Department of Psychology, Boston University, 648 Beacon St., 6th floor, Boston, MA, USA.
J Behav Ther Exp Psychiatry. 2012 Jun;43(2):752-7. doi: 10.1016/j.jbtep.2011.10.012. Epub 2011 Nov 4.
Much controversy exists regarding diagnostic subtypes of social anxiety disorder (SAD). The present study used admixture analysis to examine whether individuals with generalized and nongeneralized SAD belong to the same or different populations of origin. This can inform diagnostic subtyping of SAD in the forthcoming DSM-V.
Treatment-seeking individuals with generalized SAD (n = 154) and nongeneralized SAD (n = 48) completed a battery of questionnaires. Based on participants' responses to the Liebowitz Social Anxiety Scale (LSAS), we estimated log likelihood and chi-square goodness-of-fit for models with 1, 2, 3, or 4 populations of origin, and compared models using forward stepwise estimation and maximum likelihood ratio tests.
Admixture analyses suggested that the two diagnostic subtypes of SAD belong to the same underlying population of origin. In addition, observable differences in depression, general anxiety, and comorbidity were no longer significant when controlling for social anxiety severity.
Our sample was recruited in the U.S. and was a treatment-seeking sample. Future studies should examine whether our results generalize to different cultures, and community samples.
Support for qualitative differences between SAD subtypes was not found. Rather, our findings support the notion that the diagnostic subtypes of SAD differ quantitatively, and that SAD exists on a continuum of severity. This finding informs diagnostic subtyping of SAD in the forthcoming DSM-V.
社交焦虑障碍（SAD）的诊断亚型存在很多争议。本研究采用混合分析来检验广泛性和非广泛性 SAD 个体是否属于相同或不同的起源人群。这可以为即将出台的 DSM-V 中的 SAD 诊断亚型提供信息。
寻求治疗的广泛性 SAD 个体（n=154）和非广泛性 SAD 个体（n=48）完成了一系列问卷。根据参与者对 Liebowitz 社交焦虑量表（LSAS）的回答，我们估计了具有 1、2、3 或 4 个起源人群的模型的对数似然和卡方拟合优度，并使用逐步向前估计和最大似然比检验比较了模型。
混合分析表明，SAD 的两种诊断亚型属于相同的潜在起源人群。此外，当控制社交焦虑严重程度时，抑郁、一般焦虑和共病的可观察差异不再显著。
我们的样本是在美国招募的，是一个寻求治疗的样本。未来的研究应该检验我们的结果是否适用于不同的文化和社区样本。
没有发现 SAD 亚型之间存在定性差异的支持。相反，我们的发现支持 SAD 的诊断亚型在严重程度上存在定量差异的观点，并且 SAD 存在于严重程度的连续体上。这一发现为即将出台的 DSM-V 中的 SAD 诊断亚型提供了信息。
