A Service Audit Examining the Prevalence Rates and Clinical Profile of Social Anxiety Disorder amongst Youths: Do the Current Treatment Practices at SLaM Reflect the NICE Guidelines?

Epidemiological data in the United States suggests Social Anxiety Disorder (SAD) has a lifetime prevalence of 12% and median onset of 13 years of age (Kessler et al., 2005). SAD is observed to typically develop between childhood and early adolescence and manifest by 20 years of age (Michael et al., 2007). Based on these trends, it is unsurprising evidence suggests SAD is one of the most prevalent anxiety disorders observed amongst children. According to DSM V, childhood SAD can be recognized by a pervasive pattern of extreme discomfort which is experience in a variety of social contexts and can be exhibited through: prolonged crying or tantrums, becoming physically immobilized, shrinking away from other people, becoming extremely clinging and not being able to speak in social situations (DSM V). Such acute anxiety can culminate in a panic attack whilst attending school, public speaking or starting conversations. A distinction between clinically ‘normal’ anxiety and that of pathological origin can be seen by somatic symptoms (i.e. increased sweating and palpitations), and dysfunctional cognitive appraisals (i.e. experiencing dread by catastrophizing the event) that ultimately chronically disable individuals daily functioning. Particularly among children, the initial signs of social anxiety may be misconstrued as general shyness. Consequently, this hinders early detection and intervention that may further exacerbate its manifestation through the comorbidity of related psychopathologies. The essence of the current project is two-fold. Firstly to ascertain a clinical profile of SAD in children/adolescents within the local community, by examining the population, prevalence and demographic details of those who use SLaM services. The second part of the project involves culminating evidence to provide recommendations to improve the services we provide, in respects to the types of treatment offered and clinical outcome.