A Systems Level Intervention for Unemployed Persons with Social Anxiety Disorder

描述(由申请人提供)：拟议研究的目标是设计和开发一种认知-行为干预措施，以减少焦虑症状，从而使患有社交焦虑障碍的失业人员能够寻找和就业。这种干预将是一种文化上适当的、以职业为重点的、可持续的认知-行为干预，适用于失业、经济上处于不利地位的城市居民和社交焦虑症患者。最近的一项具有全国代表性的流行病学研究显示，DSM-IV SOCAD的终生患病率为12.1%(Kessler等人，2005年)。社交焦虑症与显著的社交功能障碍有关(Kessler，2003；Stein和Kean，2000)。绝大多数社交焦虑症患者报告了严重的职业功能障碍(Stein等人，2000；Turner等人，1986)。具体的损害包括拒绝工作机会和晋升(Stein，Torgrud和Walker，2000)、生产率和工作表现降低(Wittchen等人，2000)、教育程度降低和早期辍学(Stein&Kean，2000)、失业增加(Heimberg等人，1990a)、经济依赖(Scheier等人，1992)和收入减少(Magee等人，1996)。社交焦虑症可能会因为回避面试、在面试中过度焦虑、以及提供求职线索的社交网络有限而干扰工作成就。我们对领取福利的母亲进行的纵向研究发现，社交焦虑症的诊断是随着时间的推移依赖福利支持的最强精神病学预测因素。我们还完成了一项研究，确定社交焦虑障碍是唯一严重干扰参加国际测试、最佳实践的职业服务干预计划的个人获得工作的精神障碍。我们已经开始在密歇根州底特律的犹太职业服务中心筛查个人是否存在社交焦虑，那里的主要客户是经济上处于不利地位的非裔美国人，他们正在寻找工作。我们的筛查工作证实了疑似社交焦虑障碍与这一人群中的失业之间的联系。我们的调查团队将与犹太职业服务机构的工作人员和精选的犹太职业服务消费者合作，开发一种有效和可持续的干预措施，以改善这一服务不足人群中社交恐惧症和失业成员的生活。社交焦虑症是一种非常普遍的疾病，干扰了就业。先前的研究表明，社交焦虑障碍会干扰福利受助人的工作成就。该项目涉及设计和开发一种以社区为基础的认知行为干预措施，以减少社交焦虑并改善患有社交焦虑障碍的失业人员的就业结果。

DESCRIPTION (provided by applicant): The goal of the proposed research is to design and develop a cognitive-behavioral intervention to reduce anxiety symptoms and thereby enable unemployed persons with social anxiety disorder to seek and obtain employment. This intervention will be a culturally appropriate, vocationally focused, sustainable, cognitive- behavioral intervention for unemployed, economically disadvantaged, urban-dwelling persons with social anxiety disorder. A recent nationally representative epidemiological study places the lifetime prevalence of DSM-IV SocAD at 12.1% (Kessler et al., 2005). Social anxiety disorder is associated with notable impairments in social functioning (Kessler, 2003; Stein and Kean, 2000). A large majority of people with social anxiety disorder report significant impairment in occupational functioning (Stein, et al., 2000; Turner et al., 1986). Specific impairments include turning down job offers and promotions (Stein, Torgrud, & Walker, 2000), reduced productivity and job performance (Wittchen, et al., 2000), lowered educational attainment & early school dropout (Stein & Kean, 2000), increased unemployment (Heimberg et al.,1990a), financial dependence (Scheier et al, 1992), and reduced income (Magee et al., 1996). Social anxiety disorder likely interferes with job attainment due to job interview avoidance, excessive anxious arousal during job interviews, and limited social networks to provide job leads. Our longitudinal study of mothers receiving welfare found that the diagnosis of social anxiety disorder was the strongest psychiatric predictor of reliance on welfare for support over time. We have also completed a study that identifies social anxiety disorder as the only psychiatric disorder that significantly interferes with attaining work among individuals who participated in an internationally tested, best-practice, vocational services intervention program. We have begun to screen individuals for the presence of social anxiety at Jewish Vocational Service in Detroit Michigan, where the primary clientele are economically disadvantaged, African Americans who are seeking work. Our screening efforts confirm the association between suspected social anxiety disorder and unemployment in this population. Our investigative team will collaborate with Jewish Vocational Service agency staff and with selected Jewish Vocational Service consumers to develop an effective and sustainable intervention that will improve the lives of socially phobic, unemployed members of this underserved population. Social anxiety disorder is a highly prevalent condition that interferes with employment. Prior research indicates that social anxiety disorder interferes with work attainment among welfare recipients. This project involves the design and development of a community-based cognitive-behavioral intervention to reduce social anxiety and improve employment outcomes among unemployed persons with social anxiety disorder.