Social anxiety disorder in children

Social anxiety disorder in children is a disorder characterized by persistent excessive avoidance of contacts with peers and strangers, lasting more than 6 months and combined with a distinct desire to communicate with family members and those whom the child knows well.

Synonym: evading childhood and adolescence disorder.

ICD-10 code

F93.2 Social anxiety disorder in childhood.

Epidemiology

Social anxiety disorder is rare, mostly observed in boys. There is no exact data on prevalence, because not all children fall under the supervision of psychiatrists.

[1], [2]

Causes and pathogenesis of social anxiety disorder

The presence in the nature of the child of pathological features of psychasthenic, asthenic or sensitively schizoid type. Mental traumas transferred in early childhood are important.

[3], [4]

Symptoms of social anxiety disorder

Caution to strangers is viewed as a normal psychological phenomenon from the second half of the first year of the child's life to 2.5 years, when he has to face a new, unfamiliar social environment.

A child with a socially anxious disorder is marked by constant fear and / or avoidance of strangers and unknown situations. Fear can mainly manifest itself in adults and / or peers. In new social situations or in which the child is involuntarily involved, he experiences significant distress, manifested by crying, the absence of spontaneous speech, and social exclusion. The child manifests tension in the presence of strangers, tries to evade contact, refuses to answer questions, does not look into the eyes. Unlike true autistic disorders, the child normally communicates with parents, other family members, people who are well-known. With them, he is quite open, talkative, emotional.

The more mild cases of social anxiety disorder in childhood can be expressed in the form of excessive shyness, inhibition, shyness, resentment, inability to stand up for oneself.

In prepubertal and pubertal age, changes in character become more distinct. Greater timidity is acquired by shyness, shyness, inability to stand up for oneself. There is a feeling of insecurity, the desire to be less visible in people, increased sensitivity, impressionability. Public speeches become the most difficult.

As a rule, the anxiety that occurs before the speech itself leads to the so-called emotional disorganization of thinking. Children and adolescents who know the subject well, are confused, inconsistent in their answers, and appear to be ill-prepared. This reinforces the feeling of inferiority and discontent with oneself. The severity of the described features of the emotional-personal response can be so significant that it hinders the socialization of the child.

Diagnosis of social anxiety disorder

Diagnosis is carried out on the basis of the above features of behavior and emotional-personal response of a child or adolescent who must meet the following criteria:

• beginning in the appropriate development of the age period;
• degree of anxiety - pathological;
• anxiety is not part of a more generalized disorder.

[5], [6], [7]

Indications for consultation of other specialists

If the social anxiety disorder of childhood leads to a social disadaptation of a child or adolescent, is not completely reduced during psychological and pedagogical intervention, additional consultation of a psychiatrist and a clinical psychologist is necessary.

Forecast

The described features of the emotional-personal response, as a rule, are preserved to varying degrees throughout the life of the individual. In more severe cases of the disorder, as well as in the presence of a chronic unfavorable psychosocial situation, transformation into a disorder of a mature personality of an anxious (evading) type is possible.

[8], [9], [10]