CHILDHOOD SOCIAL PHOBIA: LONG-TERM FOLLOW-UP

社交恐惧症影响了大约3- 5%的儿童，患病率随着年龄的增长而上升。患有社交恐惧症的青少年非常害怕在公共场合演讲、阅读或写作、参加聚会、与权威人物互动、使用公共厕所以及在非正式的社交聚会中互动。临床相关症状包括头痛或胃痛、惊恐发作、哭泣、逃避、普遍焦虑、烦躁不安、孤独感以及社交关系范围非常有限。在极端情况下，可能会导致拒绝入学或其他行为问题。这些孩子缺乏正常社会发展所必需的社交技能。这种疾病是慢性的，在11岁之前发病，预示着成年后无法康复。此外，其他疾病也经常同时发生，最常见的是广泛性焦虑障碍、分离性焦虑障碍和特定恐惧症。最近的研究结果表明，一种新的社会心理治疗（Social Effectiveness Therapy for Children; SET-C）对8-12岁的儿童有效，可以减少情绪困扰，改善社会功能，并且治疗效果可以维持6个月。然而，这种治疗或任何其他治疗对儿童社交恐惧症的长期影响尚不清楚。本申请中提出的研究旨在延长我们当前研究（MH53703）中成功使用SET-C治疗的儿童的随访期。该研究旨在将这些儿童的随访期延长至治疗后5年。评估将包括诊断性访谈、自我报告清单、父母和临床医生评分、社交技能行为评估和日常日记。这项随访研究将为治疗儿童社交恐惧症的儿童提供迄今为止最长的随访。该评估策略旨在确定治疗的持久性，确定复发或其他疾病发展的风险因素，衡量学业、社会和情感功能。这项研究的数据将特别有用，因为随访期间将涵盖社交恐惧症风险最高的年龄（15-18岁）的儿童。

Social phobia affects approximately 3-5 percent of children, and the prevalence rises as age increases. Youth with social phobia have significant fear of public speaking, reading or writing in public, going to parties, interacting with authority figures, using public restrooms and interacting in informal social gatherings. Clinical correlates include headaches or stomach aches, panic attacks, crying, avoidance, general anxiety, dysphoria, a sense of loneliness, and a very restricted range of social relationships. In extreme cases, school refusal or other behavioral problems may result. These children are deficient in the social skills necessary for normal social development. The disorder is chronic and onset prior to age 11 predicts non- recovery in adulthood. Also, other disorders frequently occur concurrently, most often generalized anxiety disorder, separation anxiety disorder and specific phobia. Recent findings indicate that a new psychosocial treatment (Social Effectiveness Therapy for Children; SET-C) is efficacious for children ages 8-12, resulting in reduction in emotional distress and improvement in social functioning, and the treatment effects have been maintained for up to 6 months. However, the long-term effects of this treatment, or any other treatment, for childhood social phobia are unknown. The study proposed in this application is designed to extend the followup period for those children who were successfully treated with SET-C in our current study (MH53703). The study is designed to extend the followup period for these children to 5 years posttreatment. Assessments will include diagnostic interviews, self-report inventories, parental and clinician ratings, behavioral assessments of social skill, and daily diaries. This followup study will provide the longest followup to date for children treated for childhood social phobia. The assessment strategy is designed to allow for the determination of the durability of treatment, determination of risk factors for relapse or the development of other disorders, gauge academic, social, and emotional functioning. Data from this study will be particularly useful because the followup period will cover the children during the age of highest risk for social phobia (15-18 years).