Social phobia in a population-based female adolescent twin sample: co-morbidity and associated suicide-related symptoms
Abstract
Background This report attempted to replicate and extend prior work examining social phobia (SP), co-morbid psychiatric illnesses, and the risk of suicidal ideation and suicide attempts incurred by their adolescent sufferers. Methods SP, alcohol dependence (ALD) and major depressive disorder (MDD) diagnoses, and suicide-related symptoms, were assessed in a population-based adolescent female twin sample. The differentiation of risks as a function of co-morbidity was explored. A trivariate model was fitted to estimate sharing of genetic and environmental vulnerability between SP and co-morbid disorders. Results The lifetime prevalence of SP was 16.3 %. Significant risk for co-morbid MDD (OR = 3.2) and ALD (OR = 2.1) was observed. Strong evidence for shared genetic vulnerability between SP and MDD (respective heritabilities 28%, 45%; genetic r = 1.0) was observed with moderate support noted for similar sharing between SP and ALD (genetic r = 0.52, heritability for ALD 63%). SP with co-morbid MDD was associated with elevated risk for ALD and for suicide-related symptoms. Conclusions SP is a common illness often followed by co-morbid MDD and ALD. SP with comorbid MDD predicts a substantially elevated risk of ALD and suicide-related symptoms, stressing the need for early SP detection.
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Depression-SAD comorbidity results in greater severity of symptoms, poorer functioning, and a greater presence of comorbid substance use disorders compared with depression without SAD.
“Depression-SAD comorbidity results in greater severity of symptoms, poorer functioning, and a greater presence of comorbid substance use disorders compared with depression without SAD (Dalrymple & Zimmerman, 2007; Nelson et al., 2000; Stein et al., 2001).”
From An Integrated, Acceptance-Based Behavioral Approach for Depression With Social Anxiety: Preliminary Results (2014) · cites this paper as Nelson et al., 2000
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“The Present Study Prior research suggests that socially anxious adolescents are at increased risk for suicidal thoughts and behaviors (Nelson et al. 2000; Valentiner et al. 2002).”
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Perceived burdensomeness uniquely accounts for suicidal ideation severity in social anxiety disorder
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“Evidence indicates that depression and SAD share features that may make this comorbidity pattern unique from depression comorbid with other anxiety disorders (e.g., lower reward sensitivity, avoidance behaviors, excessive reassurance-seeking; Brown, Chorpita, & Barlow, 1998; Kashdan, 2004; Nelson et al., 2000), sugges…”
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- Authors
- NELSON, E. C., GRANT, J. D., BUCHOLZ, K. K., GLOWINSKI, A., MADDEN, P. A. F., REICH, W., & HEATH, A. C.
- Affiliations
- Washington University in St. Louis (US)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2000-07
- Volume
- 30
- Issue
- 4
- Pages
- 797-804
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2164544749
- Cited by
- 146
- References
- 4
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 1 · 2020: 2 · 2019: 8 · 2018: 11 · 2017: 6 · 2016: 8 · 2015: 4 · 2014: 10 · 2013: 3 · 2012: 8
- FWCI
- 8.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (AA11998, R01AA009022, AA 09022, AA-07728)
- 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 › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- social anxiety disorder, adolescent girls, comorbidities, major depressive disorder, alcoholism, suicidal ideation, suicide attempts, heritability, twin studies, lifetime prevalence
- MeSH terms
- Adolescent, Adult, Alcoholism, Depressive Disorder, Major, Major Depressive Disorder, Factor Analysis, Statistical, Female, Humans, Missouri, Models, Genetic, Phobic Disorders, Population Surveillance, Psychiatric Status Rating Scales, Risk, Suicide, Comorbidity, Prevalence, Genetic Predisposition to Disease
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