روابط بین اضطراب اجتماعی، نشانه های افسردگی و رفتار ضد اجتماعی: شواهد از یک مطالعه آینده نگر پسران نوجوان

Abstract Little is understood about generalized and non-generalized social anxiety disorder (SAD) and their associations with co-occurring internalizing and externalizing problems in adolescence. In the present study, we investigated adolescent boys with SAD symptoms and considered depressive symptoms as well as antisocial behaviors when looking for patterns during two developmental time periods; junior high and high school. Participants in the analyses were part of a longitudinal study. No patterns were found linking antisocial problems and non-generalized SAD in either junior high or high school. Furthermore, it was uncommon for youths in the non-generalized SAD subgroup to develop comorbidity over time. The generalized SAD subgroup of boys, however, was likely to develop comorbidity either with depressive symptoms only or with depressive symptoms and antisocial tendencies. Our findings suggest that developmental pathways for SAD subgroups may differ.

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Conclusion The present study indicates that we should be aware of and take symptoms of both the SAD subgroups seriously but for different reasons. Junior high school youths who show symptoms of non-generalized SAD (i.e., predominant performance fears) and are untreated should be taken seriously since these symptoms seem to be persistent over time. On the other hand, these symptoms seem unlikely to spread into other kinds of symptoms (interactional fears) or lead to comorbidity with depressive symptoms or disruptive problem behaviors. In contrast, generalized SAD (i.e., predominant interactional social fears) is more likely to develop into co-morbid symptoms such as depressive symptoms and/or disruptive problem behaviors. Both SAD subgroups appear to have in common a level of chronicity (at least during the 6-year period of observation) that seems unlikely to spontaneously dissipate. Whether or not early identification and intervention can reliably and cost-effectively change this course of symptoms is a question for further empirical research. In particular, the pathway(s) from interpersonal (generalized) social fears to antisocial behaviors deserve further study in this regard.