اختلال اضطراب اجتماعی و ترس اجتماعی در نظامیان کانادایی: شیوع، همبودی، اختلال و درمان جویی

Abstract Background Military mental health research has rarely investigated social anxiety disorder, despite its known serious consequences in the general population, and what work has been conducted has used specialized samples (e.g., veterans) not representative of all military personnel. Methods Data were from the 2002 Canadian Community Health Survey—Canadian Forces Supplement, a representative survey of 8441 active regular and reserve military personnel. Results Social anxiety disorder has a high lifetime (8.2%) and past-year (3.2%) prevalence in the military. It is associated with increased odds of depression, panic attacks/disorder, generalized anxiety disorder, and post-traumatic stress disorder (AOR range 4.16–16.29). Being female, ages 35–44, or separated/divorced/widowed increases the odds of having social anxiety disorder, while being an officer or a reservist decreases the odds. Treatment-seeking, as in the general population, is relatively rare. Overall, military personnel with social anxiety disorder experience significant rates of role impairment in all domains (53.1–88.3% report some impairment), with the rate of role impairment increasing with the number of social fears. Notably, many (70.6%) report at least some impairment at work (i.e., in their job with the military). Conclusion Social anxiety disorder is an important disorder to take into account when considering military mental health. Observing low rates of treatment-seeking for social anxiety disorder among military personnel highlights the importance of initiatives to allow its identification and treatment.

5. Conclusions The consequences of social anxiety disorder are well-known for the civilian population; by demonstrating some of the similar features of social anxiety disorder between civilians and the military (e.g., low treatment-seeking, significant role impairment), we hope to bring attention to this disorder as it relates military personnel. Posttraumatic stress disorder and depression receive the bulk of attention when dealing with mental health in the military. Although these disorders are irrefutably important to consider when dealing with a population that experiences high rates of traumatic exposure, our work demonstrates that when evaluating military mental health, it is important to also consider the impact of social anxiety disorder. Clinically, the elucidation of the sociodemographic correlates of social anxiety disorder is particularly important, as it identified individuals who may be at higher risk and for whom screening and interventions could be specifically tailored to help reduce the burden of this disorder in the military population. Additionally, as military personnel typically underutilize services for mental health problems (Hoge et al., 2004), this work could provide policymakers with important information that may lead to broad interventions or other opportunities for improving the mental health of the military (e.g., screening to allow cases of social anxiety disorder to be detected and treated before the disorder impacts work performance). As with all interventions targeting mental health in the military, such work would need to be conducted so as to minimize stigmatization—or even the perception of stigmatization—among participants.