Many shy teens suffer from anxiety disorder, study says


(CBS/AP) They're called quiet, introverts, wallflowers, and they're very common. But a new government report shows that some kids who say they're shy are actually suffering from a full-blown anxiety disorder.

"Shyness is a normal human temperament," said study author Dr. Kathleen Merikangas, a researcher at the NIH, and a former shy child. But "there is a blurred boundary between people who describe themselves as shy and clinically significant impairment."

What's the difference? Shy children can be drawn out of their shell and adapt, while teens or adults with social anxiety become so paralyzed during social situations that it interferes with their daily functioning.

For the study - published in the Oct. 17 issue of Pediatrics - researched surveyed more than 10,000 U.S. teens and 6,000 parents about mental health issues. The researchers found that about 47 percent of teens identified themselves as shy around peers they don't know well, and more than 62 percent of parents thought their teens were shy - perhaps reflecting parental worry.

The researchers then analyzed how many teens met American Psychiatric Association criteria for social anxiety disorder or social phobia, and discovered nearly 1 in 10 of the self-described shy kids did.

This study paves the way for more research on a child's temperament. Even garden-variety shyness worries parents - particularly boys' fathers - said, Dr. Nancy Snidman of Children's Hospital Boston.

"Shyness isn't very well tolerated in the U.S.," said Snidman who wasn't involved in the study. She and her colleagues have tracked infants through their college years, and found that babies who react negatively to new people and things often grow into shy children.

Usually, the clinging tot does just fine as he grows into a niche, Snidman said. Girls may think the shy teen boy is nice because he's not macho, for example, or the shy kids wind up on the school newspaper so they can write instead of speak in public. Many simply outgrow shyness.

Yet a very shy child is considered more at risk than others of developing some type of anxiety disorder later in life, just as the opposite extreme - a very outgoing child - can be at greater risk for attention or conduct disorders, she said.

Social phobia affects about 15 million adults. It tends to appear during adolescence when kids take their first real steps toward independence.

The main treatment is behavioral therapy, but sometimes anxiety medications can be prescribed.

What should worried parents look for?

People with social anxiety disorder experience an out-of-proportion fear that can make them tremble, their hearts pound, or even cause a panic attack during a range of social situations. They often try to avoid situations that cause this fear.

Parents should see if their shy teen is doing things typical of that age, like participating in class, getting together with friends, said Dr. Chris Mauro, a Duke University psychologist. He suggests getting them into a group - like sports or music or Boy Scouts - because belonging is protective.

Merikangas warned that parents should keep an eye on social media, too. While it encourages electronic communication, it may further isolate those already on that path, she said.

The American Psychological Association has more on anxiety.