Psychological Medicine



Social and personal resources and the prevalence of phobic disorder in a community population


C. F. HYBELS a1c1, D. G. BLAZER a1 and B. H. KAPLAN a1
a1 Center for the Study of Aging and Human Development, and Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; and Department of Epidemiology, School of Public Health, University of North Carolina, NC, USA

Abstract

Background. Phobic disorder is one of the most prevalent psychiatric disorders in community populations and much attention has focused on the association of sociodemographic factors and social resources with the disorder. There has been little investigation of the more personal resources such as self-confidence, religiosity, social support and self-perceived health that may increase vulnerability.

Methods. We used a sample of 2914 community residents aged 18 or older who participated in the Duke University Epidemiologic Catchment Area Study to explore the relationship between both social and personal resources and the prevalence of DIS/DSM-III phobic disorder.

Results. The 1-month prevalence of any phobic disorder was 7·6%. In bivariate analyses, we found both race/ethnicity and gender differences in prevalence, with a higher prevalence of phobic disorder in African-Americans and females. Lower socio-economic status, rural residence and unmarried status were also associated with current prevalence. No association was found for social network and social interaction. Impaired subjective social support, low self-confidence, perceived poorer physical health and co-morbid psychiatric disorder were significantly associated with current prevalence in uncontrolled analyses, while associations between lack of a confidant as well as religiosity and phobic disorder were not. Female gender (OR = 1·7), perceived low self- confidence (OR = 2·0), and two interaction terms, age × co-morbid psychiatric disorder and race/ethnicity × perceived physical health were associated with phobic disorder in controlled analyses using logistic regression.

Conclusions. We conclude that both social and personal resources, particularly self-confidence, co-morbidity and perceived physical health are important correlates of phobic disorder.


Correspondence:
c1 Address for correspondence: Dr Celia F. Hybels, Center for the Study of Aging and Human Development, Duke University Medical Center, Box 3875, Durham, NC 27710, USA.


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