There is extensive literature on disruptive behavior and on anxiety and a growing literature on co-morbidity. But there is little literature on co-morbidity between disruptive behavior and anxiety, and we found none that specifically discusses social phobia. Because internalizing problems are more difficult to detect than externalizing problems, the latter may obscure the former when they occur together, especially with subtle internalizing problems such as social phobia. We present a case involving co-morbidity between disruptive behavior and social phobia in a 14-year-old boy in residential care. Treatment for social phobia, involving modified public interactions, social-skills training, exposure and reinforcement-based feedback, reduced a high rate of disruptive behavior to near-zero rates.
Achenbach, T.M.
(1991). Manual for the Youth Self-Report and 1991 profile. Burlington: University of Vermont, Department of Psychiatry.
2.
Achenbach, T.M.
, McConaughy, S.H., & Howell, C.T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213-232.
3.
American Psychiatric Association
(1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Authors.
4.
Bell, R.Q.
(1968). A reinterpretation of the direction of effects in studies of socialization. Psychological Review, 75, 81-95.
5.
Bird, H.R.
, Gould, M.S., & Staghezza, B.M. (1993). Patterns of diagnostic comorbidity in a community sample of children aged 9 through 16 years. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 361-368.
6.
Boyd, J.H.
(1986). Use of mental health services for the treatment of panic disorder. American Journal of Psychiatry, 143, 1569-1574.
7.
Brown, T.A.
, & Barlow, D.H. (1992). Comorbidity among anxiety disorders: Implications for treatment and DSM-IV. Journal of Consulting and Clinical Psychology, 60, 835-844.
8.
Coughlin, D.
, & Shanahan, D. (1991). Boys Town family home program. Boys Town, NE: Boys Town Press.
9.
Dowd, T.
, & Tierney, J. (1992). Teaching social skills to youth: A curriculum for child care providers. Boys Town, NE: Boys Town Press.
10.
Ferber, R.
(1987). Sleeplessness, night awakening, and night crying in the infant and toddler. Pediatrics in Review, 9, 69-82.
11.
Hazen, A.
, & Stein, M.B. (1995). Social phobia: Prevalence and clinical characteristics. Psychiatric Annals, 25, 544-549.
12.
Hayes, S.C.
(1991). Single case experimental design and empirical clinical practice. Journal of Consulting and Clinical Psychology, 49, 193-211.
13.
Levine, M.D.
(1982). Encopresis: Its potentiation, evaluation, and alleviation. Pediatric Clinics of North America, 29, 315-330.
14.
Lydiard, R.B.
, & Falsetti, S.A. (1995). Treatment options for social phobia. Psychiatric Annals, 25, 570-576.
15.
McGrath, P.J.
, & Feldman, W. (1986). Clinical approach to recurrent abdominal pain in children. Developmental and Behavioral Pediatrics, 7, 56-61.
16.
Neef, N.A.
, & Iwata, B.A. (1994). Current research on functional analysis methodologies: An introduction. Journal of Applied Behavior Analysis, 27, 211-215.
17.
Patterson, R.G.
(1982). Coercive family processes. Eugene, OR: University Park Press.
18.
Phillips, E.L.
, Phillips, E.A., Fixsen, D.L., & Wolf, M.M. (1974). The teaching-family handbook. Lawrence: University of Kansas Press.
19.
Piacentini, J.
, Shaffer, D., Fisher, P., Schwab-Stone, M., Davies, M., & Gioia, P. (1993). The Diagnostic Interview Schedule for Children-Revised Version (DISC-R): III. Concurrent criterion validity. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 658-665.
20.
Rey, J.M.
, Schrader, E., & Morris-Yates, A. (1992). Parent-child agreement on children's behaviours reported by the Child Behavior Check List (CBCL). Journal of Adolescence, 15, 219-230.
21.
Reynolds, W.M.
(1992). The study of internalizing disorders in children and adolescents. In WM. Reynolds (Ed.), Internalizing disorders in children and adolescents, (pp. 1-18). New York: Wiley.
22.
Sanderson, W.C.
, Di Nardo, P.A., Rapee, R.M., & Barlow, D.H. (1990). Syndrome comorbidity in patients diagnosed with a DSM-III-R anxiety disorder. Journal of Abnormal Psychology, 100, 214-222.
23.
Shaffer, D.
, Schwab-Stone, M., Fisher, P., Cohen, P., Piacentini, J., Conner, K., & Regier, D. (1993). The Diagnostic Interview Schedule for Children-Revised: I. Preparation, field testing, interrater reliability, and acceptability. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 643-650.
24.
Skau, K.
, & Mouridsen, S.E. (1995). Munchausen syndrome by proxy: A review. Acta Paediatrica, 84, 977-982.
25.
Turner, S.
, Beidel, D.C., & Townsley, R.M. (1992). Behavioral treatment of social phobia. New York: Wiley.
