Social anxiety symptoms among youth with chronic health conditions: trajectories and related factors

Abstract

Purpose: This study explored three-year trajectories of social anxiety symptoms among youth with chronic health conditions and investigated factors influencing those trajectories.

Methods: Participants (N = 439) were recruited from eight pediatric rehabilitation centers. The Social Anxiety Scale for Children-Revised measured social anxiety across four time points. Latent Class Growth Analysis was used to study trajectories and logistic regression to identify related factors.

Results: A three-class solution was supported: a “high anxiety and stable” group (17.1%), a “moderate anxiety and stable” group (44.4%), and a “low anxiety and stable” group (38.5%). Youth in the “moderate and stable” group were less likely to be male compared to the “low and stable” group. Youth in the “high and stable” group were more likely to have greater cognitive symptoms and less likely to have higher levels of social participation compared to the “low and stable” group. Youth in both the “high and stable” and “moderate and stable” groups were less likely to have high support from classmates or close friends compared to the “low and stable” group. Moreover, both the “high and stable” and “moderate and stable” groups were less likely to have positive family functioning.

Conclusion: Youth with chronic conditions belonging to “high and stable” and “moderate and stable” social anxiety trajectories can be distinguished from those in a “low and stable” trajectory using personal, functional, and environmental level variables.

Implications for Rehabilitation

• Youth with chronic health conditions are at risk of developing and maintaining moderate to high levels of social anxiety symptoms as they move through adolescence.

• Compared to youth with “low and stable” social anxiety, those with “moderate and stable” social anxiety are less likely to be male, have high peer support or high family functioning.

• Compared to youth with “low and stable” social anxiety, those with “high and stable” social anxiety are more likely to have greater cognitive symptoms, and less likely to have high social participation, high peer support, or high family functioning.

• Rehabilitation and other professionals should not only consider factors that are functional in nature; they should also consider personal and environmental level factors when supporting youth with chronic health conditions who experience social anxiety symptoms.

Keywords:

• Social anxiety
• youth
• chronic conditions
• latent class growth analysis
• trajectories
• biopsychosocial

Acknowledgements

The authors thank the youth, families, and the staff at the various rehabilitation centers who participated in this work.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This study was supported by a research grant [MOP-100985–1] from the Canadian Institutes of Health Research.