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，从而使社交焦虑症的失业人员能够寻找和获得就业。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，认知行为的干预失业，经济上处于不利地位，城市居民的社交焦虑症的人。最近的一项全国代表性流行病学研究将DSM-IV SocAD的终生患病率定为12.1%（Kessler等人，2005年）。社交焦虑障碍与社交功能的显著损害相关（Kessler，2003; Stein和Kean，2000）。大多数社交焦虑症患者报告职业功能显著受损（Stein等人，2000; Turner等人，1986年）。具体的损害包括拒绝工作机会和晋升（Stein，Torgrud，&步行者，2000），降低生产力和工作绩效（Wittchen，et al.，2000年），教育程度降低和早期辍学（Stein & Kean，2000年），失业率上升（Heimberg等人，1990 a）、经济依赖（Scheier等人，1992）和收入减少（Magee等人，1996年）。社交焦虑障碍可能会干扰工作的实现，由于工作面试回避，过度焦虑的觉醒，在工作面试，有限的社交网络提供工作线索。我们对接受福利的母亲进行的纵向研究发现，社交焦虑障碍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，将社交焦虑症确定为唯一一种严重干扰参加国际测试，最佳实践，职业服务干预计划的个人获得工作的精神疾病。我们已经开始在密歇根州底特律市的犹太职业服务中心对个人进行社交焦虑的筛查，那里的主要客户是经济上处于不利地位的非洲裔美国人，他们正在寻找工作。我们的筛查工作证实了疑似社交焦虑症与这一人群失业之间的关联。我们的调查小组将与犹太职业服务机构的工作人员和选定的犹太职业服务消费者合作，制定一项有效和可持续的干预措施，改善这一服务不足人口中有社交恐惧症的失业成员的生活。社交焦虑症是一种影响就业的非常普遍的疾病。先前的研究表明，社会焦虑症会干扰福利接受者的工作成就。该项目涉及设计和开发一种基于社区的认知行为干预措施，以减少社交焦虑症患者的社交焦虑并改善其就业结果。

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.