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Cited by 225Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and Access

Social phobia and subtypes in the national comorbidity survey-adolescent supplement: prevalence, correlates, and comorbidity

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Burstein, Marcy, He, Jian-Ping, Kattan, Gabriela, Albano, Anne Marie, Avenevoli, Shelli, Merikangas, Kathleen R.·2011·Journal of the American Academy of Child & Adolescent Psychiatry
DOI 10.1016/j.jaac.2011.06.005PMC PMC3164536
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Abstract

Objective Social phobia typically develops during the adolescent years, yet no nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation were to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and comorbidity of social phobia in a large, nationally representative sample of U.S. adolescents; and (2) examine differences in the rates and features of social phobia across the proposed DSM-5 social phobia subtypes.Method The National Comorbidity Survey Replication-Adolescent Supplement is a nationally representative face-to-face survey of 10,123 adolescents 13 to 18 years of age in the continental United States.Results Approximately 9% of adolescents met criteria for any social phobia in their lifetime. Of these adolescents, 55.8% were affected with the generalized subtype and 44.2% exhibited nongeneralized social phobia. Only 0.7% met criteria for the proposed DSM-5 performance-only subtype. Generalized social phobia was more common among female adolescents and risk for this subtype increased with age. Adolescents with generalized social phobia also had a younger age of onset, higher levels of disability and clinical severity, and a greater degree of comorbidity relative to adolescents with nongeneralized forms of the disorder.Conclusions This study indicates that social phobia is a highly prevalent, persistent, and impairing psychiatric disorder among adolescent youth. Results of this study also provide evidence for the clinical utility of the generalized subtype and highlight the importance of considering the heterogeneity of social phobia in this age group.

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  • Performance-only SAD has a lifetime prevalence of approximately 0.3% to 0.7% in the general population.

    “performance-only SAD has been reported in about 0.3–0.7%”

    From Epidemiology, genetics, neuroimaging, clinical features, and treatment between overall and performance-only social anxiety disorder: a narrative review (2026) · cites this paper as Burstein et al. 2011

    The Results (Prevalence and Correlates; page not provided) report a lifetime prevalence of approximately 0.7% for the performance-only subtype in adolescents. The study sampled U.S. adolescents aged 13–18, not the general population, and our copy does not report the claimed 0.3% lower bound. (LLM, conf=0.88)

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  • Overall SAD affects approximately 5% to 13% of the general population.

    “Overall SAD affects 5–13% of the population”

    From Epidemiology, genetics, neuroimaging, clinical features, and treatment between overall and performance-only social anxiety disorder: a narrative review (2026) · cites this paper as Burstein et al. 2011

    The Results (Prevalence and Correlates) report 8.6% lifetime prevalence of social phobia among adolescents, and the Discussion cites a 12.1% rate among U.S. adults. These figures fall within 5–13%, but the paper does not give that range for the general population; its own survey covers adolescents. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Performance-only SAD accounts for less than 25% of overall SAD cases.

    “accounting for less than 25% of overall SAD cases”

    From Epidemiology, genetics, neuroimaging, clinical features, and treatment between overall and performance-only social anxiety disorder: a narrative review (2026) · cites this paper as Burstein et al. 2011

    The Results > Prevalence and Correlates passage reports that the performance-only subtype represented 0.8% of adolescents with social phobia, which is less than 25%. The study concerns adolescents, however, so it does not establish that proportion for SAD cases across all ages. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • SAD has been linked to increased vulnerability to other anxiety and mood disorders, behavioral disorders, and substance abuse.

    “Furthermore, SAD has been linked to increased vulnerability to other anxiety and mood disorders [13,14], behavioral disorders [14], and substance abuse [13,15].”

    From The Prevalence of Adolescent Social Fears and Social Anxiety Disorder in School Contexts (2022) · cites this paper as [15]

    The Results (Psychiatric Comorbidity; page unavailable) link adolescent social phobia with other anxiety disorders, oppositional defiant disorder, and drug use disorders. But these are comorbidity findings, not evidence that social phobia increases future vulnerability. The Discussion (page unavailable) also says associations with mood and alcohol use disorders were not significant after adjustment. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • The point-estimated prevalence of SAD in Portuguese adolescents (9.4%) is slightly higher than data from previous studies that considered similar age groups and much higher than a previous work using a Portuguese adolescent sample.

    “This value is slightly higher than data from previous studies that considered similar age groups (e.g., [15,37,38]) and it is much higher than a previous work using a Portuguese adolescent sample [27].”

    From The Prevalence of Adolescent Social Fears and Social Anxiety Disorder in School Contexts (2022) · cites this paper as [15]

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2 of the 48 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [46]Hofmann SG Albano AM Heimberg RG Tracey S Chorpita BF Barlow DH Subtypes of social phobia in adolescents Depress Anxiety 1999 9 1 15 18 9989345

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Authors
Burstein, M., He, J.-P., Kattan, G., Albano, A. M., Avenevoli, S., & Merikangas, K. R.
Affiliations
  • National Institute of Mental Health (US)
  • Columbia University Irving Medical Center (US)
Corresponding author
Merikangas, Kathleen R.
ORCID
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2011-09
Volume
50
Issue
9
Pages
870-880
ISSN
0890-8567 (ISSN-L)
DOI
10.1016/j.jaac.2011.06.005
PMC
PMC3164536
OpenAlex
W2135930722
Cited by
225
References
48
Citations by year
2026: 10 · 2025: 24 · 2024: 12 · 2023: 15 · 2022: 22 · 2021: 26 · 2020: 15 · 2019: 15 · 2018: 18 · 2017: 14 · 2016: 12 · 2015: 13 · 2014: 14 · 2013: 9 · 2012: 4
FWCI
11.94
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (Z99 MH999999)
  • National Institute of Mental Health (Z01MH002808, U01-MH-60220, ZIAMH002808, U01MH060220)
  • National Institute on Drug Abuse (R01DA016558)
Topics
  • 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
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
social anxiety disorder, adolescents, generalized social phobia, lifetime prevalence, comorbidities, age of onset, disability, clinical severity, sex differences, DSM-5
MeSH terms
Adolescent, Adult, Anxiety Disorders, Demography, Female, Health Surveys, Humans, Interview, Psychological, Male, Phobic Disorders, Surveys and Questionnaires, Socioeconomic Factors, United States, Comorbidity, Prevalence

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