Cunningham Charles E, McHolm Angela E, Boyle Michael H
Chedoke Campus, Hamilton Health Sciences, Hamilton, ON, Canada, L8N 3Z5.
Eur Child Adolesc Psychiatry. 2006 Aug;15(5):245-55. doi: 10.1007/s00787-006-0529-4. Epub 2006 May 9.
We compared social phobia, anxiety, oppositional behavior, social skills, and self-concept in three groups: (1) 28 children with specific mutism (who did not speak to teachers but were more likely to speak to parents and peers at home and school); (2) 30 children with generalized mutism (whose speaking was restricted primarily to their homes); and (3) 52 community controls. Children with generalized mutism evidenced higher anxiety at school, and more separation anxiety, OCD, and depressive symptoms at home. Parents and teachers reported that the social phobia and anxiety scores of children in both the specific and generalized mutism subgroups were higher than controls. Children in both the specific and generalized mutism groups evidenced greater deficits in verbal and nonverbal social skills at home and school than controls. Teachers and parents did not report differences in nonverbal measures of social cooperation and conflict resolution and we found no evidence that selective mutism was linked to an increase in externalizing problems such as oppositional behavior or ADHD. Although children with specific mutism speak in a wider range of situations and appear less anxious to their teachers than children with generalized mutism, significant socially phobic behavior and social skills deficits are present in both groups.
我们比较了三组儿童的社交恐惧症、焦虑、对立行为、社交技能和自我概念：（1）28名患有选择性缄默症的儿童（他们不与老师说话，但在家中和学校更有可能与父母和同龄人交谈）；（2）30名患有广泛性缄默症的儿童（其说话主要局限于家中）；以及（3）52名社区对照儿童。患有广泛性缄默症的儿童在学校表现出更高的焦虑，在家中表现出更多的分离焦虑、强迫症和抑郁症状。家长和老师报告说，选择性缄默症和广泛性缄默症亚组儿童的社交恐惧症和焦虑得分均高于对照组。与对照组相比，选择性缄默症和广泛性缄默症组的儿童在家中和学校在言语和非言语社交技能方面均表现出更大的缺陷。老师和家长未报告社交合作和冲突解决的非言语测量方面存在差异，并且我们没有发现证据表明选择性缄默症与诸如对立行为或注意力缺陷多动障碍等外化问题的增加有关。尽管与患有广泛性缄默症的儿童相比，患有选择性缄默症的儿童在更广泛的情境中说话，并且在老师看来焦虑程度较低，但两组均存在明显的社交恐惧行为和社交技能缺陷。
