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Adolescents with a social anxiety disorder are at a higher risk of experiencing depression and suicidal ideation two years after they first develop social anxiety symptoms, according to a study published in JCPP Advances.
“Social Anxiety Disorder typically develops in adolescence and is associated with multiple adverse outcomes during adolescence, such as poorer social functioning, poorer academic performance, suicidal ideation, and depressive symptoms,” lead author Kenny Chiu, a clinical lecturer at UEA’s Department of Clinical Psychology and Psychological Therapies, and colleagues wrote in the study. “Social relationships are highly rewarding during adolescence. However, social anxiety may cause adolescents to avoid social situations. Even when they do engage socially, their social anxiety may impact their performance due to the unintended effects of safety behaviors, making them more susceptible to receive negative feedback from peers or experience peer rejection.”
“These negative interpersonal outcomes may trigger a sense of worthlessness (e.g. “I am a failure”, “Nobody wants me around”) and hopelessness (e.g. “I will always be alone”, “I will never be good enough for anything or anyone”), reducing their sense of achievement, connection, and pleasure and promoting avoidance. These depressive symptoms can not only maintain their social anxiety but also lead them to believe that they will never fit in and that they are a burden to others,” the authors added. “These beliefs around thwarted belongingness and perceived burdensomeness may trigger suicidal ideation, as suicide may seem to be the only way. In addition, these depressive symptoms may persist over years, especially when young people hold negative social fear strongly and avoid social situations.”
To investigate how social anxiety could contribute to an adolescent’s deteriorating mental health, the researchers had recruited 2,397 young people residing in the United Kingdom who were 14 to 24 years old. The researchers approached the study participants through 50 clinics of general practitioners and schools in Cambridgeshire, London, and nearby areas from 2012 to 2017.
Each participant had completed questionnaires that delved into their mental health and whether they were experiencing symptoms of depressive symptoms, suicidal ideation, social anxiety symptoms, or generalized anxiety. Some examples of the questions the participants had to answer included “I worry about what other people think of me”, “I feel that others do not like the way I do things”, and “I worry about what my parents will say to me”, and “I feel someone will tell me I do things the wrong way”.
The researchers then conducted follow-ups with the study participants for two years. They found that social anxiety was a “significant predictor” of suicidal ideation within a two-year time frame.
In a press release, the second author of the study, Argyris Stringaris, a professor of child and adolescent psychiatry at University College London, said: “Our findings suggest addressing social anxiety early could be crucial in preventing the development of suicidal thoughts and other depressive symptoms.”