Milic Maria I, Carl Talia, Rapee Ronald M
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia.
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia.
Behav Res Ther. 2020 Oct;133:103696. doi: 10.1016/j.brat.2020.103696. Epub 2020 Jul 23.
A growing body of evidence points to a strong overlap between selective mutism (SM) and social anxiety disorder in children, specifically with regard to characteristics such as social reticence and anxiety. Yet few studies have directly compared these populations, especially with young children. This study compared 25 children (aged 3-7 years) with a primary diagnosis of SM, 17 children with a primary diagnosis of social anxiety disorder and 15 non-clinical controls using interviews and questionnaires on expressions of social anxiety and behavioural inhibition. Results showed that children with SM or social anxiety disorder were more anxious than non-clinical controls and did not significantly differ from each other on either non-verbal social anxiety or non-social forms of anxiety. Both children with SM and social anxiety disorder had fewer friends and experienced greater difficulties forming friendships than non-clinical controls. However, children with SM scored higher than children with social anxiety disorder and non-clinical controls on a few measures of inhibition (both verbal and nonverbal). The results support assertions of strong similarities between SM and social anxiety disorder, but suggest that children with SM may show even greater severity in certain symptoms at a young age. These findings point to the need for treatment to include both cognitive behavioural skills to manage social anxiety and structured practice of social skills in order to improve treatment efficacy for children with SM.
越来越多的证据表明，儿童选择性缄默症（SM）与社交焦虑障碍之间存在强烈重叠，特别是在社交沉默和焦虑等特征方面。然而，很少有研究直接比较这些人群，尤其是年幼儿童。本研究使用关于社交焦虑表达和行为抑制的访谈及问卷，对25名初步诊断为SM的儿童（3至7岁）、17名初步诊断为社交焦虑障碍的儿童和15名非临床对照儿童进行了比较。结果显示，患有SM或社交焦虑障碍的儿童比非临床对照儿童更焦虑，在非言语社交焦虑或非社交形式的焦虑方面彼此之间没有显著差异。患有SM和社交焦虑障碍的儿童都比非临床对照儿童朋友更少，在建立友谊方面遇到更大困难。然而，在一些抑制测量指标（包括言语和非言语）上，患有SM的儿童得分高于患有社交焦虑障碍的儿童和非临床对照儿童。研究结果支持了SM与社交焦虑障碍之间存在强烈相似性的观点，但表明患有SM的儿童在年幼时某些症状可能表现得更为严重。这些发现表明，治疗需要既包括管理社交焦虑的认知行为技能，也包括社交技能的结构化练习，以提高对患有SM儿童的治疗效果。
