社交焦虑障碍与认知功能的相关性研究

目的:探讨社交焦虑障碍(SAD)患者的社交障碍与认知功能的关系。方法:对60例SAD患者(SAD组)及60名性别、教育程度和年龄匹配的健康对照者(正常对照组)进行成套神经认知功能[包括威斯康辛卡片分类测验(WCST)、持续操作功能测试(CPT)、踪迹描绘测验(TMT)、词语流畅性测验(WFT)和听觉词语学习测验(AVLT)]评估及比较;并对患者进行利博维茨社交焦虑量表(LSAS)、状态-特质焦虑量表(STAI)及贝克抑郁量表第2版(BDI-II)临床评估;采用皮尔逊相关性对SAD患者临床状况评分与神经心理测试指标进行相关性分析。结果:SAD组WCST测试的完成分类数的测试分(5.2±1.4)明显低于正常对照组(5.3±0.6),持续性错误数(1.6±2.7)明显高于正常对照组(0.7±0.7)(P均0.05); LSAS评分(63.5±25.5)明显高于正常值(28.4±21.5);SAD组LSAS评分与WCST的持续性错误数呈正相关(r=0.535,P0.05),与WCST分类成绩呈负相关(r=-0.353,P0.05)。结论:SAD患者认知功能中的执行能力明显降低,并与SAD严重程度相关。     

社交焦虑障碍患者的注意偏向研究

目的探索社交焦虑障碍（SAD）患者注意偏向的特点。方法收集明确诊断为SAD，同时汉密尔顿抑郁量表（HAMD）总分小于20分的患者共30例，并设正常对照组共30例。进行一般人口学资料调查表、Liebowitz社交焦虑量表（LSAS）和数字划销测验检查。结果SAD患者在HAMD、LSAS的得分明显高于对照组（P〈0．01）。数字划销测验中，SAD组的粗分158．0±23．6、失误分17．6±12．8、得分140．6±31．7、失误率12．1±12．1，对照组的粗分179．4±13．2、失误分11．3±d．0、得分168．1±13．9、失误率6．3±2．3，两组的差异有统计学意义（P〈0．05），其中粗分和得分与LSAS显著相关（P〈0．05）。结论社交焦虑障碍患者对数字信息，也会发生注意偏向，注意的偏向与当前关注的内容有关。     

社交焦虑障碍患者家庭环境的分析

目的分析社交焦虑障碍(SAD)与患者家庭环境的关系。方法采用自编社会人口学资料表及家庭环境量表中文版(FES-CV)对42例社交焦虑障碍患者和30例正常对照者进行评估。结果社交焦虑障碍组的亲密度、情感表达、知识性、娱乐性因子分低于正常对照组(P<0.01);矛盾性因子分高于正常对照组(P<0.01)。结论社交焦虑障碍的发生与家庭环境因素有关,不良的家庭环境可能是社交焦虑障碍的发病原因之一。     

城乡大学生焦虑及社交焦虑的调查分析

目的 了解城乡大学生焦虑及社交焦虑状况。方法 采用焦虑自评量表(SAS)、社交苦恼及回避量表(SAD)、交往焦虑量表(IAS)、自我意识的社交焦虑量表(SASS)对122名城乡大学生进行测量分析。结果 SAS显示大学生焦虑状态检出率为38．52％；SAS均分显著高于常模；城镇大学生，较之来自农村大学生焦虑状态更为突出；其他量表未显示出差异。结论 大学生存在一定程度的焦虑情绪，城镇大学生更为突出，城乡大学生在社交焦虑方面没有区别。     

精神分裂症恢复期社交焦虑的研究

为探讨精神分裂症恢复期社交焦虑（SAD），对200例精神分裂症恢复期患者用汉密顿焦虑量表（HAMA），社交焦虑量表（LSAS）进行评分。结果，200例精神分裂症恢复期患者出现社交焦虑者占33．5％，其中社会功能和学习功能受影响者占41．79％。提示，对精神分裂症恢复期患者出现SAD者应引起高度重视。     

社交焦虑障碍的认知行为集体治疗的初步结果

目的探讨社交焦虑障碍(SAD)的认知行为集体治疗(CBGT)的方法和初步结果。方法上海市精神卫生中心就诊的SAD患者中自愿参加CBGT者,符合DSM-IV关于SAD的诊断标准,性别年龄不限。每个治疗小组6-8人,治疗8周,每周1次,每次2.5小时,内容包括认知重建、放松训练、社交技巧训练、系统暴露、现场暴露和家庭作业。治疗期间患者均未服用治疗SAD药物。疗效评定由两位心理治疗师进行,主要工具为Liebowitz社交焦虑评定量表(LSAS),计总分、恐惧因子分、回避因子分,统计分析用配对T检验。结果符合入组条件58例,年龄16-48岁,起病年龄11-34岁,病程6个月-19年。LSAS总分治疗前后75.89±28.82和47.00±23.71(t=12.60,p<0.01);恐惧因子分治疗前后39.28±13.12和25.39±12.42(t=8.267,p<0.01);回避因子分治疗前后36.39±16.44和22.17±13.29(t=8.067,p<0.01),均有统计学显著性差异。结论CBGT治疗SAD有很好的疗效,尤其对SAD的回避行为效果似更显著,值得推广。     

伴抑郁症状的焦虑障碍患者生活质量的研究

目的 探讨伴有抑郁症状的焦虑障碍患者的生活质量.方法 纳入符合美国精神障碍诊断与统计手册第4版焦虑障碍诊断标准的患者163例和162名正常对照,患者按是否伴有抑郁症状分为单纯焦虑组以及焦虑-抑郁共存组,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数表(PSQI)和世界卫生组织生命质量测定量表简表(WHOQOL-BREF)等分别评定受试者的情绪症状、睡眠和生活质量,采用SPSS18.0对两组进行比较.结果 46.6%(76/163)的焦虑障碍患者伴有抑郁症状.焦虑-抑郁共存组的SAS标准分、PSQI总分均高于单纯焦虑组(P<0.01),WHOQOL-BREF总分及生理、心理、社会关系及环境领域得分分别为[ (47.92±8.52 )、(10.17±2.64)、(11.12±2.55)、(11.29±2.27)、(10.69±2.65)],而单纯焦虑组和健康对照组相应得分分别为[(57.88±9.43)、(13.02±2.61)、(13.08±2.29)、(13.44±2.41)、(12.47±2.63)和(65.14±9.42)、(14.99±2.41)、(11.12±2.55)、(11.29±2.27)、(10.69±2.65)],前者各得分均分别高于后两者(P均小于0.01).结论 焦虑障碍患者常伴发抑郁症状,伴有抑郁症状的焦虑障碍患者生活质量更低.     

社交焦虑障碍患者父母养育方式分析

目的：探讨社交焦虑障碍（SAD）患者的发病与父母养育方式的关系。方法：采用自编社会人口学资料调查表、父母养育方式量表（EMBU）对30例SAD患者（患者组）和30名正常人（对照组）进行评估;以Liebowitz社交焦虑量表（LSAS）≥38分为界,评估SAD的严重程度。结果：患者组LSAS评分平均（78.0±27.8）分显著高于对照组的（22.2±9.0）分,两组比较差异有统计学意义（χ2=10.477,P〈0.01）。患者组EMBU中父亲的拒绝、否认因子分和过度保护因子分平均（11.10±3.93）分和（10.77±2.57）分显著高于对照组的（8.67±1.97）分和（9.30±1.77）分（t=3.035、2.578,P〈0.01或P〈0.05）;父亲的情感温暖、理解因子分和偏爱被试因子分平均（43.30±11.45）分和（10.50±2.91）分显著低于对照组的（51.20±8.10）分和（12.87±5.43）分（t=3.085、2.104,P〈0.01或P〈0.05）。母亲的拒绝、否认因子分平均（13.93±5.34）分显著高于对照组的（11.33±2.26）分（t=2.457,P〈0.05）,母亲的情感温暖、理解因子分和偏爱被试因子分平均为（43.07±12.07）分和（10.50±2.91）分显著低于对照组的（51.53±8.26）分和（12.87±5.43）分（t=3.170、2.104,P〈0.01或P〈0.05）。结论：SAD的发生与父母养育方式有关,不良的父母养育方式可能是SAD的发病原因之一。     

抑郁症和精神分裂症共患焦虑障碍的研究

目的：了解抑郁症和精神分裂症患者与焦虑障碍的共病发生率及其相关因素。方法：对精神分裂症41例和抑郁症40例，用简明精神病评定量表(BPRS)、Hamilton抑郁量表(HAMD)、Hamilton焦虑量表(HAMA)、Liebowitz社交焦虑量表(LSAS)进行评定。结果：抑郁症与焦虑障碍的共病率为50．0％，精神分裂症与焦虑障碍的共病率为29．3％。LSAS与HAMA呈正相关(r=0．465)。有关抑郁症和精神分裂症患者共患焦虑障碍经多元逐步回归分析可排除药源性焦虑。结论：对抑郁症和精神分裂症共患焦虑障碍问题应引起高度重视。     

社交焦虑障碍患者父母的人格特征和心理健康状况调查

目的探索社交焦虑障碍(SAD)患者父母的人格特征和心理健康状况。方法设研究组(SAD患者的父母)和对照组。入组时按要求进行艾森克人格问卷(EPQ)和症状自评量表(SCL-90)评定。结果SAD患者的父母在EPQ量表测验中的内外向因子标准分低于对照组;SAD患者的父母SCL-90各项因子除强迫和敌对因子,标准分低于对照组。结论SAD患者的父母的人格特征倾向内向,易安静、内省、离群、不喜欢接触人;SAD患者的父母更容易表现出躯体化症状、人际交往的困惑、抑郁、焦虑、恐怖和偏执。     

Psychometric properties and three proposed subscales of a self-report version of the Liebowitz Social Anxiety Scale translated into Hebrew

We investigated the overall test-retest reliability and other psychometric properties of a self-report version of the Liebowitz Social Anxiety Scale (LSAS) translated into Hebrew. We also evaluated the utility of three new subscales that were identified by nonparametric analysis (multidimensional scaling; MDS). Two hundred and seven patients who sought treatment for social anxiety or panic disorder were evaluated. All patients completed the self-administered version of the LSAS. A subsample completed the LSAS a second time prior to the beginning of treatment. The results indicate that the self-report format of the LSAS translated into Hebrew demonstrates high test-retest reliability, internal consistency, and discriminant validity. Additionally, some evidence for convergent and divergent validity was noted, and treatment sensitivity was high. MDS analysis followed by the investigation of common underlying facets for items related in two-dimensional space identified three subgroups: 1) the Group Performance/Interaction ("Group") subscale that consists of group performance and group interaction items; 2) the Dyadic Interaction ("Dyadic") subscale that consists of Dyadic interaction items; and 3) the Public Activities ("Public") subscale that consists of individual activities carried out in public. The three new subscales identified by MDS appear to provide clinically relevant information that relates to both demographic and treatment outcome variables and warrant further study.     

Examination of the known-groups validity of the Liebowitz Social Anxiety Scale

We examined the known-groups validity of the Liebowitz Social Anxiety Scale (LSAS) by comparing the scores of patients with social anxiety disorder (n=46), generalized anxiety disorder plus an additional diagnosis of social anxiety disorder (n=15), generalized anxiety disorder without social anxiety disorder (n=12), and nonanxious controls (n=34). The LSAS total score discriminated significantly among all pairs of groups. Similar analyses were conducted on the original LSAS subscales and additional subscales derived from the factor-analytic work of Safren et al. [1999]. Original subscales showed a pattern substantially similar to that of the total score, but subscale intercorrelations and total score-subscale correlations were extremely high, suggesting that these subscales do not provide much unique information beyond that provided by the total score. Factor-analytically derived subscales were less highly correlated with each other or with the LSAS total score. Although the pattern of differences was more variable across subscales, the factor-analytically derived subscales, in conjunction with the total score, may provide more nonredundant information of clinical relevance than the original subscales. Limitations and future directions for research on the LSAS are discussed.     

Frequency of social phobia and psychometric properties of the Liebowitz social anxiety scale in Parkinson's disease

There are few studies about social anxiety disorder in Parkinson's disease (PD). The objective of this study was to assess its frequency and to explore the psychometric properties of the Liebowitz social anxiety scale (LSAS) in PD. Ninety patients with PD underwent neurologic and psychiatric examination. Psychiatric examination was composed by a structured clinical interview (MINI‐Plus) followed by the application of the LSAS, the Hamilton depression rating scale (Ham‐D), and the Hamilton anxiety rating scale (Ham‐A). Neurologic examination included the MMSE, the UPDRS, the Hoehn‐Yahr Scale, and the Schwab‐England scale of activities of daily living. Social phobia was diagnosed in 50% of PD patients. The disorder was not associated with any sociodemographic or neurological feature, but was associated to major depression (P = 0.023), generalized anxiety disorder (P = 0.023), and obsessive‐compulsive disorder (P = 0.013). The score of LSAS correlated positively with the scores of Ham‐D and Ham‐A (P < 0.001 for both). A ROC curve analysis of the LSAS suggested that a cutoff score in 41/42 provided the best balance between sensitivity and specificity. This disorder seems to be more common and not just restricted to performance as previously thought. © 2008 Movement Disorder Society     

Psychometric evaluation of the mini-social phobia inventory (Mini-SPIN) in a treatment-seeking sample

The Mini-Social Phobia Inventory (Mini-SPIN) is a 3-item, self-rated screening instrument to assess social anxiety disorder, but its psychometric properties have not yet been examined in a sample seeking treatment for psychiatric disorders. We analyzed responses from 291 adults who telephoned the Adult Anxiety Clinic of Temple (AACT) seeking treatment for social anxiety or generalized anxiety and worry. The Mini-SPIN demonstrated strong internal consistency. Support for the convergent validity of the Mini-SPIN was provided by moderate correlations with several self-report measures and a clinician-administered measure of social anxiety completed by the subsample of callers who later came to the AACT for evaluation. Furthermore, the Mini-SPIN correlated significantly with two of three measures of functional disability, but not with a measure of life satisfaction. Correlations with measures of other constructs were nonsignificant, providing support for the discriminant validity of the Mini-SPIN. In addition, a cutoff score of 6 on the Mini-SPIN yielded strong sensitivity and diagnostic efficiency in the subsample of treatment seekers that later completed pretreatment evaluation, although the specificity of this cutoff score was not optimal in this sample. Overall, the Mini-SPIN demonstrated sound psychometric properties in this treatment-seeking sample.     

Is there a complex relation between social anxiety disorder,childhood traumatic experiences and dissociation?

Background: A possible relationship has been suggested between social anxiety and dissociation. Traumatic experiences, especially childhood abuse, play an important role in the aetiology of dissociation.

Aim: This study assesses childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with social anxiety disorder (SAD).

Method: The 94 psychotropic drug-naive patients participating in the study had to meet DSM-IV criteria for SAD. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), the Dissociation Questionnaire (DIS-Q), the Liebowitz Social Anxiety Scale (LSAS), and the Childhood Trauma Questionnaire (CTQ). Patients were divided into two groups using the DIS-Q, and the two groups were compared.

Results: The evaluation found evidence of at least one dissociative disorder in 31.91% of participating patients. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Average scores on LSAS and fear and avoidance sub-scale averages were significantly higher among the high DIS-Q group (p?p?Conclusions: It is concluded that, on detecting SAD symptoms during hospitalization, the clinician should not neglect underlying dissociative processes and traumatic experiences among these patients.     

Social anxiety in patients with social phobia: validation of the Liebowitz social anxiety scale: the French version

The Liebowitz's Social Anxiety Scale (LSAS) (Liebowitz, 1987) is a rating scale of fear and avoidance in social interaction (12 items) and performance-oriented situations (12 items). This paper present the study of empirical and concurrent validation of the LSAS. Ninety-six patients suffering from social phobia according to DSM IV were included and compared with 64 non-clinical control subjects. Both patients and controls were divided into two sub-groups: the LSAS passation by hetero-evaluation or auto-evaluation. Social phobics had much higher scores on anxiety and avoidance of the LSAS than control subjects, whatever the method. There were no differencies between hetero and auto-evaluation in both groups of patients and non-clinical subjects, either on anxiety or on avoidance. The LSAS correlated better with social anxiety and negative cognition in social situations than with anxiety-depression in social phobics. The French version of the LSAS showed a good empirical and concurrent validity and the scale presents a good sensitivity to change after cognitive behavioral therapy in social phobics.     

The Liebowitz social anxiety scale for children and adolescents: an initial psychometric investigation

OBJECTIVE: To examine the psychometric properties of a newly developed clinician rating scale, the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA). METHOD: A total of 154 children and adolescents participated in an assessment consisting of a diagnostic interview, the LSAS-CA, and other measures of psychopathology and impairment. Sixty-one of these children also participated in a second LSAS-CA administration, by a different rater blind to diagnosis, within 7 days of the initial assessment. RESULTS: High internal consistency (alpha =.90-.97 for full sample and.83-.95 for social phobia group) and test-retest reliability (intraclass correlation coefficient = 0.89-0.94) were obtained for LSAS-CA total and subscale scores. LSAS-CA scores had stronger associations with measures of social anxiety and general impairment than with a measure of depression. Subjects with social anxiety disorder had significantly higher LSAS-CA scores than subjects with other anxiety disorders and healthy controls. A LSAS-CA cutoff score of 22.5 represented the best balance of sensitivity and specificity when distinguishing between individuals with social phobia and normal controls, whereas a cutoff of 29.5 was optimal for distinguishing social phobia from other anxiety disorders. CONCLUSION: Initial findings suggest that the LSAS-CA is a reliable and valid instrument for the assessment of social anxiety disorder.     

Putative temperament of patients with generalized anxiety disorder: two-years' interval test-retest reliability of a Japanese version of the Generalized Anxious Temperament

This study examined long-interval test-retest reliability of the Generalized Anxious Temperament (GAT) Japanese version, which is a self-rated questionnaire to measure the temperament of patients with generalized anxiety disorder (GAD). First, we investigated the prevalence of GAT in 214 healthy Japanese subjects (107 females and 107 males). Second, we administered GAT to the 117 (77 females and 40 males) patients with GAD, together with GAF (Global Assessment of Functioning) and HAM-A (Hamilton Anxiety Scale), and readministered after 2 years to examine its reliability. GAT showed good test-retest reliability (Pearson's correlation coefficient = 0.8). Cronbach's alpha of the 26 GAT items was 0.93 that indicated a high level of internal consistency. GAT scores were not influenced by psychological, social or occupational functioning, nor by anxiety symptoms and remained stable over 2 years. GAT scores did not correlate with the age or sex of the control subjects. GAT scores were higher in patients with GAD than they were in control subjects, particularly in females. Twenty-three of 26 GAT items were significantly higher in patients with GAD than in healthy subjects. Stepwise multiple regression analysis revealed that GAT scores in patients with GAD were higher in females than in males (P < 0.01) and in those with early onset of the disorder (P < 0.05). These results suggest that the anxious temperament appears to increase the risk of early onset of GAD, particularly in females. This long interval and large sample research of test-retest reliability on GAT indicated its usefulness for understanding the core features of GAD.