The natural course of social anxiety disorder among adolescents and young adults
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Beesdo‐Baum K, Knappe S, Fehm L, Höfler M, Lieb R, Hofmann SG, Wittchen H‐U. The natural course of social anxiety disorder among adolescents and young adults. Objective: To examine the natural course of social anxiety disorder (SAD) in the community and to explore predictors for adverse long‐term outcomes. Method: A community sample of N = 3021 subjects aged 14–24 was followed‐up over 10 years using the DSM‐IV/M‐CIDI. Persistence of SAD is based on a composite score reflecting the proportion of years affected since onset. Diagnostic stability is the proportion of SAD subjects still affected at follow‐up. Results: SAD reveals considerable persistence with more than half of the years observed since onset spent with symptoms. 56.7% of SAD cases revealed stability with at least symptomatic expressions at follow‐up; 15.5% met SAD threshold criteria again. 15.1% were completely remitted (no SAD symptoms and no other mental disorders during follow‐up). Several clinical features (early onset, generalized subtype, more anxiety cognitions, severe avoidance and impairment, co‐occurring panic) and vulnerability characteristics (parental SAD and depression, behavioural inhibition, harm avoidance) predicted higher SAD persistence and – less impressively – diagnostic stability. Conclusion: A persistent course with a considerable degree of fluctuations in symptom severity is characteristic for SAD. Both consistently meeting full threshold diagnostic criteria and complete remissions are rare. Vulnerability and clinical severity indicators predict poor prognosis and might be helpful markers for intervention needs.
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SAD tends to have a chronic and unremitting course.
“and tend to have a chronic and unremitting course (Beesdo-Baum et al., 2012; Steinert et al., 2013)”
From Psychological inflexibility explains social anxiety over time: a mediation analyses with a clinical adolescent sample (2024) · cites this paper as Beesdo-Baum et al., 2012
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- Authors
- Beesdo‐Baum, K., Knappe, S., Fehm, L., Höfler, M., Lieb, R., Hofmann, S. G., & Wittchen, H. ‐.
- Affiliations
- Technische Universität Dresden (DE)
- Humboldt-Universität zu Berlin (DE)
- University of Basel (CH)
- Boston University (US)
- Corresponding author
- Beesdo‐Baum, K.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2012-05-26
- Volume
- 126
- Issue
- 6
- Pages
- 411-425
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W1602079716
- Cited by
- 167
- References
- 69
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 14 · 2023: 20 · 2022: 14 · 2021: 15 · 2020: 16 · 2019: 15 · 2018: 11 · 2017: 11 · 2016: 13 · 2015: 6 · 2014: 9 · 2013: 5 · 2012: 1
- FWCI
- 9.00
- Type
- journal article
- Language
- en
- Open access
- green
- tud.qucosa.de
- Licence
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Max Planck Institute for Plasma Physics (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- 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, natural course, adolescents, young adults, symptom persistence, diagnostic stability, remission, early onset, generalized social anxiety, avoidance, impairment, parental depression, behavioral inhibition, harm avoidance, vulnerability factors, prognosis
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Phobic Disorders, Registries, Severity of Illness Index, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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