Unit 3, Learning activity 3.1

Title:

School-Based Intervention for Adolescents with Social Anxiety Disorder

https://ezproxy.student.twu.ca:3734/article/10.1007/s10802-005-7649-z

Authors:

Carrie Masia-Warner, Rachel G. Klein, Paige H. Fisher, Jose Alvir, and Anne M. Albano

New York University Child Study Center, NYU School of Medicine, New York

Heather C. Dent

Psychology Department, University of Denver, Denver, Colorado

Mary Guardino

Freedom from Fear, Staten Island, New York.

Authors note:

Carrie Masia-Warner, Rachel G. Klein, Paige H. Fisher, Jose Alvir, and Anne M. Albano, New York University Child Study Center, NYU School of Medicine; Heather C. Dent, Psychology Department, University of Denver; Mary Guardino, Freedom from Fear, Staten Island.

This research was supported by the Anxiety Disorders Association of America and the Lowenstein Foundation. The authors thank Dr. Deborah Beidel for her consultation on this study, and Ben Adams, Joseph Capobianco, Nisha Patel, Eric Storch, and Jonathan Tobkes for their assistance in conducting the study.

Correspondence concerning this article should be addressed to CarrieMasia-Warner, NYU Child Study Center, 215 Lexington Avenue, 13th floor, New York, 10016. E-mail: carrie.masia@med.nyu.edu.

Introduction

The social anxiety disorder, which mostly happens in adolescences, is always neglected by teachers and parents for the symptoms being quiet and compliant. Not only do the authors want to raise the awareness of identifying the anxiety disorders of the adolescence, but also they have conducted a research to see if the school-based intervention will effectively facilitate the treatment for socially anxious teenagers. Also, previous research has suggested that the treatment offered by the community centres or public health centres is resistant by the majority of adolescences (Weist, 1999; Weisz, Donenberg, Han, & Weiss, 1995), the authors want to find out if the school-based treatment works better.
Methods

Participants

The participants were adolescences and their parents. The adolescences’ mean age was 14.8 years. The majority of them were female (74.3%), and their ethnicity was: 82.9% Caucasian, 8.6% African American, 2.9% Asian American, 2.9% Latin American, and 2.9% other. About half of the participants had other disorders, the most common being generalized anxiety disorder (40%) and dysthymia (14.3%).

Sampling Procedures

At the beginning, 1521 participants were recruited, and they were adolescences in grades 9 through 11 from two parochial high schools in New York City and their parents who indicated social anxiety associated with impairment in functioning. The adolescences (74.3% females) rated through instruments and teacher nominations were identified highly possible to have the social anxiety disorder. Then, 475 students (31.2% of the adolescence) who scored in the top 15% through self-rated instruments or were nominated by teachers were selected for further screening. At last, 80 students and their parents agreed to participate (Masia et al., 2005).

Measures and Intervention

First of all, the authors used the interview session to describe the research and obtain informed consent from all participants. The parents and adolescences were interviewed separately by the same evaluator using the Anxiety Disorders Interview Schedule for DSM-IV: Parent and Child Versions ( Silverman & Albano, 1996). Students were diagnosed in various ways to find out if they were unqualified or not. Among those interviewed, 42 students met study criteria and rated the subject’s social anxiety at a subclinical level.

This study was conducted as a between-subjects design because the 42 adolescences were randomly assigned to different conditions including the SASS intervention, Skills for Academic and Social Success (SASS; Masia et al., 1999), and wait-list control condition. The SASS intervention was developed with the goal of adapting clinic-based procedures to be practical for delivery in high schools (SASS; Masia et al., 1999). It includes school group sessions, individual meetings, social events, peer assistants, parent meetings, teacher meetings, and booster sessions (Masia et al., 2005).

The participants were evaluated at pre-intervention and post-intervention. The wait-list control group was provided with treatment following post-assessment evaluations, while the SASS group participated in 9-month follow-up assessments. The pre-assessments including three sets of analyses, the dichotomous outcomes (the SPDSCF-Change and ADIS diagnosis), and post-intervention comorbidity rates were compared between the two groups (Masia et al., 2005).

Results

In terms of pretreatment comparisons, there is no obvious difference on any demographic variable between the two groups. The outcome measures of the two groups at pre-intervention and post-intervention appeared distinctively. Although the data of pre-intervention of the two groups did not have much difference, the data of post-intervention of the SASS group were significantly lower than that of the control group. The results of the comorbidity comparison showed that there was no intervention group participant were diagnosed a new comorbidity, whereas 22.2% wait-listed participants did (Masia et al., 2005).

Conclusions

This study has evidently shown that the school-based intervention plays a meaningful way of treating adolescents with social anxiety disorder. The treated students clearly got better during the treatment and still kept a healthy status 9 months later. Not only has this study extended opportunities available for clinicians, but also the school-based intervention could be adopted as a long-term approach to diagnosing the social anxiety disorder and facilitating the effective treatment (Masia et al., 2005). The sustainability of the school-based intervention, which is mainly demonstrated and successfully proved in the study, is the most significant part to me.

Personal comments

This study is closely related to my research question “How to effectively help the students in the elementary school (or post-secondary school) manage their anxiety disorders and academic performance at the same time”. Although this study mainly talks about the social anxiety disorders, it does prove that one kind of anxiety disorders can be effectively treated by school-based intervention. In another word, it has provided a useful way to help the students in the school manage their social anxiety disorders. And I could resort to this intervention to find out if the other anxiety disorders can be treated equally well. In addition, this article has not mentioned any correlation between anxiety disorders and academic performance. Therefore, it still needs me to explore more and to discover other useful evidence or approach that can strongly support my research question.

References

Masia, C., Beidel, D. C., Albano, A. M., Rapee, R. M., Turner, S. M., Morris, T. L., et al. (1999). Skills for Academic and Social Success. Available from Carrie Masia-Warner, PhD, New York University School of Medicine, Child Study Center, 215 Lexington Avenue, 13th floor, New York 10016.

Masia-Warner, C., Klein, R. G., Dent, H. C., Fisher, P. H., Alvir, J., Albano, A. M., & Guardino, M. (2005). School-based intervention for adolescents with social anxiety disorder: Results of a controlled study. Journal of abnormal child psychology, 33(6), 707-722.

Silverman,W. K., & Albano, A. M. (1996). Anxiety Disorders Interview Schedule for DSM-IV-Child and Parent Versions. San Antonio, TX:Graywind, A Division of the Psychological Corporation.

Weist, M. D. (1999). Challenges and opportunities in expanded school mental health. Clinical Psychology Review, 19, 131–135.

Weisz, J. R., Donenberg, G. R., Han, S. S., & Weiss, B. (1995). Bridging the gap between laboratory and clinic in child and adolescent psychotherapy. Journal of Consulting and Clinical Psychology, 63, 688–701.

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