Childhood maltreatment linked to greater symptom severity and poorer quality of life and function in social anxiety disorder
Open accessAbstract
BACKGROUND: There is a paucity of data examining the prevalence and impact of childhood maltreatment in patients presenting with a primary diagnosis of social anxiety disorder (SAD). We thus examined the presence of a broad spectrum of childhood maltreatment, including physical, sexual, and emotional abuse and neglect, in treatment-seeking individuals with the generalized subtype of SAD (GSAD). We hypothesized that a history of childhood maltreatment would be associated with greater SAD symptom severity and poorer associated function. METHODS: One hundred and three participants with a primary diagnosis of GSAD (mean age 37+/-14; 70% male) completed the well-validated, self-rated Childhood Trauma Questionnaire (CTQ), as well as measures of SAD symptom severity and quality of life. RESULTS: Fully 70% (n=72) of the GSAD sample met severity criteria for at least one type of childhood abuse or neglect as measured by the CTQ subscales using previously established thresholds. CTQ total score adjusted for age and gender was associated with greater SAD severity, and poorer quality of life, function, and resilience. Further, the number of types of maltreatment present had an additive effect, with specific associations for emotional abuse and neglect with SAD severity. CONCLUSIONS: Despite the use of validated assessments, our findings are limited by the retrospective and subjective nature of self-report measures used to assess childhood maltreatment. Nonetheless, these data suggest a high rate of childhood maltreatment in individuals seeking treatment for GSAD, and the association of maltreatment with greater disorder severity suggests that screening is clinically prudent.
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Parenting styles associated with overcontrol or overprotection, exposure to adverse social experiences with peers, such as bullying, social ostracism, or peer victimization, early relational traumatic experiences, and strong societal expectations to adhere to strict cultural norms contribute to the development of social anxiety and may also play a maintaining role.
“For instance, parenting styles associated with overcontrol or overprotection (152–154), exposure to adverse social experiences with peers, such as bullying, social ostracism, or peer victimization (152, 155, 156), early relational traumatic experiences (154, 157, 158) and strong societal expectations to adhere to strict cultural norms (159) contribute to the development of social anxiety and may”
From MDMA-Assisted Therapy as a Means to Alter Affective, Cognitive, Behavioral, and Neurological Systems Underlying Social Dysfunction in Social Anxiety Disorder (2021) · cites this paper as [158]
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Experimental — accuracy not yet measuredA history of childhood maltreatment exerts enduring and broad effects on mental health, including social functioning.
“Childhood maltreatment has long-lasting and pervasive impact on individuals’ psychological health (Teicher and Samson 2013), including social functioning (Simon et al. 2009).”
From Nonattachment Predicts Empathy, Rejection Sensitivity, and Symptom Reduction After a Mindfulness-Based Intervention Among Young Adults with a History of Childhood Maltreatment (2020) · cites this paper as Simon et al. 2009
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“For instance, parenting styles associated with overcontrol or overprotection (152–154), exposure to adverse social experiences with peers, such as bullying, social ostracism, or peer victimization (152, 155, 156), early relational traumatic experiences (154, 157, 158) and strong societal expectations to adhere to stri…”
Background
- Authors
- Simon, N. M., Herlands, N. N., Marks, E. H., Mancini, C., Letamendi, A., Li, Z., Pollack, M. H., Van Ameringen, M., & Stein, M. B.
- Affiliations
- Massachusetts General Hospital (US)
- McMaster University Medical Centre (CA)
- University of California San Diego (US)
- Corresponding author
- Simon, Naomi M.
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2009-11
- Volume
- 26
- Issue
- 11
- Pages
- 1027-1032
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- PMC
- PMC2991116
- OpenAlex
- W2032525748
- Cited by
- 175
- References
- 31
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 7 · 2023: 14 · 2022: 12 · 2021: 15 · 2020: 13 · 2019: 12 · 2018: 11 · 2017: 12 · 2016: 7 · 2015: 13 · 2014: 12 · 2013: 16 · 2012: 9
- FWCI
- 6.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH070919)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- child abuse, social anxiety disorder, generalized social anxiety disorder, emotional abuse, emotional neglect, physical abuse, sexual abuse, symptom severity, quality of life, functional disability, resilience, Childhood Trauma Questionnaire
- MeSH terms
- Adolescent, Adult, Child, Child Abuse, Child Abuse, Sexual, Cross-Sectional Studies, Female, Humans, Male, Mass Screening, Massachusetts, Middle Aged, Patient Acceptance of Health Care, Personality Assessment, Phobic Disorders, Psychometrics, Quality of Life, Surveys and Questionnaires, Referral and Consultation, Retrospective Studies, Sex Factors, Statistics as Topic, Comorbidity, Resilience, Psychological, Young Adult
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