Weinshenker N J, Goldenberg I, Rogers M P, Goisman R M, Warshaw M G, Fierman E J, Vasile R G, Keller M B
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Depress Anxiety. 1996;4(5):209-16. doi: 10.1002/(SICI)1520-6394(1996)4:5<209::AID-DA1>3.0.CO;2-8.
This study examines a large cohort of subjects with social phobia, as part of a larger naturalistic and longitudinal study of 711 subjects with anxiety disorders. We focused on 176 subjects who were in an episode of social phobia at intake. We were particularly interested in evaluating the diagnostic distinction between generalized and specific social phobia. We compared these two groups along demographic characteristics, comorbidities, psychosocial functioning (health, role functioning, social functioning, and emotional functioning) and global assessment scores. We found that generalized social phobics tended to have an earlier age of onset as compared to the specific group; however, this is not a statistically significant difference at this level of analysis. The two groups did not differ for the current comorbidities examined. We observed no differences in the treatment received by the two types of social phobia subjects, and the two groups functioned equally well in terms of health and fulfilling social roles. In addition, we examined adverse childhood events (i.e., death of a parent, childhood abuse) and found no evidence for any differential impact these events might have on the type of social phobia. Although we did observe significantly greater fear of public speaking among the specific compared to the generalized group, which may indicate a qualitative difference between the subtypes, our results suggest that for most parameters, generalized and specific social phobia represent a continuum of similar and overlapping entities.
本研究对一大群社交恐惧症患者进行了调查,这是对711名焦虑症患者进行的一项规模更大的自然主义纵向研究的一部分。我们重点关注了176名在入组时正处于社交恐惧症发作期的患者。我们特别感兴趣的是评估广泛性社交恐惧症和特定性社交恐惧症之间的诊断差异。我们比较了这两组患者在人口统计学特征、共病情况、心理社会功能(健康、角色功能、社交功能和情绪功能)以及整体评估得分方面的情况。我们发现,与特定性社交恐惧症组相比,广泛性社交恐惧症患者的起病年龄往往更早;然而,在这个分析层面上,这一差异并无统计学意义。在所研究的当前共病情况方面,两组并无差异。我们观察到,两种类型的社交恐惧症患者所接受的治疗并无差异,并且两组在健康状况和履行社会角色方面的表现同样良好。此外,我们研究了童年不良事件(即父母死亡、童年期受虐),没有发现证据表明这些事件可能对社交恐惧症的类型产生任何差异影响。尽管我们确实观察到,与广泛性社交恐惧症组相比,特定性社交恐惧症组对公开演讲的恐惧明显更大,这可能表明两种亚型之间存在质的差异,但我们的研究结果表明,对于大多数参数而言,广泛性社交恐惧症和特定性社交恐惧症代表了相似且重叠的连续统一体。