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Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review. J Pediatr (Rio J) 2017; 93:442-451. [PMID: 28579354 DOI: 10.1016/j.jped.2017.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/12/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To identify the risk factors related to the association between social anxiety disorder and alcohol use in adolescents. SOURCE OF DATA The PICO research strategy was used to perform a systematic review in Medline, LILACS, Pubmed, IBECS and Cochrane Library databases. DeCS/MeSH: Phobic Disorders, Adolescent, Behavior, Ethanol, Risk Factors, and the Boolean operator "AND" were used. Inclusion criteria were: cross-sectional, prospective/retrospective cohort, and case-control studies, carried out in adolescents (10-19 years), original articles on social anxiety disorder and alcohol use published between 2010 and 2015. Studies that did not report the terms "anxiety disorder" and "alcohol use" in the title and abstract were excluded. SYNTHESIS OF DATA 409 articles were retrieved; after the exclusion of 277 repeated articles, the following were eligible: 94 in MEDLINE, 68 in Pubmed, 12 in IBCS, and three in LILACS. Titles and abstracts were independently read by two examiners, which resulted in the selection of eight articles for the analysis. Risk factors associated to the two disorders were female gender, age, peer approval and affective problems for alcohol use, confrontation situations and/or compliance reasons, frequency of alcohol use, and secondary comorbidities, such as depression and generalized anxiety. CONCLUSIONS It is necessary to assess the period of social anxiety disorders first symptom onset, as well as the risks for alcohol use in order to establish corrective intervention guidelines, especially for socially anxious students.
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Cruz ELDD, Martins PDDC, Diniz PRB. Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2017.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Cao J, Yang J, Zhou Y, Chu F, Zhao X, Wang W, Wang Y, Peng T. The effect of Interaction Anxiousness Scale and Brief Social Phobia Scale for screening social anxiety disorder in college students: a study on discriminative validity. J Ment Health 2016; 25:500-505. [PMID: 27935389 DOI: 10.3109/09638237.2015.1124391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Social anxiety disorder (SAD) is one of the most prevalent mental health problems, but there is little research concerning the effective screening instruments in practice. METHODS This study was designed to examine the discriminative validity of Interaction Anxiousness Scale (IAS) and Brief Social Phobia Scale (BSPS) for the screening of SAD through the compared and combined analysis. Firstly, 421 Chinese undergraduates were screened by the IAS and BSPS. Secondly, in the follow-up stage, 248 students were interviewed by the Structured Clinical Interview for DSM-IV. Receiver operating characteristic (ROC) analysis was used, and the related psychometric characters were checked. RESULTS The results indicated that the ROC in these two scales demonstrated discrimination is in satisfactory level (range: 0.7-0.8). However, the highest agreement (92.17%) was identified when a cut-off point of 50 measured by the IAS and a cut-off point of 34 by the BSPS were combined, also with higher PPV, SENS, SPEC and OA than that reached when BSPS was used individually, as well as PPV, SPEC and OA in IAS. CONCLUSION The findings indicate that the combination of these two scales is valid as the general screening instrument for SAD in maximizing the discriminative validity.
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Affiliation(s)
- Jianqin Cao
- a Department of Psychology , Harbin Medical University (Daqing) , Hei Longjiang Province , China
| | - Jinwei Yang
- a Department of Psychology , Harbin Medical University (Daqing) , Hei Longjiang Province , China
| | - Yuqiu Zhou
- a Department of Psychology , Harbin Medical University (Daqing) , Hei Longjiang Province , China
| | - Fuliu Chu
- b Da Qing Third Hospital , Daqing City, Hei Longjiang Province , China , and
| | - Xiwu Zhao
- b Da Qing Third Hospital , Daqing City, Hei Longjiang Province , China , and
| | - Weiren Wang
- a Department of Psychology , Harbin Medical University (Daqing) , Hei Longjiang Province , China
| | - Yunlong Wang
- c School of Public Health, Harbin Medical University , Hei Longjiang Province , China
| | - Tao Peng
- c School of Public Health, Harbin Medical University , Hei Longjiang Province , China
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Santos LF, Loureiro SR, Crippa JAS, Osório FL. Can the Liebowitz Social Anxiety Scale - self-report version be used to differentiate clinical and non-clinical SAD groups among Brazilians? PLoS One 2015; 10:e0121437. [PMID: 25811489 PMCID: PMC4374964 DOI: 10.1371/journal.pone.0121437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 02/13/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The Liebowitz Social Anxiety Scale (LSAS) was the first evaluation instrument developed for screening for the signs and symptoms of Social Anxiety Disorder (SAD) and is currently still the most used worldwide. The aim of this study is to evaluate the ability of the LSAS - self-report version (LSAS-SR) to discriminate different Social Anxiety Disorder (SAD) clinical groups. METHOD The sample was composed of Brazilians university students, allocated into three different groups, i.e., cases (C=118), non-cases (NC=95) and subclinical cases (SC=39). To achieve the aim, calculations of the ROC Curve and ANOVA were performed. RESULTS The results found were excellent regardless of the technique used, highlighting the discriminatory capacity of the LSAS-SR. The score equal to or greater than 32 is suggested as a cutoff score for the Brazilian population, since this presented balance between the standards evaluated and the ability to differentiate both clinical and subclinical SAD cases from non-cases. CONCLUSION Despite the specific sample used in this study being composed only of university students, the use of the LSAS-SR can be indicated, in the Brazilian setting, for SAD screening in both clinical and research contexts.
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Affiliation(s)
- Larissa F. Santos
- Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto—USP, Ribeirão Preto, São Paulo, Brazil
| | - Sonia R. Loureiro
- Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto—USP, Ribeirão Preto, São Paulo, Brazil
- National Institute of Technology and Translational Medicine—CNPq, Brazil
| | - José A. S. Crippa
- Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto—USP, Ribeirão Preto, São Paulo, Brazil
- National Institute of Technology and Translational Medicine—CNPq, Brazil
| | - Flávia L. Osório
- Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto—USP, Ribeirão Preto, São Paulo, Brazil
- National Institute of Technology and Translational Medicine—CNPq, Brazil
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Machado-de-Sousa JP, Osório FDL, Jackowski AP, Bressan RA, Chagas MHN, Torro-Alves N, DePaula ALD, Crippa JAS, Hallak JEC. Increased amygdalar and hippocampal volumes in young adults with social anxiety. PLoS One 2014; 9:e88523. [PMID: 24523911 PMCID: PMC3921212 DOI: 10.1371/journal.pone.0088523] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 01/07/2014] [Indexed: 12/02/2022] Open
Abstract
Background Functional neuroimaging studies have consistently shown abnormal limbic activation patterns in socially anxious individuals, but structural data on the amygdala and hippocampus of these patients are scarce. This study explored the existence of structural differences in the whole brain, amygdala, and hippocampus of subjects with clinical and subthreshold social anxiety compared to healthy controls. We hypothesized that there would be volumetric differences across groups, without predicting their direction (i.e. enlargement or reduction). Methods Subjects classified as having social anxiety disorder (n = 12), subthreshold social anxiety (n = 12) and healthy controls (n = 14) underwent structural magnetic resonance imaging scans. The amygdala and hippocampus were defined a priori as regions of interest and volumes were calculated by manual tracing. Whole brain volume was calculated using voxel-based morphometry. Results The bilateral amygdala and left hippocampus were enlarged in socially anxious individuals relative to controls. The volume of the right hippocampus was enlarged in subthreshold social anxiety participants relative to controls. No differences were found across groups in respect to total brain volume. Conclusions Our results show amygdalar and hippocampal volume alterations in social anxiety, possibly associated with symptom severity. The time course of such alterations and the cellular and molecular bases of limbic plasticity in social anxiety should be further investigated.
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Affiliation(s)
- João Paulo Machado-de-Sousa
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto – SP, Brazil
- * E-mail:
| | - Flávia de Lima Osório
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto – SP, Brazil
| | - Andrea P. Jackowski
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo – SP, Brazil
| | - Rodrigo A. Bressan
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo – SP, Brazil
| | - Marcos H. N. Chagas
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto – SP, Brazil
| | - Nelson Torro-Alves
- Department of Psychology, Federal University of Paraíba (UFPB), João Pessoa – PB, Brazil
| | - André L. D. DePaula
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto – SP, Brazil
| | - José A. S. Crippa
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto – SP, Brazil
| | - Jaime E. C. Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto – SP, Brazil
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Sanches SHB, Osório FDL, Udina M, Martín-Santos R, Crippa JAS. Anxiety and joint hypermobility association: a systematic review. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2013; 34 Suppl 1:S53-60. [PMID: 22729449 DOI: 10.1590/s1516-44462012000500005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Anxiety disorders are often associated with several non-psychiatric medical conditions. Among the clinical conditions found in association with anxiety stands out the joint hypermobility (JH). OBJECTIVES To carry out a systematic review of the clinical association between anxiety disorders and JH. METHOD A survey was conducted in MEDLINE, PsychINFO, LILACS e SciELO databases up to December 2011. We searched for articles using the keywords 'anxiety', 'joint' and 'hypermobility' and Boolean operators. The review included articles describing empirical studies on the association between JH and anxiety. The reference lists of selected articles were systematically hand-searched for other publications relevant to the review. RESULTS Seventeen articles were included in the analysis and classified to better extract data. We found heterogeneity between the studies relate to the methodology used. Most of the studies found an association between anxiety features and JH. Panic disorder/agoraphobia was the anxiety disorder associated with JH in several studies. Etiological explanation of the relationship between anxiety and JH is still controversial. CONCLUSION Future research in large samples from the community and clinical setting and longitudinal studies of the association between anxiety and HA and the underlying biological mechanisms involved in this association are welcome.
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Affiliation(s)
- Simone H Bianchi Sanches
- Neurosciences and Behavior Department, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil.
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Bianchi Sanches SH, Osório FDL, Udina M, Martín-Santos R, Crippa JAS. Anxiety and joint hypermobility association: a systematic review. BRAZILIAN JOURNAL OF PSYCHIATRY 2012. [DOI: 10.1016/s1516-4446(12)70054-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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A review on predictors of treatment outcome in social anxiety disorder. BRAZILIAN JOURNAL OF PSYCHIATRY 2012. [DOI: 10.1016/s1516-4446(12)70016-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Mululo SCC, de Menezes GB, Vigne P, Fontenelle LF. A review on predictors of treatment outcome in social anxiety disorder. BRAZILIAN JOURNAL OF PSYCHIATRY 2012; 34:92-100. [DOI: 10.1590/s1516-44462012000100016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 09/03/2011] [Indexed: 12/16/2022]
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Anxiety disorders in adolescence are associated with impaired facial expression recognition to negative valence. J Psychiatr Res 2012; 46:147-51. [PMID: 22018638 DOI: 10.1016/j.jpsychires.2011.09.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 09/12/2011] [Accepted: 09/29/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of the present study was to test the ability of adolescents with a current anxiety diagnosis to recognize facial affective expressions, compared to those without an anxiety disorder. METHODS Forty cases and 27 controls were selected from a larger cross sectional community sample of adolescents, aged from 10 to 17 years old. Adolescent's facial recognition of six human emotions (sadness, anger, disgust, happy, surprise and fear) and neutral faces was assessed through a facial labeling test using Ekman's Pictures of Facial Affect (POFA). RESULTS Adolescents with anxiety disorders had a higher mean number of errors in angry faces as compared to controls: 3.1 (SD=1.13) vs. 2.5 (SD=2.5), OR=1.72 (CI95% 1.02 to 2.89; p=0.040). However, they named neutral faces more accurately than adolescents without anxiety diagnosis: 15% of cases vs. 37.1% of controls presented at least one error in neutral faces, OR=3.46 (CI95% 1.02 to 11.7; p=0.047). No differences were found considering other human emotions or on the distribution of errors in each emotional face between the groups. CONCLUSION Our findings support an anxiety-mediated influence on the recognition of facial expressions in adolescence. These difficulty in recognizing angry faces and more accuracy in naming neutral faces may lead to misinterpretation of social clues and can explain some aspects of the impairment in social interactions in adolescents with anxiety disorders.
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Baptista CA, Loureiro SR, de Lima Osório F, Zuardi AW, Magalhães PV, Kapczinski F, Filho AS, Freitas-Ferrari MC, Crippa JAS. Social phobia in Brazilian university students: prevalence, under-recognition and academic impairment in women. J Affect Disord 2012; 136:857-61. [PMID: 22018945 DOI: 10.1016/j.jad.2011.09.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2011] [Revised: 07/02/2011] [Accepted: 09/21/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite the fact that public speaking is a common academic activity and that social phobia has been associated with lower educational achievement and impaired academic performance, little research has examined the prevalence of social phobia in college students. The aim of this study was to evaluate the prevalence of social phobia in a large sample of Brazilian college students and to examine the academic impact of this disorder. METHODS The Social Phobia Inventory (SPIN) and the MINI-SPIN, used as the indicator of social phobia in the screening phase, were applied to 2319 randomly selected students from two Brazilian universities. For the second phase (diagnostic confirmation), four psychiatrists and one clinical psychologist administered the SCID-IV to subjects with MINI-SPIN scores of 6 or higher. RESULTS The prevalence of social phobia among the university students was 11.6%. Women with social phobia had significantly lower grades than those without the disorder. Fear of public speaking was the most common social fear. Only two of the 237 students with social phobia (0.8%) had previously received a diagnosis of social phobia and were under treatment. LIMITATIONS Social phobia comorbidities were not evaluated in this study. The methods of assessment employed by the universities (written exams) may mask the presence of social phobia. This was not a population-based study, and thus the results are not generalizable to the entire population with social phobia. CONCLUSION Preventive strategies are recommended to reduce the under-recognition and the adverse impact of social phobia on academic performance and overall quality of life of university students.
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Affiliation(s)
- Carlos Alberto Baptista
- Department of Neurosciences and Behavior, Division of Psychiatry, Faculty of Medicine of Ribeirão Preto, University of São Paulo and INCT Translational Medicine (INCT-TM, CNPq), Brazil
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Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology 2011; 36:1219-26. [PMID: 21307846 PMCID: PMC3079847 DOI: 10.1038/npp.2011.6] [Citation(s) in RCA: 471] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Generalized Social Anxiety Disorder (SAD) is one of the most common anxiety conditions with impairment in social life. Cannabidiol (CBD), one major non-psychotomimetic compound of the cannabis sativa plant, has shown anxiolytic effects both in humans and in animals. This preliminary study aimed to compare the effects of a simulation public speaking test (SPST) on healthy control (HC) patients and treatment-naïve SAD patients who received a single dose of CBD or placebo. A total of 24 never-treated patients with SAD were allocated to receive either CBD (600 mg; n=12) or placebo (placebo; n=12) in a double-blind randomized design 1 h and a half before the test. The same number of HC (n=12) performed the SPST without receiving any medication. Each volunteer participated in only one experimental session in a double-blind procedure. Subjective ratings on the Visual Analogue Mood Scale (VAMS) and Negative Self-Statement scale (SSPS-N) and physiological measures (blood pressure, heart rate, and skin conductance) were measured at six different time points during the SPST. The results were submitted to a repeated-measures analysis of variance. Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group as assessed with the VAMS. The SSPS-N scores evidenced significant increases during the testing of placebo group that was almost abolished in the CBD group. No significant differences were observed between CBD and HC in SSPS-N scores or in the cognitive impairment, discomfort, and alert factors of VAMS. The increase in anxiety induced by the SPST on subjects with SAD was reduced with the use of CBD, resulting in a similar response as the HC.
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