Yeganeh Robin, Beidel Deborah C, Turner Samuel M, Pina Armando A, Silverman Wendy K
Department of Psychiatry, University of Maryland, College Park, MD 20742, USA.
J Am Acad Child Adolesc Psychiatry. 2003 Sep;42(9):1069-75. doi: 10.1097/01.CHI.0000070262.24125.23.
To investigate the hypothesis that children with selective mutism are more socially anxious than children with social anxiety disorder but who are not selectively mute.
Twenty-three children with comorbid selective mutism and social phobia and 23 age-matched controls with social phobia alone and their parents participated in a comprehensive assessment of social anxiety and related aspects of psychopathology.
The results do not uniformly support previous suggestions that children with selective mutism refuse speech because they are "frozen with fear." Although clinician and observer ratings for children with selective mutism revealed higher ratings of social distress than for children with social phobia alone, self-report data do not support this conclusion. Furthermore, although there were no group differences on measures of trait anxiety, general fears, or scores on the Child Behavior Checklist broadband Internalizing or Externalizing scales, children with selective mutism scored higher than children with social phobia alone on the Child Behavior Checklist Delinquency subscale, suggesting the presence of a broader clinical syndrome.
It remains unclear whether children with selective mutism have extreme levels of social anxiety. Potential areas that might shed further light on this interesting disorder are discussed.
探讨选择性缄默症儿童是否比患有社交焦虑障碍但无选择性缄默的儿童更具社交焦虑的假设。
23名患有选择性缄默症和社交恐惧症的儿童以及23名年龄匹配的仅患有社交恐惧症的对照儿童及其父母参与了一项关于社交焦虑及相关精神病理学方面的综合评估。
结果并不一致支持先前关于选择性缄默症儿童因“恐惧僵住”而拒绝说话的观点。虽然临床医生和观察者对选择性缄默症儿童的评分显示其社交痛苦程度高于仅患有社交恐惧症的儿童，但自我报告数据并不支持这一结论。此外，虽然在特质焦虑测量、一般恐惧或儿童行为清单宽泛内化或外化量表得分上两组没有差异，但选择性缄默症儿童在儿童行为清单违法量表上得分高于仅患有社交恐惧症儿童得分，这表明存在更广泛的临床综合征。
选择性缄默症儿童是否存在极端水平的社交焦虑仍不清楚。文中讨论了可能进一步阐明这种有趣障碍的潜在领域。
