Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Wilhelm-Johnen-Straße, 52428 Jülich, Germany.
J Affect Disord. 2024 Oct 15;363:662-670. doi: 10.1016/j.jad.2024.07.055. Epub 2024 Jul 15.
Social Anxiety Disorder (SAD) is a highly heterogeneous disorder. To enlighten its heterogeneity, this study focused on recalled parental behavior and aimed to empirically identify if there are subgroups of SAD based on recalled parental behavior by means of cluster analysis. Further, the study investigated whether those subgroups differed on clinical, trauma, and personality variables.
This study included 505 individuals diagnosed with SAD and 98 adult controls who were asked to fill out the Parental Bonding Instrument (PBI), the Adverse Childhood Experiences Questionnaire (ACE), and the Temperament and Character Inventory (TCI). Cluster analysis determined whether there are meaningful SAD subgroups based on PBI. The clusters obtained were compared with each other and with the control group with regard to clinical, ACE, and TCI variables.
The cluster analysis revealed two SAD clusters based on recalled parental behavior. SAD individuals in the first cluster (49.3 %) perceived their parents as intermediately caring, but not as overcontrolling. SAD individuals in the second cluster (50.7 %) perceived their parents as less caring and overcontrolling, reported more severe clinical symptoms and trauma, and had lower values in Self-Directedness and Cooperativeness.
The present study is cross-sectional, therefore unable to confirm causal interpretations.
Parenting is meaningful to enlighten the heterogeneity of SAD symptomatology and to specify treatment approaches as there are two meaningful subgroups in individuals with SAD corresponding to differences in clinical presentation, trauma, and personality.
社交焦虑障碍（SAD）是一种高度异质的障碍。为了阐明其异质性，本研究关注的是被试对父母行为的回忆，并通过聚类分析实证确定是否存在基于被试对父母行为的回忆来划分 SAD 亚组的方法。此外，该研究还调查了这些亚组在临床、创伤和人格变量上是否存在差异。
本研究纳入了 505 名被诊断为 SAD 的个体和 98 名成年对照组，他们被要求填写《父母养育方式问卷》（PBI）、《童年期不良经历问卷》（ACE）和《气质与性格问卷》（TCI）。聚类分析确定了基于 PBI 是否存在有意义的 SAD 亚组。获得的聚类与对照组进行了比较，并比较了临床、ACE 和 TCI 变量。
聚类分析根据被试对父母行为的回忆揭示了两个 SAD 亚组。第一个聚类（49.3%）中的 SAD 个体认为他们的父母关心适度，但不过度控制。第二个聚类（50.7%）中的 SAD 个体认为他们的父母关心较少且过度控制，报告了更严重的临床症状和创伤，自我导向性和合作性的得分也较低。
本研究是横断面研究，因此无法确认因果关系。
养育方式对阐明 SAD 症状的异质性很有意义，并可以确定治疗方法，因为 SAD 个体存在两个有意义的亚组，对应于临床表现、创伤和人格的差异。
