BEHAVIORAL TREATMENT OF CHILDHOOD SOCIAL PHOBIA

社交恐惧症影响了大约1%的儿童。

Social phobia affects approximately 1% of the child population. Children with social phobia have significant fears of public speaking, eating or writing in public, going to parties, using public restrooms, speaking to authority figures, and informal interactions. The clinical correlates of social phobia include depression, social withdrawal, fear of failure, poor perception of cognitive competence and high trait anxiety. Furthermore, children with social phobia sometimes refuse to attend school and a substantial percentage suffer alcohol abuse, display conduct problems, and experience difficulty getting along with peers. The onset of social fears prior to the age of 11 appears to predict non-recovery in adulthood. Thus, childhood social phobia is a much more complicated and serious disorder than heretofore believed. Although to date there are no published studies of behavioral treatments for children with social phobia, studies with socially isolated children suggest that social skills training may be an effective intervention. However, traditional skills training programs do not produce generalization to the naturalistic environment. In addition, extant data with adult social phobics indicate that the critical therapeutic element includes formalized exposure therapy, something not customarily included in social skills training programs. Therefore, a multi-modal approach, appropriate to the multi-dimensional nature of the disorder is warranted. The proposed study is being submitted under the psychosocial treatment development initiative. The study will examine the efficacy of a new treatment for children with social phobia. Social Effectiveness Therapy for Children (SET-C), a comprehensive treatment program will be compared to an attention- placebo control group in children 9-12 years of age. The efficacy of this approach will be evaluated in terms of its ability to reduce social anxiety and fear, improve social skill and interpersonal functioning, increase participation in social activities and improve self-confidence and self-concept. The study will be the first controlled comparison study of SET-C and a credible placebo control group. Durability of treatment will be determined over a 6 month followup period with assessments at 1, 3 and 6 month intervals.