Generalized versus performance-focused social phobia: Patterns of comorbidity among youth

The goal of this study was to examine patterns of comorbidity associated with generalized and performance-focused social phobia (SOP) among a community-based sample of youth while also examining whether gender and age influenced the associations found. Participants from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, aged 9–17 (N = 1295), were used. Diagnoses were based on structured clinical interviews with youth and their caregivers. Results indicated that both subtypes of SOP were associated with a range of other anxiety disorders. Contrary to the expectations, performance-focused SOP was somewhat more strongly associated with depressive disorders than was generalized SOP; this difference was driven primarily by higher rates of dysthymia (DYS) among those with performance-focused SOP than generalized SOP. Although attention-deficit hyperactivity disorder (ADHD) was associated with generalized SOP, more severe externalizing behavior (oppositional defiant disorder (ODD) and conduct disorder (CD)) was only associated with performance-focused SOP. Limited gender and age differences in these relationships were found.