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This study compared adolescent child molesters (n = 31) with nonsex offending delinquents (n = 34) and normal adolescents (n = 71) on standardized measures of social competence and psychological adjustment. The measures included the Adolescent Assertiveness Scale, the Survey of Heterosocial Interactions, the Self-Consciousness Scale, the Social Anxiety and Distress Scale, the Revised UCLA Loneliness Scale, the Coopersmith Self-Esteem Inventory, the Beck Depression Inventory, the Norwicki-Strickland Locus of Control Scale, and the Jesness Inventory. Results were consistent with predictions. Molesters showed significantly more global maladjustment than normals and were more socially anxious and threatened by heterosocial interactions than nonsex offending delinquents. A discriminant function analysis suggested that molesters, more than delinquents, were likely to perceive themselves as socially inadequate and to be externally oriented in their attributional style. Results support the hypothesis that social skill deficits and social isolation are risk factors that may predispose some adolescents to commit sexual crimes against children.
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PMID:Psychosocial adjustment in adolescent child molesters. 228 86

38 gifted students from north central school districts were administered the Coopersmith Self-esteem Inventory--Short Form, the Self-consciousness Scale, and the Children's Depression Inventory. The gifted students' mean score on depression was below the cut-off and so did not indicate depression while their mean score on self-esteem was within average range. The Pearson correlation for self-esteem and lie scores was significant and positive, indicating, if the lie scores are high, the self-esteem scores tend to be high. The General Self-consciousness mean was low; students spend time examining their own behavior and thought. The Private Self-consciousness mean was low and suggests, however, these students tend to avoid thinking about themselves and are not so overly concerned with self-examination that this interferes with everyday function. On Public Self-consciousness a borderline low mean score allows the inference that these students display little concern about how others will react to them in social settings, how they appear to others, that is, they show some insensitivity associated with high self-confidence. The mean on Social Anxiety was within the normal limits.
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PMID:Self-consciousness, self-esteem and depression of gifted school children. 237 16

Seventy-seven patients with a primary diagnosis of social phobia (DSM-III-R) were randomized to treatment with the reversible and selective monoamine oxidase type A inhibitor brofaromine (n = 37) or placebo (n = 40) for 12 weeks in a double-blind trial. A fixed dose of 150 mg/day or a matching placebo was given after a 2-week dose titration phase. Patients with additional diagnoses of simple phobia, generalized anxiety disorder, dysthymia or major depressive disorder currently in remission were accepted. Patients with other Axis I mental disorders were excluded. In the brofaromine group, 78% of the patients scored much or very much improved on the Clinical Global Impression scale compared with 23% in the placebo group. The anxiety and avoidance scores on the Liebowitz Social Anxiety Scale (LSAS) were significantly reduced in favor of brofaromine. The clinical effects were not significantly correlated with the plasma concentration of brofaromine. After 12 weeks the brofaromine group scored significantly lower than the placebo group on a core depression part of the Montgomery-Asberg Depression Rating Scale. After 12 weeks of treatment the brofaromine group had significantly higher total scores on the LSAS than an age- and gender-matched group of healthy controls. The brofaromine group improved further during 9-month follow-up treatment period, whereas 60% of the placebo responders who continued long-term treatment relapsed. The most common side effects in the brofaromine group were sleep disturbances, dry mouth and nausea.
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PMID:Social phobia: the clinical efficacy and tolerability of the monoamine oxidase -A and serotonin uptake inhibitor brofaromine. A double-blind placebo-controlled study. 861 39

In this open, prospective, structured, naturalistic study of the efficacy of long-term treatment in social phobia 93 consecutive outpatients suffering from severe generalized or circumscribed social phobia (median Liebowitz Social Anxiety Scale score 83) and a high degree of concomitant psychiatric disease were administered treatment with moclobemide (712 +/- 75 mg/day at steady state). Fifty-nine patients who responded (Clinical Global Impression for Change: very much/much improved) completed 2 years of treatment. Patients then entered a drug-free period of at least 1 month during which 88% of the patients deteriorated. In a further 2-year treatment period with moclobemide those patients who had deteriorated became responders again. Symptoms recurred in a substantial number of the patients at the end of the study when the dose was reduced and then discontinued. Post-study follow up at 6-24 months after study completion found that 63.2% of patients were almost asymptomatic or had only mild symptoms, 15.8% were off all treatment, 28.1% were back on moclobemide, 10.6% were taking another psychotropic drug and 8.8% were in psychotherapy. All previous non-responders to moclobemide and mostly alcohol abusers (36.9%), had moderate or severe social phobia and were off all treatment (13.3%), on psychotherapy (15.9%) or on another psychotropic drug (8.8%). Discriminant analysis correctly predicted outcome in 93.5% of all patients. Alcohol abuse was by far the strongest predictor of negative outcome. Coexisting generalized anxiety disorder and dysthymia were less potent in this regard, whereas high baseline Hamilton anxiety or depression scale scores, circumscribed social phobia, or social phobia unassociated with avoidant personality disorder were predictors of a positive outcome. In conclusion, severe social phobia can be successfully treated in the long-term but many patients may need medication or psychotherapy for many years. Treatment should start as early as possible because complications such as alcohol abuse make treatment difficult.
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PMID:Social phobia: long-term treatment outcome and prediction of response--a moclobemide study. 946 58

The study aimed to evaluate the clinical response to venlafaxine in social phobia in 12 patients who were non-responders to selective serotonin reuptake inhibitors, and to assess how the response could be influenced by the comorbidity in Axis II with avoidant personality disorder (APD). The duration of the study was of 15 weeks using open flexible doses regimen in individuals with or without concomitant APD. The venlafaxine dose ranged from 112.5 mg/day to 187.5 mg/day. Venlafaxine improves social phobia and/or APD symptomatology, as demonstrated by decreasing Liebowitz Social Anxiety Scale total scores (P < 0.05). In fact, venlafaxine significantly reduced the avoidant behaviour and specific sociophobic aspects, while notably improving the depression dimension and the basic anxiety symptoms. With regard to tolerability, the profile of venlafaxine was satisfactory with the main side-effects being nausea, headache and anxiety.
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PMID:Venlafaxine in social phobia: a study in selective serotonin reuptake inhibitor non-responders. 1046 17

The Liebowitz's Social Anxiety Scale (LSAS) (Liebowitz, 1987) is a rating scale of fear and avoidance in social interaction (12 items) and performance-oriented situations (12 items). This paper present the study of empirical and concurrent validation of the LSAS. Ninety-six patients suffering from social phobia according to DSM IV were included and compared with 64 non-clinical control subjects. Both patients and controls were divided into two sub-groups: the LSAS passation by hetero-evaluation or auto-evaluation. Social phobics had much higher scores on anxiety and avoidance of the LSAS than control subjects, whatever the method. There were no differencies between hetero and auto-evaluation in both groups of patients and non-clinical subjects, either on anxiety or on avoidance. The LSAS correlated better with social anxiety and negative cognition in social situations than with anxiety-depression in social phobics. The French version of the LSAS showed a good empirical and concurrent validity and the scale presents a good sensitivity to change after cognitive behavioral therapy in social phobics.
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PMID:[Social anxiety in patients with social phobia: validation of the Liebowitz social anxiety scale: the French version]. 1059 6

A multidimensional peer nomination inventory (MPNI; 30 items) and parallel versions--MPNI-Teacher and MPNI-Parental Rating Forms (37 items each)--were developed during a major new Finnish study of families with twins. The twins (477 girls and 467 boys) were 12 years old, representing subsets of three nationwide Finnish twin cohorts (b. 1983-1985). They were enrolled in 503 school classes, and the total number of children participating in peer nominations was 12,937. Three main factors were extracted from peer nominations and teacher and parental assessments. Intercorrelating sub-components were found, especially in parental assessments. Scales were formed, accordingly, for Behavioral Problems (including Hyperactivity-Impulsivity, Aggression, and Inattention), Emotional Problems (including Depression and Social Anxiety), and Adjustment (including Constructiveness, Compliance, and Social Activity). A framework for the development of the multidimensional inventory was a model of emotional and behavioural regulation. Peer nominations were most reliable, while parental assessments, although mostly satisfactory, were least reliable. Results provided evidence of concurrent validity of peer-referenced assessment, using teacher assessments as criteria; correlations between assessments of peers and parents were lower. The inventory has discriminative validity. Intra-pair correlations of monozygotic co-twins were higher than correlations of same-sex (SS) and opposite-sex (OS) dizygotic (DZ) co-twins for all scales across all three assessors, and peer nominations of both SS and OSDZ co-twins yielded correlations significantly greater than zero for all scales. All scales, except Depression and Social Anxiety, differentiated boys from girls.
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PMID:Peers, teachers and parents as assessors of the behavioural and emotional problems of twins and their adjustment: the Multidimensional Peer Nomination Inventory. 1072 6

Replicates and extends prior work with the Social Anxiety Scale for Adolescents (SAS-A) by providing psychometric data, further evidence of construct validity, and large-sample based normative data. Participants were 2,937 students (1,431 boys and 1,506 girls) in Grades 6, 7, 8, 9, and 11. Students completed the SAS-A, the Revised Children's Manifest Anxiety Scale (RCMAS), and the Children's Depression Inventory (CDI). Results replicated a three-factor structure for the SAS-A, with good internal consistencies for its subscales. Normative data were subdivided by sex and grade group. Construct validity included replication of prior relations with general anxiety (RCMAS) and depressive symptomatology (CDI). Implications of these results for further use and norming of the SAS-A are discussed.
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PMID:Social Anxiety Scale for Adolescents: normative data and further evidence of construct validity. 1096 20

Social anxiety disorder is a prevalent and highly disabling condition, affecting 7-13% of the population at some point in their lives. Most sufferers are not diagnosed however, even after visiting a healthcare professional. Social anxiety disorder need not be a difficult condition to diagnose. Characteristic features of the disorder include blushing as the principal symptom and an early age of onset. Social anxiety disorder is also easily distinguished from other anxiety disorders by the situations in which patients experience fear and avoidance; for the patient with social anxiety disorder, these situations always involve social interaction or scrutiny by other people. The consequences of untreated social anxiety disorder include social isolation, impaired educational attainment and career progression, depression, and alcohol abuse. Rating scales such as the Liebowitz Social Anxiety Scale (LSAS) give a consistent measure of severity of social anxiety disorder and so help physicians assess their patients' need for treatment and their improvement. Social anxiety disorder is an eminently treatable condition, as demonstrated by treatment-induced reduction in LSAS scores in clinical trials and by individual case histories. Appropriate therapy can give patients relief from their distressing and disabling symptoms and allows them to make substantial improvements to their quality of life.
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PMID:Recognizing the patient with social anxiety disorder. 1099 76

Paroxetine is a selective serotonin reuptake inhibitor (SSRI) with proven efficacy in the treatment of depression, panic disorder and obsessive-compulsive disorder. Evidence that paroxetine may be effective in social anxiety disorder (social phobia) first arose from open-label studies. More recently, three multicentre, randomized, placebo-controlled trials have been performed, each lasting 12 weeks, to assess the efficacy and tolerability of paroxetine in the treatment of social anxiety disorder, and these studies are reviewed here. The data from all three studies consistently demonstrated that paroxetine was effective in reducing both the symptoms of anxiety and the disability and impairment of social anxiety disorder. Paroxetine performed significantly better than placebo on all primary (Liebowitz Social Anxiety Scale, Clinical Global Impression) and secondary (Social Avoidance and Distress Scale, Sheehan Disability Scale) outcome measures. Adverse events were restricted to those already known to be associated with SSRIs, no serious adverse events associated with medication were experienced, and the numbers withdrawing from the studies were not significantly different in the paroxetine and control groups. Taken together, these studies confirm that paroxetine is an effective and well tolerated treatment for patients with social anxiety disorder.
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PMID:Clinical experience with paroxetine in social anxiety disorder. 1099 79


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