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Childhood maltreatment linked to greater symptom severity and poorer quality of life and function in social anxiety disorder
Authors:Naomi M Simon MD MSc  Nannette N Herlands BA  Elizabeth H Marks BA  Catherine Mancini MD  Andrea Letamendi MS  Zhonghe Li MA  Mark H Pollack MD  Michael Van Ameringen MD FRCPC  Murray B Stein MD MPH
Institution:1. Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts;2. McMaster University Medical Centre, Hamilton, Ontario, Canada;3. Anxiety and Traumatic Stress Disorders Program, University of California San Diego, San Diego, California
Abstract:Background: There is a paucity of data examining the prevalence and impact of childhood maltreatment in patients presenting with a primary diagnosis of social anxiety disorder (SAD). We thus examined the presence of a broad spectrum of childhood maltreatment, including physical, sexual, and emotional abuse and neglect, in treatment‐seeking individuals with the generalized subtype of SAD (GSAD). We hypothesized that a history of childhood maltreatment would be associated with greater SAD symptom severity and poorer associated function. Methods: One hundred and three participants with a primary diagnosis of GSAD (mean age 37±14; 70% male) completed the well‐validated, self‐rated Childhood Trauma Questionnaire (CTQ), as well as measures of SAD symptom severity and quality of life. Results: Fully 70% (n=72) of the GSAD sample met severity criteria for at least one type of childhood abuse or neglect as measured by the CTQ subscales using previously established thresholds. CTQ total score adjusted for age and gender was associated with greater SAD severity, and poorer quality of life, function, and resilience. Further, the number of types of maltreatment present had an additive effect, with specific associations for emotional abuse and neglect with SAD severity. Conclusions: Despite the use of validated assessments, our findings are limited by the retrospective and subjective nature of self‐report measures used to assess childhood maltreatment. Nonetheless, these data suggest a high rate of childhood maltreatment in individuals seeking treatment for GSAD, and the association of maltreatment with greater disorder severity suggests that screening is clinically prudent. Depression and Anxiety 26:1027–1032, 2009. © 2009 Wiley‐Liss, Inc.
Keywords:social anxiety disorder  social phobia  anxiety  child abuse  abuse
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