking for social anxiety disorder and demographic characteristics, psychiatric comorbidities, social anxiety disorder symptomatology, and specific feared situations. Socially anxious individuals (n = 1,255) were identified using DSM-V criteria and treatment seeking was measured by either seeking help from a professional or being prescribed medication for social anxiety disorder symptoms. Results indicate key relationships between treatment seeking and age as well as comorbid anxiety disorders. Importantly, this study found that specific feared situations such as fear of small groups (AOR = 1.78) and speaking in social gatherings (AOR = 1.66), and specific social anxiety disorder symptoms such as panic attacks (AOR = 2.92) were significantly and uniquely associated with increased treatment seeking for social anxiety disorder.

Social anxiety disorder and its associated factors: a cross-sectional study among medical students, Saudi Arabia.

BACKGROUND: Social Anxiety disorder (SAD) is common worldwide. However, data from Saudi Arabia is deficient. This study aims to determine the prevalence of SAD across Saudi medical students and its associations with sociodemographic factors and their academic performance. METHODS: The main outcome was presence/absence of SAD and the secondary outcome was its level of severity. These were assessed from the Social Phobia Inventory. Associated factors included sociodemographic variables, as well as educational characteristics of students. Descriptive statistics were reported as counts and percentages, and unadjusted and adjusted odds ratios (OR) and their 95% confidence intervals (CIs) were computed through bivariate and multivariate logistic regression. RESULTS: Of 5896 Saudi medical students who participated in the study, the prevalence of SAD was almost 51%. While 8.21% and 4.21% had reported severe and very severe SAD, respectively. Older age students were at lower risk of developing SAD (OR = 0.92, 95% CI = 0.89 - 0.96). In contrast, females (OR = 1.13, 95% CI = 1.01 - 1.26), students enrolled in private colleges and colleges implementing non-problem-based learning (OR = 1.29, 95% CI = 1.09 - 1.52 and OR = 1.29. 95% CI = 1.15 - 1.46 respectively) were at higher risk. A significant elevated risk of SAD was found among students who had previously failed, and had a low GPA. CONCLUSION: SAD is prevalent among the sampled population, and different associated factors were identified. Current results could raise the awareness of faculty members and healthcare providers towards early detection and management of these cases.

Social anxiety disorder and childhood adversities in Portugal: Findings from the WHO world mental health survey initiative.

Social anxiety disorder (SAD) is one of the most underrecognized and undertreated common mental disorders. This study aimed to describe its epidemiology and to understand the association between childhood adversities and SAD in the context of Portugal's collectivist culture. Data about SAD, childhood adversities, socio-demographic variables were collected from a nationally representative sample using well-validated scales employed for the World Mental Health Survey. Logistic and linear regression models were carried out to explore the association between childhood adversities and SAD prevalence and age of onset. The estimated lifetime prevalence of SAD was 4.68% and the 12-month prevalence was 3.14%. The mean age of onset was 13.6 ± 8.79. People with a college education had 3.42 higher odds of having SAD compared to people with no education or a primary school education. Most childhood adversities significantly increased the odds of a lifetime prevalence of SAD. Parental Maladjustment increased the odds of SAD when gender, age, and education were adjusted. The study findings show a relatively high prevalence of SAD in Portugal and confirms that females, younger people, students, and single people are more likely to have SAD. The study highlights the need to address experiences of parental maladjustment in interventions for people with SAD in Portugal.

Age of onset of social anxiety disorder and psychiatric and mental health outcomes: Results from a nationally representative study.

OBJECTIVE: Prior studies support that younger age of onset would be associated with poorer psychiatric and mental health outcomes for many psychiatric disorders. However, such relationship has never been examined for social anxiety disorder (SAD) in a nationally representative sample. METHODS: Using data from the second Wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we have identified four groups of participants with a lifetime DSM-IV diagnosis of SAD based on the self-reported age of onset (childhood onset (<12 years, N = 658), adolescence onset (12-17 years, N = 663), early-adulthood onset (18-39 years, N = 663), and late-adulthood onset (>39 years, N = 415)), and a control group without a lifetime history of SAD (N = 32,205). We performed multinomial logistic regression models to compare lifetime DSM-IV psychiatric disorders and current mental health-related quality of life (assessed with the mental component summary score (MSC) of the SF-12) across these groups. RESULTS: The lifetime prevalence rates of panic disorder, agoraphobia and post-traumatic stress disorder were significantly higher in the adulthood onset groups than in groups with an onset during childhood or adolescence (p < 0.01 for most models). MCS score was significantly higher in the childhood (46.0 (SE = 0.5)) or adolescence (46.5 (SE = 0.5)) onset groups than in the groups with an onset during adulthood (early-adulthood onset: 43.5 (SE = 0.6), and late-adulthood onset: 43.0 (SE = 0.8)). LIMITATIONS: Our results relied on retrospective self-reported data. CONCLUSION: Among individuals with SAD, a later age of onset was significantly associated with greater lifetime rates of psychiatric disorders and diminished quality of life.

The role of adverse childhood experiences and attachment styles in social anxiety disorder in adolescents.

BACKGROUND: Social Anxiety Disorder (SAD) is one of the most common disorders of adolescence and results in marked impairments in social and academic/occupational activities that likely to persist into adulthood. Multiple etiological factors contribute to the development of social anxiety disorder. Two critical factors in presenting with a primary diagnosis of SAD might be adverse childhood experiences (ACEs) and attachment styles. The current study examined how ACEs and attachment styles may be related to SAD in adolescents. METHODS: 60 participants with ages ranging from 11 to 18 (M = 14.6; female = 36), who have a primary diagnosis of SAD and 60 control group adolescents (M = 14.6; female = 30) were included in the study. Both groups completed the Liebowitz Social Anxiety Scale (LSAS), the Childhood Trauma Questionnaire (CTQ), and the Adolescent Relationship Scales Questionnaire (A-RSQ). RESULTS: After controlling adolescent gender and parental education levels, childhood emotional neglect and income significantly predicted an increased risk for adolescents' SAD diagnosis. Attachment styles did not significantly contribute to predicting adolescents' SAD diagnosis after controlling childhood emotional neglect. CONCLUSION: The high predictive value of emotional neglect in childhood emphasizes its importance as a risk factor of SAD in adolescence.

Social anxiety disorder in adolescents: Prevalence and subtypes in the Young-HUNT3 study.

BACKGROUND: Few studies have examined the prevalence of social anxiety disorder (SAD) among adolescents and the associated sex-specific fears. No previous studies have reported variance in SAD prevalence among adolescents based on a stepwise diagnostic approach. METHODS: Using various diagnostic thresholds from the Anxiety Disorders Interview Schedule child version, and the diagnostic criteria from both the 4th and 5th editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), we explored the point prevalence of SAD among a population-based sample of 8216 adolescents aged 13-19 years. RESULTS: Overall, 2.6% of adolescents met the SAD diagnostic criteria. The prevalence varied from 2.0% to 5.7% depending on the criteria-set. Twice as many females met the overall SAD criteria. The DSM-IV generalized SAD subtype was assigned to 86.5% of the sample, while 3.5% met the DSM-5 performance-only subtype. Compared with males aged 16-19 years, significantly more of those aged 13-15 years met the SAD criteria; no significant age group differences were found among females. CONCLUSIONS: This is the first study to demonstrate variance in SAD prevalence among adolescents based on the diagnostic threshold method. Depending on the threshold applied, SAD prevalence among adolescents varied from 2.0% to 5.7%. Age and sex differences in social fear experiences highlight the importance of considering developmental heterogeneity in SAD, especially for adapting prevention and treatment interventions.

Perceived helpfulness of treatment for social anxiety disorder: findings from the WHO World Mental Health Surveys.

PURPOSE: To investigate the prevalence and predictors of perceived helpfulness of treatment in persons with a history of DSM-IV social anxiety disorder (SAD), using a worldwide population-based sample. METHODS: The World Health Organization World Mental Health Surveys is a coordinated series of community epidemiological surveys of non-institutionalized adults; 27 surveys in 24 countries (16 in high-income; 11 in low/middle-income countries; N = 117,856) included people with a lifetime history of treated SAD. RESULTS: In respondents with lifetime SAD, approximately one in five ever obtained treatment. Among these (n = 1322), cumulative probability of receiving treatment they regarded as helpful after seeing up to seven professionals was 92.2%. However, only 30.2% persisted this long, resulting in 65.1% ever receiving treatment perceived as helpful. Perceiving treatment as helpful was more common in female respondents, those currently married, more highly educated, and treated in non-formal health-care settings. Persistence in seeking treatment for SAD was higher among those with shorter delays in seeking treatment, in those receiving medication from a mental health specialist, and those with more than two lifetime anxiety disorders. CONCLUSIONS: The vast majority of individuals with SAD do not receive any treatment. Among those who do, the probability that people treated for SAD obtain treatment they consider helpful increases considerably if they persisted in help-seeking after earlier unhelpful treatments.