title: Clinical distinctions between selective mutism and social phobia: an investigation of childhood psychopathology.
abstract: OBJECTIVE
  To investigate the hypothesis that children with selective mutism are more socially anxious than children with social anxiety disorder but who are not selectively mute.
  
  
  METHODS
  Twenty-three children with comorbid selective mutism and social phobia and 23 age-matched controls with social phobia alone and their parents participated in a comprehensive assessment of social anxiety and related aspects of psychopathology.
  
  
  RESULTS
  The results do not uniformly support previous suggestions that children with selective mutism refuse speech because they are "frozen with fear." Although clinician and observer ratings for children with selective mutism revealed higher ratings of social distress than for children with social phobia alone, self-report data do not support this conclusion. Furthermore, although there were no group differences on measures of trait anxiety, general fears, or scores on the Child Behavior Checklist broadband Internalizing or Externalizing scales, children with selective mutism scored higher than children with social phobia alone on the Child Behavior Checklist Delinquency subscale, suggesting the presence of a broader clinical syndrome.
  
  
  CONCLUSIONS
  It remains unclear whether children with selective mutism have extreme levels of social anxiety. Potential areas that might shed further light on this interesting disorder are discussed.
authors.affiliation: Department of Psychiatry, University of Maryland, College Park, MD 20742, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Yeganeh
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Beidel
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Turner
authors.forename: Armando A
authors.initials: AA
authors.lastname: Pina
authors.forename: Wendy K
authors.initials: WK
authors.lastname: Silverman
mesh_terms: D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009155:Mutism / Q000175:diagnosis* / Q000523:psychology*; D010698:Phobic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012919:Social Behavior