Generalized Anxiety Disorder and Social Anxiety Disorder in Youth: Are They Distinguishable?
Social anxiety disorder (SAD) is defined by persistent, irrational anxiety in social situations while generalized anxiety disorder (GAD) is characterized by excessive worry unrelated to any specific situation. These two disorders share some features and are frequently comorbid in children and adults. The current study sought to examine this comorbidity and compare the disorders on a number of dimensions in a clinical sample of children and adolescents. It was hypothesized that SAD would be accompanied by higher levels of social anxiety and behavioral inhibition and lower levels of family expressiveness and social functioning than GAD. GAD was hypothesized to be accompanied by higher levels of worry, physiological symptoms, and anxiety sensitivity and lower levels of school functioning as compared to SAD. Youth with both disorders were hypothesized to function more poorly on all dimensions as compared to either disorder alone. Participants were drawn from a sample of 397 (137 female) youth who underwent psychoeducational assessment. A series of analyses of variance, discriminant function analyses, and factor analyses were performed using the entire sample, and repeated by gender and age group. Results indicated youth with GAD had higher levels of harm avoidance as compared to youth with social anxiety disorder. However, the diagnostic groups did not differ on other features. Moreover, results of factor and discriminant function analyses did not distinguish between the two groups. The pattern of results was similar when examined for gender and age, although some differences emerged. Overall, results suggest SAD and GAD overlap significantly in children, with less overlap in adolescents. This raises questions regarding the validity of current child anxiety taxonomies. Future research should further examine this phenomenon, including longitudinal samples and a wider range of diagnoses.