Social and academic functioning in adolescents with anxiety disorders: A systematic review

BACKGROUND

Anxiety disorders are highly prevalent during adolescence. Although literature points out that anxiety symptoms are related to problems in social and academic functioning, the extent of these problems among adolescents with clinical anxiety disorders has not been systematically reviewed before.

METHODS

Electronic databases were searched up to October 2017, with keywords representing anxiety disorders, adolescents, and social or academic functioning. The inclusion criteria were studies with a sample of adolescents (10-19 years) with anxiety disorders that provided data regarding their social or academic functioning. 3431 studies were examined, of which 19 met the inclusion criteria.

RESULTS

Adolescents with anxiety disorders had a lower social competence relative to their healthy peers. They reported more negativity within interpersonal relationships, higher levels of loneliness, and victimization. Most adolescents with anxiety disorders felt impaired at school, however, findings of their average school results, compared to peers, were mixed. In addition, they had a higher risk for school refusal and entered higher education less often. Impairments in social and academic functioning differed across type and the number of anxiety disorders.

LIMITATIONS

Most studies examined social phobia or anxiety disorders in general and methodological approaches varied widely between studies.

CONCLUSIONS

This systematic review indicates that adolescents with anxiety disorders experience a range of significant problems in both social and academic functioning. These findings suggest that the assessment and treatment of anxiety disorders in adolescence should focus on improving functioning across domains.

Exercise participation decisions of Jordanian myocardial infarction patients: application of the decisional conflict theory

This study examined the utility of Janis and Mann's [Janis, I. L. & Mann, L. (1977). Decision making: a psychological analysis conflict, choice and commitment. New York, NY: Free press.] decisional conflict theory (DCT) in predicting decisions to exercise following hospitalization for a myocardial infarction (MI). A structured interview of operationalized DCT variables was conducted with 88 MI patients attending cardiology clinics in two Jordanian military hospitals. Stress was viewed as an indicator of exercise benefits-barriers decisional conflict. The findings revealed that the benefits-barriers interaction significantly predicted stress for the 48 patients who did not exercise. Rehospitalization for cardiac events was a significant predictor of stress for the 40 exercisers. Preinfarction exercise behavior, stress and gender were significant predictors of MI patients' decisions to exercise. Results of this study indicated that decisional conflict and stress were characteristics of MI patients who delayed or avoided exercising.