Knappe Susanne, Beesdo Katja, Fehm Lydia, Höfler Michael, Lieb Roselind, Wittchen Hans-Ulrich
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
J Anxiety Disord. 2009 Oct;23(7):986-94. doi: 10.1016/j.janxdis.2009.06.010. Epub 2009 Jul 5.
Parental psychopathology and unfavorable family environment are established risk factors for onset of offspring social phobia (SP), but their associations with the further course, e.g., persistence of the disorder, remain understudied. A community cohort of 1395 adolescents and their parents was followed-up over almost 10 years using the DIA-X/M-CIDI. Parental diagnostic interviews were supplemented by family history data. Parental rearing was retrospectively assessed by the Questionnaire of Recalled Parental Rearing Behavior in offspring, and family functioning by the Family Assessment Device in parents. Persistence measures (proportion of years affected since onset) were derived from diagnostic interviews, using age of onset, age of recency, and course information. Lack of emotional warmth and dysfunctional family functioning characteristics were associated with higher SP persistence, particularly in interaction with parental psychopathology. Predictors for SP persistence differ from those predicting SP onset. Unfavorable family environment alone and in interaction with parental disorders predict higher SP persistence.
父母的精神病理学和不良家庭环境是已确定的子代社交恐惧症（SP）发病的风险因素，但它们与疾病的进一步发展过程（如疾病的持续性）之间的关联仍未得到充分研究。使用DIA-X/M-CIDI对1395名青少年及其父母组成的社区队列进行了近10年的随访。父母诊断访谈辅以家族史数据。通过子代回忆父母养育行为问卷对父母养育方式进行回顾性评估，通过父母的家庭评估工具对家庭功能进行评估。持续性指标（自发病以来受影响的年数比例）来自诊断访谈，采用发病年龄、最近发病年龄和病程信息。缺乏情感温暖和功能失调的家庭功能特征与较高的SP持续性相关，特别是在与父母精神病理学的相互作用中。SP持续性的预测因素与预测SP发病的因素不同。单独的不良家庭环境以及与父母疾病相互作用时，预示着更高的SP持续性。
