Findings highlight family accommodation as a phenomenon that applies broadly and in a similar manner to children with AD and OCD. Evaluating accommodation provides useful information for clinical care and is an important part of the assessment of children with AD and OCD.
Social phobia is characterized as pervasive social timidity in social settings. Although much is known about this disorder, aspects of its clinical presentation remain unexplored, in particular characteristics that distinguish the generalized and non-generalized subtypes. For example, it remains unclear whether patients with the non-generalized subtype display social skills deficits in social interactions, and if so, are these deficits clinically, as well as statistically, significant? In this study, adults with either the non-generalized (NGSP; n=60) or generalized (GSP; n=119) subtype of social phobia and adults with no psychological disorder (n=200) completed an extensive behavioral assessment of social skill and social anxiety. As expected, adults with NGSP and GSP reported equal distress and displayed similar rates of avoidance during an impromptu speech task when compared to adults with no disorder. In contrast, the three groups were distinctly different when interacting with another person in various social situations. Adults with NGSP displayed social skill deficits when compared to individuals with no disorder, but they had fewer deficits than the GSP subtype. However, the identified skill deficits were clinically as well as statistically significant only for the GSP subtype. The results are discussed in terms of the contribution of skill deficits to the conceptualization and treatment of social phobia. Keywords social phobia; social skills; social anxiety disorder; behavioral assessment of social skill
Reducing family accommodation (FA) may be beneficial in cases of childhood anxiety disorders. Assessment of FA has so far relied on single-informant maternal report, which may be biased by factors including maternal anxiety. We compared child and mother reports of FA, and examined whether maternal anxiety moderates the association between mother and child report. Participants were fifty children with primary DSM-5 anxiety disorders, and their mothers. Mother-child agreement was good for overall FA and moderate for subdomains of FA. Mothers reported significantly more FA than children. Maternal anxiety moderated the association between mother and child report of FA, such that the correlation was stronger in more anxious mothers. Children agreed that FA helps them feel less anxious and did not agree that parents should accommodate less. FA is an important clinical characteristic of childhood anxiety disorders and assessment can be enhanced through child report and consideration of maternal anxiety.
A common assumption is that all youth with anxiety disorders (AD) experience impaired peer relationships relative to healthy control children. Social impairments have been identified among youth with certain AD (e.g., social anxiety disorder; SAD), but less is known about the peer relationships of children with generalized anxiety disorder (GAD). We therefore compared the interpersonal functioning of youth with GAD, SAD, and controls (6 to 13 years). Despite having relatively fewer friends overall, children with GAD did not differ from controls in terms of the likelihood of having a best friend, participation in groups/clubs, and parent ratings of social competence. In comparison, youth with SAD were less socially competent, had fewer friends and difficulty making new friends compared to controls. Findings suggest that peer difficulties are not a universal feature of all childhood AD and highlight a need to better understand the social experiences and functioning of children with GAD.
Social skills deficits are commonly reported among children with social phobia (SP) and children with Asperger's Disorder (AD); however, a lack of direct comparison makes it unclear whether these groups, both of which endorse the presence of social anxiety, have similar or unique skills deficits. In this investigation, the social behaviors of children with SP (n=30) or AD (n=30) were compared to a typically developing (TD) peer group (n=30) during structured role play interactions. Data were analyzed using blinded observers' ratings of overt behaviors and digital vocal analysis of verbal communication. Compared to children with AD and TD children, children with SP exhibited less overall social skill, an ineffective ability to manage the conversational topic (pragmatic social behavior), and deficient speech production (speech and prosodic social behavior). There were no differences in observer ratings between children with AD and TD children. However, using digital analysis of vocal characteristics (i.e., intensity, pitch), distinct vocal patterns emerged. Specifically, children with AD spoke more softly than TD children, and had lower vocal pitch and less vocal pitch variability than children with SP. This pattern may be subjectively heard as monotonic speech. Consistent with a vocal pattern associated with heightened anxiety, children with SP spoke more softly and had less voice volume variation than TD children, and had higher vocal pitch and more vocal pitch variability (jitteriness) than children with AD. Clinical implications of these findings are discussed.
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