[社交焦虑障碍的发展精神病理学视角]。

Q3 Pharmacology, Toxicology and Pharmaceutics Neuropsychopharmacologia Hungarica Pub Date : 2020-09-01
Flora Strell-Zimonyi, Anna Kovacs, Monika Miklosi
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引用次数: 0

摘要

本文旨在从发展精神病理学的角度对社交焦虑障碍进行综述。进化理论认为,社交焦虑可能在特定环境下具有适应性,并提出了几种功能障碍机制(适应性权衡、不匹配、个体差异)。社交焦虑障碍的病因学特点是遗传和环境因素的复杂相互作用,包括基因与环境的相互作用、相关性和表观遗传机制。虽然社交焦虑障碍的主要诊断标准在整个生命周期中是相同的,但发展特征改变了其表现。在儿童中,行为症状很常见。我们可以把拒绝说话看作是与幼年有关的回避行为的一种具体表现。因此,一些研究人员认为,选择性缄默症是该疾病的一种年龄特异性亚型。尽管大多数研究人员都认为行为抑制是社交焦虑障碍的年龄特异性气质风险因素,但它也可能被视为该障碍的早期亚临床形式。在青春期,作为正常发育的一部分,社交焦虑会暂时增加。然而,在这个年龄组中,社交焦虑障碍的患病率也有所增加。成人发病的社交焦虑症是罕见的。在成人中,社交焦虑障碍必须与回避型人格障碍区分开来。社交焦虑障碍的特点是强同型连续性,但也有证据表明异型连续性,特别是其他焦虑症和重度抑郁症,可能是由于共同的遗传因素。社交焦虑的发展精神病理学方法-发展路径,年龄特异性特征等-可能有助于早期识别该疾病并促进更有效的治疗干预。
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[Developmental psychopathology perspective of Social Anxiety Disorder].

This review aims to present social anxiety disorder from a developmental psychopathological perspective. Evolutionary theories share the view that social anxiety might be adaptive in specific contexts, and suggest several mechanisms of dysfunction (adaptive trade-off , mismatch, individual differences). The aetiology of social anxiety disorder is characterized by a complex interplay of genetic and environmental factors including gene-environment interactions,correlations and epigenetic mechanisms. Although the main diagnostic criteria of social anxiety disorder are the same throughout the lifespan, developmental characteristics alter its presentation. In children, behavioural symptoms are common. We can view refusal of speech as a specific manifestation of avoidant behaviour related to young age. Therefore, some researchers suggest that selective mutism is an age-specific subtype of the disorder. Even though the majority of researchers agree that behavioural inhibition is an age-specific temperamental risk factor of social anxiety disorder, it might also be viewed as an early, subclinical form of the disorder. In adolescence, as part of the normal development, there is a temporary increase of social anxiety. In this age group, however, there is also an increase in the prevalence of socialanxiety disorder. Adult-onset social anxiety disorder is rare. In adults, social anxiety disorder has to be diff erentiated from avoidant personality disorder. Social anxiety disorder is characterized by strong homotypic continuity, but evidence for a heterotypic continuity is also available,especially with other anxiety disorders and major depression, probably due to shared genetic factors. The developmental psychopathological approach of social anxiety - developmental paths, age-specific characteristics, etc. - may contribute to an early recognition of the disorder and facilitate more effective therapeutic interventions.

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来源期刊
Neuropsychopharmacologia Hungarica
Neuropsychopharmacologia Hungarica Medicine-Medicine (all)
CiteScore
1.60
自引率
0.00%
发文量
8
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