Abstract
Objective
Childhood traumatic experiences, rearing styles, familial mental disorders and birth risk factors have been associated with the development of social anxiety disorder.
Method
Patients with social anxiety disorder (n = 50) and healthy controls (n = 120) were investigated using a retrospective interview with 203 questions.
Results
The frequency of reports of traumatic childhood experiences was significantly higher in patients than in controls, including separation from parents, parents’ marital discord, sexual abuse, familial violence, childhood illness, and other factors. On a 0–10 point ‘severe trauma scale’ patients had significantly higher mean scores (2.0; SD 1.28) than control subjects (0.82; SD 1.1; p < 0.0001).Only 6 (12 %) of the social phobic patients, but 63 (52.5%) of the controls did not report any severe traumatic events at all (χ2= 24.0; p < 0.0001). Compared to controls, patients described their parents’ rearing styles as significantly more unfavourable. Patients reported higher rates of psychiatric disorders in their families in general, in particular anxiety disorders, depression, and suicidality. Birth risk factors did not differ between patients and controls. In a logistic regression model, the highest contribution was noted for familial anxiety disorders. Separation from parents also had a significant, but smaller influence. There was only a trend towards a significant contribution of childhood sexual abuse. Violence in the family, parental rearing styles and birth risk factors did not contribute significantly.
Conclusions
The present data suggest that the aetiology of social anxiety disorder is multifactorial and that familial mental disorders and separation experiences are the most important contributing factors.
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References
Andrews G, Stewart G, Allen R, Henderson AS (1990) The genetics of six neurotic disorders: a twin study. J Affect Disord 19:23–29
Arrindell WA, Emmelkamp PM, Monsma A, Brilman E (1983) The role of perceived parental rearing practices in the aetiology of phobic disorders: a controlled study. Br J Psychiatry 143:183–187
Arrindell WA, Kwee MG, Methorst GJ, van der Ende J, Pol E, Moritz BJ (1989) Perceived parental rearing styles of agoraphobic and socially phobic in patients. Br J Psychiatry 155:526–535
Bandelow B, Alvarez Tichauer G, Späth C, et al. (2001) Separation anxiety and actual separation experiences during childhood in patients with panic disorder. Can J Psychiatry 46:948–952
Bandelow B, Krause J, Wedekind D, Broocks A, Hajak G, Rüther E (2004) Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Research (in press)
Bandelow B, Späth C, Alvarez Tichauer G, Broocks A, Hajak G, Rüther E (2002) Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with panic disorder. Compr Psychiatry 43:269–278
Bandura A (1971) Analysis of modeling behavior. In: Bandura A (ed) Psychological modeling: conflicting theories. Aldine, Chicago, pp 71–99
Bruch MA, Heimberg RG (1989) Social phobia and perceptions of early parental and personal characteristics. Anxiety Research 2:57–65
Bruch MA, Heimberg RG (1994) Differences in perceptions of parental and personal characteristics between generalized and nongeneralized social phobics. J Anxiety Dis 8:155–168
Caster JB, Inderbitzen HM, Hope D (1999) Relationship between youth and parent perceptions of family environment and social anxiety. J Anxiety Disord 13:237–251
Chartier MJ, Walker JR, Stein MB (2001) Social phobia and potential childhood risk factors in a community sample. Psychol Med 31:307–315
Coupland NJ (2001) Social phobia: etiology, neurobiology, and treatment. J Clin Psychiatry 62:25–35
Daniels D, Plomin R (1985) Origins of individual differences in infant shyness. Developmental Psychology 21:118–121
David D, Giron A, Mellman TA (1995) Panic-phobic patients and developmental trauma. J Clin Psychiatry 56:113–117
Dill DL, Chu JA, Grob MC, Eisen SV (1991) The reliability of abuse history reports: a comparison of two inquiry formats. Compr Psychiatry 32:166–169
First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). American Psychiatric Press, Inc., Washington, DC
First MB, Spitzer RL, Gibbon M, Williams JBW (1997) Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II). American Psychiatric Press, Inc., Washington, DC
Frankel FH (1993) Adult reconstruction of childhood events in the multiple personality literature. Am J Psychiatry 150:954–958
Fredrikson M, Furmark T (2004) jr in Imaging Studies in Social Anxiety Disorder. In: Bandelow B, Stein DJ (eds) Social Anxiety Disorder. Marcel Dekker, New York, NY, pp 215–233
Freud S (1910) Über Psychoanalyse. In: Gesammelte Werke, Band 8. Imago Publishing Co., London, pp 1–60
Fyer AJ, Mannuzza S, Chapman TF, Liebowitz MR, Klein DF (1993) A direct interview family study of social phobia. Arch Gen Psychiatry 50:286–293
Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P (1997) Public beliefs about causes and risk factors for depression and schizophrenia. Soc Psychiatry Psychiatr Epidemiol 32:143–148
Kagan J, Reznick JS, Snidman N (1988) Biological bases of childhood shyness. Science 240:167–171
Kendler KS, Karkowski LM, Prescott CA (1999) Fears and phobias: reliability and heritability. Psychol Med 29:539–553
Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ (1992) The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Arch Gen Psychiatry 49:273–281
Kessler RC, McGonagle KA, Zhao S, et al. (1994) Lifetime and 12- month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19
Kraemer HC, Stice E, Kazdin A, Offord D, Kupfer D (2001) How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. Am J Psychiatry 158:848–856
Li D, Chokka P, Tibbo P (2001) Toward an integrative understanding of social phobia. J Psychiatry Neurosci 26:190–202
Lieb R, Wittchen HU, Hofler M, Fuetsch M, Stein MB, Merikangas KR (2000) Parental psychopathology, parenting styles, and the risk of social phobia in offspring: a prospective-longitudinal community study. Arch Gen Psychiatry 57:859–866
Loftus E, Joslyn S, Polage D (1998) Repression: a mistaken impression? Dev Psychopathol 10:781–792
Mancini C, van Ameringen M, MacMillan H (1995) Relationship of childhood sexual and physical abuse to anxiety disorders. J Nerv Ment Dis 183:309–314
Mancini C, van Ameringen M, Szatmari P, Fugere C, Boyle M (1996) A high-risk pilot study of the children of adults with social phobia. J Am Acad Child Adolesc Psychiatry 35:1511–1517
Parker G (1979) Reported parental characteristics of agoraphobics and social phobics. Br J Psychiatry 135:555–560
Pollock RA, Rosenbaum JF, Marrs A, Miller BS, Biederman J (1995) Anxiety disorders of childhood, Implications for adult psychopathology. Psychiatr Clin North Am 18:745–766
Rapee RM, Melville LF (1997) Recall of family factors in social phobia and panic disorder: comparison of mother and offspring reports. Depress Anxiety 5:7–11
Robinson J, Kagan J, Reznick JS (1992) The heritability of inhibited and uninhibited behavior: a twin study. Dev Psychol 28:1030–1037
Rose RJ, Ditto WB (1983) A developmental-genetic analysis of common fears from early adolescence to early adulthood. Child Dev 54:361–368
Rosenbaum JF, Biederman J, Hirshfeld DR, et al. (1991) Further evidence of an association between behavioral inhibition and anxiety disorders: results from a family study of children from a non-clinical sample. J Psychiatr Res 25:49–65
Safren SA, Gershuny BS,Marzol P, Otto MW, Pollack MH (2002) History of childhood abuse in panic disorder, social phobia, and generalized anxiety disorder. J Nerv Ment Dis 190:453–456
Schneier FR, Liebowitz MR, Abi-Dargham A, Zea-Ponce Y, Lin SH, Laruelle M (2000) Low dopamine D(2) receptor binding potential in social phobia. Am J Psychiatry 157:457–459
Schwartz CE, Snidman N, Kagan J (1999) Adolescent social anxiety as an outcome of inhibited temperament in childhood. J Am Acad Child Adolesc Psychiatry 38:1008–1015
Skre I, Onstad S, Torgersen S, Lygren S, Kringlen E (1993) A twin study of DSM-III-R anxiety disorders. Acta Psychiatr Scand 88:85–92
Stein MB, Chartier MJ, Hazen AL, et al. (1998) A direct-interview family study of generalized social phobia. Am J Psychiatry 155:90–97
Stein MB, Gelernter JG, Smoller JW (2004) Genetics of Social Anxiety Disorder and Related Traits. In: Bandelow B, Stein DJ (eds) Social Anxiety Disorder. Marcel Dekker, New York, NY, pp 197–214
Stein MB, Jang KL, Livesley WJ (2002) Heritability of social anxiety-related concerns and personality characteristics: a twin study. J Nerv Ment Dis 190:219–224
Stein MB, Walker JR, Anderson G, et al. (1996) Childhood physical and sexual abuse in patients with anxiety disorders and in a community sample. Am J Psychiatry 153:275–277
Stemberger RT, Turner SM, Beidel DC, Calhoun KS (1995) Social phobia: an analysis of possible developmental factors. J Abnorm Psychol 104:526–531
Tiihonen J, Kuikka J, Bergstrom K, Lepola U, Koponen H, Leinonen E (1997) Dopamine reuptake site densities in patients with social phobia. Am J Psychiatry 154:239–242
Torgersen S (1979) The nature and origin of common phobic fears. Br J Psychiatry 134:343–351
Tweed JL, Schoenbach VJ, George LK, Blazer DG (1989) The effects of childhood parental death and divorce on six-month history of anxiety disorders. Br J Psychiatry 154:823–828
van Ameringen M, Mancini C (2004) The rromise of Neurobiology in Social Anxiety Disorder. In: Bandelow B, Stein DJ (eds) Social Anxiety Disorder. Marcel Dekker, New York, NY, pp 181–196
Wittchen H-U, Wunderlich U, Gruschwitz S, Zaudig M (1997) Strukturiertes Klinisches Interview für DSM-IV. Hogrefe, Göttingen
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Bandelow, B., Charimo Torrente, A., Wedekind, D. et al. Early traumatic life events, parental rearing styles, family history of mental disorders, and birth risk factors in patients with social anxiety disorder. Eur Arch Psychiatry Clin Neurosci 254, 397–405 (2004). https://doi.org/10.1007/s00406-004-0521-2
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DOI: https://doi.org/10.1007/s00406-004-0521-2