Exploring the role of the DSM-5 performance-only specifier in adolescents with social anxiety disorder. (December 2018)

• Record Type: Journal Article
• Authors: Fuentes-Rodriguez, Gema; Garcia-Lopez, Luis-Joaquin; Garcia-Trujillo, Veronica
• Is Part Of: Psychiatry research. Volume 270(2018)
• Page Start: 1033
• Page End: 1038
• Publication Date: 2018-12
• Subjects: Comorbidity -- Dimensional -- performance-only specifier -- Social anxiety -- Social anxiety disorder -- Subtypes; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2018.03.052
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: DSM-5 performance-only specifiers differed from those with the no specifier condition and controls. The limited impact on some measures calls into question the clinical usefulness of the specifier. Findings are consistent with a dimensional solution, suggesting that social anxiety disorder exists on a continuum. Abstract: The DSM-5 social anxiety disorder section has recently added the performance-only specifier for individuals whose anxiety is limited to speaking or performing in public. The impact of the DSM-5 performance-only specifier remains a neglected area. The sample comprised 44 healthy controls and 50 adolescents with a clinical diagnosis of SAD (20% met criteria for the performance-only specifier). Findings revealed that adolescents with the specifier had a later age of onset; lower levels of depression, social anxiety symptomatology and clinical severity; and a lesser degree of comorbidity relative to adolescents with SAD but excluding the performance-only specifier. Specifiers only evidenced higher (cognitive) social anxiety symptomatology compared to healthy controls. Results of this study also suggested that the performance-only specifier may correspond to a mild form of social anxiety disorder. Data also revealed that SAD exists on a continuum of severity among healthy controls, specifier participants, and those with both interactional and performance fears, which is consistent with a dimensional structure for SAD. Finally, findings suggested a unique comorbid pattern for specifiers and those adolescents with SAD but excluding the performance-only specifier. The implications of these findings for the etiology, assessment, classification, and treatment of social anxiety in youth are discussed.