2,373
Views
27
CrossRef citations to date
0
Altmetric
Review

Shyness, social anxiety, social anxiety disorder, and substance use among normative adolescent populations: A systematic review

, M.A.,, , M.A., & , MD
Pages 230-247 | Received 30 Sep 2017, Accepted 12 Oct 2018, Published online: 13 Nov 2018

References

  • Substance abuse and mental health services administration. Results from the 2013 National Survey on Drug Use and Health: Summary of national findings. 2013.
  • Tucker JS, Ellickson PL, Collins RL, Klein DJ. Does solitary substance use increase adolescents’ risk for poor psychosocial and behavioral outcomes? A 9-year longitudinal study comparing solitary and social users. Psychol Addict Behav. 2006;20(4):363–72. doi:10.1037/0893-164X.20.4.363.
  • Jones WH, Briggs SR, Smith TG. Shyness: conceptualization and measurement. J Pers Soc Psychol. 1986;51(3):629–39. doi: 10.1037/0022-3514.51.3.629.
  • Burstein M, Ameli-Grillon L, Merikangas KR. *Shyness versus social phobia in US youth. Pediatrics. 2011;128(5):917–25. doi:10.1542/peds.2011-1434.
  • Schlenker BR, Leary MR. Social anxiety and self-presentation: a conceptualization model. Psychol Bull. 1982;92(3):641–69. doi: 10.1037/0033-2909.92.3.641.
  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th. Arlington, VA: American Psychiatric Publishing; 2013.
  • Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen HU. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012;21(3):169–84. doi:10.1002/mpr.1359.
  • Heiser NA, Turner SM, Beidel DC. Shyness: relationship to social phobia and other psychiatric disorders. Behav Res Ther. 2003;41(2):209–21. doi: 10.1016/S0005-7967(02)00003-7.
  • Chavira DA, Stein MB, Malcarne VL. Scrutinizing the relationship between shyness and social phobia. J Anxiety Disord. 2002;16(6):585–98. doi: 10.1016/S0887-6185(02)00124-X.
  • Weeks M, Ooi LL, Coplan RJ. Cognitive biases and the link between shyness and social anxiety in early adolescence. J Early Adolesc. 2016;36(8):1095–117. doi:10.1177/0272431615593175.
  • Findlay LC, Coplan RJ, Bowker A. Keeping it all inside: shyness, internalizing coping strategies and socio-emotional adjustment in middle childhood. Int J Behav Dev. 2009;33(1):47–54. doi:10.1177/0165025408098017.
  • Vassilopoulos SP, Brouzos A, Moberly NJ, Spyropoulou M. Linking shyness to social anxiety in children through the Clark and Wells cognitive model. Hjp. 2017;14(1):1–19.
  • Poole KL, Van Lieshout RJ, Schmidt LA. Exploring relations between shyness and social anxiety disorder: the role of sociability. Pers Individ Dif. 2017;110:55–59. doi:10.1016/j.paid.2017.01.020.
  • Cox BJ, MacPherson PSR, Enns MW. Psychiatric correlates of childhood shyness in a nationally representative sample. Behav Res Ther. 2005;43(8):1019–27. doi:10.1016/j.brat.2004.07.006.
  • Heiser NA, Turner SM, Beidel DC, Roberson-Nay R. Differentiating social phobia from shyness. J Anxiety Disord. 2009;23(4):469–76. doi:10.1016/j.janxdis.2008.10.002.
  • Brook CA, Willoughby T. Shyness and social anxiety assessed through self-report: what are we measuring?. J Pers Assess. 2017;1–10. doi:10.1080/00223891.2017.1388808.
  • Schneier FR, Foose TE, Hasin DS, Heimberg RG, Liu S-M, Grant BF, Blanco C. Social anxiety disorder and alcohol use disorder co-morbidity in the National Epidemiologic Survey on alcohol and related conditions. Psychol Med. 2010;40(6):977–88. doi:10.1017/S0033291709991231.
  • Carrigan MH, Randall CL. Self-medication in social phobia: a review of the alcohol literature. Addict Behav. 2003;28(2):269–84. doi: 10.1016/S0306-4603(01)00235-0.
  • Morris EP, Stewart SH, Ham LS. The relationship between social anxiety disorder and alcohol use disorders: a critical review. Clin Psychol Rev. 2005;25(6):734–60. doi:10.1016/j.cpr.2005.05.004.
  • Battista SR, Stewart SH, Ham LS. A critical review of laboratory-based studies examining the relationships of social anxiety and alcohol intake. Curr Drug Abuse Rev. 2010;3(1):3–22. doi: 10.2174/1874473711003010003.
  • Blumenthal H, Leen-Feldner EW, Frala JL, Badour CL, Ham LS. *Social anxiety and motives for alcohol use among adolescents. Psychol Addict Behav. 2010;24(3):529–34. doi:10.1037/a0019794.
  • Schmits E, Mathys C, Quertemont E. *Is social anxiety associated with cannabis use? The role of cannabis use effect expectancies in middle adolescence. J Child Adolesc Subst Abuse. 2016;25(4):348–59. doi:10.1080/1067828X.2015.1039683.
  • Bekman NM, Cummins K, Brown SA. *Affective and personality risk and cognitive mediators of initial adolescent alcohol use. J Stud Alcohol Drugs. 2010;71(4):570–80. doi: 10.15288/jsad.2010.71.570.
  • Hoffman BR, Sussman S, Unger JB, Valente TW. Peer influences on adolescent cigarette smoking: a theoretical review of the literature. Subst Use Misuse. 2006;41(1):103–55. doi:10.1080/10826080500368892.
  • Simons-Morton BG, Farhat T. Recent findings on peer group influences on adolescent smoking. J Prim Prev. 2010;31(4):191–208. doi:10.1007/s10935-010-0220-x.
  • Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602. doi:10.1001/archpsyc.62.6.593.
  • Pacek LR, Storr CL, Mojtabai R, Green KM, La Flair LN, Alvanzo AAH, Cullen BA, Crum RM. Comorbid alcohol dependence and anxiety disorders: a national survey. J Dual Diagn. 2013;9(4):271–80. doi:10.1080/15504263.2013.835164.
  • Buckner JD, Heimberg RG, Schneier FR, Liu S-M, Wang S, Blanco C. The relationship between cannabis use disorders and social anxiety disorder in the National Epidemiological Study of Alcohol and Related Conditions (NESARC). Drug Alcohol Depend. 2012;124(1–2):128–34. doi:10.1016/j.drugalcdep.2011.12.023.
  • Henry SL, Jamner LD, Whalen CK. *I (should) need a cigarette: adolescent social anxiety and cigarette smoking. Ann Behav Med. 2012;43(3):383–93. doi:10.1007/s12160-011-9340-7.
  • Wolitzky-Taylor K, Bobova L, Zinbarg RE, Mineka S, Craske MG. Longitudinal investigation of the impact of anxiety and mood disorders in adolescence on subsequent substance use disorder onset and vice versa. Addict Behav. 2012;37(8):982–85. doi:10.1016/j.addbeh.2012.03.026.
  • Dahne J, Banducci AN, Kurdziel G, MacPherson L. *Early adolescent symptoms of social phobia prospectively predict alcohol use. J Stud Alcohol Drugs. 2014;75(6):929–36. doi: 10.15288/jsad.2014.75.929.
  • Doey L, Coplan RJ, Kingsbury M. Bashful boys and coy girls: a review of gender differences in childhood shyness. Sex Roles. 2014;70(7–8):255–66. doi:10.1007/s11199-013-0317-9.
  • Marschall-Lévesque S, Castellanos-Ryan N, Vitaro F, Séguin JR. Moderators of the association between peer and target adolescent substance use. Addict Behav. 2014;39(1):48–70. doi:10.1016/j.addbeh.2013.09.025.
  • Zehe JM, Colder CR, Read JP, Wieczorek WF, Lengua LJ. Social and generalized anxiety symptoms and alcohol and cigarette use in early adolescence: the moderating role of perceived peer norms. Addict Behav. 2013;38(4):1931–39. doi:10.1016/j.addbeh.2012.11.013.
  • Fothergill KE, Ensminger ME. Childhood and adolescent antecedents of drug and alcohol problems: a longitudinal study. Drug Alcohol Depend. 2006;82(1):61–76. doi:10.1016/j.drugalcdep.2005.08.009.
  • Fothergill KE, Ensminger ME, Green KM, Robertson JA, Juon HS. Pathways to adult marijuana and cocaine use: a prospective study of African Americans from age 6 to 42. J Health Soc Behav. 2009;50(1):65–81. doi:10.1177/002214650905000105.
  • Bittner A, Egger HL, Erkanli A, Costello EJ, Foley DL, Angold A. What do childhood anxiety disorders predict?. J Child Psychol Psychiatry. 2007;48(12):1174–83. doi:10.1111/j.1469-7610.2007.01812.x.
  • Allen O, Page RM, Moore L, Hewitt C. *Gender differences in selected psychosocial characteristics of adolescent smokers and nonsmokers. Health Val. 1994;18(2):34–39.
  • Anderson KG, Tomlinson K, Robinson JM, Brown SA. *Friends or foes: social anxiety, peer affiliation, and drinking in middle school. J Stud Alcohol Drugs. 2011;72(1):61–69. doi: 10.15288/jsad.2011.72.61.
  • Block J, Block JH, Keyes S. *Longitudinally foretelling drug usage in adolescence: early childhood personality and environmental precursors. Child Dev. 1988;59(2):336–55. doi: 10.2307/1130314.
  • Blumenthal H, Ham LS, Cloutier RM, Bacon AK, Douglas ME. *Social anxiety, disengagement coping, and alcohol-use behaviors among adolescents. Anxiety Stress Coping. 2016;29(4):432–46. doi:10.1080/10615806.2015.1058366.
  • Botvin GJ, Baker E, Tortu S, Dusenbury L, Gessula J. *Smokeless tobacco use among adolescents: correlates and concurrent predictors. J Dev Behav Pediatr. 1989;10(4):181–86. doi: 10.1097/00004703-198908000-00004.
  • Burstein M, He J-P, Kattan G, Albano AM, Avenevoli S, Merikangas KR. *Social phobia and subtypes in the National Comorbidity Survey–Adolescent Supplement: prevalence, correlates, and comorbidity. J Am Acad Child Adolesc Psychiatry. 2011;50(9):870–80. doi:10.1016/j.jaac.2011.06.005.
  • Bush PJ, Iannotti RJ. *Elementary schoolchildren’s use of alcohol, cigarettes and marijuana and classmates’ attribution of socialization. Drug Alcohol Depend. 1992;30(3):275–87. doi: 10.1016/0376-8716(92)90062-H.
  • Chabrol H, Chauchard E, Goutaudier N, van Leeuwen N. *Exploratory study of the psychopathological profiles of adolescent cannabis users. Addict Behav. 2012;37(10):1109–13. doi:10.1016/j.addbeh.2012.05.005.
  • Cloutier RM, Blumenthal H, Mischel ER. *An examination of social anxiety in marijuana and cigarette use motives among adolescents. Subst Use Misuse. 2016;51(3):408–18. doi:10.3109/10826084.2015.1110174.
  • Conway KP, Swendsen J, Husky MM, He JP, Merikangas KR. *Association of lifetime mental disorders and subsequent alcohol and illicit drug use: results from the national comorbidity survey-adolescent supplement. J Am Acad Child Adolesc Psychiatry. 2016;55(4):280–88. doi:10.1016/j.jaac.2016.01.006.
  • Creemers HE, Dijkstra JK, Vollebergh WAM, Ormel J, Verhulst FC, Huizink AC. *Predicting life-time and regular cannabis use during adolescence; the roles of temperament and peer substance use: the TRAILS study. Addiction. 2010;105(4):699–708. doi:10.1111/j.1360-0443.2009.02819.x.
  • Creemers HE, Korhonen T, Kaprio J, Vollebergh WAM, Ormel J, Verhulst FC, Huizink AC. *The role of temperament in the relationship between early onset of tobacco and cannabis use: the TRAILS study. Drug Alcohol Depend. 2009;104(1–2):113–18. doi:10.1016/j.drugalcdep.2009.04.010.
  • Crisp AH, Stavrakaki C, Halek C, Williams E, Sedgwick P, Kiossis I. *Smoking and pursuit of thinness in schoolgirls in London and Ottawa. Postgrad Med J. 1998;74(874):473–79. doi: 10.1136/pgmj.74.874.473.
  • Di Blasi M, Pavia L, Cavani P, Lo Verso G, Schimmenti A. *Cannabis use and social anxiety in adolescence: the role of facilitation expectancies. J Child Adolesc Subst Abuse. 2015;24(6):397–404. doi:10.1080/1067828X.2013.872066.
  • Fleming JP, Kellam SG, Brown CH. *Early predictors of age at first use of alcohol, marijuana, and cigarettes. Drug Alcohol Depend. 1982;9(4):285–303. doi: 10.1016/0376-8716(82)90068-0.
  • Fröjd S, Ranta K, Kaltiala-Heino R, Marttunen M. *Associations of social phobia and general anxiety with alcohol and drug use in a community sample of adolescents. Alcohol Alcohol. 2011;46(2):192–99. doi:10.1093/alcalc/agq096.
  • Griesler PC, Hu MC, Schaffran C, Kandel D. *Comorbid psychiatric disorders and nicotine dependence in adolescence. Addiction. 2011;106(5):1010–20. doi:10.1111/j.1360-0443.2011.03403.x.
  • Korhonen T, Huizink AC, Dick DM, Pulkkinen L, Rose RJ, Kaprio J. *Role of individual, peer and family factors in the use of cannabis and other illicit drugs: a longitudinal analysis among Finnish adolescent twins. Drug Alcohol Depend. 2008;97(1–2):33–43. doi:10.1016/j.drugalcdep.2008.03.015.
  • Krahn D, Piper D, King M, Olson L, Kurth C, Moberg DP. *Dieting in sixth grade predicts alcohol use in ninth grade. J Subst Abuse. 1996;8(3):293–301. doi: 10.1016/S0899-3289(96)90161-3.
  • Leventhal AM, Strong DR, Sussman S, Kirkpatrick MG, Unger JB, Barrington-Trimis JL, Audrain-McGovern J. *Psychiatric comorbidity in adolescent electronic and conventional cigarette use. J Psychiatr Res. 2016;73:71–78. doi:10.1016/j.jpsychires.2015.11.008.
  • Lewinsohn PM, Zinbarg R, Seeley JR, Lewinsohn M, Sack WH. *Lifetime comorbidity among anxiety disorders and between anxiety disorders and other mental disorders in adolescents. J Anxiety Disord. 1997;11(4):377–94. doi: 10.1016/S0887-6185(97)00017-0.
  • Marmorstein NR, White H, Chung T, Hipwell A, Stouthamer-Loeber M, Loeber R. *Associations between first use of substances and change in internalizing symptoms among girls: differences by symptom trajectory and substance use type. J Clin Child Adolesc Psychol. 2010;39(4):545–58. doi:10.1080/15374416.2010.486325.
  • Marmorstein NR, White HR, Loeber R, Stouthamer-Loeber M. *Anxiety as a predictor of age at first use of substances and progression to substance use problems among boys. J Abnorm Child Psychol. 2010;38(2):211–24. doi:10.1007/s10802-009-9360-y.
  • Moylan S, Gustavson K, Karevold E, Øverland S, Jacka FN, Pasco JA, Berk M, Fontenelle L. *The impact of smoking in adolescence on early adult anxiety symptoms and the relationship between infant vulnerability factors for anxiety and early adult anxiety symptoms: the TOPP study. PloS One. 2013;8(5):1–11. doi:10.1371/journal.pone.0063252.
  • Myers MG, Aarons GA, Tomlinson K, Stein MB. *Social anxiety, negative affectivity, and substance use among high school students. Psychol Addict Behav. 2003;17(4):277–83. doi:10.1037/0893-164X.17.4.277.
  • Nelemans SA, Hale WW, Branje SJT, Raaijmakers QAW, Frijns T, van Lier PAC, Meeus WHJ. *Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study. Dev Psychopathol. 2014;26(1):181–202. doi:10.1017/S0954579413000503.
  • Nelemans SA, Hale WW, Raaijmakers QAW, Branje SJT, Lier PAC, Meeus WHJ. *Longitudinal associations between social anxiety symptoms and cannabis use throughout adolescence: the role of peer involvement. Eur Child Adolesc Psychiatry. 2015;25(5):483–92. doi:10.1007/s00787-015-0747-8.
  • O’Callaghan F, Doyle J. *What is the role of impression management in adolescent cigarette smoking? J Subst Abuse. 2001;13(4):459–70. doi: 10.1016/S0899-3289(01)00089-X.
  • Ohannessian CM. *Anxiety and substance use during adolescence. Subst Abus. 2014;35(4):418–25. doi:10.1080/08897077.2014.953663.
  • Page RM. *Shyness as a risk factor for adolescent substance use. J Sch Health. 1989;59(10):432–35. doi: 10.1111/j.1746-1561.1989.tb04658.x.
  • Page RM. *Shyness and sociability: a dangerous combination for illicit substance use in adolescent males? Adolescence. 1990;25(100):803–06.
  • Pardee CS, Colder CR, Bowker JC. *Dynamic associations among alcohol use and anxiety symptoms in early adolescence. Psychol Addict Behav. 2014;28(4):1246–52. doi:10.1037/a0038372.
  • Piko BF, Varga S, Mellor D. *Are adolescents with high self-esteem protected from psychosomatic symptomatology? Eur J Pediatr. 2016;175(6):785–92. doi:10.1007/s00431-016-2709-7.
  • Sartor CE, Jackson KM, McCutcheon VV, Duncan AE, Grant JD, Werner KB, Bucholz KK. *Progression from first drink, first intoxication, and regular drinking to alcohol use disorder: a comparison of African American and European American youth. Alcohol Clin Exp Res. 2016;40(7):1515–23. doi:10.1111/acer.13113.
  • Schmits E, Mathys C, Quertemont E. *A longitudinal study of cannabis use initiation among high school students: effects of social anxiety, expectancies, peers and alcohol. J Adolesc. 2015;41:43–52. doi:10.1016/j.adolescence.2015.02.009.
  • Tercyak KP, Audrain-McGovern J. *Personality differences associated with smoking experimentation among adolescents with and without comorbid symptoms of ADHD. Subst Use Misuse. 2003;38(14):1953–70. doi: 10.1081/JA-120025121.
  • Tomlinson KL, Brown SA. *Self-medication or social learning? A comparison of models to predict early adolescent drinking. Addict Behav. 2012;37(2):179–86. doi:10.1016/j.addbeh.2011.09.016.
  • Tomlinson KL, Cummins KM, Brown SA. *Social anxiety and onset of drinking in early adolescence. J Child Adolesc Subst Abuse. 2013;22(2):163–77. doi:10.1080/1067828X.2012.747994.
  • Van Zalk N, Kerr M, Tilton‐Weaver L. *Shyness as a moderator of the link between advanced maturity and early adolescent risk behavior. Scand J Psychol. 2011;52(4):341–53. doi:10.1111/j.1467-9450.2011.00877.x.
  • Varga S, Piko BF. *Being lonely or using substances with friends? A cross-sectional study of Hungarian adolescents’ health risk behaviours. BMC Public Health. 2015;15:1–9. doi:10.1186/1471-2458-15-1.
  • Walburg V, Laconi S, Van Leeuwen N, Chabrol H. *Relations entre la consommation de cannabis, le jugement moral et les distorsions cognitives liées à la délinquance [relationships between cannabis use, moral judgement and self-serving cognitive distortions]. Neuropsychiatr Enfance Adolesc. 2014;62(3):163–67. doi:10.1016/j.neurenf.2014.02.001.
  • Walther B, Morgenstern M, Hanewinkel R. *Co-occurrence of addictive behaviours: personality factors related to substance use, gambling and computer gaming. Eur Addict Res. 2012;18(4):167–74. doi:10.1159/000335662.
  • Workman M, Beer J. *Aggression, alcohol dependency, and self-consciousness among high school students of divorced and nondivorced parents. Psychol Rep. 1992;71(1):279–86. doi:10.2466/pr0.1992.71.1.279.
  • Wu P, Goodwin RD, Fuller C, Liu X, Comer JS, P C, Hoven CW. *The relationship between anxiety disorders and substance use among adolescents in the community: specificity and gender differences. J Youth Adolesc. 2010;39(2):177–88. doi:10.1007/s10964-008-9385-5.
  • Voelkel EA, Lee KM, Abrahamson CW, Dempsey AG. Social anxiety and socialization among adolescents. Storch EA, McKay D, editors. Handbook of treating variants and complications in anxiety disorders. New York, NY:Springer Science + Business Media; 2013. p.177–92.
  • Biggs BK, Sampilo ML, McFadden MM. Peer relations and victimization in adolescents with social anxiety disorder. Alfano CA, Beidel DC, editors. Social anxiety in adolescents and young adults: translating developmental science into practice. Washington, DC:American Psychological Association; 2011. p.143–60.
  • Kingery JN, Erdley CA, Marshall KC, Whitaker KG, Reuter TR. Peer experiences of anxious and socially withdrawn youth: an integrative review of the developmental and clinical literature. Clin Child Fam Psychol Rev. 2010;13(1):91–128. doi:10.1007/s10567-009-0063-2.
  • Van Zalk N, Van Zalk M, Kerr M, Stattin H. Social anxiety as a basis for friendship selection and socialization in adolescents’ social networks. J Pers. 2011;79(3):499–525. doi:10.1111/j.1467-6494.2011.00682.x.
  • Ponti L, Tani F. Shyness and psychological adjustment: the moderating role of friendship relationships. Giornale di Psicopatologia. 2015;21(1):30–39.
  • Lemyre A, Poliakova N, Vitaro F, Tremblay RE, Boivin M, Bélanger RE. Does shyness interact with peer group affiliation in predicting substance use in adolescence?. Psychol Addict Behav. 2018;32(1):132–39. doi:10.1037/adb0000328.
  • Kennedy DP, Tucker JS, Pollard MS, Go M-H, Green JHD. Adolescent romantic relationships and change in smoking status. Addict Behav. 2011;36(4):320–26. doi:10.1016/j.addbeh.2010.11.014.
  • Mermelstein RJ, Colvin PJ, Klingemann SD. Dating and changes in adolescent cigarette smoking: does partner smoking behavior matter? Nicotine Tob Res. 2009;11(10):1226–30. doi:10.1093/ntr/ntp127.
  • Aikins JW, Simon VA, Prinstein MJ. Romantic partner selection and socialization of young adolescents’ substance use and behavior problems. J Adolesc. 2010;33(6):813–26. doi:10.1016/j.adolescence.2010.07.007.
  • DeLay D, Laursen B, Bukowski WM, Kerr M, Stattin H. Adolescent friend similarity on alcohol abuse as a function of participation in romantic relationships: sometimes a new love comes between old friends. Dev Psychol. 2016;52(1):117–29. doi:10.1037/a0039882.
  • Kreager DA, Haynie DL. Dangerous liaisons? Dating and drinking diffusion in adolescent peer networks. Am Sociol Rev. 2011;76(5):737–63. doi:10.1177/0003122411416934.
  • van der Zwaluw CS, Scholte RHJ, Vermulst AA, Buitelaar J, Verkes RJ, Engels RCME. The crown of love: intimate relations and alcohol use in adolescence. Eur Child Adolesc Psychiatry. 2009;18(7):407–17. doi:10.1007/s00787-009-0748-6.
  • De Jong P, Sportel B, De Hullu E, Nauta M. Co-occurrence of social anxiety and depression symptoms in adolescence: differential links with implicit and explicit self-esteem?. Psychol Med. 2012;42(3):475–84. doi:10.1017/S0033291711001358.
  • Väänänen J-M, Isomaa R, Kaltiala-Heino R, Fröjd S, Helminen M, Marttunen M. Decrease in self-esteem mediates the association between symptoms of social phobia and depression in middle adolescence in a sex-specific manner: a 2-year follow-up of a prospective population cohort study. BMC Psychiatry. 2014;14(79):1–8. doi:10.1186/1471-244X-14-79.
  • Halldorsson B, Creswell C. Social anxiety in pre-adolescent children: what do we know about maintenance? Behav Res Ther. 2017;99:19–36. doi:10.1016/j.brat.2017.08.013.
  • Spence SH, Rapee RM. The etiology of social anxiety disorder: an evidence-based model. Behav Res Ther. 2016;86:50–67. doi:10.1016/j.brat.2016.06.007.
  • Hodson KJ, McManus FV, Clark DM, Doll HCC. Wells’(1995) cognitive model of social phobia be applied to young people?. Behav Cogn Psychother. 2008;36(4):449–61. doi:10.1017/S1352465808004487.
  • Kley H, Tuschen-Caffier B, Heinrichs N. Safety behaviors, self-focused attention and negative thinking in children with social anxiety disorder, socially anxious and non-anxious children. J Behav Ther Exp Psychiatry. 2012;43(1):548–55. doi:10.1016/j.jbtep.2011.07.008.
  • Schreiber F, Höfling V, Stangier U, Bohn C, Steil R. A cognitive model of social phobia: applicability in a large adolescent sample. Int J Cogn Ther. 2012;5(3):341–58. doi:10.1521/ijct.2012.5.3.341.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.