Skip to main content
SpringerLink
Log in

The Relevance of Age of Onset to the Psychopathology of Social Phobia

  • Published:
Journal of Psychopathology and Behavioral Assessment Aims and scope Submit manuscript

Abstract

The present study aimed to examine the relevance of age of onset to the psychopathology of social phobia using a large clinical sample of 210 patients with social phobia. The two most common periods of onset were during adolescence (ages 14–17) and early childhood (prior to age 10). Structural regression modeling was used to test predictions that early onset social phobia would be associated with greater severity of the disorder, stronger current symptoms of depression and anxiety, greater functional impairment, and more pronounced levels of emotional disorder vulnerabilities (e.g., neuroticism/behavioral inhibition, extraversion, perceptions of control). Logistic regression was used to evaluate relationships between age of onset and the presence of acute and chronic stress at the time of onset. Results showed that earlier age of social phobia onset was associated with stronger current psychopathology, functional impairment, and emotional disorder vulnerabilities, and that later age of onset predicted the presence of an acutely stressful event around the time of disorder emergence. These results are discussed in regard to their clinical implications and congruence with prominent etiological models of the emotional disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • Barlow, D. H. (2000). Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. American Psychologist, 55, 1247–1263. doi:10.1037/0003-066x.55.11.1247.

    Article  PubMed  Google Scholar 

  • Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory Manual. San Antonio: Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio: Psychological Corporation.

    Google Scholar 

  • Beidel, D. C., Turner, S. M., & Morris, T. L. (1995). A new inventory to assess childhood social anxiety and phobia: the social phobia and anxiety inventory for children. Psychological Assessment, 7, 73–79.

    Article  Google Scholar 

  • Biederman, J., Hirshfeld-Becker, D. R., Rosenbaum, J. F., Hérot, C., Friedman, D., Snidman, N., et al. (2001). Further evidence of association between behavioral inhibition and social anxiety in children. The American Journal of Psychiatry, 158, 1673–1679. doi:10.1176/appi.ajp.158.10.1673.

    Article  PubMed  Google Scholar 

  • Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York: Guilford Press.

    Google Scholar 

  • Brown, T. A. (2007). Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs. Journal of Abnormal Psychology, 116, 313–328. doi:10.1037/0021-843X.116.2.313.

    Article  PubMed  Google Scholar 

  • Brown, T. A., Antony, M. M., & Barlow, D. H. (1995). Diagnostic comorbidity in panic disorder: effect on treatment outcome and course of comorbid diagnoses following treatment. Journal of Consulting and Clinical Psychology, 63, 408–418. doi:10.1037/0022-006X.63.3.408.

    Article  PubMed  Google Scholar 

  • Brown, T. A., Chorpita, B. F., Korotitsch, W., & Barlow, D. H. (1997). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour Research and Therapy, 35, 79–89. doi:10.1016/S0005-7967(96)00068-X.

    Article  PubMed  Google Scholar 

  • Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001a). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110, 585–599. doi:10.1037/0021-843x.110.4.585.

    Article  Google Scholar 

  • Brown, T. A., Di Nardo, P. A., Lehman, C. L., & Campbell, L. A. (2001b). Reliability of DSM-IV anxiety and mood disorders: implications for the classification of emotional disorders. Journal of Abnormal Psychology, 110, 49–58. doi:10.1037/0021-843X.110.1.49.

    Article  Google Scholar 

  • Brown, T. A., White, K. S., Forsyth, J. P., & Barlow, D. H. (2004). The structure of perceived emotional control: psychometric properties of a revised Anxiety Control Questionnaire. Behavior Therapy, 35, 75–99. doi:10.1016/S0005-7894(04)80005-4.

    Article  Google Scholar 

  • Campbell, L. A., Brown, T. A., & Grisham, J. R. (2003). The relevance of age of onset to the psychopathology of generalized anxiety disorder. Behavior Therapy, 34(1), 31–48. doi:10.1016/S0005-7894(03)80020-5.

    Article  Google Scholar 

  • Campbell-Sills, L., Liverant, G. I., & Brown, T. A. (2004). Psychometric evaluation of the behavioral inhibition/behavioral activation scales in a large sample of outpatients with anxiety and mood disorders. Psychological Assessment, 16, 244–254. doi:10.1037/1040-3590.16.3.244.

    Article  PubMed  Google Scholar 

  • Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS Scales. Journal of Personality and Social Psychology, 67, 319–333. doi:10.1037/0022-3514.67.2.319.

    Article  Google Scholar 

  • Costa, P. T., & McCrae, R. R. (1992). NEO PI-R professional manual: Revised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI). Odessa: Psychological Assessment Resources.

    Google Scholar 

  • Dalrymple, K. L., & Zimmerman, M. (2011). Age of onset of social anxiety disorder in depressed outpatients. Journal of Anxiety Disorders, 25, 131–137. doi:10.1016/j.janxdis.2010.08.012.

    Article  PubMed  Google Scholar 

  • Dalrymple, K. L., Herbert, J. D., & Gaudiano, B. A. (2007). Onset of illness and developmental factors in social anxiety disorder: preliminary findings from a retrospective interview. Journal of Psychopathology and Behavioral Assessment, 29, 101–110. doi:10.1007/s10862-006-9033-x.

    Article  Google Scholar 

  • Di Nardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV-L). New York: Oxford University Press.

    Google Scholar 

  • Eysenck, S. B. G., & Eysenck, H. J. (1975). Manual of the Eysenck Personality Questionnaire. London: Hodder & Stoughton.

    Google Scholar 

  • Fanous, A. H., Neale, M. C., Aggen, S. H., & Kendler, K. S. (2007). A longitudinal study of personality and major depression in a population-based sample of male twins. Psychological Medicine, 37, 1163–1172. doi:10.1017/S0033291707000244.

    Article  PubMed  Google Scholar 

  • Grant, B. F., Hasin, D. S., Blanco, C., Stinson, F. S., Chou, S., Goldstein, R. B., et al. (2005). The epidemiology of social anxiety disorder in the United States: results from the national epidemiological survey on alcohol and related conditions. The Journal of Clinical Psychiatry, 66, 1351–1361.

    Article  PubMed  Google Scholar 

  • Hafner, J., & Marks, I. (1976). Exposure in vivo of agoraphobics: contributions of diazepam, group exposure, and anxiety evocation. Psychological Medicine, 6, 71–88. doi:10.1017/S0033291700007510.

    Article  PubMed  Google Scholar 

  • Hardt, J. J., Vellaisamy, P. P., & Schoon, I. I. (2010). Sequelae of prospective versus retrospective reports of adverse childhood experiences. Psychological Reports, 107, 425–440.

    Article  PubMed  Google Scholar 

  • Henry, B., Moffitt, T. E., Caspi, A., Langley, J., & Silva, P. A. (1994). On the ‘remembrance of things past’: a longitudinal evaluation of the retrospective method. Psychological Assessment, 6, 92–101.

    Article  Google Scholar 

  • Juster, H. R., & Heimberg, R. G. (1995). Social phobia: longitudinal course and long-term outcome of cognitive-behavioral treatment. Psychiatric Clinics of North America, 18, 821–842.

    PubMed  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602. doi:10.1001/archpsyc.62.6.593.

    Article  PubMed  Google Scholar 

  • Loo, R. (1979). A psychometric investigation of the Eysenck Personality Questionnaire. Journal of Personality Assessment, 43, 54–58.

    Article  PubMed  Google Scholar 

  • Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335–343. doi:10.1016/0005-7967(94)00075-U.

    Article  PubMed  Google Scholar 

  • Mineka, S., & Zinbarg, R. (1995). Conditioning and etological models of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 134–162). New York: Guilford Press.

    Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (1998–2009). Mplus 5.2 [Computer software]. Los Angeles: Author.

  • Ollendick, T. H., & Hirshfeld-Becker, D. R. (2002). The developmental and psychopathology of social anxiety disorder. Biological Psychiatry, 51, 44–58. doi:10.1016/s0006-3223(01)01305-1.

    Article  PubMed  Google Scholar 

  • Öst, L. (1985). Ways of acquiring phobias and outcome of behavioral treatments. Behaviour Research and Therapy, 23, 683–689. doi:10.1016/0005-7967(85)90066-X.

    Article  PubMed  Google Scholar 

  • Rapee, R. M., Craske, M. G., Brown, T. A., & Barlow, D. H. (1996). Measurement of perceived control over anxiety-related events. Behavior Therapy, 27, 279–293. doi:10.1016/S0005-7894(96)80018-9.

    Article  Google Scholar 

  • Reich, J., Goldenberg, I., Vasile, R., & Goisman, R. (1994). A prospective follow-along study of the course of social phobia. Psychiatry Research, 54, 249–258. doi:10.1016/0165-1781(94)90019-1.

    Article  PubMed  Google Scholar 

  • Robins, R. W., Fraley, R., Roberts, B. W., & Trzesniewski, K. H. (2001). A longitudinal study of personality change in young adulthood. Journal of Personality, 69, 617–640. doi:10.1111/1467-6494.694157.

    Article  PubMed  Google Scholar 

  • Rosellini, A. J., & Brown, T. A. (2011). The NEO Five-Factor Inventory: latent structure and relationships with dimensions of anxiety and depressive disorders in a large clinical sample. Assessment, 18, 27–38. doi:10.1177/1073191110382848.

    Article  PubMed  Google Scholar 

  • Ruscio, A. M., Brown, T. A., Chiu, W. T., Sareen, J., Stein, M. B., & Kessler, R. C. (2008). Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychological Medicine, 38, 15–28. doi:10.1017/s0033291707001699.

    Article  PubMed  Google Scholar 

  • Segool, N. K., & Carlson, J. S. (2008). Efficacy of cognitive-behavioral and pharmacological treatments for children with social anxiety. Depression and Anxiety, 25, 620–631. doi:10.1002/da.20410.

    Article  PubMed  Google Scholar 

  • Steer, R. A., Ball, R., Ranieri, W. F., & Beck, A. T. (1997). Further evidence for the construct validity of the Beck Depression Inventory-II with psychiatric outpatients. Psychological Reports, 80, 443–446. doi:10.2466/pr0.1997.80.2.443.

    Article  PubMed  Google Scholar 

  • Stein, M. B., Chavira, D. A., & Jang, K. L. (2001). Bringing up bashful baby: developmental pathways to social phobia. Psychiatric Clinics of North America, 24, 661–675. doi:10.1016/s0193-953x(05)70256-2.

    Article  PubMed  Google Scholar 

  • Stemberger, R. T., Turner, S. M., Beidel, D. C., & Calhoun, K. S. (1995). Social phobia: an analysis of possible developmental factors. Journal of Abnormal Psychology, 104, 526–531. doi:10.1037/0021-843x.104.3.526.

    Article  PubMed  Google Scholar 

  • Wittchen, H. U., & Beloch, E. (1996). The impact of social phobia on quality of life. International Clinical Psychopharmacology, 11(Suppl 3), 15–23. doi:10.1097/00004850-199606003-00004.

    Article  PubMed  Google Scholar 

  • Wittchen, H.-U., Stein, M. B., & Kessler, R. C. (1999). Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors and co-morbidity. Psychological Medicine, 29, 309–323. doi:10.1017/s0033291798008174.

    Article  PubMed  Google Scholar 

  • Wittchen, H. U., & Fehm, L. (2003). Epidemiology and natural course of social fears and social phobia. Acta Psychiatrica Scandinavica, 108(Suppl417), 4–18. doi:10.1034/j.1600-0447.108.s417.1.x

  • Zimmermann, P., Wittchen, H. U., Höfler, M., Pfister, H., Kessler, R. C., & Lieb, R. (2003). Primary anxiety disorders and the development of subsequent alcohol use disorders: a 4-year community study of adolescents and young adults. Psychological Medicine, 33, 1211–1222. doi:10.1017/s0033291703008158.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by Grant MH039096 from the National Institute of Mental Health to the fifth author. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.

Author information

Authors and Affiliations

  1. Center for Anxiety & Related Disorders, Department of Psychology, Boston University, 648 Beacon Street, 6th Floor, Boston, MA, 02215-2013, USA

    Anthony J. Rosellini, Lauren A. Rutter, Michelle L. Bourgeois, Benjamin O. Emmert-Aronson & Timothy A. Brown

Authors
  1. Anthony J. Rosellini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lauren A. Rutter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michelle L. Bourgeois
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Benjamin O. Emmert-Aronson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Timothy A. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anthony J. Rosellini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rosellini, A.J., Rutter, L.A., Bourgeois, M.L. et al. The Relevance of Age of Onset to the Psychopathology of Social Phobia. J Psychopathol Behav Assess 35, 356–365 (2013). https://doi.org/10.1007/s10862-013-9338-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10862-013-9338-5

Keywords

Search

Navigation