Observational Study
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World J Clin Cases. Jul 16, 2014; 2(7): 265-271
Published online Jul 16, 2014. doi: 10.12998/wjcc.v2.i7.265
Role of ethnicity in social anxiety disorder: A cross-sectional survey among health science students
Philip De Jager, Sharain Suliman, Soraya Seedat
Philip De Jager, Vrije Universiteit, Faculty of Health Sciences, 1055 VB Amsterdam, The Netherlands
Sharain Suliman, Soraya Seedat, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
Author contributions: De Jager P conceptualized and conducted the study, wrote the protocol, analyzed and interpreted data and was the first author on the manuscript; Suliman S analyzed and interpreted the data and co-authored the manuscript; Seedat S conceptualised the study, supervised the protocol and study, anlyzed and interpreted the data and co-authored and supervised the manuscript.
Supported by The South African Research Chairs Initiative of the Department of Science and Technology and the National Research Foundation
Correspondence to: Dr. Sharain Suliman, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, South Africa. sharain@sun.ac.za
Telephone: +27-21-9389161 Fax: +27-21-9335790
Received: April 14, 2014
Revised: May 26, 2014
Accepted: June 18, 2014
Published online: July 16, 2014
Abstract

AIM: To investigate the influence of ethnicity in social anxiety disorder (SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences' students .

METHODS: This was a cross-sectional survey of 112 1st, 2nd and 3rd year students from the Faculty of Medicine and Health Sciences at Stellenbosch University, Cape Town, South Africa. The self-reported Social Anxiety Spectrum questionnaire was used to assess for SAD. The Social Phobia Inventory (SPIN) was adapted to a version called the E-SPIN (Ethnic-SPIN) in order to evaluate the effects of ethnicity. Two sub-questions per stem question were included to assess whether SAD symptoms in social interactions were ethnicity dependent. Substance use was assessed with the Alcohol Use Disorders Identification Test and Drug Use Disorders Identification Test, and depression with the Centre for Epidemiological Studies Depression Scale.

RESULTS: Of 112 students who completed the E-SPIN questionnaire, 54.4% (n = 61) met criteria for SAD, with significantly more females than males meeting criteria. Ethnicity had a significant effect on SAD symptomatology, but there was no effect of ethnicity on the rates of drug and alcohol abuse in students with and without SAD. Overall significantly more students with SAD met criteria for depression compared with students without the disorder.

CONCLUSION: Among university students, SAD is prevalent regardless of whether interactions are with individuals of the same or different ethnic group. However, ethnicity may be an important determinant of social anxiety for some ethnic groups. SAD was significantly associated with major depression but not significantly associated with drug or alcohol abuse.

Keywords: Social anxiety, Social phobia, Ethnicity, Students, South Africa

Core tip: We investigated the relationship between social anxiety disorder (SAD) and ethnicity, as well as its association with depression and alcohol and drug abuse, among South African students. High levels of social anxiety were present and were significantly associated with major depression but not with drug or alcohol abuse. Ethnicity was found to independently influence social anxiety symptomatology, suggesting that it is an important factor in student interactions in this context. These results contribute to the extant literature by demonstrating that different risk factors may be uniquely associated with SAD for different ethnic/racial groups, and require further exploration given South Africa’s historical context.