Social Anxiety Disorder in Teenagers

Abstract

This review is aimed at providing an insight into the impacts of the interventions for the social anxiety disorder on the social skills of teenagers aged 13 to 18 years. The aim of the study is to explore the impact of the malaise on teenagers’ social skills in developed countries. Precisely, the literature provides a critical understanding of the major concepts concerning the social anxiety disorders based on early interventions. Evidences that are drawn from previous surveys underpin the critical analysis of the malaise in developed countries. The report consists of various subheadings that are related by three objectives that have been formulated for the study. At the outset, the study seeks to provide an understanding of early intervention and benefits of the of social anxiety disorder to teenagers. The analysis is based on various researches that are discussed in the literature review. However, the literature is based on international evidence of comprehensive interventions for social anxiety disorders. The knowledge about other social anxiety disorders is paramount to the determination of the appropriate treatment. However, preventive and treatment methods that have been discussed in this dissertation include therapies and regular diagnosis. Based on this research paper, there is evidence that a number of programmes have been developed to address the effects of social anxiety on the social skills of teenagers. Numerous researchers have also affirmed that the programmes adopt multi-modal approaches that encompass diverse interventions.

Introduction

The teen stage is characterised by a number of developmental changes such as the need for autonomy, surfacing sexuality, building relationships, and progressive education among others. These changes expose adolescents to behaviours that can result in adverse outcomes. For instance, Social Anxiety Disorder (SAD) is a common psychiatric malaise that affects many adolescents worldwide. It involves excess emotional responses and intense fear that reveals in varying social appearances. Children tend to develop anxiety as they reach adolescence. This condition develops due to the social interaction between an individual and the immediate environment. However, the social anxiety disorder occurs due to intense fear that results from such relations. The condition develops in childhood stages and reveals at the onset of adolescence. Individuals who suffer from this condition possess extreme distress when in social situations. This condition affects their daily activities such as school life, relationships with other people and family, and employment among other aspects. This proposal provides an insight into early intervention for social anxiety disorder by examining how the malaise increases social skills amongst teenagers.

Aims

The aim of the research proposal is to review the impact of the interventions for social anxiety disorder on the social skills of teenagers whose ages lie between 13 and 18 years. There is a worldwide need to implement efficient methods to prepare young people for the adolescent stage with a view of alleviating the effects of social anxiety. The paper also aims at establishing the benefits of the interventions to both early and late stages of adolescence.

The following objectives have been formulated for the research proposal.

  • To provide an understanding of early intervention for social anxiety disorders
  • To investigate the benefits of social anxiety disorder to teenagers
  • To determine whether early intervention for social anxiety disorder in teenagers increases social skills

Importance of the Study

The purpose of the study is to analyse the impact of early intervention for social anxiety disorder amongst teenagers (aged 13 to 18 years). The review focuses on establishing the effects of such interventions on the social skills of teenagers. It provides a comprehensive exploration of various strategies that have been suggested by other researchers for dealing with social anxiety during the teen age. Moreover, the research proposal offers an opportunity to investigate early interventions concerning the malaise and its implications for social skills amongst teenagers. In addition, the research proposal seeks to address various preventive, treatment, and diagnosis measures for this disorder. It also explains the importance of gaining knowledge about other social anxiety disorders. These diseases have significant impact on the social lives of many teenagers. For instance, it is responsible for early school dropouts and other mental problems among many teenagers in the developed countries (Cederlund 2013; Seedat 2013). Therefore, it is crucial to find better ways of addressing this condition before it affects their lives beyond control. Finally yet importantly, it analyses the evidence of efficient healing interventions that have been suggested for managing social anxiety disorders amongst teenagers.

Literature Review

Numerous interventions have been advanced for seeking appropriate means of dealing with disorders that are related to social anxiety among the adolescents (Masia-Warner et al. 2005). These interventions include individual therapeutic approaches that target the young people aged between 13 and 18 years such as the cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), and trauma-focused cognitive behavioural therapy (TF-CBT) among others. Masia-Warner et al. (2005) also reveals that group interventions have also been considered to address the impact of social anxiety on the social skills of the youth. Socio-ecological interventions that focus on the parents of the adolescents have also played a crucial role in influencing the skills of teenagers.

According to Gren-Landell (2010), there have been increasing cases of Social Anxiety Disorder among teenagers in America and European countries. The prevalence rate was found to be higher amongst teenagers than in adults and children (Gren-Landell 2010). However, some factors such as age, gender, and social influences that determine its prevalence rate among different groups in the society. Factors such as family setup, parenting, temperament, social skills deficit and victimisation influence the occurrence and development of social anxiety disorder (Keller et al.1992).

Adolescent-oriented Interventions

Group-focused Approaches

Early interventions that focus on groups rather than individuals have been implemented in numerous cases to influence the social skills by mitigating social anxiety amongst teenagers. Various studies have also revealed that adolescents who suffer from this condition find it hard to fit in social gatherings since they cannot express themselves before others. Usually, shyness is a common behaviour among many teenagers, especially when they are exposed to some social phenomena that involve public performance (Kerns et al. 2013). However, Ross et al. (2010) posits that group-focused interventions are appropriate for addressing social anxiety in teenagers. At the outset, it is noted that teens are more naive and enthusiastically give in to instructions that are issued by their seniors. The issuance of such information is usually based on the CBT approach. In addition, groups create an opportunity for peer interaction. In cases where the significance of relationships was addressed, the result has been positive and members of the groups readily appreciated the works of others (Ross et al. 2010).

Personal-focused therapeutic interventions

Ross et al. (2010) reveals three teen-age focused interventions that have been applied in alleviating anti-social behaviour amongst the youth. One of the early interventions that have been deemed crucial for addressing social anxiety involved therapeutic approaches that were targeted to adolescents whose ages ranged from 13 to 18 years. According to Ross et al. (2010), personal-focused therapeutic strategies have been tested to determine their relevance in treatment of depression in adolescents. In the context of this paper, social anxiety refers to intense fear that is experienced in social settings. According to Rapee (2012), this situation affects an individual’s normal activities. Ross et al. (2010) confirms that such situations lead to distress. In this case, various studies have proposed the cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT) as appropriate interventions towards alleviation of stress among the youth, especially in social setups. However, Ross et al. (2010) emphasizes that IPT has never been a suitable method for mitigating disorders that arise from social anxiety in teenagers.

A study that was conducted by Clark (1999) revealed that adolescents who suffered from the social anxiety disorder were always worried about how other people perceived them. Their thoughts were mostly exaggerated. As a result, they were always cautious of their actions, especially in social settings. Nordqvist (2010) reveals that such people fear criticism and negative evaluation by others. In the event of a slight mistake in public gatherings, the victims are significantly hurt. Emotional distress can follow such occurrences. Although this situation can occur due to a mistake, their exaggerated worry and continued dreadful thoughts about the event amplifies their incapability to control the behaviour. As a result, the victims suffer emotional distress and depression. Furthermore, victims tend to avoid all social settings where they are likely to perform, express themselves before people, or become the centre of attraction (Nordqvist 2010). In this case, Ross et al. (2010) recommended the use of trauma-focused cognitive behavioural theory (TF-CBT). This approach is primarily concerned with determination of the individual needs of the patients. Indeed, numerous other researchers underpin this intervention since it has been used in a number of cases to address issues concerning social anxiety and depression among the adolescents.

A Review of Biological and Environmental Causative Factors for SAD

Social anxiety disorder is likely to persist in adolescents who come from dysfunctional families due to lack of parental affection. Emotional distress is another factor that is likely to prolong social anxiety disorder in teenagers in developed countries. Parenting is crucial in the overall development of a child. Parental care and affection can dictate a child’s perception of the social world. For instance, aspects such as parental affection or rejection have an impact on the child’s perception towards the social world. They influence a child to develop social skills or possess inhibitory cues in social interactions (Gren-Landell2010).

Victimisation is also another significant aspect that influences a child’s behavioural patterns in the society. Victimisation involves interference of a person’s social norms by actions of another person or group of people. Teenagers who are victims of victimisation develop fearful and avoidance behaviours. Therefore, victimisation is one factor that can cause social phobia in teenagers. Peer victimisation is also another crucial factor determining the behavioural patterns of the affected teenagers. Bullying and other forms of social mistreatment cause fear to teenagers who in turn opt to withdraw from such social groups (Chatterjee, Deb, & Walsh 2010)

Possession of temperament behavioural cues such as fear, shyness, avoidance and other inhibitory cues is also another cause of social phobia. Teenagers who possess such behavioural patterns do not interact freely with their peers. In addition, they are mostly likely to evade any social interactions where they might be involved to participate actively. Expressing themselves in social gatherings becomes a significant problem for them. As a result, they prefer avoidance of such social settings. When these behavioural patterns are not restrained in time, they lead to social phobia (Chatterjee, Deb, & Walsh 2010). According to Gren-Landell (2010), possession of social skills is vital for interaction in social settings. However, some individuals are not competent enough to interact and express themselves freely in social interactions. Individuals with insufficient social skills are likely to suffer from the social anxiety disorder.

Prevalence Measure of SAD

Although biological factors are the primary causes of SAD, Wardy (2002) posits that children can as well develop SAD because of their interaction with environmental factors. Gren-Landell (2010), posits that the average onset age of the social anxiety disorder is 13 to18 years. This condition mostly occurs in early adolescents. Wardy (2002) affirms that the number of teenagers suffering from social anxiety disorder has been on the increase in recent years. The prevalence rate of social anxiety disorder adult cases in the USA slightly differs from that of the European countries. However, it was found to be among the top psychiatric conditions in adults. A previous research that was carried out among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States showed that the whites had higher prevalence rates for social anxiety compared to blacks (Himle et al. 2009). Higher prevalence rates for social anxiety disorder cases were found in persons whose age fell between 13 and 18 years. The majority in this group are teenagers. However, the studies conducted have been showing variability in the prevalence rates of SAD among different age brackets making it difficult to come to a conclusive result (Beesdo, Knappe, & Pine 2009).

Theoretical Perspectives that Underpin the SAD

Many theories have been used to explain the social anxiety disorder. One of such theories is the cognitive theory of social anxiety. This theory holds that individuals have inherent tendencies of undervaluing the social impact of the malaise on teenagers. The victims also assume that they cannot deal with social situations. In the context of the cognitive theory, the perceptions, values and beliefs of an individual are crucial factors that govern the development of social fretfulness. However, these factors bear a hidden potential that can be used to treat the malady, especially in teenagers. The theory is built on a number of assumptions that define the tendencies of patients. At the outset, there is a belief that victims underrate the magnitude of the threat in social settings. Secondly, patients of the disease seem to take their abilities to manoeuvre social situations for granted. In addition, the theory assumes that most victims are pessimistic; hence, they expect disappointing outcomes at any social interface. Finally yet importantly, the victims overemphasize the perceived aftermaths of social interactions.

The theory of mind impairments also elaborates on the social anxiety disorder. Hezel and McNally (2014) postulate that SAD victims fail to recognise how other people perceive their social actions. They lack a detailed view of the social environment in which they live. As a result, such individuals develop habits such as avoidance and deceitful beliefs (Hezel & McNally 2014)

Knowledge about other Anxiety Disorders

Allan et al. (2014) theorise that the other anxiety disorders are not critical and dreadful as compared to the social anxiety disorder. However, the knowledge about similar malaises such as panic attacks, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and social anxiety disorder (social phobia) among others is paramount to the determination of proper prevention and treatment measures. Individuals who suffer from this anxiety disorder possess both physical symptoms such as tightened muscles, sleeping problems, and irritability. They are also characterised by emotional symptoms such as explosive emotions, loneliness, and depression among others. Most anxiety disorders are notable during the late childhood and adolescent stages, usually between the age of 10 and 19 years (Gren-Landell 2010; Nilsson 2012).

Methodology

Research Design

This research proposal is based on previous studies that have been conducted to establish the causes and impact of SAD on the social lives of teenagers. Various scholars have used both qualitative and quantitative research designs to study the impact of the disorder on persons whose age falls between 13 and 18 years.

Research Instrument

Questionnaires will be used to collect data from randomly selected respondents. The questions will entail information about the age of the respondents, social fear, risk, and maintenance factors. However, the subjects will be selected from populations that are highly affected by the social anxiety disorder.

Sample and Sampling Strategy

A sample of 250 teenagers will be selected for the study. The choice of the subjects will be based on the quasi-sampling method to minimise bias. This technique will guide the selection of the respondents. However, some of the questionnaires will be administered to randomly selected teenagers in an attempt to obtained even-handed information about the impact of the social anxiety disorder.

Findings

From the analysis above it is evident that the prevalence rate of social anxiety disorder is determined by both genetic and environmental factors. According to previous researches conducted, the malady is one of the major psychiatric disorders that have high prevalence rates in adolescents. Researchers have attested that girls have a higher prevalence rate compared to boys (Rapee 2012). Various risk factors amplify the development of the illness. Early adolescents show peer victimisation and ill-treatment as a greater contribution to this condition. The previous researches have also shown varying prevalence rates of SAD among American and western countries. Greater variations have been noticed in the Asian countries. Different cultural aspects and different social settings among different communities have attributed this.

Impacts of the Social Anxiety Disorder

According to Rapee (2012), avoidance is a common trait possessed by social anxiety disorder victims. Many try to evade social settings where they are likely to participate actively before other people. Sufferers also avoid strangers and facing those in authority such as teachers. In addition, most teenagers are likely to avoid dating and per group social interactions. Another notable feature among victims is extreme worrying accompanied by negative and unpleasant thoughts. Furthermore, victims are highly cautious about themselves, their actions and perceived judgment by other people (Beesdo, Knappe, & Pine 2009).

Therefore, early intervention for SAD has proved to be very beneficial to the affected victims. Rupee (2013), posits that the intervention for SAD at its onset stages is vital for curbing the disorder in a family lineage. A research that was carried out showed different results for boys and girls. According to Rupee (2013), girls showed a more remarkable benefit for early intervention for SAD as compared to boys. Therefore, regardless of the magnitude of the impact early measures have positive effects on the affected victims and families.

Treatment and Diagnosis

Trauma-Focused Cognitive-behavioural therapy (TF-CBT) is an efficient method for treatment of social anxiety. The method promotes a cordial relationship in a social setup. This remedy enables victims of social anxiety to restructure their behaviours and adjust back to normal social interactions in the society (Nilsson 2012). Eye Movement Desensitisation Reprocessing (EMDR) is a new and effective treatment therapy for anxiety disorders. This method suits a broad range of anxiety disorders such as social phobia, post-traumatic stress disorder, and panic attacks among others. It has been termed as safe and efficient since it does not require the patient to ingest drugs (Rapee 2012).

Summary and Discussion

Many teenagers are likely to suffer from inherited social anxiety disorder during their lifetime. This disorder adversely affects their social lives since it denies them a chance to participate in public activities. Therefore, early intervention for social anxiety disorder is paramount to administration of proper treatment. The significance of early intervention for the malaise is to improve the social skills of teenagers. According to previous researches that have been conducted to assess this condition in developed countries, it has been found that the rate of acquiring social anxiety disorder has been on the rise. Therefore, there is a need for quick and immediate reaction to curb this situation. Social anxiety in the teenage stage is highly related to victimisation and ill-treatment. Other aspects such as temperament behaviours, family, parenting, and social skill deficit also lead to social anxiety in adolescents. As a result, it is important to create awareness of treatment and preventive measures for the condition. Children should also be sensitised to temperamental patterns that instigate anxiety. Nonetheless, the trauma-focused cognitive behavioural therapies (TF-CBT) should be prioritised in treatment of social anxiety in teenagers with a view of improving their social skills.

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