Social phobia subtypes in the national comorbidity survey
Social phobia subtypes in the national comorbidity survey
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DOI：
10.1176/ajp.155.5.613
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发表时间：
1998-05-01
影响因子：
17.7
通讯作者：
Berglund, P
中科院分区：
文献类型：
--
作者：
Kessler, RC;Stein, MB;Berglund, P
目的：本文介绍了以纯粹的言语恐惧为特征的社交恐惧症与以其他社交恐惧为特征的社交恐惧症之间的区别的流行病学数据。方法：数据来自科摩罗全国调查（N= 8，098）。社交恐惧症的评估与修订版的复合国际诊断访谈。结果如下：潜在的类分析表明，在调查中评估的简短的一套社会恐惧可以分为一类，其特点主要是说话的恐惧和第二类的特点是更广泛的社会恐惧。三分之一的终身社交恐惧症患者只报告了说话恐惧，而其他三分之二的人也至少评估了其他社交恐惧中的一种。后者中的绝大多数有多种社交恐惧，包括在大多数情况下，表现和干扰恐惧。这两种亚型在发病年龄分布、家族史和某些社会人口学相关因素方面相似。然而，社交恐惧症的特点是纯说话的恐惧是不持久的，较少的损害，并与其他DSM-III-R障碍的高度共病比社交恐惧症的特点是其他社会恐惧。结论：需要进一步的普通人群研究评估更多的表现和互动恐惧，以确定社交恐惧症亚型是否可以细化，以及亚型是否可以更好地概念化为不同的疾病。与此同时，患有社交恐惧症并伴有多种恐惧（其中一些是非言语恐惧）的人似乎受到的伤害最大，应该成为预防和干预工作的主要重点。
Objective: This article presents epidemiologic data on the distinction between social phobia characterized by pure speaking fears and that-characterized by other social fears. Method: The data come from the National Comorbidity Survey (N=8,098). Social phobia was assessed with a revised version of the Composite International Diagnostic Interview. Results: Latent class analysis showed that the brief set of social fears assessed in the survey can be disaggregated into a class characterized largely by speaking fears and a second class characterized by a broader range of social fears. One-third of the people with lifetime social phobia exclusively reported speaking fears, while the other two-thirds also had at least one of the other social fears assessed. The vast majority of the latter had multiple social fears including, in most cases, both performance and interactional fears. The two subtypes were similar in age at onset distribution, family history, and certain sociodemographic correlates. However, the social phobia characterized by pure speaking fears was less persistent, less impairing, and less highly comorbid with other DSM-III-R disorders than was social phobia characterized by other social fears. Conclusions: Further general population research assessing more performance and interaction fears is needed to determine whether social phobia subtypes can be refined and whether the subtypes are better conceptualized as distinct disorders. In the meantime, people who have social phobia with multiple fears, some of which are nonspeaking fears, appear to have the most impairment and should be the main focus of prevention and Intervention efforts.