CHILDHOOD SOCIAL PHOBIA: LONG-TERM FOLLOW-UP

社交恐惧症影响了大约3%-5%的儿童，随着年龄的增长，患病率上升。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、参加派对、与权威人物互动、使用公共厕所和在非正式社交聚会上互动。临床相关包括头痛或胃痛、恐慌症发作、哭泣、回避、普遍焦虑、烦躁不安、孤独感以及非常有限的社会关系。在极端情况下，可能会导致拒绝上学或其他行为问题。这些儿童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恢复。此外，其他障碍经常同时发生，最常见的是广泛性焦虑症、分离性焦虑症和特定的恐惧症。最近的研究结果表明，一种新的心理社会治疗(儿童社会有效性治疗；SET-C)对8-12岁的儿童有效，从而减少了情绪困扰，改善了社会功能，治疗效果保持了长达6个月。然而，这种疗法或任何其他疗法对儿童社交恐惧症的长期效果尚不清楚。本申请中提出的研究旨在延长本研究(MH53703)中成功使用SET-C治疗的儿童的随访期。这项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、父母和临床医生评级、社交技能行为评估和日常日记。这项跟踪研究将为接受儿童社交恐惧症治疗的儿童提供迄今为止最长的跟踪调查。评估战略旨在确定治疗的持久性，确定复发或发展其他障碍的风险因素，衡量学术、社会和情绪功能。这项研究的数据将特别有用，因为随访期将涵盖社交恐惧症最高风险年龄(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).