

ORIGINAL ARTICLE Year : 2016 | Volume : 4 | Issue : 3 | Page : 207-211

Risk factors of social anxiety in medical college students



Suneet Kumar Upadhyaya1, Chintan M Raval1, Devendra Kumar Sharma2, Jaykaran Charan3

1 Department of Psychiatry, GMERS Medical College, Patan, Gujarat, India

2 Department of Psychiatry, Government Medical College, Kota, Rajasthan, India

3 Department of Pharmacology, GMERS Medical College, Patan, Gujarat, India



Date of Web Publication 18-Jul-2016

Correspondence Address:

Suneet Kumar Upadhyaya

Department of Psychiatry, GMERS Medical College, Patan, Gujarat

India

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DOI: 10.4103/2468-6360.186496

Abstract

Context: Literature suggests that social anxiety develops due to the complex interplay of multiple risk factors including self-perception and negative life events. We examined the association between these variables and social anxiety among medical students.

Aims: The aim is to assess the association of risk factors and social anxiety in medical students.

Materials and Methods: In this cross-sectional observational study, 334 medical students were given a semi-structured self-reported questionnaire. It enquired about demographic details: self-satisfaction in terms of weight, body image and facial appearance; six negative life events which were conflict between parents, sexual, physical and emotional abuse, family violence and loss of someone close. Social anxiety was assessed using Liebowitz social anxiety scale (LSAS). Data were analysed using SPSS software (Version 16.0., SPSS Inc., Chicago, IL, USA). Chi-square and Student's t-tests were used for qualitative and quantitative data, respectively. Linear regression analysis was performed to assess association between negative life events and social anxiety scores. The value of P < 0.05 was considered statistically significant.

Results: Mean standard deviation (SD) age of sample was 18 (1.04) years. Mean (SD) LSAS score was 33 (20). Linear regression analysis adjusted for age, gender and family psychiatric history revealed positive association between LSAS score and dissatisfaction with body image (P = 0.001), dissatisfaction with facial appearance (P = 0.047), and family violence (P = 0.048). Dissatisfaction with weight showed association with social anxiety in univariate analysis, but it could not sustain on regression analysis. Other negative life events were not significantly associated with LSAS score.

Conclusions: Development of social anxiety is significantly associated with dissatisfaction with body image and facial appearance. Exposure to family violence is also an associated factor.

Keywords: Body image, facial appearance, family violence, life events, social phobia

How to cite this article:

Upadhyaya SK, Raval CM, Sharma DK, Charan J. Risk factors of social anxiety in medical college students. J Health Spec 2016;4:207-11

How to cite this URL:

Upadhyaya SK, Raval CM, Sharma DK, Charan J. Risk factors of social anxiety in medical college students. J Health Spec [serial online] 2016 [cited 2020 Sep 21];4:207-11. Available from: http://www.thejhs.org/text.asp?2016/4/3/207/186496

Introduction

Materials and methods

Results

Table 1: Characteristics and comparison of the sample (n =334)



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Table 2: Association between risk factors and LSAS score



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Discussion

Conclusion

References

1.

Furmark T. Social phobia: Overview of community surveys. Acta Psychiatr Scand 2002;105:84-93. 2. nd ed. New York: Elsevier; 2010. p. 395-422.

Heimberg RG, Brozovich FA, Rapee RM. A cognitive-behavioral model of social anxiety disorder: Update and extension. In: Hofmann SG, DiBartolo PM, editors. Social Anxiety: Clinical, Developmental, and Social Perspectives. 2ed. New York: Elsevier; 2010. p. 395-422. 3.

Lieb R, Wittchen HU, Höfler M, Fuetsch M, Stein MB, Merikangas KR. Parental psychopathology, parenting styles, and the risk of social phobia in offspring: A prospective-longitudinal community study. Arch Gen Psychiatry 2000;57:859-66. 4.

Schwartz CE, Snidman N, Kagan J. Adolescent social anxiety as an outcome of inhibited temperament in childhood. J Am Acad Child Adolesc Psychiatry 1999;38:1008-15. 5. et al. Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. Controls. Acta Psychiatr Scand 2010;122:66-74.

Hovens JG, Wiersma JE, Giltay EJ, van Oppen P, Spinhoven P, Penninx BW,Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. Controls. Acta Psychiatr Scand 2010;122:66-74. 6.

Flouri E, Mavroveli S, Tzavidis N. Modeling risks: Effects of area deprivation, family socio-economic disadvantage and adverse life events on young children′s psychopathology. Soc Psychiatry Psychiatr Epidemiol 2010;45:611-9. 7.

Briggs-Gowan MJ, Carter AS, Clark R, Augustyn M, McCarthy KJ, Ford JD. Exposure to potentially traumatic events in early childhood: Differential links to emergent psychopathology. J Child Psychol Psychiatry 2010;51:1132-40. 8.

van der Vegt EJ, Tieman W, van der Ende J, Ferdinand RF, Verhulst FC, Tiemeier H. Impact of early childhood adversities on adult psychiatric disorders: A study of international adoptees. Soc Psychiatry Psychiatr Epidemiol 2009;44:724-31. 9.

Clark C, Caldwell T, Power C, Stansfeld SA. Does the influence of childhood adversity on psychopathology persist across the lifecourse? A 45-year prospective epidemiologic study. Ann Epidemiol 2010;20:385-94. 10.

Elzinga BM, Spinhoven P, Berretty E, de Jong P, Roelofs K. The role of childhood abuse in HPA-axis reactivity in social anxiety disorder: A pilot study. Biol Psychol 2010;83:1-6. 11. et al. The hypothalamic-pituitary-adrenal axis and serotonin abnormalities: A selective overview for the implications of suicide prevention. Eur Arch Psychiatry Clin Neurosci 2010;260:583-600.

Pompili M, Serafini G, Innamorati M, Möller-Leimkühler AM, Giupponi G, Girardi P,The hypothalamic-pituitary-adrenal axis and serotonin abnormalities: A selective overview for the implications of suicide prevention. Eur Arch Psychiatry Clin Neurosci 2010;260:583-600. 12.

[ PUBMED ] Mehtalia K, Vankar GK. Social anxiety in adolescents. Indian J Psychiatry 2004;46:221-7. 13. et al. Epidemiological study of child & adolescent psychiatric disorders in urban & rural areas of Bangalore, India. Indian J Med Res 2005;122:67-79.

Srinath S, Girimaji SC, Gururaj G, Seshadri S, Subbakrishna DK, Bhola P,Epidemiological study of child & adolescent psychiatric disorders in urban & rural areas of Bangalore, India. Indian J Med Res 2005;122:67-79. 14.

Mohapatra S, Agarwal V, Sitholey P, Arya A. A clinical study of anxiety disorders in children and adolescents from North Indian children and adolescents clinic. Asian J Psychiatr 2014;8:84-8. 15. et al. Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depress Anxiety 2009;26:34-8.

Rytwinski NK, Fresco DM, Heimberg RG, Coles ME, Liebowitz MR, Cissell S,Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depress Anxiety 2009;26:34-8. 16.

Tang J, Yu Y, Du Y, Ma Y, Zhu H, Liu Z. Association between actual weight status, perceived weight and depressive, anxious symptoms in Chinese adolescents: A cross-sectional study. BMC Public Health 2010;10:594. 17. et al. Body dysmorphic disorder, social anxiety and depressive symptoms in Chinese medical students. Soc Psychiatry Psychiatr Epidemiol 2010;45:963-71.

Liao Y, Knoesen NP, Deng Y, Tang J, Castle DJ, Bookun R,Body dysmorphic disorder, social anxiety and depressive symptoms in Chinese medical students. Soc Psychiatry Psychiatr Epidemiol 2010;45:963-71. 18.

Peng ZW, Lam LT, Jin J. Factors associated with social interaction anxiety among Chinese adolescents. East Asian Arch Psychiatry 2011;21:135-41. 19.

Izgiç F, Akyüz G, Dogan O, Kugu N. Social phobia among university students and its relation to self-esteem and body image. Can J Psychiatry 2004;49:630-4. 20.

Fang A, Hofmann SG. Relationship between social anxiety disorder and body dysmorphic disorder. Clin Psychol Rev 2010;30:1040-8. 21. et al. Symptoms of disordered eating, body shape, and mood concerns in male and female Chinese medical students. Compr Psychiatry 2010;51:516-23.

Liao Y, Knoesen NP, Castle DJ, Tang J, Deng Y, Bookun R,Symptoms of disordered eating, body shape, and mood concerns in male and female Chinese medical students. Compr Psychiatry 2010;51:516-23. 22.

Hunte ML. Buying racial capital: Skin-bleaching and cosmetic surgery in a globalized world. J Pan Afr Stud 2011;4:142-64. 23.

Ishigooka J, Iwao M, Suzuki M, Fukuyama Y, Murasaki M, Miura S. Demographic features of patients seeking cosmetic surgery. Psychiatry Clin Neurosci 1998;52:283-7. 24.

Sansone RA, Sansone LA. Cosmetic surgery and psychological issues. Psychiatry Edgmont 2007;4:65-8. 25. et al. Social anxiety and negative early life events in university students. Rev Bras Psiquiatr 2012;34 Suppl 1:S69-74.

Binelli C, Ortiz A, Muñiz A, Gelabert E, Ferraz L, S Filho A,Social anxiety and negative early life events in university students. Rev Bras Psiquiatr 2012;34 Suppl 1:S69-74. 26.

Benjet C, Borges G, Medina-Mora ME. Chronic childhood adversity and onset of psychopathology during three life stages: Childhood, adolescence and adulthood. J Psychiatr Res 2010;44:732-40. 27.

Margolin G, Gordis EB. The effects of family and community violence on children. Annu Rev Psychol 2000;51:445-79. 28.

Raposo SM, Mackenzie CS, Henriksen CA, Afifi TO. Time does not heal all wounds: Older adults who experienced childhood adversities have higher odds of mood, anxiety, and personality disorders. Am J Geriatr Psychiatry 2014;22:1241-50. 29.

Hardt J, Rutter M. Validity of adult retrospective reports of adverse childhood experiences: Review of the evidence. J Child Psychol Psychiatry 2004;45:260-73. 30.

van Veen T, Wardenaar KJ, Carlier IV, Spinhoven P, Penninx BW, Zitman FG. Are childhood and adult life adversities differentially associated with specific symptom dimensions of depression and anxiety? Testing the tripartite model. J Affect Disord 2013;146:238-45. 31. et al. The specificity of childhood adversities and negative life events across the life span to anxiety and depressive disorders. J Affect Disord 2010;126:103-12.

Spinhoven P, Elzinga BM, Hovens JG, Roelofs K, Zitman FG, van Oppen P,The specificity of childhood adversities and negative life events across the life span to anxiety and depressive disorders. J Affect Disord 2010;126:103-12. 32.

Brook CA, Schmidt LA. Social anxiety disorder: A review of environmental risk factors. Neuropsychiatr Dis Treat 2008;4:123-43. 33.

Hofmann SG. Self-focused attention before and after treatment of social phobia. Behav Res Ther 2000;38:717-25. 34.

Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet 2002;360:1083-8.

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