Abstract
Background
Impairments in peer relations comprise a core feature of social anxiety, particularly among adolescents. Yet, these impairments may also stem from concerns that commonly co-occur with social anxiety, namely depressive symptoms and attention-deficit/hyperactivity disorder (ADHD) symptoms.
Objective
Although peer-related impairments spike during adolescence, we know relatively little about efficiently screening for peer-related impairments that specifically index those impairments relevant to adolescent social anxiety.
Method
We recruited 89 adolescents (M = 14.5 years, 64% female, 65.1% African American) who varied on evaluation-seeking status (30 evaluation-seeking; 59 community control). On a preliminary phone screen, parents provided reports on three peer-related impairment items identified in prior work as particularly discriminative: number of friends, trouble making friends, and trouble keeping friends. Parents and adolescents completed survey measures of social anxiety and mental health concerns commonly linked to social anxiety (i.e., depressive symptoms, ADHD symptoms).
Results
Increased peer-related impairments were uniquely related to increased social anxiety, controlling for depressive symptoms and ADHD symptoms. Increased peer-related impairments also predicted increased risk for being above the clinical cut score on measures of social anxiety, depressive symptoms, and ADHD symptoms. The number of peer-related impairments significantly distinguished adolescents on evaluation-seeking status.
Conclusions
Using a short list of three items assessing peer-related impairments (number of friends, trouble making friends, and trouble keeping friends) one can efficiently screen for peer-related impairments of specific relevance to adolescent social anxiety. These findings have important implications for leveraging efficient, evidence-based screening devices when clinically assessing adolescent social anxiety, particularly in low-resource mental health settings.
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References
Alfano, C. A., & Beidel, D. C. (2011). Social anxiety in adolescents and young adults: Translating developmental science into practice. Washington, DC: American Psychological Association. https://doi.org/10.1037/12315-000.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-V) (5 ed.). Washington, DC: American Psychiatric Association.
Augenstein, T. M., Thomas, S. A., Ehrlich, K. B., Daruwala, S. E., Reyes, S. M., Chrabaszcz, J. S., et al. (2016). Comparing multi-informant assessment measures of parental monitoring and their links with adolescent delinquent behavior. Parenting: Science and Practice, 16, 164–186. https://doi.org/10.1080/15295192.2016.1158600.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory—second edition manual. San Antonio, TX: The Psychological Corporation.
Beidas, R. S., Stewart, R. E., Walsh, L., Lucas, S., Downey, M. M., Jackson, K., et al. (2015). Free, brief, and validated: Standardized instruments for low-resource mental health settings. Cognitive and Behavioral Practice, 22, 5–19. https://doi.org/10.1016/j.cbpra.2014.02.002.
Beidel, D. C., Rao, P. A., Scharfstein, L., Wong, N., & Alfano, C. A. (2010). Social skills and social phobia: An investigation of DSM-IV subtypes. Behaviour Research and Therapy, 48, 992–1001. https://doi.org/10.1016/j.brat.2010.06.005.
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. https://doi.org/10.1037/1040-3590.7.1.73.
Beidel, D. C., Turner, S. M., & Morris, T. L. (2000). Behavioral treatment of childhood social phobia. Journal of Consulting and Clinical Psychology, 68, 1072–1080. https://doi.org/10.1037/0022-006X.68.6.1072.
De Los Reyes, A., Aldao, A., Thomas, S. A., Daruwala, S. E., Swan, A. J., Van Wie, M., et al. (2012). Adolescent self-reports of social anxiety: Can they disagree with objective psychophysiological measures and still be valid? Journal of Psychopathology and Behavioral Assessment, 34, 308–322. https://doi.org/10.1007/s10862-012-9289-2.
De Los Reyes, A., Augenstein, T. M., Wang, M., Thomas, S. A., Drabick, D. A. G., Burgers, D., et al. (2015). The validity of the multi-informant approach to assessing child and adolescent mental health. Psychological Bulletin, 141, 858–900. https://doi.org/10.1037/a0038498.
De Los Reyes, A., & Kazdin, A. E. (2006). Conceptualizing changes in behavior in intervention research: The range of possible changes model. Psychological Review, 113, 554–583. https://doi.org/10.1037/0033-295X.113.3.554.
De Los Reyes, A., Lerner, M., Thomas, S., Daruwala, S., & Goepel, K. (2013a). Discrepancies between parent and adolescent beliefs about daily life topics and performance on an emotion recognition task. Journal of Abnormal Child Psychology, 41, 971–982. https://doi.org/10.1007/s10802-013-9733-0.
De Los Reyes, A., Thomas, S. A., Goodman, K. L., & Kundey, S. M. A. (2013b). Principles underlying the use of multiple informants’ reports. Annual Review of Clinical Psychology, 9, 123–149. https://doi.org/10.1146/annurev-clinpsy-050212-185617.
Deros, D. E., Racz, S. J., Lipton, M. F., Augenstein, T. M., Karp, J. N., Keeley, L. M., et al. (2018). Multi-informant assessments of adolescent social anxiety: Adding clarity by leveraging reports from unfamiliar peer confederates. Behavior Therapy, 49, 84–98. https://doi.org/10.1016/j.beth.2017.05.001.
Epkins, C. C., & Heckler, D. R. (2011). Integrating etiological models of social anxiety and depression in youth: Evidence for a cumulative interpersonal risk model. Clinical Child and Family Psychology Review, 14, 329–376. https://doi.org/10.1007/s10567-011-0101-8.
Glenn, L. E., Keeley, L. M., Szollos, S., Okuno, H., Wang, X., Rausch, E., et al. (2018). Trained observers’ ratings of adolescents’ social anxiety and social skills within controlled, cross-contextual social interactions with unfamiliar peer confederates. Journal of Psychopathology and Behavioral Assessment. https://doi.org/10.1007/s10862-018-9676-4.
Grant, B. F., Hasin, D. S., Blanco, C., Stinson, F. S., Chou, S. P., Goldstein, R. B., et al. (2005). The epidemiology of social anxiety disorder in the United States: Results from the national epidemiologic survey on alcohol and related conditions. The Journal of Clinical Psychiatry, 66, 1351–1361. https://doi.org/10.4088/JCP.v66n1102.
Hanley, J. A., Negassa, A., Edwardes, M. D., & Forrester, J. E. (2003). Statistical analysis of correlated data using generalized estimating equations: An orientation. American Journal of Epidemiology, 157, 364–375. https://doi.org/10.1093/aje/kwf215.
Ingersoll, G. M. (1989). Adolescents (2nd ed.). Englewood Cliffs, NJ: Prentice Hall.
Jarrett, M. A., & Ollendick, T. H. (2008). A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety: Implications for future research and practice. Clinical Psychology Review, 28, 1266–1280. https://doi.org/10.1016/j.cpr.2008.05.004.
Karp, J. N., Makol, B. A., Keeley, L. M., Qasmieh, N., Deros, D. E., Weeks, J. W., et al. (2018). Convergent, incremental, and criterion-related validity of multi-informant assessments of adolescents’ fears of negative and positive evaluation. Clinical Psychology and Psychotherapy, 25, 217–230. https://doi.org/10.1002/cpp.2156.
Keeley, L. M., Makol, B. A., Qasmieh, N., Deros, D. E., Karp, J. N., Lipton, M. F., et al. (2018). Validity of adolescent and parent reports on the six-item ADHD Self-Report Scale (ASRS-6) in clinical assessments of adolescent social anxiety. Journal of Child and Family Studies, 27, 1041–1053. https://doi.org/10.1007/s10826-017-0950-y.
Kessler, R. C., Adler, L. A., Gruber, M. J., Sarawate, C. A., Spencer, T., & van Brunt, D. L. (2007). Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) screener in a representative sample of health plan members. International Journal of Methods in Psychiatric Research, 16, 52–65. https://doi.org/10.1002/mpr.208.
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. https://doi.org/10.1001/archpsyc.62.6.593.
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21, 169–184. https://doi.org/10.1002/mpr.1359.
La Greca, A., & Lopez, N. (1998). Social anxiety among adolescents: Linkages with peer relations and friendships. Journal of Abnormal Child Psychology, 26, 83–94. https://doi.org/10.1023/A:1022684520514.
Lipton, M. F., Augenstein, T. M., Weeks, J. W., & De Los Reyes, A. (2014). A multi-informant approach to assessing fear of positive evaluation in socially anxious adolescents. Journal of Child and Family Studies, 23, 1247–1257. https://doi.org/10.1007/s10826-013-9785-3.
Qasmieh, N., Makol, B. A., Augenstein, T. M., Lipton, M. F., Deros, D. E., Karp, J., et al. (2018). A multi-informant approach to assessing safety behaviors among adolescents: Psychometric properties of the Subtle Avoidance Frequency Examination. Journal of Child and Family Studies, 27, 1830–1843. https://doi.org/10.1007/s10826-018-1040-5.
Rapee, R. M., Bögels, S. M., van der Sluis, C. M., Craske, M. G., & Ollendick, T. H. (2012). Annual research review: Conceptualising functional impairment in children and adolescence. Journal of Child Psychology and Psychiatry, 53, 454–468. https://doi.org/10.1111/j.1469-7610.2011.02479.x.
Rausch, E., Racz, S. J., Augenstein, T. M., Keeley, L., Lipton, M. F., Szollos, S., et al. (2017). A multi-informant approach to measuring depressive symptoms in clinical assessments of adolescent social anxiety using the Beck Depression Inventory-II: Convergent, incremental, and criterion-related validity. Child and Youth Care Forum, 46, 661–683. https://doi.org/10.1007/s10566-017-9403-4.
Scharfstein, L., Alfano, C., Beidel, D., & Wong, N. (2011). Children with generalized anxiety disorder do not have peer problems, just fewer friends. Child Psychiatry and Human Development, 42, 712–723. https://doi.org/10.1007/s10578-011-0245-2.
Silverman, W. K., & Albano, A. M. (1996). The Anxiety Disorders Interview Schedule for DSM-IV-child and parent versions. London: Oxford University Press.
Silverman, W. K., & Ollendick, T. H. (2005). Evidence-based assessment of anxiety and its disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 380–411. https://doi.org/10.1207/s15374424jccp3403_2.
Steer, R. A., Kumar, G., Ranieri, W. F., & Beck, A. (1998). Use of the Beck Depression Inventory-II with adolescent psychiatric outpatients. Journal of Psychopathology and Behavioral Assessment, 20, 127–137. https://doi.org/10.1023/A:1023091529735.
Thomas, S. A., Daruwala, S. E., Goepel, K. A., & De Los Reyes, A. (2012). Using the Subtle Avoidance Frequency Examination in adolescent social anxiety assessments. Child and Youth Care Forum, 41, 547–559. https://doi.org/10.1007/s10566-012-9181-y.
U.S. Census Bureau. (2016). State and county quickfacts: Washington, DC. Retrieved from http://www.census.gov/quickfacts/table/PST045215/11,00.
Funding
This work was supported, in part, by an internal grant from the University of Maryland (College of Behavioral and Social Sciences Dean’s Research Initiative-Summer Scholars Program) awarded to first and last authors.
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Alexis M. Beale, Lauren M. Keeley, Hide Okuno, Sebastian Szollos, Erica Rausch, Bridget A. Makol, Tara M. Augenstein, Melanie F. Lipton, Sarah J. Racz, and Andres De Los Reyes declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Maryland at College Park’s Institutional Review Board declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Beale, A.M., Keeley, L.M., Okuno, H. et al. Efficient Screening for Impairments in Peer Functioning Among Mid-to-Late Adolescents Receiving Clinical Assessments for Social Anxiety. Child Youth Care Forum 47, 613–631 (2018). https://doi.org/10.1007/s10566-018-9458-x
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DOI: https://doi.org/10.1007/s10566-018-9458-x