title: Childhood maltreatment linked to greater symptom severity and poorer quality of life and function in social anxiety disorder.
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.
authors.affiliation: Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. nsimon@partners.org
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Simon
authors.forename: Nannette N
authors.initials: NN
authors.lastname: Herlands
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Marks
authors.forename: Catherine
authors.initials: C
authors.lastname: Mancini
authors.forename: Andrea
authors.initials: A
authors.lastname: Letamendi
authors.forename: Zhonghe
authors.initials: Z
authors.lastname: Li
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
authors.forename: Michael
authors.initials: M
authors.lastname: Van Ameringen
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000523:psychology* / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology* / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008404:Massachusetts; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010552:Personality Assessment / Q000706:statistics & numerical data; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D055500:Resilience, Psychological; D012189:Retrospective Studies; D012737:Sex Factors; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult