Theses - Faculty of Medicine

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    Social anxiety disorder among university students in Sri Lanka : prevalence, associated risk factors, and culturally adapted cognitive behavioural group therapy
    (University of Kelaniya, Sri Lanka, 2022) de Silva, B.G.R.
    Social Anxiety Disorder (SAD), one of the most common mental health disorders globally, demonstrate early-onset, chronic course, and debilitating dysfunction in all social spheres, especially in education. There is a scarcity of information on SAD in Sri Lanka, and none among university students. Therefore, the study objectives were to determine prevalence and associated risk factors among university students in Sri Lanka. A cross-sectional study was conducted among 1137 students from five state universities. The Liebowitz Social Anxiety Scale — Sinhala version and a Psychosocial Correlates Questionnaire for SAD developed for this study, were used as instruments. The analysis included bivariate analysis such as chi-square tests for independence, and Spearman’s r correlations to identify significant associations. Identified variables at p<0.05 were entered in to binary logistic regression models to determine factors associated with social anxiety disorder. Of the 985 who completed the questionnaires, 57.1% screened positive for SAD. In terms of demographic factors and _ clinical characteristics, female gender(AOR=1.41,95%CI 1.10-1.84, p= 0.01) and a history of mental health issues(AOR=2.79, 95%CI 1.90-4.10, p<0.001), and in terms of negative family and adverse childhood experiences, experiences of emotional abuse(AOR=1.31, 95% CI 1.11- 1.54, p=0.001), parent dissatisfaction (AOR=1.07, 95% CI 1.01- 1.13, p<0.05) and overcontrol by parents(AOR=1.08,95%CI1.02-1 .15,p<0.05) remained significantly associated risk factors for SAD. Further, | body dissatisfaction (AOR=1 .05, 95% CI 1.05 — 1.10, p<0.05) , and dissatisfaction with breasts (AOR=.60, 95% CI .46 — .77, p<0.001) were identified as associated significant factors of SAD. Additionally, in terms of school experiences, experiences of humiliation, not being accepted or rejection by school friends (AOR=1.63,95% Cr 1.29-2.05, p<0.001) and rejection, invalidation or isolation due to social connections(AOR=1.3, 95% Cl 1.08- 1.58, p<0.001) , while in university experiences, experiences of humiliation, not being - accepted or rejection by friends(AOR=1.31,95%CI1.09-1.60,p<0.05), experiences of mental harassment(AOR=1.47,95%CI 1.12-1.92,p<0.05), and viewing the medium of study as a challenge,(AOR=1.55,95%CI1.16-2.10,p<0.05) remained independently and significantly associated with SAD. The study recognizes a high prevalence rate of SAD and associated risk factors among university students in Sri Lanka. Although, diagnostic interviews were not conducted — and the actual prevalence rates may be lower, this is an under-recognized issue which needs further exploration as students with SAD will be challenged in their academic and occupational pursuits.