PREVALENCE AND SOCIODEMOGRAPHIC CORRELATES OF SOCIAL ANXIETY DISORDER AMONG MEDICAL UNDERGRADUATES

Background: Social anxiety disorder is a common mental health disorder characterized by persistent fear of being embarrassed, humiliated, rejected and looked down by others. It can cause impairment in education and in professional achievement, quality of life and social relationships. The objective of this study was to measure the prevalence and study associated factors of social anxiety disorder among students of a tertiary medical college and hospital. Methods: This cross-sectional study was conducted among 403 medical students of a medical college and Hospital. The questionnaire used in the study had questions related to socio-demographic details and had the social phobia inventory (SPIN) questionnaire which was used to assess social anxiety disorder. Results: Out of 403 medical students, 61.53% (n=248) students were not having any type of social anxiety disorder. Among 38.46% (n=155) of students who were having SAD, 21.33%(n=86) were having mild SAD and 17.11% (n=69) were having signi?cant SAD. Mild social anxiety is considered as normal. Factors such as age, year of study, self- perception of facial appearance, history of chronic illness, academic performance satisfaction and language barrier were found to be statistically associated with SAD. Conclusion: Social anxiety disorder was signi?cantly associated with age, year of study, self perception of facial appearance, history of chronic illness, academic performance satisfaction and language barrier.

The endocannabinoid system in social anxiety disorder: from pathophysiology to novel therapeutics

Social anxiety disorder (SAD) is a highly prevalent psychiatric disorder that presents with an early age of onset, chronic disease course, and increased risk of psychiatric comorbidity. Current treatment options for SAD are associated with low response rates, suboptimal efficacy, and possible risk of adverse effects. Investigation of new neurobiological mechanisms may aid in the identification of more specific therapeutic targets for the treatment of this disorder. Emerging evidence suggests that the endogenous cannabinoid system, also referred to as the endocannabinoid system (ECS), could play a potential role in the pathophysiology of SAD. This review discusses the known pathophysiological mechanisms of SAD, the potential role of the ECS in this disorder, current drugs targeting the ECS, and the potential of these novel compounds to enhance the therapeutic armamentarium for SAD. Further investigational efforts, specifically in human populations, are warranted to improve our knowledge of the ECS in SAD.

Memory bias and personality characteristics in college students with social anxiety disorder

Abstract Introduction Some individuals are more susceptible to recalling false information about events that never happened in their life. Nevertheless, there are several factors, such as personality characteristics, that appear to be related to memory performance. Social anxiety also provokes memory deficits for events that happen to other people, because these individuals tend to focus on their own inner selves rather than on external signs. Objective To investigate the influence of the personality characteristics of individuals with social anxiety disorder (SAD) on memory performance. Methods In this study, 183 university students had their memory tested using a complex emotional story about a mother and her son. Only subjects without clinical symptoms of depression and general anxiety (N = 148; 61 with SAD) were included in the study. Participants were compared for differences in personality characteristics using the Factorial Inventory of Personality and for SAD using the Social Phobia Inventory. Results The main results showed that memory performance of individuals with low percentile ranks in the personality characteristic dominance, i.e., those with low self-esteem, remembered more true information about the story than those with high scores when they did not have SAD. Conclusion The results are helpful to foster better understanding of the personality characteristics related to SAD, such as low dominance, which implies low self-esteem and difficulties with trust and with imposing themselves on others. The results could help development and improvement of techniques for therapeutic intervention.

Ansiedade social: adaptação e evidências de validade da forma curta da Social Interaction Anxiety Scale e da Social Phobia Scale para o Brasil / Social anxiety: adaptation and evidence of validity of the short form of the Social Interaction Anxiety Scale and Social Phobia Scale for Brazil

OBJETIVO: A ansiedade social é um transtorno psicológico pouco publicizado, mas com importante distribuição epidemiológica. O presente estudo teve como objetivo adaptar para o contexto brasileiro as versões reduzidas da Social Interaction Anxiety Scale (SIAS) e da Social Phobia Scale (SPS) (SIAS-6 e SPS-6) e produzir evidências de validade. Essas escalas avaliam ansiedade em interações sociais e ansiedade social diante da possibilidade de escrutínio por outras pessoas, sendo complementares. MÉTODOS: Como são escalas com reconhecido uso internacional, a adaptação para o Brasil pode trazer contribuições para as investigações clínicas e científicas acerca do transtorno de ansiedade social. Foram realizados processos criteriosos para a adaptação (tradução, avaliação por juízes, retrotradução, avaliação pelo público-alvo) e conduzido um levantamento on-line com 1.049 pessoas, maiores de 18 anos, com média de idade de 25,98 anos (DP = 7,55). RESULTADOS: Utilizaram-se Análises Fatoriais Confirmatórias e, desse modo, constatou-se que os índices de ajuste produzidos são, em geral, adequados (SRMR < 0,04, CFI > 0,96, TLI > 0,94 e RMSEA < 0,05) e que os itens possuem cargas fatoriais adequadas (entre 0,441 e 0,837). As evidências de validade discriminante também se mostraram satisfatórias, conseguindo diferenciar grupos por renda e orientação sexual, como esperado pela literatura. CONCLUSÕES: Os resultados sugerem que as escalas são adequadas para uso no Brasil, tanto para uso em separado como para uso combinado, como fatores correlacionados.

OBJECTIVE: Social anxiety is a poorly publicized psychological disorder, but with an important epidemiological distribution. The present study aimed to adapt the reduced versions of the Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS) (SIAS-6 and SPS-6) to the Brazilian context and produce evidence of validity. These scales assess anxiety in social interactions and social anxiety in face of the possibility of scrutiny by other people, being complementary. METHODS: As they are scales with recognized international use, adaptation to Brazil can bring contributions to clinical and scientific investigations about Social Anxiety Disorder. Judicious processes for adaptation were carried out (translation, evaluation by judges, back-translation, evaluation by the target audience) and an online survey was conducted with 1,049 people, over 18 years of age with an average age of 25.98 years (SD = 7.55). RESULTS: Confirmatory Factor Analysis was used and, thus, it was found that the adjustment indexes produced are, generally, adequate (SRMR < 0.04, CFI > 0.96, TLI > 0.94 and RMSEA < 0.05) and that the items have adequate factor loads. Evidence of discriminant validity was also satisfactory, managing to differentiate groups by income and sexual orientation as expected by the literature. CONCLUSIONS: The results suggest that the scales are suitable for use in Brazil, both for separate use and for combined use, as correlated factors.

Presença de sintomas de fobia social, transtorno do pânico e ansiedade de separação em estudantes de 11 a 17 anos, em uma escola da rede pública de ensino de Salvador / Presence of symptoms of social phobia, panic and separation anxiety in students aged 11 to 17 years from a school of th public system of Salvador

Introdução: crianças e adolescentes, não raro, apresentam sintomas de fobia social, transtorno do pânico e ansiedade de separação, que podem causar comprometimento nas habilidades sociais e dificultar as relações de forma incapacitante. Objetivo: Este estudo tem como objetivo verificar a presença de sintomas fóbicos sociais, transtorno de pânico e ansiedade de separação em adolescentes, com idade entre 11 e 17 anos, de uma escola pública da cidade de Salvador. Metodologia: este é um estudo observacional, transversal, que integra outro mais amplo, realizado em escola pública de Salvador, entre março e dezembro de 2015. A escala Revised Children's Anxiety and Depression foi aplicada em uma amostra de 674 alunos. Resultados: os alunos apresentaram sintomas de fobia social, transtorno do pânico e ansiedade de separação, em escala crescente, de acordo com a idade.

Introduction:children and adolescents often present symptoms of social phobia, panic disorder and separation anxiety disorder, which can cause social impairments and hinder relationships in a disabling way. Objective: this study aims to investigate the presence of social phobia, panic disorder and separation anxiety symptoms in adolescents aged between 11 and 17 years from a public school in the city of Salvador. Methodology: the present study is an observational cross-sectional research, which is part of a broader study conducted in a public school in Salvador, between March and December 2015. The Revised Children's Anxiety and Depression Scale (RCADS) was used in a sample of 674 students. Results: the students presented symptoms of social phobia, panic disorder and separation anxiety on an increasing scale proportional to age.

Depressão e fobia social: um caso clínico de avaliação e intervenção cognitivo-comportamental / Depression and social phobia: a clinical case study of cognitive-behavioral therapy evaluation and intervention / Depresión y fobia social: un caso clínico de evaluación y intervención cognitivo-conductual

Este artigo pretende dar a conhecer os resultados duma intervenção cognitivo-comportamental num caso clínico de um jovem com problemas de violência doméstica. Apresenta sintomas depressivos que o prejudicam a nível pessoal, acadêmico e social. Para além disso, manifesta medo e ansiedade acerca de diversas situações de âmbito social em que é exposto à possível avaliação por parte dos outros e receio de que possa vir a comportarse de modo embaraçador. A avaliação psicológica permitiu diagnosticar uma perturbação depressiva e fobia social, tendo sido acionada a intervenção cognitivo-comportamental com base no modelo cognitivo para a depressão, de Beck, e no modelo cognitivo para a ansiedade social, de Clark e Wells. Os resultados da intervenção foram positivos, indicando a importância da terapia cognitivo-comportamental nesses tipos de perturbação.

The aim of this paper is to present the results of a cognitive-behavioral therapy clinical case report of a young man with domestic violence issues. The subject shows depressive symptoms that affect him on a personal, academic and social level. Furthermore, he shows fear and anxiety about several social situations in which he may fall under the scrutiny from other people, and worries about the likelihood of behaving in an embarrassing manner. With the psychological assessment, the subject was diagnosed with depression and social phobia, and cognitive-behavioral therapy based on Beck´s Cognitive Model of Depression and Clark & Wells’s Cognitive Model for Social Anxiety were started off. The results of the intervention were positive, indicating the importance of cognitive-behavioral therapy in this kind of disorders.

Este artículo pretende dar a conocer los resultados de una intervención cognitivo-conductual en un caso clínico de un joven con problemas de violencia doméstica. Él presenta síntomas depresivos que lo perjudican a nivel personal, académico y social. Más allá de eso, presenta miedo y ansiedad sobre muchas situaciones sociales en las que es expuesto a la posible evaluación por parte de los demás y miedo de comportarse de manera embarazosa. La evaluación psicológica ha permitido diagnosticar un disturbio depresivo y fobia social, y fue accionada la intervención cognitivoconductual basada en el Modelo Cognitivo de la depresión de Beck y en el Modelo Cognitivo para la ansiedad social de Clark y Wells. Los resultados de la intervención fueron positivos, indicando la importancia de la terapia cognitivo-conductual en este tipo de disturbios.

Psychometric properties of the Brazilian Intolerance of Uncertainty Scale - Short Version (IUS-12)

Abstract Introduction The Intolerance of Uncertainty Scale - Short Version (IUS-12) is a measure of trait intolerance of uncertainty. Objective The purpose of the present study was to conduct a cross-cultural adaptation of the IUS-12 for use in Brazil and to investigate the scale's psychometric properties. Methods The research was conducted via an online research platform with a sample (n = 704; 80.1% female and 19.9% male) from different states in all five regions of Brazil. Participants were adults between 18 and 59 years of age (mean = 26.74; standard deviation = 8.36) who completed the Brazilian version of the IUS-12 online along with other anxiety-related measures. Results Confirmatory factor analysis demonstrated that the original two-dimensional structure fit the sample well. The total score for the scale had good internal consistency (Cronbach's alpha [α] = 0.88), as did both subscales (i.e. Prospective IU α = 0.79; Inhibitory IU α = 0.86). Conclusions The results demonstrated strong positive correlations with measures of anxiety-related constructs, contributing to the transdiagnostic understanding of IU. The IUS-12 appears to be a useful tool for assessment of IU and its availability has several implications of theoretical importance and practical utility for understanding of psychopathology and uncertainty.

Social anxiety disorder among medical students in a tertiary care hospital in Davangere, Karnataka

Background: Social anxiety disorder is a common psychiatric illness characterized by fear of being observed and scrutinized by others. It can impair academic performance and can lead to serious withdrawal from society and depression. The objective of the study was to measure the proportion and study the associated factors of Social Anxiety Disorder among students of a tertiary medical college and hospital.Methods: This hospital-based, cross-sectional study was conducted among the 272 medical students of a Tertiary care medical college and hospital at Davangere, Karnataka from October to December 2018. The social phobia inventory (SPIN) questionnaire was used to diagnose SAD among students.Results: Social anxiety disorder (SAD) was present among 30.5% (n=83) of the medical students. The female students (31.1%, n=45) documented a higher proportion of SAD compared to male students (29.9%, n=38). There was a higher incidence among above the 20 years age group and Muslims especially girl students.Conclusions: A higher proportion of medical students had social anxiety disorder which was influenced by increasing age, female gender, Muslim religion and higher academic years of exposure till final year.

Screening of social phobia symptoms in a sample of Egyptian university students

Abstract Background Public speaking is a main requisite for academic achievement amongst university students. Epidemiological data on social phobia among University students in the Arab World are scarce. Objectives To screen for social phobia symptoms in a representative sample of Egyptian university students, and to highlight some putative risk factors associated with them. Methods Two thousand nine hundred and nineteen Egyptian university students participated in the study. They were screened for social phobia using Brief Social Phobia Scale (BSPS). Students total and subdomain scores on the BSPS were correlated with their demographic and scholastic variables. Results Social phobia symptoms were estimated to be prevalent among (44%) of the study sample. A significant (p < 0.05) negative correlation was found between students' age and avoidance scores on BSPS and between students' educational year and their scores on fear, avoidance and physiologic subdomains on the BSPS. Regression analysis pointed out to a number of predictive factors for the higher total BSPS scores such as female gender and being a medical student. Discussion Our study demonstrated a high rate of social phobia symptoms in university students. It also demonstrated a number of significant predictive factors associated with the domains of social phobia such as gender, BMI, scholastic year and faculty type.

Transtorno de Ansiedade Social no Contexto da Aprendizagem Baseada em Problemas / Social Anxiety Disorder in the Context of Problem Based-Learning

RESUMO Objetivo Investigar os sintomas de transtorno de ansiedade social (TAS) entre os estudantes de Medicina do Centro Universitário Christus (Unichristus), instituição que adota o método de Aprendizagem Baseada em Problemas (ABP). Métodos Estudo transversal com 431 estudantes do primeiro ao quarto ano do curso de Medicina, por meio da aplicação da Escala de Ansiedade Social de Liebowitz (LSAS-SR), do Inventário de Ansiedade de Beck de Avaliação de Ansiedade, além de questionário com perguntas referentes a questões sociodemográficas, história familiar de doenças psiquiátricas, acompanhamento psicoterápico e psiquiátrico, nível de ansiedade para se expressar na tutoria e percepção de como a ansiedade variou ao longo dos semestres da faculdade. Resultados Utilizando-se a LSAS-SR como instrumento de triagem para casos de TAS, encontraram-se escores sugestivos do transtorno em 59,2% (255) dos estudantes. Em relação ao nível de ansiedade, o Inventário de Ansiedade de Beck (BAI) evidenciou que 59,3% (258) dos estudantes apresentaram nível de ansiedade mínimo; 26,6% (115), nível leve; 9,7% (42), nível moderado; e 4,4% (19), nível grave. Observou-se uma correlação significativa entre os escores obtidos nas escalas BAI e LSAS-SR: estudantes com sintomas sugestivos de ansiedade social apresentaram maior grau de ansiedade. Além disso, estudantes com sintomas de ansiedade social relataram maior nível de ansiedade para se expressar durante as sessões de tutoria. Conclusão A elevada prevalência de TAS apontada nesta investigação já justifica o estímulo à adoção de medidas psicoeducativas e estratégias pedagógicas que venham a auxiliar os estudantes com manifestações de ansiedade social a reduzir esses sintomas, favorecendo o processo de ensino-aprendizagem.

ABSTRACT Objective To investigate the symptoms of social anxiety disorder (SAD) among medical students of the Christus University Center (Unichristus), an institution that adopts the problem-based learning (PBL) method. Methods A cross-sectional study with 431 students in their first to fourth years of Medical School, through the application of the Liebowitz Social anxiety scale (LSAS-SR), Beck's anxiety Inventory, and a questionnaire with questions concerning sociodemographic issues, family history of psychiatric disorders, psychiatric appointments, level of anxiety when expressing themselves in tutorials, and the perception of how their anxiety varied throughout the college semesters. Results Using the LSAS-SR as a screening tool for cases of SAD, there were indications of the disorder in 59.2% (255) of the students. In relation to the level of anxiety, the Beck's anxiety inventory (BAI) showed that 59.3% (258) of the students presented minimal anxiety, 26.6% (115) presented light anxiety, 9.7% (42) presented moderate anxiety, and 4.4% (19) presented severe anxiety. A significant correlation was observed between the scores obtained in the BAI and LSAS-SR scales: students with symptoms suggesting social anxiety showed a greater degree of anxiety. Also, students with symptoms of social anxiety reported higher levels of anxiety when expressing themselves during tutorials. Conclusions The high prevalence of SAD pointed out in this research justifies stimulating the adoption of psycho-educational measures and pedagogical strategies that will help students with the manifestations of social anxiety, reduce these symptoms, and promote the teaching-learning process.

Prevalence of social anxiety disorder and its determinants among undergraduate medical students of East Delhi

Background: Social anxiety disorder (SAD) is a persistent fear of situations where a person is exposed to a possibility of being under scrutiny. This may lead to decreased academic performance which in turn can lead to depression and suicidal tendencies. Thus, medical students are more vulnerable since they are subjected to stress and academic pressure. The objective of the study was to find out the prevalence and determinants of SAD among medical undergraduate students.Methods: This was a cross-sectional descriptive study done among 404 undergraduate students of a Medical College in east Delhi. Data was collected using a questionnaire containing sociodemographic details and Social interaction anxiety scale (SIAS). Data analysis was done by MS Excel and SPSS 20.0 using frequencies, chi squared test and multiple logistic regression.Results: The mean age of the participants was 20.7 years with 75% males and two-third belonging to upper class. It was found that 12.62% of the study participants were having social phobia and 5.95% were having social anxiety. The determinants found to be significant by univariate analysis were language barrier, body image perception, facial appearance perception and academic performance satisfaction. However, after applying multiple logistic regression it was found out that language barrier (OR-4.36, 95% CI=1.567-12.165, p=0.005) and facial appearance perception (OR-2.98, 95% CI=1.206-7.375, p=0.018) were the main determinants of SAD.Conclusions: Early detection and appropriate intervention needs to be done among the students as they are the most vulnerable and most malleable.

Facial expressions and eye tracking in individuals with social anxiety disorder: a systematic review

Abstract Social anxiety disorder (SAD) is characterized by the fear of being judged negatively in social situations. Eye-tracking techniques have been prominent among the methods used in recent decades to investigate emotional processing in SAD. This study offers a systematic review of studies on eye-tracking patterns in individuals with SAD and controls in facial emotion recognition tasks. Thirteen articles were selected from the consulted databases. It was observed that the subjects with SAD exhibited hypervigilance-avoidance in response to emotions, primarily in the case of negative expressions. There was avoidance of conspicuous areas of the face, particularly the eyes, during observations of negative expressions. However, this hypervigilance did not occur if the stimulus was presented in virtual reality. An important limitation of these studies is that they use only static expressions, which can reduce the ecological validity of the results.

Social anxiety symptoms and body image dissatisfaction in medical students: prevalence and correlates / Sintomas de ansiedade social e insatisfação com a imagem corporal em estudantes de Medicina: prevalência e correlatos

ABSTRACT Objective Social anxiety disorder (SAD) and body image dissatisfaction (BID) are common problems among college students, but few studies focused on medical students. We aimed to estimate the prevalence, severity and correlates of SAD symptoms and BID among medical students of a Brazilian public university. Methods A cross-sectional study with 479 students, using structured instruments: Social Phobia Inventory (SPIN), Body Shape Questionnaire (BSQ), and Beck Depression Inventory (BDI). Bivariate analyses were followed by logistic regression models to obtain independent predictors of SAD symptoms, BID and both outcomes combined. Results Most students were single (99%) and female (58.7%). The prevalence rates of SAD symptoms (SPIN ≥ 19) and BID (BSQ ≥ 81) were 36.3% and 34.7%, respectively. Depressive symptoms (BDI ≥ 19) occurred in 8.8% of the sample. SAD symptoms were independently associated with: BID, thoughts of abandoning the course, difficulty making friends, depressive symptoms, and mental health treatment prior to university. Besides SAD symptoms, BID was associated with female sex, difficulty making friends, depressive symptoms, and body mass index (BMI). Seventy-eight students (16.3%) presented SAD symptoms and BID, which was associated with female sex, difficulty making friends, dissatisfaction with the course, depressive symptoms and BMI. Conclusion SAD symptoms and BID are common and related problems that should be screened for among medical students. The identification of specific correlates could contribute to the elaboration of preventive measures, minimizing the distress and negative impact of these mental health problems on relationships and academic performance.

RESUMO Objetivo O transtorno de ansiedade social (TAS) e a insatisfação com a imagem corporal (IIC) são problemas comuns em estudantes universitários, mas poucos estudos avaliaram estudantes de Medicina. O objetivo do estudo foi estimar a prevalência, a gravidade e os correlatos de sintomas de TAS e IIC em estudantes de Medicina de uma universidade pública brasileira. Métodos Estudo transversal com 479 estudantes utilizando os seguintes instrumentos de avaliação estruturados: Social Phobia Inventory (SPIN), Body Shape Questionnaire (BSQ) e Beck Depression Inventory (BDI). Análises bivariadas foram seguidas de modelos de regressão logística para identificar preditores independentes de sintomas de TAS, IIC e ambos os desfechos combinados. Resultados A maioria dos estudantes era solteira (99%) e do sexo feminino (58,7%). As prevalências de sintomas de TAS (SPIN ≥ 19) e de ICC (BSQ ≥ 81) foram de 36,3% e 34,7%, respectivamente. Sintomas depressivos (BDI ≥ 19) ocorreram em 8,8% da amostra. Sintomas de TAS associaram-se de modo independente com: IIC, pensamentos de abandonar o curso, dificuldade de fazer amigos, sintomas depressivos e tratamento de saúde mental antes de ingressar na universidade. Além de sintomas de TAS, IIC associou-se com sexo feminino, dificuldade de fazer amigos, sintomas depressivos e índice de massa corporal (IMC). Setenta e oito estudantes (16,3%) apresentaram sintomas de TAS e IIC, o que se associou com sexo feminino, dificuldade de fazer amigos, insatisfação com o curso, sintomas depressivos e IMC. Conclusão Sintomas de TAS e IIC são problemas comuns e inter-relacionados que devem ser rastreados em estudantes de Medicina. A identificação de correlatos específicos pode contribuir para a elaboração de medidas preventivas minimizando o sofrimento e o impacto negativo desses problemas de saúde mental nos relacionamentos e no desempenho acadêmico desses estudantes.

Effect of Integrated Physical Activity Training on Social Phobia in girls residing in a children's home

The purpose of the study was to determine the effect of integrated physical activity training on socialphobia. In this experimental research study, the subjects were 51 girls (age 13 to 16 years) of children'shomes of Greater Mumbai. The design of the study was Non-equivalent Control Group Design. Thedependent variable was social phobia and the psychological test administered was Social Phobia Scale(SPS). The independent variable (treatment) was Integrated Physical Activity Training for the period of 8weeks, 5 days a week and 60 minutes morning session which comprised of yoga, physical exercise andteam games. The comparison of data (pre test - post test) of control group and experimental group wasanalyzed with the help of one way analysis of covariance Ancova. The result added new information thatthe level of social phobia has been reduced due to the treatment of Integrated Physical Activity Trainingamong the adolescent girls of children's home

Validação brasileira do questionário de ansiedade social para adultos (CASO) / Brazilian validation of the social anxiety questionnaire for adults (SAQ) / Validación brasileña del cuestionario de ansiedad social para adultos (CASO)

Uma prática comum no campo da avaliação da ansiedade social em países de língua espanhola e portuguesa é o uso de instrumentos de origem anglo-saxã sem adaptação prévia para o país de nova aplicação. Recentemente, desenvolveu-se empiricamente o novo Questionário de Ansiedade Social para Adultos (CASO) com situações sociais provenientes da América Latina, da Espanha e de Portugal. Este artigo apresenta as propriedades psicométricas do CASO aplicado a uma amostra de 2.422 brasileiros. Os resultados mostram que o questionário mantém a sua estrutura original de cinco dimensões, com os seus 30 itens apresentando carga fatorial superior a 0,40 em cada um dos cinco fatores. A confiabilidade e a consistência interna são elevadas. Foram encontradas diferenças associadas ao sexo, com mulheres pontuaram de maneira mais elevada em três das cinco dimensões e na ansiedade social geral. Esses dados indicam que o CASO (SAQ) é uma medida válida e confiável para uso no Brasil.

A common practice in the field of social anxiety assessment in Portuguese and Spanish-speaking countries is the use of instruments, developed in English-speaking countries, without prior adaptation to the country of application. Recently, it has been empirically developed the new Social Anxiety Questionnaire for Adults (SAQ) with social situations from Ibero America, Spain, and Portugal. This article presents the psychometric properties of the SAQ, applied to a sample of 2,422 Brazilians. The results show that the questionnaire maintains its five-factor original structure, with its 30 items loading above 0.40 in each of the five factors. The reliability and internal consistency are high. Differences associated with gender were found, showing that women scored higher than men in three out of the five factors and in global social anxiety. These data indicate that the SAQ is a reliable and valid measure for use in Brazil.

Una práctica frecuente en el campo de la evaluación de la ansiedad social en países de lengua española y portuguesa es el empleo de instrumentos de origen anglosajón. Recientemente se ha desarrollado de forma empírica el nuevo Cuestionario de ansiedad social para adultos (CASO) con situaciones sociales generadas en Latinoamérica, España y Portugal. Este artículo presenta las propiedades psicométricas del CASO aplicado a una muestra de 2.422 brasileños. Los resultados muestran que el cuestionario mantiene su estructura original de cinco dimensiones, con sus 30 ítems presentando una saturación factorial superior a 0,40 en cada uno de los cinco factores. La fiabilidad y la consistencia interna son elevadas. Se encontraron diferencias asociadas al sexo, con las mujeres puntuando más alto que los hombres en tres de las cinco dimensiones y en la ansiedad social global. Estos datos indican que el CASO (SAQ) es una medida válida y fiable para su utilización en Brasil.

Evidencias de validez de la versión en español del Inventario de Fobia Social (SPIN) / Evidence of validity of the spanish version of the Social Phobia Inventory (SPIN)

Resumen El objetivo del presente estudio fue analizar en muestras mexicanas las propiedades psicométricas del Inventario de Fobia Social (Social Phobia Inventory, SPIN). Los participantes consistieron en estudiantes universitarios, pacientes diagnosticados con trastorno de ansiedad social y pacientes con trastorno de ansiedad generalizada. El SPIN mostró una alta consistencia interna, una buena confiabilidad test-retest y una adecuada validez convergente y discriminante. Al analizar la estructura interna, el modelo que manifestó mejores indicadores de ajuste fue el de tres factores correlacionados. El análisis de curvas ROC indicó que el SPIN es capaz de discriminar entre los trastornos de ansiedad social y de ansiedad generalizada; un punto de corte de 25 representó el mejor balance entre sensibilidad y especificidad. Se concluye que la versión en español del SPIN demuestra propiedades psicométricas sólidas, por lo que puede ser potencialmente utilizado como instrumento de cribado para detectar el trastorno de ansiedad social en población mexicana.

Abstract The aim of this study was to analyze the psychometric properties of the Social Phobia Inventory (SPIN), in Mexican samples. The participants comprised university students, patients diagnosed with social anxiety and patients with generalized anxiety disorder. The SPIN demonstrated high internal consistency, good test-retest reliability, and adequate convergent and discriminate validity. Different models of the internal structure were tested, result showed better adjustment for the three correlated factor model. Analysis of ROC curves indicated that the SPIN is able to discriminate between social anxiety and generalized anxiety disorders; a cutoff of 25 represented the best balance between sensitivity and specificity. It is possible to conclude that the Spanish version of the SPIN demonstrated solid psychometric properties, and thus it could potentially be used as a screening tool for detecting social anxiety disorder in the Mexican population.

Terapia de exposición con realidad virtual evaluada mediante minería de textos

El artículo presenta un estudio acerca de la aplicación de Minería de Textos en la evaluación de la psicoterapia. Nuestros voluntarios fueron sujetos diagnosticados con fobia social y tratados con terapia de exposición en Realidad Virtual. El cálculo de la polaridad emocional, desde el enfoque del análisis sintáctico, fue aplicado al material narrativo producido por los propios voluntarios. Para su valoración cuantitativa se utilizó el lexicón de sentimientos LIWC (Linguistic Inquiry and Word Count). Los resultados obtenidos muestran una relación proporcional entre el nivel emocional global de los textos y el avance de la práctica psicológica, lo que sugiere su consideración como evidencia para medir la efectividad de la terapia.

This article presents a study about the application of text mining in psychotherapeutic evaluations. Our volunteers are subjects diagnosed with social phobia and treated with virtual reality exposure therapy. Evaluación de psicoterapia Sentiment analysis, through syntactic analysis, was applied over narrative material the volunteers produced themselves; forthe quantitative assessment, we used the sentiment lexicon LIWC (Linguistics Inquiry and Word Count). The results show a proportional relation between the emotional level of the narrative material and the advancement of therapy, which suggests the consideration of text mining as an effectiveness indicator for psychotherapies.

O artigo apresenta um estudo sobre a aplicação do mineração de texto na avaliação da psicoterapia. Nossos voluntários foram pacientes com diagnóstico de fobia social e tratada com terapia de exposição em Realidade Virtual. O cálculo da polaridade emocional, a partir da abordagem de análise, foi aplicada no material narrativa produzida pelos próprios voluntários. Foi utilizada para a avaliação quantitativa o léxico de sentimentos LIWC (Linguistic Inquiry e Word Count). Os resultados mostram uma relação proporcional entre o nível emocional general de textos e o avanço da prática psicológica, sugerindo-sea sua consideração como prova para medir a eficacia da terapia.

Heritability of social anxiety disorder: a systematic review of methodological designs

Abstract Background The investigation of heritability stands out as an important means to establish the weight of genetic and environmental factors in the development of social anxiety disorder. Objective This study aims to make a critical review of methodological designs used in the investigation of the social anxiety disorder (SAD) heritability. Methods We reviewed 31 research articles published until October 2015 and found through the electronic search bases PubMed, Web of Science, and Scopus and manual searches in the reference lists of the selected references. Most of the investigations involved adult samples and twins to assess heritability. Results There was great variability in the screening and diagnostic instruments used in the studies, leading to different outcomes. Structural equation models proved to be the most adequate to assess SAD heritability, allowing better estimates of this aspect of the disorder. SAD heritability rates varied between 13% and 76% in the articles reviewed. Discussion We discuss methodological aspects that may affect the quality and the development of improved studies to investigate SAD heritability such as sample size, quality of screening instruments, and use of diagnostic interviews. More homogeneous investigations involving larger samples and standardized instruments and methods are desirable and opportune.

Social anxiety symptoms in alcohol-dependent outpatients: prevalence, severity and predictors / Sintomas de ansiedade social em alcoolistas em tratamento ambulatorial: prevalência, gravidade e preditores

ABSTRACT Objectives High rates of comorbidity between social anxiety disorder (SAD) and alcohol use disorders have been reported, but the predictors of this comorbidity are poorly known and most studies involve primary SAD samples. The aims were to estimate the prevalence and severity of SAD symptoms among alcohol-dependent patients and to investigate sociodemographic and clinical factors associated with SAD comorbidity, including suicidal behaviors. Methods A cross-sectional study with 53 adults who were in treatment for alcohol dependence at a Brazilian public university outpatient service. Assessment instruments Social Phobia Inventory (SPIN), Short Alcohol Dependence Data and Beck Depression Inventory. Bivariate analyses between the categorical outcome (Probable SAD: SPIN ≥ 19) and explanatory variables were conducted. Correlates of SPIN total and subscales scores (dimensional outcomes) were also investigated. Results The diagnosis and treatment of alcohol dependence occurred, on average, 30 years after the onset of alcohol use and 39.6% of the 53 patients (37 men and 16 women) reported alleviation of social anxiety symptoms with alcohol use. Twenty-four (45.3%) patients presented probable SAD. These patients differed from non-SAD alcohol-dependent individuals by having lower income and higher frequency of depression, suicidal ideation, suicide plans and attempts. The SPIN subscales mostly associated with suicidal behaviors were social inadequacy and social inferiority. Conclusions SAD symptoms are common among help-seeking alcohol-dependent individuals and should be directly investigated and treated, since depression and suicidality are associated with this comorbidity. Prospective studies are needed to assess the impact of SAD treatment on the clinical course of alcohol dependence.

RESUMO Objetivos Altas taxas de comorbidade têm sido descritas entre o transtorno de ansiedade social (TAS) e os transtornos por uso de álcool, mas os preditores dessa comorbidade são pouco conhecidos, e a maioria dos estudos envolve pacientes com diagnóstico primário de TAS. Os objetivos foram estimar a prevalência e a gravidade de sintomas de TAS em pacientes dependentes de álcool e investigar fatores sociodemográficos e clínicos associados à comorbidade com TAS, incluindo risco de suicídio. Métodos Estudo transversal com 53 adultos em tratamento ambulatorial para dependência de álcool num hospital público universitário brasileiro. Instrumentos de avaliação: Social Phobia Inventory (SPIN), Short Alcohol Dependence Data e Beck Depression Inventory. Foram conduzidas análises bivariadas entre o desfecho categorial (provável TAS: SPIN ≥ 19) e as variáveis explanatórias. Correlatos dos escores total e das subescalas da SPIN (desfechos dimensionais) também foram investigados. Resultados O diagnóstico e o tratamento da dependência de álcool ocorreram em média 30 anos após o início do uso de álcool, e 39,6% dos 53 pacientes (37 homens e 16 mulheres) relataram alívio dos sintomas de ansiedade social com o uso de álcool. Vinte e quatro (45,3%) pacientes apresentaram provável TAS. Esses pacientes diferiram dos alcoolistas sem TAS, por terem menor renda, maior frequência de depressão, ideação suicida, planos e tentativas de suicídio. As subescalas da SPIN que mais se associaram com comportamentos suicidas foram inadequação social e inferioridade social. Conclusões Sintomas de TAS são comuns em alcoolistas em tratamento e devem ser diretamente investigados e tratados, já que depressão e suicidalidade associam-se com essa comorbidade. Estudos prospectivos são necessários para investigar o impacto do tratamento do TAS no curso clínico da dependência de álcool.

Community versus clinical cognitive-behavioral intervention in young-adult Spanish population with generalized social phobia / Intervención cognitivo-conductual comunitaria versus intervención clínica en jóvenes adultos españoles con fobia social generalizada

Ei objetivo del estudio es mejorar los resultados informados por las revisiones sobre el tratamiento de adultos con Fobia social generalizada. La muestra la integraron 91 participantes con Fobia social generalizada (EM: 19.90 años; DT: 1.05) asignados aleatoriamente a tres condiciones experimentales, evaluados antes y después del tratamiento, y a los 6, 12, y 24 meses en los grupos tratados. Los resultados muestran (a) la efectividad de la detección en el contexto comunitario versus la intervención clínica, en el corto y medio plazo, y (b) una mejora significativa de los efectos del tratamiento, frente a los de las revisiones de las intervenciones clínicas ad hoc, tanto en los abandonos como en las tasas de recuperación. Ello permite concluir que esta modalidad de aplicación del tratamiento cognitivo-conductual puede ser una estrategia complementaria a la convencional con la que mejorar los resultados actuales de la intervención psicológica en este trastorno.

The study investigates how to improve the results reported by the reviews on the effects of clinical interventions in adults with Generalized social phobia. The sample was composed of 91 participants (median age = 19.90 years, SD = 1.05) randomly assigned to three experimental conditions. The evaluations were conducted before and after treatment in all three groups and at 6-, 12-, and 24-month follow-up for the treatment groups. The results show (a) the effectiveness of the cognitive-behavioral strategy of detection and intervention, in a community context, versus clinical intervention both for the short and medium term; and (b) a significant improvement over the percentages of dropouts and of rates of complete recovery from the disorder. These findings allow us to conclude that the cognitive-behavioral strategy of detection and intervention, in a community context is shown to be a complementary intervention to the conventional and with high efficiency ratios.