TITLE:Prevalence of Social Anxiety among Students in Medical College Introduction: Social Anxiety Disorder (SAD) ishighly prevalent in both clinical settings and as well as community samples. Incommunity samples SAD considered as the second most frequent anxiety disorderafter specific phobia that attained prevalence rates of 13% (Kessler,McGonagle, Zhao et al., 1994). Another community study in Switzerland reportedeven higher lifetime estimates of social phobia than the NCS did 16 percent(Wacker, Müllejans, Klein, & Battegay, 1992). In Sweden, Furmark andcolleagues (1999) further supported that social phobia is among the most commonmental disorders when they in a community survey noted a point prevalence of15.6 percent. Coming to onset, it typically beginsas early as adolescence or early adulthood (Hazen, 1995 & Ost, 1987).
The characteristicsfeature of SAD is excessive and persistent fear of social situations in whichthe patient is exposed to the observation or scrutiny of others.The fieldof medicine is very vast and inherently stressful to pursue. Students inmedical college work with high workload, beyond their duty hours very oftencompromising their sleep and social activities.
Still there is high level competition and social support for them isvery little. All of these contributes to medical student’s stress & theirdeterioting mental health (Dyrbye, Thomas, & Shanafelt, 2006). It affects physical health, academicperformance, social interaction in a negative way. Rationale: Inspite of this high prevelance, inour clinical experience, we are not seeing it as much as other mental healthdisorders. Perhaps, one of the main reasons is the lack of awareness incommunity sample about this condition and whether it needs a professional helpor not.
It’s impairment is substantial(Schneier, 1992 & Davidson, 1993). Critical social impairments usuallydevelop between the ages of fifteen and twenty-five, among both males andfemales (Piet, Hougaard, Hecksher, & Rosenberg, 2010). Functionalimpairment associated with it may be severe (Rapee, 1995). Social interationfears (e.g, interaction with strangers, authority figures, dating), performancefears (e.g, test anxiety, public speaking) and observation fears (e.g, workingin front of others, eating before others and etc) are common. Above notedimpairments and complication can even extend to inability towork, attend school, or marry which are very common (Wacker, 1992; Furmark,1999 & Zaider, 2003).
SAD, again, is usually complicatedby work absenteeism, drug and/or anxiolytics abuse, alcoholism and depression(Barlow, DiNardo, Vermilyea and Blanchard, 1986; Bowen, Cipywnyk, D’Arcy andKeegan, 1984; Chambless, Cherney, Caputo and Rheinstein, 1987; Higgins andMarlatt, 1975; Kushner, Sher and Beitman, 1990; Schneier, Martin, Liebowitz etal., 1989). In some cases these problems are the expression of an undiagnosedsocial phobia, so that the prevalence of this clinical condition may be greaterthan estimated (Stravynski, Lamontagne and Lavallee, 1986). Hence the present study can uncoverthe unidentified cases of SAD in student samples and can benefit them inguiding them for seeking effective required management options and may savethem from the associated impairments of it.Objective :1.
To measure magnitude of social anxiety acrossvarious year in MBBS.Implications :1. We will know the prevalance of SAD in medical college as perthe different batches/years.2. Awareness of such may push for early intervention.3.
It further leads to decrease of various associatedimpairments like stress, depression, insomnia, pain attacks etc.4. Increase in work productivity, coping with stress in social interaction.5. Overall we can expect a better mental health status.Methodology :Research Design: CrossSectional StudySample: Participantswill be randomly selected from students of SCB Medical College, Cuttack.
Materials: Apart fromSocio- Demographic Data Sheet, the screening tool will be Social Phobia Inventory (SPIN: Connor et al., 2000), a 17-item self-report measure of fear and avoidance of arange of social situations and of physiological symptoms of anxiety. The SPINhas been validated for use in clinical populations, has strong convergent anddiscriminant validity, and good internal consistency and test-retest reliability (Antony, Coons,McCabe, Ashbaugh, & Swinson, 2006);Alphasranged from .88 to .92 across the four assessment points in the present study.
Data Analysis: Appropriate statistical analysis will bedone. References :1. Antony, M. M., Coons, M. J.
, McCabe,R. E., Ashbaugh, A., & Swinson, R. P. (2006). Psychometric properties ofthe social phobia inventory: Further evaluation. Behaviour research andtherapy, 44(8), 1177-1185.
2. Connor, K. M., Davidson, J. R.,Churchill, L. E., Sherwood, A.
, Weisler, R. H., & FOA, E.
(2000).Psychometric properties of the social phobia inventory (SPIN). The BritishJournal of Psychiatry, 176(4), 379-386.3. Dyrbye, L. N.
, Thomas, M. R., & Shanafelt,T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distressamong US and Canadian medical students.
Academic Medicine, 81(4),354-373.4. Furmark, T., Tillfors, M., Everz, P.O., Marteinsdottir, I.
, Gefvert, O., & Fredrikson, M. (1999). Social phobiain the general population: prevalence and sociodemographic profile. Socialpsychiatry and psychiatric epidemiology, 34(8), 416-424.5. HazenAL, Stein MB.
Clinical phenomenology and comorbidity. In: Stein MB, ed. SocialPhobia: Clinical and Research Perspectives. Washington, DC: AmericanPsychiatric Press; 1995:3-41.6. KesslerRC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen H-U,Kendler KS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disordersin the United States: results from the National Comorbidity Survey.
Arch GenPsychiatry. 1994;51:8-19.7. O¨ st L-G. Age of onset in different phobias.J Abnorm Psychol.
1987;96:223-229.8. Piet, J., Hougaard, E., Hecksher, M.S., & Rosenberg, N. K.
(2010). A randomized pilot study of mindfulness-basedcognitive therapy and group cognitive-behavioral therapy for young adults withsocial phobia. ScandinavianJournal of Psychology, 51, 403-410.9. Rapee, R. M. (1995).
Descriptivepsychopathology of social phobia. Social phobia: Diagnosis, assessment, andtreatment, 41-66.10. Reich J, Goldenberg I, Vasile R, Goisman R,Keller M. A prospective followalong study of the course ofsocial phobia.
Psychiatry Res. 1994;54:249-258.11. Schneier FR, Heckelman LR, Garfinkel R,Campeas R, Fallon BA, Gitow A, Street L, DelBene D, Liebowitz MR. Functionalimpairment in social phobia. J Clin Psychiatry.1994;55:322-331.12.
Schneier FR, JohnsonJ, Hornig C, Liebowitz MR, Weissman MM. Social phobia: comorbidity andmorbidity in an epidemiologic sample. Arch Gen Psychiatry. 1992;49:282-288..13. Stravynski, A., Lamontagne, Y.
,& Lavallée, Y. J. (1986). Clinical phobias and avoidant personalitydisorder among alcoholics admitted to an alcoholism rehabilitation setting.
TheCanadian Journal of Psychiatry, 31(8), 714-719.14. Wacker, H. R., Mullejans, R., Klein,K.
H., & Battegay, R. (1992). Identification of cases of anxiety disordersand affective disorders in the community according to ICD-10 and DSM-III-R byusing the Composite International Diagnostic Interview (CIDI).
Int J MethodsPsychiatr Res, 2, 91-100.15. Zaider, T. I., Heimberg, R. G.
,Fresco, D. M., Schneier, F. R., & Liebowitz, M. R. (2003).
Evaluation ofthe clinical global impression scale among individuals with social anxietydisorder. Psychological medicine, 33(04), 611-622.