Social anxiety disorder, also known as social phobia, is a debilitating mental health diagnosis that affects millions of adults in the United States. According to the National Institute of Mental Health, approximately 6.8% of adults in the United States suffer from social phobia, and 29.9% of those cases are classified as severe.
What is social anxiety disorder? Social anxiety disorder is defined by the DSM-V as “marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.” People who experience social anxiety are plagued by fear of rejection, embarrassment, and humiliation, even when the situation is not something that healthy adults would consider daunting. Individuals with social phobia are diagnosed with social anxiety disorder if symptoms persist for more than 6 months and if it causes them significant distress. In children, these symptoms are considered social anxiety only if they occur in situations with their peers.
What causes social anxiety disorder? The average age of onset for social phobia is 13 years of age, and is typically preceded by a stressful or humiliating experience. While there may be some genetic causes, this information implicates that a traumatic childhood event may be a likely factor in the development of social phobias. Self-presentation theory suggests that anxiety is caused by the belief that, in social situations, there is a real or perceived risk involved when one does not make a good impression on others. The higher the perceived risk, the worse the anxiety becomes. School aged children are under great pressure to appear desirable to their peers and, if they do not, they risk becoming targets of bullying. Let’s explore the possible impact that bullying may have on the development of social anxiety disorder.
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If the development of social anxiety disorder is influenced by experiences with bullying, what can be done to negate the effects? In a perfect world, the best solution would be to stop bullies in their tracks, before the damage can be done. However, that is not a feasible solution since adult authority figures are not always present when bullying takes place. A study conducted by DeRosier (2004) introduced an intervention in which participants had an active role in learning prosocial behavior and attitudes, behavioral and cognitive social skills, and strategies for coping with bullying and peer pressure. They learned these things through role playing, modeling, and other hands-on activities. The results showed that the children had higher self-esteem, greater social self-efficacy, and lower social anxiety.
The Penn Resiliency Program (Schneider, et. al, 2012) offers a similar solution- building confidence through cognitive restructuring and skill acquisition:
Cognitive restructuring: Middle school aged children viewed the last frame of a cartoon that had a character with either a smile or frown on its face, and were asked to come up with an explanation for that outcome. The purpose of this was to associate one’s behavior with the feelings that resulted. They also viewed skits in which characters attributed negative outcomes to either their own failings or to outside forces. This illustrated the different ways of explaining negative outcome, including the possibility that many things are not necessarily their fault or even within their control.
Skill acquisition: Sometimes changing one’s thought process alone is not enough to resolve negative feelings. The Penn Resiliency study also taught children valuable problem-solving skills that included being more assertive and negotiating with others. Once again, these skills were presented through the cartoon medium to help simplify things for the young participants.
Results: Children who experienced both cognitive restructuring and skill acquisition were able to be less pessimistic in terms of explaining negative outcomes and their depressive symptoms were reduced. These effects lasted for 3 years after the conclusion of the study.
Evidence suggests that an effective way to help school age children avoid and cope with bullying is to show them. Through modeling, role playing, and other hands-on approaches, we can teach children how to navigate through troublesome school experiences which, in turn, is likely to help some avoid developing social anxiety disorder that persists throughout adulthood.
References:
McCabe, R. E., Anthony, M. M., Summerfeldt, L. J., Liss, A., & Swinson, R. P. (2003). Preliminary Examination of the Relationship Between Anxiety Disorders in Adults and Self-Reported History of Teasing or Bullying Experiences. Cognitive Behaviour Therapy, 32(4), 187-193.
Craig, W. M. (1998). The relationship among bullying, victimization, depression, anxiety, and aggression in elementary school children. Personality and individual differences, 24(1), 123-130.
Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, D.C.: American Psychiatric Association. Retrieved February 9, 2017, from https://psicovalero.files.wordpress.com/2014/11/dsm-v-ingles-manual-diagnc3b3stico-y-estadc3adstico-de-los-trastornos-mentales.pdf.
Schneider, F. W., Gruman, J. A., & Coutts, L. M. (2012). Applied social psychology: understanding and addressing social and practical problems. Los Angeles: Sage.
DeRosier, M. E. (2004). Building Relationships and Combating Bullying: Effectiveness of a School-Based Social Skills Group Intervention. Journal Of Clinical Child & Adolescent Psychology, 33(1), 196-201.
[Untitled illustration of bullying]. Retrieved February 10, 2017 from http://simpleacts.org/bullying-prevention/category/anti-bullying/