Cognitive Behavioral Model of Social Anxiety Disorder and Subtype Classification in Elementary and Junior High School Children

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  • OKAJIMA Isa
    Japan Somnology Center, Neuropsychiatric Research Center; Department of Somnology, Tokyo Medical University
  • KANAI Yoshihiro
    Faculty of Liberal Arts, Tohoku Gakuin University
  • FUKUHARA Yukako
    Goryokai Medical Corporation
  • FUKUHARA Yukako
    Cognitive Behavioral Therapy Center, National Center of Neurology and Psychiatry

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  • 小・中学生における社会不安障害の認知行動モデルの構築とサブタイプの検討
  • ショウ チュウガクセイ ニ オケル シャカイ フアン ショウガイ ノ ニンチ コウドウ モデル ノ コウチク ト サブタイプ ノ ケントウ

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Abstract

For children and adolescents with social anxiety disorder (SAD), effects of cognitive behavioral therapy are relatively modest, and various treatment techniques are present currently. The purposes of this study were to establish and validate the cognitive behavioral model of SAD in childhood and adolescence, and to classify them into subtypes of social anxiety symptoms including negative belief, anxiety, avoidance, and somatic symptom. Participants were 1595 (range=9-15 years old) including elementary school students (n=826) and middle school students (n=769). Results revealed that negative belief evokes anxiety in social situations, and increased anxiety induces avoidance behavior and/or somatic symptoms in children similar to adults (GFI=0.93, CFI=0.95, RMSEA=0.05). In addition, it was revealed that negative belief more strongly contributes to anxiety, and anxiety more strongly contributes to somatic symptoms in adolescents in comparison with children. Result of a cluster analysis showed that four clusters were obtained; Fear-avoidance type, Mixed Symptoms type, Low Social Anxiety type, and Anxiety-somatic type. Many children were classified as Fear-avoidance or Anxiety-somatic type, and many adolescents were Mixed Symptoms type. Finally, treatment implications for each subtype were discussed.

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