New research
Are Social and Communication Difficulties a Risk Factor for the Development of Social Anxiety?

https://doi.org/10.1016/j.jaac.2017.01.007Get rights and content
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Objective

Social anxiety (SA) is a common condition associated with social and communication (SC) difficulties in typically developing young people, as well as those with autism spectrum disorder (ASD). Whether SC difficulties place children at risk for developing SA is unclear. Using a longitudinal design, the present study aimed to disentangle the relationship between SA symptoms and SC difficulties using a population-based sample of 9,491 children from the Avon Longitudinal Study of Parents and Children (ALSPAC).

Method

Parent-reported data on SC difficulties and SA symptoms were collected at ages 7, 10, and 13 years. A cross-lagged panel model was used to investigate the longitudinal stability and directional relationship between latent SC difficulties and SA constructs over time.

Results

More SC difficulties were associated with greater SA symptoms at all ages. Earlier SC difficulties predicted a small but significant amount of variance in later SA symptoms. The reverse relationship from SA to SC difficulties was not observed. The relationship from SC difficulties to SA was strongest from age 7 to 10 years. No sex differences were observed.

Conclusion

The evidence suggests that SC difficulties may be an important risk factor for the development of SA. These findings suggest the potential usefulness of incorporating social skills training alongside effective interventions to prevent or alleviate symptoms of SA in childhood.

Key words

ALSPAC
social anxiety
social and communication difficulties
autism spectrum disorders
longitudinal

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This article can be used to obtain continuing medical education (CME) at www.jaacap.com.

The UK Medical Research Council and Wellcome (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for Avon Longitudinal Study of Parents and Children (ALSPAC). This publication is the work of the authors, who will serve as guarantors for the contents of this paper. This research was specifically funded by the Medical Research Council (MRC) (PAD7125) and Autistica (PCFTAAR).

Information in this study was presented as a poster at the Neurodevelopmental Disorders Seminar Series, London, June 23, 2016.

Prof. Happé and Dr. Mandy are joint senior authors.

Ms. Pickard served as the statistical expert for this research.

The authors are extremely grateful to all of the families who took part in this study; the midwives for their help in recruiting them; and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses.

Ms. Pickard would like to thank Joni Coleman and Laurie Hannigan for their help and guidance with learning R.

Disclosure: Dr. Rijsdijk, Prof. Happé, Dr. Mandy, and Ms. Pickard report no biomedical financial interests or potential conflicts of interest.