Strell-Zimonyi Flora, Kovacs Anna, Miklosi Monika
Pest Megyei Pedagógiai Szakszolgálat Budakeszi Tagintézménye, Budaörs, Hungary.
Neuropsychopharmacol Hung. 2020 Sep;22(3):91-100.
This review aims to present social anxiety disorder from a developmental psychopathological perspective. Evolutionary theories share the view that social anxiety might be adaptive in specific contexts, and suggest several mechanisms of dysfunction (adaptive trade-off , mismatch, individual differences). The aetiology of social anxiety disorder is characterized by a complex interplay of genetic and environmental factors including gene-environment interactions,correlations and epigenetic mechanisms. Although the main diagnostic criteria of social anxiety disorder are the same throughout the lifespan, developmental characteristics alter its presentation. In children, behavioural symptoms are common. We can view refusal of speech as a specific manifestation of avoidant behaviour related to young age. Therefore, some researchers suggest that selective mutism is an age-specific subtype of the disorder. Even though the majority of researchers agree that behavioural inhibition is an age-specific temperamental risk factor of social anxiety disorder, it might also be viewed as an early, subclinical form of the disorder. In adolescence, as part of the normal development, there is a temporary increase of social anxiety. In this age group, however, there is also an increase in the prevalence of socialanxiety disorder. Adult-onset social anxiety disorder is rare. In adults, social anxiety disorder has to be diff erentiated from avoidant personality disorder. Social anxiety disorder is characterized by strong homotypic continuity, but evidence for a heterotypic continuity is also available,especially with other anxiety disorders and major depression, probably due to shared genetic factors. The developmental psychopathological approach of social anxiety - developmental paths, age-specific characteristics, etc. - may contribute to an early recognition of the disorder and facilitate more effective therapeutic interventions.
本综述旨在从发展心理病理学的角度阐述社交焦虑障碍。进化理论一致认为，社交焦虑在特定情境下可能具有适应性，并提出了几种功能失调的机制（适应性权衡、不匹配、个体差异）。社交焦虑障碍的病因具有遗传和环境因素的复杂相互作用的特征，包括基因 - 环境相互作用、相关性和表观遗传机制。尽管社交焦虑障碍的主要诊断标准在整个生命周期中是相同的，但发展特征会改变其表现形式。在儿童中，行为症状很常见。我们可以将言语拒绝视为与年龄相关的回避行为的一种特殊表现。因此，一些研究人员认为选择性缄默症是该障碍的一种特定年龄亚型。尽管大多数研究人员一致认为行为抑制是社交焦虑障碍的一种特定年龄的气质性风险因素，但它也可能被视为该障碍的一种早期亚临床形式。在青少年时期，作为正常发育的一部分，社交焦虑会暂时增加。然而，在这个年龄组中，社交焦虑障碍的患病率也有所增加。成人期起病的社交焦虑障碍很少见。在成年人中，社交焦虑障碍必须与回避型人格障碍相区分。社交焦虑障碍具有很强的同型连续性，但也有异型连续性的证据，特别是与其他焦虑障碍和重度抑郁症，这可能是由于共享的遗传因素。社交焦虑的发展心理病理学方法——发展路径、特定年龄特征等——可能有助于早期识别该障碍，并促进更有效的治疗干预。
