Social Anxiety and Social Phobia in Youth: Characteristics, Assessment, and Psychological Treatment (Series in Anxiety and Related Disorders)
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A great bene?t of being a clinical child psychologist is the opportunity to conduct and review research on fascinating areas of human, youthful behavior. And perhaps no behavior is as central to human existence as social behavior, and the lack thereof. In writing this book, therefore, I have been doubly blessed with the chance to examine seminal works on behaviors that are so critical to the development and quality of life of children. This book covers the major historical aspects, characteristics, asse- ment strategies, and psychological treatment techniques for youths with social anxiety and social phobia. Chapter 1 provides an introduction to the related constructs and history of social phobia. Chapters 2 and 3 provide a summary of the characteristics and etiological variables that pertain most to youths with social anxiety and social phobia. Chapters 4 and 5 provide an overview of research- and clinically-based assessment strategies and recommendations for this population. Chapters 6–9 provide a description of treatment techniques that are most relevant and empirically supported for youths with social anxiety and social phobia. Chapter 10 covers issues regarding general and relapse prevention as well as dif?cult cases and future directions.
in 50 children with social phobia aged 7–13 years. Situations feared most by these children, as reported from interview, usually involved performances before others (e.g., reading, playing a musical instrument, writing) and everyday social interactions (e.g., starting a conversation, talking on the telephone, playing with other children) (see Table 2.1). TABLE 2.1. Types of Social Situations Feared by Children With Social Phobia (n = 50) Situation Reading aloud in front of the class Musical or
Finally, youths with social worries or phobia may have elevated levels of anxiety sensitivity, or overconcern about one’s internal physical sensations, as well as frequent panic attacks (Kearney, Albano, Eisen, Allen, & Barlow, 1997; Silverman & Weems, 1999). However, more research is needed regarding these latter variables. MAJOR CHARACTERISTICS OF YOUTHS WITH SOCIAL ANXIETY 33 Depression and Suicide Youths with social phobia typically rate themselves as more depressed compared to controls
identical twins (.70) was substantially higher than for fraternal twins (.38). Changes in shy, inhibited behavior in early developmental stages also appear to be more speciﬁc to identical than fraternal twins (Matheny, 1989; Plomin et al., 1993). Other characteristics similar to social phobia, such as childhood shyness or anxiety-based school refusal behavior, also appear to have a familial or heritable link (Cooper & Eke, 1999; Daniels & Plomin, 1985; Martin, Cabrol, Bouvard, Lepine, &
simple (e.g., yes/no) answers, pleas to end the interview prematurely, crying, defensiveness, and forms of resistance. Discrepancies between the child’s verbal statements and his or her actions can be instructive as well, especially in cases where the child denies any social or performance anxiety. Observations of the child’s general appearance, level of social skill, odd motor mannerisms, ﬁdgeting or other overt signs of nervousness, posture, and physical proximity to parents may also be
of questions or statements to parents to alleviate distress or avoid obligation (e.g., “Are you sure it will be okay?” “What if X happens?” “Do I have to?”). Often these questions or statements surround social- and performance-based events, school and therapy attendance, and whether parents will be at a certain place and time to retrieve or “rescue” a child (e.g., “Be sure to be there at 3:15 exactly, Mom”). In these cases, shaping is generally recommended. For example, parents are allowed to