Social Anxiety Disorder and Its Correlates among Female Students at Taif University, Saudi Arabia

Azza Ali Taha^{1, 2,} , Etemad AA El-shereef^{2, 3}, Taghreed Ismail Mohammed Abdullah⁴, Rehab Ismail Mohammed Abdullah⁵ and Wedad Abdullah Mutheeb Aldahasi⁴

¹Department of Family and Community Medicine, College of Medicine and Applied Medical Sciences, Taif University, Saudi Arabia

²Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Egypt

³Department of public Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt

⁴Fifth Year Medical Student, Medical College, Taif University, Saudi Arabia

⁵Resident of family medicine in forced military hospital, Taif City, Saudi Arabia

Cite this paper:
Azza Ali Taha, Etemad AA El-shereef, Taghreed Ismail Mohammed Abdullah, Rehab Ismail Mohammed Abdullah and Wedad Abdullah Mutheeb Aldahasi. Social Anxiety Disorder and Its Correlates among Female Students at Taif University, Saudi Arabia. Research in Psychology and Behavioral Sciences. 2017; 5(2):50-56. doi: 10.12691/rpbs-5-2-3

Abstract

Background: Social anxiety disorder (SAD) is highly prevalent among adolescents but little is known about its prevalence in Saudi adolescents. Objectives: we aimed to determine the prevalence of SAD and investigate its associated correlates among Saudi adolescent females. Methods: A cross sectional study design was conducted at Taif university in the period from January to May 2016. A self-report pre-designed questionnaire was distributed to the students about personal factors and Social Phobia Inventory (SPIN) which is a reliable and valid psychometric tool of screening SAD. Results: Data of 957 female students were analyzed and rendered a prevalence of 16.3% for SAD among them. Most of the affected students had a moderate degree of the disorder in 43.5% of cases. Personal factors significantly associated with SAD in univariate analysis were obese weight perception (p <0.001), having body deformities (p = 0.004), insufficient income (p = 0.003), 1st birth order (p = 0.006), parental conflict (p = 0.003), parental death (p <0.001) and smoking (p <0.001). Conclusion and recommendations: Our results show there is a high prevalence of SAD among female university students in Taif, Saudi Arabia. Independent personal factors associated with SAD in our study were smoking, parent death and obese weight perception. Based on the high prevalence encountered in our study, we recommend early detection and intervention to reduce the overall burden associated with this psychiatric disorder in the adolescent population as emphasized by the literature.

Keywords:
adolescent female social phobia social anxiety

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Elalky, M.I., et al., The Effect of Birth Order and Socio Demographic Characteristics on Anxiety and Depression among Adolescents. International Journal of Nursing Science, 2015. 5(3): p. 110-121.
[2]	Tassin, C., et al., Anxiety disorders in adolescence. Psychiatria Danubina, 2014. 26(1): p. 27-30.
[3]	Burstein, M., et al., Social phobia and subtypes in the National Comorbidity Survey–Adolescent Supplement: prevalence, correlates, and comorbidity. Journal of the American Academy of Child & Adolescent Psychiatry, 2011. 50(9): p. 870-880.
[4]	Association, A.P., Diagnostic and statistical manual of mental disorders (DSM-5®). 2013: American Psychiatric Pub.
[5]	Brook, C.A. and L.A. Schmidt, Social anxiety disorder: a review of environmental risk factors. Neuropsychiatric disease and treatment, 2008. 4(1A): p. 123.
[6]	Doehrmann, O., et al., Predicting treatment response in social anxiety disorder from functional magnetic resonance imaging. JAMA psychiatry, 2013. 70(1): p. 87-97.
[7]	Schneier, F.R., Social anxiety disorder. New England Journal of Medicine, 2006. 355(10): p. 1029-1036.
[8]	Jazaieri, H., et al., The role of emotion and emotion regulation in social anxiety disorder. Current psychiatry reports, 2015. 17(1): p. 1-9.
[9]	Fehm, L. and H.-U. Wittchen, Comorbidity in social anxiety disorder. MEDICAL PSYCHIATRY, 2004. 29: p. 49-64.
[10]	Baldwin, D.S. and C. Buis, Burden of social anxiety disorder. MEDICAL PSYCHIATRY, 2004. 29: p. 65-74.
[11]	Furmark, T., Social phobia: overview of community surveys. Acta Psychiatrica Scandinavica, 2002. 105(2): p. 84-93.
[12]	Tyrer, P. and K.R. Silk, Cambridge textbook of effective treatments in psychiatry. 2008: Cambridge University Press.
[13]	Muris, P., The pathogenesis of childhood anxiety disorders: Considerations from a developmental psychopathology perspective. International Journal of Behavioral Development, 2006. 30(1): p. 5-11.
[14]	Haller, S.P., et al., Social anxiety disorder in adolescence: How developmental cognitive neuroscience findings may shape understanding and interventions for psychopathology. Developmental cognitive neuroscience, 2015. 13: p. 11-20.
[15]	Health, N.C.C.f.M. Social anxiety disorder: recognition, assessment and treatment. 2013. British Psychological Society.
[16]	Ghazwani, J.Y., S.N. Khalil, and R.A. Ahmed, Social anxiety disorder in Saudi adolescent boys: Prevalence, subtypes, and parenting style as a risk factor. Journal of family & community medicine, 2016. 23(1): p. 25.
[17]	Connor, K.M., et al., Psychometric properties of the social phobia inventory (SPIN). The British Journal of Psychiatry, 2000. 176(4): p. 379-386.
[18]	Harikrishnan, U., A. Arif, and H. Sobhana, Prevalence of Social Phobia among School Going Adolescents. 2016.
[19]	Antony, M.M., et al., Psychometric properties of the social phobia inventory: Further evaluation. Behaviour research and therapy, 2006. 44(8): p. 1177-1185.
[20]	Ranta, K., et al., Screening social phobia in adolescents from general population: The validity of the Social Phobia Inventory (SPIN) against a clinical interview. European Psychiatry, 2007. 22(4): p. 244-251.
[21]	Beesdo, K., S. Knappe, and D.S. Pine, Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatric Clinics of North America, 2009. 32(3): p. 483-524.
[22]	Shah, P. and L. Kataria, Social phobia and its impact in Indian university students. The Internet Journal of Mental Health, 2010. 6(2).
[23]	Furmark, T., Social phobia. From epidemiology to brain function. 2000, Acta Universitatis Upsaliensis.
[24]	Rabe-Jabłońska, J., A. Dietrich-Muszalska, and A. Gmitrowicz, The prevalence od social phobia in representative group of adolescents from Lodz. Psychiatria polska, 2002. 37(1): p. 87-95.
[25]	Farooq, S.A., et al., Quality of Life Perceptions in School-Going Adolescents with Social Anxiety. Journal of Childhood & Developmental Disorders, 2017.
[26]	GÜLTEKIN, B.K. and I.F. Dereboy, The prevalence of social phobia, and its impact on quality of life, academic achievement, and identity formation in university students. Turk Psikiyatri Dergisi, 2011. 22(3): p. 150.
[27]	Momani, F.A. and A.-K.M. Jaradat, Social Phobia among University Students: Prevalence and Socio-Demographic Factors. Jordan Journal of Social Sciences, 2011. 4(1).
[28]	Afifi, D.Y., Social anxiety among Egyptian University students. 2012, Cairo University.
[29]	AL-QAHTANI, A. and A. SBFM, Prevalence and risk factors of social phobia among secondary school male students in Khamis Mushayt, Kingdom of Saudi Arabia. Medical Journal of Cairo University, 2012. 8(1): p. 871-876.
[30]	Alkhathami, S., Social anxiety and quality of life in adolescents: cognitive aspect, social interaction and cultural tendency. 2014.
[31]	Kareem, S.K.A.M.S. and D.A. Al-Banna, Assessment of Social Phobia among Students of Nursing College in Hawler Medical University at Erbil City-Iraq. Kufa Journal for Nursing Sciences 2016. 6(2).
[32]	Mehtalia, K. and G. Vankar, Social anxiety in adolescents. Indian journal of psychiatry, 2004. 46(3): p. 221.
[33]	Upadhyaya, S.K., et al., Risk factors of social anxiety in medical college students. Journal of Health Specialties, 2016. 4(3): p. 207.
[34]	Bagchi, D., Global perspectives on childhood obesity: current status, consequences and prevention. 2010: Academic Press.
[35]	Teychenne, M., S.A. Costigan, and K. Parker, The association between sedentary behaviour and risk of anxiety: a systematic review. BMC public health, 2015. 15(1): p. 513.
[36]	Anderson, S.E., et al., Adolescent obesity and risk for subsequent major depressive disorder and anxiety disorder: prospective evidence. Psychosomatic Medicine, 2007. 69(8): p. 740-747.
[37]	Lee, J.-I. and C.-F. Yen, Associations between body weight and depression, social phobia, insomnia, and self-esteem among Taiwanese adolescents. The Kaohsiung journal of medical sciences, 2014. 30(12): p. 625-630.
[38]	Phillips, K.A., Understanding body dysmorphic disorder. 2009: Oxford University Press.
[39]	Phillips, K.A., et al., Psychosocial functioning and quality of life in body dysmorphic disorder. Comprehensive psychiatry, 2005. 46(4): p. 254-260.
[40]	Fang, A. and S.G. Hofmann, Relationship between social anxiety disorder and body dysmorphic disorder. Clinical psychology review, 2010. 30(8): p. 1040-1048.
[41]	Coles, M.E., et al., Body dysmorphic disorder and social phobia: cross-sectional and prospective data. Depression and anxiety, 2006. 23(1): p. 26-33.
[42]	Menezes, G.B.d., L.F. Fontenelle, and M. Versiani, Early-onset social anxiety disorder in adults: clinical and therapeutic features. Revista Brasileira de Psiquiatria, 2005. 27(1): p. 32-36.
[43]	Dashiff, C., et al., Poverty and adolescent mental health. Journal of Child and Adolescent Psychiatric Nursing, 2009. 22(1): p. 23-32.
[44]	McLaughlin, K.A., et al., Socioeconomic status and adolescent mental disorders. American journal of public health, 2012. 102(9): p. 1742-1750.
[45]	Lund, C., et al., Poverty and common mental disorders in low and middle income countries: A systematic review. Social science & medicine, 2010. 71(3): p. 517-528.
[46]	Merikangas, K.R., Vulnerability factors for anxiety disorders in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 2005. 14(4): p. 649-679.
[47]	Sulloway, F.J., Birth order and sibling competition. Handbook of evolutionary psychology, 2007: p. 297-311.
[48]	Pearson, T.R., Anxiety and birth order: does birth order play a role in a child's anxiety level? 2009.
[49]	Grover, R.L., G.S. Ginsburg, and N. Ialongo, Childhood predictors of anxiety symptoms: A longitudinal study. Child Psychiatry & Human Development, 2005. 36(2): p. 133-153.
[50]	Lansford, J.E., et al., Trajectories of internalizing, externalizing, and grades for children who have and have not experienced their parents' divorce or separation. Journal of family Psychology, 2006. 20(2): p. 292.
[51]	Spence, S.H., et al., Maternal anxiety and depression, poverty and marital relationship factors during early childhood as predictors of anxiety and depressive symptoms in adolescence. Journal of Child Psychology and Psychiatry, 2002. 43(4): p. 457-469.
[52]	Wood, J.J., R.L. Repetti, and S.C. Roesch, Divorce and children’s adjustment problems at home and school: The role of depressive/withdrawn parenting. Child Psychiatry and Human Development, 2004. 35(2): p. 121-142.
[53]	Peleg-Popko, O. and R. Dar, Marital quality, family patterns, and children's fears and social anxiety. Contemporary Family Therapy, 2001. 23(4): p. 465-487.
[54]	Bandelow, B., et al., Early traumatic life events, parental rearing styles, family history of mental disorders, and birth risk factors in patients with social anxiety disorder. European archives of psychiatry and clinical neuroscience, 2004. 254(6): p. 397-405.
[55]	Blöte, A.W., A.C. Miers, and P.M. Westenberg, Adolescent Social Anxiety and Substance Use: The Role of Susceptibility to Peer Pressure. Child Development Research, 2016. 2016.
[56]	Merikangas, K.R., et al., The spectrum of social phobia in the Zurich cohort study of young adults. Biological Psychiatry, 2002. 51(1): p. 81-91.
[57]	Marmorstein, N.R., et al., Anxiety as a predictor of age at first use of substances and progression to substance use problems among boys. Journal of abnormal child psychology, 2010. 38(2): p. 211-224.
[58]	Sonntag, H., et al., Are social fears and DSM-IV social anxiety disorder associ7ated with smoking and nicotine dependence in adolescents and young adults? European Psychiatry, 2000. 15(1): p. 67-74.
[59]	Abdollahi, A., et al., Social anxiety and cigarette smoking in adolescents: The mediating role of emotional intelligence. School Mental Health, 2015. 7(3): p. 184-192.
[60]	Moylan, S., et al., Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies. BMC medicine, 2012. 10(1): p. 123.
[61]	Goodwin, R.D., P.M. Lewinsohn, and J.R. Seeley, Cigarette smoking and panic attacks among young adults in the community: the role of parental smoking and anxiety disorders. Biological psychiatry, 2005. 58(9): p. 686-693.
[62]	Cuijpers, P., et al., Smoking is associated with first-ever incidence of mental disorders: a prospective population-based study. Addiction, 2007. 102(8): p. 1303-1309.
[63]	Swendsen, J., et al., Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity Survey. Addiction, 2010. 105(6): p. 1117-1128.
[64]	Ham, L.S. and D.A. Hope, Incorporating social anxiety into a model of college student problematic drinking. Addictive behaviors, 2005. 30(1): p. 127-150.
[65]	Tjora, T., et al., Distal and proximal family predictors of adolescents' smoking initiation and development: a longitudinal latent curve model analysis. BMC public health, 2011. 11(1): p. 911.
[66]	Isensee, B., et al., Smoking increases the risk of panic: findings from a prospective community study. Archives of General Psychiatry, 2003. 60(7): p. 692-700.
[67]	Pedersen, W. and T. Von Soest, Smoking, nicotine dependence and mental health among young adults: a 13-year population-based longitudinal study. Addiction, 2009. 104(1): p. 129-137.
[68]	Preter, M. and D.F. Klein, Panic, suffocation false alarms, separation anxiety and endogenous opioids. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2008. 32(3): p. 603-612.
[69]	Iniguez, S.D., et al., Nicotine exposure during adolescence induces a depression-like state in adulthood. Neuropsychopharmacology, 2009. 34(6): p. 1609-1624.
[70]	Reichborn-Kjennerud, T., et al., Genetic and environmental influences on the association between smoking and panic attacks in females: a population-based twin study. Psychological medicine, 2004. 34(7): p. 1271-1277.
[71]	Hettema, J.M., et al., The structure of genetic and environmental risk factors for anxiety disorders in men and women. Archives of general psychiatry, 2005. 62(2): p. 182-189.
[72]	Schaap, M. and A. Kunst, Monitoring of socio-economic inequalities in smoking: learning from the experiences of recent scientific studies. Public health, 2009. 123(2): p. 103-109.
[73]	Kessler, R.C., et al., Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 2005. 62(6): p. 617-627.
[74]	Raposo, S.M., et al., Time does not heal all wounds: older adults who experienced childhood adversities have higher odds of mood, anxiety, and personality disorders. The American Journal of Geriatric Psychiatry, 2014. 22(11): p. 1241-1250.