Social fears arise when fearing to be judged in social events. When these fears are intense, persistent, and debilitating, the individual may suffer from social anxiety disorder (SAD), which has its most frequent onset during adolescence and tends to be chronic. Still, evidence on the prevalence of social fears and SAD in adolescence is scarce. This study analyzed the prevalence of social fears and of SAD in Portuguese adolescents. Of the initial sample (n = 1495), 26% presented with intense self-reported social fears. Of those, 53.9% accepted to be further assessed for diagnosis, resulting in a point-estimate prevalence of adolescent SAD of 9.4%; this is slightly higher than previously found. Social performance was the most feared social event. Of the adolescents with SAD, 12.9% were receiving psychological intervention, 12.1% refused intervention, and 92 (65.7%) accepted intervention. Findings confirm SAD as a highly prevalent mental disorder among adolescents, particularly girls, and additionally, that most of these adolescents did not seek treatment but are willing to receive help if made available. Hence, schools should be invested not only in identifying vulnerable adolescents but also in providing diverse intervention options, tailored to their needs, and directing them to successful developmental trajectories.

Social Anxiety Disorder (SAD) has its usual onset during adolescence when it is a highly prevalent and debilitating condition. Evidence regarding the processes that underline social anxiety and SAD is not compelling, especially in adolescents. Within an Acceptance and Commitment Therapy (ACT) framework, the causal role of ACT processes on adolescents’ social anxiety and how these processes contribute to sustain social anxiety over time is still unknown. Hence, this study explored the role of psychological inflexibility (PI) and acceptance and committed action (as psychological flexibility processes) on social anxiety over time, in a clinical sample of adolescents. Twenty-one adolescents (Mage = 16.19, SD = 0.750) with a primary diagnosis of SAD completed a set of self-report measures assessing PI, acceptance (i.e., willingness to experience social anxiety symptoms), action (i.e., moving towards valued life directions despite social anxiety symptoms) and social anxiety. Path analysis was used to investigate a mediation model linking acceptance, committed action, and PI to social anxiety, directly and indirectly. Findings revealed that acceptance and action were negatively and directly associated with PI after 10-weeks. In turn, PI yielded a positive and direct effect on social anxiety after another 12-weeks. PI totally mediated the relation between acceptance and action and social anxiety, with significant indirect effects. Overall, findings offer evidence for the applicability of the ACT model to adolescent SAD and support the use of clinical interventions targeting PI to understand and alleviate adolescents’ social anxiety.

SAD is an intense fear or anxiety associated with past, current, or future social situations. The Clark and Wells (1995) cognitive model for SAD has been proved to be clinically effective in adults, and its developmentally sensitive adaptations for adolescents have recently shown promising results. Given this evidence and considering that adolescence is typically the age of onset for the first SAD symptoms and a critical developmental period for the delivery of evidence-based interventions, we adapted CT for adolescents for online intervention (CT@TeenSAD) encompassing 10 weekly, 90 min sessions, extended by two booster sessions. This work presents the first case study of that intervention as applied to Merida (M.; pseudonym; 17-year-old, girl). The estimated Reliable Change Index shows M.’s progress for most of her symptoms, from pre-to post-treatment (RCI-1 range: −.53 to −8.03), and the maintenance of benefits at 3 months follow-up (RCI-2 range: .00 to −2.25). A relapse in the adoption of safety behaviors was seen between post-treatment and follow-up, which might be explained by the life-changing challenges experienced by M. between session 10 and follow-up, concerning her transition from high school to college. M.’s case study offers a first glance on the promising results of CT@TeenSAD related to its efficacy and feasibility. Likewise, it offers the opportunity to critically appraise the limitations of the intervention as well as practical challenges and suggestions thought to be useful for therapists willing to implement CT@TeenSAD in the future.

Social anxiety disorder (SAD) is characterized by marked and persistent fear in social situations in which one may be exposed and/or anticipates being exposed to external evaluation and in which embarrassment/humiliation may occur. Acceptance and Commitment Therapy (ACT) has been showing promising results in several disorders, including adult SAD. Considering this evidence and given that adolescence is typically the age of onset for SAD, we developed the ACT@TeenSAD, which is a manualized approach to adolescent SAD delivered via videoconference. It encompasses 10 weekly, 90-minute sessions targeting core pathological processes and fostering higher levels of psychological flexibility; it also includes two booster sessions. The current work illustrates the case conceptualization and therapeutic trajectory of a 17-year-old adolescent (Josie; pseudonym) with a 5-year history of SAD that underwent the ACT@TeenSAD. During the course of the intervention, Josie found purpose and learned life skills to cope with adversity, especially in socially relevant situations. This aligns with the pre- to post-intervention progress shown by Josie (using the Reliable Change Index), particularly in measures assessing acceptance, psychological inflexibility, and self-reported social anxiety. Josie’s case study gives preliminary evidence of the acceptability and feasibility of the ACT@TeenSAD, making it a helpful tool for therapists to become familiarized with. The current work also discusses the limitations of the intervention and presents practical challenges and suggestions thought to be useful for therapists.

This study presents the Core Social Fears Scale for Adolescents (CSFS-A), developed to assess the Interaction, Performance, and Observation social fears that may be core to social anxiety in adolescence. This measure also assesses General Avoidance of social situations. A school-based sample of 3009 adolescents (53.7% female; age range: 12–19 years) and a clinical sample of 162 adolescents diagnosed with social anxiety disorder (70.4% female; age range: 15–18 years) provided information on anxiety experienced and avoidance engaged in during in social events; some participants also reported on another measure of social anxiety and fears of negative and positive evaluation. Confirmatory factor analyses supported a three-factor model reflecting correlated core social fears, as well as a unidimensional model for general avoidance, as applied to community and clinical participants. These models were invariant based on sex, age-groups (early, middle, and late adolescence), and clinical status. All measures had at least good internal consistency values. Evidence of convergent validity was found based on correlations between the scale’s measures and measures of social anxiety and fear of negative and positive evaluation. The Core Social Fears Scale for Adolescents proved to be a psychometrically robust measure for the assessment and characterization of the adolescents’ experience of social anxiety.

Clark and Wells’ model for social anxiety proposed several maintenance factors for social anxiety (SA), which is assumed to exist in a continuum from normative to pathological levels (i.e., Social Anxiety Disorder – SAD). Based on these premises, we used a cross-sectional design to investigate pathways linking those maintenance factors to SA, in adolescents (Mage = 16.02, SD = .97) with SAD (n = 30) and healthy controls (n = 23), who filled in self-report questionnaires about those variables. Separate moderation models were tested using the same dependent variable (i.e., SA) and different independent variables (i.e., Negative Social Thoughts and Beliefs, Self-focused Attention, and Safety-seeking Behaviors); group was the moderating variable. All variables were significant predictors of SA, explaining between 80% (i.e., Self-focused Attention) and 83% (i.e., Safety-seeking Behaviors and Negative Social Thoughts and Beliefs) of its variance. Group was never a significant moderator. These results favor Clark and Wells’ model for explaining SA along its continuum. The pervasiveness of negative cognitions, safety-seeking behaviors, and self-focused attention in adolescents with SAD seems to contribute to a more disrupting experience of SA. As such, addressing these maintenance factors may be useful, as a preventive and remedial approach to SA in adolescence.