Behaviour Research and Therapy 45 (2007) 1181–1191 Social anxiety disorder in childhood and adolescence: Descriptive psychopathology Patricia A. Rao a,Ã , Deborah C. Beidel a , Samuel M. Turner { , Robert T. Ammerman b , Lori E. Crosby b , Floyd R. Sallee c a Penn State Hershey College of Medicine, Hershey Medical Center, H073, 500 University Drive, Hershey, PA 17033, USA b Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA c Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA Received 30 January 2006; received in revised form 14 June 2006; accepted 27 July 2006 Abstract Although the presentation of social anxiety disorder (SAD) in adults is well documented, less is known about its clinical manifestation in children and adolescents. To date, most studies have included combined samples of children and adolescents despite the fact that this age range represents an extensive period of growth and development. This study compares and contrasts the clinical presentation of SAD among children (ages 7–12) and adolescents (ages 13–17). One hundred and fifty children (n ¼ 74) and adolescents (n ¼ 76) with a primary diagnosis of SAD participated in the study. The assessment battery included clinical ratings and behavioral observation as well as parental and self-report. The results indicate that, although the symptom presentation of children and adolescents with primary SAD shares many features, children tend to present with a broader pattern of general psychopathology, while adolescents have a more pervasive pattern of social dysfunction and may be more functionally impaired as a result of their disorder. These findings suggest that interventions for SAD need to carefully consider clinical presentation of the disorder as it manifests in childhood and adolescence. r 2006 Elsevier Ltd. All rights reserved. Keywords: Anxiety; Children; Adolescents; Social anxiety disorder Background/Introduction Social anxiety disorder (SAD) is characterized by a pervasive pattern of social timidity (American Psychiatric Association [APA], 1994). It is the third most common psychiatric disorder, with a lifetime prevalence of approximately 13% of the general population (Kashdan & Herbert, 2001). The average age of onset is mid-adolescence, but the disorder occurs in children as young as age eight (Beidel, Turner, & Morris, 1999). Although SAD has been recognized in adult populations for some time, it was not until the fourth ARTICLE IN PRESS www.elsevier.com/locate/brat 0005-7967/$ - see front matter r 2006 Elsevier Ltd. All rights reserved. doi:10.1016/j.brat.2006.07.015 Ã Corresponding author. Tel.: +1 717 531 9763. E-mail address: prao1@hmc.psu.edu (P.A. Rao). { Deceased.