Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
J Psychiatr Res. 2012 Sep;46(9):1223-30. doi: 10.1016/j.jpsychires.2012.06.002. Epub 2012 Jul 5.
Major depressive disorder and bipolar spectrum disorders are debilitating conditions associated with severe impairment. The presence of co-occurring social phobia can make the clinical course of these disorders even more challenging. To better understand the nature of social anxiety in the context of ongoing mood disorders, we report the results of exploratory factor analyses of the Social Phobia Spectrum Self-Report Instrument (SHY), a 162-item measure designed to capture the full spectrum of manifestations and features associated with social anxiety experienced across the lifespan. We examined data from 359 adult outpatients diagnosed with major depressive disorder and 403 outpatients diagnosed with a bipolar spectrum disorder. The measure was divided into its two components: the SHY-General (SHY-G), reflecting general social anxiety features, and the SHY-Specific (SHY-S), reflecting anxiety in specific situations. Exploratory factor analyses were conducted for each using tetrachoric correlation matrices and an unweighted least squares estimator. Item invariance was evaluated for important patient subgroups. Five factors were identified for the SHY-G, representing general features of social anxiety: Fear of Social Disapproval, Childhood Social Anxiety, Somatic Social Anxiety, Excessive Agreeableness, and Behavioral Submission. Seven specific-situation factors were identified from the SHY-S: Writing in Public, Dating, Public Speaking, Eating in Public, Shopping Fears, Using Public Restrooms, and Unstructured Social Interactions. The identified dimensions provide clinically valuable information about the nature of the social fears experienced by individuals diagnosed with mood disorders and could help guide the development of tailored treatment strategies for individuals with co-occurring mood disorders and social anxiety.
重度抑郁症和双相情感障碍谱系障碍是导致严重功能障碍的致残性疾病。同时存在社交恐惧症会使这些疾病的临床病程更加具有挑战性。为了更好地理解在持续心境障碍背景下社交焦虑的本质，我们报告了社交恐惧症谱系自我报告量表（SHY）探索性因素分析的结果，这是一种 162 项的测量工具，旨在捕捉与整个生命周期中经历的社交焦虑相关的表现和特征的全貌。我们检查了 359 名被诊断为重度抑郁症的成年门诊患者和 403 名被诊断为双相情感障碍谱系障碍的门诊患者的数据。该测量工具分为两个组成部分：SHY-一般（SHY-G），反映一般社交焦虑特征，以及 SHY-特定（SHY-S），反映特定情况下的焦虑。使用四元相关矩阵和未加权最小二乘法估计对每个部分进行探索性因素分析。对重要的患者亚组进行了项目不变性评估。针对 SHY-G 确定了五个因素，代表社交焦虑的一般特征：对社会否定的恐惧、儿童期社交焦虑、躯体社交焦虑、过度和蔼可亲和行为屈服。从 SHY-S 中确定了七个特定情境因素：在公共场合写作、约会、公开演讲、在公共场合进食、购物恐惧、使用公共厕所和非结构化社交互动。确定的维度提供了有关被诊断为心境障碍的个体所经历的社交恐惧性质的有临床价值的信息，并可能有助于为同时存在心境障碍和社交焦虑的个体制定量身定制的治疗策略。
