title: Subtyping social anxiety in youth.
abstract: Few empirical studies have examined subtypes of social anxiety disorder (SAD) in youth, and limited consensus resides on the nature of potential subtypes. Identifying subtypes, based on both fear and avoidance patterns, can help improve assessment and treatment of SAD. Subtypes of fear and avoidance were examined in a sample comprising 131 youth (age 8-15 years) diagnosed with SAD using the Anxiety Disorders Interview Schedule for children and parents (ADIS-C/P). Exploratory factor analysis of fear responses revealed three factors, defining fear subtypes linked to: (1) performance, (2) observation, and (3) interaction situations, respectively. Exploratory factor analysis of avoidance responses showed these were best represented by one avoidance factor. Few youth qualified exclusively for either of the fear subtypes, thus calling into question the clinical utility of these subtypes. Nevertheless, the findings indicate distinct contributions of fear and avoidance in SAD presentation. This finding might help clinicians target and improve treatment of the disorder.
authors.affiliation: Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Research Department, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. Electronic address: Arne.Kodal@helse-bergen.no.
authors.forename: A
authors.initials: A
authors.lastname: Kodal
authors.affiliation: Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Research Department, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: I
authors.initials: I
authors.lastname: Bjelland
authors.affiliation: Research Department, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Gjestad
authors.affiliation: Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Regional Center for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research, Bergen, Norway.
authors.forename: G J
authors.initials: GJ
authors.lastname: Wergeland
authors.affiliation: Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.
authors.forename: O E
authors.initials: OE
authors.lastname: Havik
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: E R
authors.initials: ER
authors.lastname: Heiervang
authors.affiliation: Department of Psychology, University of Oslo, Oslo, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Fjermestad
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D001362:Avoidance Learning; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005163:Factor Analysis, Statistical; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D000072861:Phobia, Social / Q000175:diagnosis* / Q000523:psychology; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy
keywords: Avoidance; Classification; DSM-5; Social anxiety disorder; Subtypes; Youth