Peer Relationships among Children with Social and Generalized Anxiety Disorders


Children with anxiety disorders often are believed to experience a similar degree of difficulty with social functioning regardless of the type of anxiety suffered as compared to non-anxious children. However, some research suggests that there might be important differences in social functioning based on the type of anxiety experienced but little research has examined this possibility. Therefore, this study compared peer functioning across children with social anxiety disorder (SAD), generalized anxiety disorder (GAD), and healthy, non-anxious children and found that children with different anxiety disorders experience unique patterns of social functioning and impairments. The details and implications of this study are discussed below (Scharfstein, Alfano, Beidel, & Wong, 2011).


What were the goals of this study?

The main goal of this study was to compare aspects of social functioning for children with social anxiety disorder (SAD), generalized anxiety disorder (GAD), and non-anxious, healthy children. This study addressed a general need for research comparing specific characteristics of peer relationships for children with specific types of anxiety.

How did this study address these goals?

This study included children 6 to 13 years old who met criteria for SAD, GAD, or no diagnosis. Children and their parents were evaluated in person by professionals. Children and parents were given a semi-structured interview to determine diagnoses. Parents were given additional questionnaires to assess aspects of their children’s peer relationships, social competence, and social problems.

What were the main results of this study?

This study found that children with SAD, GAD, and healthy children experienced similarities and differences in the nature of their peer relationships. For aspects of peer relationships in general, all groups of children showed similarities in the frequency of having a best friend, in the extent of difficulty maintaining friendships, and in the level of current involvement in social organizations or groups. Also, all groups of children had similar levels of social problems that were within a normal range of functioning.

However, compared to healthy children, anxious children had significantly fewer friends compared to their peers. Within the anxiety groups, children with either SAD or GAD had similarly low numbers of friendships. In regards to difficulty making friends, children with GAD were similar to healthy children, but children with SAD had significantly more difficulty making friends compared to healthy children and children with GAD. A similar pattern emerged for social competence in which healthy children and those with GAD had similar abilities whereas children with SAD had significantly lower social competence than all other children assessed.

How might families and supporters use this research to help youth with social anxiety disorder?

Overall, this study highlights how children with generalized versus social anxiety experience unique patterns of functioning within peer relationships compared to healthy children. The findings of this study are relevant for families and supporters of youth with SAD for raising awareness regarding the challenges children face with anxiety and peer functioning and how these challenges might differ across GAD and SAD. For example, this study draws attention to how children with SAD experience greater difficulty than those with GAD or healthy children in the areas of making friends, the number of friendships in general, and the extent of social skills or competencies necessary for peer interactions.

For families and supporters seeking appropriate interventions for children with SAD, these researchers emphasize the importance of treatments that incorporate social skills training in addition to treatments aimed at lowering anxiety responses during peer interactions. Supporters of youth with SAD may be interested in learning more about the types of interventions being actively investigated for children with SAD. For example, Dr. Deborah Beidel, director of the Anxiety Disorders Clinic at the University of Central Florida, currently leads a research study examining how virtual reality technology using avatars can teach children effective social skills and provide them realistic social settings to build confidence and abilities.

Where can families and supporters learn more about this research?

The study discussed here is available for free at this link:

The research by Dr. Beidel discussed here can be explored further at this link:


Scharfstein, L., Alfano, C., Beidel, D., & Wong, N. (2011). Children with Generalized Anxiety Disorder Do Not Have Peer Problems, Just Fewer Friends. Child Psychiatry and Human Development, 42, 712-723.



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