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

Abstract

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.

School completion and progression to higher education in adolescents with social anxiety: a linkage between Young-HUNT3 and national educational data (2008–2019), Norway

“…There are several possible mechanisms that might contribute to lower completion rates of upper secondary school among adolescents with social anxiety. For instance, educational activities require engaging in various social and performative situations (e.g., public speaking, talking to authority figures, collaborating with classmates, and socializing with pupils outside the classroom) that might be distressing for individuals with social anxiety [ 12 – 14 , 28 , 55 ]. One suggested explanation is that experiencing anxiety in a school situation generates difficulties with concentrating in class, which in turn, affect academic performance [ 56 ].…”

“…SAD and social anxiety at subclinical levels include symptoms of excessive fear and avoidance of social and performance situations [ 11 ]. Therefore, school may represent one of the most anxiety-provoking settings for adolescents with social anxiety [ 12 – 14 ]. Compared to class mates, pupils with SAD are more likely to report school-related impairment during adolescence [ 15 ].…”

Psychological inflexibility explains social anxiety over time: a mediation analyses with a clinical adolescent sample

“…Difficulties associated with SAD usually start in adolescence (Stein et al, 2017 ; Knappe et al, 2015 ) and tend to have a chronic and unremitting course (Beesdo-Baum et al, 2012 ; Steinert et al, 2013 ), causing significant and persistent impairments in various life domains (e.g., Acquah et al, 2015 ; Chiu et al, 2021 ; Hebert et al, 2012 ; Soohinda & Sampath, 2016 ). Despite its significant prevalence rates in adolescence (e.g., Alves et al, 2022 ), evidence regarding the processes contributing to social anxiety in this developmental period is still scarce. There is promising evidence regarding the applicability of ACT to understand and intervene in internalizing disorders (Landy et al, 2015 ; Twohig & Levin, 2017 ), including adult (e.g., Caletti et al, 2022 ) and adolescent SAD (Oyetunde & Ajibola, 2019 ).…”

Outcomes from a brief group behavior therapy approach for social anxiety disorder in adolescence: An exploratory clinical trial

“…SAD has its more frequent onset during adolescent years, with estimated prevalence rates varying between 8.6% (Burstein et al, 2011) and 9.1% (Merikangas et al, 2010) in the USA. A recent study in Portugal indicates similar prevalence rates (i.e., 9.4% in a school-based sample of adolescents; Alves, et al, 2022). It usually follows a chronic course if left untreated (Keller, 2006), particularly for those adolescents who perform worse in social events (Miers et al, 2013).…”

“…These therapeutic changes are superior to a pharmacological treatment (Beidel et al, 2007) and similar to the standard cognitive-behavioral group treatment (Olivares et al, 2002). Still, it is a very intensive intervention (at least 24 sessions over a 12-week period), and hence possibly less applicable or appealing to non-treatment seeking samples (i.e., adolescents taken from schools who are diagnosed with SAD), of which, nevertheless, over 65.7% would be available to receive treatment if offered (Alves et al, 2022). Shorter interventions may be more appealing to adolescents with SAD, who, similarly to adults with SAD, might be reluctant to seek treatment (Griffiths, 2013).…”