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A Prospective-Longitudinal Community Study

Roselind Lieb, PhD; Hans-Ulrich Wittchen, PhD; Michael Höfler, DiplStat; Martina Fuetsch, Mag.rer.nat; Murray B. Stein, MD; Kathleen R. Merikangas, PhD

Arch Gen Psychiatry. 2000;57:859-866.

Background  This article examines the associations between DSM-IV social phobia and parental psychopathology, parenting style, and characteristics of family functioning in a representative community sample of adolescents.

Methods  Findings are based on baseline and first follow-up data of 1047 adolescents aged 14 to 17 years at baseline (response rate, 74.3%), and independent diagnostic interviews with one of their parents. Diagnostic assessments in parents and adolescents were based on the DSM-IV algorithms of the Munich-Composite International Diagnostic Interview. Parenting style (rejection, emotional warmth, and overprotection) was assessed by the Questionnaire of Recalled Parental Rearing Behavior, and family functioning (problem solving, communication, roles, affective responsiveness, affective involvement, and behavioral control) was assessed by the McMaster Family Assessment Device.

Results  There was a strong association between parental social phobia and social phobia among offspring (odds ratio [OR], 4.7; 95% confidence interval [CI], 1.6-13.5). Other forms of parental psychopathology also were associated with social phobia in adolescents (depression: OR, 3.6; 95% CI, 1.4-9.1; any anxiety disorder other than social phobia: OR, 3.5; 95% CI, 1.4-8.8; and any alcohol use disorder: OR, 3.0; 95% CI, 1.1-7.8). Parenting style, specifically parental overprotection (OR, 1.4; 95% CI, 1.0-1.9) and rejection (OR, 1.4; 95% CI, 1.1-1.9), was found to be associated with social phobia in respondents. Family functioning was not associated with respondents' social phobia.

Conclusions  Data suggest that parental psychopathology, particularly social phobia and depression, and perceived parenting style (overprotection and rejection) are both associated with the development of social phobia in youth.

From the Department of Clinical Psychology and Epidemiology, Max Planck Institute of Psychiatry, Munich, Germany (Drs Lieb and Wittchen, Mr Höfler and Ms Fuetsch); Department of Psychiatry, University of California at San Diego, La Jolla (Dr Stein); and the Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn (Dr Merikangas).

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