Chartier M J, Hazen A L, Stein M B
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
Depress Anxiety. 1998;7(3):113-21.
This study describes the natural course of social phobia as recalled by a sample of nonclinical subjects and explores, using qualitative research methods, perceived risk factors and factors that may cause changes in its course. Thirty-nine respondents with a lifetime diagnosis of social phobia were interviewed using a semistructured interview schedule based on DSM-IV criteria. Four main lifetime patterns emerged: a slight worsening of social phobic symptoms over time, no change, slight improvement and complete remission. Thirty-eight percent of the sample was in remission at the time of interview. The mean age of onset was 12.8 +/- 4.1 years. The average duration of illness was 29.0 +/- 12.7 years. Factors perceived by respondents to precipitate social phobia, using contract analysis, were family and school environment, onset of adolescence, low self-esteem, temperament and poverty. Factors perceived to improve symptoms were building self-esteem, exposure, determination, maturity and counseling. Factors perceived to worsen symptoms were avoidance, exposure to negative attention and comorbid disorders.
本研究描述了非临床受试者样本所回忆的社交恐惧症的自然病程，并运用定性研究方法探讨了感知到的风险因素以及可能导致其病程变化的因素。采用基于《精神疾病诊断与统计手册》第四版标准的半结构化访谈提纲，对39名终生诊断为社交恐惧症的受访者进行了访谈。出现了四种主要的终生模式：社交恐惧症状随时间略有恶化、无变化、略有改善和完全缓解。在访谈时，38%的样本处于缓解状态。平均发病年龄为12.8±4.1岁。平均病程为29.0±12.7年。通过内容分析，受访者认为引发社交恐惧症的因素有家庭和学校环境、青春期开始、自卑、性格和贫困。认为能改善症状的因素有增强自尊、暴露、决心、成熟和咨询。认为会使症状恶化的因素有回避、受到负面关注和共病障碍。
