Latent structure of social fears and social anxiety disorders.

BACKGROUND: Despite its high prevalence and associated levels of impairment, the latent structure of social anxiety disorder (SAD) is not well understood, with published studies reporting inconsistent results. Furthermore, it is unknown whether the latent structure of social fears in individuals with and without SAD is the same. METHOD: Exploratory factor analysis (EFA) and confirmatory factor analysis followed by multiple indicators multiple causes (MIMIC) analysis were conducted on 13 commonly feared social situations assessed in a nationally representative sample including individuals with SAD and those with social fears but who did not meet DSM-IV criteria for SAD. RESULTS: An EFA conducted in the full sample, including individuals with no social fears (88% of the sample), yielded only one factor. When the sample was restricted to those with at least one social fear, the EFA yielded three factors, in both the subsample with at least one social fear but no SAD and the subsample with SAD. The three factors represented feared situations related to public performance, close scrutiny and social interaction. The MIMIC analyses further indicated that the three-factor structure was able to explain differences in prevalence of social fears across a broad range of sociodemographic covariates. CONCLUSIONS: Among individuals with at least one social fear and those with DSM-IV SAD the latent structure of social fears appears to be best described by three factors, although this may partially depend on how the sample is specified. These results may help reconcile the findings of different numbers of factors identified in previous studies.

Functional network dysfunction in anxiety and anxiety disorders.

A recent paradigm shift in systems neuroscience is the division of the human brain into functional networks. Functional networks are collections of brain regions with strongly correlated activity both at rest and during cognitive tasks, and each network is believed to implement a different aspect of cognition. We propose here that anxiety disorders and high trait anxiety are associated with a particular pattern of functional network dysfunction: increased functioning of the cingulo-opercular and ventral attention networks as well as decreased functioning of the fronto-parietal and default mode networks. This functional network model can be used to differentiate the pathology of anxiety disorders from other psychiatric illnesses such as major depression and provides targets for novel treatment strategies.

Convergent, discriminant, and criterion-related validity of the Social Phobia and Anxiety Inventory.

The psychometric properties of the Social Phobia Anxiety Inventory (SPAI) were assessed in a sample of participants who either had a primary diagnosis of social phobia or were normal volunteers. Positive evidence was obtained on the SPAI's concurrent and predictive convergent validity: it was significantly correlated with other measures of social anxiety obtained from self-report questionnaires of social impairment and with behavioral assessment measures administered in conjunction with a conversation role-play, including measures of negative thinking, subjective anxiety, and self-perceived skill and apparent nervousness. Discriminant validity was demonstrated by the SPAI's significantly stronger relationship with public than private self-consciousness. There was no overlap in SPAI scores in the normal volunteer and socially phobic groups, demonstrating criterion-related validity.