A Review of “The Natural Course of Social Anxiety Disorder Among Adolescents & Young Adults”


In a recent study, Beesdo-Baum et al. (2012) examined the course of social anxiety disorder, over several years in a large sample of adolescents and young adults in Germany. The authors found that social anxiety disorder was fairly persistent over time, although individuals did experience some periods with fewer symptoms. This more persistent course was strongly predicted by several factors, including earlier age of onset. The authors note that results of this study suggest that intervention, particularly early intervention, is important.


What were the goals of this study?

The main goals of the study were the following:

  • To examine the persistence, stability and remission rates of social anxiety disorder among adolescents and young adults. In other words, to examine the natural course of the disorder.
  • To investigate what factors predict a better vs. worse of social anxiety disorder.


How did the authors examine the study goals?

The authors examined the study goals by collecting data over time, in a prospectively-designed study. The authors recruited a large, representative sample of adolescents and young adults from Germany, which means that the participants in study had similar characteristics as individuals in the population. Individuals were assessed at 4 different time points, which allowed the authors to examine how social anxiety disorder changed over time.

What were the main findings from this study?

There were three main findings:

  • The majority of adolescents and young adults who met diagnostic criteria for social anxiety disorder at the first time point continued to struggle with symptoms when they were assessed later.
  • Most participants who met criteria for social anxiety disorder at the first time point experienced some reductions in symptoms at later time points, such that they no longer met full diagnostic criteria for the disorder.
  • A minority of participants (15.1%) experienced complete remission (no longer meeting any symptoms) at later time points.
  • Factors such as having a generalized subtype of social anxiety disorder (which means that the individual has more than 2 feared social situations), a personality style characterized by pessimism/negative thoughts, and an earlier age of onset were all found to predict a more persistent and stable course of social anxiety disorder.


What are the implications of this study?

The results of this study suggest that social anxiety disorder is not something that most kids will simply grow out of; rather, social anxiety disorder is fairly persistent across time, even though individuals may experience times with fewer symptoms. In fact, one of the factors that predicted a more persistent and problematic picture, was an earlier age of onset, which suggests that early intervention with younger children who are struggling with social fears is important.

What does this all mean for my child with social anxiety disorder?

This means that your child’s symptoms should be taken seriously as he or she is likely to struggle with social anxiety disorder over time.

What can I do to help my child?

Speak with your child and their mental health care provider about treatment options and support your child on this journey to greater mental health.

How can I learn more about this study?

If you would like to learn more about this study, please click the following link:




Beesdo-Baum, K., Knappe, S., Fehm, L., Höfler, M., Lieb, R., Hofmann, S. G., & Wittchen, H. U. (2012). The natural course of social anxiety disorder among adolescents and young adults. Acta Psychiatrica Scandinavica, 126(6), 411-425. doi: 10.1111/j.1600-0447.2012.01886.x


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