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      Understanding Social Anxiety Disorder in Adolescents and Improving Treatment Outcomes: Applying the Cognitive Model of Clark and Wells (1995)

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          Abstract

          Social anxiety disorder is a condition characterised by a marked and persistent fear of being humiliated or scrutinised by others. Age-of-onset data point to adolescence as a developmentally sensitive period for the emergence of the condition, at a time when the peer group becomes increasingly important. Social anxiety in adolescence is associated with considerable impairment that persists through to adulthood. There are clear potential benefits to delivering effective interventions during adolescence. However, there is limited evidence on the specific efficacy of available therapies. This is in contrast to adults, for whom we have interventions with very specific treatment effects. One such treatment is individual cognitive therapy. Cognitive therapy is based on the cognitive model of social anxiety proposed by Clark and Wells (in: Heimberg, Leibowitz, Hope, Scheiber (eds) Social phobia: diagnosis, assessment and treatment, The Guilford Press, New York, 1995). The present review examines the potential application of this adult cognitive model to the understanding of adolescent social anxiety and considers additional adolescent-specific factors that need to be accommodated. It is suggested that a developmentally sensitive adoption of the cognitive model of social anxiety disorder (Clark and Wells 1995) for adolescents may lead to better treatment outcomes.

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          Cyberbullying: its nature and impact in secondary school pupils.

          Cyberbullying describes bullying using mobile phones and the internet. Most previous studies have focused on the prevalence of text message and email bullying. Two surveys with pupils aged 11-16 years: (1) 92 pupils from 14 schools, supplemented by focus groups; (2) 533 pupils from 5 schools, to assess the generalisability of findings from the first study, and investigate relationships of cyberbullying to general internet use. Both studies differentiated cyberbullying inside and outside of school, and 7 media of cyberbullying. Both studies found cyberbullying less frequent than traditional bullying, but appreciable, and reported more outside of school than inside. Phone call and text message bullying were most prevalent, with instant messaging bullying in the second study; their impact was perceived as comparable to traditional bullying. Mobile phone/video clip bullying, while rarer, was perceived to have more negative impact. Age and gender differences varied between the two studies. Study 1 found that most cyberbullying was done by one or a few students, usually from the same year group. It often just lasted about a week, but sometimes much longer. The second study found that being a cybervictim, but not a cyberbully, correlated with internet use; many cybervictims were traditional 'bully-victims'. Pupils recommended blocking/avoiding messages, and telling someone, as the best coping strategies; but many cybervictims had told nobody about it. Cyberbullying is an important new kind of bullying, with some different characteristics from traditional bullying. Much happens outside school. Implications for research and practical action are discussed.
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            Peer influence on risk taking, risk preference, and risky decision making in adolescence and adulthood: an experimental study.

            In this study, 306 individuals in 3 age groups--adolescents (13-16), youths (18-22), and adults (24 and older)--completed 2 questionnaire measures assessing risk preference and risky decision making, and 1 behavioral task measuring risk taking. Participants in each age group were randomly assigned to complete the measures either alone or with 2 same-aged peers. Analyses indicated that (a) risk taking and risky decision making decreased with age; (b) participants took more risks, focused more on the benefits than the costs of risky behavior, and made riskier decisions when in peer groups than alone; and (c) peer effects on risk taking and risky decision making were stronger among adolescents and youths than adults. These findings support the idea that adolescents are more inclined toward risky behavior and risky decision making than are adults and that peer influence plays an important role in explaining risky behavior during adolescence.
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              Psychological, physical, and academic correlates of cyberbullying and traditional bullying.

              To examine the relationship between children's and adolescents' experiences with cyberbullying and traditional bullying and psychological health, physical health, and academic performance. Nine hundred thirty-one students in grades 6 through 12 completed an anonymous survey examining their experiences with cyberbullying and traditional bullying. Also included were measures of anxiety, depression, self-esteem, physical well-being, school attendance, and academic performance. Participants were categorized as belonging to one of four groups: cyber victims, cyberbullies, cyber bully/victims, and those not involved in cyberbullying. A similar categorization was done with traditional bullying. Those in the bully/victim groups (and particularly the cyber bully/victim group) had the most negative scores on most measures of psychological health, physical, health, and academic performance. There appears to be a substantial, although not perfect, overlap between involvement in traditional bullying and cyberbullying. Additionally, the physical, psychological, and academic correlates of the two types of bullying resembled one another. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                +44 1865 618600 , eleanor.leigh@psy.ox.ac.uk
                Journal
                Clin Child Fam Psychol Rev
                Clin Child Fam Psychol Rev
                Clinical Child and Family Psychology Review
                Springer US (New York )
                1096-4037
                1573-2827
                13 April 2018
                13 April 2018
                2018
                : 21
                : 3
                : 388-414
                Affiliations
                [1 ]ISNI 0000 0004 1936 8948, GRID grid.4991.5, Department of Experimental Psychology, , University of Oxford, ; Oxford, UK
                [2 ]Oxford Centre for Anxiety Disorders and Trauma, The Old Rectory, Paradise Square, Oxford, OX1 1TW UK
                Author information
                http://orcid.org/0000-0003-2756-3770
                http://orcid.org/0000-0002-8173-6022
                Article
                258
                10.1007/s10567-018-0258-5
                6447508
                29654442
                b824d3c6-e686-4920-a032-584643826b80
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: 102176/Z/13/Z
                Award ID: WT069777
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100000272, National Institute for Health Research;
                Award ID: NF-SI-0512-10132
                Award Recipient :
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                © Springer Science+Business Media, LLC, part of Springer Nature 2018

                Clinical Psychology & Psychiatry
                social anxiety disorder,adolescents,young people,cognitive model,cognitive therapy,psychological therapy

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