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A Direct Interview Family Study of Social Phobia

A Direct Interview Family Study of Social Phobia Abstract • Risks for DSM-III-R anxiety and affective disorders and "subdisorder" (nonimpairing) irrational social fears, among directly interviewed first-degree relatives (n=83) of probands who met criteria for social phobia but for no other lifetime anxiety disorder diagnosis, were contrasted to risks for disorder among similarly evaluated relatives (n=231) of never mentally ill controls. Relatives of social phobia probands had a significantly increased risk for social phobia (16% vs 5%, relative risk=3.12) but not for other anxiety disorders. These results suggest a familial contribution to the development of some cases of social phobia. The specificity of the pattern of intergenerational transmission is consistent with the current nosologic distinction between social phobia and other anxiety disorders. References 1. Liebowitz MR, Gorman JM, Fyer AJ, Klein DF. Social phobia: review of a neglected anxiety disorder . Arch Gen Psychiatry . 1985;42:729-736.Crossref 2. Pollard CA, Henderson JG. Four types of social phobia in a community sample . J Nerv Ment Dis . 1988;176:440-445.Crossref 3. Liebowitz MR, Fyer AF, Gorman JM, Campeas R, Levin A, Sandberg D, Hollander E, Papp L, Goetz D. Pharmacotherapy of social phobia: an interim report of a placebo-controlled comparison of phenelzine and atenolol . J Clin Psychiatry . 1988;49:252-257. 4. Stein MB, Shea CA, Uhde TW. Social phobic symptoms in patients with panic disorder: practical and theoretical implications . Am J Psychiatry . 1989;146:235-238. 5. Mannuzza S, Fyer AJ, Liebowitz MR, Klein DF. Delineating the boundaries of social phobia: its relationship to panic disorder and agoraphobia . J Anxiety Disord . 1990;4:41-59.Crossref 6. Noyes R, Crowe RR, Harris EL, Hamra BJ, McChesney CM, Chaudhry DR. Relationship between panic disorder and agoraphobia: a family study . Arch Gen Psychiatry . 1986;42:227-232.Crossref 7. Lenane MC, Swedo SE, Leonard H, Pauls DL, Sceery W, Rapoport JL. Psychiatric disorders in first-degree relatives of children and adolescents with obsessive-compulsive disorder . J Am Acad Child Adolesc Psychiatry . 1990;29:407-412.Crossref 8. Fyer AJ, Mannuzza S, Gallops S, Martin LY, Aaronson C, Gorman JM, Liebowitz MR, Klein DF. Familial transmission of simple phobias and fears . Arch Gen Psychiatry . 1990;47:252-256.Crossref 9. Torgersen S. Genetic factors in anxiety disorders . Arch Gen Psychiatry . 1983;40:1085-1089.Crossref 10. Carey G, Gottesman II. Twin and family study of anxiety, phobic, and obsessive disorders . In: Klein DF, Rabkin JG, eds. Anxiety: New Research and Changing Concepts . New York, NY: Raven Press; 1981:117-136. 11. Reich J, Yates W. Family history of psychiatric disorders in social phobia . Compr Psychiatry . 1988;29:72-75.Crossref 12. Torgersen S. The nature and origin of common phobic fears . Br J Psychiatry . 1979;134:343-351.Crossref 13. Plomin R, Daniels D. Genetics and shyness . In: Jones WH, Cheek JM, Briggs SR, eds. Shyness:Perspectives on Research and Treatment . New York, NY: Plenum; 1986:63-90. 14. American Psychiatric Association, Work Group to Revise DSM-III. DSM-III-R in Development . 2nd draft. Washington, DC: American Psychiatric Association; 1985. 15. Schneier FR, Fyer AJ, Martin LY, Ross D, Salvatore M, Liebowitz MR, Gorman JM, Klein DF. A comparison of phobic subtypes within panic disorder . J Anxiety Disord . 1991;5:65-75.Crossref 16. Cloninger CR, Sigvardsson S, Gilligan SB. Genetic heterogeneity and the classification of alcoholism . Adv Alcohol Subst Abuse . 1988;7:3-16.Crossref 17. Weissman MM, Merikangas KR, Wickramaratne P, Kidd KK, Prusoff BA, Leckman JF, Pauls DL. Understanding the clinical heterogeneity of major depression using family data . Arch Gen Psychiatry . 1986;43:430-434.Crossref 18. Cox DR. Regression models and life tables (with discussion) . J R Stat soc B . 1972;34:187-220. 19. Kalbfleisch JD, Prentice RL. The Statistical Analysis of Failure Time Data . New York, NY: John Wiley & Sons Inc; 1980. 20. Wickramaratne PJ, Prusoff BA, Merikangas KR, Weissman MM. The use of survival time models with nonproportional hazard functions to investigate age of onset in family studies . J Chronic Disord . 1986;39:389-397.Crossref 21. Katz MM, Klerman GL. Introduction: overview of the clinical studies program . Am J Psychiatry . 1979;136:49-51. 22. Fyer AJ, Endicott J, Mannuzza S, Klein DF. Schedule for Affective Disorders amd Schizophrenia-Lifetime Version (Modified for the Study of Anxiety Disorders) . New York, NY: Anxiety Disorders Clinic, New York State Psychiatric Institute; 1985. 23. Mannuzza S, Fyer AJ, Endicott J, Klein DF. Schedule for Affective Disorders and Schizophrenia-lifetime version (modified for the study of anxiety disorders) (SADS-LA): rationale and conceptual development . J Psychiatr Res . 1986;20:317-325.Crossref 24. Mannuzza S, Fyer AJ, Martin LY, Gallops MS, Endicott J, Gorman J, Liebowitz MR, Klein DF. Reliability of anxiety assessment, I: diagnostic agreement . Arch Gen Psychiatry . 1989;46:1093-1101.Crossref 25. Fyer AJ, Mannuzza S, Martin L, Gallops M, Gorman JM, Liebowitz MR, Klein DF. Reliability of anxiety, II: symptom agreement . Arch Gen Psychiatry . 1989;46:1102-1110.Crossref 26. Spitzer RL, Endicott J. Schedule of Schizophrenic and Affective Disorders-Lifetime Version . 3rd ed. New York, NY: Research Assessment and Training Unit, New York State Psychiatric Institute; 1979. 27. American Psychiatric Association Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 28. SAS Institute Inc. SUGI Supplemental Library User's Guide, Version 5 Edition. Cary NC: SAS Institute Inc; 1986. 29. American Psychiatric Association Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 30. Ohman A. Face the beast and fear the face: animal and social fears as prototypes for evolutionary analyses of emotion . Psychophysiology . 1986;23:123-145.Crossref 31. Uhde TW, Tancer ME, Gurguis GNM. Chemical models of anxiety: evidence for diagnostic and neurotransmitter specificity . Int Rev Psychiatry . 1990;2:367-384.Crossref 32. Liebowitz MR, Fyer AJ, Gorman JM, Dillon D, Davies SO, Stein JM, Cohen BS, Klein DF. Specificity of lactate infusions in social phobia vs panic disorders . Am J Psychiatry . 1985;142:947-949. 33. Beitman B, Klerman G. Integrating Pharmacotherapy and Psychotherapy . Washington, DC: American Psychiatric Press; 1991:231-252. 34. Marks IM. Fears, Phobias, and Rituals . New York, NY: Oxford University Press Inc; 1987. 35. Kendler KS, Heath AC, Martin NG, Eves LJ. Symptoms of anxiety and symptoms of depression: same genes, different environments? Arch Gen Psychiatry . 1987;44:451-457.Crossref 36. Heimberg RG, Hope DA, Bodge CS, Becker RE. DSM-III-R subtypes of social phobia: comparison of generalized social phobics and publicspeaking phobics . J Nerv Ment Dis . 1990;178:172-179.Crossref 37. Levin AP, Saaud J, Strauman T, Gorman J, Fyer AJ, Crawford R, Liebowitz MR. Responses of 'generalized' and 'discrete' social phobics during public speaking . J Anxiety Disord . In press. 38. Rose RJ, Ditto WB. A developmental-genetic analysis of common fears from early adolescence of early childhood . Child Dev . 1983;54:361-368.Crossref 39. Ruben DC, ed. Autobiographical Memory . New York, NY: Cambridge University Press; 1986. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1993.01820160056007
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Abstract

Abstract • Risks for DSM-III-R anxiety and affective disorders and "subdisorder" (nonimpairing) irrational social fears, among directly interviewed first-degree relatives (n=83) of probands who met criteria for social phobia but for no other lifetime anxiety disorder diagnosis, were contrasted to risks for disorder among similarly evaluated relatives (n=231) of never mentally ill controls. Relatives of social phobia probands had a significantly increased risk for social phobia (16% vs 5%, relative risk=3.12) but not for other anxiety disorders. These results suggest a familial contribution to the development of some cases of social phobia. The specificity of the pattern of intergenerational transmission is consistent with the current nosologic distinction between social phobia and other anxiety disorders. References 1. Liebowitz MR, Gorman JM, Fyer AJ, Klein DF. Social phobia: review of a neglected anxiety disorder . Arch Gen Psychiatry . 1985;42:729-736.Crossref 2. Pollard CA, Henderson JG. Four types of social phobia in a community sample . J Nerv Ment Dis . 1988;176:440-445.Crossref 3. Liebowitz MR, Fyer AF, Gorman JM, Campeas R, Levin A, Sandberg D, Hollander E, Papp L, Goetz D. Pharmacotherapy of social phobia: an interim report of a placebo-controlled comparison of phenelzine and atenolol . J Clin Psychiatry . 1988;49:252-257. 4. Stein MB, Shea CA, Uhde TW. Social phobic symptoms in patients with panic disorder: practical and theoretical implications . Am J Psychiatry . 1989;146:235-238. 5. Mannuzza S, Fyer AJ, Liebowitz MR, Klein DF. Delineating the boundaries of social phobia: its relationship to panic disorder and agoraphobia . J Anxiety Disord . 1990;4:41-59.Crossref 6. Noyes R, Crowe RR, Harris EL, Hamra BJ, McChesney CM, Chaudhry DR. Relationship between panic disorder and agoraphobia: a family study . Arch Gen Psychiatry . 1986;42:227-232.Crossref 7. Lenane MC, Swedo SE, Leonard H, Pauls DL, Sceery W, Rapoport JL. Psychiatric disorders in first-degree relatives of children and adolescents with obsessive-compulsive disorder . J Am Acad Child Adolesc Psychiatry . 1990;29:407-412.Crossref 8. Fyer AJ, Mannuzza S, Gallops S, Martin LY, Aaronson C, Gorman JM, Liebowitz MR, Klein DF. Familial transmission of simple phobias and fears . Arch Gen Psychiatry . 1990;47:252-256.Crossref 9. Torgersen S. Genetic factors in anxiety disorders . Arch Gen Psychiatry . 1983;40:1085-1089.Crossref 10. Carey G, Gottesman II. Twin and family study of anxiety, phobic, and obsessive disorders . In: Klein DF, Rabkin JG, eds. Anxiety: New Research and Changing Concepts . New York, NY: Raven Press; 1981:117-136. 11. Reich J, Yates W. Family history of psychiatric disorders in social phobia . Compr Psychiatry . 1988;29:72-75.Crossref 12. Torgersen S. The nature and origin of common phobic fears . Br J Psychiatry . 1979;134:343-351.Crossref 13. Plomin R, Daniels D. Genetics and shyness . In: Jones WH, Cheek JM, Briggs SR, eds. Shyness:Perspectives on Research and Treatment . New York, NY: Plenum; 1986:63-90. 14. American Psychiatric Association, Work Group to Revise DSM-III. DSM-III-R in Development . 2nd draft. Washington, DC: American Psychiatric Association; 1985. 15. Schneier FR, Fyer AJ, Martin LY, Ross D, Salvatore M, Liebowitz MR, Gorman JM, Klein DF. A comparison of phobic subtypes within panic disorder . J Anxiety Disord . 1991;5:65-75.Crossref 16. Cloninger CR, Sigvardsson S, Gilligan SB. Genetic heterogeneity and the classification of alcoholism . Adv Alcohol Subst Abuse . 1988;7:3-16.Crossref 17. Weissman MM, Merikangas KR, Wickramaratne P, Kidd KK, Prusoff BA, Leckman JF, Pauls DL. Understanding the clinical heterogeneity of major depression using family data . Arch Gen Psychiatry . 1986;43:430-434.Crossref 18. Cox DR. Regression models and life tables (with discussion) . J R Stat soc B . 1972;34:187-220. 19. Kalbfleisch JD, Prentice RL. The Statistical Analysis of Failure Time Data . New York, NY: John Wiley & Sons Inc; 1980. 20. Wickramaratne PJ, Prusoff BA, Merikangas KR, Weissman MM. The use of survival time models with nonproportional hazard functions to investigate age of onset in family studies . J Chronic Disord . 1986;39:389-397.Crossref 21. Katz MM, Klerman GL. Introduction: overview of the clinical studies program . Am J Psychiatry . 1979;136:49-51. 22. Fyer AJ, Endicott J, Mannuzza S, Klein DF. Schedule for Affective Disorders amd Schizophrenia-Lifetime Version (Modified for the Study of Anxiety Disorders) . New York, NY: Anxiety Disorders Clinic, New York State Psychiatric Institute; 1985. 23. Mannuzza S, Fyer AJ, Endicott J, Klein DF. Schedule for Affective Disorders and Schizophrenia-lifetime version (modified for the study of anxiety disorders) (SADS-LA): rationale and conceptual development . J Psychiatr Res . 1986;20:317-325.Crossref 24. Mannuzza S, Fyer AJ, Martin LY, Gallops MS, Endicott J, Gorman J, Liebowitz MR, Klein DF. Reliability of anxiety assessment, I: diagnostic agreement . Arch Gen Psychiatry . 1989;46:1093-1101.Crossref 25. Fyer AJ, Mannuzza S, Martin L, Gallops M, Gorman JM, Liebowitz MR, Klein DF. Reliability of anxiety, II: symptom agreement . Arch Gen Psychiatry . 1989;46:1102-1110.Crossref 26. Spitzer RL, Endicott J. Schedule of Schizophrenic and Affective Disorders-Lifetime Version . 3rd ed. New York, NY: Research Assessment and Training Unit, New York State Psychiatric Institute; 1979. 27. American Psychiatric Association Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 28. SAS Institute Inc. SUGI Supplemental Library User's Guide, Version 5 Edition. Cary NC: SAS Institute Inc; 1986. 29. American Psychiatric Association Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 30. Ohman A. Face the beast and fear the face: animal and social fears as prototypes for evolutionary analyses of emotion . Psychophysiology . 1986;23:123-145.Crossref 31. Uhde TW, Tancer ME, Gurguis GNM. Chemical models of anxiety: evidence for diagnostic and neurotransmitter specificity . Int Rev Psychiatry . 1990;2:367-384.Crossref 32. Liebowitz MR, Fyer AJ, Gorman JM, Dillon D, Davies SO, Stein JM, Cohen BS, Klein DF. Specificity of lactate infusions in social phobia vs panic disorders . Am J Psychiatry . 1985;142:947-949. 33. Beitman B, Klerman G. Integrating Pharmacotherapy and Psychotherapy . Washington, DC: American Psychiatric Press; 1991:231-252. 34. Marks IM. Fears, Phobias, and Rituals . New York, NY: Oxford University Press Inc; 1987. 35. Kendler KS, Heath AC, Martin NG, Eves LJ. Symptoms of anxiety and symptoms of depression: same genes, different environments? Arch Gen Psychiatry . 1987;44:451-457.Crossref 36. Heimberg RG, Hope DA, Bodge CS, Becker RE. DSM-III-R subtypes of social phobia: comparison of generalized social phobics and publicspeaking phobics . J Nerv Ment Dis . 1990;178:172-179.Crossref 37. Levin AP, Saaud J, Strauman T, Gorman J, Fyer AJ, Crawford R, Liebowitz MR. Responses of 'generalized' and 'discrete' social phobics during public speaking . J Anxiety Disord . In press. 38. Rose RJ, Ditto WB. A developmental-genetic analysis of common fears from early adolescence of early childhood . Child Dev . 1983;54:361-368.Crossref 39. Ruben DC, ed. Autobiographical Memory . New York, NY: Cambridge University Press; 1986.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Apr 1, 1993

References