Cecilia A. Essau

Frequency and comorbidity of social phobia and social fears in adolescents

This report presents findings on the frequency, comorbidity and psychosocial impairment of social phobia and social fears among 1035 adolescents, aged 12-17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Social phobia and other psychiatric disorders were coded based on DSM-IV criteria using the computerized Munich version of the Composite International Diagnostic Interview. Seventeen (1.6%) of the adolescents met the DSM-IV criteria for social phobia sometimes in their life. More girls than boys received the diagnosis of social phobia and the frequency of the disorder increased with age. The lifetime frequency of social fears were much higher than that of social phobia. The most common types of feared social situations were fear of doing something in front of other people, followed by public speaking. Social phobia comorbid highly with depressive disorders, somatoform disorders and substance use disorders. Despite the high level of psychosocial impairment experienced by cases with social phobia and those with any social fears, only a small portion of them did receive professional help.

Häufigkeit der Posttraumatischen Belastungsstörung bei Jugendlichen: Ergebnisse der Bremer Jugendstudie

The frequency and comorbidity of posttraumatic stress disorders (PTSD) were assessed together with the resultant psychosocial impairment in 1035 adolescents between the ages of 12 and 17 years. Posttraumatic stress disorder and other psychiatric disorders were coded on the basis of the DSM-IV criteria using the computerized personal interview of the Munich version of the Composite International Diagnostic Interview (CIDI). A total of 17 (1.6%) adolescents met the DSM-IV criteria for PTSD at some point in their life. Slightly more girls than boys met the criteria for the disorder, whose frequency increased with age. The lifetime prevalence of traumatic events is much higher still: 233 (22.5%) adolescents reported one or more traumatic events in their life. The types of traumatic events experienced by the greatest number of adolescents were: physical attack, injury, and serious accident. Boys experienced significantly more traumatic events than did girls. The occurrence of a traumatic event was mostly associated with hypervigilance and recurrent and intrusive psychological distress upon exposure to cues which symbolized the event itself or resembled an aspect thereof. PTSD occurred in highly frequent comorbidity with depressive disorders, somatoform disorders, and substance abuse. Over 90% of those with posttraumatic stress disorder were severely impaired in their daily life and activities. Despite the high-grade psychosocial impairment, only a small number sought professional help.

Frequency of panic attacks and panic disorder in adolescents.

By using data from the Bremer Adolescent Study, this report presents findings on the frequency, comorbidity, and psychosocial impairment of panic disorder and panic attacks among 1,035 adolescents. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Panic disorder and other psychiatric disorders were coded based on DSM-IV criteria using the computerized-assisted personal interview of the Munich version of the Composite International Diagnostic Interview. Panic disorder occurred rather rare, with only 0.5% of all the adolescents met the DSM-IV criteria for this disorder sometimes in their live. Panic attack occurred more frequently, with 18% of the adolescents reported having had at least one panic attack. Slightly more girls than boys had panic attack and panic disorder. The occurrence of panic attack and panic disorder were the greatest among the 14–15 year olds. The experience of having a panic attack was associated with a number of problems, the most frequent being avoiding the situation for fear of having another attack. Four most common symptoms associated with a panic attack were that of palpitations, trembling/shaking, nausea or abdominal distress, and chills or hot flushes. Panic disorder comorbid highly with other psychiatric disorders covered in our study, especially with that of major depression. Among those with a panic disorder, about 40% of them were severely impaired during the worst episode of their illness. Only one out of five adolescents with panic disorder sought professional help for emotional and psychiatric problems. The implication of our findings for research and clinical practice are discussed. Depression and Anxiety 9:19–26, 1999.

Adolescent control beliefs : cross-cultural variations of primary and secondary orientations

This article reports of two studies addressing the meaning of primary and secondary control beliefs for transition to modernity and modern adolescents. Study 1 participants (N = 365) were Malaysian (transition to modernity), and German and North American (modern) adolescents. Study 2 participants (N = 757) were Israeli Druze (transition to modernity) and Israeli Jewish (modern) adolescents. The control beliefs scales employed in the two studies drew from the primary-secondary control beliefs conceptualisation (Rothbaum, Weisz, & Snyder, 1982), shared a similar Likert-type item structure, but differed in operationalisation. Analyses tested two hypotheses: (1) the value mediation hypothesis postulated that transition to modernity adolescents will score higher on secondary control beliefs and modern adolescents will score higher on primary control beliefs; (2) the double transition hypothesis postulated that transition to modernity adolescents will score higher on both primary and secondary control beliefs. Results supported these hypotheses only partly. However, they did show clearly that transition to modernity adolescents endorsed secondary control beliefs more strongly than did modem adolescents. The discussion focuses on possible explanations of inconsistent results. It also suggests that future research should address two issues brought to light: the adaptive value of primary and secondary control beliefs; and the explanatory value of different control types. Both should be studied in historical, developmental, and cultural contexts.

Klassifikation, Epidemiologie und diagnostisches Vorgehen

Die am haufigsten eingesetzten Klassifikationssysteme fur Angst- und andere psychische Storungen sind das „diagnostische und statistische Manual psychischer Storungen“ (DSM; American Psychiatric Association, 1994) und die „internationale Klassifikation psychischer Storungen“ (ICD) (Tabelle 5.1) (WHO, 1993). Ihre operationalisierten diagnostischen Kriterien stellen einen wichtigen Fortschritt bei der Entwicklung des gegenwartigen Konzepts von Angststorungen bei Kindern dar. Im Gegensatz zu fruheren Versionen beider Klassifikationssysteme stimmen die derzeitigen Fassungen in grosen Teilen uberein und unterscheiden sich nur in einigen Punkten. Hauptunterschiede zwischen dem DSM-IV und der ICD-10 bestehen darin, dass in der ICD-10 die Angststorungen in 1. phobisehe Angststorungen (F40) und 2. andere Angststorungen (F41) unterteilt sind, die die Panikstorung und die generalisierte Angststorung umfassen.