Science.gov

Sample records for agoraphobia social phobia

  1. Cognitive mediation of clinical improvement after intensive exposure therapy of agoraphobia and social phobia.

    PubMed

    Vögele, Claus; Ehlers, Anke; Meyer, Andrea H; Frank, Monika; Hahlweg, Kurt; Margraf, Jürgen

    2010-03-01

    The present study investigated cognitive mediation of clinical improvement in patients with agoraphobia (N=427) or social phobia (N=98) receiving high-density exposure therapy in a naturalistic clinical treatment setting. Patients were assessed before therapy, 6 weeks after the end of therapy, and 1 year thereafter, using a self-report assessment battery. Lower level mediation analyses provided support for the notion that cognitive changes partially mediate clinical improvement after exposure therapy. Changes in cognitions relating to physical catastrophes mediated treatment outcome only for patients with agoraphobia, whereas changes in cognitions about loss of control mediated outcome for both agoraphobia and social phobia patients. Changes in relationship satisfaction did not mediate symptomatic improvement. The results extend previous findings by demonstrating mediation in an unselected clinical sample and by providing evidence for the specificity of mediation effects. They further support the importance of cognitive changes in cognitive-behavior therapy. (c) 2009 Wiley-Liss, Inc.

  2. Use of medical services and treatment for panic disorder with agoraphobia and for social phobia.

    PubMed Central

    Swinson, R P; Cox, B J; Woszczyna, C B

    1992-01-01

    OBJECTIVE: To examine the medical services and treatment for anxiety disorders reported by patients who had either panic disorder with agoraphobia or else social phobia. DESIGN: Archival research of consecutive records of psychiatric interviews conducted between January 1990 and December 1991. The records were examined by a trained research assistant who had had no contact with the patients. PATIENTS: One hundred patients who had panic disorder with agoraphobia and twenty-eight patients who had social phobia. SETTING: An anxiety disorders clinic in a university-affiliated psychiatric institute. OUTCOME MEASURES: Variables related to the use of medical services included history of hospitalization, emergency department visits and referrals to specialists. Variables related to treatment included types of medication received, whether behaviour therapy was received and types of health care professionals seen. RESULTS: Almost 30% of the patients with panic disorder and more than 20% of those with social phobia had a history of a major depressive episode at some time in their lives; 30% and 25% respectively had a current nonpsychiatric medical diagnosis. In the past year nearly one-third of both patient groups had seen three or more different health care professionals and almost one-fifth of those with panic disorder had gone to a general hospital emergency department. Of the patients with panic disorder 9% had previously been assessed by a cardiologist and 17% by a neurologist. At least two-thirds of each group had received benzodiazepines, often for use as needed. Although most of the patients in both groups had been seen by mental health professionals such as psychiatrists, few had received optimal treatment. Of those with panic disorder, only 15% had received the tricyclic antidepressant imipramine, 13% alprazolam and 11% cognitive-behavioural therapy. Only 4% of the patients with social phobia had received cognitive-behavioural therapy. CONCLUSIONS: Both groups of

  3. Health anxiety and fear of fear in panic disorder and agoraphobia vs. social phobia: a prospective longitudinal study.

    PubMed

    Rudaz, Myriam; Craske, Michelle G; Becker, Eni S; Ledermann, Thomas; Margraf, Jürgen

    2010-04-01

    This study is aimed to evaluate the role of two vulnerability factors, health anxiety and fear of fear, in the prediction of the onset of panic disorder/agoraphobia (PDA) relative to a comparison anxiety disorder. Young women, aged between 18 and 24 years, were investigated at baseline and, 17 months later, using the Anxiety Disorders Interview Schedule-Lifetime and measures of health anxiety and fear of bodily sensations (subscale disease phobia of the Whiteley Index, and total score of the Body Sensations Questionnaire). First, 22 women with current PDA were compared to 81 women with current social phobia and 1,283 controls. Second, 24 women with an incidence of PDA were compared to 60 women with an incidence of social phobia and 1,036 controls. Multiple logistic regression analyses adjusted for history of physical diseases, somatic symptoms, and other psychological disorders revealed that (a) fear of bodily sensations was elevated for women with PDA vs. controls as well as women with social phobia, and (b) health anxiety (and history of physical diseases) was elevated in women who developed PDA vs. controls and vs. women who developed social phobia. These results suggest that health anxiety, as well as history of physical diseases, may be specific vulnerability factors for the onset of PDA relative to social phobia. Whereas fear of bodily sensations was not found to be a risk factor for the onset of panic disorder/agoraphobia, it was a specific marker of existing PDA relative to social phobia. Copyright 2010 Wiley-Liss, Inc.

  4. Social Phobia

    MedlinePlus

    ... and family are there to celebrate each small success along the way. Overcoming Social Phobia Dealing with social phobia takes patience, courage to face fears and try new things, and the willingness to ...

  5. Genetic and environmental influences on the comorbidity between depression, panic disorder, agoraphobia and social phobia: A twin study

    PubMed Central

    Mosing, Miriam A.; Gordon, Scott D.; Medland, Sarah E.; Statham, Dixie J.; Nelson, Elliot C.; Heath, Andrew C.; Martin, Nicholas G.; Wray, Naomi R.

    2011-01-01

    Background Major depression (MD) and anxiety disorders such as panic disorder (PD), agoraphobia (AG) and social phobia (SP) are heritable and highly comorbid. However, the relative importance of genetic and environmental aetiology of the covariation between these disorders, particularly the relationship between PD and AG is less clear. Methods The present study measured MD, PD and AG in a population sample of 5440 twin pairs and 1245 single twins, about 45% of whom were also scored for SP. Prevalences, within individual comorbidity and twin odds ratios for comorbidity are reported. A behavioural genetic analysis of the four disorders using the classical twin design was conducted. Results Odds ratios for MD, PD, AG, and SP in twins of individuals diagnosed with one of the four disorders were increased. Heritability estimates under a threshold-liability model for MD, PD, AG, and SP respectively were 0.33 (CI:0.30–0.42), 0.38 (CI:0.24–0.55), 0.48 (CI:0.37–0.65) of, and 0.39 (CI:0.16–0.65), with no evidence for any variance explained by the common environment shared by twins. We find that a common genetic factor explains a moderate proportion of variance in these four disorders. The genetic correlation between PD and AG was 0.83. Conclusion MD, PD, AG, and SP strongly co-aggregate within families and common genetic factors explain a moderate proportion of variance in these four disorders. The high genetic correlation between PD and AG and the increased odds ratio for PD and AG in siblings of those with AG without PD suggests a common genetic aetiology for PD and AG. PMID:19750555

  6. [Social phobia].

    PubMed

    Bandelow, B; Wedekind, D

    2014-05-01

    With a lifetime prevalence of 13% social phobia (social anxiety disorder) is a common and serious condition that should not be played down because of the burden associated with the disorder, an increased suicide rate and the frequent comorbidity with substance abuse disorders. Social phobia is characterized by the excessive and unrealistic fear of being scrutinized or criticized by others. The disorder often begins in adolescence.Symptoms of social phobia can be effectively treated with evidence-based treatment, including cognitive behavior therapy (CBT) and psychopharmacological medications. In the present paper, treatment recommendations are given, which are based on a systematic review of all available randomized trials for the treatment of social phobia. Among psychological therapies, variants of CBT have been proven to be effective in controlled studies. Selective serotonin reuptake inhibitors (SSRIs) and the selective serotonin norepinephrine reuptake inhibitor (SNRI) venlafaxine are among the drugs of first choice.

  7. Social Anxiety Disorder (Social Phobia)

    MedlinePlus

    Social anxiety disorder (social phobia) Overview It's normal to feel nervous in some social situations. For example, going on ... of butterflies in your stomach. But in social anxiety disorder, also called social phobia, everyday interactions cause ...

  8. Social Anxiety Disorder (Social Phobia)

    MedlinePlus

    Social anxiety disorder (social phobia) Overview By Mayo Clinic Staff It's normal to feel nervous in some social situations. ... of butterflies in your stomach. But in social anxiety disorder, also called social phobia, everyday interactions cause ...

  9. Agoraphobia.

    ERIC Educational Resources Information Center

    Brehony, Kathleen A.

    Agoraphobia is the most pervasive and serious phobic response seen by clinicians, accounting for approximately 50 to 60% of all phobic problems. The symptoms of agoraphobia, a condition in which an individual fears entering public areas, include fears of leaving home, fainting, entering open and closed spaces, shopping, entering social situations,…

  10. Social phobia

    MedlinePlus

    ... Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment ... social events. Causes People with social anxiety disorder fear and avoid situations in which they may be ...

  11. Differentiating social phobia from shyness.

    PubMed

    Heiser, Nancy A; Turner, Samuel M; Beidel, Deborah C; Roberson-Nay, Roxann

    2009-05-01

    To clarify the relationship between social phobia and shyness, this study examined the characteristics of highly shy persons with social phobia, highly shy persons without social phobia, and non-shy persons. Those with social phobia reported more symptomatology, more functional impairment, and a lower quality of life than those without social phobia. About one-third of the highly shy without social phobia reported no social fears, highlighting heterogeneity of the shy. The social phobia group reported similar levels of anxiety as the shy without social phobia during analogue conversation tasks, but they reported more anxiety during a speech task. The social phobia group performed less effectively across tasks than those without social phobia. All groups' perceptions of anxiety and effectiveness during behavioral tasks were consistent with ratings of independent observers. None of the groups differed on psychophysiological measures. Results are discussed in the context of theoretical models of social phobia.

  12. Discriminant validity of the Social Phobia and Anxiety Inventory (SPAI), the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS).

    PubMed

    Peters, L

    2000-09-01

    Three measures commonly used in assessment of social phobia, the Social Phobia and Anxiety Inventory (SPAI [Turner, S. M., Beidel, D. C. & Dancu, C. V. (1996). Social phobia and anxiety inventory: manual. Toronto, Ont.: Multi-Health Systems Inc.), the Social Phobia Scale (SPS [Mattick, R. P. & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470] and the Social Interaction Anxiety Scale (SIAS [Mattick, R. P. & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470], were compared for their ability to discriminate between social phobia and other anxiety disorders (panic disorder with or without agoraphobia). Participants were 117 patients attending a specialized anxiety disorders unit for treatment. While all three measures were able to detect differences between social phobic patients and patients with panic disorder with or without agoraphobia, a logistic regression analysis showed that the SPAI, but not the SPS and SIAS, was a significant predictor of membership of the social phobia group. Receiver operating characteristic (ROC) analysis also showed that the SPAI was the better measure for discriminating between social phobia and panic disorder with and without agoraphobia. Analysis of the sensitivity, specificity and positive and negative predictive power of the measures at the optimum cutoff scores produced by the ROC analysis are presented.

  13. Neurobiology of social phobia.

    PubMed

    Tancer, M E

    1993-12-01

    The neurobiology of social phobia has been examined using four research strategies employed to investigate the neurobiology of patients with other anxiety or mood disorders--chemical challenge paradigms, psychoneuroendocrine assessments, naturalistic challenges, and neuropharmacologic challenges. This article reviews the studies that used each of the research paradigms in patients with social phobia. The author describes these results in the context of the results of other anxiety disorder studies using these four strategies and discusses implications for future research.

  14. Phobias

    MedlinePlus

    ... of anxiety disorder. It is a strong, irrational fear of something that poses little or no real ... There are many specific phobias. Acrophobia is a fear of heights. Agoraphobia is a fear of public ...

  15. Height phobia and biases in the interpretation of bodily sensations: some links between acrophobia and agoraphobia.

    PubMed

    Davey, G C; Menzies, R; Gallardo, B

    1997-11-01

    The present study was designed to investigate some of the factors that might underlie the commonly found association between agoraphobia and fear of heights (acrophobia). The results showed that measures of acrophobia are highly associated with the tendency to interpret ambiguous bodily sensations as threatening, and with an increased tendency to report bodily sensations of anxiety. These features of acrophobia did not appear to be characteristics found in phobic states in general, nor did measures of acrophobia show any significant relationship to the tendency to interpret external and social stimuli as threatening. These findings suggest that the frequently found co-morbidity between agoraphobia and acrophobia may be linked to cognitive biases in the discrimination and interpretation of bodily sensations that agoraphobia and acrophobia share in common. In addition, the present findings also generate testable hypotheses about the aetiology of acrophobia.

  16. Internet treatment for social phobia reduces comorbidity.

    PubMed

    Titov, Nickolai; Gibson, Matthew; Andrews, Gavin; McEvoy, Peter

    2009-08-01

    Social phobia can be treated by brief Internet-based cognitive behaviour therapy (CBT). Most people with social phobia, however, meet criteria for another mental disorder; this comorbidity is associated with significant disability, and cases of comorbidity may be more difficult to treat. The present study examined the impact of the Shyness programme, an Internet-based treatment programme for social phobia, on comorbid symptoms of depression and generalized anxiety disorder. Data from three randomized controlled trials using the Shyness programme to treat social phobia were reanalysed. The 211 subjects, all of whom met DSM-IV criteria for social phobia, were divided into four groups: (i) social phobia only; (ii) social phobia with elevated symptoms of depression; (iii) social phobia with elevated symptoms of generalized anxiety; and (iv) social phobia with elevated symptoms of both generalized anxiety and depression. The improvement in social phobia, depression and anxiety following Internet-based treatment for social phobia was measured. Improvement in social phobia was seen in all groups, whether comorbid or not. Significant improvements in comorbid symptoms of depression and generalized anxiety occurred even though the treatment was focused on the social phobia. Brief Internet-based CBT can reduce both the target disorder as well as comorbid symptoms. These findings are consistent with evidence that unified or transdiagnostic programmes may reduce the severity of comorbid disorders and symptoms, indicating an important direction for future research.

  17. Social phobia and perceived friendship quality.

    PubMed

    Rodebaugh, Thomas L

    2009-10-01

    Although it is clear that people with social phobia have interpersonal impairment, evidence that social phobia (as opposed to other mental disorders) affects friendship in particular is lacking. Two large epidemiological datasets were used to test whether diagnosis of social phobia is related to perceived friendship quality above and beyond perceived family relationship quality, diagnosis of other mental disorders, and a variety of demographic variables. After Bonferroni correction, social phobia was the only diagnosis related to perceived friendship quality above and beyond other factors, such that people with social phobia reported more impaired friendship quality. Social phobia's effect was similar in magnitude to demographic characteristics in both samples. The current study demonstrates that social phobia is specifically related to perceived friendship quality, suggesting that this aspect of social phobia's effects is worthy of further study.

  18. Social phobia: epidemiology and health care.

    PubMed

    Wancata, Johannes; Fridl, Marion; Friedrich, Fabian

    2009-12-01

    This paper gives an overview on the epidemiology of social phobia. About 4.5% of the adult general populations suffer from social phobia, i.e. it is the most frequent of all anxiety disorders. Social phobia is clearly more frequent among women than among men. About the half of all individuals with social phobia suffer from any comorbid mental disorders. Reviews show a large variability between single studies, probably due to methodological differences. Several population surveys indicate that a marked proportion of those with social phobia do not receive adequate treatment.

  19. Understanding and Treating Social Phobia

    ERIC Educational Resources Information Center

    Curtis, Russell C.; Kimball, Amy; Stroup, Erin L.

    2004-01-01

    Social phobia, a relatively obscure disorder, is receiving increased attention due to evidence suggesting that it is more prevalent and debilitative than once thought. The purpose of this article is to help counselors better understand the nature of and treatments for this disorder. Effective behavioral and pharmacological approaches are reviewed,…

  20. Understanding and Treating Social Phobia

    ERIC Educational Resources Information Center

    Curtis, Russell C.; Kimball, Amy; Stroup, Erin L.

    2004-01-01

    Social phobia, a relatively obscure disorder, is receiving increased attention due to evidence suggesting that it is more prevalent and debilitative than once thought. The purpose of this article is to help counselors better understand the nature of and treatments for this disorder. Effective behavioral and pharmacological approaches are reviewed,…

  1. Social phobia in spasmodic torticollis

    PubMed Central

    Gundel, H; Wolf, A; Xidara, V; Busch, R; Ceballos-Baumann, A

    2001-01-01

    OBJECTIVES—To study the prevalence of psychiatric comorbidity assessed by the use of a structured clinical interview in a large, representative sample of patients with spasmodic torticollis (ST) and to test the hypothesis that social phobia would be highly prevalent.
METHODS—In a consecutive cohort of 116 patients with ST treated with botulinum toxin overall psychiatric comorbidity was studied prospectively with the structured clinical interview (SCID) for DSM-IV axis I disorders. Physical disability and psychosocial variables were also assessed with standardised self rating questionnaires.
RESULTS—41.3% of the subjects met DSM-IV clinical criteria A-G for current social phobia as the primary psychiatric diagnosis. This figure rose to 56% including secondary and tertiary psychiatric diagnosis. There was no correlation between severity of disease (Tsui score, severity of pain, body image dissatisfaction score) and psychiatric comorbidity. The only significant predictor of psychiatric comorbidity was depressive coping behaviour (logistic regression analysis, p<0.01; OR=10.8). Compared with a representative sample of the general adult population, in the patients with ST the prevalence of clinically relevant social phobia is 10-fold, of mood disorders 2.4-fold, and of lifetime psychiatric comorbidity 2.6-fold increased.
CONCLUSIONS—A particularly high prevalence of social phobia was found in the cohort of patients with ST. The finding of a high prevalence of social phobia and depressive coping behaviour as the main predictor of psychiatric comorbidity may make a subgroup of patients with ST particularly amenable to specific psychotherapeutic interventions.

 PMID:11561034

  2. Nomophobia: the mobile phone in panic disorder with agoraphobia: reducing phobias or worsening of dependence?

    PubMed

    King, Anna Lucia S; Valença, Alexandre M; Nardi, Antonio Egidio

    2010-03-01

    In this report, we present and discuss a hypothesis for the development, in individuals with panic disorder and agoraphobia, of dependence on his or her mobile phone (MP). This disorder, termed nomophobia, is a result of the development of new technologies. Nomophobia is considered a disorder of the modern world and refers to discomfort or anxiety caused by being out of contact with a MP or computer. It is the pathologic fear of remaining out of touch with technology. We present, the case report of a patient who has continuously kept his MP with him since 1995 because of his overwhelming need to feel safe and to be able to immediately call emergency services and people he trusts should he feel sick. The patient was treated with medication and cognitive-behavior psychotherapy. He has remained asymptomatic for 4 years. The patient showed significant medical improvement in his panic disorder and phobias, but there has been no change in his nomophobia. The case presented here illustrates the dependence of an individual with panic disorder on his MP. A specific approach for this dependence should be used in some panic disorder patients.

  3. Social anxiety and agoraphobia in the eating disorders: associations with core beliefs.

    PubMed

    Hinrichsen, Hendrik; Waller, Glenn; Emanuelli, Francesca

    2004-11-01

    The eating disorders have a high comorbidity with anxiety disorders, but it is not clear what cognitions underpin those anxiety symptoms. The present study investigated whether social anxiety and agoraphobia in eating-disordered individuals are associated with different types of unconditional core beliefs. The participants were 70 women meeting DSM-IV criteria for an eating disorder. The short version of Young's Schema Questionnaire (YSQ-S) was used as a measure of core beliefs, while the Social Phobia and Anxiety Inventory was used as a measure of levels of social anxiety and agoraphobia. Eating-disordered individuals reporting high levels of comorbid social anxiety had higher abandoment and emotional inhibition core beliefs. In contrast, patients with high levels of agoraphobia had higher vulnerability to harm beliefs. The findings highlight the importance of identifying and addressing core beliefs in subgroups of eating-disordered individuals presenting with comorbid anxiety. Implications for future research are discussed, including the need for longitudinal studies to elaborate on the specificity of the cognition-anxiety link in the eating disorders.

  4. Social phobia: further evidence of dimensional structure.

    PubMed

    Crome, Erica; Baillie, Andrew; Slade, Tim; Ruscio, Ayelet Meron

    2010-11-01

    Social phobia is a common mental disorder associated with significant impairment. Current research and treatment models of social phobia rely on categorical diagnostic conceptualizations lacking empirical support. This study aims to further research exploring whether social phobia is best conceptualized as a dimension or a discrete categorical disorder. This study used three distinct taxometric techniques (mean above minus below a cut, maximum Eigen value and latent mode) to explore the latent structure of social phobia in two large epidemiological samples, using indicators derived from diagnostic criteria and associated avoidant personality traits. Overall, outcomes from multiple taxometric analyses supported dimensional structure. This is consistent with conceptualizations of social phobia as lying on a continuum with avoidant personality traits. Support for the dimensionality of social phobia has important implications for future research, assessment, treatment, and public policy.

  5. Social phobia and selective mutism.

    PubMed

    Keeton, Courtney P; Crosby Budinger, Meghan

    2012-07-01

    Social phobia (SOP) and selective mutism (SM) are related anxiety disorders characterized by distress and dysfunction in social situations. SOP typically onsets in adolescence and affects about 8% of the general population, whereas SM onsets before age 5 and is prevalent in up to 2% of youth. Prognosis includes a chronic course that confers risk for other disorders or ongoing social disability, but more favorable outcomes may be associated with young age and low symptom severity. SOP treatments are relatively more established, whereas dissemination of promising and innovative SM-treatment strategies is needed.

  6. Shyness versus social phobia in US youth.

    PubMed

    Burstein, Marcy; Ameli-Grillon, Leila; Merikangas, Kathleen R

    2011-11-01

    Scholars and the popular press have suggested that the diagnostic entity of social phobia "medicalizes" normal human shyness. In this study we examined the plausibility of this hypothesis by (1) determining the frequency of shyness and its overlap with social phobia in a nationally representative adolescent sample, (2) investigating the degree to which shyness and social phobia differ with regard to sociodemographic characteristics, functional impairment, and psychiatric comorbidity, and (3) examining differences in rates of prescribed medication use among youth with shyness and/or social phobia. The National Comorbidity Survey-Adolescent Supplement is a nationally representative, face-to-face survey of 10,123 adolescents, aged 13 to 18 years, in the continental United States. Lifetime social phobia was assessed by using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview. Adolescents and parents also provided information on youth shyness and prescribed medication use. Only 12% of the youth who identified themselves as shy also met the criteria for lifetime social phobia. Relative to adolescents who were characterized as shy, adolescents affected with social phobia displayed significantly greater role impairment and were more likely to experience a multitude of psychiatric disorders, including disorders of anxiety, mood, behavior, and substance use. However, those adolescents were no more likely than their same-age counterparts to be taking prescribed medications. The results of this study provide evidence that social phobia is an impairing psychiatric disorder, beyond normal human shyness. Such findings raise questions concerning the "medicalization" hypothesis of social phobia.

  7. Information-processing bias in social phobia.

    PubMed

    Hirsch, Colette R; Clark, David M

    2004-11-01

    Social phobia is a persistent disorder that is unlikely to be maintained by avoidance alone. One reason for the enduring nature of social phobia may be the way individuals with the disorder process social information. It is important for those involved in social phobia to have an understanding of information-processing biases, because it has the potential to guide psychological interventions. In this review of social phobia, probability and cost estimates of social situations are examined, interpretive biases are evaluated and findings relating to memory and negative imagery are also reviewed. The clinical implications of social-phobia-related information-processing biases are discussed and possible avenues for future research are outlined.

  8. Social phobia with sudden onset--post-panic social phobia?

    PubMed

    Kristensen, Ann Suhl; Mortensen, Erik Lykke; Mors, Ole

    2008-05-01

    Overlap between social phobia (SP) and panic disorder (PD) has been observed in epidemiological, family, and challenge studies. One possible explanation is that some cases of SP develop as a consequence of a panic attack in a social situation. By definition, these cases of SP have sudden onset. It is hypothesized that patients with SP with sudden onset are more similar to patients with comorbid SP and PD than to patients with SP without sudden onset regarding age of onset, extraversion, and prevalence of anxiety symptoms. One hundred and eighty-two patients with a lifetime diagnosis of PD and/or SP were recruited as part of an etiological study. Patients with SP with sudden onset did, as hypothesized, differ from patients with SP without sudden onset with regard to age of onset and extraversion, but not with regard to symptoms. They did not differ markedly from patients with comorbid SP and PD. The concept of post-panic SP is discussed.

  9. Interpretation of positive social events in social phobia: an examination of cognitive correlates and diagnostic distinction.

    PubMed

    Laposa, Judith M; Cassin, Stephanie E; Rector, Neil A

    2010-03-01

    Research suggests that individuals with social phobia fear positive social events and interpret them in a negative fashion that serves to maintain anxiety. To better elucidate the nature and role of interpretation of positive events in social phobia, two studies were conducted. Study 1 examined symptom and cognitive correlates of negative interpretation of positive social events. Participants with DSM-IV diagnosed generalized social phobia (GSP) completed a measure of interpretation of positive social events (IPES) in relation to a range of symptom and cognition measures of social anxiety. Results indicated that perfectionism and a measure tapping interpersonal fears associated with social anxiety were significantly predictive of IPES scores. Study 2 examined IPES scores in clinical participants with GSP, obsessive compulsive disorder (OCD), panic disorder with or without agoraphobia (PD/A), generalized anxiety disorder (GAD), and non-anxious controls. Results indicated that individuals with GSP scored higher on the IPES than those with PD/A, GAD and controls, but did not differ from OCD. These findings suggest that negative interpretation of positive events is a distinct and characteristic feature of social phobia with significant associations with other cognitive risk factors for the disorder. Copyright 2009 Elsevier Ltd. All rights reserved.

  10. Toward an integrative understanding of social phobia.

    PubMed Central

    Li, D; Chokka, P; Tibbo, P

    2001-01-01

    Our objective was to examine the neurobiology of social phobia from the perspectives of basic sciences, genetics, immunology, neuroendocrinology, neurotransmission and neuroimaging and to provide an integrated understanding of social phobia in the framework of a hypothetical neural circuit. Family and twin studies provide evidence that social phobia is heritable with significant genetic influence, and molecular genetics offers possibilities in understanding the nature of the trait that is transmitted. The biologic distinctiveness of social phobia from anxiety disorders and physiological validation of differences between generalized and discrete social phobia subtypes have been implicated in genetic, naturalistic and chemical challenge studies. Evidence of specific dysfunction of dopaminergic, serotonergic, noradrenergic and GABAergic (gamma-aminobutyric acid) neurotransmitter systems has been presented in animal models, challenge studies and treatment investigations. Preliminary neuroimaging research supports previous studies suggesting striatal dopaminergic dysfunction in social phobia and suggests the importance of functional circuits. A neural circuit involving the striatum, thalamus, amygdala and cortical structures may provide a framework for integrating much of the current knowledge on the neurobiology of social phobia. PMID:11394189

  11. Social phobia and depression: prevalence and comorbidity.

    PubMed

    Ohayon, Maurice M; Schatzberg, Alan F

    2010-03-01

    Social phobia may seriously impair the functioning of affected individuals. It is frequently associated with other mental disorders. To estimate the co-occurrence of social phobia with major depressive disorder (MDD) and to analyze their interaction. Subjects were 18,980 individuals, aged 15 years or older, representative of the general population of the United Kingdom, Germany, Italy, Spain and Portugal, who were interviewed by telephone. DSM-IV diagnoses were made with the Sleep-EVAL system. The point prevalence for social phobia was 4.4% (95% confidence interval: 4.1-4.7%) of the sample. It was higher in women (odds ratio: 1.6) and decreased with age. MDDs were found in 19.5% of participants with social phobia. Co-occurrence of another anxiety disorder was high and increased when a MDD was present (65.2%). The odds of developing a major depressive episode 2 years after the appearance of the social phobia was of 5.74. Social phobia is highly prevalent in the general population. It increases the risk of developing a MDD and has a high comorbidity with other mental disorders. Social phobia is often present in the course of depression, more obviously during remission period of MDD. Physicians must explore and treat more systematically this frequent pathology. Copyright 2010 Elsevier Inc. All rights reserved.

  12. Shyness Versus Social Phobia in US Youth

    PubMed Central

    Burstein, Marcy; Ameli-Grillon, Leila

    2011-01-01

    OBJECTIVES: Scholars and the popular press have suggested that the diagnostic entity of social phobia “medicalizes” normal human shyness. In this study we examined the plausibility of this hypothesis by (1) determining the frequency of shyness and its overlap with social phobia in a nationally representative adolescent sample, (2) investigating the degree to which shyness and social phobia differ with regard to sociodemographic characteristics, functional impairment, and psychiatric comorbidity, and (3) examining differences in rates of prescribed medication use among youth with shyness and/or social phobia. METHODS: The National Comorbidity Survey-Adolescent Supplement is a nationally representative, face-to-face survey of 10 123 adolescents, aged 13 to 18 years, in the continental United States. Lifetime social phobia was assessed by using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview. Adolescents and parents also provided information on youth shyness and prescribed medication use. RESULTS: Only 12% of the youth who identified themselves as shy also met the criteria for lifetime social phobia. Relative to adolescents who were characterized as shy, adolescents affected with social phobia displayed significantly greater role impairment and were more likely to experience a multitude of psychiatric disorders, including disorders of anxiety, mood, behavior, and substance use. However, those adolescents were no more likely than their same-age counterparts to be taking prescribed medications. CONCLUSIONS: The results of this study provide evidence that social phobia is an impairing psychiatric disorder, beyond normal human shyness. Such findings raise questions concerning the “medicalization” hypothesis of social phobia. PMID:22007009

  13. Working memory capacity in generalized social phobia.

    PubMed

    Amir, Nader; Bomyea, Jessica

    2011-05-01

    Research suggests that understanding complex social cues depends on the availability of cognitive resources (e.g., Phillips, Channon, Tunstall, Hedenstrom, & Lyons, 2008). In spite of evidence suggesting that executive control functioning may impact anxiety (e.g., Eysenck, Derakshan, Santos, & Calvo, 2007), relatively few studies have examined working memory in individuals with generalized social phobia. Moreover, few studies have examined the role of threat-relevant content in working memory performance in clinically anxious populations. To this end, the present study assessed working memory capacity (WMC) in individuals with generalized social phobia and nonanxious controls using an operation span task with threat-relevant and neutral stimuli. Results revealed that nonanxious individuals demonstrated better WMC than individuals with generalized social phobia for neutral words but not for social threat words. Individuals with generalized social phobia demonstrated better WMC performance for threat words relative to neutral words. These results suggest that individuals with generalized social phobia may have relatively enhanced working memory performance for salient, socially relevant information. This enhanced working memory capacity for threat-relevant information may be the result of practice with this information in generalized social phobia.

  14. Predictors of outcome in residential cognitive and interpersonal treatment for social phobia: do cognitive and social dysfunction moderate treatment outcome?

    PubMed

    Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold

    2010-09-01

    The predictors of residential cognitive (RCT) and residential interpersonal Treatment (RIPT) for social phobia were explored. (1) Sotsky et al. (1991) found differential effects of CT and IPT for depression, suggesting that the level of cognitive or social dysfunction predicted differential outcome. We examined whether an analogous effect could be demonstrated in 10 weeks of residential treatment of 80 social phobia subjects. (2) We also included expectations, age of onset, severity of illness, concurrent anxiety, mood, avoidant personality disorder, and body dysmorphic disorder as predictors in this exploratory study. Main outcome was the social phobia subscale of Social Phobia and Anxiety Inventory (SPAI SP). DSM-IV axis I and II interviews were completed. (1) Sotsky et al. (1991) findings were not reproduced. However, RIPT subjects with poor general functioning were less improved following treatment. Subjects with concurrent agoraphobia responded better with RCT than subjects without agoraphobia. (2) Age of onset and expectations were the most powerful predictors of post treatment outcome. Some patient characteristics appear to impact outcome with RIPT and RCT differentially. The findings are discussed. (c) 2010 Elsevier Ltd. All rights reserved.

  15. [Neurobiology and pharmacotherapy of social phobia].

    PubMed

    Aouizerate, B; Martin-Guehl, C; Tignol, J

    2004-01-01

    Social phobia (also known as social anxiety disorder) is still not clearly understood. It was not established as an authentic psychiatric entity until the diagnostic nomenclature of the American Psychiatric Association DSM III in 1980. In recent years, increasing attention among researchers has contributed to provide important information about the genetic, familial and temperamental bases of social phobia and its neurochemical, neuroendocrinological and neuroanatomical substrates, which remain to be further investigated. Up to date, there have been several findings about the possible influence of variables, including particularly genetic, socio-familial and early temperamental (eg behavioral inhibition) factors that represent risk for the later development of social phobia. Clinical neurobiological studies, based on the use of exogenous compounds such as lactate, CO2, caffeine, epinephrine, flumazenil or cholecystokinin/pentagastrin to reproduce naturally occurring phobic anxiety, have shown that patients with social phobia appear to exhibit an intermediate sensitivity between patients with panic disorder and control subjects. No difference in the rate of panic attacks in response to lactate, low concentrations of CO2 (5%), epinephrine or flumazenil was observed between patients with social phobia and normal healthy subjects, both being less reactive compared to patients with panic disorder. However, patients with social phobia had similar anxiety reactions to high concentrations of CO2 (35%), caffeine or cholecystokinin/pentagastrin than those seen in patients with panic disorder, both being more intensive than in controls. Several lines of evidence suggest specific neurotransmitter system alterations in social phobia, especially with regard to the serotoninergic, noradrenergic and dopaminergic systems. Although no abnormality in platelet serotonin transporter density has been found, patients with social phobia appear to show an enhanced sensitivity of both post

  16. Finding social phobia patients from the Internet.

    PubMed

    Chen, Jian-Ting; Lin, Chao-Cheng; Wang, Sheng-Chang; Liao, Shih-Cheng; Chen, Jen-Yeu; Liu, Chia-Yih; Lee, Ming-Been

    2011-11-30

    Patients with social phobia commonly resist face-to-face assessments, and a number of alternative assessment methods based on the Internet are being developed. The aim of this study was to identify patients with social phobia on the Internet and characterize their condition, using the Social Phobia Inventory (SPIN). In Stage I, this study recruited 1307 participants from the Internet, most of whom were well-educated young females, who had remained unmarried and unemployed. The Internet-based SPIN demonstrated excellent internal consistency (Cronbach's α=0.937) and good test-retest reliability (intraclass correlation coefficient=0.942). In Stage II, we examined the discriminant validity of the SPIN via structured telephone interviews. The area under the receiver operating characteristic curve used to discriminate social phobia was 0.871 with an optimal cut-off point of 24 on the total score for the SPIN. According to the SPIN scores, 919 of Stage I participants (70.3%) reached the threshold of social phobia, 531 of which (57.8%) had never sought professional help. These results suggest that the Internet is a potential avenue through which to find untreated patients with social phobia. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Prevalence of social phobia in non-demented elderly from a swedish population study.

    PubMed

    Karlsson, Björn; Klenfeldt, Isak Fredén; Sigström, Robert; Waern, Margda; Ostling, Svante; Gustafson, Deborah; Skoog, Ingmar

    2009-02-01

    To examine the prevalence of social phobia, and how the different Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic components of social phobia influence prevalence rates, among a population sample aged 70 years and older. A general population sample was investigated in 2000-2001 with semistructured psychiatric examinations, including the Comprehensive Psychopathological Rating Scale, the Mini International Neuropsychiatric Interview, the Global Assessment of Functioning (GAF) scale, and the Mini Mental State Examination. General population Participants: Randomized sample of 914 nondemented elderly, response rate 68%. The sample was stratified into two age groups: 70-year olds (N = 338 women and 224 men) and aged 78 and above (N = 352 women). Social phobia according to DSM-IV requiring: a) fearing social situations, b) experiencing the fear as unreasonable or excessive, c) avoiding feared social situations or enduring them with intense anxiety or distress, and d) that this causes social consequences. The 1-month prevalence of social phobia was 1.9% (N = 17), an additional 1.6% (N = 15) fulfilled criteria a, c, and d, but not b. Thus, 3.5% had "social phobia" that caused social consequences. This was related to lower GAF-score and concurrent depression,panic attacks, and agoraphobia. Almost one fourth (N = 220) of the total sample feared social situations. This was more common in 70-year-old women compared with 70-year-old men (29.9% versus 20.5%), and to women aged 78-92 years (21.0%). Our results indicate that DSM-IV criteria exclude a large group of individuals with social phobia. It could be discussed whether DSM-IV criteria should be revised to also encompass these individuals.

  18. Sudden Gains during Therapy of Social Phobia

    ERIC Educational Resources Information Center

    Hofmann, Stefan G.; Schultz, Stefan M.; Meuret, Alicia E.; Moscovitch, David A.; Suvak, Michael

    2006-01-01

    The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive-behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967…

  19. Sudden Gains during Therapy of Social Phobia

    ERIC Educational Resources Information Center

    Hofmann, Stefan G.; Schultz, Stefan M.; Meuret, Alicia E.; Moscovitch, David A.; Suvak, Michael

    2006-01-01

    The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive-behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967…

  20. Major depression in panic disorder patients with comorbid social phobia.

    PubMed

    Reiter, S R; Otto, M W; Pollack, M H; Rosenbaum, J F

    1991-07-01

    Rates of depression among panic disorder patients are particularly elevated in patients with comorbid social phobia. However, it is unclear whether this association is specific to social phobia, or whether any comorbid anxiety disorder increases the risk of depression. We assessed 100 panic disorder patients and found a significantly higher incidence of lifetime major depression for panic patients with comorbid social phobia or generalized anxiety disorder (GAD). Panic patients with comorbid social phobia had significantly higher scores on measures of dysfunctional attitudes and lower scores on measures of assertiveness; these variables may mediate the link between social phobia and depression in this population.

  1. Phobias

    MedlinePlus

    Specific phobias Overview By Mayo Clinic Staff Specific phobias are an overwhelming and unreasonable fear of objects or situations ... giving a speech or taking a test, specific phobias are long lasting, cause intense physical and psychological ...

  2. Sudden Gains During Therapy of Social Phobia

    PubMed Central

    Hofmann, Stefan G.; Schulz, Stefan M.; Meuret, Alicia E.; Moscovitch, David A.; Suvak, Michael

    2007-01-01

    The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive–behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967 session-to-session intervals met criteria for sudden gains, which most frequently occurred in Session 5. Individuals with sudden gains showed similar improvements in the 2 treatment groups. Although cognitive–behavioral therapy was associated with more cognitive changes than exposure therapy, cognitive changes did not precede sudden gains. In general, the results of this study question the clinical significance of sudden gains in social phobia treatment. PMID:16881776

  3. The structure of genetic and environmental risk factors for phobias in women

    PubMed Central

    Czajkowski, N.; Kendler, K. S.; Tambs, K.; Røysamb, E.; Reichborn-Kjennerud, T.

    2011-01-01

    Background To explore the genetic and environmental factors underlying the co-occurrence of lifetime diagnoses of DSM-IV phobia. Method Female twins (n = 1430) from the population-based Norwegian Institute of Public Health Twin Panel were assessed at personal interview for DSM-IV lifetime specific phobia, social phobia and agoraphobia. Comorbidity between the phobias were assessed by odds ratios (ORs) and polychoric correlations and multivariate twin models were fitted in Mx. Results Phenotypic correlations of lifetime phobia diagnoses ranged from 0.55 (agoraphobia and social phobia, OR 10.95) to 0.06 (animal phobia and social phobia, OR 1.21). In the best fitting twin model, which did not include shared environmental factors, heritability estimates for the phobias ranged from 0.43 to 0.63. Comorbidity between the phobias was accounted for by two common liability factors. The first loaded principally on animal phobia and did not influence the complex phobias (agoraphobia and social phobia). The second liability factor strongly influenced the complex phobias, but also loaded weak to moderate on all the other phobias. Blood phobia was mainly influenced by a specific genetic factor, which accounted for 51% of the total and 81% of the genetic variance. Conclusions Phobias are highly co-morbid and heritable. Our results suggest that the co-morbidity between phobias is best explained by two distinct liability factors rather than a single factor, as has been assumed in most previous multivariate twin analyses. One of these factors was specific to the simple phobias, while the other was more general. Blood phobia was mainly influenced by disorder specific genetic factors. PMID:21211096

  4. The structure of genetic and environmental risk factors for phobias in women.

    PubMed

    Czajkowski, N; Kendler, K S; Tambs, K; Røysamb, E; Reichborn-Kjennerud, T

    2011-09-01

    To explore the genetic and environmental factors underlying the co-occurrence of lifetime diagnoses of DSM-IV phobia. Female twins (n=1430) from the population-based Norwegian Institute of Public Health Twin Panel were assessed at personal interview for DSM-IV lifetime specific phobia, social phobia and agoraphobia. Comorbidity between the phobias were assessed by odds ratios (ORs) and polychoric correlations and multivariate twin models were fitted in Mx. Phenotypic correlations of lifetime phobia diagnoses ranged from 0.55 (agoraphobia and social phobia, OR 10.95) to 0.06 (animal phobia and social phobia, OR 1.21). In the best fitting twin model, which did not include shared environmental factors, heritability estimates for the phobias ranged from 0.43 to 0.63. Comorbidity between the phobias was accounted for by two common liability factors. The first loaded principally on animal phobia and did not influence the complex phobias (agoraphobia and social phobia). The second liability factor strongly influenced the complex phobias, but also loaded weak to moderate on all the other phobias. Blood phobia was mainly influenced by a specific genetic factor, which accounted for 51% of the total and 81% of the genetic variance. Phobias are highly co-morbid and heritable. Our results suggest that the co-morbidity between phobias is best explained by two distinct liability factors rather than a single factor, as has been assumed in most previous multivariate twin analyses. One of these factors was specific to the simple phobias, while the other was more general. Blood phobia was mainly influenced by disorder specific genetic factors.

  5. A discussion of various aspects of panic disorder depending on presence or absence of agoraphobia.

    PubMed

    Inoue, Ken; Kaiya, Hisanobu; Hara, Naomi; Okazaki, Yuji

    2016-08-01

    The quality of life of individuals with panic disorder and agoraphobia can be improved by the alleviation of agoraphobia. In other words, examining panic disorder in terms of whether agoraphobia is present is crucial. The current study examined panic disorder from this perspective. Subjects were 253 patients who met the diagnostic criteria for panic disorder (lifetime) according to the Mini International Neuropsychiatric Interview (MINI). Of those patients, 179 had agoraphobia and 74 did not. Statistical analysis was used to examine gender differences in the presence (or absence) of agoraphobia, comorbidities, and the effects of the presence of agoraphobia (severity, assessment of depression, assessment of anxiety, and personality) in these patients. Results indicated gender differences in the presence (or absence) of agoraphobia. Compared to patients without agoraphobia, significantly more patients with agoraphobia were female (p<.001), and had a higher prevalence of comorbidities. Patients with agoraphobia had a higher suicide risk (p<.05), more hypomanic episodes (current) (p<.05), and more frequent episodes of social phobia (p<.05). In addition, patients with agoraphobia had more severe panic disorder and a higher level of neuroticism, sensitivity to anxiety, and trait anxiety [PDSS-J, P&A, NEO-N: p<.01, ASI, STAI (Trait Anxiety): p<.05]. The current findings suggest that when treating a panic disorder, diagnosing the presence of agoraphobia is extremely important. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Social phobia: research and clinical practice.

    PubMed

    Alnaes, R

    2001-01-01

    Social phobia is a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity, occurring in about 18% of the clinical population. Despite good results with cognitive-behavioural treatment, social phobia seems to be a chronic disorder with several complications. The author describes an analysis of a divorced woman who was exposed to an early premature sexual seduction by her father, abruptly terminated because of an accident. The loss of the father was repaired by a delusional system as defence against the re-emergence of a catastrophic situation. Her compulsion to repeat the traumatic situation was seen in symbolic attempts to reproduce the lost experience of forbidden pleasure with other men, ending in hopeless affairs. According to DSM-IV the patient had-besides social phobia-several personality disturbances, clinically manifested by weak ego boundaries, an unclear identity, and low self-esteem. Cognitive-behavioural therapy and psychopharmaca were without any effect. The childhood experiences were repeated in the context of the analysis and worked through, especially the pre-oedipal and oedipal conflicts. Important repeating themes were "crime", guilt, and punishment. After 3 years of analysis it was possible for the patient to expose herself to anxiety-producing situations with less symptoms. It was possible for her to withdraw the projections and take more responsibility for the unconscious sexual and aggressive impulses. At the 5-year follow-up her satisfactions had become more realistic and she became involved in a positive relationship.

  7. Depersonalization/derealization during acute social stress in social phobia.

    PubMed

    Hoyer, Juergen; Braeuer, David; Crawcour, Stephen; Klumbies, Elisabeth; Kirschbaum, Clemens

    2013-03-01

    The present study aimed at investigating how frequently and intensely depersonalization/derealization symptoms occur during a stressful performance situation in social phobia patients vs. healthy controls, as well as testing hypotheses about the psychological predictors and consequences of such symptoms. N=54 patients with social phobia and N=34 control participants without mental disorders were examined prior to, during, and after a standardized social performance situation (Trier Social Stress Test, TSST). An adapted version of the Cambridge Depersonalization Scale was applied along with measures of social anxiety, depression, personality, participants' subjective appraisal, safety behaviours, and post-event processing. Depersonalization symptoms were more frequent in social phobia patients (92%) than in controls (52%). Specifically in patients, they were highly positively correlated with safety behaviours and post-event-processing, even after controlling for social anxiety. The role of depersonalization/derealization in the maintenance of social anxiety should be more thoroughly recognized and explored. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Issues in the Assessment of Social Phobia: A Review

    PubMed Central

    Letamendi, Andrea M.; Chavira, Denise A.; Stein, Murray B.

    2010-01-01

    Since the emergence of social phobia in DSM nomenclature, the mental health community has witnessed an expansion in standardized methods for the screening, diagnosis, and measurement of the disorder. This article reviews formal assessment methods for social phobia, including diagnostic interview, clinician-administered instruments, and self report questionnaires. Frequently used tools for assessing constructs related to social phobia, such as disability and quality of life, are also briefly presented. This review evaluates each method by highlighting the assessment features recommended in social phobia literature, including method of administration, item content, coverage, length of scale, type of scores generated, and time frame. PMID:19728569

  9. [A psychological content of social phobia syndrome].

    PubMed

    Sagalakova, O A; Truevtsev, D V; Stoyanova, I Ya

    2017-01-01

    To perform a psychological analysis of social phobia syndrome. The subject area of research is the structure of mental activity and behavior in social activity. The study included 32 patients with symptoms of social phobia (ICD-10 F40.1) and 29 healthy people (controls). A complex of psychological methods (questionnaires; pathopsychological experiment) was used. Early maladaptive schemes and a tendency to mental rigidity can be a premorbid basis of the syndrome. Primary violation is in organizational target component by type of distortion of goal-setting regulation. The mechanism is a reduction in the mediation of emotions and behavior (an influence of emotions on the process of activity, excess metacognitive anxiety control leading to multi-task and exhaustion of resources of voluntary activity). Fear of negative evaluation leads to the fact that a wide class of situations is interpreted as threatening. Secondary are changes in the system of goals and motives of activity (technically performing components of social behavior act as a focus of attention, along with the target, the target replaces the suprasituational meaning). Along with a strong motivation to succeed, the motive of avoiding failure is formed, which leads to a decrease in social activity. Tertiary symptoms of syndrome dynamics (ways to cope with maladaptation) are destructive forms of decompensation (substance abuse, learned helplessness and hopelessness, suicidal behavior, etc.), repeatedly reinforcing the primary and secondary disturbances.

  10. Social Phobia in College Students: A Developmental Perspective

    ERIC Educational Resources Information Center

    Stewart, Donald W.; Mandrusiak, Michael

    2007-01-01

    We used the Social Phobia Inventory (SPIN) to identify self-reported social phobia symptoms in 59 students presenting for intake at our counseling center and 119 students meeting a course requirement for research participation. We expected that students presenting for clinical service would have higher scores than the students not seeking such…

  11. Economic costs of social phobia: a population-based study.

    PubMed

    Acarturk, C; Smit, Filip; de Graaf, R; van Straten, A; Ten Have, M; Cuijpers, P

    2009-06-01

    Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based prospective study (n=4,789). Costs related to health service uptake, patients' out-of-pocket expenses, and costs arising from production losses were calculated for the reference year 2003. The costs for people with social phobia were compared with the costs for people with no mental disorder. The annual per capita total costs of social phobia were euro 11,952 (95% CI=7,891-16,013) which is significantly higher than the total costs for people with no mental disorder, euro 2957 (95% CI=2690-3224). When adjusting for mental and somatic co-morbidity, the costs decreased to euro 6,100 (95% CI=2681-9519), or 136 million euro per year per 1 million inhabitants, which was still significantly higher than the costs for people with no mental disorder. The costs of subthreshold social phobia were also significantly higher than the costs for people without any mental disorder, at euro 4,687 (95% CI=2557-6816). The costs presented here are conservative lower estimates because we only included costs related to mental health services. The economic costs associated with social phobia are substantial, and those of subthreshold social phobia approach those of the full-blown disorder.

  12. Social Phobia in College Students: A Developmental Perspective

    ERIC Educational Resources Information Center

    Stewart, Donald W.; Mandrusiak, Michael

    2007-01-01

    We used the Social Phobia Inventory (SPIN) to identify self-reported social phobia symptoms in 59 students presenting for intake at our counseling center and 119 students meeting a course requirement for research participation. We expected that students presenting for clinical service would have higher scores than the students not seeking such…

  13. Panic and phobic anxiety: associations among neuroticism, physiological hyperarousal, anxiety sensitivity, and three phobias.

    PubMed

    Longley, Susan L; Watson, David; Noyes, Russell; Yoder, Kevin

    2006-01-01

    A dimensional and psychometrically informed taxonomy of anxiety is emerging, but the specific and nonspecific dimensions of panic and phobic anxiety require greater clarification. In this study, confirmatory factor analyses of data from a sample of 438 college students were used to validate a model of panic and phobic anxiety with six content factors; multiple scales from self-report measures were indicators of each model component. The model included a nonspecific component of (1) neuroticism and two specific components of panic attack, (2) physiological hyperarousal, and (3) anxiety sensitivity. The model also included three phobia components of (4) classically defined agoraphobia, (5) social phobia, and (6) blood-injection phobia. In these data, agoraphobia correlated more strongly with both the social phobia and blood phobia components than with either the physiological hyperarousal or the anxiety sensitivity components. These findings suggest that the association between panic attacks and agoraphobia warrants greater attention.

  14. Parental Assessment of Childhood Social Phobia: Psychometric Properties of the Social Phobia and Anxiety Inventory for Children-Parent Report

    ERIC Educational Resources Information Center

    Higa, Charmaine K.; Fernandez, Shantel N.; Nakamura, Brad J.; Chorpita, Bruce F.; Daleiden, Eric L.

    2006-01-01

    Validity and parent-child agreement of the Social Phobia and Anxiety Inventory for Children-Parent Report (SPAI-C-P) were examined in a racially diverse sample of 158 students in Grades 5 through 8 (87 girls; ages 10 to 14; M = 11.53) and their caregivers. Children completed the Social Phobia and Anxiety Inventory for Children (SPAI-C), and…

  15. Attentional mechanisms of social perception are biased in social phobia.

    PubMed

    Boll, Sabrina; Bartholomaeus, Marie; Peter, Ulrike; Lupke, Ulrike; Gamer, Matthias

    2016-05-01

    Previous studies of social phobia have reported an increased vigilance to social threat cues but also an avoidance of socially relevant stimuli such as eye gaze. The primary aim of this study was to examine attentional mechanisms relevant for perceiving social cues by means of abnormalities in scanning of facial features in patients with social phobia. In two novel experimental paradigms, patients with social phobia and healthy controls matched on age, gender and education were compared regarding their gazing behavior towards facial cues. The first experiment was an emotion classification paradigm which allowed for differentiating reflexive attentional shifts from sustained attention towards diagnostically relevant facial features. In the second experiment, attentional orienting by gaze direction was assessed in a gaze-cueing paradigm in which non-predictive gaze cues shifted attention towards or away from subsequently presented targets. We found that patients as compared to controls reflexively oriented their attention more frequently towards the eyes of emotional faces in the emotion classification paradigm. This initial hypervigilance for the eye region was observed at very early attentional stages when faces were presented for 150ms, and persisted when facial stimuli were shown for 3s. Moreover, a delayed attentional orienting into the direction of eye gaze was observed in individuals with social phobia suggesting a differential time course of eye gaze processing in patients and controls. Our findings suggest that basic mechanisms of early attentional exploration of social cues are biased in social phobia and might contribute to the development and maintenance of the disorder. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Subtypes of social phobia: are they of any use?

    PubMed

    Vriends, Noortje; Becker, Eni S; Meyer, Andrea; Michael, Tanja; Margraf, Jürgen

    2007-01-01

    This study investigated the existence of DSM-IV social phobia subtype models in the community. Data came from the Dresden Predictor Study of a representative sample of 1877 German women (aged 18-24 years) who completed a diagnostic interview and filled out various self-report questionnaires. The number of feared social situations was distributed continuously without a clear-cut for delineation of subtypes and significantly increased functional impairment, comorbidity, subjective need for psychotherapy, seeking psychotherapeutic help and dysfunctional attitudes, and decreased social support and mental health. Subtype models based on the number (1, 2-4 and >4) and type ('formal speaking fear' versus 'other fears') of social fear did not have extra value above the continuum model of social phobia. The heterogeneity within social phobia has to be seen as a continuum of severity of social phobia, with a greater number of feared situations associated with more functional, social and psychological disability.

  17. Cognitive therapy for depressed adults with comorbid social phobia.

    PubMed

    Smits, Jasper A J; Minhajuddin, Abu; Jarrett, Robin B

    2009-04-01

    Evidence suggests that comorbid depression influences the outcome of cognitive-behavioral treatment for patients presenting with social phobia. Little is known, however, about the influence of comorbid social phobia on the response to cognitive therapy (CT) for depression among adults presenting with recurrent major depressive disorder (MDD). These analyses seek to clarify this relationship. Patients (N=156) with recurrent DSM-IV MDD entered CT (20% also met DSM-IV criteria for social phobia). Every week during the course of CT, clinicians assessed depressive symptoms and patients completed self-report instruments measuring severity of depression and anxiety. At presentation, outpatients with comorbid social phobia reported greater levels of depressive symptoms and clinicians rated their impairment as more severe, compared to their counterparts without social phobia. Patients with or without comorbid social phobia did not differ significantly in (1) attrition rates; (2) response or sustained remission rates; (3) time to response or sustained remission; or (4) rate of improvement in symptoms of depression or anxiety. The lack of domain-specific measures limits inference with respect to the improvements in social anxiety that occur with CT of depression. These findings introduce the hypothesis that CT for depression may be flexible enough to treat the depressive symptoms of patients presenting with MDD who also suffer from social phobia.

  18. Scrutinizing the relationship between shyness and social phobia.

    PubMed

    Chavira, Denise A; Stein, Murray B; Malcarne, Vanessa L

    2002-01-01

    The nature of the relationship between shyness and social phobia can be clarified by assessing rates of social phobia in highly shy and normative samples. In the present study, 2202 participants were screened and categorized on a shyness scale as highly shy (90th percentile) or "normatively" shy (40-60th percentile). The Composite International Diagnostic Interview and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II; Avoidant Personality Disorder module) were used to assign clinical diagnoses. Approximately 49% of individuals in the highly shy group had a social phobia diagnosis compared to 18% in the normatively shy group. Significantly more generalized social phobia (36% vs. 4%) and avoidant personality disorder (14% vs. 4%) diagnoses were present in the highly shy group compared to the normatively shy group. Equal rates of nongeneralized social phobia (i.e., 14% vs. 14%) were present in the highly shy and the normatively shy comparison group. Findings suggest that shyness and social phobia (especially the generalized type) are related constructs but not completely synonymous; an individual can be extremely shy yet not have a social phobia diagnosis.

  19. Prevalence of common phobias and their socio-demographic correlates in children and adolescents in a traditional developing society.

    PubMed

    Bener, A; Ghuloum, S; Dafeeah, E E

    2011-05-01

    The aim of this study was to identify the most common phobias in children and adolescents and to determine the prevalence, age distribution, and socio-demographic correlates of phobias. This was a prospective cross-sectional study conducted at public and private schools from July 2009 to February 2009. The questionnaire included socio-demographic information, extra-curricular activities and hobbies, behaviour at home and various phobic fears and it was distributed among children aged 6 to 18 years. Psychiatrists determined the definitive diagnosis for various phobias by checking and screening their symptoms. Of the studied subjects, 44% were males and 56% were females. The overall prevalence of phobia in children and adolescents was 19.7%. Among children with phobia, females had higher rates of phobias (62.4% vs 37.6%) than males. Nearly half of total sufferers were in the 12-15 year age group (46.3%). Social phobia (12.7%) was the commonest phobia found followed by agoraphobia (8.6%). Secondary school children were highly afflicted with social phobia (14.9%), agoraphobia (11.7%) and specific phobia (9.6%), while preparatory students (8.3%) were more likely to have 'medical' phobia (fear of physical illness, medical tests and procedures). A significant difference was observed between the age groups in children with agoraphobia (p=0.002). The overall prevalence of phobia in children and adolescents in Qatar was higher than rates found in other epidemiologic studies, with the most common phobias observed being social phobia, agoraphobia and specific phobia.

  20. [Social phobia in anorexia nervosa: evolution during the care].

    PubMed

    Coulon, N; Jeammet, P; Godart, N

    2009-12-01

    The links between anorexia nervosa (AN) and anxiety disorders, and particularly social phobia, are little known. However, social phobia occurs frequently in AN. Some studies have shown reduction in anxious and depressive symptomatology in AN with re-nutrition. But, to our knowledge, no work has examined the evolution of social phobia symptoms during re-nutrition in AN. To specify the links between AN, nutritional state, and social phobia. The population consisted of 2 samples and the analysis was conducted using the SPSS11.5. Sample 1 (N=24 AN) was evaluated on admission and on leaving the hospital. Our evaluation used the body mass index (BMI), the Liebowitz scale, the Mini International Neuropsychiatric Interview (MINI), and the Yale-Brown Obsessive Compulsive Scale for Eating Disorders scale (Y-BOCS-ED) respectively to evaluate or diagnose the state of malnutrition, social anxiety symptomatology, social phobia in Diagnostic and Statistical Manual-4 (DSM-IV) and anorexic symptomatology. Sample 2 (N=60) was assessed at the end of the hospitalization and then 6, 12 and 18 months later. We used the BMI, Liebowitz scale, MINI, and Eating Disorders Inventory (EDI) to assess anorexic symptomatology. In addition, the Morgan-Russell outcome assessment schedule (MR schedule) was used to assess the total clinical state of the patients. Social anxiety symptomatology and actual diagnosis decreased throughout the treatment. However, regardless of the point at which the patient received care, there was no correlation between social phobia and nutritional state, as indicated by BMI. A correlation existed between social phobia and AN symptomatology, and between social phobia and total clinical state, during the out-patient care. A component of AN-social phobia comorbidity is still questionable. Is it linked to the clinical state of the subjects (question of an additional effect of under nutrition and cognition), or even to AN? Others indicators of under nutrition are of interest

  1. Fearful imagery in social phobia: Generalization, comorbidity, and physiological reactivity

    PubMed Central

    McTeague, Lisa M.; Lang, Peter J.; Laplante, Marie-Claude; Cuthbert, Bruce N.; Strauss, Cyd C.; Bradley, Margaret M.

    2009-01-01

    Background Social phobia has been characterized as a disorder of exaggerated fear of social threat and heightened sensitivity to imagery of social failure. Methods To assess the physiological basis of this description, social phobia patients (n=75) and demographically-matched controls (n=75) imagined neutral and fearful events while acoustic startle probes were occasionally presented and eye-blink responses (orbicularis occuli) recorded. Changes in heart rate, skin conductance level, and facial expressivity were also indexed. In addition to comparing controls and social phobia patients, the influences of diagnostic subtype (circumscribed, generalized), comorbid depression, and chronicity were assessed. Results Patients exceeded controls in startle reflex and autonomic responding during imagery of social threat whereas the groups evinced commensurate reactivity to contents depicting commonly shared fears (survival threat). Individuals with circumscribed performance phobia were similar to controls, with the exception of more robust reactions to idiographic, performance fear imagery. In contrast, generalized phobic patients were characterized by longer disorder chronicity and demonstrated heightened sensitivity to a broader range of fear contents. Those with generalized phobia plus comorbid depression showed attenuation of fear-potentiated startle and reported the most protracted social anxiety. Conclusions Subtypes of social phobia can be objectively distinguished in patterns of physiological reactivity. Furthermore, subtypes vary systematically in chronicity and defensive engagement with the shortest disorder duration (circumscribed phobia) associated with the most robust and focal physiological reactivity, followed by broader defensive sensitivity in more chronic generalized phobia, and finally attenuation of the formerly exaggerated fear potentiation in the comorbidly depressed—the most chronic form. PMID:18996510

  2. Fearful imagery in social phobia: generalization, comorbidity, and physiological reactivity.

    PubMed

    McTeague, Lisa M; Lang, Peter J; Laplante, Marie-Claude; Cuthbert, Bruce N; Strauss, Cyd C; Bradley, Margaret M

    2009-03-01

    Social phobia has been characterized as a disorder of exaggerated fear of social threat and heightened sensitivity to imagery of social failure. To assess the physiological basis of this description, social phobia patients (n=75) and demographically matched control participants (n=75) imagined neutral and fearful events while acoustic startle probes were occasionally presented and eye-blink responses (orbicularis occuli) recorded. Changes in heart rate, skin conductance level, and facial expressivity were also indexed. In addition to comparing control participants and social phobia patients, the influences of diagnostic subtype (circumscribed, generalized), comorbid depression, and chronicity were assessed. Patients exceeded control participants in startle reflex and autonomic responding during imagery of social threat, whereas the groups evinced commensurate reactivity to contents depicting commonly shared fears (survival threat). Individuals with circumscribed performance phobia were similar to control participants, with the exception of more robust reactions to idiographic, performance fear imagery. In contrast, generalized phobic patients were characterized by longer disorder chronicity and demonstrated heightened sensitivity to a broader range of fear contents. Those with generalized phobia plus comorbid depression showed attenuation of fear-potentiated startle and reported the most protracted social anxiety. Subtypes of social phobia can be objectively distinguished in patterns of physiological reactivity. Furthermore, subtypes vary systematically in chronicity and defensive engagement with the shortest disorder duration (circumscribed phobia) associated with the most robust and focal physiological reactivity, followed by broader defensive sensitivity in more chronic generalized phobia, and finally attenuation of the formerly exaggerated fear potentiation in the comorbidly depressed, the most chronic form.

  3. The genetic epidemiology of irrational fears and phobias in men.

    PubMed

    Kendler, K S; Myers, J; Prescott, C A; Neale, M C

    2001-03-01

    Much of our knowledge of the role of genetic factors in the etiology of phobias comes from one population-based sample of female twins. We examined the sources of individual differences in the risks for phobias and their associated irrational fears in male twins. In personal interviews with both members of 1198 male-male twin pairs (707 monozygotic [MZ] and 491 dizygotic [DZ]) ascertained from a population-based registry, we assessed the lifetime history of agoraphobia and social, animal, situational, and blood/injury phobias as well as their associated irrational fears. Twin resemblance was assessed by means of probandwise concordance, odds ratios, tetrachoric correlations, and univariate and multivariate biometrical model fitting. The suggestive results obtained by analysis of phobias only were supported by analyzing both fears and phobias. All 5 phobia subtypes aggregate within twin-pairs. This aggregation is due largely or solely to genetic factors with heritability of liabilities ranging from 25% to 37%. Multivariate analysis revealed a common genetic factor, genetic factors specific to each subtype, and a common familial-environmental factor. In male subjects, genetic risk factors, which are partially common across all subtypes and partially subtype specific, play a moderate role in the etiology of phobias and their associated irrational fears. Family environment probably has an impact on risk for agoraphobia and social phobia. The genetic liability to blood/injury phobias is not distinct from those of the more typical phobias.

  4. Cognitive Correlates of Social Phobia among Children and Adolescents

    ERIC Educational Resources Information Center

    Alfano, Candice A.; Beidel, Deborah C.; Turner, Samuel M.

    2006-01-01

    We examined different cognitive phenomena in relation to social phobia among children (aged 7 to 11) and adolescents (aged 12-16) separately. Fifty socially phobic youths were compared to 30 normal control children on measures of social anxiety, social expectation as well as self-and observer-rated performance during two social tasks involving a…

  5. Cognitive Correlates of Social Phobia among Children and Adolescents

    ERIC Educational Resources Information Center

    Alfano, Candice A.; Beidel, Deborah C.; Turner, Samuel M.

    2006-01-01

    We examined different cognitive phenomena in relation to social phobia among children (aged 7 to 11) and adolescents (aged 12-16) separately. Fifty socially phobic youths were compared to 30 normal control children on measures of social anxiety, social expectation as well as self-and observer-rated performance during two social tasks involving a…

  6. Nonverbal expressive behaviour in schizophrenia and social phobia.

    PubMed

    Del-Monte, Jonathan; Raffard, Stéphane; Salesse, Robin N; Marin, Ludovic; Schmidt, Richard C; Varlet, Manuel; Bardy, Benoît G; Philippe Boulenger, Jean; Christine Gély-Nargeot, Marie; Capdevielle, Delphine

    2013-11-30

    Expressive behaviour plays a crucial role in the success of social interactions. Abnormality of expressive behaviour has been reported in interpersonal interactions of patients suffering from schizophrenia and social phobia, two debilitating mental disorders with important social deficits. However, no study has compared the expressive behaviour in these two disorders. Thirty schizophrenia patients, 21 social phobia patients and 30 healthy controls were evaluated and compared on expressive, cognitive and clinical dimensions. Expressive behaviour was assessed using the Motor Affective subscale of the Motor-Affective-Social-Scale (MASS). Covariables include the Positive and Negative Syndrome Scale (PANSS), the anxiety level Liebowitz-Social-Anxiety-Scale (LSAS) and cognitive tasks. After controlling for depression, schizophrenia and social phobia patients both exhibited significantly fewer expressive behaviours compared to healthy controls. Moreover, our results showed specific signatures: schizophrenia patients performed fewer spontaneous gestures (hand gestures and smiles) whereas social phobia patients had an impaired ability to produce voluntary smiles in comparison to healthy controls. Interestingly, poor social functioning was significantly correlated with a decrease of expressive behaviour for schizophrenia patients. Expressive behaviour is impaired in different ways in social phobia and schizophrenia and is associated in schizophrenia with poorer social functioning. The Motor Affective subscale of the MASS is an interesting tool for assessing the dysfunction of interpersonal expressive behaviour in mental disorders.

  7. Agoraphobia: Fear of Fear.

    ERIC Educational Resources Information Center

    Musetto, Andrew P.

    1984-01-01

    Agoraphobia is a complex phobia in which individuals react with intense anxiety to certain stress situations. Basically, agoraphobics live in fear of becoming afraid. Describes the psychotherapeutic treatment that helps agoraphobics to become more self-sufficient and to face their fears by understanding themselves better. (CS)

  8. Interpersonal subtypes in social phobia: diagnostic and treatment implications.

    PubMed

    Cain, Nicole M; Pincus, Aaron L; Grosse Holtforth, Martin

    2010-11-01

    Interpersonal assessment may provide a clinically useful way to identify subtypes of social phobia. In this study, we examined evidence for interpersonal subtypes in a sample of 77 socially phobic outpatients. A cluster analysis based on the dimensions of dominance and love on the Inventory of Interpersonal Problems-Circumplex Scales (Alden, Wiggins, & Pincus, 1990) found 2 interpersonal subtypes of socially phobic patients. These subtypes did not differ on pretreatment global symptom severity as measured by the Brief Symptom Inventory (Derogatis, 1993) or diagnostic comorbidity but did exhibit differential responses to outpatient psychotherapy. Overall, friendly-submissive social phobia patients had significantly lower scores on measures of social anxiety and significantly higher scores on measures of well-being and satisfaction at posttreatment than cold-submissive social phobia patients. We discuss the results in terms of interpersonal theory and the clinical relevance of assessment of interpersonal functioning prior to beginning psychotherapy with socially phobic patients.

  9. Phobias

    MedlinePlus

    ... bee-uh) is the fancy name for a fear. But a phobia isn't just any kind of fear. It's normal for kids to be afraid of ... is different because it is an extremely strong fear of a situation or thing. It is also ...

  10. Impaired conditional discrimination learning in social phobia.

    PubMed

    Sachs, Gabriele; Anderer, Peter; Doby, Dagmar; Saletu, Bernd; Dantendorfer, Karl

    2003-01-01

    Eyelid conditional discrimination learning (ECDL) is a test of discriminative aversive conditioning. It places minimal demands on motivation and was shown to selectively test temporal lobe function. Twenty-five unmedicated social phobia (SP) patients (mean age 29.5 +/- 7.0 years), diagnosed according to DSM-IV criteria, and 25 age- and gender-matched healthy controls (HC, mean age 34.0 +/- 8.6 years) were examined with an ECDL paradigm. In the experiment two differently colored stimuli are randomly presented. Only one of the stimuli (reinforced trial) is followed by an aversive airpuff to the cornea, as opposed to unreinforced trials not followed by an airpuff. Conditioned responses (CRs) consist of reflex eyelid closures already upon light presentation. HC as well as SP patients showed a significant difference between reinforced and unreinforced trials. In SP patients, CR frequency did not increase during the ECDL task, while HCs showed appropriate conditional discrimination ability. Thus the results indicate an impairment of adequate behavior modification in an aversive conditioning task in SP. Copyright 2003 S. Karger AG, Basel

  11. New developments in cognitive-behavioral therapy for social phobia.

    PubMed

    Heimberg, R G; Barlow, D H

    1991-11-01

    Significant advances in cognitive-behavioral therapy for social phobia have occurred during the past 5 years. A new psychobiological model of social anxiety is described, and recent controlled clinical trials are reviewed. An effective cognitive-behavioral approach to therapy for social phobia developed in the authors' setting is described with case studies. Finally, future directions in cognitive-behavioral approaches to therapy for social anxiety, including clinical trials of interactive approaches that combine drug therapy with behavioral therapy and of intensive treatment of patients with avoidant personality disorder, are described briefly.

  12. Measurement Invariance of the Social Phobia and Anxiety Inventory

    PubMed Central

    Bunnell, Brian E.; Joseph, Dana L.; Beidel, Deborah C.

    2012-01-01

    The Social Phobia and Anxiety Inventory (SPAI) is a commonly used self-report measure of social phobia that has demonstrated adequate reliability, convergent validity, discriminant validity, and criterion-related validity. However, research has yet to address whether this measure functions equivalently in (a) individuals with and without a diagnosis of social phobia and (b) males and females. Evaluating measurement equivalence is necessary in order to determine that the construct of social anxiety is conceptually understood invariantly across these populations. The results of the current investigation, using a series of nested factorial models proposed by Vandenberg and Lance (2000), provide evidence for strong equivalence across 420 individuals with and without diagnoses of social anxiety disorder and across male and female samples. Accordingly, these results provide psychometric justification for comparison of SPAI scores across the symptom continuum and sexes. PMID:23247204

  13. Time-course of attention biases in social phobia.

    PubMed

    Schofield, Casey A; Inhoff, Albrecht W; Coles, Meredith E

    2013-10-01

    Theoretical models of social phobia implicate preferential attention to social threat in the maintenance of anxiety symptoms, though there has been limited work characterizing the nature of these biases over time. The current study utilized eye-movement data to examine the time-course of visual attention over 1500ms trials of a probe detection task. Nineteen participants with a primary diagnosis of social phobia based on DSM-IV criteria and 20 non-clinical controls completed this task with angry, fearful, and happy face trials. Overt visual attention to the emotional and neutral faces was measured in 50ms segments across the trial. Over time, participants with social phobia attend less to emotional faces and specifically less to happy faces compared to controls. Further, attention to emotional relative to neutral expressions did not vary notably by emotion for participants with social phobia, but control participants showed a pattern after 1000ms in which over time they preferentially attended to happy expressions and avoided negative expressions. Findings highlight the importance of considering attention biases to positive stimuli as well as the pattern of attention between groups. These results suggest that attention "bias" in social phobia may be driven by a relative lack of the biases seen in non-anxious participants. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Social phobia and other psychiatric problems in children with strabismus.

    PubMed

    Cumurcu, Tongabay; Cumurcu, Birgul Elbozan; Ozcan, Ozlem; Demirel, Soner; Duz, Cem; Porgalı, Esra; Doganay, Selim

    2011-06-01

    To investigate the rate of social phobia, anxiety, depression, and other psychiatric problems in children with strabismus. Prospective, cross-sectional, case-control study. Forty-two children with strabismus and 47 control subjects 8-13 years of age were enrolled in this study. After the ophthalmologist's examination, all cases were assessed by a psychiatrist based on the structured interview technique of Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version (Kiddie-SADS-PL). The Screen for Child Anxiety Related Emotional Disorders (SCARED) was administered to each subject to evaluate social phobia. All participants completed the Children's Depression Inventory (CDI). Age as well as sex and income were comparable between the strabismus patients and control groups. Social phobia was diagnosed in 8 (19.04%) of the 42 strabismic children and in 1 (2.12%) of the control subjects. The CDI and SCARED (total score, social phobia, separation anxiety) scores of strabismus patients were significantly higher than the control group (p = 0.001, p = 0.004, p = 0.0001, p = 0.05, respectively). A relationship between strabismus in children and social phobia, depression, and anxiety on a symptom basis was underlined by our data. Copyright © 2011. Published by Elsevier Inc.

  15. Covariation bias for ambiguous social stimuli in generalized social phobia.

    PubMed

    Hermann, Christiane; Ofer, Julia; Flor, Herta

    2004-11-01

    The authors investigated whether the negative interpretation bias in generalized social phobia (GSP) reflects and is maintained by illusory correlations. Participants were exposed to descriptions of ambiguous social events, situations involving fear-relevant animals and nature scenes that were randomly paired with negative, positive, or neutral emotional facial expressions. Prior to the experiment, the GSP participants overestimated the contingency social situations-negative outcome, whereas the controls judged negative outcomes as least likely. A posteriori, the GSP participants exhibited an illusory correlation specifically between social cues and negative outcomes. During the experiment, only the controls showed distorted outcome predictions for social situations. Hence, illusory correlations--possibly resulting from acquired associations between social cues and negative consequences--may contribute to a negative interpretation bias in GSP. Copyright 2004 APA.

  16. Social Phobia in Youth: The Diagnostic Utility of Feared Social Situations

    ERIC Educational Resources Information Center

    Puliafico, Anthony C.; Comer, Jonathan S.; Kendall, Philip C.

    2007-01-01

    The present study evaluated the utility of parent- and child-reported social fears for reaching a diagnosis of social phobia in youth. The diagnostic utility of (a) the number of fears and (b) specific feared social situations was examined. The sample included 140 youth and their parents: youth diagnosed with social phobia (n = 50), youth…

  17. Social Phobia in Youth: The Diagnostic Utility of Feared Social Situations

    ERIC Educational Resources Information Center

    Puliafico, Anthony C.; Comer, Jonathan S.; Kendall, Philip C.

    2007-01-01

    The present study evaluated the utility of parent- and child-reported social fears for reaching a diagnosis of social phobia in youth. The diagnostic utility of (a) the number of fears and (b) specific feared social situations was examined. The sample included 140 youth and their parents: youth diagnosed with social phobia (n = 50), youth…

  18. Differentiating High-Functioning Autism and Social Phobia

    ERIC Educational Resources Information Center

    Tyson, Katherine E.; Cruess, Dean G.

    2012-01-01

    Both high-functioning autism (HFA) and social phobia (SP) involve profound social interaction deficits. Although these disorders share some similar symptoms, they are conceptualized as distinct. Because both HFA and SP are defined behaviorally, the degree of overlap between the two disorders may result in misinterpretation of symptoms. However,…

  19. Imagery Rescripting of Early Traumatic Memories in Social Phobia

    ERIC Educational Resources Information Center

    Wild, Jennifer; Clark, David M.

    2011-01-01

    Negative self-images appear to play a role in the maintenance of social phobia and research suggests they are often linked to earlier memories of socially traumatic events. Imagery rescripting is a clinical intervention that aims to update such unpleasant or traumatic memories, and is increasingly being incorporated in cognitive behavioral therapy…

  20. Restricted Autonomic Flexibility in Children with Social Phobia

    ERIC Educational Resources Information Center

    Schmitz, Julian; Kramer, Martina; Tuschen-Caffier, Brunna; Heinrichs, Nina; Blechert, Jens

    2011-01-01

    Background: Psychophysiological hyperresponsiveness to social-evaluative stress plays a key role in current theories of social phobia (SP). Owing to the early onset of this disorder, the study of children with SP can help to improve etiological models. However, research to date has failed to clarify whether children with SP are physiologically…

  1. Post-Event Processing in Children with Social Phobia

    ERIC Educational Resources Information Center

    Schmitz, Julian; Kramer, Martina; Blechert, Jens; Tuschen-Caffier, Brunna

    2010-01-01

    In the aftermath of a distressing social event, adults with social phobia (SP) engage in a review of this event with a focus on its negative aspects. To date, little is known about this post-event processing (PEP) and its relationship with perceived performance in SP children. We measured PEP in SP children (n = 24) and healthy controls (HC; n =…

  2. Restricted Autonomic Flexibility in Children with Social Phobia

    ERIC Educational Resources Information Center

    Schmitz, Julian; Kramer, Martina; Tuschen-Caffier, Brunna; Heinrichs, Nina; Blechert, Jens

    2011-01-01

    Background: Psychophysiological hyperresponsiveness to social-evaluative stress plays a key role in current theories of social phobia (SP). Owing to the early onset of this disorder, the study of children with SP can help to improve etiological models. However, research to date has failed to clarify whether children with SP are physiologically…

  3. Changes in Self-Perception During Treatment of Social Phobia

    ERIC Educational Resources Information Center

    Hofmann, Stefan G.; Moscovitch, David A.; Kim, Hyo-Jin; Taylor, Andrea N.

    2004-01-01

    Ninety individuals with social phobia were randomly assigned to a waitlist control group, a cognitive-behavioral therapy group, or an exposure therapy group without explicit cognitive intervention. Two independent raters classified more than 2,000 thoughts that were reported by participants while anticipating socially stressful situations at…

  4. Differentiating High-Functioning Autism and Social Phobia

    ERIC Educational Resources Information Center

    Tyson, Katherine E.; Cruess, Dean G.

    2012-01-01

    Both high-functioning autism (HFA) and social phobia (SP) involve profound social interaction deficits. Although these disorders share some similar symptoms, they are conceptualized as distinct. Because both HFA and SP are defined behaviorally, the degree of overlap between the two disorders may result in misinterpretation of symptoms. However,…

  5. Post-Event Processing in Children with Social Phobia

    ERIC Educational Resources Information Center

    Schmitz, Julian; Kramer, Martina; Blechert, Jens; Tuschen-Caffier, Brunna

    2010-01-01

    In the aftermath of a distressing social event, adults with social phobia (SP) engage in a review of this event with a focus on its negative aspects. To date, little is known about this post-event processing (PEP) and its relationship with perceived performance in SP children. We measured PEP in SP children (n = 24) and healthy controls (HC; n =…

  6. Imagery Rescripting of Early Traumatic Memories in Social Phobia

    ERIC Educational Resources Information Center

    Wild, Jennifer; Clark, David M.

    2011-01-01

    Negative self-images appear to play a role in the maintenance of social phobia and research suggests they are often linked to earlier memories of socially traumatic events. Imagery rescripting is a clinical intervention that aims to update such unpleasant or traumatic memories, and is increasingly being incorporated in cognitive behavioral therapy…

  7. Solution-Focused Therapy: Strength-Based Counseling for Children with Social Phobia

    ERIC Educational Resources Information Center

    George, Cindy M.

    2008-01-01

    Solution-focused therapy is proposed as an effective strength-based model for children with social phobia. Social phobia is described along with the etiology and prevailing treatment approaches. A case illustration demonstrates the application of solution-focused therapy with a child who experienced social phobia. Implications for counseling and…

  8. Solution-Focused Therapy: Strength-Based Counseling for Children with Social Phobia

    ERIC Educational Resources Information Center

    George, Cindy M.

    2008-01-01

    Solution-focused therapy is proposed as an effective strength-based model for children with social phobia. Social phobia is described along with the etiology and prevailing treatment approaches. A case illustration demonstrates the application of solution-focused therapy with a child who experienced social phobia. Implications for counseling and…

  9. Shyness and Social Phobia: A Social Work Perspective on a Problem in Living.

    ERIC Educational Resources Information Center

    Walsh, Joseph

    2002-01-01

    Social phobia can be conceptualized from a social work perspective as an extreme shyness that can be overcome with cognitive learning and behavioral rehearsal. This article reviews the biopsychosocial causes of social phobia and presents a summary of cognitive and behavioral interventions with empirically demonstrated effectiveness. (Author)

  10. Nosological status of social phobia: contrasting classical and recent literature.

    PubMed

    Nedic, Aleksandra; Zivanovic, Olga; Lisulov, Ratomir

    2011-01-01

    The aim of this review is to contrast classical and recent literature relating to social anxiety disorder in the context of its past, present and future position in classification systems. Social phobia is common; it starts early and is chronic and disabling. It runs in families. Social phobia is frequently comorbid with other anxiety, mood and substance use disorders and it often precedes axis I disorders. Concerning neurobiology of social anxiety disorder research is sparse and the results are inconclusive. The data from research on genetics, early environment, temperamental features, cognitive processing, phenomenology and treatment response indicate significant overlap between social phobia and a number of other axis I and axis II disorders (avoidant personality disorder). The review of the recent findings does not point to the existence of qualitative differences between social phobia and other anxiety and mood disorders. The results of recent research run against the current classification dividing anxiety and mood disorders into discrete categories and support the continuity among them. Taking into account conceptual issues of psychiatric classifications would promote subsequent research that could become a foundation for the development of psychiatric nosology.

  11. The structure of genetic and environmental risk factors for fears and phobias.

    PubMed

    Loken, E K; Hettema, J M; Aggen, S H; Kendler, K S

    2014-08-01

    Although prior genetic studies of interview-assessed fears and phobias have shown that genetic factors predispose individuals to fears and phobias, they have been restricted to the DSM-III to DSM-IV aggregated subtypes of phobias rather than to individual fearful and phobic stimuli. We examined the lifetime history of fears and/or phobias in response to 21 individual phobic stimuli in 4067 personally interviewed twins from same-sex pairs from the Virginia Adult Twin Study of Psychiatric and Substance Abuse Disorders (VATSPSUD). We performed multivariate statistical analyses using Mx and Mplus. The best-fitting model for the 21 phobic stimuli included four genetic factors (agora-social-acrophobia, animal phobia, blood-injection-illness phobia and claustrophobia) and three environmental factors (agora-social-hospital phobia, animal phobia, and situational phobia). This study provides the first view of the architecture of genetic and environmental risk factors for phobic disorders and their subtypes. The genetic factors of the phobias support the DSM-IV and DSM-5 constructs of animal and blood-injection-injury phobias but do not support the separation of agoraphobia from social phobia. The results also do not show a coherent genetic factor for the DSM-IV and DSM-5 situational phobia. Finally, the patterns of co-morbidity across individual fears and phobias produced by genetic and environmental influences differ appreciably.

  12. The structure of genetic and environmental risk factors for fears and phobias

    PubMed Central

    Loken, E. K.; Hettema, J.M.; Aggen, S.H.; Kendler, K. S.

    2014-01-01

    Background Although prior genetic studies of interview-assessed fears and phobias have shown that genetic factors predispose individuals to fears and phobias, they have been restricted to the DSM-III to DSM-IV aggregated subtypes of phobias rather than to individual fearful and phobic stimuli. Method We examined the lifetime history of fears and/or phobias in response to 21 individual phobic stimuli in 4067 personally interviewed twins from same-sex pairs from the Virginia Adult Twin Study of Psychiatric and Substance Abuse Disorders (VATSPSUD). We performed multivariate statistical analyses using Mx and Mplus. Results The best-fitting model for the 21 phobic stimuli included four genetic factors (agora-social-acrophobia, animal phobia, blood-injection-illness phobia and claustrophobia) and three environmental factors (agora-social-hospital phobia, animal phobia, and situational phobia). Conclusions This study provides the first view of the architecture of genetic and environmental risk factors for phobic disorders and their subtypes. The genetic factors of the phobias support the DSM-IV and DSM-5 constructs of animal and blood-injection-injury phobias but do not support the separation of agoraphobia from social phobia. The results also do not show a coherent genetic factor for the DSM-IV and DSM-5 situational phobia. Finally, the patterns of co-morbidity across individual fears and phobias produced by genetic and environmental influences differ appreciably. PMID:24384457

  13. The association between social phobia, social anxiety cognitions and paranoid symptoms.

    PubMed

    Schutters, S I J; Dominguez, M-d-G; Knappe, S; Lieb, R; van Os, J; Schruers, K R J; Wittchen, H-U

    2012-03-01

    Previous research suggests high levels of comorbidity between social phobia and paranoid symptoms, although the nature of this association remains unclear. Data were derived from the Early Developmental Stages of Psychopathology study, a 10-year longitudinal study in a representative German community sample of 3021 participants aged 14-24 years at baseline. The Munich-Composite International Diagnostic Interview was used to assess social phobia and paranoid symptoms, along with data on social phobia features. Cross-sectional and longitudinal analyses were conducted. Differential associations with environmental risk factors and temperamental traits were investigated. Lifetime social phobia and paranoid symptoms were associated with each other cross-sectionally (OR = 1.80, 95% CI = 1.31-2.47). Lifetime paranoid symptoms were associated specifically with social anxiety cognitions. Lifetime cognitions of negative evaluation predicted later onset of paranoid symptoms, whereas onset of social phobia was predicted by cognitions of loss of control and fear/avoidance of social situations. Lifetime social phobia and paranoid symptoms shared temperamental traits of behavioural inhibition, but differed in environmental risks. The present study showed that paranoid symptoms and social phobia share similarities in cognitive profile and inhibited temperament. Avoidance appears to be important in the development of social phobia, whereas cannabis use and traumatic experiences may drive paranoid thinking in vulnerable individuals. © 2011 John Wiley & Sons A/S.

  14. The relationship between panic disorder/agoraphobia and personality disorders.

    PubMed

    Mavissakalian, M

    1990-12-01

    This selective review of the relationship between panic disorder/agoraphobia and DSM-III personality disorders points to a preponderance of dependent, avoidant, and histrionic features and reveals a certain degree of covariation between severity of Axis I disorder and personality functioning. However, the link between panic/agoraphobia and Axis II disorders does not appear to be specific because (1) general features such as neuroticism, stress, dysphoric mood, and interpersonal sensitivity, rather than duration and severity of panic attacks and phobias, emerge as unique predictors or determinants of personality disorder; and (2) similar personality profiles are obtained in a heterogenous population of psychiatric outpatients or patients with social phobia, obsessive-compulsive disorder, and major depression.

  15. The Effects of Maternal Social Phobia on Mother-Infant Interactions and Infant Social Responsiveness

    ERIC Educational Resources Information Center

    Murray, Lynne; Cooper, Peter; Creswell, Cathy; Schofield, Elizabeth; Sack, Caroline

    2007-01-01

    Background: Social phobia aggregates in families. The genetic contribution to intergenerational transmission is modest, and parenting is considered important. Research on the effects of social phobia on parenting has been subject to problems of small sample size, heterogeneity of samples and lack of specificity of observational frameworks. We…

  16. The Effects of Maternal Social Phobia on Mother-Infant Interactions and Infant Social Responsiveness

    ERIC Educational Resources Information Center

    Murray, Lynne; Cooper, Peter; Creswell, Cathy; Schofield, Elizabeth; Sack, Caroline

    2007-01-01

    Background: Social phobia aggregates in families. The genetic contribution to intergenerational transmission is modest, and parenting is considered important. Research on the effects of social phobia on parenting has been subject to problems of small sample size, heterogeneity of samples and lack of specificity of observational frameworks. We…

  17. Screening for ADHD in an Adult Social Phobia Sample

    ERIC Educational Resources Information Center

    Mortberg, Ewa; Tilfors, Kerstin; Bejerot, Susanne

    2012-01-01

    Objective: Recent studies have suggested a link between a primary anxiety disorder and ADHD. Method: A total of 39 participants with a primary diagnosis of social phobia were compared with 178 patients with ADHD and 88 patients with other psychiatric disorders on measures for childhood and adult ADHD (the Wender Utah Rating Scale and the Adult…

  18. Shyness 1: distance treatment of social phobia over the Internet.

    PubMed

    Titov, Nickolai; Andrews, Gavin; Schwencke, Genevieve; Drobny, Juliette; Einstein, Danielle

    2008-07-01

    The purpose of the present study was to examine the effectiveness of an Internet-based clinician-assisted computerized cognitive behavioural therapy programme for social phobia. A total of 105 individuals with social phobia were randomly assigned to a six-lesson cognitive behavioural treatment programme or to a waitlist control group. Treatment consisted of four components: six online lessons; homework assignments; participation in an online discussion forum; and regular email contact with a therapist. An intention-to-treat model was used for data analyses. A total of 78% of treatment group participants completed all lessons, and post-treatment data were obtained from 93/105 participants. Significant post-treatment differences between treatment and waitlist participants were found on two measures of symptoms of social phobia. Mean within- and between-group effect sizes (Cohen's d) for the primary social phobia outcome measures were 1.15, and 0.95, respectively. These results were comparable with those obtained in exemplary face-to-face treatment programmes. They provide further positive data about the utility of Internet-based guided self-help programmes for people with common mental disorders.

  19. Screening for ADHD in an Adult Social Phobia Sample

    ERIC Educational Resources Information Center

    Mortberg, Ewa; Tilfors, Kerstin; Bejerot, Susanne

    2012-01-01

    Objective: Recent studies have suggested a link between a primary anxiety disorder and ADHD. Method: A total of 39 participants with a primary diagnosis of social phobia were compared with 178 patients with ADHD and 88 patients with other psychiatric disorders on measures for childhood and adult ADHD (the Wender Utah Rating Scale and the Adult…

  20. Low perceived social support predicts later depression but not social phobia in middle adolescence

    PubMed Central

    Väänänen, Juha-Matti; Marttunen, Mauri; Helminen, Mika; Kaltiala-Heino, Riittakerttu

    2014-01-01

    Social phobia and depression are common and highly comorbid disorders in adolescence. There is a lack of studies on possible psychosocial shared risk factors for these disorders. The current study examined if low social support is a shared risk factor for both disorders among adolescent girls and boys. This study is a part of the Adolescent Mental Health Cohort Study's two-year follow-up. We studied cross-sectional and longitudinal associations of perceived social support with social phobia, depression, and comorbid social phobia and depression among girls and boys. The study sample consisted of 2070 15-year-old adolescents at baseline. Depression was measured by the 13-item Beck Depression Inventory, social phobia by the Social Phobia Inventory (SPIN), and perceived social support by the Perceived Social Support Scale-Revised (PSSS-R). Girls reported higher scores on the PSSS-R than boys in total scores and in friend and significant other subscales. Cross-sectional PSSS-R scores were lower among adolescents with social phobia, depression, and comorbid disorder than among those without these disorders. Low PSSS-R total score and significant other subscale were risk factors for depression among both genders, and low support from friends among girls only. Low perceived social support from any source was not a risk factor for social phobia or comorbid social phobia and depression. As conclusion of the study, low perceived social support was a risk factor for depression, but not a shared risk factor for depression and social phobia. Interventions enhancing perceived social support should be an important issue in treatment of depression. PMID:25750832

  1. Shyness 2: treating social phobia online: replication and extension.

    PubMed

    Titov, Nickolai; Andrews, Gavin; Schwencke, Genevieve

    2008-07-01

    In a randomized controlled trial Titov et al. (2008) demonstrated significant benefit from an Internet- and email-based treatment programme for social phobia. The present study (Shyness 2) seeks to replicate that finding and compares results with benchmark data. Eighty-eight individuals with social phobia were randomly assigned to a clinician-assisted computerized cognitive behavioural treatment programme or to a waitlist control group. Participants completed the same treatment programme used in Shyness 1, consisting of six online lessons, cognitive behavioural homework assignments, email contact with a therapist, and participation in an online discussion forum. An intention-to-treat model was used for data analyses. A total of 80% of treatment group participants completed all lessons, and post-treatment data were obtained from 78/81 participants. Treatment group participants each had an average of 127 min of therapist contact over the 10 week programme, including an average of 22 email contacts plus therapist responses to forum postings. Pre- to post-treatment differences were seen between treatment and waitlist participants across two measures of symptoms of social phobia, and across a measure of disability. Mean within- and between-group effect sizes (Cohen's d) across the two primary outcome measures were 1.18, and 1.20, respectively. Quantitative and qualitative data indicate that the procedure is very acceptable to participants. These results closely replicate those obtained in Shyness 1, indicating that the treatment procedure is reliable. These results compare favourably with outcomes reported in benchmarking studies from high-quality face-to-face treatment programmes for social phobia. These results provide further positive data about the utility of Internet-based guided self-help programmes for people with social phobia.

  2. Social Fears and Social Phobia in the United States: Results from the National Comorbidity Survey Replication

    PubMed Central

    Ruscio, Ayelet Meron; Brown, Timothy A.; Chiu, Wai Tat; Sareen, Jitender; Stein, Murray B.; Kessler, Ronald C.

    2008-01-01

    Background Despite heightened awareness of the clinical significance of social phobia, information is still lacking about putative subtypes, functional impairment, and treatment-seeking. New epidemiologic data on these topics are presented from the National Comorbidity Survey Replication (NCS-R). Methods The NCS-R is a nationally representative household survey fielded in 2001–2003. The WHO Composite International Diagnostic Interview (CIDI 3.0) was used to assess 14 performance and interactional fears and DSM-IV social phobia. Results The estimated lifetime and 12-month prevalence of social phobia are 12.1% and 7.1%. Performance and interactional fears load onto a single latent factor, and there is little evidence for distinct subtypes based either on the content or number of fears. Social phobia is associated with significant psychiatric comorbidity, role impairment, and treatment-seeking, all of which have a dose-response relationship with number of social fears. However, social phobia is the focus of clinical attention in only about half of cases where treatment is obtained. Among non-comorbid cases, those with the most fears were least likely to receive social phobia treatment. Conclusions Social phobia is a common, under-treated disorder that leads to significant functional impairment. Increasing numbers of social fears are associated with increasingly severe manifestations of the disorder. PMID:17976249

  3. The role of parenting experiences in the development of social anxiety and agoraphobia in the eating disorders.

    PubMed

    Hinrichsen, Hendrik; Sheffield, Alexandra; Waller, Glenn

    2007-08-01

    While social anxiety and agoraphobia are commonly observed in patients with eating disorders, little is known about the types of family environment that may predispose patients to the development of these types of comorbid anxiety problem. The present study investigated whether social anxiety and agoraphobia in patients with eating disorders are linked to different types of parenting experiences. A sample of 70 women meeting DSM-IV criteria for an eating disorder completed self-report measures of social anxiety, agoraphobia and perceived parenting experiences. Social anxiety in patients with eating disorders is associated with emotionally inhibited parenting by fathers (i.e., parenting that reflects a lack of ability to share feelings with the child), while agoraphobia is associated with anxious/fearful parenting by mothers (i.e., parenting that reflects anxious, fearful traits in the parent and a pessimistic outlook on life). Specific parenting experiences may contribute to the development of comorbid social anxiety and agoraphobia in patients with eating disorders. Implications for future research and clinical practice are discussed.

  4. Social phobia in Brazilian university students: prevalence, under-recognition and academic impairment in women.

    PubMed

    Baptista, Carlos Alberto; Loureiro, Sonia Regina; de Lima Osório, Flávia; Zuardi, Antonio Waldo; Magalhães, Pedro V; Kapczinski, Flávio; Filho, Alaor Santos; Freitas-Ferrari, Maria Cecília; Crippa, José Alexandre S

    2012-02-01

    Despite the fact that public speaking is a common academic activity and that social phobia has been associated with lower educational achievement and impaired academic performance, little research has examined the prevalence of social phobia in college students. The aim of this study was to evaluate the prevalence of social phobia in a large sample of Brazilian college students and to examine the academic impact of this disorder. The Social Phobia Inventory (SPIN) and the MINI-SPIN, used as the indicator of social phobia in the screening phase, were applied to 2319 randomly selected students from two Brazilian universities. For the second phase (diagnostic confirmation), four psychiatrists and one clinical psychologist administered the SCID-IV to subjects with MINI-SPIN scores of 6 or higher. The prevalence of social phobia among the university students was 11.6%. Women with social phobia had significantly lower grades than those without the disorder. Fear of public speaking was the most common social fear. Only two of the 237 students with social phobia (0.8%) had previously received a diagnosis of social phobia and were under treatment. Social phobia comorbidities were not evaluated in this study. The methods of assessment employed by the universities (written exams) may mask the presence of social phobia. This was not a population-based study, and thus the results are not generalizable to the entire population with social phobia. Preventive strategies are recommended to reduce the under-recognition and the adverse impact of social phobia on academic performance and overall quality of life of university students. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Paroxetine: new indication. In social phobia: minimal assessment.

    PubMed

    2003-08-01

    Social phobia is generally defined as an intense and persistent fear of one or several social situations, with important repercussions for occupational activity or social life. Cognitive psychotherapy and antidepressants have partial efficacy. There is no reference drug therapy. In France, paroxetine is the first drug to be granted a licence for patients with social phobia. Clinical evaluation consists of data from four placebo-controlled trials lasting only 12 to 24 weeks. Treatment with paroxetine was associated with a significant improvement in standard social-phobia scores, although most patients remained symptomatic. Paroxetine is the best assessed selective serotonin reuptake inhibitor in this setting. However, long-term data are lacking, and the disorder is chronic. Paroxetine has not been compared with cognitive therapy. About one-third of patients in clinical trials stopped taking paroxetine, mainly because of adverse events. Gastrointestinal upset, sleep disturbance and ejaculatory problems are frequent. Paroxetine also has the potential to interact with other drugs. In practice, paroxetine may help some patients, provided they are aware of its limitations. The long-term effects of paroxetine in this setting remain unknown.

  6. The relationship between avoidant personality disorder and social phobia.

    PubMed

    Hummelen, Benjamin; Wilberg, Theresa; Pedersen, Geir; Karterud, Sigmund

    2007-01-01

    The main explanatory hypothesis for the distinction between social phobia (SP) and avoidant personality disorder (APD) has been the severity continuum hypothesis, stating that APD only differs from SP in terms of severity of dysfunction and symptomatic distress, that is, social anxiety and depressive symptoms. This study aimed at a comprehensive evaluation of this hypothesis in a large sample (n = 2192) of thoroughly assessed patients, most of whom had a diagnosis of personality disorder. Social phobia was stronger associated with APD than with other personality disorders, and APD was stronger associated with SP than with other symptom disorders. Social phobia-pure patients had a higher level of global functioning and lower levels of general symptom distress and interpersonal problems than APD-pure patients. The 2 groups were similar on domains that pertain to social anxiety and introversion, but APD was associated with a broader array of symptoms and interpersonal problems and was substantially lower on the personality domain of conscientiousness. Avoidant personality disorder was stronger associated with eating disorders, and SP was stronger associated with panic disorder. The APD diagnosis seems to capture a broader constellation of symptoms and personality features pointing toward more severe personality dysfunction. Our findings suggest that the severity continuum hypothesis lacks specificity and exploratory power to account for both similarities and differences between SP and APD.

  7. Quality of life impairments among adults with social phobia: the impact of subtype.

    PubMed

    Wong, Nina; Sarver, Dustin E; Beidel, Deborah C

    2012-01-01

    Social phobia is characterized by extreme fear in social or performance situations in which the individual may be exposed to embarrassment or scrutiny by others, which creates occupational, social and academic impairment. To date, there are few data examining the relationship of social phobia impairments to quality of life. In this investigation, we examined how demographic characteristics, comorbidity, and social competence are related to quality of life among patients with social phobia and normal controls. In addition, we examined the impact of social phobia subtype. Results indicated that individuals with generalized social phobia had significantly impaired quality of life when compared to individuals with no disorder or individuals with nongeneralized social phobia. Comorbid disorders decreased quality of life only for patients with nongeneralized social phobia. Hierarchical linear regression revealed that a diagnosis of social phobia and observer ratings of social effectiveness exerted strong and independent effects on quality of life scores. Results are discussed in terms of the role of social anxiety, social competence, and comorbidity on the quality of life for adults with social phobia. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. SET-C versus Fluoxetine in the Treatment of Childhood Social Phobia

    ERIC Educational Resources Information Center

    Beidel, Deborah C.; Turner, Samuel M.; Ammerman, Robert T.; Sallee, Floyd R.; Crosby, Lori A.; Pathak, Sanjeev

    2007-01-01

    A study examines the effectiveness of fluoxetine, pill placebo and Social Effectiveness Therapy for Children (SET-C) for children and adolescents with social phobia. The results conclude that both fluoxetine and SET-C are effective for social phobia but SET-C is better for enhancing social skills.

  9. SET-C versus Fluoxetine in the Treatment of Childhood Social Phobia

    ERIC Educational Resources Information Center

    Beidel, Deborah C.; Turner, Samuel M.; Ammerman, Robert T.; Sallee, Floyd R.; Crosby, Lori A.; Pathak, Sanjeev

    2007-01-01

    A study examines the effectiveness of fluoxetine, pill placebo and Social Effectiveness Therapy for Children (SET-C) for children and adolescents with social phobia. The results conclude that both fluoxetine and SET-C are effective for social phobia but SET-C is better for enhancing social skills.

  10. Social Phobia and Difficulties in Occupational Adjustment.

    ERIC Educational Resources Information Center

    Bruch, Monroe A.; Fallon, Melissa; Heimberg, Richard G.

    2003-01-01

    Examines whether social phobics differ from nonanxious controls in occupational adjustment. Results indicated that social phobics were underemployed and believed that their supervisor would rate them as less dependable. Social phobics were more anxious when starting their current job but did not differ in job satisfaction. Discusses results…

  11. Performance Anxiety among African-American College Students: Racial Bias as a Factor in Social Phobia

    ERIC Educational Resources Information Center

    Johnson, Aleta Bok

    2006-01-01

    This article examines the etiology of social phobia, and proposes that the sensitivity to self-scrutiny common to social phobics can be exacerbated by the effects of longstanding racial bias. The impact of racism on identity and the importance of context are explored as salient factors in the onset of a case of social phobia for an…

  12. Rescripting Early Memories Linked to Negative Images in Social Phobia: A Pilot Study

    ERIC Educational Resources Information Center

    Wild, Jennifer; Hackmann, Ann; Clark, David M.

    2008-01-01

    Negative self-images are a maintaining factor in social phobia. A retrospective study (Hackmann, A., Clark, D.M., McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601-610) suggested that the images may be linked to early memories of unpleasant social experiences. This preliminary study…

  13. Rescripting Early Memories Linked to Negative Images in Social Phobia: A Pilot Study

    ERIC Educational Resources Information Center

    Wild, Jennifer; Hackmann, Ann; Clark, David M.

    2008-01-01

    Negative self-images are a maintaining factor in social phobia. A retrospective study (Hackmann, A., Clark, D.M., McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601-610) suggested that the images may be linked to early memories of unpleasant social experiences. This preliminary study…

  14. Performance Anxiety among African-American College Students: Racial Bias as a Factor in Social Phobia

    ERIC Educational Resources Information Center

    Johnson, Aleta Bok

    2006-01-01

    This article examines the etiology of social phobia, and proposes that the sensitivity to self-scrutiny common to social phobics can be exacerbated by the effects of longstanding racial bias. The impact of racism on identity and the importance of context are explored as salient factors in the onset of a case of social phobia for an…

  15. The pathology of social phobia is independent of developmental changes in face processing.

    PubMed

    Blair, Karina S; Geraci, Marilla; Korelitz, Katherine; Otero, Marcela; Towbin, Ken; Ernst, Monique; Leibenluft, Ellen; Blair, R J R; Pine, Daniel S

    2011-11-01

    While social phobia in adolescence predicts the illness in adulthood, no study has directly compared the neural responses in social phobia in adults and adolescents. The authors examined neural responses to facial expressions in adults and adolescents with social phobia to determine whether the neural correlates of adult social phobia during face processing also manifest in adolescent social phobia. Blood-oxygen-level-dependent (BOLD) responses were compared in 39 medication-free participants with social phobia (25 adults and 14 adolescents) and 39 healthy comparison subjects (23 adults and 16 adolescents) matched on age, IQ, and gender. During fMRI scans, participants saw angry, fearful, and neutral expression stimuli while making a gender judgment. Significant diagnosis-by-emotion interactions were observed within the amygdala and the rostral anterior cingulate cortex, as has previously been hypothesized. In these regions, both the adolescent and adult social phobia patients showed significantly increased BOLD responses relative to their respective age-matched comparison subjects, and there was no evidence of age-related modulation of between-group differences. These enhanced responses occurred specifically when viewing angry (rostral anterior cingulate cortex) and fearful (amygdala and rostral anterior cingulate cortex) expressions but not when viewing neutral expressions. In addition, the severity of social phobia was significantly correlated with the enhanced rostral anterior cingulate cortex response in the adults. The neural correlates of adult social phobia during face processing also manifest in adolescents. Neural correlates that are observed in adult social phobia may represent the persistence of profiles established earlier in life rather than adaptive responses to such earlier perturbations or maturational changes. These cross-sectional observations might encourage longitudinal fMRI studies of adolescent social phobia.

  16. Advances in behavioral-cognitive therapy of social phobia.

    PubMed

    Marks, I M

    1995-01-01

    Behavioral-cognitive therapy is a cost-effective treatment for social phobia. The doctor's role is to teach the patient how to do successful self-exposure. The clinician acts as a guide and monitor; there is no need to waste time accompanying the patient into the phobic situation. The patient first reads a self-exposure manual to learn how to confront panic-evoking social cues for prolonged period without avoidance until habituation sets in. This might require an hour daily of self-exposure over weeks or months. As patients habituate to social cues to which they have exposed themselves, they arrange exposure to fresh cues until they become used to all. The patient tracks progress by recording completed exposure-homework tasks in a daily diary. In instances where it is technically difficult to do regular exposure, the patient carries out imagined tape-recorded exposure in his/her own voice. The therapist can briefly help the patient role-play such exposure. Rational role-play enhances outcome of body dysmorphic disorder or delusional disorder somatic type with prominent social phobia. Cognitive therapy can be useful. Most social phobics improve with behavioral-cognitive treatment without medication. When patients have low mood, concurrent antidepressants can be synergistic.

  17. Visual search attentional bias modification reduced social phobia in adolescents.

    PubMed

    De Voogd, E L; Wiers, R W; Prins, P J M; Salemink, E

    2014-06-01

    An attentional bias for negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated whether visual search ABM might affect attentional bias and emotional functioning in adolescents. A visual search task was used as a training paradigm; participants (n = 16 adolescents, aged 13-16) had to repeatedly identify the only smiling face in a 4 × 4 matrix of negative emotional faces, while participants in the control condition (n = 16) were randomly allocated to one of three placebo training versions. An assessment version of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and self-esteem were measured pre- and post-training. After two sessions of training, the ABM group showed a significant decrease in attentional bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood or self-esteem. No correlation between attentional bias and social phobia was found, which raises questions about the validity of the attentional bias assessment task. Also, the small sample size precludes strong conclusions. Visual search ABM might be beneficial in changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. The social phobia and anxiety inventory: psychometric properties in a Spanish sample.

    PubMed

    Baños, R M; Botella, C; Quero, S; Medina, P

    2007-04-01

    This study is a validation of the Spanish version of the Social Phobia and Anxiety Inventory using a nonclinical sample (198 participants) and a clinical sample (72 participants with social phobia). The factor structure and concurrent validity with Fear of Negative Evaluation and Social Avoidance and Distress scales were analyzed. The Social Phobia and Anxiety Inventory demonstrated good concurrent validity, showing statistically significant relationships with Fear of Negative Evaluation and Social Avoidance and Distress. Results confirmed the rationale for the division of the SPAI into two subscales. Results also demonstrated the utility of the Social Phobia and Anxiety Inventory for differentiating between a nonclinical sample and participants with a social phobia, and its adequate reliability.

  19. Psychometric evaluation of the Social Interaction Phobia Scale.

    PubMed

    Reilly, Alison R; Carleton, R Nicholas; Weeks, Justin W

    2012-01-01

    The present study evaluated the psychometric properties of a novel measure of social anxiety symptoms, the Social Interaction Phobia Scale (SIPS), as a stand-alone item set, using an undergraduate sample (N=512). The 14-item SIPS has three subscales assessing Social Interaction Anxiety, Fear of Overt Evaluation, and Fear of Attracting Attention. Confirmatory factor analyses replicated the three-factor structure for the SIPS originally reported by Carleton et al. All SIPS scores demonstrated good internal consistency. The convergent validity of the SIPS was supported by strong and positive correlations between all SIPS scores and measures of social anxiety and fear of evaluation; the finding that the relationships between all SIPS scores and a social anxiety measure were stronger than relationships between all SIPS scores and measures of other constructs supported the discriminant validity of the SIPS. Results suggest that the SIPS possesses excellent psychometric properties.

  20. [The prevalence od social phobia in representative group of adolescents from Lodz].

    PubMed

    Rabe-Jabłońska, Jolanta; Dietrich-Muszalska, Anna; Gmitrowicz, Agnieszka

    2003-01-01

    Recent epidemiological studies have produced a remarkable variation in the estimated life-time prevalence of social phobia, ranking from 0.5% to 22.6%. About 95% of social phobia occurs prior to the age of 20, approximately 40% prior to the age of 10. Studies of mainly patient samples report a mean age of onset of 14.6 to 20 years. In co-operation with GUS, the year 2000 we assessed with a specially prepared questionnaire including DSM-IV criteria for social phobia and CIDI, the prevalence of specific and generalised type of social phobia in a representative group of adolescent population from Łódź. Subjects of the study (n = 1929) were chosen from 36450 adolescents. We found, that generalised social phobia was present in 7% of subjects, specific subtype in 17% of subjects, more frequently in women than in men (p < 0.05), with the same prevalence in adolescents from various type of schools. 15% of adolescents with social phobia were alcohol or psychoactive drug abusers, 5% attempted suicide. Only 1/4th of adolescents with social phobia was in psychological or psychiatric therapy. Subjects with social phobia have a high risk of other comorbid psychiatric disorders and significant worsening of social functioning.

  1. Examination of the Correlation Between Internet Addiction and Social Phobia in Adolescents.

    PubMed

    Yayan, Emriye Hilal; Arikan, Duygu; Saban, Fatma; Gürarslan Baş, Nazan; Özel Özcan, Özlem

    2017-09-01

    This was a descriptive and cross-sectional study conducted with adolescents to examine the correlation between Internet addiction and social phobia. The population of the study consisted of 24,260 students aged between 11 and 15 years. Sampling method was used from population with known number, and 1,450 students were calculated as sample of the study. In this study, 13.7% of the adolescents had an Internet addiction, and 4.2% spent more than 5 hr on the computer every day. There was a positive correlation between Internet addiction and social phobia. The form of time spent on Internet was examined in terms of addiction and social phobia; although Internet addiction was related to games, dating sites, and web surfing, social phobia was related to homework, games, and web surfing. It was hypothesized that adolescents with social phobia were Internet addicts, and the participants used the Internet to spend time rather than socialize.

  2. The Treatment of Social Phobia in a Young Boy with Asperger's Disorder

    ERIC Educational Resources Information Center

    Schleismann, Kelly D.; Gillis, Jennifer M.

    2011-01-01

    Anxiety disorders, including social phobia, occur often in children with autism spectrum disorders (ASD; Gillott, Furniss, & Walter, 2001; Leyfer et al., 2006; Simonoff et al., 2008); however, little is known about the conceptualization and treatment of social phobia in this population. The current study presents the case of "James," a 6-year-old…

  3. Testing the Efficacy of Theoretically Derived Improvements in the Treatment of Social Phobia

    ERIC Educational Resources Information Center

    Rapee, Ronald M.; Gaston, Jonathan E.; Abbott, Maree J.

    2009-01-01

    Recent theoretical models of social phobia suggest that targeting several specific cognitive factors in treatment should enhance treatment efficacy over that of more traditional skills-based treatment programs. In the current study, 195 people with social phobia were randomly allocated to 1 of 3 treatments: standard cognitive restructuring plus in…

  4. Differentiating among singular and comorbid obsessive-compulsive disorder and social phobia symptomology.

    PubMed

    Rudy, Brittany M; May, Anna C; Whiting, Sara E; Davis, Thompson E; Jenkins, Whitney S; Reuther, Erin T

    2014-01-01

    Social phobia is a frequent co-occurring diagnosis with obsessive-compulsive disorder (OCD); however, co-occurring OCD in those with social phobia is less common. Genetic, environmental, and cognitive traits are common risk factors for anxiety disorders broadly. It is plausible that shared variables related to OCD and/or social phobia could provide insight into the co-occurrence of these two disorders. The current study explored differences in fear of negative evaluation (FNE) and perfectionism among four groups: those with (1) elevated social phobia symptoms, (2) elevated OCD symptoms, (3) elevated symptoms of OCD and social phobia, and those who were (4) asymptomatic as a control group. A non-clinical sample of 196 participants completed several online questionnaires about social phobia and OCD symptomology. Results identified three cognitive variables (i.e., FNE, total perfectionism, and concern over mistakes) as differential variables in comorbid symptom presentation of OCD and social phobia. A fourth variable (i.e., doubts about actions) was identified as a potential dual risk factor, and four subsequent variables (i.e., parental criticism, personal standards, parental expectations, and organization) were not implicated in differential symptom presentation. Given the different rates of OCD and social phobia co-occurrence, identification of differentiating variables could aid in better understanding of potential risk factors, which may enhance preventative and therapeutic techniques. Study implications, limitations, and future recommendations are discussed.

  5. Testing the Efficacy of Theoretically Derived Improvements in the Treatment of Social Phobia

    ERIC Educational Resources Information Center

    Rapee, Ronald M.; Gaston, Jonathan E.; Abbott, Maree J.

    2009-01-01

    Recent theoretical models of social phobia suggest that targeting several specific cognitive factors in treatment should enhance treatment efficacy over that of more traditional skills-based treatment programs. In the current study, 195 people with social phobia were randomly allocated to 1 of 3 treatments: standard cognitive restructuring plus in…

  6. The Treatment of Social Phobia in a Young Boy with Asperger's Disorder

    ERIC Educational Resources Information Center

    Schleismann, Kelly D.; Gillis, Jennifer M.

    2011-01-01

    Anxiety disorders, including social phobia, occur often in children with autism spectrum disorders (ASD; Gillott, Furniss, & Walter, 2001; Leyfer et al., 2006; Simonoff et al., 2008); however, little is known about the conceptualization and treatment of social phobia in this population. The current study presents the case of "James," a 6-year-old…

  7. Change Processes in Residential Cognitive and Interpersonal Psychotherapy for Social Phobia: A Process-Outcome Study

    ERIC Educational Resources Information Center

    Hoffart, Asle; Borge, Finn-Magnus; Sexton, Harold; Clark, David M.

    2009-01-01

    The purpose of this study was to test cognitive and interpersonal models for improving social phobia. Eighty patients with social phobia were randomized to 10-week residential cognitive (RCT) or residential interpersonal psychotherapy (RIPT). They completed process measures every Thursday and a sub-outcome measure every Monday. The ratings were…

  8. Change Processes in Residential Cognitive and Interpersonal Psychotherapy for Social Phobia: A Process-Outcome Study

    ERIC Educational Resources Information Center

    Hoffart, Asle; Borge, Finn-Magnus; Sexton, Harold; Clark, David M.

    2009-01-01

    The purpose of this study was to test cognitive and interpersonal models for improving social phobia. Eighty patients with social phobia were randomized to 10-week residential cognitive (RCT) or residential interpersonal psychotherapy (RIPT). They completed process measures every Thursday and a sub-outcome measure every Monday. The ratings were…

  9. Recent Findings in Social Phobia among Children and Adolescents

    PubMed Central

    Hitchcock, Carla A.; Chavira, Denise A.; Stein, Murray B.

    2010-01-01

    Childhood social phobia (SP) is common and associated with varying forms of impairment. The cause of social anxiety disorder is often complex, involving both genetic and environmental factors. Shyness in young children may be a possible precursor to social anxiety later in life, although not the sole antecedent. Current assessment of childhood social anxiety includes psychometrically sound self report and clinician administered measures either specifically targeting SP disorder or including the construct as a subscale of a broader measure. The type of measure that is used most often depends on the purpose of the assessment, the setting, time constraints, and required training. Extant data support the efficacy of both psychosocial and pharmacological interventions, with response rates ranging from 50–80%. Further research is needed to clarify the developmental stages of SP, the psychometric properties of brief measures, as well as the efficacy of combined interventions. PMID:19728571

  10. Clinical characteristics of flight phobia.

    PubMed

    Wilhelm, F H; Roth, W T

    1997-01-01

    Sixty-six subjects with severe fear of flying were recruited by advertisement and compared to 21 controls without flying fears. Subjects were interviewed and given several questionnaires to determine DSM-III-R diagnoses, history of flying, and development and course of flying phobia. Our phobic sample had a mean age of 46 and was 89% female. Diagnostically, 27% met criteria for current Panic Disorder with Agoraphobia, and 17% criteria for that diagnosis in the past. These two groups were more concerned with internal or social anxiety stimuli during flight than the group who had never had panic attacks but met criteria for Simple Phobia (flying). All three groups were equally concerned about external dangers. Traumatic flight events were common in phobics and controls, but phobics reported reacting to these events more strongly. Our results suggest a vulnerability-stress model with several vulnerability factors, including cognitive ones. Treatment implications are discussed.

  11. What Is the Core Fear in Social Phobia? A New Model to Facilitate Individualized Case Conceptualization and Treatment

    ERIC Educational Resources Information Center

    Moscovitch, David A.

    2009-01-01

    What, exactly, do individuals with social phobia fear? Whereas fear of anxiety-related bodily sensations characterizes and defines panic disorder, is there a fundamental focus of anxiety that unifies individuals under the diagnostic category of social phobia? Current conceptualizations of social phobia suggest several possible candidates,…

  12. What Is the Core Fear in Social Phobia? A New Model to Facilitate Individualized Case Conceptualization and Treatment

    ERIC Educational Resources Information Center

    Moscovitch, David A.

    2009-01-01

    What, exactly, do individuals with social phobia fear? Whereas fear of anxiety-related bodily sensations characterizes and defines panic disorder, is there a fundamental focus of anxiety that unifies individuals under the diagnostic category of social phobia? Current conceptualizations of social phobia suggest several possible candidates,…

  13. Over-representation of Myers Briggs Type Indicator introversion in social phobia patients.

    PubMed

    Janowsky, D S; Morter, S; Tancer, M

    2000-01-01

    The purpose of this study is to profile the personalities of patients with social phobia. Sixteen patients with social phobia were compared with a normative population of 55,971, and with 24 hospitalized Major Depressive Disorder inpatients, using the Myers Briggs Type Indicator. The Myers Briggs Type Indicator, a popular personality survey, divides individuals into eight categories: Extroverts versus Introverts, Sensors versus Intuitives, Thinkers versus Feelers, and Judgers versus Perceivers. Social phobia patients were significantly more often Introverts (93.7%) than were subjects in the normative population (46.2%). In addition, using continuous scores, the social phobia patients scored as significantly more introverted than did the patients with Major Depressive Disorder, who also scored as Introverted. Introversion is a major component of social phobia, and this observation may have both etiological and therapeutic significance.

  14. Social Phobia as a Predictor of Social Competence Perceived by Teenagers

    ERIC Educational Resources Information Center

    Ates, Bünyamin

    2016-01-01

    In this research, it was analyzed to what extent the variables of social avoidance, concern for being criticized and sense of individual worthlessness as sub-dimensions of social phobia predicted the perceived social competence levels of teenagers. The study group of this study included totally 648 students including 301 (46.5%) female and 347…

  15. Social Phobia and Subtypes in the National Comorbidity Survey-Adolescent Supplement: Prevalence, Correlates, and Comorbidity

    PubMed Central

    Burstein, Marcy; He, Jian-Ping; Kattan, Gabi; Albano, Anne Marie; Avenevoli, Shelli; Merikangas, Kathleen R.

    2011-01-01

    Objective Social phobia typically develops during the adolescent years, yet no nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation are to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and comorbidity of social phobia in a large, nationally representative sample of U.S. adolescents; (2) examine differences in the rates and features of social phobia across the proposed DSM-5 social phobia subtypes. Method The National Comorbidity Survey Replication-Adolescent Supplement (NCS-A) is a nationally representative face-to-face survey of 10,123 adolescents aged 13–18 years in the continental U.S. Results Approximately 9% of adolescents met criteria for any social phobia in their lifetime. Of these adolescents, 55.8% were affected with the generalized subtype and 44.2% exhibited non-generalized social phobia. Only 0.7% met criteria for the proposed DSM-5 performance only subtype. Generalized social phobia was more common among female adolescents and risk for this subtype increased with age. Adolescents with generalized social phobia also experienced an earlier age of onset, higher levels of disability and clinical severity, and a greater degree of comorbidity relative to adolescents with non-generalized forms of the disorder. Conclusions This study indicates that social phobia is a highly prevalent, persistent, and impairing psychiatric disorder among adolescent youth. Results of this study also provide evidence for the clinical utility of the generalized subtype and highlight the importance of considering the heterogeneity of social phobia in this age group. PMID:21871369

  16. Social phobia and subtypes in the national comorbidity survey-adolescent supplement: prevalence, correlates, and comorbidity.

    PubMed

    Burstein, Marcy; He, Jian-Ping; Kattan, Gabriela; Albano, Anne Marie; Avenevoli, Shelli; Merikangas, Kathleen R

    2011-09-01

    Social phobia typically develops during the adolescent years, yet no nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation were to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and comorbidity of social phobia in a large, nationally representative sample of U.S. adolescents; and (2) examine differences in the rates and features of social phobia across the proposed DSM-5 social phobia subtypes. The National Comorbidity Survey Replication-Adolescent Supplement is a nationally representative face-to-face survey of 10,123 adolescents 13 to 18 years of age in the continental United States. Approximately 9% of adolescents met criteria for any social phobia in their lifetime. Of these adolescents, 55.8% were affected with the generalized subtype and 44.2% exhibited nongeneralized social phobia. Only 0.7% met criteria for the proposed DSM-5 performance-only subtype. Generalized social phobia was more common among female adolescents and risk for this subtype increased with age. Adolescents with generalized social phobia also had a younger age of onset, higher levels of disability and clinical severity, and a greater degree of comorbidity relative to adolescents with nongeneralized forms of the disorder. This study indicates that social phobia is a highly prevalent, persistent, and impairing psychiatric disorder among adolescent youth. Results of this study also provide evidence for the clinical utility of the generalized subtype and highlight the importance of considering the heterogeneity of social phobia in this age group. Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. Social Phobia Is Associated with Delayed Onset of Chickenpox, Measles, and Mumps Infections.

    PubMed

    Ajdacic-Gross, Vladeta; Aleksandrowicz, Aleksandra; Rodgers, Stephanie; Müller, Mario; Kawohl, Wolfram; Rössler, Wulf; Castelao, Enrique; Vandeleur, Caroline; von Känel, Roland; Mutsch, Margot; Lieb, Roselind; Preisig, Martin

    2016-01-01

    Evidence showing that infectious diseases in childhood play an important role in the etiopathogenesis of neurodevelopmental and other mental disorders is growing. The aim of this study was to explore the timing of common childhood diseases in early-onset anxiety disorders. We analyzed data from PsyCoLaus, a large Swiss Population Cohort Study (N = 3720). In this study, we regressed overanxious disorder, separation anxiety disorder, social phobia, and specific phobias on the age of onset of several childhood diseases, always adjusting for the other anxiety disorders listed above and for sex. The timing of viral childhood diseases (chickenpox, measles, and mumps) was consistently delayed in social phobia, notably both in men and women. We found no evidence for a reversed sequence of onset of phobia symptoms before that of the infections included. Social phobia was the only early anxiety disorder to show an association with a delayed onset of common viral childhood diseases.

  18. The prognosis and incidence of social phobia in an elderly population. A 5-year follow-up.

    PubMed

    Karlsson, B; Sigström, R; Waern, M; Ostling, S; Gustafson, D; Skoog, I

    2010-07-01

    To examine the prognosis and incidence of social fears and phobia in an elderly population sample followed for 5 years. A general population sample (N = 612) of non-demented men (baseline age 70) and women (baseline age 70 and 78-86) was investigated in 2000-2001 and in 2005-2006 with semi-structured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM-IV criteria. Among nine individuals with DSM-IV social phobia in 2000, 5 (55.6%) had no social fears in 2005, and 1 (11.1%) still met the criteria for DSM-IV social phobia. Among individuals without DSM-IV social phobia in 2000 (N = 603), 12 (2.0%) had DSM-IV social phobia in 2005. These findings challenge the notion that social phobia is a chronic disorder with rare occurrence in old age.

  19. Quality of Life in College Students with and without Social Phobia

    ERIC Educational Resources Information Center

    Ghaedi, Gholam Hossein; Tavoli, Azadeh; Bakhtiari, Maryam; Melyani, Mahdieh; Sahragard, Mahdi

    2010-01-01

    Prior studies demonstrating quality of life impairment in phobia and anxiety disorders have relied upon epidemiological samples or clinical data. Using the same quality of life scale, the Short Form 36-item Health Survey (SF-36), in Iranian college students allowed us to study the impact of social phobia (SP) on quality of life among the college…

  20. Quality of Life in College Students with and without Social Phobia

    ERIC Educational Resources Information Center

    Ghaedi, Gholam Hossein; Tavoli, Azadeh; Bakhtiari, Maryam; Melyani, Mahdieh; Sahragard, Mahdi

    2010-01-01

    Prior studies demonstrating quality of life impairment in phobia and anxiety disorders have relied upon epidemiological samples or clinical data. Using the same quality of life scale, the Short Form 36-item Health Survey (SF-36), in Iranian college students allowed us to study the impact of social phobia (SP) on quality of life among the college…

  1. Developmental Differences in Functioning in Youth With Social Phobia.

    PubMed

    Hoff, Alexandra L; Kendall, Philip C; Langley, Audra; Ginsburg, Golda; Keeton, Courtney; Compton, Scott; Sherrill, Joel; Walkup, John; Birmaher, Boris; Albano, Anne Marie; Suveg, Cynthia; Piacentini, John

    2015-12-02

    Social phobia (SoP) in youth may manifest differently across development as parent involvement in their social lives changes and social and academic expectations increase. This cross-sectional study investigated whether self-reported and parent-reported functioning in youth with SoP changes with age in social, academic, and home/family domains. Baseline anxiety impairment data from 488 treatment-seeking anxiety-disordered youth (ages 7-17, N = 400 with a SoP diagnosis) and their parents were gathered using the Child Anxiety Impact Scale and were analyzed using generalized estimating equations. According to youth with SoP and their parents, overall difficulties, social difficulties, and academic difficulties increased with age, even when controlling for SoP severity. These effects significantly differed for youth with anxiety disorders other than SoP. Adolescents may avoid social situations as parental involvement in their social lives decreases, and their withdrawn behavior may result in increasing difficulty in the social domain. Their avoidance of class participation and oral presentations may increasingly impact their academic performance as school becomes more demanding. Implications are discussed for the early detection and intervention of SoP to prevent increased impairment over the course of development.

  2. Subjective, Autonomic, and Endocrine Reactivity during Social Stress in Children with Social Phobia

    ERIC Educational Resources Information Center

    Kramer, Martina; Seefeldt, Wiebke Lina; Heinrichs, Nina; Tuschen-Caffier, Brunna; Schmitz, Julian; Wolf, Oliver Tobias; Blechert, Jens

    2012-01-01

    Reports of exaggerated anxiety and physiological hyperreactivity to social-evaluative situations are characteristic of childhood social phobia (SP). However, laboratory research on subjective, autonomic and endocrine functioning in childhood SP is scarce, inconsistent and limited by small sample sizes, limited breadth of measurements, and the use…

  3. Subjective, Autonomic, and Endocrine Reactivity during Social Stress in Children with Social Phobia

    ERIC Educational Resources Information Center

    Kramer, Martina; Seefeldt, Wiebke Lina; Heinrichs, Nina; Tuschen-Caffier, Brunna; Schmitz, Julian; Wolf, Oliver Tobias; Blechert, Jens

    2012-01-01

    Reports of exaggerated anxiety and physiological hyperreactivity to social-evaluative situations are characteristic of childhood social phobia (SP). However, laboratory research on subjective, autonomic and endocrine functioning in childhood SP is scarce, inconsistent and limited by small sample sizes, limited breadth of measurements, and the use…

  4. Validation of the Social Interaction Anxiety Scale and the Social Phobia Scale across the Anxiety Disorders.

    ERIC Educational Resources Information Center

    Brown, Elissa J.; And Others

    1997-01-01

    The psychometric adequacy of the Social Interaction Scale and the Social Phobia Scale (both by R. P. Mattick and J. C. Clark, 1989) was studied with 165 patients with anxiety disorders and 21 people without anxiety. Results support the usefulness of the scales for screening and treatment design and evaluation. (SLD)

  5. Comparison of attention training and cognitive therapy in the treatment of social phobia: a preliminary investigation.

    PubMed

    Donald, Juliet; Abbott, Maree J; Smith, Evelyn

    2014-01-01

    Prominent models of social phobia highlight the role played by attentional factors, such as self-focused attention, in the development and maintenance of social phobia. Elevated self-focused attention is associated with increases in self-rated anxiety. Treatments that aim to modify and change attentional processes, specifically self-focused attention, will have a direct effect on social phobia symptoms. Thus, Attention Training targets attentional focus. The present study aimed to investigate the efficacy of Attention Training in comparison to an established treatment for social phobia, Cognitive Therapy. Participants (Intention-to-treat = 45; completers = 30) were allocated to either 6 weeks of Attention Training or Cognitive Therapy. It was hypothesized that both treatments would be effective in reducing social phobia symptoms, but that Attention Training would work primarily by reducing levels of self-focused attention. The results found an overall effectiveness of both treatment conditions in reducing social phobia symptoms. However, Attention Training significantly improved scores on the Self-Focused Attention questionnaire and the Brief Fear of Negative Evaluation questionnaire compared to Cognitive Therapy. Attention Training seems to be a promising treatment for social phobia.

  6. Social phobia and sexual problems: A comparison of social phobic, sexually dysfunctional and normal individuals.

    PubMed

    Munoz, Valentina; Stravynski, Ariel

    2010-03-01

    This study sought to test the putative link between social phobia and sexual functioning. Three groups consisting of 106 social phobic, 164 sexually dysfunctional and 111 normal participants were assessed in terms of sexual functioning, social anxiety, social functioning and general psychopathology. Although social phobic men were less sexually active than normal men, they were as sexually satisfied. Social phobic women were alike their normal counterparts in all respects. Overall, social phobic individuals were not more prone to report sexual problems than normal individuals despite reporting the severest levels of social anxiety. Theoretically, our results are best understood as supporting an interpersonal conception of social phobia and a related socio-cultural perspective regarding sexual roles.

  7. Biases in interpretation and memory in generalized social phobia.

    PubMed

    Hertel, Paula T; Brozovich, Faith; Joormann, Jutta; Gotlib, Ian H

    2008-05-01

    Two experiments examined the link between interpretation and memory in individuals diagnosed with Generalized Social Phobia (GSP). In Experiment 1, GSP and control participants generated continuations for nonsocial and ambiguous social scenarios. GSP participants produced more socially anxious and negative continuations for the social scenarios than did the controls. On the subsequent test of recalling the social scenarios, intrusion errors that shared meaning with the original continuations were made more frequently by the GSP group, producing false recall with emotionally negative features. To examine whether nonanxious individuals would also produce such errors if given emotional interpretations, in Experiment 2 the authors asked university students to read the scenarios plus endings produced by GSP participants in Experiment 1. The students either constructed vivid mental images of themselves as the main characters or thought about whether the endings provided closure. Low-anxious students in the closure condition produced fewer ending-based intrusions in recalling the social scenarios than did students in the other 3 conditions. Results illustrate the importance of examining the nature of source-monitoring errors in investigations of memory biases in social anxiety.

  8. [Self-esteem: a comparison study between eating disorders and social phobia].

    PubMed

    Eiber, R; Vera, L; Mirabel-Sarron, C; Guelfi, J-D

    2003-01-01

    Eating disorder patients evidenced very often a low self-esteem. Self-esteem in eating disorder patients is excessively based on body dissatisfaction. In eating disorders there seems to be a link between body image dissatisfaction and social anxiety. We hypothesised: self-esteem would be as low in eating disorder patients as in social phobia patients; self-esteem would be lower in eating disorder patients with social phobia than in patients with social phobia alone; self-esteem would be lower in eating disorder patients with depressive cognitions than in social phobia patients with depressive cognitions; self-esteem could have different characteristics in the two disorders; self-esteem would be as low in anorexia as in bulimia; 103 eating disorder patients (33 restrictive anorectics, 34 anorectics-bulimics, 36 bulimics) and 26 social phobia patients diagnosed according to DSM IV and ICD-10 criteria have been investigated by the Self-Esteem Inventory of Coopersmith, the Assertiveness Schedule of Rathus, the Fear Survey Schedule of Wolpe (FSS III) and the Beck Depression Inventory (BDI). Patients were free of medication and presented no episode of major depression according to DSM IV criteria. Evaluations took place before any psychotherapy. Self-esteem in eating disorder patients is reduced at the same level as in social phobia patients; 86.1% of the total sample and 84.5% of the eating disorder patients have a very low self-esteem (score 33 in the SEI). Eating disorder patients have significantly higher scores in the Social (p=0.016) and Professional (p=0.0225) sub-scales of the SEI than social phobia patients. Eating disorder patients show higher scores on the Assertiveness Schedule of Rathus (p=0.0013) than social phobia patients. Eating disorder patients disclose higher scores on the BDI (p=0.0003) but eating disorder patients with depressive cognitions do not differ from social phobia patients with depressive cognitions in the level of self-esteem. The FSS III

  9. The prevalence of social phobia, and its impact on quality of life, academic achievement, and identity formation in university students.

    PubMed

    Gültekin, Bülent Kadri; Dereboy, I Ferhan

    2011-01-01

    The present study aimed to determine the prevalence of social phobia, and the sociodemographic variables, substance use patterns, and comorbid psychiatric disorders associated with it. The impact of social phobia on quality of life, academic achievement, and identity formation were also examined. The study was conducted between 01 March and 01 June 2008, and included 700 undergraduate students at Adnan Menderes University. A sociodemographic data form, the Liebowitz Social Anxiety Scale (LSAS), World Health Organization Quality of Life-Brief Form, Turkish Version (WHOQoL-BREF-TR), and Instrument for Assessing Identity Confusion (IFAIC) were administered to the participants. In all, 20.9% of the participants had social phobia during the previous year and 21.7% had social phobia for a lifetime. In total, 74.6% of those that had social phobia during the previous year and 76.5% of those that had social phobia for their whole lives also had a specific social phobia. There was a significant difference between the participants with generalized social phobia or a specific social phobia, and those without social phobia, in terms of LSAS and IFAIC scores. Logistic regression analysis showed that the risk of social phobia was 1.7-fold higher among the females than males, 1.5-fold higher among those that lived in cities for the last 15 years than those that lived in towns, 1.9-fold higher among those that lived in cities for the last 15 years than those that lived in villages, and 1.8-fold higher among those that had relatives with a psychiatric illness than those that didn't. Higher socioeconomic status was negatively correlated with the prevalence of social phobia. Cigarette smoking was more prevalent among the students without social phobia and suicidal ideation was more prevalent among the students with social phobia. WHOQOL-BREF-TR scores showed that students without social phobia had significantly higher quality of life quality than those with social phobia. Self

  10. Disability and quality of life in pure and comorbid social phobia. Findings from a controlled study.

    PubMed

    Wittchen, H U; Fuetsch, M; Sonntag, H; Müller, N; Liebowitz, M

    2000-02-01

    Social phobia is increasingly recognized as a prevalent and socially impairing mental disorder. However, little data is available regarding the general and disease-specific impairments and disabilities associated with social phobia. Furthermore, most studies have not controlled for the confounding effects of comorbid conditions. This study investigates: (a) the generic quality of life; (b) work productivity; and, (c) various other disorder-specific social impairments in current cases with pure (n = 65), comorbid (n = 51) and subthreshold (n = 34) DSM-IV social phobia as compared to controls with no social phobia (subjects with a history of herpes infections). Social phobia cases reported a mean illness duration of 22.9 years with onset in childhood or adolescence. Current quality of life, as assessed by the SF-36, was significantly reduced in all social phobia groups, particularly in the scales measuring vitality, general health, mental health, role limitations due to emotional health, and social functioning. Comorbid cases revealed more severe reductions than pure and subthreshold social phobics. Findings from the Liebowitz self-rated disability scale indicated that: (a) social phobia affects most areas of life, but in particular education, career, and romantic relationship; (b) the presence of past and current comorbid conditions increases the frequency and severity of disease-specific impairments; and, (c) subthreshold social phobia revealed slightly lower overall impairments than comorbid social phobics. Past-week work productivity of social phobics was significantly diminished as indicated by: (a) a three-fold higher rate of unemployed cases; (b) elevated rates of work hours missed due to social phobia problems; and (c) a reduced work performance. Overall, these findings underline that social phobia in our sample of adults, whether comorbid, subthreshold, or pure was a persisting and impairing condition, resulting in considerable subjective suffering and

  11. Changes in intolerance of uncertainty during cognitive behavior group therapy for social phobia.

    PubMed

    Mahoney, Alison E J; McEvoy, Peter M

    2012-06-01

    Recent research suggests that intolerance of uncertainty (IU), most commonly associated with generalized anxiety disorder, also contributes to symptoms of social phobia. This study examines the relationship between IU and social anxiety symptoms across treatment. Changes in IU, social anxiety symptoms, and depression symptoms were examined following cognitive behavior group therapy (CBGT) for social phobia (N=32). CBGT led to significant improvements in symptoms of social anxiety and depression, as well as reductions in IU. Reductions in IU were associated with reductions in social anxiety but were unrelated to improvements in depression symptoms. Reductions in IU were predictive of post-treatment social phobia symptoms after controlling for pre-treatment social phobia symptoms and changes in depression symptoms following treatment. The relationship between IU and social anxiety requires further examination within experimental and longitudinal designs, and needs to take into account additional constructs that are thought to maintain social phobia. Current findings suggest that the enhancing tolerance of uncertainty may play a role in the optimal management of social phobia. Theoretical and clinical implications are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Self-disclosure, emotional expression and intimacy within romantic relationships of people with social phobia.

    PubMed

    Sparrevohn, Roslyn M; Rapee, Ronald M

    2009-12-01

    The current study examined aspects of communication and intimacy between people with social phobia and their romantic partners. Forty-eight individuals with social phobia and 58 community controls completed a series of questionnaires to measure self-disclosure, emotional expression and levels of intimacy within their romantic relationships. Participants with social phobia reported less emotional expression, self-disclosure and intimacy than controls, even after controlling for a diagnosis of mood disorder. The group differences did not differ significantly by gender. A continuous measure of social anxiety also correlated significantly with the three relationship measures and these associations held for emotional expression and self-disclosure after controlling for levels of dysphoria. People with social phobia report reduced quality within their romantic relationships, which may have implications for impairment, social support and ultimately maintenance of the disorder.

  13. Generalized social phobia and avoidant personality disorder: meaningful distinction or useless duplication?

    PubMed

    Chambless, Dianne L; Fydrich, Thomas; Rodebaugh, Thomas L

    2008-01-01

    Participants with generalized social phobia (GSP) with (n=36) and without (n=19) avoidant personality disorder (AVPD) were compared via contrasts of group means and classification analysis on purported core features of AVPD. GSP-AVPD participants proved to be more severely impaired or distressed on some group contrasts. Cluster analysis identified two groups in the sample, with group membership significantly correlated to AVPD diagnosis. However, almost all significant findings were nullified when severity of social phobia was statistically controlled. Thus, at least where participants with social phobia are concerned, it seems most parsimonious to consider AVPD a severe form of GSP rather than a separate diagnostic category.

  14. Assessment of Childhood Social Phobia: Construct, Convergent and Discriminative Validity of the Social Phobia and Anxiety Inventory for Children (SPAI-C).

    ERIC Educational Resources Information Center

    Beidel, Deborah C.; And Others

    1996-01-01

    The convergent validity of the SPAI-C was studied by comparing scores to daily diary ratings of social distress for 10 elementary school children with social phobia, 3 of whom had overanxious disorder, and 10 controls. Results support the ability of the SPAI-C to distinguish social phobic children. (SLD)

  15. High social phobia frequency and related disability in patients with acne vulgaris.

    PubMed

    Bez, Yasin; Yesilova, Yavuz; Kaya, Mehmet Cemal; Sir, Aytekin

    2011-01-01

    Acne is an easily recognizable abnormality which may cause some adverse psychosocial consequences. We aimed to determine the social phobia frequency, social anxiety level, and disease related disability in a group of acne vulgaris patients. One-hundred and forty acne vulgaris patients and 98 healthy control subjects were included in the study. Acne severity was determined by the Global Acne Grading System (GAGS). A psychiatrist interviewed each participant and the Liebowitz Social Anxiety Scale (LSAS) was administered to all participants, who also completed the Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale (SDS). Social phobia was diagnosed in 45.7% of acne vulgaris patients and in 18.4% of control subjects. Acne vulgaris patients demonstrated higher performance avoidance and total avoidance scores in LSAS than controls. Acne vulgaris patients without social phobia had higher scores in HADS and LSAS than the acne vulgaris patients with social phobia. They were more disabled in their occupational, social, and familial lives. Social phobia diagnosis predicted disability at work, whereas education level predicted the disability in family life of acne vulgaris patients. Social phobia seems to be a common psychiatric comorbidity which may give rise to some additional disability among acne vulgaris patients.

  16. [Social phobia - the blind spot: infrequently diagnosed, highly complex, and a predictor for unfavourable therapy outcomes?].

    PubMed

    Pöhlmann, Karin; Döbbel, Susanne; Löffler, Sabine; Israel, Matthias; Joraschky, Peter

    2009-01-01

    The objectives of the study were to examine (1) whether patients with social phobia report higher symptom load at the beginning and at the end of treatment and 1 year after treatment; and (2) whether the presence of social phobia is a factor that influences the course of treatment. 613 patients from a university hospital for psychosomatic medicine filled out questionnaires assessing symptom load (SCL 90-R, KOPS), physical symptoms, psychological and social impairment (KOPS), and depression (BDI). Social phobia was diagnosed based on a standardized diagnostic interview. 25%of the patients suffered from social phobia. They had significantly more concurrent mental disorders (4.18 vs. 2.41) and a higher symptom load than patients suffering from other mental disorders. They reported more physical complaints and depression and felt more impaired psychologically as well as socially. Even though both groups of patients profited from the treatment, compared to other patients, social phobia patients still had higher symptom load, impairment, and depression scores at the end of treatment and even at the follow-up 1 year after treatment. Social phobia is a severe disorder in which concurrent disorders frequently cause a high level of distress and impairment. These patients may benefit more from longer courses of treatment and/or disorder-specific treatment elements. Diagnostic and therapy approaches tailored to the generalized type of social anxiety are discussed.

  17. Social Skills and Social Phobia: An Investigation of DSM-IV Subtypes

    PubMed Central

    Beidel, Deborah C.; Rao, Patricia A.; Scharfstein, Lindsay; Wong, Nina; Alfano, Candice A.

    2010-01-01

    Social phobia is characterized as pervasive social timidity in social settings. Although much is known about this disorder, aspects of its clinical presentation remain unexplored, in particular characteristics that distinguish the generalized and non-generalized subtypes. For example, it remains unclear whether patients with the non-generalized subtype display social skills deficits in social interactions, and if so, are these deficits clinically, as well as statistically, significant? In this study, adults with either the non-generalized (NGSP; n=60) or generalized (GSP; n=119) subtype of social phobia and adults with no psychological disorder (n=200) completed an extensive behavioral assessment of social skill and social anxiety. As expected, adults with NGSP and GSP reported equal distress and displayed similar rates of avoidance during an impromptu speech task when compared to adults with no disorder. In contrast, the three groups were distinctly different when interacting with another person in various social situations. Adults with NGSP displayed social skill deficits when compared to individuals with no disorder, but they had fewer deficits than the GSP subtype. However, the identified skill deficits were clinically as well as statistically significant only for the GSP subtype. The results are discussed in terms of the contribution of skill deficits to the conceptualization and treatment of social phobia. PMID:20637452

  18. Social skills and social phobia: an investigation of DSM-IV subtypes.

    PubMed

    Beidel, Deborah C; Rao, Patricia A; Scharfstein, Lindsay; Wong, Nina; Alfano, Candice A

    2010-10-01

    Social phobia is characterized as pervasive social timidity in social settings. Although much is known about this disorder, aspects of its clinical presentation remain unexplored, in particular characteristics that distinguish the generalized and non-generalized subtypes. For example, it remains unclear whether patients with the non-generalized subtype display social skills deficits in social interactions, and if so, are these deficits clinically, as well as statistically, significant? In this study, adults with either the non-generalized (NGSP; n=60) or generalized (GSP; n=119) subtype of social phobia and adults with no psychological disorder (n=200) completed an extensive behavioral assessment of social skill and social anxiety. As expected, adults with NGSP and GSP reported equal distress and displayed similar rates of avoidance during an Impromptu Speech Task when compared to adults with no disorder. In contrast, the three groups were distinctly different when interacting with another person in various social situations. Adults with NGSP displayed social skill deficits when compared to individuals with no disorder, but they had fewer deficits than the GSP subtype. However, the identified skill deficits were clinically as well as statistically significant only for the GSP subtype. The results are discussed in terms of the contribution of skill deficits to the conceptualization and treatment of social phobia.

  19. Response to Emotional Expressions in Generalized Social Phobia and Generalized Anxiety Disorder: Evidence for Separate Disorders

    PubMed Central

    Blair, Karina; Shaywitz, Jonathan; Smith, Bruce W.; Rhodes, Rebecca; Geraci, Marilla; Jones, Matthew; McCaffrey, Daniel; Vythilingam, Meena; Finger, Elizabeth; Mondillo, Krystal; Jacobs, Madeline; Charney, Dennis S.; Blair, R.J.R.; Drevets, Wayne C.; Pine, Daniel S.

    2010-01-01

    Objective Generalized social phobia involves fear/avoidance, specifically of social situations, whereas generalized anxiety disorder involves intrusive worry about diverse circumstances. It remains unclear the degree to which these two, often comorbid, conditions represent distinct disorders or alternative presentations of a single, core underlying pathology. Functional magnetic resonance imaging assessed the neural response to facial expressions in generalized social phobia and generalized anxiety disorder. Method Individuals matched on age, IQ, and gender with generalized social phobia without generalized anxiety disorder (N=17), generalized anxiety disorder (N= 17), or no psychopathology (N=17) viewed neutral, fearful, and angry expressions while ostensibly making a simple gender judgment. Results The patients with generalized social phobia without generalized anxiety disorder showed increased activation to fearful relative to neutral expressions in several regions, including the amygdala, compared to healthy individuals. This increased amygdala response related to self-reported anxiety in patients with generalized social phobia without generalized anxiety disorder. In contrast, patients with generalized anxiety disorder showed significantly less activation to fearful relative to neutral faces compared to the healthy individuals. They did show significantly increased response to angry expressions relative to healthy individuals in a lateral region of the middle frontal gyrus. This increased lateral frontal response related to self-reported anxiety in patients with generalized anxiety disorder. Conclusions These results suggest that neural circuitry dysfunctions differ in generalized social phobia and generalized anxiety disorder. PMID:18483136

  20. Response to emotional expressions in generalized social phobia and generalized anxiety disorder: evidence for separate disorders.

    PubMed

    Blair, Karina; Shaywitz, Jonathan; Smith, Bruce W; Rhodes, Rebecca; Geraci, Marilla; Jones, Matthew; McCaffrey, Daniel; Vythilingam, Meena; Finger, Elizabeth; Mondillo, Krystal; Jacobs, Madeline; Charney, Dennis S; Blair, R J R; Drevets, Wayne C; Pine, Daniel S

    2008-09-01

    Generalized social phobia involves fear/avoidance, specifically of social situations, whereas generalized anxiety disorder involves intrusive worry about diverse circumstances. It remains unclear the degree to which these two, often comorbid, conditions represent distinct disorders or alternative presentations of a single, core underlying pathology. Functional magnetic resonance imaging assessed the neural response to facial expressions in generalized social phobia and generalized anxiety disorder. Individuals matched on age, IQ, and gender with generalized social phobia without generalized anxiety disorder (N=17), generalized anxiety disorder (N=17), or no psychopathology (N=17) viewed neutral, fearful, and angry expressions while ostensibly making a simple gender judgment. The patients with generalized social phobia without generalized anxiety disorder showed increased activation to fearful relative to neutral expressions in several regions, including the amygdala, compared to healthy individuals. This increased amygdala response related to self-reported anxiety in patients with generalized social phobia without generalized anxiety disorder. In contrast, patients with generalized anxiety disorder showed significantly less activation to fearful relative to neutral faces compared to the healthy individuals. They did show significantly increased response to angry expressions relative to healthy individuals in a lateral region of the middle frontal gyrus. This increased lateral frontal response related to self-reported anxiety in patients with generalized anxiety disorder. These results suggest that neural circuitry dysfunctions differ in generalized social phobia and generalized anxiety disorder.

  1. Brief strategic therapy in patients with social phobia with or without personality disorder.

    PubMed

    Rakowska, Jadwiga Malgorzata

    2011-07-01

    The aim of this study was to test the effects of brief strategic therapy in people with social phobia distinguished by the presence or absence of DSM anxious personality disorder. A group of 120 outpatients with social phobia, 60 of them with comorbid DSM anxious personality disorder, were randomly assigned to 10 weeks of brief strategic therapy or minimal supportive therapy. Outcome analyses were conducted on the intent-to-treat sample at posttreatment and 3-month follow-up using self-report interpersonal sensitivity and phobic anxiety measures, and at 6-month follow-up using social phobia diagnostic status. Brief strategic therapy was superior to minimal supportive therapy in patients with social phobia only. It was not significantly better in patients with comorbid personality disorder. It was concluded that 10 weeks of brief strategic therapy shows promise as a cost-effective method for management of social phobia. It has limited value as a method for management of social phobia with personality disorder.

  2. Social phobia and avoidant personality disorder: similar but different?

    PubMed

    Lampe, Lisa; Sunderland, Matthew

    2015-02-01

    Avoidant personality disorder (AvPD) is regarded as a severe variant of social phobia (SP), consistent with a dimensional model. However, these conclusions are largely drawn from studies based on individuals with SP, with or without comorbid AvPD. The present study hypothesized that there are qualitative differences between AvPD and SP that are undermined by limiting research to participants with SP. The authors sought to test this hypothesis by comparing three groups-SP only, AvPD only, and SP+AvPD-using data extracted from an epidemiological sample of 10,641 adults aged 18 years and over. Screening questions were used in the epidemiological survey to identify ICD-10 personality disorders; from this the author developed a proxy measure for DSM-IV AvPD. Axis I diagnoses, including DSM-IV SP, were identified using the Composite International Diagnostic Interview (CIDI). In this sample, the majority of those with AvPD did not also have SP: The authors found 116 persons with AvPD only, 196 with SP only, and 69 with SP+AvPD. There was little difference between any of the groups on sex, marital status, employment, education, or impairment variables. The SP+AvPD group reported more distress and comorbidity than the SP only and AvPD only groups, which did not differentiate from each other. More feared social situations were endorsed in the SP only group compared to the AvPD only group. Although the finding of few differences between SP only and AvPD only groups among the variables measured in this epidemiological survey fails to provide support for the hypothesis of qualitative differences, the finding that the AvPD only group appears more similar to the SP only group than to the SP+AvPD group also fails to provide support for the alternative continuity hypothesis. The greater distress and additional comorbidity with depression associated with SP+AvPD may be due to the additional symptom load of a second disorder rather than simply representing a more severe variant of

  3. The dutch social interaction anxiety scale and the social phobia scale: reliability, validity, and clinical utility.

    PubMed

    de Beurs, Edwin; Tielen, Deirdre; Wollmann, Lisa

    2014-01-01

    The social interaction anxiety scale (SIAS) and the social phobia scale (SPS) assess anxiety in social interactions and fear of scrutiny by others. This study examines the psychometric properties of the Dutch versions of the SIAS and SPS using data from a large group of patients with social phobia and a community-based sample. Confirmatory factor analysis revealed that the SIAS is unidimensional, whereas the SPS is comprised of three subscales. The internal consistency of the scales and subscales was good. The concurrent and discriminant validity was supported and the scales were well able to discriminate between patients and community-based respondents. Cut-off values with excellent sensitivity and specificity are presented. Of all self-report measures included, the SPS was the most sensitive for treatment effects. Normative data are provided which can be used to assess whether clinically significant change has occurred in individual patients.

  4. Antioxidant enzyme and malondialdehyde levels in patients with social phobia.

    PubMed

    Atmaca, Murad; Kuloglu, Murat; Tezcan, Ertan; Ustundag, Bilal

    2008-05-30

    A growing body of reports have indicated that free radicals are involved in the etiopathogenesis of some neuropsychiatric disorders. In the present study, we aimed to evaluate whether antioxidant enzymes (superoxide dismutase; SOD, glutathione peroxidase; GSH-Px, and catalase; CAT) activity levels and malondialdehyde (MDA), a product of lipid peroxidation, were associated with social phobia (SP). Eighteen patients diagnosed with SP and 18 healthy controls were enrolled. A clinical evaluation and measurements of MDA, SOD, GSH-Px and CAT were performed. Additionally, all patients were assessed with the Liebowitz Social Anxiety Scale (LSAC). The mean MDA, SOD, GSH-Px and CAT levels in the patient group were significantly higher than those in the control group. There was a positive correlation between LSAC scores and MDA, SOD, GSH-Px and LSAC levels, and between the duration of illness, and MDA, SOD and CAT levels in the patient group. In conclusion, our results suggest that there may be a relationship between increased antioxidant enzyme levels and MDA, and SP.

  5. Bruxism and oral parafunctional hyperactivity in social phobia outpatients.

    PubMed

    Hermesh, H; Schapir, L; Marom, S; Skopski, R; Barnea, E; Weizman, A; Winocur, E

    2015-02-01

    Anxiety and selective serotonin reuptake inhibitors (SSRIs) are considered aggravating factors for bruxism. We examined the influence of anxiety, depression and SSRI on bruxism in social phobia (SP). Twenty-three drug naïve, 17 SSRI-treated SP patients and 33 healthy controls underwent a psychiatric assessment and completed Leibowitz Social Anxiety Scale and Beck Depression Inventory. Oral parafunctional activity (PF) was evaluated by TM-dental examination and by a questionnaire. Drug- naïve and SSRI-treated SP patients did not differ on demographic and clinical measures. Awake bruxism, 'JAW PLAY' and at least one PF were more prevalent in SP than in controls. Severity of SP predicted the presence of PF. SP, but not depression, was associated with higher risk of oral PF and awake bruxism. Chronic SSRI treatment of SP did not affect sleep and awake bruxism. Dental and anxiety screening may improve the prognosis psychiatric and dental patients. Effective treatment of SP may mitigate bruxism.

  6. A comparison study of body dysmorphic disorder versus social phobia

    PubMed Central

    Kelly, Megan M.; Dalrymple, Kristy; Zimmerman, Mark; Phillips, Katharine A.

    2012-01-01

    Body dysmorphic disorder (BDD) shares many characteristics with social phobia (SP), including high levels of social anxiety and avoidance, but to our knowledge no studies have directly compared these disorders’ demographic and clinical features. Demographic and clinical features were compared in individuals with BDD (n=172), SP (n=644), and comorbid BDD/SP (n=125). SP participants had a significantly earlier age of onset and lower educational attainment than BDD participants. BDD participants were significantly less likely to ever be married than SP participants, had a greater likelihood of ever being psychiatrically hospitalized, and had significantly lower mean GAF scores than SP participants. The two groups had different comorbidity patterns, which included a greater likelihood for BDD participants to have comorbid obsessive-compulsive disorder (OCD) or an eating disorder, versus a greater likelihood for SP participants to have a comorbid non-OCD anxiety disorder. The comorbid BDD/SP group had significantly greater morbidity across several domains than the SP only group, but not the BDD only group. In summary, although BDD and SP were similar across many demographic and clinical features, they had important differences. Future studies are needed to confirm these findings and address similarities and differences between these disorders across a broader range of variables. PMID:22999105

  7. Interpretation of ambiguous social scenarios in social phobia and depression: evidence from event-related brain potentials.

    PubMed

    Moser, Jason S; Huppert, Jonathan D; Foa, Edna B; Simons, Robert F

    2012-02-01

    In the current study, event-related potentials (ERPs) and behavioral responses were measured in individuals meeting diagnostic criteria for social phobia, depression, their combination, or neither in order to examine the unique and combined effects of social phobia and depression on the interpretation of ambiguous social scenarios. ERPs revealed a lack of positive interpretation bias and some suggestion of a negative bias in the semantic expectancy N4 component across all clinical groups. Furthermore, socially phobic and comorbid individuals showed reductions in baseline attention allocation to the task, as indexed by P6 amplitude. RT and accuracy likewise revealed a lack of positive interpretation bias across disordered groups. When considered on a continuum across all samples, social phobia and depression symptoms were related to the N4 interpretation bias effect whereas P6 amplitude reduction and RT interpretation bias appeared uniquely associated with social phobia. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. Evidence based clinical assessment of child and adolescent social phobia: a critical review of rating scales.

    PubMed

    Tulbure, Bogdan T; Szentagotai, Aurora; Dobrean, Anca; David, Daniel

    2012-10-01

    Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social anxiety scales for children and adolescents were identified. An overview about the scientific support accumulated by these scales is offered. Our main results are consistent with recent reviews that consider the Social Phobia and Anxiety Scale for Children (SPAI-C) and the Social Anxiety Scale for Adolescents (SAS-A) among the most pertinent and empirically supported measures of social anxiety for youngsters. However, after considering the existing evidence, we highly recommend another couple of scales that proved to be empirically supported (i.e., the Social Phobia Inventory-SPIN, and the Liebowitz Social Anxiety Scale for Children and Adolescents-LSAS-CA).

  9. Do Pharmacological and Behavioral Interventions Differentially Affect Treatment Outcome for Children with Social Phobia?

    ERIC Educational Resources Information Center

    Scharfstein, Lindsay A.; Beidel, Deborah C.; Rendon Finnell, Laura; Distler, Aaron; Carter, Nathan T.

    2011-01-01

    In a randomized trial for children with social phobia (SP), Social Effectiveness Therapy for Children (SET-C; a treatment consisting of exposure and social skills training) and fluoxetine were more effective than pill placebo in reducing social distress and behavioral avoidance, but only SET-C demonstrated significantly improved overall social…

  10. Do Pharmacological and Behavioral Interventions Differentially Affect Treatment Outcome for Children with Social Phobia?

    ERIC Educational Resources Information Center

    Scharfstein, Lindsay A.; Beidel, Deborah C.; Rendon Finnell, Laura; Distler, Aaron; Carter, Nathan T.

    2011-01-01

    In a randomized trial for children with social phobia (SP), Social Effectiveness Therapy for Children (SET-C; a treatment consisting of exposure and social skills training) and fluoxetine were more effective than pill placebo in reducing social distress and behavioral avoidance, but only SET-C demonstrated significantly improved overall social…

  11. Mediation of Changes in Anxiety and Depression During Treatment of Social Phobia

    ERIC Educational Resources Information Center

    Moscovitch, David A.; Stefan G. Hofmann, Michael K.; Suvak, Michael K.; In-Albon, Tina

    2005-01-01

    To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive- behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated…

  12. Mediation of Changes in Anxiety and Depression During Treatment of Social Phobia

    ERIC Educational Resources Information Center

    Moscovitch, David A.; Stefan G. Hofmann, Michael K.; Suvak, Michael K.; In-Albon, Tina

    2005-01-01

    To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive- behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated…

  13. [Prevalence of Alcohol Abuse and Dependence in Adults With Social Phobia in Medellin].

    PubMed

    Peña-Salas, Gabriel Felipe; Bareño, José; Berbesi Fernández, Dedsy Yajaira; Gaviria, Silvia L

    2014-01-01

    Having a social phobia may lead to consuming alcohol for greater social assertiveness, running the risk of leading to an abuse disorder or alcohol dependence. The aim of the study was to estimate prevalence of pathological comorbidity between social phobia and alcohol consumption in adults of the city of Medellin, and the behavior of comorbidity by gender, age, presence of a father figure in childhood, and education. Secondary analysis of the database of the first Mental Health Population Survey conducted in the city of Medellin in 2011 and 2012 based on the methodology of the World Mental Health Survey guidelines and coordinated by WHO-HARVARD. The lifetime prevalence of abuse and dependence in people with social phobia was 24.1% and 11.2%, respectively. For people with social phobia the prevalence was 13% for abuse and 4.4% for dependence (OR=2.11 for abuse, OR=2.46 for dependence). Annual prevalence of people with social phobia who abused or were dependent on alcohol was 7.8% and 5.9%, respectively, compared to those who do not suffer from this disorder, with a prevalence of 3.4% and 1.7%, respectively (OR=2.39 for abuse and OR=3.57 for dependence). There was significant correlation in the annual and lifetime prevalence between social phobia and the pathological consumption of alcohol. Statistically significant relationships were found for the variables associated with social phobia, however, more work is needed to confirm or refute these associations. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  14. Imagery rescripting as a stand-alone treatment for patients with social phobia: a case series.

    PubMed

    Frets, Petra G; Kevenaar, Ciska; van der Heiden, Colin

    2014-03-01

    The majority of patients with social phobia reports experiencing negative images, usually linked to memories of earlier aversive social experiences. Several studies have indicated that such negative self-imagery appears to have a causal role in maintaining social phobia, which suggests that interventions aimed at dealing with these images could be beneficial in the treatment of social phobia. One potentially powerful approach is imagery rescripting (IR), a clinical intervention that focuses on changing the meaning and impact of unpleasant memories. In the treatment of social phobia IR was only used as part of a broader cognitive-behavioral treatment package. However, we propose that IR alone might also be an effective treatment for this anxiety disorder. The present study reports an initial evaluation of the application of IR as a stand-alone treatment for six adult outpatients presenting with social phobia. A single case series using an A-B replication across patients design was employed. Following a no-treatment baseline period, IR was delivered weekly and patients were followed up for 3 and 6 months. For all patients, substantial reductions were obtained on all outcome measures at post-treatment, and gains were largely maintained at 6-months follow-up. The generalizability of the effects of IR for social phobia is limited by the small number of patients treated by only one therapist. The results of this preliminary case series suggest that IR as a stand alone treatment is an apparently effective intervention in the treatment of patients with social phobia, and indicate that controlled evaluation of its efficacy might be worthwhile. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Cortisol levels in response to starting school in children at increased risk for social phobia.

    PubMed

    Russ, Stephanie J; Herbert, Joe; Cooper, Peter; Gunnar, Megan R; Goodyer, Ian; Croudace, Tim; Murray, Lynne

    2012-04-01

    Research on depression has identified hyperactivity of the HPA axis as a potential contributory factor to the intergenerational transmission of affective symptoms. This has not yet been examined in the context of social phobia. The current study compared HPA axis activity in response to a universal social stressor (starting school) in children of 2 groups of women: one with social phobia and one with no history of anxiety (comparison group). To determine specificity of effects of maternal social phobia, a third group of children were also examined whose mothers had generalised anxiety disorder (GAD). Children provided salivary cortisol samples in the morning, afternoon and at bedtime across 3 time-blocks surrounding the school start: a month before starting school (baseline), the first week at school (stress response), and the end of the first school term (stress recovery). Child behavioural inhibition at 14 months was assessed to explore the influence of early temperament on later stress responses. All children displayed an elevation in morning and afternoon cortisol from baseline during the first week at school, which remained elevated until the end of the first term. Children in the social phobia group, however, also displayed an equivalent elevation in bedtime cortisol, which was not observed for comparison children or for children of mothers with GAD. Children in the social phobia group who were classified as 'inhibited' at 14 months displayed significantly higher afternoon cortisol levels overall. A persistent stress response to school in the morning and afternoon is typical for all children, but children of mothers with social phobia also display atypical elevations in evening cortisol levels when at school--signalling longer-term disruption of the circadian rhythm in HPA axis activity. This is the first study to report HPA axis disruption in children at increased risk of developing social phobia. Future research should determine whether this represents a

  16. The Social Phobia Inventory: screening and cross-cultural validation in Spanish adolescents.

    PubMed

    Garcia-Lopez, Luis Joaquín; Bermejo, Rosa Ma; Hidalgo, Ma Dolores

    2010-11-01

    Availability of brief, self-report measures to be used as screening instruments is crucial to detect correctly youth with social anxiety disorder and therefore, reach those otherwise under-detected and under-treated. A previous study revealed that the Social Phobia Inventory (SPIN) was potentially an appropriate measure for screening social anxiety among US adolescents. However, there is a lack of information concerning its properties as a screening test in other cultures and languages. This is the main objective of this study, although further validity of the scale is provided as well. The sample consisted of 192 adolescents (a sample composed of 114 subjects with a principal diagnosis of social anxiety disorder; and a group consisting of 78 subjects with no diagnosis of social phobia). Results suggest that the Social Phobia Inventory has demonstrated good psychometric properties and indeed may be used as a screening tool in Spanish-speaking adolescents.

  17. Shyness 3: randomized controlled trial of guided versus unguided Internet-based CBT for social phobia.

    PubMed

    Titov, Nickolai; Andrews, Gavin; Choi, Isabella; Schwencke, Genevieve; Mahoney, Alison

    2008-12-01

    In two previous randomized controlled trials Titov et al. demonstrated significant benefit from an Internet- and email-based treatment programme for social phobia. The present study (Shyness 3) explores whether participants are able to complete this programme independently. A total of 98 individuals with social phobia were randomly assigned to a clinician-assisted computerized cognitive behavioural treatment (CaCCBT) group, a self-guided computerized CBT (CCBT) group, or to a waitlist control group. CaCCBT group participants completed the usual Shyness programme consisting of six online lessons, cognitive behavioural homework assignments, email contact with a therapist, and participation in an online discussion forum. CCBT group participants accessed the same resources except for therapist emails. An intention-to-treat model was used for data analyses. A total of 77% of CaCCBT and 33% of CCBT group participants completed all lessons. Significant differences were found after treatment between CaCCBT and control groups (mean between-groups effect size (ES) for the social phobia measures=1.04), and between the CaCCBT and CCBT groups (mean between-groups ES for the social phobia measures=0.66). No significant differences were found after treatment between the CCBT and control groups (mean between-groups ES for the social phobia measures=0.38). CCBT participants, however, who completed the six lessons made good progress (mean within-group ES for the social phobia measures=0.62). Quantitative and qualitative data indicate that both the CaCCBT and CCBT procedures were acceptable to participants. The reliability of this Internet-based treatment programme for social phobia has been confirmed. The therapist-guided condition was superior to the self-guided condition, but a subgroup of participants still benefited considerably from the latter. These data confirm that self-guided education or treatment programmes for common anxiety disorders can result in significant

  18. Somatic symptoms in social phobia: a treatment method based on rational emotive therapy and paradoxical interventions.

    PubMed

    Mersch, P P; Hildebrand, M; Lavy, E H; Wessel, I; van Hout, W J

    1992-09-01

    Social phobia is often accompanied by somatic symptoms such as trembling, blushing, and sweating. In cases where these symptoms are predominant and, rather than the social situation, represent the feared stimulus, their unpredictable occurrence may reduce the effectiveness of an otherwise successful treatment, such as exposure in vivo. In this study, a paradoxical treatment approach, combined with rational emotive therapy, is employed with three social phobic patients with fears of blushing, trembling, and sweating, respectively. Results indicate that a paradoxical treatment may be an effective strategy in reducing somatic symptoms in social phobia.

  19. Childhood history of behavioral inhibition and comorbidity status in 256 adults with social phobia.

    PubMed

    Rotge, Jean-Yves; Grabot, Denis; Aouizerate, Bruno; Pélissolo, Antoine; Lépine, Jean-Pierre; Tignol, Jean

    2011-03-01

    Behavioral inhibition (BI), a heritable temperament, predisposes one to an increased risk of social phobia. Recent investigations have reported that BI may also be a precursor to anxiety as well as depressive and alcohol-related disorders, which are frequently comorbid with social phobia. In the present study, we explored the relationship between BI and psychiatric disorders in 256 adults with a primary diagnosis of social phobia. BI severity was retrospectively assessed with the Retrospective Self-Report of Inhibition (RSRI). The severity of social phobia and the presence of comorbid diagnoses were evaluated with the Liebowitz Social Anxiety Scale (LSAS) and the Mini-International Neuropsychiatric Interview, respectively. The RSRI score was significantly and positively correlated with both the LSAS score and the occurrence of a major depressive disorder. No significant association was found with other anxiety and substance-related disorders. The assessment of BI was retrospective and self-reported. A childhood history of BI was associated with an increased risk of depressive comorbidity in social phobia. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Is there any influence of personality disorder on the short term intensive group cognitive behavioral therapy of social phobia?

    PubMed

    Vyskocilova, Jana; Prasko, Jan; Novak, Tomas; Pohlova, Libuse

    2011-03-01

    The treatment of personality disorder is repeatedly reported as less successful than the treatment of patients without personality disorder. Most clinicians believe that anxiety disorder in tandem with a personality disorder often leads to longer treatment, worsens the prognosis, and thus increases treatment costs. Our study was designed to compare the short-term effectiveness of therapy in patients suffering from social phobia with and without personality disorder. The specific aim of the study was to assess the efficacy of a 6 week therapeutic program designed for social phobia (SSRIs and CBT) in patients suffering from social phobia with comorbid personality disorder (17 patients) and social phobia without comorbid personality disorder (18 patients). The patients were regularly assessed in weeks 0, 2, 4 and 6 using the CGI (Clinical Global Improvement) for severity, LSAS (Liebowitz Social Anxiety Scale), and in self-assessments BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory). Patients in both groups improved their scores in most of the assessment instruments used. A combination of CBT and pharmacotherapy proved to be the most effective treatment for patients suffering with social phobia with or without comorbid personality disorder. Treatment efficacy in patients with social phobia without personality disorder was significantly better than in the group with social phobia comorbid with personality disorder for CGI and specific inventory for social phobia - LSAS. The scores on the subjective depression inventory (BDI) also showed significantly greater decrease over the treatment in the group without personality disorder. The treatment effect between groups did not differ in subjective general anxiety scales BAI. Our study showed that patients suffering from social phobia and comorbid personality disorder showed a smaller decrease in specific social phobia symptomatology during treatment compared than patients with social phobia without personality

  1. Have we met before? Neural correlates of emotional learning in women with social phobia.

    PubMed

    Laeger, Inga; Keuper, Kati; Heitmann, Carina; Kugel, Harald; Dobel, Christian; Eden, Annuschka; Arolt, Volker; Zwitserlood, Pienie; Dannlowski, Udo; Zwanzger, Peter

    2014-05-01

    Altered memory processes are thought to be a key mechanism in the etiology of anxiety disorders, but little is known about the neural correlates of fear learning and memory biases in patients with social phobia. The present study therefore examined whether patients with social phobia exhibit different patterns of neural activation when confronted with recently acquired emotional stimuli. Patients with social phobia and a group of healthy controls learned to associate pseudonames with pictures of persons displaying either a fearful or a neutral expression. The next day, participants read the pseudonames in the magnetic resonance imaging scanner. Afterwards, 2 memory tests were carried out. We enrolled 21 patients and 21 controls in our study. There were no group differences for learning performance, and results of the memory tests were mixed. On a neural level, patients showed weaker amygdala activation than controls for the contrast of names previously associated with fearful versus neutral faces. Social phobia severity was negatively related to amygdala activation. Moreover, a detailed psychophysiological interaction analysis revealed an inverse correlation between disorder severity and frontolimbic connectivity for the emotional > neutral pseudonames contrast. Our sample included only women. Our results support the theory of a disturbed cortico limbic interplay, even for recently learned emotional stimuli. We discuss the findings with regard to the vigilance-avoidance theory and contrast them to results indicating an oversensitive limbic system in patients with social phobia.

  2. Virtual reality exposure using three-dimensional images for the treatment of social phobia.

    PubMed

    Gebara, Cristiane M; Barros-Neto, Tito P de; Gertsenchtein, Leticia; Lotufo-Neto, Francisco

    2016-03-01

    To test a potential treatment for social phobia, which provides exposure to phobia-inducing situations via computer-generated, three-dimensional images, using an open clinical trial design. Twenty-one patients with a DSM-IV diagnosis of social phobia took part in the trial. Treatment consisted of up to 12 sessions of exposure to relevant images, each session lasting 50 minutes. Improvements in social anxiety were seen in all scales and instruments used, including at follow-up 6 months after the end of treatment. The average number of sessions was seven, as the participants habituated rapidly to the process. Only one participant dropped out. This study provides evidence that exposure to computer-generated three-dimensional images is relatively inexpensive, leads to greater treatment adherence, and can reduce social anxiety. Further studies are needed to corroborate these findings.

  3. [Symptoms of social phobia and their relationship to interpersonal characteristics in a sample of German medical students].

    PubMed

    Baldauf, Matthias; Thomas, Andrea; Strauß, Bernhard

    2014-02-01

    The study aimed to detect the frequency of social phobia symptoms in a sample of German medical students and to compare students with and without these symptoms related to interpersonal characteristics. 525 students filled out a battery of self-report questionnaires consisting of the LSAS (Liebowitz Social Anxiety Scale), the SPAI (Social Phobia Anxiety Inventory), the IIP-32 (Inventar of interpersonal problems) and the IIM (Inventar of interpersonal motives). Relevant social phobia symptoms were found in 12.2%. Students with symptoms of social phobia differed significantly in subscales of the IIP and the IIM. Students with symptoms of social phobia also had higher scores for interpersonal problems especially related to the main issue of being too "socially avoidant".

  4. Differential Effect of Mirror Manipulation on Self-Perception in Social Phobia Subtypes.

    PubMed

    Hofmann, Stefan G; Heinrichs, Nina

    2003-04-01

    This study employed mirror manipulation to examine differences in self-perception between the DSM-IV subtypes of social phobia (social anxiety disorder). We asked 82 consecutively admitted patients with social phobia to record three positive and three negative characteristics about themselves. Sixty-three percent of them met criteria for a generalized subtype of social phobia (GSP). A random half of the total sample sat in front of a mirror before and during this task. Participants' responses were classified into either positive or negative self-statements concerning their bodily appearance, competence, and socially relevant or non-socially relevant personality characteristics. The mirror manipulation had a differential effect on self-perception in social phobia subtypes. The presence of a mirror led to more positive and negative self statements about bodily appearance, and to fewer negative self-statements about socially-relevant personality characteristics in participants with GSP. In contrast, participants not meeting criteria for GSP responded to mirror exposure only with fewer negative self-statements about non-socially relevant personality characteristics. These results suggest that mirror exposure leads to fewer negative self-statements about private aspects of the self, concerning social situations, while it enhances public self-consciousness in individuals with GSP.

  5. When the present visits the past: Updating traumatic memories in social phobia

    PubMed Central

    Wild, Jennifer; Hackmann, Ann; Clark, David M.

    2007-01-01

    Research suggests that distorted images of the self are common in social phobia and play a role in maintaining the disorder. The images are often linked in thematic and sensory detail to distressing memories that are clustered around the onset or worsening of the disorder. This has led to speculation about the likely benefit of working directly with these memories to improve symptoms of social phobia. In this exploratory study, we describe a process of cognitive restructuring followed by imagery rescripting to update the meanings of distressing memories and images in social phobia. We first present illustrative clinical examples and then data of 14 patients with social phobia, on whom we developed this approach. Patients attended an imagery rescripting session in which a semi-structured interview was used to identify their recurrent images, the associated memories and their meanings. Next the identified memory was evoked and elaborated. We updated the meaning of the memory by first using cognitive restructuring to arrive at new perspectives and then linking these perspectives with the memory using imagery techniques. The procedure resulted in significant within session change in beliefs, and in image and memory distress and vividness. One week later significant change was seen in social phobia cognitions and a self-report measure of social anxiety. Rescripting distressing memories in social phobia appears to be an effective way of modifying maladaptive beliefs linked to recurrent negative imagery. This paper presents our exploratory investigation of how to work with the memories and encourages more rigorous investigation in this area. PMID:17765865

  6. Hypochondriasis Differs From Panic Disorder and Social Phobia: Specific Processes Identified Within Patient Groups.

    PubMed

    Höfling, Volkmar; Weck, Florian

    2017-03-01

    Studies of the comorbidity of hypochondriasis have indicated high rates of cooccurrence with other anxiety disorders. In this study, the contrast among hypochondriasis, panic disorder, and social phobia was investigated using specific processes drawing on cognitive-perceptual models of hypochondriasis. Affective, behavioral, cognitive, and perceptual processes specific to hypochondriasis were assessed with 130 diagnosed participants based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria (66 with hypochondriasis, 32 with panic disorder, and 32 with social phobia). All processes specific to hypochondriasis were more intense for patients with hypochondriasis in contrast to those with panic disorder or social phobia (0.61 < d < 2.67). No differences were found between those with hypochondriasis with comorbid disorders and those without comorbid disorders. Perceptual processes were shown to best discriminate between patients with hypochondriasis and those with panic disorder.

  7. A preliminary study of dopamine-mediated prolactin inhibition in generalised social phobia.

    PubMed

    Condren, Rita M; Sharifi, Neda; Thakore, Jogin H

    2002-08-05

    The biology of social phobia has been little studied, but a possible role for dopamine has been implicated in this disorder. The aim of this study was to examine central dopaminergic function in patients with generalised social phobia using the prolactin response to quinagolide, a dopamine D2 receptor agonist, and to compare responses with those of normal controls. The study included 14 patients with moderate or severe generalised social phobia and 14 healthy age- and gender-matched comparison subjects. Quinagolide (0.5 mg) was administered orally and prolactin responses were measured over 4 h. There was no significant difference between prolactin responses in patients and healthy controls, nor was there a correlation between prolactin response and age, sex, or severity of illness. This would suggest that tuberoinfundibular dopamine D2 receptor sensitivity is normal in this disorder.

  8. Facial Emotion Recognition in Children with High Functioning Autism and Children with Social Phobia

    ERIC Educational Resources Information Center

    Wong, Nina; Beidel, Deborah C.; Sarver, Dustin E.; Sims, Valerie

    2012-01-01

    Recognizing facial affect is essential for effective social functioning. This study examines emotion recognition abilities in children aged 7-13 years with High Functioning Autism (HFA = 19), Social Phobia (SP = 17), or typical development (TD = 21). Findings indicate that all children identified certain emotions more quickly (e.g., happy [less…

  9. Pilot Study of Community-Based Cognitive Behavioral Group Therapy for Adolescents with Social Phobia.

    ERIC Educational Resources Information Center

    Baer, Susan; Garland, E. Jane

    2005-01-01

    Objective: A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community outpatient psychiatric…

  10. Predicting Depression, Social Phobia, and Violence in Early Adulthood from Childhood Behavior Problems

    ERIC Educational Resources Information Center

    Mason, W. Alex; Kosterman, Rick; Hawkins, J. David; Herrenkohl, Todd I.; Lengua, Liliana J.; McCauley, Elizabeth

    2004-01-01

    Objective: This study examined childhood behavior problems at ages 10 and 11 years as predictors of young adult depression, social phobia, and violence at age 21 years. Method: Data were collected as part of the Seattle Social Development Project, a longitudinal study of 808 elementary school students from high-crime neighborhoods of Seattle.…

  11. Attention Training in Individuals with Generalized Social Phobia: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Amir, Nader; Beard, Courtney; Taylor, Charles T.; Klumpp, Heide; Elias, Jason; Burns, Michelle; Chen, Xi

    2009-01-01

    The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or…

  12. Attention Training in Individuals with Generalized Social Phobia: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Amir, Nader; Beard, Courtney; Taylor, Charles T.; Klumpp, Heide; Elias, Jason; Burns, Michelle; Chen, Xi

    2009-01-01

    The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or…

  13. Facial Emotion Recognition in Children with High Functioning Autism and Children with Social Phobia

    ERIC Educational Resources Information Center

    Wong, Nina; Beidel, Deborah C.; Sarver, Dustin E.; Sims, Valerie

    2012-01-01

    Recognizing facial affect is essential for effective social functioning. This study examines emotion recognition abilities in children aged 7-13 years with High Functioning Autism (HFA = 19), Social Phobia (SP = 17), or typical development (TD = 21). Findings indicate that all children identified certain emotions more quickly (e.g., happy [less…

  14. Predicting Depression, Social Phobia, and Violence in Early Adulthood from Childhood Behavior Problems

    ERIC Educational Resources Information Center

    Mason, W. Alex; Kosterman, Rick; Hawkins, J. David; Herrenkohl, Todd I.; Lengua, Liliana J.; McCauley, Elizabeth

    2004-01-01

    Objective: This study examined childhood behavior problems at ages 10 and 11 years as predictors of young adult depression, social phobia, and violence at age 21 years. Method: Data were collected as part of the Seattle Social Development Project, a longitudinal study of 808 elementary school students from high-crime neighborhoods of Seattle.…

  15. Pilot Study of Community-Based Cognitive Behavioral Group Therapy for Adolescents with Social Phobia.

    ERIC Educational Resources Information Center

    Baer, Susan; Garland, E. Jane

    2005-01-01

    Objective: A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community outpatient psychiatric…

  16. Social Skills Deficits and Vocal Characteristics of Children with Social Phobia or Asperger's Disorder: A Comparative Study

    ERIC Educational Resources Information Center

    Scharfstein, Lindsay A.; Beidel, Deborah C.; Sims, Valerie K.; Finnell, Laura Rendon

    2011-01-01

    Social skills deficits are commonly reported among children with social phobia (SP) and children with Asperger's Disorder (AD); however, a lack of direct comparison makes it unclear whether these groups, both of which endorse the presence of social anxiety, have similar or unique skills deficits. In this investigation, the social behaviors of…

  17. Social Skills Deficits and Vocal Characteristics of Children with Social Phobia or Asperger's Disorder: A Comparative Study

    ERIC Educational Resources Information Center

    Scharfstein, Lindsay A.; Beidel, Deborah C.; Sims, Valerie K.; Finnell, Laura Rendon

    2011-01-01

    Social skills deficits are commonly reported among children with social phobia (SP) and children with Asperger's Disorder (AD); however, a lack of direct comparison makes it unclear whether these groups, both of which endorse the presence of social anxiety, have similar or unique skills deficits. In this investigation, the social behaviors of…

  18. Social phobia and quality of life in morbidly obese patients before and after bariatric surgery.

    PubMed

    Mirijello, Antonio; D'Angelo, Cristina; Iaconelli, Amerigo; Capristo, Esmeralda; Ferrulli, Anna; Leccesi, Laura; Cossari, Anthony; Landolfi, Raffaele; Addolorato, Giovanni

    2015-07-01

    Morbidly obesity is characterized by physical and psychological comorbidities which are associated with reduced quality of life. Bariatric surgery has been linked to a reduction of psychopathology other than to a reduction of weight and improvement in physical functioning. Aim of the present study was to compare psychological features of two groups of morbidly obese patients, before and after bariatric surgery, assessing social phobia and quality of life. A total of 46 morbidly obese patients were enrolled in the study. Of them, 20 were waiting for bilio-pancreatic diversion (group A), while 26 had already undergone surgical procedure (group B). Psychometric evaluation assessed social phobia, fear for the body-shape and quality of life, using appropriate psychometric tests. The percentage of patients showing social phobia was significantly higher compared to a sample of healthy controls (p=0.004), both in group A (p=0.003) and in group B (p=0.029). No differences in percentage of patients affected by social phobia were found between groups. A significantly higher percentage of patients affected by distress about the body (p<0.0001) was found in group A with respect to group B. A reduction of quality of life was found in both groups. The present study shows a high prevalence of social phobia in a population of morbidly obese patients, both before and after surgery. A general reduction of quality of life was also observed, with a partial improvement after surgery. Future studies are needed to clarify the relationship between social phobia and quality of life in surgically-treated morbidly obese patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Psychophysiological and subjective indicators of aversive pavlovian conditioning in generalized social phobia.

    PubMed

    Hermann, Christiane; Ziegler, Silvio; Birbaumer, Niels; Flor, Herta

    2002-08-15

    Aversive conditioning has been proposed as an important etiologic mechanism in social phobia; however, empirical evidence is scarce and has not relied on a detailed analysis of the acquisition and extinction of the conditioned emotional response. Fourteen men sustaining generalized social phobia and 19 healthy control subjects participated in differential aversive conditioning with two neutral faces as conditioned stimuli and an aversive odor as unconditioned stimulus. Subjective and peripheral physiological responses were obtained. Both groups were successfully conditioned as reflected by differential subjective (valence, arousal, subjective unconditioned stimulus expectancy) and peripheral physiological responses (skin conductance, startle response). There was no evidence for an enhanced conditionability in the social phobics; however, they showed an enhanced unconditioned stimulus expectancy, especially for the nonreinforced conditioned stimuli during acquisition, and a delayed extinction of the conditioned skin conductance response as well as a certain dissociation between subjective and physiological responses.The enhanced unconditioned stimulus expectancy during acquisition and the overall elevated subjective arousal suggest that, under threat, subjects with generalized social phobia may be more prone to associate neutral social cues and an aversive outcome. Furthermore, delayed extinction of the conditioned response seems to contribute to the etiology and maintenance of generalized social phobia.

  20. Virtual reality therapy versus cognitive behavior therapy for social phobia: a preliminary controlled study.

    PubMed

    Klinger, E; Bouchard, S; Légeron, P; Roy, S; Lauer, F; Chemin, I; Nugues, P

    2005-02-01

    Social phobia is one of the most frequent mental disorders and is accessible to two forms of scientifically validated treatments: anti-depressant drugs and cognitive behavior therapies (CBT). In this last case, graded exposure to feared social situations is one of the fundamental therapeutic ingredients. Virtual reality technologies are an interesting alternative to the standard exposure in social phobia, especially since studies have shown its usefulness for the fear of public speaking. This paper reports a preliminary study in which a virtual reality therapy (VRT), based on exposure to virtual environments, was used to treat social phobia. The sample consisted of 36 participants diagnosed with social phobia assigned to either VRT or a group-CBT (control condition). The virtual environments used in the treatment recreate four situations dealing with social anxiety: performance, intimacy, scrutiny, and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors in order to reduce anxiety in the corresponding real situations. Both treatments lasted 12 weeks, and sessions were delivered according to a treatment manual. Results showed statistically and clinically significant improvement in both conditions. The effect-sizes comparing the efficacy of VRT to the control traditional group-CBT revealed that the differences between the two treatments are trivial.

  1. Early behavioral inhibition and increased error monitoring predict later social phobia symptoms in childhood.

    PubMed

    Lahat, Ayelet; Lamm, Connie; Chronis-Tuscano, Andrea; Pine, Daniel S; Henderson, Heather A; Fox, Nathan A

    2014-04-01

    Behavioral inhibition (BI) is an early childhood temperament characterized by fearful responses to novelty and avoidance of social interactions. During adolescence, a subset of children with stable childhood BI develop social anxiety disorder and concurrently exhibit increased error monitoring. The current study examines whether increased error monitoring in 7-year-old, behaviorally inhibited children prospectively predicts risk for symptoms of social phobia at age 9 years. A total of 291 children were characterized on BI at 24 and 36 months of age. Children were seen again at 7 years of age, when they performed a Flanker task, and event-related potential (ERP) indices of response monitoring were generated. At age 9, self- and maternal-report of social phobia symptoms were obtained. Children high in BI, compared to those low in BI, displayed increased error monitoring at age 7, as indexed by larger (i.e., more negative) error-related negativity (ERN) amplitudes. In addition, early BI was related to later childhood social phobia symptoms at age 9 among children with a large difference in amplitude between ERN and correct-response negativity (CRN) at age 7. Heightened error monitoring predicts risk for later social phobia symptoms in children with high BI. Research assessing response monitoring in children with BI may refine our understanding of the mechanisms underlying risk for later anxiety disorders and inform prevention efforts. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. All rights reserved.

  2. Correlates of DSM-III personality disorder in panic disorder and agoraphobia.

    PubMed

    Mavissakalian, M; Hamann, M S

    1988-01-01

    One hundred eighty-seven patients meeting DSM-III criteria for panic disorder (n = 26) or agoraphobia with panic (n = 161) were assessed with the Personality Diagnostic Questionnaire (PDQ), a self-rating scale designed to assess Axis II personality disorders and traits. Results replicated our earlier findings of a preponderance of dependent, avoidant, and histrionic features and the finding that patients exhibiting a greater number of personality traits were also significantly more symptomatic. Patients with the diagnosis of panic disorder did not differ on any personality disorder variables from patients with the diagnosis of agoraphobia with panic. Furthermore, none of the specific symptom dimensions, i.e., panic, anxiety, or agoraphobia, was selected as a unique predictor of any personality variables in the regression analyses. Rather, the most important correlates of personality disorder in these patients consisted of general factors such as dysphoric mood, social phobia, or interpersonal sensitivity, and Eysenck's neuroticism dimension. The results are discussed in light of recent findings suggesting a nonspecific link between panic disorder or agoraphobia and personality disorder.

  3. Social fear and social phobia types among community youth: differential clinical features and vulnerability factors.

    PubMed

    Knappe, Susanne; Beesdo-Baum, Katja; Fehm, Lydia; Stein, Murray B; Lieb, Roselind; Wittchen, Hans-Ulrich

    2011-01-01

    To compare different social fears and social phobia subtypes with regard to clinical (age of onset, avoidance, impairment, comorbidities) and vulnerability factors (behavioural inhibition (BI), parental psychopathology and parental rearing) among community youth. Fears of 6 social situations and Social Phobia (SP), along with their clinical features, were assessed using the Munich-Composite International Diagnostic Interview (DIA-X/M-CIDI) in a population-based sample of N = 3021 14-24 year olds that were followed up for 10 years. BI and parental rearing were assessed using self-report questionnaires. Parental psychopathology was assessed directly in parents via DIA-X/M-CIDI, supplemented by offsprings' family history reports. In the total sample, 20.0%, 11.6%, 11.7% reported fear of 1, 2, 3 or more social situations, respectively; rates were 24.2%, 18.7%, and 57.1% in SP-cases (6.6% of the total sample). Exploring the factorial structure indicated rather unidimensionality of social fears than mutual distinction of social fears by interaction vs. performance situations. Except for fear of taking tests and public speaking, social fears rarely occurred in isolation. Social fears of both interaction and performance situations were associated with severe avoidance (vs. fear of either situation; Odds Ratios, OR = 1.5, 95%CI: 1.1-1.9) and impairment (OR = 3.6, 95%CI: 2.6-4.9), and more comorbid anxiety and depressive disorders (OR range 3.2-5.8, p > .001). Fear of interaction situations was associated with higher BI (vs. performance-related fears, OR range 1.2-2.1, p < .05). Associations with parental psychopathology and unfavourable parental rearing were less consistent, albeit stronger for fear of interaction situations (vs. performance-related fears). Interactions with time indicated an earlier onset of SP for higher BI, but not for parental psychopathology or unfavourable parental rearing. Interaction-related social fears differ in their clinical and

  4. Recognition of facial affect by children and adolescents diagnosed with social phobia.

    PubMed

    Simonian, S J; Beidel, D C; Turner, S M; Berkes, J L; Long, J H

    2001-01-01

    This study compared the ability of children with social phobia and children with no psychiatric disorder to accurately judge facial affect. Fifteen children and adolescents with social phobia and 14 control children were asked to identify emotions depicted in slides from the Pictures of Facial Affect. In addition, they rated their level of anxiety on a pictorial Likert scale prior to and upon completion of the facial recognition task. The results indicated that children with social phobia had significantly poorer facial affect recognition skills than normal controls and reported greater anxiety upon completion of the recognition task. Multivariate analysis revealed significant differences between groups in the number of errors based on the type of facial affect. Posthoc analysis indicated that deficits were most pronounced for facial representations of happiness, sadness, and disgust. The results are discussed in relation to an integrated model of social skills training that includes facial affect recognition training as a integral component in treatment programs for children and adolescents with social phobia. Directions for future research with larger samples of more ethnically diverse children and adolescents are presented.

  5. Specific and social fears in children and adolescents: separating normative fears from problem indicators and phobias.

    PubMed

    Laporte, Paola P; Pan, Pedro M; Hoffmann, Mauricio S; Wakschlag, Lauren S; Rohde, Luis A; Miguel, Euripedes C; Pine, Daniel S; Manfro, Gisele G; Salum, Giovanni A

    2017-01-01

    To distinguish normative fears from problematic fears and phobias. We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA)/item response theory (IRT) and nonparametric receiver operating characteristic (ROC) curve. According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.

  6. Predicting depression, social phobia, and violence in early adulthood from childhood behavior problems.

    PubMed

    Mason, W Alex; Kosterman, Rick; Hawkins, J David; Herrenkohl, Todd I; Lengua, Liliana J; McCauley, Elizabeth

    2004-03-01

    This study examined childhood behavior problems at ages 10 and 11 years as predictors of young adult depression, social phobia, and violence at age 21 years. Data were collected as part of the Seattle Social Development Project, a longitudinal study of 808 elementary school students from high-crime neighborhoods of Seattle. Reports of childhood behavior problems were obtained from parents and children in fall 1985 and from teachers in spring 1986. Follow-up reports of violence and DSM-III-R depression and social phobia were collected from 765 respondents using standard survey items and the Diagnostic Interview Schedule in 1996. The past-year prevalences of depressive episode and social phobia were 20% and 17%, respectively. Twenty-one percent of the respondents reported two or more violent acts in the past year at age 21 years. Several available measures of childhood behavior problems as reported by parents, teachers, and children predicted violence (e.g., conduct problems, oppositional defiance); the strongest positive predictor of young adult violence was self-reported conduct problems, whereas self-reported shyness inhibited later violence. Relatively few child behavioral problems predicted social phobia (e.g., shyness). Results showed that children who reported higher, relative to lower, levels of conduct problems were nearly four times more likely to experience a depressive episode in early adulthood. Findings suggest the potential value of intervening to reduce childhood conduct problems as a prevention strategy for not only violence but also depression.

  7. Influence of expressed emotion and perceived criticism on cognitive-behavioral therapy for social phobia.

    PubMed

    Fogler, Jason M; Tompson, Martha C; Steketee, Gail; Hofmann, Stefan G

    2007-02-01

    This study examined significant others' expressed emotion (EE) and a closely related construct, perceived criticism, as predictors of cognitive-behavioral therapy outcome in a sample of 40 patients with social phobia (social anxiety disorder). Patients enrolled in group therapy for social phobia completed pre- and post-treatment questionnaire measures of perceived criticism and anxious and depressive symptoms. Designated significant others were assessed for the components of high EE (criticism, hostility and emotional overinvolvement) using the Camberwell Family Interview. It was hypothesized that these high-EE components and patients' perceived criticism would be associated with poorer treatment outcome, and results ran counter to these expectations. Controlling for initial social phobia severity, lower levels of perceived criticism predicted treatment dropout. There was also a nonsignificant trend for participants with a significant other rated as high in emotional overinvolvement to show less change on a composite symptom measure. Findings from this study suggest that close relationships impact the outcome of cognitive-behavioral interventions for social phobia.

  8. Behavioral treatment of social phobia in youth: does parent education training improve the outcome?

    PubMed

    Öst, Lars-Göran; Cederlund, Rio; Reuterskiöld, Lena

    2015-04-01

    Social phobia is one of the most common anxiety disorders in children and adolescents, and it runs a fairly chronic course if left untreated. The goals of the present study were to evaluate if a parent education course would improve the outcome for children with a primary diagnosis of social phobia and if comorbidity at the start of treatment would impair the outcome of the social phobia. A total of 55 children, 8-14 years old, were randomly assigned to one of three conditions: 1) Child is treated, 2) Child is treated and parent participates in the course, or 3) A wait-list for 12 weeks. The treatment consisted of individual exposure and group social skills training based on the Beidel, Turner, and Morris (2000) SET-C. Children and parents were assessed pre-, post-, and at one year follow-up with independent assessor ratings and self-report measures. Results showed that there was no significant difference between the two active treatments and both were better than the wait-list. The treatment effects were maintained or furthered at the follow-up. Comorbidity did not lead to worse outcome of social phobia. Comorbid disorders improved significantly from pre-to post-treatment and from post-to follow-up assessment without being targeted in therapy.

  9. [Oxytocin: the hormone of love, trust and social bond. Clinical use in autism and social phobia].

    PubMed

    Martin-Du Pan, R C

    2012-03-21

    Oxytocin, an octapeptide synthesized in the hypothalamus, stimulates milk election and uterine contractions. In the brain this hormone acts as a neuropeptide. It could inhibit through the GABAergic system the activity of limbic amygdala, which is involved in the response to fear. Oxytocin could also induce the protective behaviour of the mother towards its offspring through the dopaminergic system. In mankind, oxytocin plays a role in trust, empathy, generosity, stress and sexuality. Clinical studies are testing potential benefits of oxytocin administration in autism, depression and social phobia. Results are still preliminary.

  10. Changes in perfectionism following cognitive-behavioral treatment for social phobia.

    PubMed

    Ashbaugh, Andrea; Antony, Martin M; Liss, Andrea; Summerfeldt, Laura J; McCabe, Randi E; Swinson, Richard P

    2007-01-01

    Previous studies have found that social phobia (social anxiety disorder) is associated with elevated levels of perfectionism, particularly concerns over making mistakes (CM) and doubts about actions (DA). This study investigated the extent to which various dimensions of perfectionism change as a result of participating in a 12-session cognitive-behavioral group treatment for social phobia. One hundred seven individuals completed the Frost Multidimensional Perfectionism Scale before and after treatment. Participants improved on several measures of social anxiety, generalized anxiety, and depression. With respect to perfectionism, significant reductions were seen on total perfectionism scores and scores on particular dimensions (CM, DA, organization), but not on other dimensions (personal standards, parental expectations, parental criticism). Furthermore, changes in DA and to some extent CM predicted posttreatment levels of social anxiety after controlling for pretreatment levels of social anxiety and changes in anxiety and depression. Implications of these findings are discussed.

  11. Social Phobia and Subtypes in the National Comorbidity Survey-Adolescent Supplement: Prevalence, Correlates, and Comorbidity

    ERIC Educational Resources Information Center

    Burstein, Marcy; He, Jian-Ping; Kattan, Gabriela; Albano, Anne Marie; Avenevoli, Shelli; Merikangas, Kathleen R.

    2011-01-01

    Objective: Social phobia typically develops during the adolescent years, yet no nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation were to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and…

  12. Evaluation of Children with Selective Mutism and Social Phobia: A Comparison of Psychological and Psychophysiological Arousal

    ERIC Educational Resources Information Center

    Young, Brennan J.; Bunnell, Brian E.; Beidel, Deborah C.

    2012-01-01

    Although children with social phobia (SP) and selective mutism (SM) present similarly in a clinical setting, it remains unclear whether children with SM are unable to speak due to overwhelming anxiety, or whether withholding speech functions as an avoidance mechanism. A total of 35 children (ages 5-12 years) with either SM (n = 10), SP (n = 11),…

  13. Evidence Based Clinical Assessment of Child and Adolescent Social Phobia: A Critical Review of Rating Scales

    ERIC Educational Resources Information Center

    Tulbure, Bogdan T.; Szentagotai, Aurora; Dobrean, Anca; David, Daniel

    2012-01-01

    Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social…

  14. Cognitive Therapy Versus Exposure and Applied Relaxation in Social Phobia: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Clark, David M.; Ehlers, Anke; Hackmann, Ann; McManus, Freda; Fennell, Melanie; Grey, Nick; Waddington, Louise; Wild, Jennifer

    2006-01-01

    A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP = AR), or wait-list (WAIT). CT…

  15. Evaluation of Children with Selective Mutism and Social Phobia: A Comparison of Psychological and Psychophysiological Arousal

    ERIC Educational Resources Information Center

    Young, Brennan J.; Bunnell, Brian E.; Beidel, Deborah C.

    2012-01-01

    Although children with social phobia (SP) and selective mutism (SM) present similarly in a clinical setting, it remains unclear whether children with SM are unable to speak due to overwhelming anxiety, or whether withholding speech functions as an avoidance mechanism. A total of 35 children (ages 5-12 years) with either SM (n = 10), SP (n = 11),…

  16. The Relevance of Age of Onset to the Psychopathology of Social Phobia

    PubMed Central

    Rosellini, Anthony J.; Rutter, Lauren A.; Bourgeois, Michelle L.; Emmert-Aronson, Benjamin O.; Brown, Timothy A.

    2013-01-01

    The present study aimed to examine the relevance of age of onset to the psychopathology of social phobia using a large clinical sample of 210 patients with social phobia. The two most common periods of onset were during adolescence (ages 14–17) and early childhood (prior to age 10). Structural regression modeling was used to test predictions that early onset social phobia would be associated with greater severity of the disorder, stronger current symptoms of depression and anxiety, greater functional impairment, and more pronounced levels of emotional disorder vulnerabilities (e.g., neuroticism/behavioral inhibition, extraversion, perceptions of control). Logistic regression was used to evaluate relationships between age of onset and the presence of acute and chronic stress at the time of onset. Results showed that earlier age of social phobia onset was associated with stronger current psychopathology, functional impairment, and emotional disorder vulnerabilities, and that later age of onset predicted the presence of an acutely stressful event around the time of disorder emergence. These results are discussed in regard to their clinical implications and congruence with prominent etiological models of the emotional disorders. PMID:23935239

  17. Cognition about Cognition: Metacognitive Therapy and Change in Generalized Anxiety Disorder and Social Phobia

    ERIC Educational Resources Information Center

    Wells, Adrian

    2007-01-01

    Metacognitive theory and therapy views the persistence of negative beliefs and thoughts as a result of metacognitions controlling cognition. This paper describes, with reference to the treatment of generalized anxiety disorder (GAD) and social phobia, how metacognition contributes to cognitive stability and to change. Metacognitive therapy offers…

  18. Social Phobia and Subtypes in the National Comorbidity Survey-Adolescent Supplement: Prevalence, Correlates, and Comorbidity

    ERIC Educational Resources Information Center

    Burstein, Marcy; He, Jian-Ping; Kattan, Gabriela; Albano, Anne Marie; Avenevoli, Shelli; Merikangas, Kathleen R.

    2011-01-01

    Objective: Social phobia typically develops during the adolescent years, yet no nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation were to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and…

  19. Cognitive Therapy Versus Exposure and Applied Relaxation in Social Phobia: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Clark, David M.; Ehlers, Anke; Hackmann, Ann; McManus, Freda; Fennell, Melanie; Grey, Nick; Waddington, Louise; Wild, Jennifer

    2006-01-01

    A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP = AR), or wait-list (WAIT). CT…

  20. [SOPHO-NET - a research network on psychotherapy for social phobia].

    PubMed

    Leichsenring, Falk; Salzer, Simone; Beutel, Manfred E; von Consbruch, Katrin; Herpertz, Stephan; Hiller, Wolfgang; Hoyer, Jürgen; Hüsing, Johannes; Irle, Eva; Joraschky, Peter; Konnopka, Alexander; König, Hans-Helmut; de Liz, Therese; Nolting, Björn; Pöhlmann, Karin; Ruhleder, Mirjana; Schauenburg, Henning; Stangier, Ulrich; Strauss, Bernhard; Subic-Wrana, Claudia; Vormfelde, Stefan V; Weniger, Godehard; Willutzki, Ulrike; Wiltink, Jörg; Leibing, Eric

    2009-01-01

    This paper presents the Social Phobia Psychotherapy Research Network (SOPHO-NET). SOPHO-NET is among the five research networks on psychotherapy funded by "Bundesministerium für Bildung und Forschung". The research program encompasses a coordinated group of studies of social phobia. In the central project (Study A), a multi-center randomized controlled trial, refined models of manualized cognitive-behavioral therapy (CBT) and manualized short-term psychodynamic psychotherapy (STPP) are compared in the treatment of social phobia. A sample of n=512 outpatients will be randomized to either CBT, STPP or wait list. For quality assurance and treatment integrity, a specific project has been established (Project Q). Study A is complemented by four interrelated projects focusing on attachment style (Study B1), cost-effectiveness (Study B2), polymorphisms in the serotonin transporter gene (Study C1) and on structural and functional deviations of hippocampus and amygdala (Study C2). Thus, the SOPHO-NET program allows for a highly interdisciplinary research of psychotherapy in social phobia.

  1. Evidence Based Clinical Assessment of Child and Adolescent Social Phobia: A Critical Review of Rating Scales

    ERIC Educational Resources Information Center

    Tulbure, Bogdan T.; Szentagotai, Aurora; Dobrean, Anca; David, Daniel

    2012-01-01

    Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social…

  2. The fear of others: a qualitative analysis of interpersonal threat in social phobia and paranoia.

    PubMed

    Stopa, Luisa; Denton, Ruth; Wingfield, Megan; Taylor, Katherine Newman

    2013-03-01

    The cognitive models indicate that people with social phobia and paranoia share a common fear of others. While we recognize clinical differences, it is likely that some of the same psychological processes contribute to the maintenance of both presentations, yet the nature and extent of these similarities and differences are not yet clearly understood. This study explored threat experiences in people with social phobia and persecutory delusions in order to elucidate these aspects of the respective cognitive models. Accounts of interpersonal threat experiences were examined in nine people with social phobia and nine people with persecutory delusions. Verbatim transcripts were analyzed using thematic analysis. Three major themes emerged from the data: participants' experience of threat, reactions while under threat, and subsequent reflections. Narrative coherence emerged as a superordinate theme. Typical fear responses were found in both groups, particularly in their reactions to threat. The key differences were in participants' perceptual experiences, ability to stand back from the threat following the event, and narrative coherence. The findings are discussed in relation to current cognitive models of social phobia and paranoia. Theoretical and clinical implications are drawn out, and highlight the need to examine attentional and metacognitive processes more closely if we are to understand the maintenance of perceived threat in these groups, and means of alleviating associated distress.

  3. Cognition about Cognition: Metacognitive Therapy and Change in Generalized Anxiety Disorder and Social Phobia

    ERIC Educational Resources Information Center

    Wells, Adrian

    2007-01-01

    Metacognitive theory and therapy views the persistence of negative beliefs and thoughts as a result of metacognitions controlling cognition. This paper describes, with reference to the treatment of generalized anxiety disorder (GAD) and social phobia, how metacognition contributes to cognitive stability and to change. Metacognitive therapy offers…

  4. Short forms of the Social Interaction Anxiety Scale and the Social Phobia Scale.

    PubMed

    Fergus, Thomas A; Valentiner, David P; McGrath, Patrick B; Gier-Lonsway, Stephanie L; Kim, Hyun-Soo

    2012-01-01

    Mattick and Clarke's (1998) Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS) are commonly used self-report measures that assess 2 dimensions of social anxiety. Given the need for short, readable measures, this research proposes short forms of both scales. Item-level analyses of readability characteristics of the SIAS and SPS items led to the selection of 6 items from each scale for use in the short forms. The SIAS and SPS short forms had reading levels at approximately the 6th and 5th grade level, respectively. Results using nonclinical (Study 1: N = 469) and clinical (Study 2: N = 145) samples identified these short forms as being factorially sound, possessing adequate internal consistency, and having strong convergence with their full-length counterparts. Moreover, these short forms showed convergence with other measures of social anxiety, showed divergence from measures assessing related constructs, and predicted concurrent interpersonal functioning. Recommendations for the use of these short forms are discussed.

  5. Personality and treatment response in agoraphobia with panic attacks.

    PubMed

    Clair, A L; Oei, T P; Evans, L

    1992-01-01

    The present study investigated the association of specific personality characteristics with agoraphobia, and whether they predicted long-term outcome following a group cognitive behavior therapy program. Thirty-three patients with agoraphobia with panic attacks, 18 with social phobia, and 26 "normals" were used in the study. Personality factors were measured with the Maudsley Personality Inventory (MPI), the Hostility and Direction of Hostility Questionnaire (HDHQ), and the Fundamental Interpersonal Relations Orientation-Behavior Scale (FIRO-B). The results showed that (1) agoraphobics are more extroverted and more likely to include others in their activities than are social phobics; however, they are less extroverted, more neurotic, more hostile and intropunitive, and less likely to include others in their activities than are normals; (2) social phobics are similarly less extroverted, more neurotic, and more hostile and intropunitive than normals, but, in addition, are less likely to exert control over others, more likely to want to be controlled, and less expressive of affection than normals; and (3) personality characteristics did not predict treatment outcome.

  6. Psychometric properties of the Japanese version of the Social Phobia Inventory.

    PubMed

    Nagata, Toshihiko; Nakajima, Takenori; Teo, Alan R; Yamada, Hisashi; Yoshimura, Chiho

    2013-04-01

    The aim of the current study was to study the psychometric properties of the Japanese version of the Social Phobia Inventory (SPIN-J) among Japanese subjects with social anxiety disorder (SAD). The sample consisted of 86 subjects with SAD and 86 controls. Diagnosis was based on a modified version of the Structured Clinical Interview for the DSM-IV. In addition to the SPIN-J, clinician-administered and self-rating scales, including the Japanese versions of the Liebowitz Social Anxiety Scale, the Social Phobia Scale, and the Social Interaction Anxiety Scale, were used. The SPIN-J showed adequate internal consistency (0.82-0.96) for the total and subscales. Correlations between the SPIN-J and the Liebowitz Social Anxiety Scale, the Social Phobia Scale, and the Social Interaction Anxiety Scale ranged from 0.83 to 0.89 and indicated adequate concurrent validity. A cut-off point of 22 between subjects with SAD and controls showed a sensitivity of 96.5% and specificity of 87.2%, indicating robust discriminant validity. The SPIN-J showed adequate reliability and validity for use as a screening tool for social anxiety disorder in Japanese clinical settings. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

  7. Parental psychopathology, parenting styles, and the risk of social phobia in offspring: a prospective-longitudinal community study.

    PubMed

    Lieb, R; Wittchen, H U; Höfler, M; Fuetsch, M; Stein, M B; Merikangas, K R

    2000-09-01

    This article examines the associations between DSM-IV social phobia and parental psychopathology, parenting style, and characteristics of family functioning in a representative community sample of adolescents. Findings are based on baseline and first follow-up data of 1047 adolescents aged 14 to 17 years at baseline (response rate, 74.3%), and independent diagnostic interviews with one of their parents. Diagnostic assessments in parents and adolescents were based on the DSM-IV algorithms of the Munich-Composite International Diagnostic Interview. Parenting style (rejection, emotional warmth, and overprotection) was assessed by the Questionnaire of Recalled Parental Rearing Behavior, and family functioning (problem solving, communication, roles, affective responsiveness, affective involvement, and behavioral control) was assessed by the McMaster Family Assessment Device. There was a strong association between parental social phobia and social phobia among offspring (odds ratio [OR], 4.7; 95% confidence interval [CI], 1.6-13.5). Other forms of parental psychopathology also were associated with social phobia in adolescents (depression: OR, 3.6; 95% CI, 1.4-9.1; any anxiety disorder other than social phobia: OR, 3.5; 95% CI, 1.4-8.8; and any alcohol use disorder: OR, 3.0; 95% CI, 1.1-7.8). Parenting style, specifically parental overprotection (OR, 1.4; 95% CI, 1.0-1.9) and rejection (OR, 1.4; 95% CI, 1.1-1.9), was found to be associated with social phobia in respondents. Family functioning was not associated with respondents' social phobia. Data suggest that parental psychopathology, particularly social phobia and depression, and perceived parenting style (overprotection and rejection) are both associated with the development of social phobia in youth.

  8. Disability and quality of life in pure and comorbid social phobia--findings from a controlled study.

    PubMed

    Wittchen, H U; Fuetsch, M; Sonntag, H; Müller, N; Liebowitz, M

    1999-06-01

    Social phobia is increasingly recognized as a prevalent and socially impairing mental disorder. However, little data is available regarding the general and disease-specific impairments and disabilities associated with social phobia. Furthermore, most studies have not controlled for the confounding effects of comorbid conditions. This study investigates: (a) the generic quality of life; (b) work productivity; and, (c) various other disorder-specific social impairments in current cases with pure (n = 65), comorbid (n = 51) and subthreshold (n = 34) DSM-IV social phobia as compared to controls with no social phobia (subjects with a history of herpes infections). Social phobia cases reported a mean illness duration of 22.9 years with onset in childhood or adolescence. Current quality of life, as assessed by the SF-36, was significantly reduced in all social phobia groups, particularly in the scales measuring vitality, general health, mental health, role limitations due to emotional health, and social functioning. Comorbid cases revealed more severe reductions than pure and subthreshold social phobics. Findings from the Liebowitz self-rated disability scale indicated that: (a) social phobia affects most areas of life, but in particular education, career, and romantic relationship; (b) the presence of past and current comorbid conditions increases the frequency of disease-specific impairments; and, (c) subthreshold social phobia revealed slightly lower overall impairments than comorbid social phobics. Past week work productivity of social phobics was significantly diminished as indicated by: (a) a three-fold higher rate of unemployed cases; (b) elevated rates of work hours missed due to social phobia problems; and, (c) a reduced work performance. Overall, these findings underline that social phobia in our sample of adults, whether comorbid, subthreshold, or pure was a persisting and impairing condition, resulting in considerable subjective suffering and negative impact

  9. Prediction of treatment outcome in social phobia: a cross-validation.

    PubMed

    Scholing, A; Emmelkamp, P M

    1999-07-01

    This study was a replication of a study on the prediction of treatment outcome in social phobic patients [Chambless, D. L., Tran, G. Q. Glass, C.R. (1997). Predictors of response to cognitive-behavioral group therapy for social phobia. Journal of Anxiety Disorders, 11 221-240]. Results at the posttest and the 18-months follow-up were analyzed for DSM-III-R social phobic patients, with either a generalized social phobia (n = 50) or a nongeneralized fear, i.e. fear of blushing, trembling or sweating in social situations (n = 26). Predictors were pretreatment depression, personality disorder traits, clinician rated severity of impairment and frequency of negative self-statements during social interactions. The criterium variable was (the residual gain score of) self-reported avoidance of social situations. In line with Chambless et al., pretreatment depression showed some predictive value, but smaller and only at the posttest. Change in the frequency of negative self-statements paralleled, but did not predict, change in social phobia symptoms. In contrast with Chambless et al., clinician rated severity was (slightly) predictive for treatment outcome, whereas avoidant personality traits had reverse correlations with outcome in both subgroups. The results are discussed and directions for further research are given.

  10. Who is looking at me? The cone of gaze widens in social phobia.

    PubMed

    Gamer, Matthias; Hecht, Heiko; Seipp, Nina; Hiller, Wolfgang

    2011-06-01

    Gaze direction is an important cue that regulates social interactions and facilitates joint attention. Although humans are very accurate in determining gaze directions in general, they have a surprisingly liberal criterion for the presence of mutual gaze. Using an established psychophysical task that required observers to adjust the eyes of a virtual head to the margins of the area of mutual gaze, we examined whether the resulting cone of gaze is altered in people with social phobia. It turned out that during presence of a second virtual person, the gaze cone's width was specifically enlarged in patients with social phobia as compared to healthy controls. The size of this effect was correlated with the severity of social anxiety. As this effect was found for merely virtual lookers, it seems to be a fundamental mechanism rather than a specific effect related to the fear of being observed and evaluated by others.

  11. Group cohesion in cognitive-behavioral group therapy for social phobia.

    PubMed

    Taube-Schiff, Marlene; Suvak, Michael K; Antony, Martin M; Bieling, Peter J; McCabe, Randi E

    2007-04-01

    Cognitive-behavior therapy (CBT) for Social Phobia is effective in both group and individual formats. However, the impact of group processes on treatment efficacy remains relatively unexplored. In this study we examined group cohesion ratings made by individuals at the midpoint and endpoint of CBT groups for social phobia. Symptom measures were also completed at the beginning and end of treatment. We found that cohesion ratings significantly increased over the course of the group and were associated with improvement over time in social anxiety symptoms, as well as improvement on measures of general anxiety, depression, and functional impairment. In conclusion, findings are consistent with the idea that changes in group cohesion are related to social anxiety symptom reduction and, therefore, speak to the importance of nonspecific therapeutic factors in treatment outcome.

  12. Comparing short forms of the Social Interaction Anxiety Scale and the Social Phobia Scale.

    PubMed

    Carleton, R Nicholas; Thibodeau, Michel A; Weeks, Justin W; Teale Sapach, Michelle J N; McEvoy, Peter M; Horswill, Samantha C; Heimberg, Richard G

    2014-12-01

    The Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS; Mattick & Clarke, 1998) are companion scales developed to measure anxiety in social interaction and performance situations, respectively. The measures have strong discriminant and convergent validity; however, their factor structures remain debated, and furthermore, the combined administration length (i.e., 39 items) can be prohibitive for some settings. There have been 4 attempts to assess the factor structures of the scales and reduce the item content: the 14-item Social Interaction Phobia Scale (SIPS; Carleton et al., 2009), the 12-item SIAS-6/SPS-6 (Peters, Sunderland, Andrews, Rapee, & Mattick, 2012), the 21-item abbreviated SIAS/SPS (ASIAS/ASPS; Kupper & Denollet, 2012), and the 12-item Readability SIAS and SPS (RSIAS/RSPS; Fergus, Valentiner, McGrath, Gier-Lonsway, & Kim, 2012). The current study compared the short forms on (a) factor structure, (b) ability to distinguish between clinical and non-clinical populations, (c) sensitivity to change following therapy, and (d) convergent validity with related measures. Participants included 3,607 undergraduate students (55% women) and 283 patients with social anxiety disorder (43% women). Results of confirmatory factor analyses, sensitivity analyses, and correlation analyses support the robust utility of items in the SIPS and the SPS-6 and SIAS-6 relative to the other short forms; furthermore, the SIPS and the SPS-6 and SIAS-6 were also supported by convergent validity analyses within the undergraduate sample. The RSIAS/RSPS and the ASIAS/ASPS were least supported, based on the current results and the principle of parsimony. Accordingly, researchers and clinicians should consider carefully which of the short forms will best suit their needs.

  13. Perception of control over anxiety mediates the relation between catastrophic thinking and social anxiety in social phobia.

    PubMed

    Hofmann, Stefan G

    2005-07-01

    Cognitive models of social phobia (social anxiety disorder) assume that individuals with social phobia experience anxiety in social situations in part because they overestimate the social cost associated with a potentially negative outcome of a social interaction. Some emotion theorists, on the other hand, point to the perception of control over anxiety-related symptoms as a determinant of social anxiety. In order to examine the relationship between perceived emotional control (PEC), estimated social cost (ESC), and subjective anxiety, we compared three alternative structural equation models: Model 1 assumes that PEC and ESC independently predict social anxiety; Model 2 assumes that ESC partially mediates the relationship between PEC and anxiety, and Model 3 assumes that PEC partially mediates the relationship between ESC and anxiety. We recruited 144 participants with social phobia and administered self-report measures of estimated social cost, perceived anxiety control, and social anxiety. The results support Model 3 and suggest that "costly" social situations are anxiety provoking in part because social phobic individuals perceive their anxiety symptoms as being out of control.

  14. Social anxiety disorders in clinical practice: differentiating social phobia from avoidant personality disorder.

    PubMed

    Lampe, Lisa

    2015-08-01

    To outline the problems around overlap between social phobia (SAD) and avoidant personality disorder (AVPD) and provide guidelines that may assist clinicians to differentiate these conditions. A constellation of symptoms can be identified that may distinguish AVPD from SAD, with key features being a strong and pervasively negative self-concept, a view of rejection as equating to a global evaluation of the individual as being of little worth and a sense of not fitting in socially that dates from early childhood. It is important to identify the presence of AVPD in order to anticipate potential problems with engagement and retention in therapy, to target treatment interventions and optimise outcome. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  15. Hypervigilance and avoidance in visual attention in children with social phobia.

    PubMed

    Seefeldt, Wiebke L; Krämer, Martina; Tuschen-Caffier, Brunna; Heinrichs, Nina

    2014-03-01

    Attentional bias towards threat in socially anxious adults is well documented; however, research on this bias in children with social phobia is rather scarce. The present study investigates whether the hypervigilance-avoidance hypothesis also applies to children with social phobia. Thirty children (aged 8-12) with social phobia and 43 control children participated in an eye-tracking experiment while their attentional distribution was recorded. Social anxiety was induced in half of the children before the eye-tracking task. Stimuli were presented for 3000 ms, and bias scores for initial fixations and the time span of attention were assessed. Results indicated initial vigilance towards angry faces for all children independent of anxiety induction, while hypervigilance (but not avoidance) was only established in children with social phobia for angry-neutral face pairs and with social fears induced. Self-report measures of anxiety correlated with bias towards threat with more pronounced associations occurring in the anxiety induction condition. We did not record reaction times simultaneously which limits the opportunity to compare our results to some previous studies which focused on this variable as an indicator of attention. Cognitive biases in elementary school children (between 8 and 12 years) relate to hypervigilant rather than to avoidant information processing. Attentional distribution varies over time. Differences between clinical anxious and healthy children seem to be modified by anxiety induction, symptom severity and contextual stimuli, such as the emotional valence of a face and the context in which the threat stimulus appears. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Psychometric properties of the social phobia and anxiety inventory-child version in a Swedish clinical sample.

    PubMed

    Cederlund, Rio; Ost, Lars-Göran

    2013-06-01

    The social phobia and anxiety inventory for children (SPAI-C) is a 26 item, empirically derived self-report instrument developed for assessing social phobic fears in children. Evidence for satisfactory psychometric properties of the SPAI-C has been found in multiple community studies. Since its development, however, no study has presented an extensive psychometric evaluation of SPAI-C in a sample of carefully diagnosed children with social phobia. The present study sought to replicate and expand previous studies by administrating the SPAI-C to a sample of 59 children that fulfilled DSM-IV criteria for social phobia, and 49 children with no social phobia diagnosis. An exploratory factor analysis resulted in a three factor solution reflecting: (1) fear of social interactions, (2) fear of public performance situations, and (3) physical and cognitive symptoms connected with social phobia. These factors appear to parallel domains of social phobia also evident in adults. The SPAI-C total scale and each factor was found to possess good internal consistency, good test-retest reliability and was generally strongly correlated with both self-report and clinician measures of anxiety and fears. The discriminative properties of the total scale were satisfactory. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Social phobia and avoidant personality disorder: are they separate diagnostic entities or do they reflect a spectrum of social anxiety?

    PubMed

    Tillfors, Maria; Ekselius, Lisa

    2009-01-01

    The Axis I disorder social phobia and the Axis II disorder avoidant personality disorder were first introduced in the DSM nomenclature in 1980. Since then a major nosological theme in research has concerned whether or not social phobia and avoidant personality disorder represent distinct clinical categories. Our main aim was to summarize both the current situation regarding this conceptual debate, as well as what we still do not know. In the present review we describe the evolution of these disorders as they have been addressed over time, from their introduction in the DSM-III system to their current descriptions in the DSM-IV. Thereafter, earlier empirical literature concerning this conceptual debate is evaluated, with the main focus on comorbidity between social phobia and avoidant personality disorder. The PsycINFO and PubMed electronic databases were searched for studies, and complementary searches of references in articles and books were conducted. To conclude, the studies summarized provide support for the view that social phobia and avoidant personality disorder are more than arbitrary cutoffs along a continuum of social anxiety.

  18. The efficacy of imagery rescripting (IR) for social phobia: a randomized controlled trial.

    PubMed

    Lee, Seung Won; Kwon, Jung-Hye

    2013-12-01

    There is a need for brief effective treatment of social phobia and Imagery Rescripting (IR) is a potential candidate. The purpose of this study was to examine the efficacy of IR preceded by cognitive restructuring as a stand-alone brief treatment using a randomized controlled design. Twenty-three individuals with social phobia were randomly assigned to an IR group or to a control group. Participants in the IR group were provided with one session of imagery interviewing and two sessions of cognitive restructuring and Imagery Rescripting. Those in the control group had one session of clinical interviewing and two sessions of supportive therapy. Outcome measures including the Korean version of the social avoidance and distress scale (K-SADS) were administered before and after treatment, and at three-month follow-up. The short version of the Questionnaire upon Mental Imagery and the Traumatic Experience Scale were also administered before treatment. Participants in the IR group improved significantly on K-SADS and other outcome measures, compared to the control group. The beneficial effects of IR were maintained at three-month follow-up. It was also found that mental imagery ability and the severity of the traumatic experience did not moderate the outcome of IR. Further studies are needed to replicate the findings of our study using a large sample. The efficacy of IR as a stand-alone brief treatment was demonstrated for social phobia. The findings indicate that IR could be utilized as a cost-effective intervention for social phobia. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Pre-existing antidepressants and the outcome of group cognitive behaviour therapy for social phobia.

    PubMed

    Rosser, Stephanie; Erskine, Alicia; Crino, Rocco

    2004-04-01

    This is a naturalistic treatment outcome study investigating the impact of pre-existing antidepressant use on the effectiveness of group cognitive behaviour therapy (CBT) for social phobia. Of the 133 participants who completed the CBT program, 49 reported taking antidepressants (CBT + AD group), while 84 reported not taking antidepressants (CBT group). The treatment program involves 40 h of structured, group-based CBT over 7 weeks. The dependent measures included the Social Phobia Scale and Social Interaction Anxiety Scale, the Fear of Negative Evaluation Scale, the Depression, Anxiety and Stress Scale and the Short Form-12. Both the CBT + AD group and the CBT group improved significantly across treatment on all dependent measures. There were no significant differences between the groups on any outcome measure and the rate of improvement from pre- to post-treatment for both groups did not differ. Pre-existing antidepressants did not significantly enhance or detract from the positive treatment outcome of a structured, group-based CBT program for social phobia.

  20. [Validation of the portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN)].

    PubMed

    D'El Rey, Gustavo José Fonseca; Matos, Cláudia Wilmor

    2009-01-01

    Social phobia (also known as social anxiety disorder) is a severe mental disorder that brings distress and disability. The aim of this study was validate to the Portuguese language the Mini-Social Phobia Inventory (Mini-SPIN) in a populational sample. We performed a discriminative validity study of the Mini-SPIN in a sample of 644 subjects (Mini-SPIN positive group: n = 218 and control/negative group: n = 426) of a study of anxiety disorders' prevalence in the city of Santo André-SP. The Portuguese version of the Mini-SPIN (with score of 6 points, suggested in the original English version) demonstrated a sensitivity of 95.0%, specificity of 80.3%, positive predictive value of 52.8%, negative predictive value of 98.6% and incorrect classification rate of 16.9%. With score of 7 points, was observed an increase in the specificity and positive predictive value (88.6% and 62.7%), while the sensitivity and negative predictive value (84.8% and 96.2%) remained high. The Portuguese version of the Mini-SPIN showed satisfactory psychometric qualities in terms of discriminative validity. In this study, the cut-off of 7, was considered to be the most suitable to screening of the generalized social phobia.

  1. The factor structure of the Social Interaction Anxiety Scale and the Social Phobia Scale.

    PubMed

    Heidenreich, Thomas; Schermelleh-Engel, Karin; Schramm, Elisabeth; Hofmann, Stefan G; Stangier, Ulrich

    2011-05-01

    The Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS) are two compendium measures that have become some of the most popular self-report scales of social anxiety. Despite their popularity, it remains unclear whether it is necessary to maintain two separate scales of social anxiety. The primary objective of the present study was to examine the factor analytic structure of both measures to determine the factorial validity of each scale. For this purpose, we administered both scales to 577 patients at the beginning of outpatient treatment. Analyzing both scales simultaneously, a CFA with two correlated factors showed a better fit to the data than a single factor model. An additional EFA with an oblique rotation on all 40 items using the WLSMV estimator further supported the two factor solution. These results suggest that the SIAS and SPS measure similar, but not identical facets of social anxiety. Thus, our findings provide support to retain the SIAS and SPS as two separate scales.

  2. Optimal treatment of social phobia: systematic review and meta-analysis

    PubMed Central

    Canton, John; Scott, Kate M; Glue, Paul

    2012-01-01

    This article proposes a number of recommendations for the treatment of generalized social phobia, based on a systematic literature review and meta-analysis. An optimal treatment regimen would include a combination of medication and psychotherapy, along with an assertive clinical management program. For medications, selective serotonin reuptake inhibitors and dual serotonin-norepinephrine reuptake inhibitors are first-line choices based on their efficacy and tolerability profiles. The nonselective monoamine oxidase inhibitor, phenelzine, may be more potent than these two drug classes, but because of its food and drug interaction liabilities, its use should be restricted to patients not responding to selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. There are other medication classes with demonstrated efficacy in social phobia (benzodiazepines, antipsychotics, alpha-2-delta ligands), but due to limited published clinical trial data and the potential for dependence and withdrawal issues with benzodiazepines, it is unclear how best to incorporate these drugs into treatment regimens. There are very few clinical trials on the use of combined medications. Cognitive behavior therapy appears to be more effective than other evidence-based psychological techniques, and its effects appear to be more enduring than those of pharmacotherapy. There is some evidence, albeit limited to certain drug classes, that the combination of medication and cognitive behavior therapy may be more effective than either strategy used alone. Generalized social phobia is a chronic disorder, and many patients will require long-term support and treatment. PMID:22665997

  3. Shyness 5: the clinical effectiveness of Internet-based clinician-assisted treatment of social phobia.

    PubMed

    Aydos, Leticia; Titov, Nickolai; Andrews, Gavin

    2009-12-01

    Objective: The present study explores the clinical effectiveness of an Internet-based cognitive behavioural treatment program for social phobia (the Shyness program) administered by a psychiatric registrar as part of standard clinical treatment at an outpatient mental health service (the Anxiety Disorders Clinic, St Vincent's Hospital, Sydney). Method: Seventeen individuals with social phobia were assigned to this 8 week clinician-assisted program. All patients had access to online lessons, homework assignments, an online discussion forum with other patients, and regular emails from the clinician. Both completer and intention-to-treat models were used in data analyses. Results: Fourteen (82%) patients completed all six lessons within the 8 weeks, and 11/17 (65%) completed post-treatment questionnaires. Mean within-group effect sizes (Cohen's d) for the two social phobia measures were 1.06 and 0.77, based on completer and intention-to-treat analyses, respectively. Data indicate that the procedure was acceptable to patients. Conclusions: These results indicate that the procedure was clinically effective when operated as part of standard clinical treatment. These results provide further support for the potential clinical utility of the Shyness program.

  4. Panic disorder and social phobia: possible implications of comorbid depression for drug therapy.

    PubMed

    Lydiard, R B

    1996-01-01

    Major depression is a common mental disorder with a lifetime prevalence of approximately 15% of the general population, affecting almost twice as many females as males. Panic disorder is a severe anxiety disorder with a lifetime prevalence of 2-3% or more. Like major depression, panic disorder affects nearly twice as many females as males. Both panic disorder and major depression are often chronic conditions, resulting in significant morbidity and mortality. Among patients who seek treatment for either panic disorder or major depression, both conditions are present in approximately one-third of the patient population. Substantial information suggests that individuals who suffer from both panic disorder and major depression respond poorly to acute treatment, are more likely to remain ill over the long term, require more psychiatric treatment, and are at approximately twice the risk of suicide attempts than individuals who suffer from either condition alone. There has been very little systematic study of individuals with coexisting panic disorder and major depression. This has left significant gaps in our knowledge about optimal treatment for the substantial subgroup of individuals suffering from both disorders simultaneously. Social phobia is a common disorder which affects 2-8% (females more than males) of the population. Recent advances in the pharmacological treatment of social phobia are reviewed. Patterns of comorbidity, effects of coexisting psychiatric disorders on disability, health care utilization and suicidality are discussed, together with treatment implications for coexisting social phobia and major depression.

  5. The neuroanatomical basis of panic disorder and social phobia in schizophrenia: a voxel based morphometric study.

    PubMed

    Picado, Marisol; Carmona, Susanna; Hoekzema, Elseline; Pailhez, Guillem; Bergé, Daniel; Mané, Anna; Fauquet, Jordi; Hilferty, Joseph; Moreno, Ana; Cortizo, Romina; Vilarroya, Oscar; Bulbena, Antoni

    2015-01-01

    It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitofrontal cortex, temporal gyrus and angular/inferior parietal gyrus when compared to the control group. Our findings suggest that the comorbidity of schizophrenia with panic disorder and social phobia might be characterized by specific neuroanatomical and clinical alterations that may be related to maladaptive emotion regulation related to anxiety. Even thought our findings need to be replicated, our study suggests that the identification of neural abnormalities involved in anxiety, schizophrenia and schizophrenia-anxiety may lead to an improved diagnosis and management of these conditions.

  6. Associations between body weight and depression, social phobia, insomnia, and self-esteem among Taiwanese adolescents.

    PubMed

    Lee, Jia-In; Yen, Cheng-Fang

    2014-12-01

    The aims of this cross-sectional study were to examine the associations between body weight and mental health indicators including depression, social phobia, insomnia, and self-esteem among Taiwanese adolescents in Grades 7-12. The body mass index (BMI) of 5254 adolescents was calculated based on self-reported weight and height measurements. Body weight status was determined by the age- and gender-specific International Obesity Task Force reference tables. By using participants of average weight as the reference group, the association between body weight status (underweight, overweight, and obesity) and mental health indicators (depression, social phobia, insomnia, and self-esteem) were examined by using multiple regression analysis. The possible moderating effects of sociodemographic characteristics on the association were also examined. After controlling for the effects of sociodemographic characteristics, both overweight (p < 0.05) and obese adolescents (p < 0.001) had a lower level of self-esteem than did those of average weight; however, no significant differences in depression, social phobia, or insomnia were found between those who were overweight/obese and those of average weight. No significant differences in the four mental health indicators were found between those who were underweight and those of average weight. Sociodemographic characteristics had no moderating effect on the association between body weight and mental health indicators. In conclusion, mental health and school professionals must take the association between overweight/obesity and self-esteem into consideration when approaching the issue of mental health among adolescents.

  7. The Neuroanatomical Basis of Panic Disorder and Social Phobia in Schizophrenia: A Voxel Based Morphometric Study

    PubMed Central

    Picado, Marisol; Carmona, Susanna; Hoekzema, Elseline; Pailhez, Guillem; Bergé, Daniel; Mané, Anna; Fauquet, Jordi; Hilferty, Joseph; Moreno, Ana; Cortizo, Romina; Vilarroya, Oscar; Bulbena, Antoni

    2015-01-01

    Objective It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. Methods Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. Results Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitofrontal cortex, temporal gyrus and angular/inferior parietal gyrus when compared to the control group. Conclusions Our findings suggest that the comorbidity of schizophrenia with panic disorder and social phobia might be characterized by specific neuroanatomical and clinical alterations that may be related to maladaptive emotion regulation related to anxiety. Even thought our findings need to be replicated, our study suggests that the identification of neural abnormalities involved in anxiety, schizophrenia and schizophrenia-anxiety may lead to an improved diagnosis and management of these conditions. PMID:25774979

  8. Agoraphobia is a disease: a tribute to Sir Martin Roth.

    PubMed

    Fava, Giovanni A; Rafanelli, Chiara; Tossani, Eliana; Grandi, Silvana

    2008-01-01

    The evidence which has accumulated on the course of agoraphobia challenges the DSM view that phobic avoidance is secondary to panic attacks. In particular, a longitudinal study by Wittchen et al. indicates that agoraphobia, as a diagnostic category, is frequently independent of panic disorder and panic attacks, is unlikely to remit spontaneously and entails compromised quality of life. A staging system of agoraphobia is presented. Panic may ensue in the longitudinal development of agoraphobia, as well as of other anxiety disorders, and be conceptualized as a potential outcome in the course of anxiety, phobias and hypochondriasis as more than a specific disease entity. These recent research findings confirm the clinical observations and phenomenological research of Sir Martin Roth (1917-2006) and call for a reassessment of the concept of neurosis.

  9. Latent dimensions of social anxiety disorder: A re-evaluation of the Social Phobia Inventory (SPIN).

    PubMed

    Campbell-Sills, Laura; Espejo, Emmanuel; Ayers, Catherine R; Roy-Byrne, Peter; Stein, Murray B

    2015-12-01

    The Social Phobia Inventory (SPIN; Connor et al., 2000) is a well-validated instrument for assessing severity of social anxiety disorder (SAD). However, evaluations of its factor structure have produced inconsistent results and this aspect of the scale requires further study. Primary care patients with SAD (N=397) completed the SPIN as part of baseline assessment for the Coordinated Anxiety Learning and Management study (Roy-Byrne et al., 2010). These data were used for exploratory and confirmatory factor analysis of the SPIN. A 3-factor model provided the best fit for the data and factors were interpreted as Fear of Negative Evaluation, Fear of Physical Symptoms, and Fear of Uncertainty in Social Situations. Tests of a second-order model showed that the three factors loaded strongly on a single higher-order factor that was labeled Social Anxiety. Findings are consistent with theories identifying Fear of Negative Evaluation as the core feature of SAD, and with evidence that anxiety sensitivity and intolerance of uncertainty further contribute to SAD severity.

  10. Do autistic traits play a role in the bullying of obsessive-compulsive disorder and social phobia sufferers?

    PubMed

    Bejerot, S; Mörtberg, E

    2009-01-01

    Social phobia and obsessive-compulsive disorder (OCD) share several similarities: both are categorized as anxiety disorders, avoidant personality disorder and depression are common in both, they have a similar age of onset and course, and both disorders respond to treatments with serotonin reuptake inhibitors and cognitive behavioural therapy. However, OCD and social phobia differ in respect to their relation to autism spectrum disorders (ASD; i.e. Asperger's syndrome, autism, pervasive disorder not otherwise specified). Findings that suggest a link between OCD and ASD have no parallel in social phobia. Moreover, obsessive-compulsive, paranoid and schizotypal personality disorders are prevalent in OCD and in ASD, but not in social phobia. Individuals with ASD are known to be frequent targets of bullying. We hypothesised that individuals with autistic traits would have been frequent targets for bullies during their childhood, as opposed to people without such traits. Adult patients with social phobia (n = 63) or OCD (n = 65) were assessed regarding autistic traits, and interviewed about being bullied at school. A reference group (n = 551) responded to questions about being bullied. There was a significant difference in the prevalence of being bullied between OCD (50%), social phobia patients (20%) and the reference group (27%). Autistic traits were more common in OCD than in social phobia. A history of being bullied was related to autistic traits among patients. Falling victim to bullying is not a random event. Autistic traits, i.e. low social skills, may be a predictor of being bullied in school. The high rate of bullying victims in persons who later develop OCD is suggested to be related to the overlap between OCD and ASD. Copyright 2009 S. Karger AG, Basel.

  11. The Relationship Among Social Phobia, Objective and Perceived Physiological Reactivity, and Anxiety Sensitivity in an Adolescent Population

    PubMed Central

    Anderson, Emily R.; Hope, Debra A.

    2009-01-01

    Physiological theories may be important in the development and maintenance of social phobia in youth. A limited literature base indicates that youth with social phobia experience increases in objective physiological arousal during social-evaluative situations and are more aware of such increases compared to nonanxious youth. Recent research suggests that youth with social phobia also evidence heightened levels of anxiety sensitivity, which may lead to interpretation of physiological arousal as dangerous or distressing, and, as a result, in avoidance of situations which produce increased physiological arousal. The purpose of the current study was to examine interaction among objective physiological arousal, perceived physiological arousal, and anxiety sensitivity among adolescents diagnosed with social phobia. A sample of community adolescents participated in two anxiety-provoking tasks during which objective physiological arousal was monitored, and after which perceived physiological arousal and anxiety sensitivity were evaluated. Results from this study evidenced no differences between social phobic and nonanxious adolescents with regard to objective physiological arousal during either anxiety-provoking tasks. Adolescents with social phobia, however, were more aware of measured increases in physiological arousal, as well as more afraid of the potential social implications of that arousal compared to nonanxious adolescents. Implications for theory and treatment are discussed. PMID:18436426

  12. Assessing Social Anxiety in African American Youth using the Social Phobia and Anxiety Inventory for Children

    PubMed Central

    Pina, Armando A.; Little, Michelle; Wynne, Henry; Beidel, Deborah C.

    2013-01-01

    Examined measurement invariance and cut-off scores of the Social Phobia and Anxiety Inventory for Children (SPAI-C) using data corresponding to a convenience sample of 501 African American and Caucasian youth (Mage = 11.62 years, 249 girls; 49% with social anxiety disorder) using exploratory structural equation modeling and a weighted least squares mean variance estimator. For the cut-off scores, Receiver Operator Characteristic analyses were used along with Youden’s index to evaluate the balance between sensitivity and specificity. Overall, results supported the SPAI-C’s cross-race invariance but a few items emerged as non-invariant. Compared to past research, lower SPAI-C cutoff scores were found (13 to 15 range). Findings support research showing that African American youth generally have significantly lower (or similar) social anxiety levels than their White counterparts. Suggestions for using the SPAI-C with African American under non-invariant conditions youth are provided and implications of using lower cutoff scores are discussed. PMID:23872906

  13. Looking After the Clinical and Social Support Needs of Military Families Impacted by Operational Stress Injuries

    DTIC Science & Technology

    2006-04-01

    couples in which one partner had an anxiety disorder (panic disorder, social phobia, agoraphobia , simple phobia or generalized anxiety disorder), and 26...experiences and suffering. To learn concrete crisis management techniques. To develop and enhance self-care and relationship skills (e.g.: healthy...coping strategies, communication, anger management , coping with life transitions, meeting one’s needs). To recognize the signs of stress and

  14. Modelling relationships between cognitive variables during and following public speaking in participants with social phobia.

    PubMed

    Rapee, Ronald M; Abbott, Maree J

    2007-12-01

    Cognitive models of social phobia predict that several cognitive processes will mediate the relationship between trait levels of social anxiety and the extent of anxiety experienced in a specific social-evaluative situation. The current study aimed to provide a test of these relationships. Over 200 clinical participants with social phobia completed measures of their general social anxiety and a week later performed a brief impromptu speech. They completed a measure of state anxiety in response to the speech as well as questionnaires assessing several cognitive constructs including focus of perceived attention, perceived performance, and probability and cost of negative evaluation. A week later, they completed measures of negative rumination experienced over the week, as well as a measure of the recollection of their perceived performance. Path analysis provided support for a model in which the cognitive factors mediated between general social anxiety and the degree of anxiety experienced in response to the speech. A second model supported the theory that negative rumination mediated between characteristic social anxiety and negative bias in the recollection of performance.

  15. Detection and distraction effects for threatening information in social phobia and change after treatment.

    PubMed

    Baños, R M; Quero, S; Botella, C

    2008-01-01

    This work examines differences in the detection and distraction by social-threat-related information between a social phobia group (SP; N=33) and a normal control group (NC; N=32). The change obtained after psychological treatment is also studied for the SP group. A paper-and-pencil visual search task is used, in which the emotional valence of the "target" (social threat, physical threat, and neutral words) and "distractor" (social threat, physical threat, neutral, and nonsense words) verbal stimuli is manipulated. Results indicate that there are no differences in the detection of social-threat targets between SP and NC participants. However, the performance of SP individuals is more impaired when distractor stimuli related to social threat are presented, regardless of the target valence. This increased distraction by social-threat-related stimuli is reduced after psychological treatment, and this decrease is maintained at 6-month follow-up.

  16. Hypnosis aided fixed role therapy for social phobia: a case report.

    PubMed

    Iglesias, Alex; Iglesias, Adam

    2014-04-01

    This case study details how hypnosis aided fixed role therapy (HAFRT) was employed in the successful treatment of a case of social phobia with a history of refractory outcomes to previous therapy trials. The treatment consisted of 10 office sessions, scheduled every two weeks, of HAFRT along with twice a day self-hypnotic sessions where the patient performed multiple visualization rehearsals of the vignettes that were successfully mastered in hypnosis during office visits. The results indicated that this patient was able to engage in social and professional affairs that were impossible prior to treatment. The patient retained the therapy gains at follow up 6 months later.

  17. The reaction to social stress in social phobia: discordance between physiological and subjective parameters.

    PubMed

    Klumbies, Elisabeth; Braeuer, David; Hoyer, Juergen; Kirschbaum, Clemens

    2014-01-01

    Research on the biopsychological background of social phobia (SP) is scarce and inconsistent. We investigated endocrine and autonomic markers along with subjective responses to a standardized stress situation (Trier Social Stress Test, TSST) in SP patients and healthy controls (HC). We examined 88 patients with the primary diagnosis of SP as well as 78 age and sex comparable HCs with the TSST. Blood and saliva samples were obtained before and after the TSST for the assessment of salivary cortisol, plasma cortisol, salivary alpha-amylase (sAA), and prolactin. Heart rate (HR) and heart rate variability (HRV) were recorded continuously. Scalp-near hair samples were collected for the assessment of long-term cortisol secretion. The self-reported stress response was measured with different state and trait scales. While self-reported anxiety was elevated in SP before, during, immediately after, and one week after the TSST, no significant differences in biological stress responses were observed between SP and HC. There was a trend for SP to show higher baseline stress markers. Also long-term cortisol deposition in hair remained unaltered. Our results suggest that the excessive self-reported stress in SP is not reflected by a respective biological stress response. Patients with SP apparently show neither an extreme form of focused fear reactivity nor excessive defensive impairment.

  18. Association between Level of Emotional Intelligence and Severity of Anxiety in Generalized Social Phobia

    PubMed Central

    Jacobs, Madeline; Snow, Joseph; Geraci, Marilla; Vythilingam, Meena; Blair, R.J.R.; Charney, Dennis S.; Pine, Daniel S.; Blair, Karina S.

    2008-01-01

    Generalized Social Phobia (GSP) is characterized by a marked fear of most social situations. It is associated with an anomalous neural response to emotional stimuli, and individuals with the disorder frequently show interpretation bias in social situations. From this it might be suggested that GSP involves difficulty in accurately perceiving, using, understanding and managing emotions. Here we applied the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) to medication-free GSP (n=28) and no pathology (n=21) individuals. Patients with GSP performed within the normal range on the measure however severity of social anxiety significantly correlated with emotional intelligence (EI). Specifically, there was a negative correlation between social anxiety severity and Experiential (basic-level emotional processing) EI. In contrast, there was no significant correlation between social anxiety severity and Strategic (higher-level conscious emotional processing) EI. These results suggest that EI may index emotional processing systems that mitigate the impact of systems causally implicated in GSP. PMID:18439799

  19. Association between level of emotional intelligence and severity of anxiety in generalized social phobia.

    PubMed

    Jacobs, Madeline; Snow, Joseph; Geraci, Marilla; Vythilingam, Meena; Blair, R J R; Charney, Dennis S; Pine, Daniel S; Blair, Karina S

    2008-12-01

    Generalized social phobia (GSP) is characterized by a marked fear of most social situations. It is associated with an anomalous neural response to emotional stimuli, and individuals with the disorder frequently show interpretation bias in social situations. From this it might be suggested that GSP involves difficulty in accurately perceiving, using, understanding and managing emotions. Here we applied the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) to medication-free GSP (n=28) and no pathology (n=21) individuals. Patients with GSP performed within the normal range on the measure however severity of social anxiety significantly correlated with emotional intelligence (EI). Specifically, there was a negative correlation between social anxiety severity and Experiential (basic-level emotional processing) EI. In contrast, there was no significant correlation between social anxiety severity and Strategic (higher-level conscious emotional processing) EI. These results suggest that EI may index emotional processing systems that mitigate the impact of systems causally implicated in GSP.

  20. Psychometric properties of the Social Phobia and Anxiety Inventory for Children in a Spanish sample.

    PubMed

    Olivares, José; Sánchez-García, Raquel; López-Pina, José Antonio; Rosa-Alcázar, Ana Isabel

    2010-11-01

    The objectives of the present study were to adapt and analyze the factor structure, reliability, and validity of the Social Phobia and Anxiety Inventory for Children (SPAI-C; Beidel, Turner, & Morris, 1995) in a Spanish population. The SPAI-C was applied to a sample of 1588 children and adolescents with ages ranging from 10 to 17 years. The confirmatory factor analysis (CFA) showed a four-factor structure: Public performance, Assertiveness, Fear and avoidance/escape in social encounters, and Cognitive and psychophysiological interferences. Internal consistency was high (.90) and test-retest reliability was moderate (.56). Significant differences were found in the variables sex and age, although the effect size was small in both variables and their interaction. Overall, the increase of the age value was inversely proportional to that of social anxiety measured with the SPAI-C; in participants of the same age, values were higher for girls than for boys. Results suggest that the Social Phobia and Anxiety Inventory For Children is a valid and reliable instrument to assess social anxiety in Spanish children and adolescents.

  1. Definition of a VR-based protocol to treat social phobia.

    PubMed

    Roy, S; Klinger, E; Légeron, P; Lauer, F; Chemin, I; Nugues, P

    2003-08-01

    Social phobia is an anxiety disorder that is accessible to two forms of treatment yielding scientifically validated results: drugs and cognitive-behavioral therapies. Graded exposure to feared social situations is fundamental to obtain an improvement of the anxious symptoms. Traditionally, exposure therapies are done either in vivo or by imagining the situations. In vivo exposure is sometimes difficult to control and many patients have some difficulties in using imagination. Virtual reality (VR) seems to bring significant advantages. It allows exposures to numerous and varied situations. This paper reports the definition of a clinical protocol whose purpose is to assess the efficiency of a VR therapy compared to a CBT and to the absence of treatment for social phobic patients. It explains the illness' diagnosis and its usual treatments. It exposes all the architecture of the study, the assessment tools, the content and unfold of the therapy sessions. It finally reports first results of a clinical trial in a between-group design in 10 patients suffering from social phobia. The virtual environments used in the treatment reproduce four situations that social phobics feel the most threatening: performance, intimacy, scrutiny and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors with the aim of reducing her or his anxiety in the corresponding real situations. The novelty of our work is to address a group of situations that the phobic patient is most likely to experience and to treat patients according to a precise protocol.

  2. Shyness and social phobia in Israeli Jewish vs Arab students.

    PubMed

    Iancu, Iulian; Sarel, Amiram; Avital, Avi; Abdo, Basheer; Joubran, Samia; Ram, Edward

    2011-01-01

    Social anxiety disorder (SAD) has been repeatedly shown to be very prevalent in the Western society with prevalence rates of 10% or above. However, very few studies have been performed in the Middle East and in Arab countries. A total of 300 Israeli students participated in our study and were administered the Liebowitz Social Anxiety Scale (LSAS), the Cheek and Buss Shyness Questionnaire (CBSQ), and a sociodemographic questionnaire. A total of 153 Jewish and 147 Arab students participated in the survey. Social anxiety disorder was found in 12.33% of the sample, according to the LSAS cutoff score of more than 60. The 2 subsamples had similar LSAS and CBSQ scores and similar SAD-positive rates (LSAS >60). Females had higher scores on the LSAS, as were those without a spouse and those who had been in psychological treatment. Based on a regression analysis, the significant predictors of the LSAS score were the CBSQ score and female sex. A very high correlation was found between the LSAS and the CBSQ scores. Although our sample is not representative of the whole Israeli population, we conclude that SAD and shyness were similarly prevalent in Jewish and Arab students in Israel. Social anxiety disorder scores were higher among females, those without a spouse, and those who received psychological treatment. Further studies on the clinical and cultural characteristics of SAD in Israeli subcultures would add to the growing body of knowledge on SAD in various cultures. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Social Phobia: A Comparison of Behavior Therapy and Atenolol.

    ERIC Educational Resources Information Center

    Turner, Samuel M.; And Others

    1994-01-01

    Randomly assigned 72 social phobics to behavioral (flooding) or drug treatment with atenolol or placebo. Found that flooding consistently was superior to placebo, whereas atenolol was not. Flooding also was superior to atenolol on behavioral measures and composite indexes. Subjects who improved during treatment maintained gains at six-month…

  4. The impact of an 8-day intensive treatment for adolescent panic disorder and agoraphobia on comorbid diagnoses.

    PubMed

    Gallo, Kaitlin P; Chan, Priscilla T; Buzzella, Brian A; Whitton, Sarah W; Pincus, Donna B

    2012-03-01

    Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets.

  5. Self-Esteem, Social Phobia and Depression Status in Patients with Epilepsy

    PubMed Central

    KUTLU, Ayşe; GÖKÇE, Gökçen; BÜYÜKBURGAZ, Ülkü; SELEKLER, Macit; KOMŞUOğLU, Sezer

    2013-01-01

    Introduction The increased risk for psychiatric disorders in epilepsy can be related to a number of clinical, psychosocial and biological factors. Due to the unpredictability of seizures and the possibility that they may occur at any time and in any place, patients with epilepsy may develop social phobia and may have feelings of worthlessness and stigma. These factors decrease their psychosocial function, self-efficacy, and quality of life and even increase the suicide rate. Considering the above-mentioned scientific data, the present study was designed to investigate phobia, self-esteem and depression status in patients with epilepsy. Methods One hundred thirty-two patients (aged 21–52 years) and age- and gender-matched control group of 61 subjects (aged 25–60 years) were included in this study. All patients in both groups were administered the Liebowitz Social Anxiety Scale (LSAS), Coopersmith Self-Esteem Inventory (CSEI), and the Beck Depression Inventory (BDI). Results The mean ages of the patient group and the healthy controls were 29.66±11.3 and 32.16±7.99, respectively. There was no statistical significance between the two groups in terms of age and sex (p>0.05). BDI, LSAS and CSEI scores in the patient group were statistically significantly different than in the control group (p<0.05). Discussion Our results showed that social phobia, lower self-esteem and depression are important comorbid conditions in epileptic patients. Psychiatric disorders are usually underrecognized and undertreated in patients with epilepsy. Therefore, it is very important to identify and treat the psychiatric comorbid conditions in epilepsy because of their significant burden on patients’ quality of life.

  6. Relationship between social phobia and depression differs between boys and girls in mid-adolescence.

    PubMed

    Väänänen, Juha-Matti; Fröjd, Sari; Ranta, Klaus; Marttunen, Mauri; Helminen, Mika; Kaltiala-Heino, Riittakerttu

    2011-09-01

    Earlier studies suggest that social phobia (SP) and depression (DEP) often have their onset in adolescence, and are highly comorbid, with SP mainly preceding depression. There is a lack of population-based prospective studies among adolescents vulnerable to both disorders, taking into account possible gender differences in the relationship between the two. This study is part of a prospective Adolescent Mental Health Cohort (AMHC) study. Subjects are 9th grade pupils (mean age 15.5 years (sd 0.39)) responding to a survey conducted 2002-2003 (T1) and a 2-year follow-up 2004-2005 (T2) (N=2038). Social phobia was measured by the Social Phobia Inventory (SPIN) and depression by the 13-item Beck Depression Inventory (BDI-13). Risk for depression at T2 by SP at T1 was elevated only among boys (OR 3.6, 95% C.I. 1.507-8.579, p=0.004), whereas among girls, risk for SP at T2 by DEP at T1 was elevated (OR 7.8, 95% CI 4.529-13.391, p<0.001). The course of both disorders was unstable and recovery was common. Lack of diagnostic interviews and fairly high drop-out rate (36.9%) in follow-up. The relationship between SP and depression in adolescence seems different for boys and girls. Further studies are needed to explore factors explaining the different course of these disorders among boys and girls. Clinicians need to be alert to comorbidity when examining an adolescent with SP or depression. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Perception of Threat in Children with Social Phobia: Comparison to Nonsocially Anxious Children before and after Treatment

    ERIC Educational Resources Information Center

    Cederlund, Rio; Ost, Lars-Goran

    2011-01-01

    The present study investigated interpretation bias and reduced evidence for danger (RED) bias in 49 children with social phobia and 49 nonsocially anxious children between the ages of 8 and 14 years, using an ambiguous stories task. A posttreatment and follow-up measure was included for 26 of the socially phobic children to examine whether there…

  8. Negative Self-Imagery among Adolescents with Social Phobia: A Test of an Adult Model of the Disorder

    ERIC Educational Resources Information Center

    Alfano, Candice A.; Beidel, Deborah C.; Turner, Samuel M.

    2008-01-01

    Based on findings from the adult literature, this study examined the role of negative self-images (NSI) in social phobia during adolescence. NSI was manipulated among 21 nonphobic (IMAG) adolescents (M age = 14.05 years, SD = 1.56) during two social tasks. Self and observer-rated anxiety and performance as well as co-occurring cognition were…

  9. Perception of Threat in Children with Social Phobia: Comparison to Nonsocially Anxious Children before and after Treatment

    ERIC Educational Resources Information Center

    Cederlund, Rio; Ost, Lars-Goran

    2011-01-01

    The present study investigated interpretation bias and reduced evidence for danger (RED) bias in 49 children with social phobia and 49 nonsocially anxious children between the ages of 8 and 14 years, using an ambiguous stories task. A posttreatment and follow-up measure was included for 26 of the socially phobic children to examine whether there…

  10. Behavioral and psychophysiological characteristics of children of parents with social phobia: a pilot study.

    PubMed

    Campbell, Mira J; Schmidt, Louis A; Santesso, Diane L; Van Ameringen, Michael; Mancini, Catherine L; Oakman, Jonathan M

    2007-05-01

    Recent studies have noted a relation between the pattern of resting frontal EEG activity and individual differences in affective style in typically developing infants, children, and adults. The authors conducted a pilot study to investigate the pattern of frontal EEG activity during a resting condition (eyes-open, eyes-closed) in a group of children who had one parent clinically diagnosed with social phobia (SP; n = 6) and in a group of typically developing children of similar age with healthy parents (n = 7). Patients with a primary DSM-IV diagnosis of SP with at least one biological child were recruited from the Anxiety Disorders Clinic at McMaster University Medical Centre. We found that children of parents clinically diagnosed with SP tended to exhibit higher overall resting frontal EEG activity compared with the children of healthy parents. This pattern of overall high EEG activity that is specific to the frontal region is similar to that observed in socially anxious profiles. Preliminary findings are discussed in terms of how overall resting frontal brain activation may be an early psychophysiological marker for placing children of parents with social phobia at risk for socioemotional problems before such problems emerge.

  11. Mindfulness and the attenuation of post-event processing in social phobia: an experimental investigation.

    PubMed

    Cassin, Stephanie E; Rector, Neil A

    2011-01-01

    The present experimental study examined the ability of metacognitive strategies to reduce the distress associated with post-event processing (PEP). Individuals with DSM-IV generalized social phobia (N = 57) were randomly allocated to receive brief training in mindfulness, distraction, or no training (control group). Next, they underwent an experimental PEP induction. Following the induction, they were instructed to apply the metacognitive strategy (mindfulness or distraction) they were taught or to continue thinking about the social event the way they typically would following such an event (control). Participants rated their distress on a visual analogue scale prior to the PEP induction, and then every minute for 5 min while applying the metacognitive strategy. They also rated their affect immediately after applying the metacognitive strategy. Results suggest that mindfulness reduces distress significantly over the post-event period and results in significantly more positive affect than when receiving no training. In contrast, distraction does not reduce distress over the post-event period performs comparable to receiving no training. The results of this experimental investigation suggest that mindfulness has the potential to reduce distress associated with PEP and provide further support for the clinical utility of mindfulness in the treatment of generalized social phobia.

  12. Evaluation of children with selective mutism and social phobia: a comparison of psychological and psychophysiological arousal.

    PubMed

    Young, Brennan J; Bunnell, Brian E; Beidel, Deborah C

    2012-07-01

    Although children with social phobia (SP) and selective mutism (SM) present similarly in a clinical setting, it remains unclear whether children with SM are unable to speak due to overwhelming anxiety, or whether withholding speech functions as an avoidance mechanism. A total of 35 children (ages 5-12 years) with either SM (n = 10), SP (n = 11), or no diagnosis (n = 14) participated in the current study. Measurements included clinician, child, and parent ratings as well as behavioral observations and psychophysiological measures. Independent evaluators and clinicians rated children with SM as more severely impaired, more anxious, and less socially effective, but the groups did not differ in self- or parent-reported anxiety. Psychophysiological measures indicated that children in the SM group experienced less arousal than other children during social interaction tasks. The authors postulate that lack of speech may serve as an avoidance mechanism and thus account for this lack of arousal.

  13. Social phobia in Finnish general adolescent population: prevalence, comorbidity, individual and family correlates, and service use.

    PubMed

    Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Rantanen, Päivi; Marttunen, Mauri

    2009-01-01

    Few studies have investigated the epidemiology of social phobia (SP) among early to middle adolescents, at the time of suggested mean onset of the disorder. The objective of this study was to investigate the prevalence, comorbidity, individual and familial correlates, and service use associated with SP among Finnish 12-17-year-old adolescents in general population. A sample of 784 adolescents was screened with the Social Phobia Inventory, and a sub-sample (n=350) was interviewed with a semi-structured clinical interview to identify SP, sub-clinical SP (SSP), and a range of other axis I DSM-IV disorders. Individual and familial correlates, and service use associated with SP were also inquired. We found a 12-month prevalence of 3.2% for SP, and 4.6% for SSP. The prevalence rose and the gender ratio shifted to female preponderance as age increased. SP was frequently comorbid with other anxiety disorders (41%) and depressive disorders (41%). Adolescents with SP/SSP were impaired in their academic and global functioning, and reported more parental psychiatric treatment contacts. Two thirds (68%) of adolescents with SP reported having been bullied by peers. Only one fifth of adolescents with non-comorbid SP had been in contact with a mental health professional. We conclude that adolescent SP is a relatively frequent, undertreated and highly comorbid condition, associated with educational impairment, depression and anxiety in parents, and peer victimization. (c) 2009 Wiley-Liss, Inc.

  14. Effectiveness randomized controlled trial of face to face versus Internet cognitive behaviour therapy for social phobia.

    PubMed

    Andrews, Gavin; Davies, Matthew; Titov, Nickolai

    2011-04-01

    To compare the effectiveness of Internet cognitive behaviour therapy (CBT) with face-to-face CBT in social phobia. Randomized controlled trial of 75 patients with social phobia referred to an anxiety disorders clinic. A total of 37 patients participated, and post-treatment data was obtained from 25 Subjects (Ss). An intention to treat analysis was used. The same therapist (M.D.) treated both groups. Both groups made significant progress on symptoms and disability measures. There were no significant differences in outcome between the Internet and face-to-face groups. The total amount of therapist time required was 18 min per patient for the Internet group and 240 min per patient for the face-to-face group. Both forms of treatment were equally effective and this is consistent with previous findings in depression and panic disorder. The difference in clinician time required was substantial. If Internet CBT was offered as 'standard of care' the staff time saved would permit a stepped care model in which in-depth therapy for the difficult to recover patients could be provided without an increase in staff.

  15. An experimental investigation of the functional relationship between social phobia and cigarette smoking.

    PubMed

    Dahne, Jennifer; Hise, Leanne; Brenner, Misha; Lejuez, C W; MacPherson, Laura

    2015-04-01

    Individuals with social phobia (SP) represent a large group with elevated rates of cigarette smoking and cessation rates lower than that of individuals without psychopathology. For individuals with SP, cigarette smoking may be used to reduce social anxiety in anticipation of and during social situations. However, no study to date has experimentally examined this association. The aim of the current study was to experimentally examine the relationship between cigarette smoking and SP as a function of induced social stress. We recruited daily smokers ages 18-21 who scored in either a clinical or normative range on the Social Interaction Anxiety Scale (SIAS). Participants included 54 smokers (42.6% female, 77.8% White, age M(SD)=19.65(1.18), CPSD M(SD)=7.67(4.36), 46.30% high SP) who attended two sessions: one social stress session and one neutral session. Results indicated that high SP smokers experienced significant decreases in negative affect (NA) following smoking a cigarette when experiencing social stress. This effect was specific to high SP smokers under social stress and was not observed among individuals' average in SP or when examining changes in positive affect. For individuals with SP, cigarette smoking may be maintained due to changes in NA associated with smoking specifically in the context of social stress. These results speak to the importance of targeted cessation interventions that address the nature of smoking for individuals with SP. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Evaluation of the psychometric properties of two short forms of the social interaction anxiety scale and the social phobia scale.

    PubMed

    Le Blanc, Allura L; Bruce, Laura C; Heimberg, Richard G; Hope, Debra A; Blanco, Carlos; Schneier, Franklin R; Liebowitz, Michael R

    2014-06-01

    The Social Interaction Anxiety Scale and Social Phobia Scale are widely used measures of social anxiety. Using data from individuals with social anxiety disorder (n = 435) and nonanxious controls (n = 86), we assessed the psychometric properties of two independently developed short forms of these scales. Indices of convergent and discriminant validity, diagnostic specificity, sensitivity to treatment, and readability were examined. Comparisons of the two sets of short forms to each other and the original long forms were conducted. Both sets of scales demonstrated adequate internal consistency in the patient sample, showed expected patterns of correlation with measures of related and unrelated constructs, adequately discriminated individuals with social anxiety disorder from those without, and showed decreases in scores over the course of cognitive-behavioral therapy and/or pharmacotherapy. However, some significant differences in scale performance were noted. Implications for the clinical assessment of social anxiety are discussed.

  17. Personality functioning in patients with avoidant personality disorder and social phobia.

    PubMed

    Eikenaes, Ingeborg; Hummelen, Benjamin; Abrahamsen, Gun; Andrea, Helene; Wilberg, Theresa

    2013-12-01

    Avoidant personality disorder (APD) and social phobia (SP) are closely related, such that they are suggested to represent different severity levels of one social anxiety disorder. This cross-sectional study aimed to compare patients with APD to patients with SP, with particular focus on personality dysfunction. Ninety-one adult patients were examined by diagnostic interviews and self-report measures, including the Index of Self-Esteem and the Severity Indices of Personality Problems. Patients were categorized in three groups; SP without APD (n = 20), APD without SP (n = 15), and APD with SP (n = 56). Compared to patients with SP without APD, patients with APD reported more symptom disorders, psychosocial problems, criteria of personality disorders, and personality dysfunction regarding self-esteem, identity and relational problems. These results indicate that APD involves more severe and broader areas of personality dysfunction than SP, supporting the conceptualization of APD as a personality disorder as proposed for DSM-5.

  18. Social Phobia and Educational and Interpersonal Impairments in Adolescence: A Prospective Study.

    PubMed

    Ranta, Klaus; La Greca, Annette M; Kaltiala-Heino, Riittakerttu; Marttunen, Mauri

    2016-08-01

    We examined longitudinal associations between social phobia (SP) and educational and interpersonal impairments among Finnish adolescents. Participants were 3278 adolescents (9th grade; M age = 15.5 years) who completed measures of SP and depressive symptoms; 2070 participated in follow-up two years later. Indicators for educational and interpersonal functioning were assessed for each sex separately. Multivariate analyses, controlling for depression and relevant socioeconomic covariates, indicated that for boys, age 15 SP predicted slow academic progression, being without a close friend or not having a romantic relationship, and poor support from friends and significant others at age 17. However, for girls, age 15 SP only predicted not having been involved in a romantic relationship by age 17. In conclusion, we found striking sex differences for adolescent SP as a predictor for subsequent educational and interpersonal impairments in late adolescence. SP may have a more devastating effect on boys' social and academic functioning relative to that of girls.

  19. Social Phobia

    MedlinePlus

    ... could be partly due to the genes and temperament a person inherits. Inherited genetic traits from parents ... Likewise, some people are born with a shy temperament and tend to be cautious and sensitive in ...

  20. A New Model to Facilitate Individualized Case Conceptualization and Treatment of Social Phobia: An Examination and Reaction to Moscovitch's Model

    ERIC Educational Resources Information Center

    Heimberg, Richard G.

    2009-01-01

    Moscovitch's (2009) model of social phobia is put forth as an integration and extension of previous cognitive-behavioral models. The author asserts that his approach overcomes a number of shortcomings of previous models and will serve to better guide case conceptualization, treatment planning, and intervention implementation for clients with…

  1. Development of an Abbreviated Social Phobia and Anxiety Inventory (SPAI) Using Item Response Theory: The SPAI-23

    ERIC Educational Resources Information Center

    Roberson-Nay, Roxann; Strong, David R.; Nay, William T.; Beidel, Deborah C.; Turner, Samuel M.

    2007-01-01

    An abbreviated version of the Social Phobia and Anxiety Inventory (SPAI) was developed using methods based in nonparametric item response theory. Participants included a nonclinical sample of 1,482 undergraduates (52% female, mean age = 19.4 years) as well as a clinical sample of 105 individuals (56% female, mean age = 36.4 years) diagnosed with…

  2. An Open Study of Internet-Based Bibliotherapy with Minimal Therapist Contact via Email for Social Phobia

    ERIC Educational Resources Information Center

    Carlbring, Per; Furmark, Tomas; Steczko, Johan; Ekselius, Lisa; Andersson, Gerhard

    2006-01-01

    This study evaluated a 9-week Internet-based self-help program for people suffering from social phobia. After confirming the diagnosis with a structured clinical interview for the "DSM-IV" (SCID) by telephone, 26 participants were treated with a multimodal treatment package based on cognitive behavioural therapy plus weekly therapist…

  3. An Open Study of Internet-Based Bibliotherapy with Minimal Therapist Contact via Email for Social Phobia

    ERIC Educational Resources Information Center

    Carlbring, Per; Furmark, Tomas; Steczko, Johan; Ekselius, Lisa; Andersson, Gerhard

    2006-01-01

    This study evaluated a 9-week Internet-based self-help program for people suffering from social phobia. After confirming the diagnosis with a structured clinical interview for the "DSM-IV" (SCID) by telephone, 26 participants were treated with a multimodal treatment package based on cognitive behavioural therapy plus weekly therapist…

  4. Associations between Peer Victimization, Self-Reported Depression and Social Phobia among Adolescents: The Role of Comorbidity

    ERIC Educational Resources Information Center

    Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Pelkonen, Mirjami; Marttunen, Mauri

    2009-01-01

    Associations of peer victimization with adolescent depression and social phobia (SP), while controlling for comorbidity between them, have not been sufficiently explored in earlier research. A total of 3156 Finnish adolescents aged 15-16 years participated in a survey study. Self-reported peer victimization, as well as self-reported depression…

  5. Development of an Abbreviated Social Phobia and Anxiety Inventory (SPAI) Using Item Response Theory: The SPAI-23

    ERIC Educational Resources Information Center

    Roberson-Nay, Roxann; Strong, David R.; Nay, William T.; Beidel, Deborah C.; Turner, Samuel M.

    2007-01-01

    An abbreviated version of the Social Phobia and Anxiety Inventory (SPAI) was developed using methods based in nonparametric item response theory. Participants included a nonclinical sample of 1,482 undergraduates (52% female, mean age = 19.4 years) as well as a clinical sample of 105 individuals (56% female, mean age = 36.4 years) diagnosed with…

  6. Associations between Peer Victimization, Self-Reported Depression and Social Phobia among Adolescents: The Role of Comorbidity

    ERIC Educational Resources Information Center

    Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Pelkonen, Mirjami; Marttunen, Mauri

    2009-01-01

    Associations of peer victimization with adolescent depression and social phobia (SP), while controlling for comorbidity between them, have not been sufficiently explored in earlier research. A total of 3156 Finnish adolescents aged 15-16 years participated in a survey study. Self-reported peer victimization, as well as self-reported depression…

  7. A New Model to Facilitate Individualized Case Conceptualization and Treatment of Social Phobia: An Examination and Reaction to Moscovitch's Model

    ERIC Educational Resources Information Center

    Heimberg, Richard G.

    2009-01-01

    Moscovitch's (2009) model of social phobia is put forth as an integration and extension of previous cognitive-behavioral models. The author asserts that his approach overcomes a number of shortcomings of previous models and will serve to better guide case conceptualization, treatment planning, and intervention implementation for clients with…

  8. Panic disorder and agoraphobia: A direct comparison of their multivariate comorbidity patterns.

    PubMed

    Greene, Ashley L; Eaton, Nicholas R

    2016-01-15

    Scientific debate has long surrounded whether agoraphobia is a severe consequence of panic disorder or a frequently comorbid diagnosis. Multivariate comorbidity investigations typically treat these diagnoses as fungible in structural models, assuming both are manifestations of the fear-subfactor in the internalizing-externalizing model. No studies have directly compared these disorders' multivariate associations, which could clarify their conceptualization in classification and comorbidity research. In a nationally representative sample (N=43,093), we examined the multivariate comorbidity of panic disorder (1) without agoraphobia, (2) with agoraphobia, and (3) regardless of agoraphobia; and (4) agoraphobia without panic. We conducted exploratory and confirmatory factor analyses of these and 10 other lifetime DSM-IV diagnoses in a nationally representative sample (N=43,093). Differing bivariate and multivariate relations were found. Panic disorder without agoraphobia was largely a distress disorder, related to emotional disorders. Agoraphobia without panic was largely a fear disorder, related to phobias. When considered jointly, concomitant agoraphobia and panic was a fear disorder, and when panic was assessed without regard to agoraphobia (some individuals had agoraphobia while others did not) it was a mixed distress and fear disorder. Diagnoses were obtained from comprehensively trained lay interviewers, not clinicians and analyses used DSM-IV diagnoses (rather than DSM-5). These findings support the conceptualization of agoraphobia as a distinct diagnostic entity and the independent classification of both disorders in DSM-5, suggesting future multivariate comorbidity studies should not assume various panic/agoraphobia diagnoses are invariably fear disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Emptiness in agoraphobia patients.

    PubMed

    Milrod, Barbara

    2007-01-01

    In light of new research findings about the efficacy of psychodynamic treatment for panic disorder and agoraphobia, it seems a prudent time to carefully address psychoanalytic thinking about the treatment of agoraphobia. The literature has highlighted oedipal contributions to its genesis and clinical unraveling in psychoanalysis. While those contributions are indeed central to the disorder, structural deficits in the self-representation often become a central focus of treatment once symptomatic remission has been achieved in psychoanalytic treatment. This aspect of the clinical presentation of agoraphobia has not yet been specifically addressed in the psychiatric literature. Some aspects of the phenomenon have been described by psychoanalysts. It is more difficult to treat this "emptiness" than the overt symptoms of agoraphobia, as described in DSM-IV. Nonetheless, this phenomenon may be one of the contributors to the chronicity of the disorder. Two clinical cases illustrate these points.

  10. Agoraphobia: A Situational Analysis.

    ERIC Educational Resources Information Center

    Sinnott, Austin; And Others

    1981-01-01

    Agoraphobia patients answered a questionnaire describing anxiety-producing situations. Home environment was associated with supportive company. Situations requiring patients to venture out alone were most anxiety-producing. The overriding importance of a significant other suggests treatment implications. (JAC)

  11. Homicidal/violent thoughts, suicidal ideation and violent behavior in adolescents with social phobia in Metropolitan Lima, Perú.

    PubMed

    Vivar, Roxana; Morón, Giannina; Padilla, Martín; Alarcón, Renato D

    2014-09-01

    Social phobia and violent behavior are both important mental health problems among adolescent populations in different parts of the world. This study attempts to evaluate possible connections between social phobia, homicidal/violent thoughts, suicidal ideation, and subsequent violent behavior among adolescents living in the metropolitan area of Lima, Perú. A sample of 991 adolescents, part of the 2002 Epidemiological Study in Metropolitan Lima, conducted by the National Institute of Mental Health "Honorio Delgado-Hideyo Noguchi" (INSM "HD-HN") was studied. Social phobia was diagnosed on the basis of clinical assessment and the use of MINI, and suicidal ideation, homicidal/violent thoughts, and violent behavior were identified through the Mental Health Questionnaire. Odds ratio (OR) statistical analyses adjusted by logistic regression controlling for age and gender were performed. Variables associated with social phobia were homicidal thoughts in the last month (OR: 5.19, confidence interval [CI] at 95% 4.95-5.40), an impulse to hit known (OR: 1.56; 95% CI, 1.53-1.59) and unknown (OR: 3.98, 95% CI,3.89-4.07) persons, the wish to take revenge for a past offense (OR: 2.60, 95% CI 2.54-2.64), getting involved in fights with different kinds of weapons (OR: 1,78, 95% CI 1.70-1.87), suicidal ideation throughout lifetime (OR: 4.74, 95% CI 4.65-4.83), and life prevalence of suicidal attempt (OR: 5.39, 95% CI 5.23-5.55). Social phobia in adolescents of this Peruvian sample seems to be closely associated with both homicidal/violent thoughts, violent behavior, and suicidal ideation. © 2014 Wiley Publishing Asia Pty Ltd.

  12. Associations of social phobia and general anxiety with alcohol and drug use in a community sample of adolescents.

    PubMed

    Fröjd, Sari; Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Marttunen, Mauri

    2011-01-01

    This study explores whether associations between anxiety and alcohol and other substance use are already evident in middle adolescence, and whether general anxiety or symptoms of social phobia affect continuity of frequent alcohol use, frequent drunkenness and cannabis use. Data from the Adolescent Mental Health Cohort Study, a school-based Finnish survey among adolescents aged 15-16 years at baseline, was utilized to assess prevalence, incidence and continuity of symptoms of social phobia, general anxiety, frequent alcohol use, frequent drunkenness and cannabis use (which in this context was smoked 'hashish' of unknown constituency), and the associations between the substance use variables and the anxiety variables in 2-year follow-up. Anxiety preceded substance use while no reciprocal associations were observed. Depression mediated the associations between anxiety and substance use. Symptoms of social phobia did not elevate the incidence of substance use, but general anxiety did. Frequent drunkenness was less significantly associated with anxiety than the other two substance use variables. Co-morbid general anxiety increased the persistence of frequent alcohol use while co-morbid social phobia decreased its persistence. Continuity of frequent drunkenness and cannabis use were unaffected by co-morbid anxiety. General anxiety in middle adolescence places adolescents at risk for concurrent and subsequent substance use. The risk may, however, be associated with co-morbid depression. Social phobia in middle adolescence may protect from substance use. Adolescents with internalizing symptoms may need guidance in coping with the symptoms even if the symptoms do not fulfil the criteria of mood or anxiety disorder.

  13. Biased attention to threat in paediatric anxiety disorders (generalized anxiety disorder, social phobia, specific phobia, separation anxiety disorder) as a function of 'distress' versus 'fear' diagnostic categorization.

    PubMed

    Waters, A M; Bradley, B P; Mogg, K

    2014-02-01

    Structural models of emotional disorders propose that anxiety disorders can be classified into fear and distress disorders. Sources of evidence for this distinction come from genetic, self-report and neurophysiological data from adults. The present study examined whether this distinction relates to cognitive processes, indexed by attention bias towards threat, which is thought to cause and maintain anxiety disorders. Diagnostic and attention bias data were analysed from 435 children between 5 and 13 years of age; 158 had principal fear disorder (specific phobia, social phobia or separation anxiety disorder), 75 had principal distress disorder (generalized anxiety disorder, GAD) and 202 had no psychiatric disorder. Anxious children were a clinic-based treatment-seeking sample. Attention bias was assessed on a visual-probe task with angry, neutral and happy faces. Compared to healthy controls, children with principal distress disorder (GAD) showed a significant bias towards threat relative to neutral faces whereas children with principal fear disorder showed an attention bias away from threat relative to neutral faces. Overall, children displayed an attention bias towards happy faces, irrespective of diagnostic group. Our findings support the distinction between fear and distress disorders, and extend empirically derived structural models of emotional disorders to threat processing in childhood, when many anxiety disorders begin and predict lifetime impairment.

  14. Space phobia: syndrome or agoraphobic variant?

    PubMed

    Marks, I; Bebbington, P

    1976-08-07

    Four elderly women had intense fears of falling when there was no visible support at hand or on seeing space cues while driving. Two patients had cervical spondylosis. The mean age at onset of the fear was 54--thirty years later than that for agoraphobia. Fear of public places and of heights was not prominent, nor was depersonalisation or depression. These "space phobias" might be a hitherto unrecognised syndrome or an unusual variant of agoraphobia. The visuospatial reflexes involved might illuminate the pathogenesis of certain fears.

  15. Do parental psychopathology and unfavorable family environment predict the persistence of social phobia?

    PubMed

    Knappe, Susanne; Beesdo, Katja; Fehm, Lydia; Höfler, Michael; Lieb, Roselind; Wittchen, Hans-Ulrich

    2009-10-01

    Parental psychopathology and unfavorable family environment are established risk factors for onset of offspring social phobia (SP), but their associations with the further course, e.g., persistence of the disorder, remain understudied. A community cohort of 1395 adolescents and their parents was followed-up over almost 10 years using the DIA-X/M-CIDI. Parental diagnostic interviews were supplemented by family history data. Parental rearing was retrospectively assessed by the Questionnaire of Recalled Parental Rearing Behavior in offspring, and family functioning by the Family Assessment Device in parents. Persistence measures (proportion of years affected since onset) were derived from diagnostic interviews, using age of onset, age of recency, and course information. Lack of emotional warmth and dysfunctional family functioning characteristics were associated with higher SP persistence, particularly in interaction with parental psychopathology. Predictors for SP persistence differ from those predicting SP onset. Unfavorable family environment alone and in interaction with parental disorders predict higher SP persistence.

  16. A comparison of attentional biases and memory biases in women with social phobia and major depression.

    PubMed

    Rinck, Mike; Becker, Eni S

    2005-02-01

    Cognitive processes play an important role in the etiology and maintenance of anxiety and depression. Current theories differ, however, in their predictions regarding the occurrence of attentional biases and memory biases in depression and anxiety. To allow for a systematic comparison of disorders and cognitive processes, 117 women (35 with generalized social phobia, 27 with major depression, and 55 healthy controls) participated in a test of visual attention (visual search), an explicit memory test (free recall), and an implicit memory test (anagram solving). Both clinical groups exhibited attentional biases for disorder-related words, whereas only depressed participants showed clear evidence of explicit and implicit memory biases. The implications of these results for competing theories are discussed. Copyright (c) 2005 APA, all rights reserved.

  17. The Mini-Social Phobia Inventory: psychometric properties in an adolescent general population sample.

    PubMed

    Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Rantanen, Päivi; Marttunen, Mauri

    2012-07-01

    Onset of social phobia (SP) typically occurs in adolescence. Short screening instruments for its assessment are needed for use in primary health and school settings. The 3-item Mini-Social Phobia Inventory (SPIN) has demonstrated effectiveness in screening for generalized SP (GSP) in adults. This study examined the psychometrics of the Mini-SPIN in an adolescent general population sample. Three hundred fifty adolescents aged 12 to 17 years were clinically interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version for identification of SP and other Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I disorders, blind to their Mini-SPIN status. Associations between SP; subclinical SP; other anxiety, depressive, and disruptive disorders; and Mini-SPIN scores were examined, and diagnostic efficiency statistics were calculated. The association between Mini-SPIN scores and the generalized subtype of SP was also examined. As in adults, the Mini-SPIN items differentiated subjects with SP from those without. A score of 6 points or greater was found optimal in predicting SP with a sensitivity of 86%, specificity of 84%, and positive and negative predictive values of 26% and 99%. The Mini-SPIN also possessed discriminative validity, as scores were higher for adolescents with SP than they were for those with depressive, disruptive, and other anxiety disorders. The Mini-SPIN was also able to differentiate adolescents with GSP from the rest of the sample. The Mini-SPIN has good psychometrics for screening SP in adolescents from general population and may have value in screening for GSP. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Cognition, imagery and coping among adolescents with social anxiety and phobia: testing the Clark and Wells model in the population.

    PubMed

    Ranta, Klaus; Tuomisto, Martti T; Kaltiala-Heino, Riittakerttu; Rantanen, Päivi; Marttunen, Mauri

    2014-01-01

    The Clark and Wells' cognitive model of social phobia suggests that self-focused attention, negative observer-perspective images of oneself and safety behaviours maintain anxiety in subjects with SP. Empirical research among adults supports the model, but limited evidence for it has been obtained in other age groups or in the general population. We examined automatic thoughts, imagery, safety behaviours and general coping of adolescents with social anxiety and phobia. These were elicited by a thought listing procedure in a recalled, distressing social situation. The target variables were compared between adolescents with high versus normal self-reported social anxiety (HSA/NSA) and between adolescents with clinical/subclinical SP (SP/SSP) versus no diagnosis. Adolescents with HSA reported overall negative thoughts, negative observer-perspective images and safety behaviours more frequently than adolescents with NSA. The SP/SSP group displayed the same difference, and clearer, relative to the no diagnosis group, but additionally reported negative thoughts focused more often on self. Minor differences in coping were found between the groups. The study suggests that adolescents with SP already display the negative self-focused cognitions, observer-perspective imagery and behavioural pattern found among adults with SP. Social anxiety associates with observer-perspective imagery and safety behaviours in adolescence. Adolescents with clinical social phobia report frequent negative self-focused thoughts. However, such negative cognitions focused on self do not associate to self-reported social anxiety. The cognitive model of social phobia (Clark & Wells, 1995) is applicable to adolescents. Copyright © 2013 John Wiley & Sons, Ltd.

  19. Confirmatory Factor Analysis of the Combined Social Phobia Scale and Social Interaction Anxiety Scale: Support for a Bifactor Model

    PubMed Central

    Gomez, Rapson; Watson, Shaun D.

    2017-01-01

    For the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) together, this study examined support for a bifactor model, and also the internal consistency reliability and external validity of the factors in this model. Participants (N = 526) were adults from the general community who completed the SPS and SIAS. Confirmatory factor analysis (CFA) of their ratings indicated good support for the bifactor model. For this model, the loadings for all but six items were higher on the general factor than the specific factors. The three positively worded items had negligible loadings on the general factor. The general factor explained most of the common variance in the SPS and SIAS, and demonstrated good model-based internal consistency reliability (omega hierarchical) and a strong association with fear of negative evaluation and extraversion. The practical implications of the findings for the utilization of the SPS and SIAS, and the theoretical and clinical implications for social anxiety are discussed. PMID:28210232

  20. Psychometric properties of the social phobia and social interaction anxiety scales: evidence of construct equivalence in an African American sample.

    PubMed

    Carter, Michele M; Sbrocco, Tracy; Tang, Dickson; Rekrut, Frances M; Condit, Caitlin

    2014-10-01

    This study evaluated the psychometric properties of the Social Phobia Scale and Social Interaction Anxiety scale in a community sample of African Americans. We conducted a confirmatory factor analysis of the combined scales comparing the data to 2- and 3-factor solutions commonly reported in the literature. The results indicated that neither solution produce an adequate fit to the data in this study. We then proceeded to conduct an exploratory factor analysis within a confirmatory framework of both scales. While we were able to extract a 2-factor solution from the data, the item composition of the factors was somewhat different for African Americans than what is typically reported in non-Hispanic White samples. While we conclude that use of the two social anxiety scales is warranted, we make recommendations regarding the interpretation of both scales with African Americans. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Confirmatory Factor Analysis of the Combined Social Phobia Scale and Social Interaction Anxiety Scale: Support for a Bifactor Model.

    PubMed

    Gomez, Rapson; Watson, Shaun D

    2017-01-01

    For the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) together, this study examined support for a bifactor model, and also the internal consistency reliability and external validity of the factors in this model. Participants (N = 526) were adults from the general community who completed the SPS and SIAS. Confirmatory factor analysis (CFA) of their ratings indicated good support for the bifactor model. For this model, the loadings for all but six items were higher on the general factor than the specific factors. The three positively worded items had negligible loadings on the general factor. The general factor explained most of the common variance in the SPS and SIAS, and demonstrated good model-based internal consistency reliability (omega hierarchical) and a strong association with fear of negative evaluation and extraversion. The practical implications of the findings for the utilization of the SPS and SIAS, and the theoretical and clinical implications for social anxiety are discussed.

  2. Children with social phobia have lower quality friendships than children with other anxiety disorders.

    PubMed

    Baker, J R; Hudson, J L

    2015-01-01

    Whilst shy, socially anxious or socially withdrawn children in nonclinical community samples report lower friendship quality (FQ) than nonanxious children, no study has examined the FQ of clinically anxious children. The aim of the study was to examine the FQ of children with anxiety disorders; and whether it differs for clinical children with or without a diagnosis of social phobia (SP). The study design was cross-sectional self-report. Clinical children - 39 anxiety-disordered children with SP and 28 anxiety-disordered children without SP (No-SP) - presented for psychological treatment, and 29 nonclinical children were recruited from the community. Same-sex close friends were invited to participate using an unrestricted nomination procedure. All children were aged between 7 and 13 years. Both target child and friend completed the Friendship Quality Questionnaire and the Spence Children's Anxiety Scale. Using multilevel modeling within the framework of the Actor-Partner Interdependence Model, SP dyads were found to report lower overall FQ than No-SP dyads. SP dyads did not report lower overall FQ than nonclinical dyads. Children with SP in their diagnostic profile may be unique in their friendship experiences relative to children with other anxiety disorders.

  3. The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia?

    PubMed

    Rudaz, Myriam; Ledermann, Thomas; Margraf, Jürgen; Becker, Eni S; Craske, Michelle G

    2017-01-01

    Theories of anxiety disorders and phobias have ascribed a critical role to avoidance behavior in explaining the persistence of fear and anxiety, but knowledge about the role of avoidance behavior in the maintenance of anxiety in social anxiety disorder relative to specific phobia is lacking. This study examined the extent to which avoidance behavior moderates the relationship between general anxiety at baseline and 18 months later in women with a diagnosed social anxiety disorder (n = 91) and women with a diagnosed specific phobia (n = 130) at baseline. Circumscribed avoidance of social and specific situations were clinician-rated using the Anxiety Disorders Interview Schedule-Lifetime (ADIS-IV-L), and general anxiety was measured using the Beck Anxiety Inventory (BAI). Moderated regression analyses revealed that (a) general anxiety at baseline predicted general anxiety at follow-up in both women with a specific phobia and women with a social anxiety disorder and (b) avoidance behavior moderated this relationship in women with a specific phobia but not in women with a social anxiety disorder. Specifically, high avoidance behavior was found to amplify the effect between general anxiety at baseline and follow-up in specific phobia. Reasons for the absence of a similar moderating effect of avoidance behavior within social anxiety disorder are discussed.

  4. The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia?

    PubMed Central

    Rudaz, Myriam; Ledermann, Thomas; Margraf, Jürgen; Becker, Eni S.; Craske, Michelle G.

    2017-01-01

    Theories of anxiety disorders and phobias have ascribed a critical role to avoidance behavior in explaining the persistence of fear and anxiety, but knowledge about the role of avoidance behavior in the maintenance of anxiety in social anxiety disorder relative to specific phobia is lacking. This study examined the extent to which avoidance behavior moderates the relationship between general anxiety at baseline and 18 months later in women with a diagnosed social anxiety disorder (n = 91) and women with a diagnosed specific phobia (n = 130) at baseline. Circumscribed avoidance of social and specific situations were clinician-rated using the Anxiety Disorders Interview Schedule-Lifetime (ADIS-IV-L), and general anxiety was measured using the Beck Anxiety Inventory (BAI). Moderated regression analyses revealed that (a) general anxiety at baseline predicted general anxiety at follow-up in both women with a specific phobia and women with a social anxiety disorder and (b) avoidance behavior moderated this relationship in women with a specific phobia but not in women with a social anxiety disorder. Specifically, high avoidance behavior was found to amplify the effect between general anxiety at baseline and follow-up in specific phobia. Reasons for the absence of a similar moderating effect of avoidance behavior within social anxiety disorder are discussed. PMID:28671977

  5. Social phobia among long-term internally displaced persons: An epidemiological study of adults in two internally displaced person settlements in Sudan.

    PubMed

    Salah, Tarig Taha Mohamed; Ayazi, Touraj; Lien, Lars; Eide, Arne; Hauff, Edvard

    2015-09-01

    Despite the high worldwide prevalence and association with other mental disorders and disability, only few studies are available on social phobia in low-income countries. This study aims to assess the prevalence, socio-demographic correlates and comorbidity of social phobia and its association with disability among long-term internally displaced persons (IDPs) in one urban and one rural area in Central Sudan. This cross-sectional study was implemented in two IDP areas in Central Sudan. Data were collected during face-to-face interviews using structured questionnaires to assess socio-demographic factors and the Mini International Neuropsychiatric Interview (MINI) to determine psychiatric diagnoses. A total of 1,876 adults were enrolled from both study areas. The overall lifetime prevalence of social phobia was 14.2%, with higher rates among IDPs in the rural area and among those who were less educated. Social phobia was associated with other mental disorders in both study areas. Disability and prolonged displacement increased the risk of having social phobia in the rural area. Further work needs to be done to improve our understanding and to establish proper interventions in dealing with social phobia, other common mental disorders and disability among long-term IDPs in these impoverished areas. © The Author(s) 2014.

  6. Intensive group-based CBT for child social phobia: a pilot study.

    PubMed

    Donovan, Caroline L; Cobham, Vanessa; Waters, Allison M; Occhipinti, Stefano

    2015-05-01

    Although CBT has proven efficacious in the treatment of child social phobia (SP), most children do not present for treatment and child SP may be less responsive to treatment than other anxiety disorders. Intensive, group-based, SP-specific CBT may improve the efficacy of, and access to, treatment for child SP. The aim of this study was to provide a preliminary examination of such a program. Forty Australian children aged 7-12 years (15 male and 25 female) were allocated into treatment and waitlist groups. Clinical interviews to determine diagnostic status were conducted prior to treatment, following treatment and at 6-month follow-up. Parent and child questionnaire measures of child anxiety symptoms, internalizing symptoms, depression, social skills, social competence, and parental social anxiety were administered at the same time points. Treatment was delivered in 4 separate 3-hour sessions conducted over 3 consecutive weekends. At postassessment, 52.4% of children in the treatment group and 15.8% of children in the waitlist group were free of their SP diagnosis. At postassessment, compared to waitlist children, treatment group children demonstrated a greater drop in clinical severity, a greater increase in overall functioning, and held fewer clinical diagnoses. Treatment group children also reported a greater reduction in SP symptoms compared to waitlist children, and treatment group parents reported a greater reduction in child internalizing and anxiety symptoms, a greater increase in child social competence, and a greater decrease in parental SP symptoms, compared to parents of children in the waitlist group. By 6-month follow-up, 76.9% of the treatment group were free of their SP diagnosis and gains on all other measures were maintained. The results of this study are encouraging, and suggest that brief, intensive, group CBT for children with social anxiety is beneficial for many youngsters. Copyright © 2014. Published by Elsevier Ltd.

  7. Attachment styles in patients with avoidant personality disorder compared with social phobia.

    PubMed

    Eikenaes, Ingeborg; Pedersen, Geir; Wilberg, Theresa

    2016-09-01

    Avoidant personality disorder (AvPD) and social phobia (SP) are common, closely related conditions. Little is known about the underlying processes related to the social discomfort of subjects with AvPD and SP. Both disorders are associated with interpersonal problems. An attachment perspective may shed light on similarities and differences in close relationships between the disorders. The aim of the study was to compare self-reported attachment styles in patients with AvPD and SP. We expected that patients with AvPD would have more attachment anxiety and avoidance and more often a Fearful attachment style, compared with SP. This is a cross-sectional multisite study of 90 adult patients with AvPD and SP. Patients with AvPD with and without SP (AvPD group) were compared with patients with SP without AvPD (SP group). Patients were assessed using structured diagnostic interviews and self-reporting questionnaires, including Experiences in Close Relationships (ECR). The ECR dimensions, Anxiety and Avoidance, and the new described five factors of the ECR were used. The AvPD group had higher levels of attachment anxiety than the SP group, especially for the sub-factors Anxiety for abandonment and Separation frustration. The diagnostic groups did not differ in levels of avoidance. Anxiety for abandonment was still associated with AvPD after controlling for symptom disorders and the criteria of other personality disorders. A Fearful attachment style was more frequent among patients with AvPD. The results indicate AvPD is associated with more attachment anxiety than SP. Fear of abandonment may play a significant role in the AvPD pathology. This is the first study to compare attachment styles in patients with avoidant personality disorder (AvPD) and social phobia (SP). The AvPD group had higher attachment-related anxiety than the SP group, and anxiety was most pronounced for the fear of abandonment. Fear of abandonment may play an important role in the AvPD pathology.

  8. Controlled-release fluvoxamine in obsessive-compulsive disorder and social phobia.

    PubMed

    Owen, Richard T

    2008-12-01

    Specific serotonin reuptake inhibitors are currently recommended as first-line treatments for obsessive-compulsive disorder (OCD) and social phobia or social anxiety disorder (SAD). Fluvoxamine has demonstrated efficacy in both these conditions and has recently been marketed in a controlled-release (CR) formulation in the United States for treatement of OCD and SAD. Three 12-week double-blind, multicenter, randomized, placebo-controlled studies were conducted with this formulation - two in SAD and one in OCD. All three studies showed a robust effect on the key symptoms of OCD and SAD and had broadly comparable efficacy to studies conducted with immediate-release (IR) fluvoxamine. The beneficial effects of fluvoxamine CR were maintained in a 12-week double-blind, randomized extension to one SAD trial. The CR formulation, when compared to its IR counterpart, offers less daily fluctuation in fluvoxamine levels and a more rapid titration schedule; in addition, a more rapid onset of effect may result from these features. Overall, the benefits of the CR formulation, among them the convenience of oncedaily dosing, were achieved without an increased adverse event burden versus the IR form.

  9. Comparison of automatical thoughts among generalized anxiety disorder, major depressive disorder and generalized social phobia patients.

    PubMed

    Gül, A I; Simsek, G; Karaaslan, Ö; Inanir, S

    2015-08-01

    Automatic thoughts are measurable cognitive markers of the psychopathology and coping styles of individuals. This study measured and compared the automatic thoughts of patients with generalized anxiety disorder (GAD), major depressive disorder (MDD), and generalized social phobia (GSP). Fifty-two patients with GAD, 53 with MDD, and 50 with GSP and 52 healthy controls completed the validated Automatic Thoughts Questionnaire (ATQ) and a structured psychiatric interview. Patients with GAD, MDD, and GSP also completed the validated Generalized Anxiety Disorder-7 questionnaire, the Beck Depression Inventory (BDI), and the Liebowitz Social Anxiety Scale (LSAS) to determine the severity of their illnesses. All scales were completed before treatment and after diagnosis. The ATQ scores of all pairs of groups were compared. The ATQ scores of the GAD, MDD, and GSP groups were significantly higher than were those of the control group. We also found significant correlations among scores on the GAD-7, BDI, and LSAS. The mean age of patients with GSP was lower than was that of the other groups (30.90 ± 8.35). The significantly higher ATQ scores of the MDD, GAD, and GSP groups, compared with the control group, underscore the common cognitive psychopathology characterizing these three disorders. This finding confirms that similar cognitive therapy approaches should be effective for these patients. This study is the first to compare GAD, MDD, and GSP from a cognitive perspective.

  10. Atypical modulation of medial prefrontal cortex to self-referential comments in generalized social phobia.

    PubMed

    Blair, Karina S; Geraci, Marilla; Otero, Marcela; Majestic, Catherine; Odenheimer, Stephanie; Jacobs, Madeline; Blair, R J R; Pine, Daniel S

    2011-07-30

    Generalized social phobia (GSP) involves the fear of being negatively evaluated. Previous work suggests that self-referentiality, mediated by the medial prefrontal cortex (MFPC), plays an important role in the disorder. However, it is not clear whether this anomalous MPFC response to self-related information in patients with GSP concerns an increased representation of their own or others' opinions. In this article, we examine whether GSP is associated with increased response to own (1st person) or other individuals' (2nd person) opinions relative to healthy individuals. Unmedicated individuals with GSP (n=15) and age-, IQ-, and gender-matched comparison individuals (n=15) read 1st (e.g., I'm ugly), and 2nd (e.g., You're ugly) person viewpoint comments during functional magnetic resonance imaging. We observed significant group-by-viewpoint interactions within the ventral MPFC. Whereas the healthy comparison individuals showed significantly increased (or less decreased) BOLD responses to 1st relative to 2nd person viewpoints, the patients showed significantly increased responses to 2nd relative to 1st person viewpoints. The reduced BOLD responses to 1st person viewpoint comments shown by the patients correlated significantly with severity of social anxiety symptom severity. These results underscore the importance of dysfunctional self-referential processing and MPFC in GSP. We believe that these data reflect a reorganization of self-referential reasoning in the disorder with a self-concept perhaps atypically related to the view of others.

  11. Autonomic markers associated with generalized social phobia symptoms: heart rate variability and salivary alpha-amylase.

    PubMed

    García-Rubio, María J; Espín, Laura; Hidalgo, Vanesa; Salvador, Alicia; Gómez-Amor, Jesús

    2017-01-01

    The study of autonomic nervous system changes associated with generalized social phobia (GSP) disorder has increased in recent years, showing contradictory results. The present study aimed to evaluate how young people with GSP reacted before, during, and after exposure to the Trier Stress Social Test (TSST), focusing on their autonomic changes (heart rate variability (HRV) and salivary alpha-amylase (sAA)) compared to a control group (non-GSP). Some psychological variables were also considered. Sex was specifically studied as a possible modulator of autonomic fluctuations and psychological state. Eighty young people were randomly distributed into two counterbalanced situations: stress condition (N = 18 and 21 for GSP and non-GSP, respectively) and control condition (N = 21 and 20 for GSP and non-GSP, respectively), where cardiovascular variables were continuously recorded. Psychological questionnaires about mood and perceived stress were filled out, and five saliva samples were collected to analyze sAA. GSP participants showed higher values on low- and high-frequency ratios (HR domains), compared to non-GSP people, during exposure to the TSST, but no differences were observed after the stressor. Furthermore, the two groups did not differ in sAA. Importantly, positive affect in GSP participants was modulated by sex. The present study suggests that the balance between high- and low-frequency domains of HRV is a key cardiovascular marker reflecting the stress response of GSP people, as well the importance of sex in positive affect when facing a stressful situation.

  12. Methylphenidate treatment in children with attention deficit hyperactivity disorder and comorbid social phobia.

    PubMed

    Golubchik, Pavel; Sever, Jonathan; Weizman, Abraham

    2014-07-01

    The aim of this study was to assess the response of social phobia (SP) symptoms to methylphenidate (MPH) treatment in children with attention deficit hyperactivity disorder (ADHD). Twenty-one ADHD patients with SP, aged between 8 and 18 years, received 12 weeks of MPH treatment. The severity of SP symptoms were assessed by the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA), and the severity of ADHD symptoms was assessed by the ADHD Rating Scale at baseline and at endpoint. MPH treatment was associated with a significant decrease in the ADHD Rating Scale scores (P<0.0001) and in the total LSAS-CA scores (P=0.013), as well as the school-related items of LSAS-CA (P=0.011). A significant correlation was found between the reductions in ADHD score and total LSAS-CA score (P=0.038), especially in school-related SP. The improvement in ADHD symptoms because of MPH treatment correlates with a parallel improvement in SP. MPH treatment appears to be safe and effective in ADHD/SP children.

  13. Avoidant personality disorder versus social phobia: the significance of childhood neglect.

    PubMed

    Eikenaes, Ingeborg; Egeland, Jens; Hummelen, Benjamin; Wilberg, Theresa

    2015-01-01

    Avoidant personality disorder (AvPD) and social phobia (SP) are common disorders both in the community and in clinical settings. Whether the two disorders represent different severity levels of social anxiety disorder is currently in dispute. The relationship between AvPD and SP is probably more complex than previously assumed. Several environmental, temperamental, and constitutional factors may play a role in the etiology of AvPD and SP. Better knowledge about childhood experiences may shed light on similarities and differences between the two disorders. The aim of this study was to compare self-reported childhood experiences in AvPD and SP patients. This is a cross-sectional multi-site study of 91 adult patients with AvPD and/ or SP. We compared patients with AvPD with and without SP (AvPD group) to patients with SP without AvPD (SP group). The patients were examined using structured diagnostic interviews and self-report measures, including Child Trauma Questionnaire, Parental Bonding Instrument, and Adult Temperament Questionnaire. Both AvPD and SP were associated with negative childhood experiences. AvPD patients reported more severe childhood neglect than patients with SP, most pronounced for physical neglect. The difference between the disorders in neglect remained significant after controlling for temperamental factors and concurrent abuse. The study indicates that childhood neglect is a risk factor for AvPD and may be one contributing factor to phenomenological differences between AvPD and SP.

  14. D-cycloserine does not improve but might slightly speed up the outcome of in-vivo exposure therapy in patients with severe agoraphobia and panic disorder in a randomized double blind clinical trial.

    PubMed

    Siegmund, Anja; Golfels, Fabian; Finck, Claudia; Halisch, Anna; Räth, Daniela; Plag, Jens; Ströhle, Andreas

    2011-08-01

    D-cycloserine (DCS)-augmented exposure therapy has proven efficacy in the treatment of acrophobia, social phobia, panic disorder and OCD. Here we studied whether DCS can also improve the effect of cognitive behavioral therapy (CBT) in patients with agoraphobia and panic disorder. To this end, 39 patients with the diagnoses of agoraphobia and panic disorder were treated with 11 sessions of CBT including three individual in-vivo exposure sessions (flooding), augmented with either 50mg of DCS (N=20) or placebo (N=19) in a randomized double blind design. Primary outcome was the total score of the panic and agoraphobia scale. Both groups profited considerably from therapy and DCS did not significantly improve this outcome (p=0.475; η(2)p = 0.01). However, there was a statistical trend (p=0.075; η(2)p = 0.17) in the more severely ill patients that DCS accelerated symptom reduction in the primary outcome at post-therapy. No serious adverse effects occurred during the trial. We conclude that in patients with agoraphobia and panic disorder, DCS seems to lack an additional benefit to efficient cbt, probably due to a floor effect. Nonetheless, the acceleration of symptom reduction in severely ill patients might represent a valuable treatment option deserving further investigation.

  15. Gender differences in the effects of family adversity on the risk of onset of DSM-III-R social phobia.

    PubMed

    DeWit, David J; Chandler-Coutts, Michelle; Offord, David R; King, Gillian; McDougall, Janette; Specht, Jacqueline; Stewart, Shannon

    2005-01-01

    Utilizing a random probability sample of Canadian residents aged 15-64 (n = 8116), this study assessed gender differences in the onset of social phobia and the moderating influence of gender on indicators of childhood family adversity hypothesized to increase the risk of developing the disorder. Results revealed statistically significant "gender by family adversity" interactions that varied by disorder sub-type. Among males, absence of a parent or other adult close confidant during childhood was associated with an elevated risk of developing social phobia (all diagnosed cases and the non-generalized sub-type). Risk factors unique to females included parental conflict while growing up (all diagnosed cases), childhood physical abuse by a father figure (generalized sub-type), and maternal mania (non-generalized sub-type). Results highlight the importance of distinguishing between social phobia sub-types in gender-based research as well as the use of family adversity measures that capture the parenting behaviors and mental health status of both parents.

  16. Learning to change a way of being: An interpretative phenomenological perspective on cognitive therapy for social phobia

    PubMed Central

    McManus, Freda; Peerbhoy, Dawn; Larkin, Michael; Clark, David M.

    2010-01-01

    Social phobia (SP) is a common and disabling condition for which cognitive-behavioral treatments (CBT) have demonstrated efficacy. However, there remains room for improvement. Hence, further exploration of the means by which CBT helps patients with SP is warranted. Studies examining patients’ perspectives on which aspects of treatment were most or least helpful may augment other established methodologies for identifying the more or less effective components and thus help to increase the efficacy and cost-effectiveness of CBT for SP. The current study used interpretive phenomenological analysis to analyze the transcripts of interviews with eight patients who had completed cognitive therapy (CT) for SP. Four related themes were identified: (i) social phobia as a way of being; (ii) learning to challenge social phobia as a way of being: transformative mechanisms of therapy; (iii) challenges faced in the pursuit of change; (iv) a whole new world: new ways of being. This analysis of patients’ experiences of CT for SP confirmed that the factors hypothesized to be important in maintaining SP in cognitive-behavioral models of the disorder are evident in patients’ descriptions of the processes of change in CT for SP (e.g., reducing internal focus of attention and reducing safety behaviors and avoidance). Helpful components of CT for SP were identified as areas where the protocol could be enhanced. Recommendations for the way in which CT for SP is implemented are made. PMID:20413253

  17. The comorbid psychiatric symptoms of Internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility.

    PubMed

    Yen, Ju-Yu; Ko, Chih-Hung; Yen, Cheng-Fang; Wu, Hsiu-Yueh; Yang, Ming-Jen

    2007-07-01

    To: (1) determine the association between Internet addiction and depression, self-reported symptoms of attention deficit and hyperactivity disorder (ADHD), social phobia, and hostility for adolescents; and (2) evaluate the sex differences of association between Internet addiction and the above-mentioned psychiatric symptoms among adolescents. A total of 2114 students (1204 male and 910 female) were recruited for the study. Internet addiction, symptoms of ADHD, depression, social phobia, and hostility were evaluated by the self-report questionnaire. The results demonstrated that adolescents with Internet addiction had higher ADHD symptoms, depression, social phobia, and hostility. Higher ADHD symptoms, depression, and hostility are associated with Internet addiction in male adolescents, and only higher ADHD symptoms and depression are associated with Internet addiction in female students. These results suggest that Internet addiction is associated with symptoms of ADHD and depressive disorders. However, hostility was associated with Internet addiction only in males. Effective evaluation of, and treatment for ADHD and depressive disorders are required for adolescents with Internet addiction. More attention should be paid to male adolescents with high hostility in intervention of Internet addiction.

  18. Of 'disgrace' and 'pain'--corticolimbic interaction patterns for disorder-relevant and emotional words in social phobia.

    PubMed

    Laeger, Inga; Dobel, Christian; Radenz, Britta; Kugel, Harald; Keuper, Kati; Eden, Annuschka; Arolt, Volker; Zwitserlood, Pienie; Dannlowski, Udo; Zwanzger, Peter

    2014-01-01

    Limbic hyperactivation and an impaired functional interplay between the amygdala and the prefrontal cortex are discussed to go along with, or even cause, pathological anxiety. Within the multi-faceted group of anxiety disorders, the highly prevalent social phobia (SP) is characterized by excessive fear of being negatively evaluated. Although there is widespread evidence for amygdala hypersensitivity to emotional faces in SP, verbal material has rarely been used in imaging studies, in particular with an eye on disorder-specificity. Using functional magnetic resonance imaging (fMRI) and a block design consisting of (1) overall negative, (2) social-phobia related, (3) positive, and (4) neutral words, we studied 25 female patients with social phobia and 25 healthy female control subjects (HC). Results demonstrated amygdala hyperactivation to disorder-relevant but not to generally negative words in SP patients, with a positive correlation to symptom severity. A functional connectivity analysis revealed a weaker coupling between the amygdala and the left middle frontal gyrus in patients. Symptom severity was negatively related to connectivity strength between the amygdala and the ventromedial prefrontal and orbitofrontal cortex (Brodmann Area 10 and 11). The findings clearly support the view of a hypersensitive threat-detection system, combined with disorder-related alterations in amygdala-prefrontal cortex connectivity in pathological anxiety.

  19. Factor solutions of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) in a Swedish population.

    PubMed

    Mörtberg, Ewa; Reuterskiöld, Lena; Tillfors, Maria; Furmark, Tomas; Öst, Lars-Göran

    2017-06-01

    Culturally validated rating scales for social anxiety disorder (SAD) are of significant importance when screening for the disorder, as well as for evaluating treatment efficacy. This study examined construct validity and additional psychometric properties of two commonly used scales, the Social Phobia Scale and the Social Interaction Anxiety Scale, in a clinical SAD population (n = 180) and in a normal population (n = 614) in Sweden. Confirmatory factor analyses of previously reported factor solutions were tested but did not reveal acceptable fit. Exploratory factor analyses (EFA) of the joint structure of the scales in the total population yielded a two-factor model (performance anxiety and social interaction anxiety), whereas EFA in the clinical sample revealed a three-factor solution, a social interaction anxiety factor and two performance anxiety factors. The SPS and SIAS showed good to excellent internal consistency, and discriminated well between patients with SAD and a normal population sample. Both scales showed good convergent validity with an established measure of SAD, whereas the discriminant validity of symptoms of social anxiety and depression could not be confirmed. The optimal cut-off score for SPS and SIAS were 18 and 22 points, respectively. It is concluded that the factor structure and the additional psychometric properties of SPS and SIAS support the use of the scales for assessment in a Swedish population.

  20. Untangling genetic networks of panic, phobia, fear and anxiety

    PubMed Central

    Villafuerte, Sandra; Burmeister, Margit

    2003-01-01

    As is the case for normal individual variation in anxiety levels, the conditions panic disorder, agoraphobia and other phobias have a significant genetic basis. Recent reports have started to untangle the genetic relationships between predispositions to anxiety and anxiety disorders. PMID:12914652

  1. Altered emotion regulation capacity in social phobia as a function of comorbidity.

    PubMed

    Burklund, Lisa J; Craske, Michelle G; Taylor, Shelley E; Lieberman, Matthew D

    2015-02-01

    Social phobia (SP) has been associated with amygdala hyperreactivity to fear-relevant stimuli. However, little is known about the neural basis of SP individuals' capacity to downregulate their responses to such stimuli and how such regulation varies as a function of comorbid depression and anxiety. We completed an functional magnetic resonance imaging (fMRI) study wherein SP participants without comorbidity (n = 30), with comorbid depression (n = 18) and with comorbid anxiety (n = 19) and healthy controls (n = 15) were scanned while completing an affect labeling emotion regulation task. Individuals with SP as a whole exhibited a reversal of the pattern observed in healthy controls in that they showed upregulation of amygdala activity during affect labeling. However, subsequent analyses revealed a more complex picture based on comorbidity type. Although none of the SP subgroups showed the normative pattern of amygdala downregulation, it was those with comorbid depression specifically who showed significant upregulation. Effects could not be attributed to differences in task performance, amygdala reactivity or right ventral lateral prefrontal cortex (RVLPFC) engagement, but may stem from dysfunctional communication between amygdala and RVLPFC. Furthermore, the particularly altered emotion regulation seen in those with comorbid depression could not be fully explained by symptom severity or state anxiety. Results reveal altered emotion regulation in SP, especially when comorbid with depression. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  2. The association between online gaming, social phobia, and depression: an internet survey

    PubMed Central

    2012-01-01

    Background Online gaming technology has developed rapidly within the past decade, and its related problems have received increasing attention. However, there are few studies on the psychiatric symptoms associated with excessive use of online games. The aim of this study is to investigate the characteristics of online gamers, and the association between online gaming hours, social phobia, and depression using an internet survey. Methods An online questionnaire was designed and posted on a popular online game websites, inviting the online gamers to participate the survey. The content of the questionnaire included demographic data, profiles of internet usage and online gaming, and self-rating scales of Depression and Somatic Symptoms Scale (DSSS), Social Phobia Inventory (SPIN), and Chen Internet Addiction Scale (CIAS). Results A total of 722 online gamers with a mean age of 21.8 ± 4.9 years completed the online survey within one month. 601 (83.2%) participants were male, and 121 (16.8%) were female. The mean weekly online gaming time was 28.2 ± 19.7 hours, which positively associated with history of online gaming (r = 0.245, p < 0.001), total DSSS (r = 0.210, p < 0.001), SPIN (r = 0.150, p < 0.001), and CIAS (r = 0.290, p < 0.001) scores. The female players had a shorter history of online gaming (6.0 ± 3.1 vs. 7.2 ± 3.6 years, p = 0.001) and shorter weekly online gaming hours (23.2 ± 17.0 vs. 29.2 ± 20.2 hours, p = 0.002), but had higher DSSS (13.0 ± 9.3 vs. 10.9 ± 9.7, p = 0.032) and SPIN (22.8 ± 14.3 vs. 19.6 ± 13.5, p = 0.019) scores than the male players. The linear regression model showed that higher DSSS scores were associated with female gender, higher SPIN scores, higher CIAS scores, and longer weekly online gaming hours, with controlling for age and years of education. Conclusion The online gamers with longer weekly gaming hours tended to have a longer

  3. The association between online gaming, social phobia, and depression: an internet survey.

    PubMed

    Wei, Han-Ting; Chen, Mu-Hong; Huang, Po-Cheng; Bai, Ya-Mei

    2012-07-28

    Online gaming technology has developed rapidly within the past decade, and its related problems have received increasing attention. However, there are few studies on the psychiatric symptoms associated with excessive use of online games. The aim of this study is to investigate the characteristics of online gamers, and the association between online gaming hours, social phobia, and depression using an internet survey. An online questionnaire was designed and posted on a popular online game websites, inviting the online gamers to participate the survey. The content of the questionnaire included demographic data, profiles of internet usage and online gaming, and self-rating scales of Depression and Somatic Symptoms Scale (DSSS), Social Phobia Inventory (SPIN), and Chen Internet Addiction Scale (CIAS). A total of 722 online gamers with a mean age of 21.8 ± 4.9 years completed the online survey within one month. 601 (83.2%) participants were male, and 121 (16.8%) were female. The mean weekly online gaming time was 28.2 ± 19.7 hours, which positively associated with history of online gaming (r = 0.245, p < 0.001), total DSSS (r = 0.210, p < 0.001), SPIN (r = 0.150, p < 0.001), and CIAS (r = 0.290, p < 0.001) scores. The female players had a shorter history of online gaming (6.0 ± 3.1 vs. 7.2 ± 3.6 years, p = 0.001) and shorter weekly online gaming hours (23.2 ± 17.0 vs. 29.2 ± 20.2 hours, p = 0.002), but had higher DSSS (13.0 ± 9.3 vs. 10.9 ± 9.7, p = 0.032) and SPIN (22.8 ± 14.3 vs. 19.6 ± 13.5, p = 0.019) scores than the male players. The linear regression model showed that higher DSSS scores were associated with female gender, higher SPIN scores, higher CIAS scores, and longer weekly online gaming hours, with controlling for age and years of education. The online gamers with longer weekly gaming hours tended to have a longer history of online gaming, and more severe

  4. Recognition of irrationality of fear and the diagnosis of social anxiety disorder and specific phobia in adults: implications for criteria revision in DSM-5.

    PubMed

    Zimmerman, Mark; Dalrymple, Kristy; Chelminski, Iwona; Young, Diane; Galione, Janine N

    2010-11-01

    In DSM-IV, the diagnosis of social anxiety disorder (SAD) and specific phobia in adults requires that the person recognize that his or her fear of the phobic situation is excessive or unreasonable (criterion C). The DSM-5 Anxiety Disorders Work Group has proposed replacing this criterion because some patients with clinically significant phobic fears do not recognize the irrationality of their fears. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project we determined the number of individuals who were not diagnosed with SAD and specific phobia because they did not recognize the excessiveness or irrationality of their fear. We interviewed 3,000 psychiatric outpatients and 1,800 candidates for bariatric surgery with a modified version of the Structured Clinical Interview for DSM-IV. In the SAD and specific phobia modules we suspended the skip-out that curtails the modules if criterion C is not met. Patients who met all DSM-IV criteria for SAD or specific phobia except criterion C were considered to have "modified" SAD or specific phobia. The lifetime rates of DSM-IV SAD and specific phobia were 30.5 and 11.8% in psychiatric patients and 11.7 and 10.2% in bariatric surgery candidates, respectively. Less than 1% of the patients in both samples were diagnosed with modified SAD or specific phobia. Few patients were excluded from a phobia diagnosis because of criterion C. We suggest that in DSM-5 this criterion be eliminated from the SAD and specific phobia criteria sets. © 2010 Wiley-Liss, Inc.

  5. Results of a naturalistic longitudinal study of benzodiazepine and SSRI use in the treatment of generalized anxiety disorder and social phobia.

    PubMed

    Vasile, Russell G; Bruce, Steven E; Goisman, Robert M; Pagano, Maria; Keller, Martin B

    2005-01-01

    The past decade has brought major new developments in the psychopharmacologic management of generalized anxiety disorder and social phobia. We examined medication-prescribing patterns for the treatment of these anxiety disorders for 12 years to assess changes in patients' anti-anxiety psychotropic medication usage during that period of evolving practice guidelines. We examined psychotropic medication use in 305 patients with generalized anxiety disorder and 232 with social phobia enrolled in the Harvard/Brown Anxiety Disorders Research Project (HARP), a prospective, longitudinal study of anxiety disorders. Psychotropic treatment patterns seem to have remained relatively stable over 12 years with benzodiazepines the medications most commonly used for both generalized anxiety disorder and social phobia. Comparatively, selective serotonin reuptake inhibitor (SSRI) and venlafaxine usage as stand-alone medications for these disorders remained low throughout the follow-up period. At the 12-year follow-up, 24% of patients with generalized anxiety disorder and 30% of patients with social phobia were utilizing neither an SSRI/selective norepinephrine reuptake inhibitor (SNRI) nor a benzodiazepine. Treatment recommendations for use of SSRIs and venlafaxine in the management of generalized anxiety disorder and social phobia initially promulgated in 1998 had a modest impact on changes in psychopharmacologic practice 4-5 years later. Difficulties in the implementation of treatment guidelines are discussed.

  6. Self-help cognitive-behavioral therapy with minimal therapist contact for social phobia: a controlled trial.

    PubMed

    Abramowitz, Jonathan S; Moore, Elizabeth L; Braddock, Autumn E; Harrington, Diana L

    2009-03-01

    Due to treatment accessibility and cost issues, interest in self-help programs (e.g., bibliotherapy, telehealth) for common psychological disorders is growing. Research supporting the efficacy of such a program for social anxiety, however, is limited. The present study examined the efficacy of an 8-week self-directed cognitive behavioral treatment with minimal therapist involvement for social phobia based on a widely available self-help book. Twenty-one adults with social phobia initially received either treatment (i.e. assigned readings in the workbook with limited therapist contact) or were wait-listed. Wait-listed patients eventually received the same self-directed treatment. Results revealed that the self-help/minimal therapist contact treatment was superior to wait-list on most outcome measures. Across the entire sample, reductions in social anxiety, global severity, general anxiety, and depression were observed at posttest and 3-month follow-up. These findings provide preliminary support for using this self-help workbook for individuals with mild to moderate social anxiety in conjunction with infrequent therapist visits to reinforce the treatment principles. Study limitations and future directions are discussed.

  7. Integrating cognitive bias modification into a standard cognitive behavioural treatment package for social phobia: a randomized controlled trial.

    PubMed

    Rapee, Ronald M; MacLeod, Colin; Carpenter, Leigh; Gaston, Jonathan E; Frei, Jacqueline; Peters, Lorna; Baillie, Andrew J

    2013-05-01

    The aim of the current study was to integrate recent developments in the retraining of attentional biases towards threat into a standard cognitive behavioural treatment package for social phobia. 134 participants (M age-32.4: 53% female) meeting DSM-IV criteria for social phobia received a 12-week cognitive behavioural treatment program. They were randomly allocated to receive on a daily basis using home practice, either an additional computerised probe procedure designed to train attentional resource allocation away from threat, or a placebo variant of this procedure. Measures included diagnostic severity, social anxiety symptoms, life interference, and depression as well as state anxiety in response to a laboratory social threat. At the end of treatment there were no significant differences between groups in attentional bias towards threat or in treatment response (all p's>0.05). Both groups showed similar and highly significant reductions in diagnostic severity, social anxiety symptoms, depression symptoms, and life interference at post-treatment that was maintained and in most cases increased at 6 month follow-up (uncontrolled effect sizes ranged from d=0.34 to d=1.90). The current results do not indicate that integration of information processing-derived attentional bias modification procedures into standard treatment packages as conducted in this study augments attentional change or enhances treatment efficacy. Further refinement of bias modification techniques, and better methods of integrating them with conventional approaches, may be needed to produce better effects. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Two-year course of generalized anxiety disorder, social anxiety disorder, and panic disorder with agoraphobia in a sample of Latino adults.

    PubMed

    Bjornsson, Andri S; Sibrava, Nicholas J; Beard, Courtney; Moitra, Ethan; Weisberg, Risa B; Benítez, Carlos I Pérez; Keller, Martin B

    2014-12-01

    It is imperative to study the clinical course of anxiety disorders among Latinos, given the implications for culturally sensitive treatment in this population. The current study is the first prospective, observational, longitudinal study of anxiety disorders among Latinos. Data are reported on 139 adult Latinos (M age = 34.65 years, SD = 10.98, 70.5% female) diagnosed with social anxiety disorder (SAD; n = 86), generalized anxiety disorder (GAD; n = 90), or panic disorder with agoraphobia (PDA; n = 62). The participants were interviewed with standardized clinical interviews at intake and annually over 2 years of follow-up. Probabilities of recovery were calculated using standard survival analysis methods. The 2-year recovery rates in this study were 0.07 for SAD, 0.14 for GAD, 0.03 for PDA, and 0.50 for major depressive disorder (MDD). Overall functioning, social adjustment, and life satisfaction in this sample were poor. The recovery rates for anxiety disorders in this Latino sample were markedly low. Although caution must be used in comparing these data with prior longitudinal studies, these recovery rates seem to be much lower than in non-Latino White samples. However, the clinical course of MDD in this sample was similar to its course among non-Latino Whites, invoking the pressing question of whether there is something about the experience of anxiety disorders (but not MDD) among Latinos that makes them more impairing and persistent. The answer to that question should inform future treatment development for this population.

  9. Corticolimbic brain reactivity to social signals of threat before and after sertraline treatment in generalized social phobia.

    PubMed

    Phan, K Luan; Coccaro, Emil F; Angstadt, Mike; Kreger, K Jane; Mayberg, Helen S; Liberzon, Israel; Stein, Murray B

    2013-02-15

    Generalized social phobia (gSP), also known as generalized social anxiety disorder, is characterized by excessive fear of scrutiny by others and pervasive avoidance of social interactions. Pathophysiologic models of gSP implicate exaggerated reactivity of the amygdala and insula in response to social evaluative threat, making them plausible targets for treatment. Although selective serotonin reuptake inhibitor (SSRI) treatment is known to be an effective treatment, little is known about the mechanism through which these agents exert their anxiolytic effects at a brain level in gSP. We acquired functional magnetic resonance imaging data of brain response to social signals of threat (fearful/angry faces) in 21 gSP patients before and after they completed 12 weeks of open-label treatment with the SSRI sertraline. For comparison, 19 healthy control (HC) subjects also underwent two functional magnetic resonance imaging scans, 12 weeks apart. Whole-brain voxelwise analysis of variance revealed significant Group×Time interactions in the amygdala and the ventral medial prefrontal cortex. Follow-up analyses showed that treatment in gSP subjects reduced amygdala reactivity to fearful faces (which was exaggerated relative to HCs before treatment) and enhanced ventral medial prefrontal cortex activation to angry faces (which was attenuated relative to HCs before treatment). However, these brain changes were not significantly related to social anxiety symptom improvement. SSRI treatment response in gSP is associated with changes in a discrete limbic-paralimbic brain network, representing a neural mechanism through which SSRIs may exert their actions. Published by Elsevier Inc.

  10. Corticolimbic Brain Reactivity to Social Signals of Threat Before and After Sertraline Treatment in Generalized Social Phobia

    PubMed Central

    Phan, K. Luan; Coccaro, Emil F.; Angstadt, Mike; Kreger, K. Jane; Mayberg, Helen S.; Liberzon, Israel; Stein, Murray B.

    2012-01-01

    Objective Generalized social phobia (gSP), also known as generalized social anxiety disorder, is characterized by excessive fear of scrutiny by others and pervasive avoidance of social interactions. Pathophysiological models of gSP implicate exaggerated reactivity of the amygdala and insula in response to social evaluative threat, making them plausible targets for treatment. Although selective serotonin reuptake inhibitor (SSRI) treatment is known to be an effective treatment, little is known about the mechanism by which these agents exert their anxiolytic effects at a brain level in gSP. Method We acquired functional magnetic resonance imaging (fMRI) data of brain response to social signals of threat (fearful/angry faces) in twenty-one GSAD patients before and after they completed 12 weeks of open label treatment with the SSRI sertraline. For comparison, nineteen healthy control (HC) subjects also underwent two fMRI scans, 12 weeks apart. Results Whole-brain voxel-wise analysis of variance revealed significant Group×Time interactions in the amygdala and the ventral medial prefrontal cortex (vmPFC). Follow up analyses showed that treatment in gSP subjects: 1) reduced amygdala reactivity to fearful faces (which was exaggerated relative to HCs prior to treatment); and 2) enhanced vmPFC activation to angry faces (which was attenuated relative to HCs prior to treatment). However, these brain changes were not significantly related to social anxiety symptom improvement. Conclusions SSRI treatment response in gSP is associated with changes in a discrete limbic-paralimbic brain network, representing a neural mechanism by which SSRIs may exert their actions. PMID:23164370

  11. Development of a short form Social Interaction Anxiety (SIAS) and Social Phobia Scale (SPS) using nonparametric item response theory: the SIAS-6 and the SPS-6.

    PubMed

    Peters, Lorna; Sunderland, Matthew; Andrews, Gavin; Rapee, Ronald M; Mattick, Richard P

    2012-03-01

    Shortened forms of the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS) were developed using nonparametric item response theory methods. Using data from socially phobic participants enrolled in 5 treatment trials (N = 456), 2 six-item scales (the SIAS-6 and the SPS-6) were developed. The validity of the scores on the SIAS-6 and the SPS-6 was then tested using traditional methods for their convergent validity in an independent clinical sample and a student sample, as well as for their sensitivity to change and diagnostic sensitivity in the clinical sample. The scores on the SIAS-6 and the SPS-6 correlated as well as the scores on the original SIAS and SPS, with scores on measures of related constructs, discriminated well between those with and without a diagnosis of social phobia, providing cutoffs for diagnosis and were as sensitive to measuring change associated with treatment as were the SIAS and SPS. Together, the SIAS-6 and the SPS-6 appear to be an efficient method of measuring symptoms of social phobia and provide a brief screening tool.

  12. The Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS): a comparison of two short-form versions.

    PubMed

    Fergus, Thomas A; Valentiner, David P; Kim, Hyun-Soo; McGrath, Patrick B

    2014-12-01

    The widespread use of Mattick and Clarke's (1998) Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS) led 2 independent groups of researchers to develop short forms of these measures (Fergus, Valentiner, McGrath, Gier-Lonsway, & Kim, 2012; Peters, Sunderland, Andrews, Rapee, & Mattick, 2012). This 3-part study examined the psychometric properties of Fergus et al.'s and Peters et al.'s short forms of the SIAS and SPS using an American nonclinical adolescent sample in Study 1 (N = 98), American patient sample with an anxiety disorder in Study 2 (N = 117), and both a South Korean college student sample (N = 341) and an American college student sample (N = 550) in Study 3. Scores on both sets of short forms evidenced adequate internal consistency, interitem correlations, and measurement invariance. Scores on Fergus et al.'s short forms, particularly their SIAS short form, tended to capture more unique variance in scores of criterion measures than did scores on Peters et al.'s short forms. Implications for the use of these 2 sets of short forms are discussed.

  13. No effects of psychosocial stress on memory retrieval in non-treated young students with Generalized Social Phobia.

    PubMed

    Espín, Laura; Marquina, Mónica; Hidalgo, Vanesa; Salvador, Alicia; Gómez-Amor, Jesús

    2016-11-01

    Generalized Social Phobia (GSP) is a common anxiety disorder that produces clear social life disruptions. There is no consensus on the specific processes involved in its development, but the role of the hypothalamic-pituitary-adrenal (HPA) axis has been suggested. This study analyzed the effects of the cortisol response to the Trier Social Stress Test (TSST) on the memory retrieval of pictures with different emotional valences in 45 non-treated young students with GSP and 50 non-anxious (NA) subjects (mean=19.35years, SD=0.18). No differences were found in the cortisol response of GSP and NA subjects to the TSST and control sessions. In addition, psychosocial stress impaired memory retrieval in both the GSP and NA groups, with no differences between them. Regarding the sex factor, no effects were found in the cortisol response to the TSST. However, during the encoding session, GSP men had higher cortisol levels than GSP women and NA subjects. There was also a significant interaction between sex and stress exposure on memory retrieval. Women recognized more unpleasant and neutral pictures than men; however, under stress, the women's advantage disappeared, and the men's performance improved. Sex also interacted with social phobia on positive mood, with GSP women exposed to the TSST showing the lowest positive mood. These results suggest that GSP subjects do not present an HPA axis sensitization to psychosocial stress, and they emphasize the importance of Sex in understanding stress effects on memory.

  14. Associations in the Longitudinal Course of Body Dysmorphic Disorder with Major Depression, Obsessive Compulsive Disorder, and Social Phobia

    PubMed Central

    Phillips, Katharine A.; Stout, Robert L.

    2009-01-01

    Body dysmorphic disorder (BDD) is an impairing and relatively common disorder that has high comorbidity with certain Axis I disorders. However, the longitudinal associations between BDD and comorbid disorders have not previously been examined. Such information may shed light on the nature of BDD’s relationship to putative “near-neighbor” disorders, such as major depression, obsessive-compulsive disorder (OCD), and social phobia. This study examined time-varying associations between BDD and these comorbid disorders in 161 participants over 1 to 3 years of follow-up in the first prospective longitudinal study of the course of BDD. We found that BDD had significant longitudinal associations with major depression – that is, change in the status of BDD and major depression were closely linked in time, with improvement in major depression predicting BDD remission, and, conversely, improvement in BDD predicting depression remission. We also found that improvement in OCD predicted BDD remission, but that BDD improvement did not predict OCD remission. No significant longitudinal associations were found for BDD and social phobia (although the results for analyses of OCD and social phobia were less numerically stable). These findings suggest (but do not prove) that BDD may be etiologically linked to major depression and OCD – i.e., that BDD may be a member of both the putative OCD spectrum and the affective spectrum. However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a sizable proportion of subjects who remitted from these comorbid disorders. Additional studies are needed to elucidate the nature of BDD’s relationship to commonly co-occurring disorders, as this issue has important theoretical and clinical implications. PMID:16309706

  15. Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks.

    PubMed

    Munjack, D J; Crocker, B; Cabe, D; Brown, R; Usigli, R; Zulueta, A; McManus, M; McDowell, D; Palmer, R; Leonard, M

    1989-02-01

    Fifty-five patients completed a 5-week double-blind study comparing alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks. There was no concomitant behavioral treatment. Patient and therapist rating scales included Sheehan's Panic and Anxiety Attack Scales, the Marks-Sheehan Phobia Scale, the Hamilton Anxiety Scale, the Hamilton Depression Scale, and the Side Effects Checklist. The results generally support the efficacy of alprazolam, but not propranolol, in the treatment of panic disorder and agoraphobia with panic attacks. The significance of the results are discussed, as well as a number of the unique aspects of our procedures and patient population.

  16. Internet-Based Self-Help with Therapist Feedback and in Vivo Group Exposure for Social Phobia: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Andersson, Gerhard; Carlbring, Per; Holmstrom, Annelie; Sparthan, Elisabeth; Furmark, Tomas; Nilsson-Ihrfelt, Elisabeth; Buhrman, Monica; Ekselius, Lisa

    2006-01-01

    Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a 9-week, Internet-delivered, self-help program that was combined with 2 group exposure sessions in real life and minimal therapist contact via e-mail.…

  17. Internet-Based Self-Help with Therapist Feedback and in Vivo Group Exposure for Social Phobia: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Andersson, Gerhard; Carlbring, Per; Holmstrom, Annelie; Sparthan, Elisabeth; Furmark, Tomas; Nilsson-Ihrfelt, Elisabeth; Buhrman, Monica; Ekselius, Lisa

    2006-01-01

    Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a 9-week, Internet-delivered, self-help program that was combined with 2 group exposure sessions in real life and minimal therapist contact via e-mail.…

  18. Panic disorder and agoraphobia: an overview and commentary on DSM-5 changes.

    PubMed

    Asmundson, Gordon J G; Taylor, Steven; Smits, Jasper A J

    2014-06-01

    The recently published DSM-5 contains a number of changes pertinent to panic disorder and agoraphobia. These changes include separation of panic disorder and agoraphobia into separate diagnoses, the addition of criteria and guidelines for distinguishing agoraphobia from specific phobia, the addition of a 6-month duration requirement for agoraphobia, the addition of panic attacks as a specifier to any DSM-5 diagnosis, changes to descriptors of panic attack types, as well as various changes to the descriptive text. It is crucial that clinicians and researchers working with individuals presenting with panic attacks and panic-like symptoms understand these changes. The purpose of the current paper is to provide a summary of the main changes, to critique the changes in the context of available empirical evidence, and to highlight clinical implications and potential impact on mental health service utilization. Several of the changes have the potential to improve access to evidence-based treatment; yet, although certain changes appear justified in that they were based on converging evidence from different empirical sources, other changes appear questionable, at least based on the information presented in the DSM-5 text and related publications. Ongoing research of DSM-5 panic disorder and agoraphobia as well as application of the new diagnostic criteria in clinical contexts is needed to further inform the strengths and limitations of DSM-5 conceptualizations of panic disorder and agoraphobia. © 2014 Wiley Periodicals, Inc.

  19. Social anxiety disorder/social phobia: epidemiology, diagnosis, neurobiology, and treatment.

    PubMed

    den Boer, J A

    2000-01-01

    Some anticipatory anxiety is expected on specific occasions such as giving a speech. However, some individuals have an excessive fear of such situations when they are under scrutiny, believing that their performance will cause them embarrassment or humiliation, frequently leading to deliberate avoidance of these situations. This disabling condition has been termed social anxiety disorder. Social anxiety disorder is common, with a lifetime prevalence of 2% to 5%, but is probably underreported. The sufferer often avoids seeking assistance, leading to comorbid mental disorders, greater disability, and an increased risk of suicide. Consequently, a high burden is placed on the patient's caregivers and on society. The diagnosis of social anxiety disorder is aided by the patient's history together with DSM-IV criteria. Research into the neurobiology of social anxiety disorder suggests a dysfunction of postsynaptic serotonin receptors and a hypersensitivity to challenge with caffeine, CO2, and pentagastrin. Neuroimaging studies suggest a dysfunction of the striatal presynaptic dopamine transporter in social anxiety disorder. Clear guidelines for the management of social anxiety disorder, including both pharmacotherapy and psychotherapy, are yet to be established. Selective serotonin reuptake inhibitors (SSRIs) show the most promise for the future, while cognitive-behavioral therapy may also be helpful. In the meantime, physicians should treat social anxiety disorder promptly and aggressively.

  20. Assessing the efficacy of treatments for panic disorder and agoraphobia. II. The Panic and Agoraphobia Scale.

    PubMed

    Bandelow, B

    1995-06-01

    Despite the plethora of rating scales for anxiety disorders and agoraphobia, a qualified scale for assessing the severity of panic disorder and agoraphobia (PDA) is still lacking. The new Panic and Agoraphobia Scale (P&A) is presented in this paper. It was developed to assess the degree of severity of these disorders after a diagnosis has been made according to the criteria of the DSM-III-R/IV or the ICD-10. The P&A was specially developed for use in clinical drug trials. Factors which impair the quality of life in panic disorder and agoraphobia patients (panic attacks, phobic avoidance, anticipatory anxiety, impairment in social relationships and work, assumption of somatic disease) were considered in the development of this scale so that the efficacy of a certain drug therapy on each of these factors can be assessed separately. Both an observer rating and a self-rating with matching items are available. The observer rating only takes about 10 minutes to complete. Translation into many European languages is planned so that it can be used in multicentre trials. Satisfactory results of item analysis, inter-rater reliability, objectivity, external validity and factor structure are presented. The P&A should be a useful tool for assessing the severity of PDA and may solve some of the methodological problems that have arisen in former PDA studies.

  1. Dreams In Jungian Psychology: The use of Dreams as an Instrument For Research, Diagnosis and Treatment of Social Phobia

    PubMed Central

    Khodarahimi, Siamak

    2009-01-01

    Background: The significance of dreams has been explained in psychoanalysis, depth psychology and gestalt therapy. There are many guidelines in analytic psychology for dream interpretation and integration in clinical practice. The present study, based on the Jungian analytic model, incorporated dreams as an instrument for assessment of aetiology, the psychotherapy process and the outcome of treatment for social phobia within a clinical case study. Method: This case study describes the use of dream analysis in treating a female youth with social phobia. Results: The present findings supported the three stage paradigm efficiency in the Jungian model for dream working within a clinical setting, i.e. written details, reassembly with amplification and assimilation. It was indicated that childhood and infantile traumatic events, psychosexual development malfunctions, and inefficient coping skills for solving current life events were expressed in the patient’s dreams. Conclusion: Dreams can reflect a patient’s aetiology, needs, illness prognosis and psychotherapy outcome. Dreams are an instrument for the diagnosis, research and treatment of mental disturbances in a clinical setting. PMID:22135511

  2. Dreams In Jungian Psychology: The use of Dreams as an Instrument For Research, Diagnosis and Treatment of Social Phobia.

    PubMed

    Khodarahimi, Siamak

    2009-10-01

    The significance of dreams has been explained in psychoanalysis, depth psychology and gestalt therapy. There are many guidelines in analytic psychology for dream interpretation and integration in clinical practice. The present study, based on the Jungian analytic model, incorporated dreams as an instrument for assessment of aetiology, the psychotherapy process and the outcome of treatment for social phobia within a clinical case study. This case study describes the use of dream analysis in treating a female youth with social phobia. The present findings supported the three stage paradigm efficiency in the Jungian model for dream working within a clinical setting, i.e. written details, reassembly with amplification and assimilation. It was indicated that childhood and infantile traumatic events, psychosexual development malfunctions, and inefficient coping skills for solving current life events were expressed in the patient's dreams. Dreams can reflect a patient's aetiology, needs, illness prognosis and psychotherapy outcome. Dreams are an instrument for the diagnosis, research and treatment of mental disturbances in a clinical setting.

  3. Cross- cultural validation of the Brazilian Portuguese version of the Social Phobia Inventory (SPIN): study of the items and internal consistency.

    PubMed

    Osório, Flávia de Lima; Crippa, José Alexandre S; Loureiro, Sonia Regina

    2009-03-01

    The objective of the present study was to carry out the cross- cultural validation for Brazilian Portuguese of the Social Phobia Inventory, an instrument for the evaluation of fear, avoidance and physiological symptoms associated with social anxiety disorder. The process of translation and adaptation involved four bilingual professionals, appreciation and approval of the back- translation by the authors of the original scale, a pilot study with 30 Brazilian university students, and appreciation by raters who confirmed the face validity of the Portuguese version, which was named ' Inventário de Fobia Social' . As part of the psychometric study of the Social Phobia Inventory, analysis of the items and evaluation of the internal consistency of the instrument were performed in a study conducted on 2314 university students. The results demonstrated that item 11, related to the fear of public speaking, was the most frequently scored item. The correlation of the items with the total score was quite adequate, ranging from 0.44 to 0.71, as was the internal consistency, which ranged from 0.71 to 0.90. The authors conclude that the Brazilian Portuguese version of the Social Phobia Inventory proved to be adequate regarding the psychometric properties initially studied, with qualities quite close to those of the original study. Studies that will evaluate the remaining indicators of validity of the Social Phobia Inventory in clinical and non-clinical samples are considered to be opportune and necessary.

  4. CLINICAL CONSEQUENCES OF THE REVISED DSM-5 DEFINITION OF AGORAPHOBIA IN TREATMENT-SEEKING ANXIOUS YOUTH.

    PubMed

    Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

    2015-07-01

    In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Analyses (N = 151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a "circumscribed" agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. © 2015 Wiley Periodicals, Inc.

  5. Clinical consequences of the revised DSM-5 definition of agoraphobia in treatment-seeking anxious youth

    PubMed Central

    Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

    2015-01-01

    Background In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Method Analyses (N=151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. Results One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. Conclusions A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a “circumscribed” agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. PMID:25845579

  6. [Psychoimmunologic correlation between allergies, panic and agoraphobia].

    PubMed

    Schmidt-Traub, S; Bamler, K J

    1992-01-01

    The present behavioral medical paper is a contribution to basic research in neuroimmunology. The relationship of panic/agoraphobia and allergy/anaphylaxis (IgE-mediated immediate reaction) is demonstrated and discussed with specific consideration of vasomotor reactions, tachycardia and hyperventilation in panic patients and allergies with anaphylactic reactions. The vegetative symptoms of panic reactions and anaphylaxis showed a high correlative correspondence. 74% of 23 panic and/or agoraphobia patients in a pretest to an epidemiologic study turned out to have an allergic illness that needed treatment; but there were no more anxiety disorders disclosed in 50 allergic patients than in the general population according to expectancies found in epidemiologic publications. If these data are confirmed then panic and agoraphobia cannot be seen as merely a cognitive-emotional event, but also as a further kind of allergic disease with genetic, ecological, psychological and social determinants; they would then have to be diagnosed as psychoimmunological disturbances and treated with behavior medicine (preferably with exposition and immunotherapy or hyposensitization). Anxiety therapies would improve qualitatively and could be cut down in duration.

  7. The Utility of the PAI and the MMPI-2 for Discriminating PTSD, Depression, and Social Phobia in Trauma-Exposed College Students

    ERIC Educational Resources Information Center

    McDevitt-Murphy, Meghan E.; Weathers, Frank W.; Flood, Amanda M.; Eakin, David E.; Benson, Trisha A.

    2007-01-01

    This study investigated the Minnesota Multiphasic Personality Inventory-Revised (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and the Personality Assessment Inventory (PAI; Morey, 1991) with regard to each instrument's utility for discriminating post-traumatic stress disorder (PTSD) from depression and social phobia in a…

  8. Predicting anxious response to a social challenge: the predictive utility of the social interaction anxiety scale and the social phobia scale in a college population.

    PubMed

    Gore, K L; Carter, M M; Parker, S

    2002-06-01

    Trait anxiety is believed to be a hierarchical construct composed of several lower-order factors (Adv. Behav. Res. Therapy, 15 (1993) 147; J. Anxiety Disorders, 9 (1995) 163). Assessment devices such as the Social Interaction Anxiety Scale, the Social Phobia Scale (SIAS and SPS; Behav. Res. Therapy, 36 (4) (1998) 455), and the Anxiety Sensitivity Index (ASI; Behav. Res. Therapy, 24 (1986) 1) are good measures of the presumably separate lower-order factors. This study compared the effectiveness of the SIAS, SPS, ASI-physical scale and STAI-T (State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press (1970)) as predictors of anxious response to a social challenge (asking an aloof confederate out on a date). Consistent with the hierarchical model of anxiety, the measures of trait anxiety were moderately correlated with each other and each was a significant predictor of anxious response. The specific measures of trait social anxiety were slightly better predictors of anxious response to the social challenge than was either the ASI-physical scale or the STAI-T. The results provide evidence of the predictive validity of these social trait measures and some support for their specificity in the prediction of anxious response to a social challenge.

  9. School Phobia

    ERIC Educational Resources Information Center

    Tyrrell, Maureen

    2005-01-01

    School phobia is a serious disorder affecting up to 5% of elementary and middle school children. Long-term consequences include academic failure, diminished peer relationships, parental conflict, and development of additional psychiatric disorders. Hiding behind such common physical symptoms as headaches, stomachaches, and fatigue, school phobia…

  10. School Phobia

    ERIC Educational Resources Information Center

    Tyrrell, Maureen

    2005-01-01

    School phobia is a serious disorder affecting up to 5% of elementary and middle school children. Long-term consequences include academic failure, diminished peer relationships, parental conflict, and development of additional psychiatric disorders. Hiding behind such common physical symptoms as headaches, stomachaches, and fatigue, school phobia…

  11. Is Social Phobia a "Mis-Communication" Disorder? Brain Functional Connectivity during Face Perception Differs between Patients with Social Phobia and Healthy Control Subjects.

    PubMed

    Danti, Sabrina; Ricciardi, Emiliano; Gentili, Claudio; Gobbini, Maria Ida; Pietrini, Pietro; Guazzelli, Mario

    2010-01-01

    Recently, a differential recruitment of brain areas throughout the distributed neural system for face perception has been found in social phobic patients as compared to healthy control subjects. These functional abnormalities in social phobic patients extend beyond emotion-related brain areas, such as the amygdala, to include cortical networks that modulate attention and process other facial features, and they are also associated with an alteration of the task-related activation/deactivation trade-off. Functional connectivity is becoming a powerful tool to examine how components of large-scale distributed neural systems are coupled together while performing a specific function. This study was designed to determine whether functional connectivity networks among brain regions within the distributed system for face perception also would differ between social phobic patients and healthy controls. Data were obtained from eight social phobic patients and seven healthy controls by using functional magnetic resonance imaging. Our findings indicated that social phobic patients and healthy controls have different patterns of functional connectivity across brain regions within both the core and the extended systems for face perception and the default mode network. To our knowledge, this is the first study that shows that functional connectivity during brain response to socially relevant stimuli differs between social phobic patients and healthy controls. These results expand our previous findings and indicate that brain functional changes in social phobic patients are not restricted to a single specific brain structure, but rather involve a mis-communication among different sensory and emotional processing brain areas.

  12. Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators

    PubMed Central

    Craske, Michelle G; Niles, Andrea N.; Burklund, Lisa J.; Wolitzky-Taylor, Kate B.; Vilardaga, Jennifer C. Plumb; Arch, Joanna J.; Saxbe, Darby E.; Lieberman, Matthew D.

    2014-01-01

    Objective Cognitive behavioral therapy (CBT) is an empirically supported treatment for social phobia. However, not all individuals respond to treatment and many who show improvement do not maintain their gains over the long-term. Thus, alternative treatments are needed. Method The current study (N=87) was a 3-arm randomized clinical trial comparing CBT, Acceptance and Commitment therapy (ACT), and a waitlist control group (WL) in participants with a DSM-IV diagnosis of social phobia. Participants completed 12 sessions of CBT or ACT or a 12-week waiting period. All participants completed assessments at baseline and post-treatment, and participants assigned to CBT and ACT also completed assessments at 6 and 12 months following baseline. Assessments consisted of self-report measures, a public speaking task, and clinician ratings. Results Multilevel modeling was used to examine between-group differences on outcomes measures. Both treatment groups outperformed WL, with no differences observed between CBT and ACT on self-report, independent clinician, or public speaking outcomes. Lower self-reported psychological flexibility at baseline was associated with greater improvement by the 12-mo follow-up in CBT compared to ACT. Self-reported fear of negative evaluation significantly moderated outcomes as well, with trends for both extremes to be associated with superior outcomes from CBT and inferior outcomes from ACT. Across treatment groups, higher perceived control, and extraversion were associated with greater improvement, whereas comorbid depression was associated with poorer outcomes. Conclusions Implications for clinical practice and future research are discussed. PMID:24999670

  13. Stable “Trait” Variance of Temperament as a Predictor of the Temporal Course of Depression and Social Phobia

    PubMed Central

    Naragon-Gainey, Kristin; Gallagher, Matthew W.; Brown, Timothy A.

    2013-01-01

    A large body of research has found robust associations between dimensions of temperament (e.g., neuroticism, extraversion) and the mood and anxiety disorders. However, mood-state distortion (i.e., the tendency for current mood state to bias ratings of temperament) likely confounds these associations, rendering their interpretation and validity unclear. This issue is of particular relevance to clinical populations who experience elevated levels of general distress. The current study used the “trait-state-occasion” latent variable model (Cole, Martin, & Steiger, 2005) to separate the stable components of temperament from transient, situational influences such as current mood state. We examined the predictive power of the time-invariant components of temperament on the course of depression and social phobia in a large, treatment-seeking sample with mood and/or anxiety disorders (N = 826). Participants were assessed three times over the course of one year, using interview and self-report measures; most participants received treatment during this time. Results indicated that both neuroticism/behavioral inhibition (N/BI) and behavioral activation/positive affect (BA/P) consisted largely of stable, time-invariant variance (57% to 78% of total variance). Furthermore, the time-invariant components of N/BI and BA/P were uniquely and incrementally predictive of change in depression and social phobia, adjusting for initial symptom levels. These results suggest that the removal of state variance bolsters the effect of temperament on psychopathology among clinically distressed individuals. Implications for temperament-psychopathology models, psychopathology assessment, and the stability of traits are discussed. PMID:24016004

  14. Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators.

    PubMed

    Craske, Michelle G; Niles, Andrea N; Burklund, Lisa J; Wolitzky-Taylor, Kate B; Vilardaga, Jennifer C Plumb; Arch, Joanna J; Saxbe, Darby E; Lieberman, Matthew D

    2014-12-01

    Cognitive behavioral therapy (CBT) is an empirically supported treatment for social phobia. However, not all individuals respond to treatment and many who show improvement do not maintain their gains over the long-term. Thus, alternative treatments are needed. The current study (N = 87) was a 3-arm randomized clinical trial comparing CBT, acceptance and commitment therapy (ACT), and a wait-list control group (WL) in participants with a diagnosis of social phobia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Participants completed 12 sessions of CBT or ACT or a 12-week waiting period. All participants completed assessments at baseline and posttreatment, and participants assigned to CBT and ACT also completed assessments 6 and 12 months following baseline. Assessments consisted of self-report measures, a public-speaking task, and clinician ratings. Multilevel modeling was used to examine between-group differences on outcomes measures. Both treatment groups outperformed WL, with no differences observed between CBT and ACT on self-report, independent clinician, or public-speaking outcomes. Lower self-reported psychological flexibility at baseline was associated with greater improvement by the 12-month follow-up in CBT compared with ACT. Self-reported fear of negative evaluation significantly moderated outcomes as well, with trends for both extremes to be associated with superior outcomes from CBT and inferior outcomes from ACT. Across treatment groups, higher perceived control and extraversion were associated with greater improvement, whereas comorbid depression was associated with poorer outcomes. Implications for clinical practice and future research are discussed.

  15. Psychometric evaluation of social phobia and anxiety inventory for children (SPAI-C) and social anxiety scale for children-revised (SASC-R).

    PubMed

    Kuusikko, Sanna; Sanna, Kuusikko; Pollock-Wurman, Rachel; Rachel, Pollock-Wurman; Ebeling, Hanna; Hanna, Ebeling; Hurtig, Tuula; Tuula, Hurtig; Joskitt, Leena; Leena, Joskitt; Mattila, Marja-Leena; Marja-Leena, Mattila; Jussila, Katja; Katja, Jussila; Moilanen, Irma; Irma, Moilanen

    2009-02-01

    The study evaluated the psychometric properties of Finnish versions of the Social Phobia and Anxiety Inventory for Children (SPAI-C) and the Social Anxiety Scale for Children-Revised (SASC-R). 352 students (M = 12.2 years) participated in the study and completed the SPAI-C and SASC-R. In addition, 68 participants (M = 12.2 years) and their parents were interviewed with the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL). The SPAI-C was more sensitive for identifying youth meeting criteria for social phobia (SP), whereas the SASC-R demonstrated greater specificity. The youth in this sample had lower mean total scores on the self-report questionnaires than did those in the original validitation studies of the SPAI-C and SASC-R conducted in America. These findings question whether cross-cultural differences in the expression of SP influence the clinical cut-off scores used in translated versions of social anxiety questionnaires.

  16. Embarrassment about the first panic attack predicts agoraphobia in panic disorder patients.

    PubMed

    Amering, M; Katschnig, H; Berger, P; Windhaber, J; Baischer, W; Dantendorfer, K

    1997-06-01

    In order to find out whether contextual variables of the first panic attack and the person's reaction to it predict the development of agoraphobia in panic disorder patients, 60 patients with a DSM-III-R diagnosis of panic disorder with agoraphobia and 30 patients suffering from panic disorder without agoraphobia were interviewed about their first panic attack. Single comparisons between groups of agoraphobic and non-agoraphobic patients were carried out and a logistic regression model was applied. Occurrence of the first panic attack in public and the feeling of embarrassment were found to be significantly associated with the development of agoraphobia. It is concluded that eliciting this specific form of social concern at an early stage might help to identify patients at risk for later agoraphobia, which could, in turn, help to further specify early therapeutic interventions and concentrate therapeutic efforts on a high-risk group of panic disorder patients.

  17. Latent growth curve analysis of fear during a speech task before and after treatment for social phobia.

    PubMed

    Price, Matthew; Anderson, Page L

    2011-11-01

    Models of social phobia highlight the importance of anticipatory anxiety in the experience of fear during a social situation. Anticipatory anxiety has been shown to be highly correlated with performance anxiety for a variety of social situations. A few studies show that average ratings of anxiety during the anticipation and performance phases of a social situation decline following treatment. Evidence also suggests that the point of confrontation with the feared stimulus is the peak level of fear. No study to date has evaluated the pattern of anxious responding across the anticipation, confrontation, and performance phases before and after treatment, which is the focus of the current study. Socially phobic individuals (N = 51) completed a behavioral avoidance task before and after two types of manualized cognitive behavioral therapy, and gave ratings of fear during the anticipation and performance phases. Results from latent growth curve analysis were the same for the two treatments and suggested that before treatment, anxiety sharply increased during the anticipation phase, was highly elevated at the confrontation, and gradually increased during the performance phase. After treatment, anxiety increased during the anticipation phase, although at a much slower rate than at pretreatment, peaked at confrontation, and declined during the performance phase. The findings suggest that anticipatory experiences are critical to the experience of fear for public speaking and should be incorporated into exposures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Treating university students with social phobia and public speaking fears: Internet delivered self-help with or without live group exposure sessions.

    PubMed

    Tillfors, Maria; Carlbring, Per; Furmark, Tomas; Lewenhaupt, Susanne; Spak, Maria; Eriksson, Anna; Westling, Bengt E; Andersson, Gerhard

    2008-01-01

    This study investigated the efficacy of an Internet-based self-help program with minimal therapist contact via e-mail for Swedish university students with social phobia and public speaking fears. The main objective was to test if the Internet-based self-help program would be more effective if five live group exposure sessions were added. Thirty-eight students meeting the diagnostic and statistical manual of mental disorders, 4th edition criteria for social phobia were randomized into two different treatment groups: Internet delivered cognitive behavior therapy combined with five group exposure sessions (ICBT+ exp) or the Internet program alone (ICBT). Results were analyzed on an intention-to-treat basis. Both treatment groups showed significant improvement from pre- to post-test, and from pre-test to 1-year follow-up, on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). For both the groups, the average within-group effect sizes for the primary social anxiety scales, expressed as Cohen's d, were comparable to those seen in traditionally administered cognitive behavioral therapy both at post-test and at 1- year follow-up. The results suggest that the Internet-based self-help program on its own is efficient in the treatment of university students with social phobia. Adding group exposure sessions did not improve the outcome significantly. Copyright 2008 Wiley-Liss, Inc.

  19. Transfer of manualized Short Term Psychodynamic Psychotherapy (STPP) for social phobia into clinical practice: study protocol for a cluster-randomised controlled trial.

    PubMed

    Wiltink, Jörg; Ruckes, Christian; Haselbacher, Antje; Canterino, Marco; Leichsenring, Falk; Joraschky, Peter; Leweke, Frank; Pöhlmann, Karin; Beutel, Manfred E

    2011-06-08

    Psychodynamic psychotherapy is frequently applied in the treatment of social phobia. Nevertheless, there has been a lack of studies on the transfer of manualized treatments to routine psychodynamic practice. Our study is the first one to examine the effects of additional training in a manualized Short Term Psychodynamic Psychotherapy (STPP) procedure on outcome in routine psychotherapy for social phobia. This study is an extension to a large multi-site RCT (N = 512) comparing the efficacy of STPP to Cognitive-Behavioral Therapy (CBT) of Social Phobia. The manualized treatment is designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners will be randomized to training in manualized STPP vs. treatment as usual without a specific training (control condition). We plan to enrol a total of 105 patients (84 completers). Assessments will be conducted before treatment starts, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 months and 12 months after termination of treatment. The primary outcome measure is the Liebowitz Social Anxiety Scale. Remission from social phobia is defined scoring with 30 or less points on this scale. We will investigate how the treatment can be transferred from a controlled trial into the less structured setting of routine clinical care. This question represents Phase IV of psychotherapy research. It combines the benefits of randomized controlled and naturalistic research. The study is genuinely designed to promote faster and more widespread dissemination of effective interventions. It will answer the questions whether manualized STPP can be implemented into routine outpatient care, whether the new methods improve treatment courses and outcomes and whether treatment effects reached in routine psychotherapeutic treatments are comparable to those of the controlled, strictly manualized treatment of the main study. German Clinical Trials Register (DRKS) DRKS00000570.

  20. Social Phobia in an Italian region: do Italian studies show lower frequencies than community surveys conducted in other European countries?

    PubMed Central

    Carta, Mauro Giovanni; Hardoy, Maria Carolina; Cadeddu, Mariangela; Carpiniello, Bernardo; Dell'Osso, Liliana; Reda, Mario Antonio; Wittchen, Hans-Ulrich

    2004-01-01

    Background The lifetime prevalence of Social Phobia (SP) in European countries other than Italy has been estimated to range from 3.5% to 16.0%. The aim of this study was to assess the frequency of SP in Sardinia (Italy) in order to verify the evidence of a lower frequency of SP in Italy observed in previous studies (from 1.0% to 3.1%). Methods A randomised cross sample of 1040 subjects, living in Cagliari, in rural areas, and in a mining district in Sardinia were interviewed using a Simplified version of the Composite International Diagnostic Interview (CIDIS). Diagnoses were made according to the 10th International Classification of Diseases (ICD-10). Results Lifetime prevalence of SP was 2.2% (males: 1.5%, females: 2.8%) whereas 6-month prevalence resulted in 1.5% (males: 0.9%, females: 2.1%). Mean age at onset was 16.2 ± 9.3 years. A statistically significant association was found with Depressive Episode, Dysthymia and Generalized Anxiety Disorder. Conclusions The study is consistent with findings reported in several previous studies of a lower prevalence of SP in Italy. Furthermore, the results confirm the fact that SP, due to its early onset, might constitute an ideal target for early treatment aimed at preventing both the accumulation of social disabilities and impairments caused by anxiety and avoidance behaviour, as well as the onset of more serious, associated complications in later stages of the illness. PMID:15488146

  1. Psychometric properties of the Mini-Social Phobia Inventory (Mini-SPIN) in a large online treatment-seeking sample.

    PubMed

    Fogliati, Vincent J; Terides, Matthew D; Gandy, Milena; Staples, Lauren G; Johnston, Luke; Karin, Eyal; Rapee, Ronald M; Titov, Nickolai; Dear, Blake F

    2016-04-01

    The Mini-Social Phobia Inventory (Mini-SPIN) is a brief, three-item measure designed as a screening tool for social anxiety disorder (SAD). This study investigated the Mini-SPIN's psychometric properties in a series of trials of Internet-delivered treatment. Participants were 993 people seeking Internet-delivered cognitive behavioural therapy for a range of anxiety and mood disorders. Participants completed the Mini-SPIN, and were diagnosed using the Mini International Neuropsychiatric Interview Version 5.0.0 (MINI). They also completed measures of depression, general anxiety, panic, neuroticism and general impairment. The Mini-SPIN's ability to discriminate between people with and without SAD, within a large sample of people seeking treatment for a range of psychological disorders, was assessed at initial assessment and three-month follow-up. The Mini-SPIN's criterion group validity, internal consistency, test-retest reliability, construct validity and responsiveness to treatment were also examined. Results demonstrated that the Mini-SPIN has an excellent ability to discriminate between those with and without SAD in a highly comorbid clinical sample, and also has good criterion group validity. The Mini-SPIN also exhibited excellent internal consistency, good test-retest reliability, and was responsive to treatment. These results highlight the Mini-SPIN's potential as an efficient and reliable measure of SAD in heterogeneous populations.

  2. [Effectiveness of cognitive-behavioral treatment in social phobia: a description of the results obtained in a public mental health service].

    PubMed

    Leveni, Daniela; Piacentini, Daniele; Campana, Arturo

    2002-01-01

    Cognitive Behavioural Therapy for the treatment of Social Phobia has proved effective through several controlled trials and meta-analyses. In spite of this the CBT has not spread in clinical field yet. Therefore our aim was to verify the effectiveness of the CBT in a public mental health service and to compare our results with those described by experimental research. Participants were 11 public mental health center clients, with a primary diagnosis of Social Phobia (according to DSM-IV criteria). The transportability of CBT to a common clinical setting was examined comparing treatment outcome data, at the end of the treatment and at a six months follow up, with results described in controlled efficacy studies. We employed self completion rating scales relating to both general health conditions and life satisfaction (SF36) and trend of symptoms (LSPS). Moreover we recorded the Clinical Global Impression (CGI) and Patient's Global Impression (PGI). Despite differences in setting, clients and treatment providers, both the magnitude of change from pre-treatment and maintenance of change at a six months follow up were comparable with the parallel findings in the efficacy studies. The results attest the effectiveness of CBT even in a public mental health center setting so, in consideration of the fact that social phobia is a very common disease and involve high degree of severity, chronicity and disability, we hope that this effectual and relatively cheap therapy will be routinely applied in public mental health services.

  3. The SPAI-18, a brief version of the social phobia and anxiety inventory: reliability and validity in clinically referred and non-referred samples.

    PubMed

    de Vente, Wieke; Majdandžić, Mirjana; Voncken, Marisol J; Beidel, Deborah C; Bögels, Susan M

    2014-03-01

    We developed a new version of the Social Phobia and Anxiety Inventory (SPAI) in order to have a brief instrument for measuring social anxiety and social anxiety disorder (SAD) with a strong conceptual foundation. In the construction phase, a set of items representing 5 core aspects of social anxiety was selected by a panel of social anxiety experts. The selected item pool was validated using factor analysis, reliability analysis, and diagnostic analysis in a sample of healthy participants (N = 188) and a sample of clinically referred participants diagnosed with SAD (N = 98). This procedure resulted in an abbreviated version of the Social Phobia Subscale of the SPAI consisting of 18 items (i.e. the SPAI-18), which correlated strongly with the Social Phobia Subscale of the original SPAI (both groups r = .98). Internal consistency and diagnostic characteristics using a clinical cut-off score > 48 were good to excellent (Cronbach's alpha healthy group = .93; patient group = .91; sensitivity: .94; specificity: .88). The SPAI-18 was further validated in a community sample of parents-to-be without SAD (N = 237) and with SAD (N = 65). Internal consistency was again excellent (both groups Cronbach's alpha = .93) and a screening cut-off of > 36 proved to result in good sensitivity and specificity. The SPAI-18 also correlated strongly with other social anxiety instruments, supporting convergent validity. In sum, the SPAI-18 is a psychometrically sound instrument with good screening capacity for social anxiety disorder in clinical as well as community samples. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Further development and validation of the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scales: relationship to anxiety and social phobia among adults who stutter.

    PubMed

    Iverach, Lisa; Menzies, Ross; Jones, Mark; O'Brian, Sue; Packman, Ann; Onslow, Mark

    2011-01-01

    In an initial validation study, the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS I) scale, demonstrated excellent psychometric properties as a self-report measure of the frequency of unhelpful cognitions associated with social anxiety for adults who stutter. The aim was to further validate the original UTBAS I scale, and to develop two additional scales to assess beliefs (UTBAS II) and anxiety (UTBAS III) associated with negative thoughts. A total of 140 adults seeking speech-restructuring treatment for stuttering completed the original UTBAS I scale, the newly developed UTBAS II and III scales, and self-report measures of psychological functioning. Participants also completed a first-stage screener for the presence of anxious personality disorder, and a diagnostic assessment to evaluate the presence of social phobia, according to criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10). The mean UTBAS I score for the present sample did not differ significantly from the mean score reported in the original UTBAS I validation study. Convergent validity was confirmed by significant correlations between the UTBAS Total score and all anxiety-related measures. Discriminant validity was established by the absence of strong correlations between the UTBAS Total score and some of the self-report measures of unrelated constructs, although it was found to tap into the negative cognitions associated with depression and life problems. Approximately one-quarter of participants met criteria for a diagnosis of DSM-IV or ICD-10 social phobia (23.5% and 27.2% respectively), and nearly one-third met first-stage screening criteria for anxious personality disorder (30%). The mean UTBAS scores for participants who met criteria for these disorders were significantly higher than scores for participants who did not, confirming known-groups validity. The present study demonstrates the validity and

  5. [Workplace-related anxiety, workplace phobia and disorders of participation].

    PubMed

    Muschalla, B; Linden, M

    2009-06-01

    Work is an important domain of life. It is therefore clear that problems at the workplace and mental disorders will have negative interactions. Job-related anxieties are of special importance as any workplace causes or intensifies anxiety by its very nature. A common final pathway of mental disorders in general and workplace-related anxieties in particular is workplace phobia. Similarly to agoraphobia, it is characterised by panic when approaching or even thinking of the stimulus, in this case the workplace. Workplace phobia has serious negative consequences for the further course of illness. It impairs the ability to work, and can lead to sick leave and early retirement. It requires special therapeutic interventions. This paper describes workplace-related anxieties and workplace phobia and gives a conceptual framework for their understanding.

  6. Anxiety disorders and onset of cardiovascular disease: the differential impact of panic, phobias and worry.

    PubMed

    Batelaan, Neeltje M; ten Have, Margreet; van Balkom, Anton J L M; Tuithof, Marlous; de Graaf, Ron

    2014-03-01

    Anxiety has been linked to onset of cardiovascular disease. This study examines the differential impact of types of anxiety (panic, phobia and worry) on 3-year onset of non-fatal cardiovascular disease (CVD). By investigating anxiety disorders as opposed to anxiety symptoms and by using a reliable diagnostic instrument to assess anxiety, limitations of previous studies are considered. 5149 persons at risk for CVD were interviewed using the Composite International Diagnostic Interview. The panic-type included panic disorder and panic attacks; the phobic-type included agoraphobia and social phobia, and the worry-type included generalized anxiety disorder. CVD was self-reported and required treatment or monitoring by a doctor. Analyses were adjusted for sociodemographics, behavioral variables, and comorbid somatic and psychiatric disorders. During follow-up, 62 persons (1.2%) developed CVD. Baseline generalized anxiety disorder was strongly associated with onset of CVD (adjusted OR: 3.39). Further research should replicate findings and focus on biological underpinnings of this association.

  7. A meta-analysis and scoping review of social cognition performance in social phobia, posttraumatic stress disorder and other anxiety disorders.

    PubMed

    Plana, India; Lavoie, Marie-Audrey; Battaglia, Marco; Achim, Amélie M

    2014-03-01

    Social cognition deficits are observed in a variety of psychiatric illnesses. However, data concerning anxiety disorders are sparse and difficult to interpret. This meta-analysis aims at determining if social cognition is affected in social phobia (SP) or posttraumatic stress disorder (PTSD) compared to non-clinical controls and the specificity of such deficits relatively to other anxiety disorders. The scoping review aims to identify research gaps in the field. Forty studies assessing mentalizing, emotion recognition, social perception/knowledge or attributional style in anxiety disorders were included, totalizing 1417 anxious patients and 1321 non-clinical controls. Results indicate distinct patterns of social cognition impairments: people with PTSD show deficits in mentalizing (effect size d = -1.13) and emotion recognition (d = -1.6) while other anxiety disorders including SP showed attributional biases (d = -0.53 to d = -1.15). The scoping review identified several under investigated domains of social cognition in anxiety disorders. Some recommendations are expressed for future studies to explore the full range of social cognition in anxiety disorders and allow direct comparisons between different disorders.

  8. Treatment of panic and agoraphobia. An integrative review.

    PubMed

    Mattick, R P; Andrews, G; Hadzi-Pavlovic, D; Christensen, H

    1990-09-01

    There is now agreement about the clinical features of panic disorder and agoraphobia but less agreement about treatment because of controversy over whether the disorder is primarily biological or psychological. The authors were requested to produce an impartial review for continuing education and peer review. We chose to do this by using a quantitative review procedure, by providing a bibliography of studies, and by a literature review. We found that symptoms of panic and phobia did not change significantly while on wait-list control or while receiving placebo. The evidence for the efficacy of the low-potency benzodiazepines or of monoamine oxidase inhibitors was limited. It was also clear that only limited improvement can be expected from behavior therapies that do not involve exposure to the symptoms of panic or to the feared situation. Symptoms of panic, as well as the frequency of spontaneous panic, were shown to be substantially improved following imipramine, high-potency benzodiazepines such as alprazolam, exposure in vivo (especially if a cognitive anxiety management procedure was used), and the combination of imipramine and exposure in vivo. The effects on panic produced by the exposure therapies (with or without imipramine) were maintained over long follow-up periods. Imipramine, alprazolam, exposure therapy, and imipramine plus exposure each produced significant improvements in phobias. In the short term and in the long term, the larger improvements in phobias were associated with exposure therapy, particularly if used in combination with imipramine. We conclude that it would be unwise to theorize about the etiology of this disorder on the basis of response to a specific treatment because, both at the meta-analytic level and from the review of individual studies, it is clear that both drug and nondrug therapies can produce substantial and long-lasting changes in panic and in phobias.

  9. Delays in referral of patients with social phobia, panic disorder and generalized anxiety disorder attending a specialist anxiety clinic.

    PubMed

    Wagner, Renate; Silove, Derrick; Marnane, Claire; Rouen, David

    2006-01-01

    Individuals with anxiety disorders experience substantial delays in obtaining treatment, but little is known about whether people with specific anxiety subcategories are differentially affected. The present study used a modified Encounter Form to examine the cause and length of delays in reaching primary care and specialist services amongst patients with panic disorder (PD/PD-Ag), social phobia (SP), and generalized anxiety disorder (GAD). Participants were 142 consecutive patients attending a specialist anxiety clinic in South Western Sydney. On average, participants with SP took much longer to consult a primary health care provider. Primary care assessments of those with SP often failed to detect anxiety as the key problem, and subsequently, those with SP reported longer delays in reaching specialist care (>9 years). It is not possible to extrapolate the findings to all individuals with SP, as the study was based on specialist service attenders. Nevertheless, the data supports previous findings in suggesting that SP may not be well-recognized as a disorder needing treatment, either by the patient or the primary health care provider. Appropriate educational programs seem warranted to ensure appropriate treatment for this condition.

  10. Reliability and validity of the work and social adjustment scale in phobic disorders.

    PubMed

    Mataix-Cols, David; Cowley, Amy J; Hankins, Matthew; Schneider, Andreas; Bachofen, Martin; Kenwright, Mark; Gega, Lina; Cameron, Rachel; Marks, Isaac M

    2005-01-01

    The Work and Social Adjustment Scale (WSAS) is a simple widely used 5-item measure of disability whose psychometric properties need more analysis in phobic disorders. The reliability, factor structure, validity, and sensitivity to change of the WSAS were studied in 205 phobic patients (73 agoraphobia, 62 social phobia, and 70 specific phobia) who participated in various open and randomized trials of self-exposure therapy. Internal consistency of the WSAS was excellent in all phobics pooled and in agoraphobics and social phobics separately. Principal components analysis extracted a single general factor of disability. Specific phobics gave less consistent ratings across WSAS items, suggesting that some items were less relevant to their problem. Internal consistency was marginally higher for self-ratings than clinician ratings of the WSAS. Self-ratings and clinician ratings correlated highly though patients tended to rate themselves as more disabled than clinicians did. WSAS total scores reflected differences in phobic severity and improvement with treatment. The WSAS is a valid, reliable, and change-sensitive measure of work/social and other adjustment in phobic disorders, especially in agoraphobia and social phobia.

  11. Mediators and Moderators of Outcome in the Behavioral Treatment of Childhood Social Phobia

    ERIC Educational Resources Information Center

    Alfano, Candica A.; Pina, Armando A.; Villalta, Ian K.; Beidel, Deborah C.; Ammerman, Robert T.; Crosby, Lori E.

    2009-01-01

    Data from a study involving 88 youths who participated in one of two randomized controlled treatment trials of Social Effectiveness Therapy for Children reveals that loneliness scores and social effectiveness predicted changes in social anxiety and overall functioning after the treatment. Child-reported loneliness mediated changes in social…

  12. The Social Phobia Inventory: Validity and Reliability in an Adolescent Community Sample

    ERIC Educational Resources Information Center

    Johnson, Helena S.; Inderbitzen-Nolan, Heidi M.; Anderson, Emily R.

    2006-01-01

    Social anxiety disorder and social anxiety are highly prevalent psychological conditions in youth. Because of the known risks associated with the spectrum of social anxiety in youth, early detection with valid and reliable assessment measures is imperative. Self-report measures have become the most widely used method of assessment for child and…

  13. Mediators and Moderators of Outcome in the Behavioral Treatment of Childhood Social Phobia

    ERIC Educational Resources Information Center

    Alfano, Candica A.; Pina, Armando A.; Villalta, Ian K.; Beidel, Deborah C.; Ammerman, Robert T.; Crosby, Lori E.

    2009-01-01

    Data from a study involving 88 youths who participated in one of two randomized controlled treatment trials of Social Effectiveness Therapy for Children reveals that loneliness scores and social effectiveness predicted changes in social anxiety and overall functioning after the treatment. Child-reported loneliness mediated changes in social…

  14. The Social Phobia Inventory: Validity and Reliability in an Adolescent Community Sample

    ERIC Educational Resources Information Center

    Johnson, Helena S.; Inderbitzen-Nolan, Heidi M.; Anderson, Emily R.

    2006-01-01

    Social anxiety disorder and social anxiety are highly prevalent psychological conditions in youth. Because of the known risks associated with the spectrum of social anxiety in youth, early detection with valid and reliable assessment measures is imperative. Self-report measures have become the most widely used method of assessment for child and…

  15. Decrease in self-esteem mediates the association between symptoms of social phobia and depression in middle adolescence in a sex-specific manner: a 2-year follow-up of a prospective population cohort study.

    PubMed

    Väänänen, Juha-Matti; Isomaa, Rasmus; Kaltiala-Heino, Riittakerttu; Fröjd, Sari; Helminen, Mika; Marttunen, Mauri

    2014-03-19

    Social phobia and depression are common, highly comorbid disorders in middle adolescence. The mechanism underlying this comorbidity, however, is unclear. Decrease in self-esteem caused by the initial disorder might play a decisive role in the development of the subsequent disorder. The present study aimed to determine whether the association between symptoms of social phobia and depression is mediated by decrease in self-esteem in mid-adolescent girls and boys. As a part of the prospective Adolescent Mental Health Cohort (AMCH), subjects of this study were 9th grade pupils (mean age, 15.5) responding to a survey conducted in 2002-2003 (T1) and to a 2-year follow-up survey in 2004-2005 (T2) (N = 2070, mean age 17.6 years, 54.5% girls). Symptoms of social phobia without symptoms of depression at age 15 and symptoms of depression at age 17 were associated only among boys, and this association was mediated by decrease in self-esteem. Symptoms of depression without symptoms of social phobia at age 15 and symptoms of social phobia at age 17 were associated only among girls, and this association was partially mediated by decrease in self-esteem. Decrease in self-esteem plays a decisive role in the association between social phobia and depression. Self-esteem should be a key focus in interventions for adolescents suffering from social phobia or depression. Efficient intervention for the first disorder might help to prevent the decline in self-esteem and thus the incidence of the subsequent disorder. These findings are based on a sample of Finnish adolescents and should be confirmed in other jurisdictions or in more ethnically diverse samples.

  16. Decrease in self-esteem mediates the association between symptoms of social phobia and depression in middle adolescence in a sex-specific manner: a 2-year follow-up of a prospective population cohort study

    PubMed Central

    2014-01-01

    Background Social phobia and depression are common, highly comorbid disorders in middle adolescence. The mechanism underlying this comorbidity, however, is unclear. Decrease in self-esteem caused by the initial disorder might play a decisive role in the development of the subsequent disorder. The present study aimed to determine whether the association between symptoms of social phobia and depression is mediated by decrease in self-esteem in mid-adolescent girls and boys. Methods As a part of the prospective Adolescent Mental Health Cohort (AMCH), subjects of this study were 9th grade pupils (mean age, 15.5) responding to a survey conducted in 2002–2003 (T1) and to a 2-year follow-up survey in 2004–2005 (T2) (N = 2070, mean age 17.6 years, 54.5% girls). Results Symptoms of social phobia without symptoms of depression at age 15 and symptoms of depression at age 17 were associated only among boys, and this association was mediated by decrease in self-esteem. Symptoms of depression without symptoms of social phobia at age 15 and symptoms of social phobia at age 17 were associated only among girls, and this association was partially mediated by decrease in self-esteem. Conclusions Decrease in self-esteem plays a decisive role in the association between social phobia and depression. Self-esteem should be a key focus in interventions for adolescents suffering from social phobia or depression. Efficient intervention for the first disorder might help to prevent the decline in self-esteem and thus the incidence of the subsequent disorder. These findings are based on a sample of Finnish adolescents and should be confirmed in other jurisdictions or in more ethnically diverse samples. PMID:24641987

  17. Needle Phobia.

    PubMed

    Cook, Lynda S

    2016-01-01

    Venipuncture is generally associated with some degree of pain, discomfort, and/or apprehension. Yet most patients accept it with tolerance, even nonchalance. A few, not only pediatric patients, exhibit a higher degree of anxiety and face the procedure with tears, tension, and a variety of bargaining techniques (ie, stick on the count of 3; use only this vein). But for 1 group of people, venipuncture is associated with such fear that avoidance of the procedure is practiced. The end results are detrimental to the patient and may have an impact on society as well. These are patients the American Psychiatric Association classifies as needle phobic. What can a nurse with no training in psychiatry do to assist these patients? To form an appropriate professional response, it's beneficial for practitioners to recognize the different pathways that lead to needle phobia and the issues related to the disorder.

  18. Validation of the Social Phobia and Anxiety Inventory for Children (SPAI-C) in a sample of Brazilian children.

    PubMed

    Gauer, G J C; Picon, P; Vasconcellos, S J L; Turner, S M; Beidel, D C

    2005-05-01

    The purpose of the present study was to examine the factor structure and psychometric properties of the Social Phobia and Anxiety Inventory for Children (SPAI-C), an instrument developed in the United States and applied to a sample of Brazilian schoolchildren. The process included the translation of the original material from English into Portuguese by two bilingual psychiatrists and a back translation by a bilingual physician. Both the front and back translations were revised by a bilingual child psychiatrist. The study was performed using a cross-sectional design and the Portuguese version of the SPAI-C was applied to a sample of 1954 children enrolled in 3rd to 8th grade attending 2 private and 11 public schools. Eighty-one subjects were excluded due to an incomplete questionnaire and 2 children refused to participate. The final sample consisted of 1871 children, 938 girls (50.1%) and 933 boys (49.8%), ranging in age from 9 to 14 years. The majority of the students were Caucasian (89.0%) and the remainder were African-Brazilian (11.0%). The Pearson product-moment correlation showed that the two-week test-retest reliability coefficient was r = 0.780 and Cronbach's alpha was 0.946. The factor structure was almost similar to that reported in previous studies. The results regarding the internal consistency, the test-retest reliability and the factor structure were similar to the findings obtained in studies performed on English speaking children. The present study showed that the Portuguese language version of SPAI-C is a reliable and valid measure of social anxiety for Brazilian children.

  19. FAT PHOBIA IN MEXICAN NUTRITION STUDENTS.

    PubMed

    Bacardía Gascón, Montserrat; Jiménez-Cruz, Arturo; Castillo-Ruiz, Octelina; Bezares-Sarmiento, Vidalma Del Rosario; León-González, Juan Marcos

    2015-12-01

    Nutritionists play a major role in the prevention and treatment of obesity. Currently, fat phobia among nutrition students and health workers is resulting in health and social consequences. The aim of this study was to assess the fat phobia among nutrition college students of two schools from different regions in Mexico. Six hundred and thirty 18 to 25 yo nutrition students participated in the study. Fat phobia was assessed using the F-scale, containing 14 pairs of adjectives that described people with obesity. Participants achieved a mean F-scale score of 3.45, which could be considered a moderate amount of fat phobia. Only twelve per cent showed neutral or positive attitudes towards obesity (≤ 2.5), while negative attitude (≥ 2.5) was observed among 88% of all students showing a high prevalence of fat phobia towards obesity. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  20. Effects of corrective surgery on social phobia, psychological distress, disease-related disability and quality of life in adult strabismus patients.

    PubMed

    Alpak, Gokay; Coskun, Erol; Erbagci, Ibrahim; Bez, Yasin; Okumus, Seydi; Oren, Burak; Gurler, Bulent

    2014-07-01

    Corrective surgery is done for ocular alignment and disrupted facial expression in some cases of adult strabismus patients. The effects of corrective surgery on the presence of social phobia (SP) diagnosis, the severity of social anxiety symptoms, the disease-related disability and the quality of life (QoL) among strabismus patients have not been thoroughly studied yet. The study sample was composed of patients who had undergone corrective surgery for strabismus. Preoperative and postoperative evaluations made by using standardised measures of social phobia diagnosis (DSM-IV-TR) and severity (Liebowitz Social Anxiety Scale (LSAS)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), disability (Sheehan Disability Scale) and quality of life (short form-36). Preoperatively, SP diagnosis was detected in 17 of 31 (54.8%) patients, whereas postoperatively 6 of 31 (19.4%) patients had SP (p=0.001). Participants showed a significant decrease in all subscale scores and total score of both LSAS and HADS compared with their preoperative scores. Significant improvements were observed in QoL and disability scores as well. Adult strabismus patients seem to gain benefits from corrective surgery not only for their ocular misalignment but also for social anxiety levels that may be associated with improvements in their QoL and disability levels.

  1. Morals, medicine and change: morality brokers, social phobias, and French psychiatry.

    PubMed

    Lloyd, Stephanie

    2008-06-01

    This paper will examine how French neurotics are being transformed into 'social phobics' and how the appearance of this group may be tied to new personal and social ideals. There are many people and factors that contribute to this changing definition of mental illness. Amongst these, I will focus on the role of three groups who are most vocally acting as morality brokers in the creation of these new subjects: psychiatrists, patients' groups and pharmaceutical companies.

  2. School Phobia: An Overview

    ERIC Educational Resources Information Center

    McDonald, James E.; Sheperd, George

    1976-01-01

    This article discusses general features of school phobia and specific clinical and familial traits and characteristics. Included are overviews of theoretical explanations, types of school phobia, suggested methods of treatment, and their efficacy. (Author)

  3. Phobia - simple/specific

    MedlinePlus

    ... enable JavaScript. A phobia is an ongoing intense fear or anxiety of a certain object, animal, activity, ... panic attack when exposed to the object of fear. Specific phobias are a common mental disorder. Common ...

  4. Specific phobias.

    PubMed

    Hamm, Alfons O

    2009-09-01

    Exposure based treatments in which patients are systematically confronted with their feared objects of situations are highly effective in the treatment of specific phobias and produce stable improvement both in reported fear and behavioral avoidance. Exposure in reality is more effective in most cases than exposure in sensu. For situations that are difficult to realize, exposure in virtual environments has become increasingly valuable. Exposure in vivo is clearly superior to pharmacotherapy, although cognitive enhancers have been successfully used recently to increase the effect of exposure therapy. The induction of relaxation is not a necessary precondition for exposure therapy. Rather the current mechanisms of change focus on extinction learning as being the central mechanism both on a cognitive level namely that the feared object is no longer associated with severely threatening consequence but also on an affective level, meaning that feared cue is no longer capable to activate the fear circuit in the brain. Accordingly future diagnostic categorizations of phobic disorders in the DSM-V should rather focus on the pattern of the fear response that needs to be changed than on the eliciting cues or situations that are avoided.

  5. Social phobia: individual response patterns and the effects of behavioral and cognitive interventions.

    PubMed

    Mersch, P P; Emmelkamp, P M; Bögels, S M; van der Sleen, J

    1989-01-01

    In the present study, the role of individual response patterns in the treatment of social phobic patients was investigated. Seventy-four patients were diagnosed as social phobics. On the basis of extreme scores on a behavioral test (the Simulated Social Interaction Test) and on a cognitive measure (the Rational Behavior Inventory), the response patterns of 39 patients were analyzed, and the patients themselves were classified as either 'behavioral reactors' or 'cognitive reactors'. Half of the patients with each response pattern received a behavioral focused treatment, i.e. social skills training (SST), while the other half received a cognitive oriented treatment, i.e. rational emotive therapy (RET). Patients received group therapy in eight weekly sessions. Within-group differences showed a considerable improvement in all treatment groups. Between-group differences failed to lend support to the hypothesis that treatment that fits a response pattern (i.e. SST for behavioral reactors and RET for cognitive reactors) will result in a greater improvement than one that does not.

  6. Baseline Patient Characteristics Predicting Outcome and Attrition in Cognitive Therapy for Social Phobia: Results from a Large Multicentre Trial.

    PubMed

    Hoyer, Juergen; Wiltink, Joerg; Hiller, Wolfgang; Miller, Robert; Salzer, Simone; Sarnowsky, Stephan; Stangier, Ulrich; Strauss, Bernhard; Willutzki, Ulrike; Leibing, Eric

    2016-01-01

    We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Beyond socio-demographic and clinical variables such as symptom severity and comorbidity status, previously neglected patient characteristics (e.g., personality, self-esteem, shame, interpersonal problems and attachment style) were analysed. Data came from the CT arm of a multicentre RCT with n = 244 patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied. Up to 37% of the post-treatment variance (LSAS) could be explained by all pre-treatment variables combined. Symptom severity (baseline LSAS) was consistently negatively associated with end-state functioning and remission, but not with response. Number of comorbid diagnoses was negatively associated with end-state functioning and response, but not with remission. Self-esteem was positively associated with higher end-state functioning and more shame with better response. Attrition could not be significantly predicted. The results indicate that the initial probability for treatment success mainly depends on severity of disorder and comorbid conditions while other psychological variables are of minor importance, at least on a nomothetic level. This stands in contrast with efforts to arrive at an empirical-based foundation for differential indication and argues to search for more potent moderators of therapeutic change rather on the process level. Personality, self-esteem, shame, attachment style and interpersonal problems do not or only marginally moderate the effects of interventions in CT of social phobia. Symptom severity and comorbid diagnoses might affect treatment outcome negatively

  7. Mediating effects of bullying involvement on the relationship of body mass index with social phobia, depression, suicidality, and self-esteem and sex differences in adolescents in Taiwan.

    PubMed

    Yen, Cheng-Fang; Liu, Tai-Ling; Ko, Chih-Hung; Wu, Yu-Yu; Cheng, Chung-Ping

    2014-03-01

    The aims of this study were to examine the mediating effect of bullying involvement on the relationships between body mass index (BMI) and mental health problems, including social phobia, depression, suicidality, and low self-esteem among adolescents in Taiwan. The moderation effect of sex on the mediating role of bullying involvement was also examined. Five thousand two hundred and fifty-two students of high schools completed the questionnaires. Victimization and perpetration of passive and active bullying were assessed using the Chinese version of the School Bullying Experience Questionnaire. BMI was calculated from self-reported weight and height measurements. The Social Phobia Inventory, the Mandarin Chinese version of the Center for Epidemiological Studies-Depression Scale, the suicidality-related questionnaire from the epidemiological version of the Kiddie-Schedule for Affective Disorders and Schizophrenia, and the Rosenberg Self-Esteem Scale were applied to assess social phobia, depression, suicidality, and low self-esteem, respectively. The mediating effect of bullying involvement on the associations between increased BMI and mental health problems was examined by the Sobel test. The moderation effect of sex on the mediating role of bullying involvement was tested by the multiple-group structural equation model. Victimization of passive and active bullying and perpetration of passive bullying, but not perpetration of active bullying, had a mediating effect on the relationships between increased BMI and all four mental health problems. Sex did not have a significant moderation effect on the mediating role of bullying involvement. Bullying involvement should be a target of prevention and intervention in developing a strategy to improve mental health among adolescents with increased BMI.

  8. Clinical efficacy of Manasamitra Vataka (an Ayurveda medication) on generalized anxiety disorder with comorbid generalized social phobia: a randomized controlled study.

    PubMed

    Tubaki, Basavaraj R; Chandrashekar, Channapatna R; Sudhakar, Deverakonda; Prabha, Talakad N Sathya; Lavekar, Gandhidas S; Kutty, Bindu M

    2012-06-01

    Studies on alternative medicines for generalized anxiety disorder (GAD) are few. Manasamitra Vataka (an Ayurveda preparation) is explored for its efficacy in patients with GAD with comorbid generalized social phobia. Seventy-two (72) patients with GAD with comorbid social phobia meeting DSM IV TR criteria, and who were between the ages of 20 and 55 of either sex, participated in the study. They were randomly divided into three treatment groups: Group 1 (n=24) and Group II (n=24) received Manasamitra Vataka tablets (100 mg twice daily for 30 days). Group II, in addition to Manasamitra Vataka, underwent Shirodhara (therapy involving dripping of medicated oil [Brahmi tail] over the forehead) treatment for the first 7 days. Group III (n=24) received clonazepam 0.75 mg daily in divided dose for 30 days. The assessment of the study was done using the Hamilton Anxiety Rating Scale, Beck Anxiety Inventory, Beck Depression Inventory, Epworth Sleepiness Scale (ESS), World Health Organization Quality of Life BREF, and Clinical Global Impression scales (Improvement and Efficacy). Patients from all the groups showed significant reduction in clinical parameters evaluated. However, improvement in ESS was observed only in Group II. The treatment outcome was comparable between the three groups. This is the first study conducted on the efficacy of Manasamitra Vataka in anxiety disorders. The results suggest that Manasamitra Vataka is effective in the management GAD with comorbid generalized social phobia. Add-on effect of Shirodhara reduced the daytime sleepiness. Further studies on Manasamitra Vataka need to be carried out to judge its potential as a first-line treatment modality.

  9. Collaborative care for panic disorder, generalised anxiety disorder and social phobia in general practice: study protocol for three cluster-randomised, superiority trials.

    PubMed

    Curth, Nadja Kehler; Brinck-Claussen, Ursula Ødum; Davidsen, Annette Sofie; Lau, Marianne Engelbrecht; Lundsteen, Merete; Mikkelsen, John Hagel; Csillag, Claudio; Hjorthøj, Carsten; Nordentoft, Merete; Eplov, Lene Falgaard

    2017-08-16

    People with anxiety disorders represent a significant part of a general practitioner's patient population. However, there are organisational obstacles for optimal treatment, such as a lack of coordination of illness management and limited access to evidence-based treatment such as cognitive behavioral therapy. A limited number of studies suggest that collaborative care has a positive effect on symptoms for people with anxiety disorders. However, most studies are carried out in the USA and none have reported results for social phobia or generalised anxiety disorder separately. Thus, there is a need for studies carried out in different settings for specific anxiety populations. A Danish model for collaborative care (the Collabri model) has been developed for people diagnosed with depression or anxiety disorders. The model is evaluated through four trials, of which three will be outlined in this protocol and focus on panic disorder, generalised anxiety disorder and social phobia. The aim is to investigate whether treatment according to the Collabri model has a better effect than usual treatment on symptoms when provided to people with anxiety disorders. Three cluster-randomised, clinical superiority trials are set up to investigate treatment according to the Collabri model for collaborative care compared to treatment-as-usual for 364 patients diagnosed with panic disorder, generalised anxiety disorder and social phobia, respectively (total n = 1092). Patients are recruited from general practices located in the Capital Region of Denmark. For all trials, the primary outcome is anxiety symptoms (Beck Anxiety Inventory (BAI)) 6 months after baseline. Secondary outcomes include BAI after 15 months, depression symptoms (Beck Depression Inventory) after 6 months, level of psychosocial functioning (Global Assessment of Functioning) and general psychological symptoms (Symptom Checklist-90-R) after 6 and 15 months. Results will add to the limited pool of information about

  10. 12-Step Therapy and Women with and without Social Phobia: A Study of the Effectiveness of 12-Step Therapy to Facilitate AA Engagement

    PubMed Central

    Tonigan, J. Scott; Book, Sarah W.; Pagano, Maria E.; Randall, Patrick K.; Smith, Joshua P.; Randall, Carrie L.

    2011-01-01

    Alcoholism treatment often encourages involvement in Alcoholics Anonymous (AA). Little provision is made for women with social phobia (SP), who have been reported to have worse outcomes in twelve-step-facilitation (TSF) relative to cognitive behavioral therapy. This study examined whether SP moderated the effects of gender for these women in TSF. 133 SP alcoholics assigned to TSF (35 females and 98 males) in Project MATCH were compared to a non-SP control group. SP women drank earlier and more intensely than non-SP women and all males, had equivalent AA attendance and completion of Step 5, and were less likely to acquire a sponsor during TSF. PMID:21423569

  11. The effect of Interaction Anxiousness Scale and Brief Social Phobia Scale for screening social anxiety disorder in college students: a study on discriminative validity.

    PubMed

    Cao, Jianqin; Yang, Jinwei; Zhou, Yuqiu; Chu, Fuliu; Zhao, Xiwu; Wang, Weiren; Wang, Yunlong; Peng, Tao

    2016-12-01

    Social anxiety disorder (SAD) is one of the most prevalent mental health problems, but there is little research concerning the effective screening instruments in practice. This study was designed to examine the discriminative validity of Interaction Anxiousness Scale (IAS) and Brief Social Phobia Scale (BSPS) for the screening of SAD through the compared and combined analysis. Firstly, 421 Chinese undergraduates were screened by the IAS and BSPS. Secondly, in the follow-up stage, 248 students were interviewed by the Structured Clinical Interview for DSM-IV. Receiver operating characteristic (ROC) analysis was used, and the related psychometric characters were checked. The results indicated that the ROC in these two scales demonstrated discrimination is in satisfactory level (range: 0.7-0.8). However, the highest agreement (92.17%) was identified when a cut-off point of 50 measured by the IAS and a cut-off point of 34 by the BSPS were combined, also with higher PPV, SENS, SPEC and OA than that reached when BSPS was used individually, as well as PPV, SPEC and OA in IAS. The findings indicate that the combination of these two scales is valid as the general screening instrument for SAD in maximizing the discriminative validity.

  12. Fears and phobias in people with diabetes.

    PubMed

    Green, L; Feher, M; Catalan, J

    2000-01-01

    Phobic disorders are more common in people with diabetes than in the general population. The management of phobic disorders in patients with diabetes, particularly when associated with a fear of hypoglycaemia, is especially challenging and requires close collaboration between psychological medicine and diabetes teams. Difficulty in distinguishing symptoms of anxiety from those of hypoglycaemia, and the real dangers associated with hypoglycaemia, complicate the delivery of psychological interventions that are used routinely in the treatment of phobias. Avoidance of hypoglycaemia can lead to deterioration in diabetes control. This case report describes a man with Type 1 diabetes who developed agoraphobia with panic disorder, associated with fear of hypoglycaemia and deterioration in glycaemic control. The management of patients with diabetes and phobic disorders, with particular reference to those associated with fear of hypoglycaemia, is discussed. Copyright 2000 John Wiley & Sons, Ltd.

  13. The Social Interaction Phobia Scale: Continued support for the psychometric validity of the SIPS using clinical and non-clinical samples.

    PubMed

    Menatti, Alison R; Weeks, Justin W; Carleton, R Nicholas; Morrison, Amanda S; Heimberg, Richard G; Hope, Debra A; Blanco, Carlos; Schneier, Franklin R; Liebowitz, Michael R

    2015-05-01

    The present study sought to extend findings supporting the psychometric validity of a promising measure of social anxiety (SA) symptoms, the Social Interaction Phobia Scale (SIPS; Carleton et al., 2009). Analyses were conducted using three samples: social anxiety disorder (SAD) patients, generalized anxiety disorder (GAD) patients, and healthy controls. SIPS scores of SAD patients demonstrated internal consistency and construct validity, and the previously demonstrated three-factor structure of the SIPS was replicated. Further, the SIPS total score uniquely predicted SA symptoms, and SIPS scores were significantly higher for SAD patients than GAD patients or controls. Two cut-off scores that discriminated SAD patients from GAD patients and from healthy controls were identified. The current study is the first to replicate the SIPS three-factor model in a large, treatment-seeking sample of SAD patients and establish a cut-off score discriminating SAD from GAD patients. Findings support the SIPS as a valid, SAD-specific assessment instrument.

  14. [Reliability of the Portuguese-language version of the Social Phobia Inventory (SPIN) among adolescent students in the city of Rio de Janeiro].

    PubMed

    Vilete, Liliane Maria Pereira; Coutinho, Evandro da Silva Freire; Figueira, Ivan Luiz de Vasconcellos

    2004-01-01

    It is believed that social phobia has its onset during adolescence and precedes other mental disorders; it is thus important to investigate the condition among young people. To date there is no self-reported scale validated for the Brazilian population. The present study investigated the reliability of the Portuguese-language version of the Social Phobia Inventory (SPIN) among adolescent students from public schools in the city of Rio de Janeiro. After SPIN was translated into Portuguese, a test-retest reliability study was carried out with 190 students. Intra-class correlation coefficient (ICC) and weighted kappa (kappaw2) were estimated, log-linear models were fitted, and Bland & Altman graphs were built. The Portuguese version showed good internal consistency (Cronbach's alpha=0.88) and good reliability for total score (ICC=0.78). Reliability for single items was not very good (kappaw2 between 0.32 and 0.65). The "semi-association" model fit most of the items best. Based on these findings we concluded that the Portuguese-language version of SPIN showed good reliability results, similar to those obtained with the original English-language version.

  15. A cerebellar-vestibular explanation for fears/phobias: hypothesis and study.

    PubMed

    Levinson, H N

    1989-02-01

    To clarify and test the cerebellar-vestibular (CV) basis of fears/phobias, responses of 4000 learning disabled children, adolescents, and adults with neurological and electronystagmographic (ENG) evidence of CV-dysfunction were analyzed for anxiety-related symptoms. Of this sample, 64.6% indicated fears/phobias; females were significantly more predisposed; mixed-handedness was significantly related to fears of heights and reduced vestibular response or asymmetric vestibular functioning. Also, adults had a higher incidence of the specific fears/phobias characterizing agoraphobia than children and adolescents. Analysis of factors reported as triggering the fears/phobias led to (1) a classification and theory of fears/phobias, obsessions/compulsions, and related anxiety symptoms based on realistic or traumatic, neurotic, and CV- or other CNS-based mechanisms rather than on DSM-III--R surface descriptions; (2) an understanding of the relationships between mitral valve prolapse, agoraphobia and panic episodes, as well as depression; and (3) new insights into differential diagnosis and selective treatment.

  16. Psychophysiological evidence for cortisol-induced reduction in early bias for implicit social threat in social phobia.

    PubMed

    van Peer, Jacobien M; Spinhoven, Philip; Roelofs, Karin

    2010-01-01

    The stress hormone cortisol is important for the regulation of social motivational processes. High cortisol levels have been associated with social fear and avoidance, which play an important role in social anxiety disorder (SAD), as does hypervigilant processing of social threat. However, causal effects of cortisol on threat processing in SAD remain unclear. In an event-related potential (ERP) study we investigated the effects of cortisol on task-irrelevant (implicit) processing of social threat in SAD, exploring the temporal dynamics as well as the role of symptom severity and stimulus awareness. Angry face processing was measured in participants with clinical SAD after double-blind, within-subject oral administration of cortisol (50mg) and placebo, using a masked and an unmasked emotional Stroop task. Both tasks showed significantly increased P2 midline ERP amplitudes for angry compared to neutral and happy faces in the placebo condition, reflecting an early attentional bias for social threat in SAD. Furthermore, cortisol administration significantly decreased P2 amplitudes for masked angry faces. This effect correlated with social anxiety, showing stronger decreases in patients with higher levels of social anxiety. These results indicate a highly specific effect of cortisol on early motivated attention to social threat and, together with previous findings, highlight the importance of motivational context (stimulus- or task-relevance) as well as symptom severity.

  17. Use of a religious hymn in remission of symptoms of social phobia (social anxiety disorder): a case study.

    PubMed

    Khouzam, Hani Raoul; Ghafoori, Bita; Nichols, Emma E A

    2005-04-01

    This case report described a veteran with social anxiety disorder who reported fears of negative evaluation by others, social avoidance, and accompanying physiological symptoms of heart palpitations, gastrointestinal discomfort, muscle tension and mental confusion. The symptoms of social anxiety disorder subsided with the use of a Christian hymn "Be Still My Soul" and its accompanying musical poem, in Finlandia. The veteran attributed the symptom remission to the feeling of stillness and surrender to God conveyed by the words and music of the hymn. Although previous studies have shown that both music and religious beliefs can affect mental health, the findings in this case cannot be generalized without conducting further prospective empirical studies.

  18. Social phobia: individual response patterns and the long-term effects of behavioral and cognitive interventions. A follow-up study.

    PubMed

    Mersch, P P; Emmelkamp, P M; Lips, C

    1991-01-01

    In this study the long-term effectiveness of Social Skills Training (SST) and Rational Emotive Therapy (RET), on social phobia was studied, as well as the differential influence of patient characteristics on treatment effectiveness. Fifty-seven patients were assessed 14 months after the post-test. Results showed that long-term effectiveness was independent of the response-pattern of the patients. Comparisons between methods, irrespective of the response-pattern of the patients, showed no differences in effectiveness in favor of either SST or RET. Explorative analysis indicated the potential predictive power for treatment-outcome of confederate ratings of overt behavior on the SSIT. Patients who needed additional treatment appeared to perform significantly worse on this measure at the pretest. No factors could be traced that predict relapse after a relatively successful treatment.

  19. The relative efficacy of imaginal and in vivo desensitization in the treatment of agoraphobia.

    PubMed

    James, J E; Hampton, B A; Larsen, S A

    1983-09-01

    Claims have often been made that in vivo procedures are generally superior to imaginal approaches in the clinical management of anxiety and avoidance behavior. Such claims seem unwarranted in that the relevant clinical research appears only to have involved either flooding or rapid exposure techniques. The aim of the present study was specifically to examine the relative efficacy of imaginal and in vivo desensitization in the clinical management of debilitating phobia. Six agoraphobic women participated in the study which employed a multiple-baseline single-subject methodology. Severity of phobia was repeatedly assessed on measures of avoidance behavior and subjective distress, and subjects self-monitored pulse rate. Significant reductions in phobic behavior were observed during both imaginal and in vivo desensitization, but neither treatment was found to be more effective than the other. Moreover, the same pattern of results was observed for both treatment and generalization settings. As such, the results do not support previous suggestions that in vivo exposure is necessarily superior to imaginal desensitization in the treatment of agoraphobia. Encouraging follow-up results provided some confirmation of previous findings indicating the effectiveness of self-management procedures in the long-term control of agoraphobia.

  20. Agoraphobia Related to Unassertiveness in Panic Disorder.

    PubMed

    Levitan, Michelle Nigri; Simoes, Pedro; Sardinha, Aline G; Nardi, Antonio E

    2016-05-01

    Despite developments in panic disorder (PD) research, a significant percentage of patients do not benefit from conventional treatments. Interpersonal factors have been identified as potential predictors of treatment failures. We aimed to evaluate assertiveness in a sample of patients with PD and its implications for treatment. Forty-six symptomatic patients with PD and 46 college students responded to assessment scales regarding assertiveness and clinical data. Seventy-five percent of the patients had a secondary diagnosis of agoraphobia. We found that the PD group was characterized as nonassertive and slightly less assertive than control subjects. Furthermore, the deficit in the level of assertiveness correlated with the severity of the PD. The diagnosis of agoraphobia was correlated with unassertiveness (p < 0.05). Agoraphobia predisposes individuals to dependency and insecurity about their ability to overcome anxiogenic situations. These data demonstrate the importance of managing assertiveness in patients with PD accompanied by agoraphobia.

  1. Neurobiological correlates of panic disorder and agoraphobia.

    PubMed

    Al-Haddad, M K; Sequeira, R P; Nayar, U

    2001-01-01

    Panic Disorder and agoraphobia offer considerable diagnostic and management challenges, particularly in general practice. We describe a typical case of panic disorder in a young adult. The recent advances in our understanding of brain functions can be used to explain to a certain extent the biologic basis of panic disorder. A hypothetical model integrating current views on panic disorder and agoraphobia has been proposed. The management principles including the role of cognitive therapy and pharmacotherapy have been discussed.

  2. Lamotrigine administration in panic disorder with agoraphobia.

    PubMed

    Masdrakis, Vasilios G; Papadimitriou, George N; Oulis, Panagiotis

    2010-05-01

    Several anticonvulsants, although as yet not lamotrigine (LTG), have been found useful in the treatment of panic disorder with (PDA) or without agoraphobia. We administered LTG (200 mg/d) to 4 outpatients with PDA, as an augmentation therapy (3 patients with chronic and severe agoraphobia) or monotherapy (1 drug-naive patient with first-onset PDA) in a 14-week trial. The patient under LTG monotherapy improved significantly, whereas PDA symptoms in 2 of the other patients improved to some extent.

  3. Agoraphobia: an outreach treatment programme.

    PubMed

    Croft, Alison; Hackmann, Ann

    2013-05-01

    Agoraphobia is disabling and clients find it hard to access effective treatment. This paper describes the development of an inexpensive service, delivered by trained volunteers in or near the client's own home. We describe the development of the service, including selection, training and supervision. Outcomes were evaluated over 5 years, and compared with those available from the local psychology service. Effect sizes on all measures were high. Benchmarking indicated that results on comparable measures were not significantly different from the local psychology service. As in many previous studies drop-out rate was fairly high. This model worked well, and was inexpensive and effective. Further research on long term outcome and methods of enhancing engagement is needed.

  4. Specific phobias in older adults: characteristics and differential diagnosis.

    PubMed

    Coelho, Carlos M; Gonçalves, Daniela C; Purkis, Helena; Pocinho, Margarida; Pachana, Nancy A; Byrne, Gerard J

    2010-08-01

    Differential diagnosis implies identifying shared and divergent characteristics between clinical states. Clinical work with older adults demands not only the knowledge of nosological features associated with differential diagnosis, but also recognition of idiosyncratic factors associated with this population. Several factors can interfere with an accurate diagnosis of specific phobia in older cohorts. The goal of this paper is to review criteria for specific phobia and its differential diagnosis with panic disorder, agoraphobia, post-traumatic stress disorder and obsessive compulsive disorder, while stressing the specific factors associated with aging. A literature search regarding specific phobia in older adults was carried out using PubMed. Relevant articles were selected and scanned for further pertinent references. In addition, relevant references related to differential diagnosis and assessment were used. Etiologic factors, specificity of feared stimulus or situation, fear predictability and the nature of phobic situations are key points to be assessed when implementing a differential diagnosis of specific phobia. First, age-related sensory impairments are common and interfere both with information processing and communication. Second, medical illnesses create symptoms that might cause, interfere with, or mimic anxiety. Third, cohort effects might result in underreporting, through the inability to communicate or recognize anxiety symptoms, misattributing them to physical conditions. Finally, diagnostic criteria and screening instruments were usually developed using younger samples and are therefore not adapted to the functional and behavioral characteristics of older samples.

  5. Agoraphobia

    MedlinePlus

    ... ready to stop taking medication. Certain dietary and herbal supplements claim to have calming and anti-anxiety benefits. ... health risks in some people. For example, the herbal supplement called kava appeared to be a promising treatment ...

  6. Agoraphobia

    MedlinePlus

    ... a type of anxiety disorder in which you fear and avoid places or situations that might cause ... make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using ...

  7. Agoraphobia

    MedlinePlus

    ... are most often the first choice of antidepressant. Serotonin-norepinephrine reuptake inhibitors (SNRIs) are another choice. Other medicines used to treat depression or medicines used to treat seizures may also ...

  8. Transdiagnostic group CBT vs. standard group CBT for depression, social anxiety disorder and agoraphobia/panic disorder: Study protocol for a pragmatic, multicenter non-inferiority randomized controlled trial.

    PubMed

    Arnfred, Sidse M; Aharoni, Ruth; Hvenegaard, Morten; Poulsen, Stig; Bach, Bo; Arendt, Mikkel; Rosenberg, Nicole K; Reinholt, Nina

    2017-01-23

    Transdiagnostic Cognitive Behavior Therapy (TCBT) manuals delivered in individual format have been reported to be just as effective as traditional diagnosis specific CBT manuals. We have translated and modified the "The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders" (UP-CBT) for group delivery in Mental Health Service (MHS), and shown effects comparable to traditional CBT in a naturalistic study. As the use of one manual instead of several diagnosis-specific manuals could simplify logistics, reduce waiting time, and increase therapist expertise compared to diagnosis specific CBT, we aim to test the relative efficacy of group UP-CBT and diagnosis specific group CBT. The study is a partially blinded, pragmatic, non-inferiority, parallel, multi-center randomized controlled trial (RCT) of UP-CBT vs diagnosis specific CBT for Unipolar Depression, Social Anxiety Disorder and Agoraphobia/Panic Disorder. In total, 248 patients are recruited from three regional MHS centers across Denmark and included in two intervention arms. The primary outcome is patient-ratings of well-being (WHO Well-being Index, WHO-5), secondary outcomes include level of depressive and anxious symptoms, personality variables, emotion regulation, reflective functioning, and social adjustment. Assessments are conducted before and after therapy and at 6 months follow-up. Weekly patient-rated outcomes and group evaluations are collected for every session. Outcome assessors, blind to treatment allocation, will perform the observer-based symptom ratings, and fidelity assessors will monitor manual adherence. The current study will be the first RCT investigating the dissemination of the UP in a MHS setting, the UP delivered in groups, and with depressive patients included. Hence the results are expected to add substantially to the evidence base for rational group psychotherapy in MHS. The planned moderator and mediator analyses could spur new hypotheses about mechanisms of change in

  9. Public speaking in social phobia: a pilot study of self-ratings and observers' ratings of social skills.

    PubMed

    Levitan, Michelle Nigri; Falcone, Eliane Mary; Placido, Monique; Krieger, Stephanie; Pinheiro, Layse; Crippa, Jose Alexandre; Bruno, Leandro Marchetti; Pastore, Daniele; Hallak, Jaime; Nardi, Antonio Egidio

    2012-04-01

    The aim of this pilot study was to investigate whether patients with social anxiety disorder (SAD) differ from controls in the quality of skill-related behaviors displayed during a speech and in overall behavioral adequacy as perceived by observers and by the patients themselves. A total of 18 SAD patients and 18 controls were screened by a diagnostic interview and took part in a 3-minute speech of their own choosing. For each videotaped speech, observers rated the adequacy of the skill-related behaviors and overall performance adequacy. After the experiment, participants were asked to rate their own overall performance adequacy. The results showed that SAD patients exhibited significantly worse voice intonation and fluency of the speech, however no differences were found in global self-ratings. Moreover, the performance evaluations of the SAD group were consistent with the observers, while the controls evaluated their performance lower than the observers. The results are inconsistent with the cognitive model, because patients with SAD did not underestimate their performance. Compared with spontaneous interactions, the clear rules established for such social situations as speeches may result in less cognitive distortion for SAD patients. © 2012 Wiley Periodicals, Inc.

  10. Phobias and their management.

    PubMed Central

    Marks, I; Horder, J

    1987-01-01

    Disabling phobias and phobia like compulsive rituals are surprisingly common in the general population, though only a minority ask for help. Behavioural treatment (exposure) and antidepressants are the most helpful approaches. Most patients can help themselves if they use a self exposure approach systematically under the guidance of a clinician. The method seems well suited for use by general practitioners. Anti-depressants are a useful adjuvant, not a substitute, for exposure when there is evidence of depression complicating the phobias or rituals. PMID:3117246

  11. The clinical-familial correlates and naturalistic outcome of panic-disorder-agoraphobia with and without lifetime bipolar II comorbidity

    PubMed Central

    Toni, Cristina; Perugi, Giulio; Frare, Franco; Tusini, Giuseppe; Fountoulakis, Konstantinos N; Akiskal, Kareen K; Akiskal, Hagop S

    2008-01-01

    Background Much of the literature on panic disorder (PD)-bipolar disorder (BP) cormorbidity concerns BP-I. This literature emphasizes the difficulties encountered in pharmacologic treatment and outcome when such comorbidity is present. The present report explores these issues with respect to BP-II. Methods The sample comprised 326 outpatients (aged 34.5 ± 11.5 years old; 222 females) with Diagnostic and Statistical Manual of Mental Disorders 3rd edn, revised (DSM-III-R) PD-agoraphobia; among them 52 subjects (16%) were affected by lifetime comorbidity with BP-II. Patients were evaluated by means of the Structured Clinical Interview for DSM-IV (SCID), the Panic-Agoraphobia Interview, and the Longitudinal Interview Follow-up Examination (Life-Up) and treated according to routine clinical practice at the University of Pisa, Italy, for a period of 3 years. Clinical and course features were compared between subjects with and without BP-II. All patients received the clinicians' choice of antidepressants and, in the case of the subsample with BP-II, mood stabilizers (for example, valproate, lithium) were among the mainstays of treatment. Results In comparison to patients without bipolar comorbidity, those with BP-II showed a significantly greater frequency of social phobia, obsessive-compulsive disorder, alcohol-related disorders, and separation anxiety during childhood and adolescence. Regarding family history, a significantly greater frequency of PD and mood disorders was present among the BP-II. No significant differences were observed in the long-term course of PD or agoraphobic symptoms under pharmacological treatment or the likelihood of spontaneous pharmacological treatment interruptions. Conclusion Although the severity and outcome of panic-agoraphobic symptomatology appear to be similar in patients with and without lifetime bipolar comorbidity, the higher number of concomitant disorders in our PD patients with BP-II does indicate a greater complexity of the

  12. Using a hybrid model to investigate the comorbidity and symptom overlap between social phobia and the other anxiety disorders and unipolar mood disorders.

    PubMed

    Gros, Daniel F; McCabe, Randi E; Antony, Martin M

    2013-11-30

    New hybrid models of psychopathology have been proposed that combine the current categorical approach with symptom dimensions that are common across various disorders. The present study investigated the new hybrid model of social anxiety in a large sample of participants with anxiety disorders and unipolar mood disorders to improve understanding of the comorbidity and symptom overlap between social phobia (SOC) and the other anxiety disorders and unipolar mood disorders. Six hundred and eighty two participants from a specialized outpatient clinic for anxiety treatment completed a semi-structured diagnostic interview and the Multidimensional Assessment of Social Anxiety (MASA). A hybrid model symptom profile was identified for SOC and compared with each of the other principal diagnoses. Significant group differences were identified on each of the MASA scales. Differences also were identified when common sets of comorbidities were compared within participants diagnosed with SOC. The findings demonstrated the influence of both the principal diagnosis of SOC and other anxiety disorders and unipolar mood disorders as well as the influence of comorbid diagnoses with SOC on the six symptom dimensions. These findings highlight the need to shift to transdiagnostic assessment and treatment practices that go beyond the disorder-specific focus of the current categorical diagnostic systems.

  13. Fears and Phobias

    MedlinePlus

    ... that thing or situation. Someone might develop a bee phobia after being stung during a particularly scary ... that person, looking at a photograph of a bee, seeing a bee from a distance, or even ...

  14. Cognitive factors in panic disorder, agoraphobic avoidance and agoraphobia.

    PubMed

    Berle, David; Starcevic, Vladan; Hannan, Anthony; Milicevic, Denise; Lamplugh, Claire; Fenech, Pauline

    2008-02-01

    There remains a lack of consensus regarding the possibility that especially high levels of panic-related cognitions characterise panic disorder with agoraphobia. We administered the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire and the Anxious Thoughts and Tendencies Scale as well as measures of agoraphobic avoidance to patients diagnosed with panic disorder with agoraphobia (n=75) and without agoraphobia (n=26). Patients with panic disorder with agoraphobia did not score significantly higher on any of the cognitive variables than did panic disorder patients without agoraphobia. However, most of the cognitive variables showed small to moderate-strength correlations with self-report measures of agoraphobic avoidance. Our findings suggest that anxiety sensitivity, catastrophising of the consequences of panic and a general anxiety-prone cognitive style, although to some extent associated with agoraphobic avoidance, do not discriminate panic disorder with agoraphobia from panic disorder without agoraphobia.

  15. Daily fluctuation of emotions and memories thereof: Design and methods of an experience sampling study of major depression, social phobia, and controls.

    PubMed

    Gloster, Andrew T; Miché, Marcel; Wersebe, Hanna; Mikoteit, Thorsten; Hoyer, Jürgen; Imboden, Christian; Bader, Klaus; Meyer, Andrea H; Hatzinger, Martin; Lieb, Roselind

    2017-09-01

    Symptom fluctuations and the dynamic contexts provoking these are poorly understood. This deficit is compounded by people's limited ability to accurately report about such dimensions in retrospect. Utilizing the advantages of experience sampling methodology (ESM), this study rigorously describes and tests proximal environmental, neurobiological and psychological factors associated with symptoms and mood states. Participants were assigned to three diagnostic groups: Major Depressive Disorder (MDD; n = 118), Social Phobia (SP; n = 47), or a Control Group without SP or MDD (CG; n = 119). Laboratory assessments included cognitive abilities, memory, constructs, and brain derived neurotrophic factor (BDNF). ESM lasted seven days, with six assessments per day covering symptoms, affect, daily events, social interactions, post-event processing, well-being, etc. Morning cortisol and actigraphy were also assessed during ESM. Thereafter, participants provided subjective retrospective recall estimates of the emotions they reported during ESM. The multi-level data of >10,000 observations will allow for thorough examination of fluctuations of psychopathology and well-being in two highly prevalent disorders. Using two clinical groups and a non-affected control group, the clinical specificity versus generalizability of processes can be directly tested, thus providing stimulating information about the overlap and differences between anxiety and affective disorders. This research informs about the development, fluctuation, and maintaining factors of emotions and symptoms and examines the accuracy with which participants recall these dimensions. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Find Your Voice: Eliminate Classroom Phobias

    ERIC Educational Resources Information Center

    Miranda, Michael V.

    2007-01-01

    The academically underprepared community college student may also be psychosocially underprepared for college, a condition contributing to the development of classroom-specific social phobia and to the high attrition rate at community colleges. The "Find Your Voice Program" uses individual and group cognitive-behavioral techniques to develop…

  17. Find Your Voice: Eliminate Classroom Phobias

    ERIC Educational Resources Information Center

    Miranda, Michael V.

    2007-01-01

    The academically underprepared community college student may also be psychosocially underprepared for college, a condition contributing to the development of classroom-specific social phobia and to the high attrition rate at community colleges. The "Find Your Voice Program" uses individual and group cognitive-behavioral techniques to develop…

  18. [A specific phobia of amyotrophic lateral sclerosis (ALS phobia)].

    PubMed

    Levitskiĭ, G N; Gilod, V M; Levin, O S

    2012-01-01

    A specific phobia of amyotrophic lateral sclerosis (ALS phobia) was not previously described in the literature. We examined 21 patients, 11 men and 10 women, aged 28-72 years, with symptoms of this phobia. Only 23% of patients had a history of the psychiatric disorder in the past. The duration of phobia symptoms was significantly higher in patients with moderate and severe phobia than in mild cases (1.5±0.6 and 5.0±1.1 months respectively; р<0.05). The severity of ALS phobia was correlated with its duration (r= -0.5; p=0.004). The primary character of phobia was established in 52.4% of patients basing on the regression of phobia symptoms assessed by the Hamilton anxiety scale after psychotherapy and pharmacotherapy (17±4 and 3±1 scores before and 3 months after treatment, respectively; p<0.05).

  19. Blood injury and injection phobia: the neglected one.

    PubMed

    Wani, Ab Latif; Ara, Anjum; Bhat, Sajad Ahmad

    2014-01-01

    Blood injury and injection (BII) phobia is a unique phobia associated with a diphasic cardiovascular response. The aim of this survey was to report the prevalence of BII phobia, its heritability, and clinical characteristics among the males and females in the Indian subcontinent. An interview and a survey were conducted using a developed BII phobia 21-item questionnaire among 3261 participant males (n = 1648) and females (n = 1613). Cronbach' alpha (α) of 0.972 of internal consistency was reported. The prevalence of BII phobia and associated fainting in females was slightly more than double in the males with a significant gender related effect. Similar avoidance behaviours involving hospital visits were reported for both males and females. The relative frequency of BII phobia among first and third degree relatives was found to be higher than among second degree relatives. Depression was found highly comorbid with BII phobia while a low rate of obsessive compulsion disorder (OCD) and social anxiety disorder (SAD) was reported. Morbidity associated with BII phobia may increase dramatically when other medical problems coincide with it.

  20. Blood Injury and Injection Phobia: The Neglected One

    PubMed Central

    2014-01-01

    Blood injury and injection (BII) phobia is a unique phobia associated with a diphasic cardiovascular response. The aim of this survey was to report the prevalence of BII phobia, its heritability, and clinical characteristics among the males and females in the Indian subcontinent. An interview and a survey were conducted using a developed BII phobia 21-item questionnaire among 3261 participant males (n = 1648) and females (n = 1613). Cronbach' alpha (α) of 0.972 of internal consistency was reported. The prevalence of BII phobia and associated fainting in females was slightly more than double in the males with a significant gender related effect. Similar avoidance behaviours involving hospital visits were reported for both males and females. The relative frequency of BII phobia among first and third degree relatives was found to be higher than among second degree relatives. Depression was found highly comorbid with BII phobia while a low rate of obsessive compulsion disorder (OCD) and social anxiety disorder (SAD) was reported. Morbidity associated with BII phobia may increase dramatically when other medical problems coincide with it. PMID:25049451

  1. Factors in the panic-agoraphobia transition.

    PubMed

    Katerndahl, D A

    1989-01-01

    A cause-and-effect relation between panic attacks and agoraphobia is an accepted concept. It is believed that, left unchecked, a subgroup of patients with panic attacks will consistently develop agoraphobia. However, to date, there are no means for early identification of this at-risk group. This study analyzed patients with panic attacks and phobic avoidance behaviors by using population-based, survey-collected data. Path analysis was used to determine relations among panic symptoms, phobic behaviors, panic-phobic lag times, and measures of pervasiveness and severity of fears and panic. Panic-related chest pain, dyspnea, trembling, and fear were important factors in the development, pervasiveness, and severity of situational fears and anticipatory anxiety. However, full-blown agoraphobia was only related to the presence of anticipatory anxiety and the pervasiveness of phobic avoidance behaviors. Although the age-of-onset of panic and phobic avoidance was unrelated to other factors, lag times were dependent upon panic symptomatology and the presence of depression. These findings suggest that patients with panic attacks who are at risk for agoraphobia can be identified by the nature of their panic symptoms, and perhaps, through early treatment, the development of phobic avoidance can be averted.

  2. Depersonalization and agoraphobia associated with marijuana use.

    PubMed

    Moran, C

    1986-06-01

    This paper examines the role of uncontrolled depersonalization associated with marijuana use in the development of agoraphobia. Cases of six people are described, all of whom reported first experiencing depersonalization while using marijuana, and subsequently experiencing depersonalization while not using the drug. A fear of this 'uncontrolled' depersonalization resulted in considerable anticipatory anxiety and panic attacks. Patients ultimately presented for treatment of agoraphobia. A temporal relationship between marijuana use, uncontrolled depersonalization, panic attacks and agoraphobia does not imply causality. Comparison of these cases with other agoraphobia clinic patients provides tentative evidence for a difference between the two types of patients. There were no systematic patterns of stressors in the cases prior to the onset of symptoms. Data obtained before and after treatment indicated the cases were slightly more severe than clinic patients. Males and females were represented equally in the cases, whereas there was a higher incidence of females in the clinic patients. The cases' age of onset was younger than that of the clinic patients. Our standard cognitive-behavioural treatment programme required modification to account for the intensity of the fear of depersonalization in the cases.

  3. Out of Place: Narrative Insights into Agoraphobia.

    ERIC Educational Resources Information Center

    Capps, Lisa; Ochs, Elinor

    1995-01-01

    Explores how agoraphobia is realized through the activity of storytelling. Analyzes one agoraphobic woman's narrative to articulate the narrative structuring of a panic episode, the grammatical resources systematically recruited to portray panic as unaccountable and the protagonist as irrational and helpless, and a recurrent communicative dilemma…

  4. How cognitive performance-induced stress can influence right VLPFC activation: an fMRI study in healthy subjects and in patients with social phobia.

    PubMed

    Koric, Lejla; Volle, Emmanuelle; Seassau, Magali; Bernard, Frédéric A; Mancini, Julien; Dubois, Bruno; Pelissolo, Antoine; Levy, Richard

    2012-08-01

    The neural bases of interactions between anxiety and cognitive control are not fully understood. We conducted an fMRI study in healthy participants and in patients with an anxiety disorder (social phobia) to determine the impact of stress on the brain network involved in cognitive control. Participants performed two working memory tasks that differed in their level of performance-induced stress. In both groups, the cognitive tasks activated a frontoparietal network, involved in working memory tasks. A supplementary activation was observed in the right ventrolateral prefrontal cortex (VLPFC) in patients during the more stressful cognitive task. Region of interest analyses showed that activation in the right VLPFC decreased in the more stressful condition as compared to the less stressful one in healthy subjects and remain at a similar level in the two cognitive tasks in patients. This pattern was specific to the right when compared to the left VLPFC activation. Anxiety was positively correlated with right VLPFC activation across groups. Finally, left dorsolateral prefrontal cortex (DLPFC) activation was higher in healthy subjects than in patients in the more stressful task. These findings demonstrate that in healthy subjects, stress induces an increased activation in left DLPFC, a critical region for cognitive control, and a decreased activation in the right VLPFC, an area associated with anxiety. In patients, the differential modulation between these dorsal and ventral PFC regions disappears. This absence of modulation may limit anxious patients' ability to adapt to demanding cognitive control tasks.

  5. RESPIRATORY, AUTONOMIC, AND EXPERIENTIAL RESPONSES TO REPEATED INHALATIONS OF 20% CO2 ENRICHED AIR IN PANIC DISORDER, SOCIAL PHOBIA, AND HEALTHY CONTROLS

    PubMed Central

    Blechert, Jens; Wilhelm, Frank H.; Meuret, Alicia E.; Wilhelm, Eva M.; Roth, Walton T.

    2010-01-01

    Inhalation of carbon-dioxide (CO2) enriched air triggers anxiety in panic disorder (PD) patients, which is often interpreted as a sign of biological vulnerability. However, most studies have not measured respiration in these tasks. We compared patients with PD (N=20) and social phobia (SP, N=19) to healthy controls (N=18) during eight inhalations of 20% CO2, preceded and followed by two inhalations of room air, while continuously measuring subjective anxiety and dyspnea as well as autonomic and respiratory variables. PD patients showed increased reactivity and delayed recovery during CO2 inhalations for most measures. Unlike both other groups, the PD group’s tidal volume responses did not habituate across CO2 inhalations. However, PD patients did not differ from SP patients on most other measures, supporting a continuum model of CO2 sensitivity across anxiety disorders. Both patient groups showed continued reactivity during the last air inhalations, which is unlikely to be due to a biological sensitivity. PMID:20064582

  6. Moderators and mediators among panic, agoraphobia symptoms, and suicidal ideation in patients with panic disorder.

    PubMed

    Huang, Mei-Feng; Yen, Cheng-Fang; Lung, For-Wey

    2010-01-01

    The most important change of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) is the use of dimensional approach to assess the severity of symptoms across different diagnosis. There are 2 purposes in this study: the first purpose was to identify the proportion of outpatients with panic disorder who have suicidal ideation. The second aim was to examine the relationships among panic, agoraphobic symptoms, and suicidal ideation in patients with panic disorder, adjusting by age, social support, and alcohol use. Sixty patients with panic disorder were recruited from outpatient psychiatric clinics in southern Taiwan. Suicidal ideation in the preceding 2 weeks was measured. The Panic and Agoraphobic Symptoms Checklist, Social Support Scale, Questionnaire for Adverse Effects of Medication for Panic Disorder, and Social Status Rating Scale were used to understand the severity of panic and agoraphobia, social support, drug adverse effects, and social status. Significant variables from the univariate analysis were included in a forward regression model. Then, we used structural equation modeling to fit the model. We found that 31.7% of outpatients with panic disorder had had suicidal ideation in the preceding 2 weeks. Multiple regression analysis showed that younger age, current alcohol use, more severe panic symptoms, and less social support were associated with suicidal ideation. In addition, the structural equation model illustrated the recursive model from panic to agoraphobia and suicidal ideation. Agoraphobia had no association with suicidal ideation. Panic symptom was a mediator to suicidal ideation but not agoraphobic symptoms. A high proportion of patients with panic disorder had suicidal ideation. We found that panic symptoms, social support, age, and alcohol use affected suicide and could be identified. The 3-level model from panic to agoraphobia revealed that panic was a predictor of agoraphobia and agoraphobia was not a predictor

  7. A randomized controlled trial of a transdiagnostic Internet intervention for individuals with panic and phobias - One size fits all.

    PubMed

    Schröder, Johanna; Jelinek, Lena; Moritz, Steffen

    2017-03-01

    Many individuals with anxiety disorders do not receive professional treatment. Internet interventions have shown to be effective in the treatment of anxiety. The present randomized controlled trial was designed to examine the effectiveness of a short-term (4-week) Internet intervention in treating panic disorder, agoraphobia, social anxiety disorder, and specific phobias ('ConfID'). We addressed the questions of whether this transdiagnostic program would affect these disorders to varying degrees and whether there would be moderators of effectiveness. Adults who were recruited in online forums for anxiety underwent an online baseline assessment (N = 179) and were randomized either to the intervention group (ConfID) or the control group (care as usual). Online post-assessment took place 4 weeks later. The primary outcome was assessed with the Beck Anxiety Inventory (BAI); the secondary outcomes targeted the disorder-specific symptoms, depression, and somatization. Participants in the intervention group showed a significantly stronger anxiety reduction compared to participants receiving care as usual (small-to-medium effect size between groups in intention-to-treat analysis). The treatment effect was similar for the different disorders and was moderated by participants' attitudes towards Internet interventions. Secondary outcomes yielded effect sizes in the medium range. Moderate treatment adherence, lack of measures beyond online self-reports, and unavailability of long-term results. The study provides further evidence that transdiagnostic Internet interventions are promising in reducing the existing treatment gap in individuals with panic disorder and phobias. Results extend previous findings by showing that significant effects can also be reached by comprehensive short-term programs and that the effects might be moderated by participants' attitudes towards Internet interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. [Panic disorders and agoraphobia: Freudian concepts and DSM IV].

    PubMed

    Manfredi de Poderoso, Clelia; Linetzky, Leonardo

    2003-01-01

    This paper refers to the relationship between panic and agoraphobia, regarding Panic Disorder and Agoraphobia (DSM IV), from two different points of view coming from Psychoanalysis and Psychiatry. Psychoanalysis (S. Freud) considers agoraphobia as a defensive organization to avoid anxiety, not bound to the original conflict, but to substitutive formation. The exposure to space (its unconscious significance) provokes panic attack. The psychiatric approach considers agoraphobia, meaningless by its own, as a consequence of spontaneous panic attacks. The etiology is referred to neurophysiological mechanisms. The authors reviewd D Klein's hypothesis about panic and Freud's theories on anxiety, partiularly Anxiety Neurosis.

  9. Benzodiazepines in panic disorder and agoraphobia.

    PubMed

    Sheehan, D V

    1987-01-01

    Benzodiazepines, particularly alprazolam, are quickly becoming the drugs of first choice in the treatment of many cases of panic and agoraphobia. The reason for this choice is that these drugs are safer to use, quicker in onset of action, easier for the physician to prescribe and more pleasant for the patient to take than the alternatives. Although the treatment of panic disorder and agoraphobia has been best studied with the benzodiazepine alprazolam, it now appears likely that other benzodiazepines, for example diazepam, lorazepam and chlorazepam, may also be effective when correctly used. There is no reason at this point to believe that any of the benzodiazepines are unique in this regard. Future research will undoubtedly clarify this observation. In the meantime, it is hoped that some of the guidelines in this paper will help the practicing clinician in the management of his patient with this disabling and neglected disease.

  10. Specific phobia in youth: phenomenology and psychological characteristics.

    PubMed

    Ollendick, Thomas H; Raishevich, Natoshia; Davis, Thompson E; Sirbu, Cristian; Ost, Lars-Göran

    2010-03-01

    Sociodemographic and psychological characteristics of 62 youth with animal and natural environment types of specific phobia were examined in a treatment-seeking sample. Differences due to age, sex, ethnicity, family structure, and family socioeconomic status were not found between youth with the two types of specific phobia. Moreover, differences were not obtained between the two groups in the clinical severity of their phobias, the perceived dangerousness of the feared outcomes associated with their phobias, the perceived levels of coping with their phobias, or overall fearfulness. However, differences between youth with the two types of specific phobias were found on somatic/anxious symptoms, depressive symptoms, and life satisfaction. In addition, differences were noted on withdrawn, somatic complaints, anxious/depressed symptoms, and social problems as reported by the mothers of these youngsters. Finally, differences in the percent of co-occurring anxiety disorders between youth with the two types of specific phobia were found. On all of the domains in which differences were found, youth with the natural environment type fared more poorly than those with the animal type. These findings converge with those obtained in treatment studies which indicate that youth with the natural environment type are more difficult to treat than youth with the animal type.

  11. Specific Phobia in Youth: Phenomenology and Psychological Characteristics

    PubMed Central

    Ollendick, Thomas H.; Raishevich, Natoshia; Davis, Thompson E.; Sirbu, Cristian; Öst, Lars-Göran

    2012-01-01

    Sociodemographic and psychological characteristics of 62 youth with animal and natural environment types of specific phobia were examined in a treatment-seeking sample. Differences due to age, sex, ethnicity, family structure, and family socioeconomic status were not found between youth with the two types of specific phobia. Moreover, differences were not obtained between the two groups in the clinical severity of their phobias, the perceived dangerousness of the feared outcomes associated with their phobias, the perceived levels of coping with their phobias, or overall fearfulness. However, differences between youth with the two types of specific phobias were found on somatic/anxious symptoms, depressive symptoms, and life satisfaction. In addition, differences were noted on withdrawn, somatic complaints, anxious/depressed symptoms, and social problems as reported by the mothers of these youngsters. Finally, differences in the percent of co-occurring anxiety disorders between youth with the two types of specific phobia were found. On all of the domains in which differences were found, youth with the natural environment type fared more poorly than those with the animal type. These findings converge with those obtained in treatment studies which indicate that youth with the natural environment type are more difficult to treat than youth with the animal type. PMID:20171334

  12. Prescribing patterns in agoraphobia with panic attacks.

    PubMed

    Evans, L E; Oei, T P; Hoey, H

    1988-01-18

    Although medication is used commonly in the treatment of agoraphobia with panic attacks, the actual drug-prescribing patterns of the medical profession have not been well studied in this condition. The present study compares the prescribing patterns of general practitioners and psychiatrists in their treatment of agoraphobia with panic attacks. The medical records of 111 agoraphobic patients with panic attacks were analysed and divided into those who were referred by general practitioners and those who were referred by psychiatrists. Over all, in the treatment of agoraphobia with panic attacks, general practitioners prescribed drugs less often than did psychiatrists. They used fewer combinations of drugs and tended to prescribe tricyclic antidepressant agents in doses which generally are considered to be below the therapeutic range. This finding would suggest that general practitioners are less effective than are psychiatrists in prescribing for this condition as judged by current practice, although they are less likely to prescribe combinations of drugs--a practice which might well be to their credit.

  13. Behaviour completion mechanisms, anxiety and agoraphobia.

    PubMed

    McConaghy, N; Silove, D; Hall, W

    1989-09-01

    Little attention has been paid to the situations which provoke the initial attack of anxiety in agoraphobia. According to the behaviour completion hypothesis many normal subjects experience increased tension in such situations when there is a delay in the completion of a behaviour. One hundred and eight medical students completed a questionnaire designed to investigate this hypothesis. They reported experiencing increased tension or anxiety significantly more frequently in situations provoking agoraphobia when the situations contained a component of delay, as compared to such situations without this component, or to situations not commonly provoking agoraphobia. It is proposed that tension, anxiety and panic form a continuum of increasing levels of arousal, but are associated with different cognitions. It is further proposed that the arousal level of agoraphobics is sensitized, so that delay which provokes mild increases of arousal in the healthy, provokes high arousal in agoraphobics. This finding supports the hypothesis that delay in behaviour completion is a mechanism in the generation of tension and anxiety.

  14. School phobia in children with dyslexia.

    PubMed

    Łodygowska, Ewa; Czepita, Damian A

    2012-01-01

    Dyslexic disorders are found in many children, affecting the emotional and social sphere and producing negative consequences for school functioning of the child. The aim of the present work was to determine the impact of the type of therapy on school phobia in dyslexic children. 165 dyslexic children were examined using the questionnaire "Me and my school" developed by Elzbieta Skrzypek-Siwińska. The therapeutic experience of the children was taken into account and three groups were formed: 1) children with regular therapy; 2) children with occasional therapy; 3) children without therapy. Children with occasional therapy demonstrated higher levels of school phobia. These children exhibited a higher level of fear in situations when their knowledge was tested. Girls revealed a higher level of school phobia and knowledge testing fear, regardless of their therapeutic experience. The present study disclosed that the quality of therapy affects the emotional sphere of dyslexic children. Irregular therapy can produce serious consequences in the form of enhanced school phobia.

  15. WAYS OF ACQUIRING FLYING PHOBIA.

    PubMed

    Schindler, Bettina; Vriends, Noortje; Margraf, Jürgen; Stieglitz, Rolf-Dieter

    2016-02-01

    The few studies that have explored how flying phobia is acquired have produced contradictory results. We hypothesized that classical conditioning plays a role in acquiring flying phobia and investigated if vicarious (model) learning, informational learning through media, and experiencing stressful life events at the time of onset of phobia also play a role. Thirty patients with flying phobia and thirty healthy controls matched on age, sex, and education were interviewed with the Mini-DIPS, the short German version of the Anxiety Disorders Interview Schedule (DSM-IV diagnostic criteria) and the Fear-of-Flying History Interview. Fifty Percent of patients with flying phobia and 53% of healthy controls reported frightening events in the air. There was no significant difference between the two samples. Thus there were not more classical conditioning events for patients with flying phobia. There also was no significant difference between the two samples for vicarious (model) learning: 37% of flying phobia patients and 23% of healthy controls felt influenced by model learning. The influence of informational learning through media was significantly higher for the clinical sample (70%) than for the control group (37%). Patients with flying phobia experienced significantly more stressful life events in the period of their frightening flight experience (60%) than healthy controls (19%). Frightening experiences while flying are quite common, but not everybody develops a flying phobia. Stressful life events and other factors might enhance conditionability. Informational learning through negative media reports probably reinforces the development of flying phobia. Clinical implications are discussed. © 2015 Wiley Periodicals, Inc.

  16. Cortisol-induced enhancement of emotional face processing in social phobia depends on symptom severity and motivational context.

    PubMed

    van Peer, Jacobien M; Spinhoven, Philip; van Dijk, J Gert; Roelofs, Karin

    2009-05-01

    We investigated the effects of cortisol administration on approach and avoidance tendencies in 20 patients with social anxiety disorder (SAD). Event-related brain potentials (ERPs) were measured during a reaction time task, in which patients evaluated the emotional expression of photographs of happy and angry faces by making an approaching (flexion) or avoiding (extension) arm movement. Patients showed significant avoidance tendencies for angry but not for happy faces, both in the placebo and cortisol condition. Moreover, ERP analyses showed a significant interaction of condition by severity of social anxiety on early positive (P150) amplitudes during avoidance compared to approach, indicating that cortisol increases early processing of social stimuli (in particular angry faces) during avoidance. This result replicates previous findings from a non-clinical sample of high anxious individuals and demonstrates their relevance for clinical SAD. Apparently the cortisol-induced increase in processing of angry faces in SAD depends on symptom severity and motivational context.

  17. Is dental phobia a blood-injection-injury phobia?

    PubMed

    van Houtem, C M H H; Aartman, I H A; Boomsma, D I; Ligthart, L; Visscher, C M; de Jongh, A

    2014-12-01

    Dental phobia is part of the Blood-Injection-Injury (B-I-I) phobia subtype of specific phobia within DSM-IV-TR. To investigate the conceptual validity of this classification, the purpose of the present study was to determine the co-occurrence of dental phobia, typical dental (and B-I-I related) fears, vasovagal fainting, and avoidance of dental care. Data were collected by an online survey in Dutch twin families (n = 11,213). Individuals with a positive screen of dental phobia (0.4% of the sample) rated typical B-I-I-related stimuli as relatively little anxiety provoking (e.g. of all 28 fears the stimulus "the sight of blood" was ranked lowest). Presence of dental phobia was significantly associated with a history of dizziness or fainting during dental treatment (OR = 3.4; 95% CI: 1.5-8.1), but of the dental phobic individuals only 13.0% reported a history of dizziness or fainting during dental treatment. Presence of dental phobia (OR = 5.0; 95% CI: 2.8-8.8) was found to be associated with avoidance of dental care, but a history of dizziness or fainting during dental treatment was not (OR = 1.0; 95% CI: 0.8-1.2). The present findings converge to the conclusion that dental phobia should be considered a specific phobia subtype independent of the B-I-I cluster within the DSM classification system. © 2013 Wiley Periodicals, Inc.

  18. An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol

    PubMed Central

    2013-01-01

    Background Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment. Methods/design A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation. Discussion The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12608000228381. PMID:23895258

  19. An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol.

    PubMed

    Baillie, Andrew J; Sannibale, Claudia; Stapinski, Lexine A; Teesson, Maree; Rapee, Ronald M; Haber, Paul S

    2013-07-30

    Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment. A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation. The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems. Australian New Zealand Clinical Trials Registry: ACTRN12608000228381.

  20. Agoraphobia in a Rehabilitation Medicine Setting: A Case Report.

    ERIC Educational Resources Information Center

    Kaplan, Steven P.

    1987-01-01

    Agoraphobia is a pervasive constellation of fears and avoidance behaviors relating to open spaces, crowds, being alone, and other everyday situations. Presents the case of a client with agoraphobia on a medical rehabilitation unit. Outlines psychological interventions, giving discharge and follow-up status. Literature review focused on possible…

  1. Needle phobia: etiology, adverse consequences, and patient management.

    PubMed

    Sokolowski, Chester J; Giovannitti, Joseph A; Boynes, Sean G

    2010-10-01

    Needle phobia has profound health, dental, societal, and legal implications, and severe psychological, social, and physiologic consequences. There is genetic evidence for the physiologic response to needle puncture, and a significant familial psychological component, showing evidence of inheritance. Needle phobia is also a learned behavior. The dental practitioner must recognize patients with needle phobia before the administration of local anesthetics to identify patients who are potentially reactive and to prevent untoward sequelae. Needle phobia is highly associated with avoidance behavior, and the dentist must exhibit compassion and respect. To avoid bradycardia, hypotension, unconsciousness, convulsions, and possibly asystole, oral premedication with benzodiazepines or other antianxiety agents must be considered for patients who are needle phobic. Management of needle phobiaeinduced syncope includes perioperative monitoring, oxygen administration, positioning, atropine, and vasopressors. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. The discrimination of children's phobias using the Revised Fear Survey Schedule for children.

    PubMed

    Weems, C F; Silverman, W K; Saavedra, L M; Pina, A A; Lumpkin, P W

    1999-09-01

    The discriminant validity of children's and parents' ratings of the child's fear on the Revised Fear Survey Schedule for Children (FSSC-R; Ollendick, 1983) was examined using a clinic sample of children who met DSM criteria for phobic disorders (N = 120). Discriminant function analyses and item analyses were conducted to determine if children meeting diagnostic criteria for a primary disorder of social phobia, simple phobia of the dark/sleeping alone, simple phobia of animals, or a simple phobia of shots/doctors could be differentiated on the basis of FSSC-R subscale scores and items. Results of the discriminant function analyses indicated that the child-completed as well as the parent-completed FSSC-Rs were similarly useful in differentiating the specific types of phobias. Results of the item analyses indicated that child-completed FSSC-R items could discriminate among the different simple phobias but not social phobia and that parent-completed FSSC-R items could discriminate not only the different simple phobias but also social phobia. Results are discussed in terms of the utility of the FSSC-R in the assessment of clinically significant fears in children with phobic disorders and the relative utility of child and parent ratings in the assessment of childhood fears.

  3. Agoraphobia and the Modern Learner

    ERIC Educational Resources Information Center

    Dron, Jon; Anderson, Terry

    2014-01-01

    Read/write social technologies enable rich pedagogies that centre on sharing and constructing content but have two notable weaknesses. Firstly, beyond the safe, nurturing environment of closed groups, students participating in more or less public network- or set-oriented communities may be insecure in their knowledge and skills, leading to…

  4. Effect of quetiapine vs. placebo on response to two virtual public speaking exposures in individuals with social phobia.

    PubMed

    Donahue, Christopher B; Kushner, Matt G; Thuras, Paul D; Murphy, Tom G; Van Demark, Joani B; Adson, David E

    2009-04-01

    Clinical practice and open-label studies suggest that quetiapine (an atypical anti-psychotic) might improve symptoms for individuals with social anxiety disorder (SAD). The purpose of this study was to provide a rigorous test of the acute impact of a single dose of quetiapine (25mg) on SAD symptoms. Individuals with SAD (N=20) were exposed to a 4-min virtual reality (VR) public speaking challenge after having received quetiapine or placebo (double-blind) 1h earlier. A parallel VR challenge occurred 1 week later using a counter-balanced cross-over (within subject) design for the medication-placebo order between the two sessions. There was no significant drug effect for quetiapine on the primary outcome measures. However, quetiapine was associated with significantly elevated heart rate and sleepiness compared with placebo. Study findings suggest that a single dose of 25mg quetiapine is not effective in alleviating SAD symptoms in individuals with fears of public speaking.

  5. Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients

    PubMed Central

    Bergamaschi, Mateus M; Queiroz, Regina Helena Costa; Chagas, Marcos Hortes Nisihara; de Oliveira, Danielle Chaves Gomes; De Martinis, Bruno Spinosa; Kapczinski, Flávio; Quevedo, João; Roesler, Rafael; Schröder, Nadja; Nardi, Antonio E; Martín-Santos, Rocio; Hallak, Jaime Eduardo Cecílio; Zuardi, Antonio Waldo; Crippa, José Alexandre S

    2011-01-01

    Generalized Social Anxiety Disorder (SAD) is one of the most common anxiety conditions with impairment in social life. Cannabidiol (CBD), one major non-psychotomimetic compound of the cannabis sativa plant, has shown anxiolytic effects both in humans and in animals. This preliminary study aimed to compare the effects of a simulation public speaking test (SPST) on healthy control (HC) patients and treatment-naïve SAD patients who received a single dose of CBD or placebo. A total of 24 never-treated patients with SAD were allocated to receive either CBD (600 mg; n=12) or placebo (placebo; n=12) in a double-blind randomized design 1 h and a half before the test. The same number of HC (n=12) performed the SPST without receiving any medication. Each volunteer participated in only one experimental session in a double-blind procedure. Subjective ratings on the Visual Analogue Mood Scale (VAMS) and Negative Self-Statement scale (SSPS-N) and physiological measures (blood pressure, heart rate, and skin conductance) were measured at six different time points during the SPST. The results were submitted to a repeated-measures analysis of variance. Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group as assessed with the VAMS. The SSPS-N scores evidenced significant increases during the testing of placebo group that was almost abolished in the CBD group. No significant differences were observed between CBD and HC in SSPS-N scores or in the cognitive impairment, discomfort, and alert factors of VAMS. The increase in anxiety induced by the SPST on subjects with SAD was reduced with the use of CBD, resulting in a similar response as the HC. PMID:21307846

  6. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients.

    PubMed

    Bergamaschi, Mateus M; Queiroz, Regina Helena Costa; Chagas, Marcos Hortes Nisihara; de Oliveira, Danielle Chaves Gomes; De Martinis, Bruno Spinosa; Kapczinski, Flávio; Quevedo, João; Roesler, Rafael; Schröder, Nadja; Nardi, Antonio E; Martín-Santos, Rocio; Hallak, Jaime Eduardo Cecílio; Zuardi, Antonio Waldo; Crippa, José Alexandre S

    2011-05-01

    Generalized Social Anxiety Disorder (SAD) is one of the most common anxiety conditions with impairment in social life. Cannabidiol (CBD), one major non-psychotomimetic compound of the cannabis sativa plant, has shown anxiolytic effects both in humans and in animals. This preliminary study aimed to compare the effects of a simulation public speaking test (SPST) on healthy control (HC) patients and treatment-naïve SAD patients who received a single dose of CBD or placebo. A total of 24 never-treated patients with SAD were allocated to receive either CBD (600 mg; n=12) or placebo (placebo; n=12) in a double-blind randomized design 1 h and a half before the test. The same number of HC (n=12) performed the SPST without receiving any medication. Each volunteer participated in only one experimental session in a double-blind procedure. Subjective ratings on the Visual Analogue Mood Scale (VAMS) and Negative Self-Statement scale (SSPS-N) and physiological measures (blood pressure, heart rate, and skin conductance) were measured at six different time points during the SPST. The results were submitted to a repeated-measures analysis of variance. Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group as assessed with the VAMS. The SSPS-N scores evidenced significant increases during the testing of placebo group that was almost abolished in the CBD group. No significant differences were observed between CBD and HC in SSPS-N scores or in the cognitive impairment, discomfort, and alert factors of VAMS. The increase in anxiety induced by the SPST on subjects with SAD was reduced with the use of CBD, resulting in a similar response as the HC.

  7. The Prevalence and Comorbidity of Specific Phobias in College Students and Their Interest in Receiving Treatment

    ERIC Educational Resources Information Center

    Seim, Richard W.; Spates, C. Richard

    2010-01-01

    While the prevalence of specific phobias and social phobias is believed to be high in the general adult population, little data exists regarding the prevalence of these fears among college students. This paper describes an epidemiological study that surveyed 813 college students regarding the severity of fears experienced toward 12 objects and…

  8. The Prevalence and Comorbidity of Specific Phobias in College Students and Their Interest in Receiving Treatment

    ERIC Educational Resources Information Center

    Seim, Richard W.; Spates, C. Richard

    2010-01-01

    While the prevalence of specific phobias and social phobias is believed to be high in the general adult population, little data exists regarding the prevalence of these fears among college students. This paper describes an epidemiological study that surveyed 813 college students regarding the severity of fears experienced toward 12 objects and…

  9. The prevalence of specific phobia and associated co-morbid features in children and adolescents.

    PubMed

    Kim, Soo-Jin; Kim, Bung-Nyun; Cho, Soo-Churl; Kim, Jae-Won; Shin, Min-Sup; Yoo, Hee-Jung; Kim, Hyo Won

    2010-08-01

    The aims of this study were to investigate the prevalence, associated co-morbid psychiatric disorders and behavioral/emotional problems associated with the subtypes of specific phobia in children and adolescents. A total of 2673 randomly selected children and adolescents from Seoul, Korea were assessed using the parent version of the Diagnostic Interview Schedule for Children (DISC-IV) and Children's Behavior Checklist (CBCL). We analyzed differences in psychiatric co-morbidities and CBCL profiles among the subtypes of specific phobia. The 1-year prevalence of specific phobia was 7.9% (95% CI 7.63-8.17). Animal phobia was associated with anxiety disorder (OR 8.68, 95% CI 1.91-39.51) and oppositional defiant disorder (OR 2.55, 95% CI 1.27-5.12). Nature-environment phobia was associated with anxiety disorder (OR 25.70, 95% CI 6.16-107.10). Blood-injection-injury phobia showed associations with attention-deficit/hyperactivity disorder (ADHD: OR 6.74, 95% CI 2.81-16.15). Subjects with nature-environment phobia scored higher than did controls on the anxious/depressed, social problems, attention problems, and total behavioral problem profiles of the CBCL. Subjects with blood-injection-injury phobia scored significantly higher than did controls on the attention problems, aggressive behaviors, and externalizing problem profiles. Contrary to animal phobias, nature-environment and blood-injection-injury phobias were associated with various behavioral and emotional problems and approximately correlated to their co-morbid psychiatric disorders. Among these subtypes, significant differences were found in demographic characteristics, co-morbid psychiatric disorders, and emotional/behavioral problems. These findings suggest that distinctive clinical characteristics might be related with different subtypes of specific phobia and clinician must consider psychiatric co-morbidities when treating children & adolescents with specific phobia. (c) 2010 Elsevier Ltd. All rights reserved.

  10. Agoraphobia and Follicle-Stimulating Hormone Levels between Tamoxifen and Goserelin versus Tamoxifen Alone in Premenopausal Hormone Receptor-Positive Breast Cancer: A 12-Month Prospective Randomized Study.

    PubMed

    Heo, Jung-Yoon; Yi, Hawoo; Fava, Maurizio; Mischoulon, David; Kim, Kiwon; Yoon, Sechang; Jeon, Hong Jin; Lee, Jeong Eon

    2017-07-01

    Tamoxifen is an estrogen receptor antagonist used to prevent recurrence of breast cancer, which may provoke depression and anxiety and increase follicle-stimulating hormone (FSH) to patients. We compared anxiety and depression symptoms and FSH levels who received conventional tamoxifen alone and combination treatment of goserelin, a gonadotropin-releasing hormone (GnRH) analogue, with tamoxifen. Sixty-four premenopausal women with hormone receptor-positive early-stage breast cancer were included and were assigned randomly to receive either tamoxifen and goserelin combination or tamoxifen alone for 12 months. The participants were evaluated blindly using the Hamilton Depression and Anxiety Rating Scale, the Beck Depression Rating Scale, and the Albany Panic and Phobia Questionnaire (APPQ). Blood FSH levels were assessed at baseline, 6 and 12 months. A significant time×group difference was detected in the agoraphobia trends subscale of the APPQ and in FSH levels. The combination group showed significantly less increases in agoraphobia subscale of APPQ and greater decreases in FSH level than those in the tamoxifen-alone group from baseline to 12 months of treatment. No significant differences for age, tumor grade, body mass index, or family history were found at baseline between the two groups. Our results suggest that the combination treatment of tamoxifen and goserelin resulted in less agoraphobia than tamoxifen alone in premenopausal women with breast cancer, which may associated with FSH suppression of goserelin.

  11. Agoraphobia and Follicle-Stimulating Hormone Levels between Tamoxifen and Goserelin versus Tamoxifen Alone in Premenopausal Hormone Receptor-Positive Breast Cancer: A 12-Month Prospective Randomized Study

    PubMed Central

    Heo, Jung-Yoon; Yi, Hawoo; Fava, Maurizio; Mischoulon, David; Kim, Kiwon; Yoon, Sechang

    2017-01-01

    Objective Tamoxifen is an estrogen receptor antagonist used to prevent recurrence of breast cancer, which may provoke depression and anxiety and increase follicle-stimulating hormone (FSH) to patients. We compared anxiety and depression symptoms and FSH levels who received conventional tamoxifen alone and combination treatment of goserelin, a gonadotropin-releasing hormone (GnRH) analogue, with tamoxifen. Methods Sixty-four premenopausal women with hormone receptor-positive early-stage breast cancer were included and were assigned randomly to receive either tamoxifen and goserelin combination or tamoxifen alone for 12 months. The participants were evaluated blindly using the Hamilton Depression and Anxiety Rating Scale, the Beck Depression Rating Scale, and the Albany Panic and Phobia Questionnaire (APPQ). Blood FSH levels were assessed at baseline, 6 and 12 months. Results A significant time×group difference was detected in the agoraphobia trends subscale of the APPQ and in FSH levels. The combination group showed significantly less increases in agoraphobia subscale of APPQ and greater decreases in FSH level than those in the tamoxifen-alone group from baseline to 12 months of treatment. No significant differences for age, tumor grade, body mass index, or family history were found at baseline between the two groups. Conclusion Our results suggest that the combination treatment of tamoxifen and goserelin resulted in less agoraphobia than tamoxifen alone in premenopausal women with breast cancer, which may associated with FSH suppression of goserelin. PMID:28845177

  12. Associative learning in flying phobia.

    PubMed

    Vriends, Noortje; Michael, Tanja; Schindler, Bettina; Margraf, Jürgen

    2012-06-01

    Modern learning theories suggest that particularly strong associative learning contributes to the etiology and maintenance of anxiety disorders, thus explaining why some individuals develop an anxiety disorder after a frightening (conditioning) event, whereas others do not. However, associative learning has rarely been investigated experimentally in specific phobias. The current study investigated associative learning in patients with flying phobia and healthy controls using a modified version of Olson and Fazio's associative learning paradigm (Olson & Fazio, 2001). Under the guise of an attention task, patients with flying phobia (n = 33), and healthy controls (n = 39) viewed a series of distracters interspersed with pairings of novel objects (counterbalanced conditioned stimuli, CSs) with frightening and pleasant stimuli (unconditioned stimuli, USs). After the conditioning procedure patients with flying phobia rated both CSs more frightening and showed stronger discrimination between the CSs for valence compared to healthy controls. Our findings indicate a particularly stronger conditioning effect in flying phobia. These results contribute to the understanding of the etiology of specific phobia and may help to explain why only some individuals develop a flying phobia after an aversive event associated with flying. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Bio-phobias/techno-philias: virtual reality exposure as treatment for phobias of 'nature'.

    PubMed

    Davidson, Joyce; Smith, Mick

    2003-09-01

    In modern society natural objects like spiders or snakes have a primary role as the loci of specific phobias. Drawing on interviews with members of the UK National Phobics Society (NPS) and associated service providers, this paper explores the implications of the increasingly significant role played by new media, particularly Virtual Reality technologies, in the treatment of these 'bio-phobias'. While advanced technological approaches provide new possibilities for individual sufferers to experiment with and control their phobic responses they also exemplify certain aspects of those specifically modern social relations that are the media within which bio-phobic behaviours develop. From a critical sociological perspective the techno-philic move to the medium of cyber-space may actually exaggerate characteristically modern social relations that seek (but never convincingly manage) to assert complete 'cultural' control over the unpredictable 'natural' elements threatening our cultural integrity.

  14. Panic disorder and agoraphobia: hypothesis hothouse.

    PubMed

    Klein, D F

    1996-01-01

    Panic disorder and agoraphobia have been postulated to occur when (1) fear is elicited by some automatic mechanism that requires catastrophic cognition, (2) there is a flaw in the physiology of fear, with special reference to the noradrenergic system, or (3) a putative suffocation alarm mechanism sends out false alarms. The presence of a suffocation alarm system has been supported by studies of children who lack this protective mechanism because they suffer from congenital central hypoventilation syndrome. Antidepressants with serotonin activity seem to control panic disorder by down-regulating the suffocation alarm system. Serotonin selective reuptake inhibitors (SSRIs) are among the most effective drugs for panic disorder, emphasizing the role of serotonin in respiratory regulation. Dyspnea and hyperventilation are the cardinal signs of a panic attack. Because carbon monoxide (CO) does not cause panic, it may sabotage the suffocation alarm system by acting as an inhibitory neurotransmitter within the carotid body.

  15. Virtual reality applications to agoraphobia: a protocol.

    PubMed

    Cárdenas, Georgina; Muñoz, Sandra; González, Maribel; Uribarren, Guillermo

    2006-04-01

    Recently, educators and instructional designers have focused on the development and implementation of virtual learning environments that effectively combine theoretical and applied knowledge to teach university students. One of the trusts of the Psychology Virtual Teaching Laboratory in collaboration with the IXTLI observatory is to develop dissemination programs to promote the insertion of virtual reality (VR) technologies applied to rehabilitation in their clinical practice. This paper describes the development of (1) agoraphobia VR learning objects to be use as a teaching support tools in class and (2) a multimedia teaching program that incorporate digital video and VR scenarios address to students in the field of mental health. Promotion among professors and students about the use of this technology will allow us to initiate research in our country as well as to validate contextualized applications for our culture, therefore contributing with new advances in this field.

  16. The treatment of social phobia: the differential effectiveness of exposure in vivo and an integration of exposure in vivo, rational emotive therapy and social skills training.

    PubMed

    Mersch, P P

    1995-03-01

    Thirty-four social phobic patients were treated with either exposure in vivo or an integrated treatment, consisting of rational emotive therapy, social skills training and exposure in vivo. Comparison with a waiting-list control group showed the effectiveness of both treatments. Contrary to expectations, the integrated approach was not superior over exposure in vivo alone. Also, the long-term effectiveness of both treatments was equally good.

  17. Counterconditioning for a Flight Phobia

    ERIC Educational Resources Information Center

    Sank, Lawrence I.

    1976-01-01

    This article describes a concentrated program of desensitization used to treat flight phobia. A case history illustrates the use of expanded emotive imagery, stimulus breakdown and techniques of covert positive reinforcement. (SJL)

  18. Counterconditioning for a Flight Phobia

    ERIC Educational Resources Information Center

    Sank, Lawrence I.

    1976-01-01

    This article describes a concentrated program of desensitization used to treat flight phobia. A case history illustrates the use of expanded emotive imagery, stimulus breakdown and techniques of covert positive reinforcement. (SJL)

  19. Determinants of public phobia about infectious diseases in South Korea: effect of health communication and gender difference.

    PubMed

    Jung, Minsoo; Choi, Mankyu; Lee, Tae-Ro

    2015-03-01

    This study investigated the individual and social determinants of the public's phobia of infectious diseases in South Korea, where collective action was recently fueled by the public phobia over mad cow disease (bovine spongiform encephalopathy [BSE]). Gender-specific multivariate regression was used to compare the public perception of BSE and highly pathogenic avian influenza (HPAI). The analysis results differentiated between the determinants of the phobia for the 2 diseases, BSE and HPAI (N = 1002). As with HIV/AIDS and leprosy, the public fear of HPAI was expressed as a disease phobia that seeks to ensure the social exclusion of infection sources, whereas the fear of BSE was influenced by social and communication factors. Therefore, BSE, unlike previous HPAI, can be rapidly amplified amid the growing distrust in health communication, in which case the social determinants of disease phobia are associated with communicator trust, social values, and political attitude toward diseases rather than disease perception. © 2013 APJPH.

  20. [Group psychotherapy in patients with panic disorder and agoraphobia].

    PubMed

    Scheibe, G; Albus, M; Walther, A U; Schmauss, M

    1993-07-01

    The one-year supportive group-psychotherapy (3 groups with 8-9 patients) was carried out once-weekly by two therapists in 26 patients who met the DSM-III-R criteria for panic disorder and agoraphobia. Patients filled in various ratings at the beginning and at the end of the therapy and a visual analog scale before as well as after each session. Twelve months after the end of the group-therapy the Longitudinal Interval Follow-up Evaluation (LIFE) was carried out. During the group-psychotherapy panic sensations, anxiety, nervousness and fears as well as psychosocial disability decreased. Duration of illness affected the reduction of panic sensations, anxiety, nervousness and fears during the first 6 months of the group-psychotherapy. Phobic fears and avoidance behavior mostly improved in patients with a duration of illness of more than 5 years and an additional depressive disorder. At the one-year follow-up 80% of panic patients without depressive disorder were symptom-free and reported better partner-relationships, more satisfaction, and a better social adjustment compared with panic patients with concomitant depressive disorders.

  1. Characteristics of African-American and white patients with panic disorder and agoraphobia.

    PubMed

    Friedman, S; Paradis, C M; Hatch, M

    1994-08-01

    The authors explored the clinical characteristics and treatment response of African-American and white patients with panic disorder and agoraphobia who presented for treatment at an anxiety disorders clinic. One hundred white and 43 African-American patients were evaluated using a structured interview and completed a variety of standardized rating scales. In addition, data regarding clinical characteristics, psychiatric history, childhood history, life stressors, and treatment outcome were obtained by chart review. The incidence of isolated sleep paralysis was also assessed in a subsample of patients. The two groups had no significant differences in psychiatric symptoms. African-American patients were more likely to use a medical emergency room, to have had childhood separations, and to have had parents who abused substances. They also reported less separation anxiety, school phobia, and affective illness in family members. In addition, African Americans, both patients and nonclinical control subjects, were more likely to report that they experienced repetitive episodes of isolated sleep paralysis. Treatment outcome was moderately successful among both African-American patients and white patients. Although African-American and white patients show similar symptoms of panic disorder, African-American patients had more unnecessary psychiatric hospitalizations, a higher rate of medical emergency room visits, a higher incidence of isolated sleep paralysis, greater likelihood of childhood trauma, and a greater number of life stressors. Addressing these issues in treatment is critical in reducing the dropout rate and maintaining successful treatment.

  2. Agency and Anxiety: Delusions of Control and Loss of Control in Schizophrenia and Agoraphobia

    PubMed Central

    Gallagher, Shaun; Trigg, Dylan

    2016-01-01

    We review the distinction between sense of agency and sense of ownership, and then explore these concepts, and their reflective attributions, in schizophrenic symptoms and agoraphobia. We show how the underlying dynamics of these experiences are different across these disorders. We argue that these concepts are complex and cannot be reduced to neural mechanisms, but involve embodied and situated processes that include the physical and social environments. We conclude by arguing that the subjective and intersubjective dimensions of agency and ownership cannot be considered in isolation from one another, but instead form an interdependent pairing. PMID:27725796

  3. [The psychoimmunological network og panic disorders, agoraphobia and allergic reactions].

    PubMed

    Schmidt-Traub, S

    1995-02-01

    While treating panic and agoraphobia patients with behaviour therapy, a high frequency of allergic reaction of the IgE-mediated type I was observed. Panic disorder, agoraphobia, allergic disorder, and vasomotor reactions are briefly discussed in the framework of psycho-endocrino-immunological research. A pilot study had shown a high correlation between panic disorder with and without agoraphobia and allergic reaction. A controlled study was then planned to test the hypothesized psychoimmunological relationship. 100 allergic patients, 79 panic/agoraphobic patients, and 66 controls underwent psychodiagnostic and allergic screening. 70% of the anxiety patients responded to test allergens with IgE-mediated type-I immediate reactions in comparison to 28% of the control persons. Another 15% of the panic patients reacted to nickle compound with type-IV delayed skin reactions (7% of the controls). Conversely, 10% of the allergic patients suffered from panic disorder (45% had experienced panic attacks) in contrast to 2% of the controls (24% of these reported panic attacks). The relative risk for allergic patients to develop panic disorder with and without agoraphobia is obviously five times as high as for controls. With this assumption of a psychoimmunological preparedness in mind, a behavioural medical diagnostic and therapeutic concept seems more adequate in coping both with panic/agoraphobia and allergic disorder.

  4. Blood-Injury-Illness Phobia: A Review.

    ERIC Educational Resources Information Center

    Thyer, Bruce A.; And Others

    1985-01-01

    Surveys empirical literature pertaining to phobias of blood, injury, or illness (BII); defines BII phobia as selectively associated with vasovagal fainting response upon exposure to phobic stimuli. Presents clinical, demographic, and etiological information from 15 BII phobics and suggests that BII phobia warrants diagnostic category separate from…

  5. The effects of extraverted temperament on agoraphobia in panic disorder.

    PubMed

    Rosellini, Anthony J; Lawrence, Amy E; Meyer, Joseph F; Brown, Timothy A

    2010-05-01

    Although situational avoidance is viewed as the most disabling aspect of panic disorder, few studies have evaluated how dimensions of neurotic (i.e., neuroticism, behavioral inhibition) and extraverted (i.e., extraversion, behavioral activation) temperament may influence the presence and severity of agoraphobia. Using logistic regression and structural equation modeling, we examined the unique effects of extraverted temperament on situational avoidance in a sample of 274 outpatients with a diagnosis of panic disorder with and without agoraphobia. Results showed low extraverted temperament (i.e., introversion) to be associated with both the presence and the severity of situational avoidance. Findings are discussed in regard to conceptualizations of conditioned avoidance, activity levels, sociability, and positive emotions within the context of panic disorder with agoraphobia.

  6. Finding gene-environment interactions for phobias.

    PubMed

    Gregory, Alice M; Lau, Jennifer Y F; Eley, Thalia C

    2008-03-01

    Phobias are common disorders causing a great deal of suffering. Studies of gene-environment interaction (G x E) have revealed much about the complex processes underlying the development of various psychiatric disorders but have told us little about phobias. This article describes what is already known about genetic and environmental influences upon phobias and suggests how this information can be used to optimise the chances of discovering G x Es for phobias. In addition to the careful conceptualisation of new studies, it is suggested that data already collected should be re-analysed in light of increased understanding of processes influencing phobias.

  7. Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V.

    PubMed

    LeBeau, Richard T; Glenn, Daniel; Liao, Betty; Wittchen, Hans-Ulrich; Beesdo-Baum, Katja; Ollendick, Thomas; Craske, Michelle G

    2010-02-01

    The present review was conducted in order to evaluate the current diagnostic criteria for specific phobia (SP) in light of the empirical evidence gathered since DSM-IV and to propose changes to DSM-V where change is clearly and reliably indicated by the evidence. In response to questions put forth by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group, four primary areas were determined for this review: the accuracy and utility of the current SP type classification system, the validity of test anxiety as a type of SP, the boundary between agoraphobia and SP, and the reliability and utility of the diagnostic criteria for SP. Developmental issues are addressed within each area. Literature reviews examining academic findings published between 1994 and 2009 were carried out and the results are included herein. The review presents a number of options and preliminary recommendations to be considered for DSM-V. All of these recommendations should be considered tentative as they await the field trials and expert consensus necessary prior to their inclusion in the DSM-V. The present review also reveals a great need for future research in the area of SP and directions for such research is provided.

  8. A taxometric investigation of agoraphobia in a clinical and a community sample.

    PubMed

    Slade, Tim; Grisham, Jessica R

    2009-08-01

    The nosological status of agoraphobia is controversial. Agoraphobia may be a distinct diagnostic entity or a marker of avoidance severity. The current study examines the latent structure of agoraphobia through the use of taxometric analysis. The latent structure of agoraphobia was examined in two independent samples, one comprising outpatients presenting for treatment for panic disorder (PD) with or without agoraphobia (n=365), and the other comprising community volunteers to a national mental health survey who experienced fear or avoidance of at least one prototypic agoraphobic situation (n=640). Two taxometric procedures were carried out - maximum eigenvalue (MAXEIG) and mean above minus below a cut (MAMBAC) - using indicators derived from questionnaire measures of, and structured diagnostic interviews for, agoraphobia. Results show consistent evidence of dimensional latent structure in both samples. It is concluded that scores on measures of agoraphobia best represent an agoraphobic severity dimension.

  9. Agoraphobia and Paradigm Strain: A Family Systems Perspective.

    ERIC Educational Resources Information Center

    Shean, Glenn; Rohrbaugh, Michael

    Agoraphobia is an increasingly common, often chronically incapacitating anxiety disorder. Both behavior therapy and pharmacotherapy can be effective in reducing the intensity of agoraphobic symptoms. There are promising new developments, however, from a family systems perspective. Researchers are finding that an agoraphobic's marriage and family…

  10. A case of choking phobia: towards a conceptual approach.

    PubMed

    Lopes, Rui; Melo, Raquel; Curral, Rosário; Coelho, Rui; Roma-Torres, António

    2014-03-01

    Choking phobia, also known as phagophobia or swallowing phobia is an uncommon clinical entity that has been underappreciated and is included in the new DSM-5 and upcoming ICD-11 diagnostic category of avoidant/restrictive food intake disorder. Phenomenologically distinct from other eating disorders, it is characterized by the phobic stimulus of swallowing that results in the avoidance of food or drinks, and ultimately to low weight, social withdrawal, anxiety and depression states. Its prevalence and long-term course on the general population still needs to be determined, probably reflecting years of indefiniteness regarding its nosology and by the absence of a clear set of diagnostic criteria. We present a clinical case of choking phobia in a 32-year-old male patient after an episode of choke when eating chicken. An early diagnosis and distinction from other eating disorders is important for proper treatment and fundamental for prognosis. We also make a thorough revision on literature in clinical features, differential diagnosis and treatment approaches, suggesting a conceptual approach for choking phobia as a clinical spectrum settled by different degrees of phobic subtypes, which may depend on a varied number of clinical variables.

  11. One session treatment for specific phobias in children: Comorbid anxiety disorders and treatment outcome.

    PubMed

    Ryan, Sarah M; Strege, Marlene V; Oar, Ella L; Ollendick, Thomas H

    2017-03-01

    One-Session Treatment (OST) for specific phobias has been shown to be effective in reducing phobia severity; however, the effect of different types of co-occurring anxiety disorders on OST outcomes is unknown. The present study examined (1) the effects of co-occurring generalized anxiety disorder (GAD), social anxiety disorder (SAD), or another non-targeted specific phobia (OSP) on the efficacy of OST for specific phobias, and (2) the effects of OST on these co-occurring disorders following treatment. Three groups of 18 youth (7-15 years) with a specific phobia and comorbid GAD, SAD, or OSP were matched on age, gender, and phobia type. Outcome measures included diagnostic status and severity, and clinician rated improvement. All groups demonstrated an improvement in their specific phobia following treatment. Treatment was equally effective regardless of co-occurring anxiety disorder. In addition, comorbid anxiety disorders improved following OST; however, this effect was not equal across groups. The SAD group showed poorer improvement in their comorbid disorder than the GAD group post-treatment. However, the SAD group continued to improve and this differential effect was not evident six-months following treatment. The current study sample was small, with insufficient power to detect small and medium effect sizes. Further, the sample only included a portion of individuals with primary GAD or SAD, which may have attenuated the findings. The current study demonstrated that co-occurring anxiety disorders did not interfere with phobia treatment. OST, despite targeting a single specific phobia type, significantly reduced comorbid symptomatology across multiple anxiety disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Specific phobia predicts psychopathology in young women

    PubMed Central

    Margraf, Jürgen; Vriends, Noortje; Meyer, Andrea H.; Becker, Eni S.

    2009-01-01

    Background Although specific phobia is characterized by an early age at onset and by high rates of comorbidity, few studies have examined comorbid relationships prospectively. Objectives The present study investigated the association between specific phobia and the risk of a broad range of psychopathology among young women in the community. Method Data came from the Dresden Predictor Study in which 1,538 German women (18–25 years) completed a diagnostic interview at two time points. Results Women with specific phobia had a twofold increase in odds of developing any anxiety disorder, generalized anxiety disorder, depression, and any somatoform disorder during 17 months, compared to women without specific phobia. Except for depression, these associations persisted after adjustment for all comorbid mental disorders. Conclusions Specific phobia thus appears to be a risk factor for a variety of problems. The result further underpins the necessity for early intervention for specific phobia to prevent later mental health problems. PMID:19888542

  13. Electroconvulsive therapy in a physically restrained man with comorbid major depression, severe agoraphobia with panic disorder, and histrionic personality disorder.

    PubMed

    Rapinesi, Chiara; Serata, Daniele; Del Casale, Antonio; Kotzalidis, Giorgio D; Romano, Silvia; Milioni, Mara; Capezzuto, Silvia; Carbonetti, Paolo; Angeletti, Gloria; Fensore, Claudio; Tatarelli, Roberto; Girardi, Paolo

    2012-03-01

    A 36-year-old man with comorbid panic disorder with agoraphobia, major depression, and histrionic personality disorder since age 21 was resistant to combined drug and psychotherapy treatment. His conditions had progressively worsened with time, causing him to withdraw socially and to simultaneously require continuous physical restraint, which further worsened his functioning. He spent almost 3 consecutive years in restraint, until he consented to receive bilateral ECT treatment. He improved after 13 sessions in all areas (social and role functioning, and panic, depressive, and histrionic symptoms) and is well 3 months later with a lithium-atypical antipsychotic combination.

  14. The etiology of childhood dog phobia.

    PubMed

    King, N J; Clowes-Hollins, V; Ollendick, T H

    1997-01-01

    This study evaluated Rachman's theory of fear acquisition in a sample of 30 children with dog phobia. The children were on the waiting list of a university-based clinic. Parents were asked to indicate the most influential factor in the onset of their child's dog phobia. Nearly all parents were able to attribute their child's phobia to one of the fear pathways: direct conditioning, modelling or transmission of information.

  15. Assessing the clinical utility of agoraphobia in the context of panic disorder.

    PubMed

    Schmidt, Norman B; Cromer, Kiara R

    2008-01-01

    In the DSM-IV, a panic disorder (PD) diagnosis includes specification of agoraphobia, which is primarily an index of situational avoidance due to fear of panic. No other anxiety diagnosis requires specification of level of avoidance. This raises the question as to whether agoraphobia provides unique information beyond the core features of PD (i.e., panic attacks and panic-related worry). The incremental validity of agoraphobia, defined using DSM-IV specifiers versus level of situational avoidance, was examined in relation to the expression and treatment of PD (N=146). Analyses indicate that agoraphobia status adds uniquely to the prediction of PD symptoms, impairment, and response to treatment. However, level of situational avoidance, defined either as a continuous or dichotomous variable, appears to have greater utility compared to the DSM-IV method of classifying agoraphobia. In summary, the agoraphobia specifier seems to have clinical utility but this could be improved by focusing on a dimensional assessment of situational avoidance.

  16. Constraint and loneliness in agoraphobia: an empirical investigation.

    PubMed

    Pehlivanidis, A; Koulis, S; Papakostas, Y

    2014-01-01

    While progress in the aetiopathology and treatment of panic disorder is indisputable, research regarding agoraphobia lacks behind. One significant-yet untested- theory by Guidano and Liotti, suggests the existence of inner representations of fear of "constraint" and fear of "loneliness" as two major schemata, important in the pathogenesis and manifestation of agoraphobia. Activation of these schemata may occur in situations in which the patient: (a) feels as in an inescapable trap (constraint) or (b) alone, unprotected and helpless (loneliness). Upon activation, the "constraint" schema elicits such symptoms as asphyxiation, chest pain, difficult breathing, motor agitation and muscular tension, while the "loneliness" schema elicits such symptoms as sensation of tachycardia, weakness of limbs, trembling or fainting. Activation of these schemata by content-compatible stimuli is expected to trigger various, yet distinct, response patterns, both of which are indiscriminately described within the term "agoraphobia". In order to investigate this hypothesis and its possible clinical applications, several mental and physical probes were applied to 20 patients suffering primarily from agoraphobia, and their responses and performance were recorded. Subjects also completed the "10-item Agoraphobia Questionnaire" prepared by our team aiming at assessing cognitions related to Guidano and Liotti's notion of "loneliness" and "constraint". Breath holding (BH) and Hyperventilation (HV) were selected as physical probes. BH was selected as an easily administered hypercapnea - induced clinical procedure, because of its apparent resemblance to the concept of "constraint". Subjects were instructed to hold their breath for as long as they could and stop at will. Similarly, it was hypothesized that HV might represent a physical "loneliness" probe, since it can elicit such symptoms as dizziness, paraesthesias, stiff muscles, cold hands or feet and trembling, reminiscent of a "collapsing

  17. Inpatient treatment of complicated agoraphobia and panic disorder.

    PubMed

    Pollard, C A; Obermeier, H J; Cox, G L

    1987-09-01

    Despite recent advances in the treatment of agoraphobia and panic disorder, some patients do not respond to standard outpatient regimens of biological and psychosocial intervention and may require more intensive, closely supervised care. The authors describe a specialized inpatient program that integrates pharmacotherapy, intensive levels of exposure and other behavioral therapies, a structured and strategically reinforcing environment, panic and anxiety management strategies, and other interventions designed specifically for patients with complicated panic-based disorders. Outcome data for 25 patients indicate that after a mean stay of 35 days, 19 patients were significantly improved. These preliminary results suggest that appropriately designed inpatient programs offer an effective treatment option for some patients with refractory conditions of agoraphobia or panic disorder.

  18. Coping strategies and phobias: the relationship between fears, phobias and methods of coping with stressors.

    PubMed

    Davey, G C; Burgess, I; Rashes, R

    1995-09-01

    Two studies are described which assessed the extent to which fears and phobias are associated with particular types of strategies for coping with stress. Study 1 compared scores on the Fear Survey Schedule (FSS) with scores on a modified version of the Health and Daily Living Form and the Miller Behavioural Style Scale (MBSS) in a normal population. A principal component analysis revealed that high scores on the social fears and miscellaneous phobias subscales of the FSS were directly associated with avoidance coping strategies, inversely associated with cognitive reappraisal strategies which devalue or deny the importance of the stressor, but unrelated to any of the measures on the MBSS. Study 2 compared the coping strategies of simple phobics, panic disorder patients and normal controls. Both simple phobics and panic disorder patients differed from normal control subjects by reporting greater use of avoidance coping strategies, and reduced use of cognitive threat devaluation. These findings are consistent with models of anxiety-based disorders which implicate avoidance or escape in the maintenance of such disorders, or which identify the evaluation of the precipitating trauma as important in the acquisition of such disorders.

  19. Could virtual reality be effective in treating children with phobias?

    PubMed

    Bouchard, Stéphane

    2011-02-01

    The use of virtual reality to treat anxiety disorders in adults is gaining popularity and its efficacy is supported by numerous outcome studies. Similar research for children is lagging behind. The outcome studies on the use of virtual reality to treat anxiety disorders in children currently address only specific phobias, and all of the available trials are reviewed in this article. Despite the limited number of studies, results are very encouraging for the treatment of school and spider phobias. A study with adolescents suggests that, at least for social anxiety, exposure stimuli would be more effective if they were developed specifically for younger populations. Virtual reality may not increase children's motivation towards therapy unless their fearful apprehension is addressed before initiating the treatment.

  20. School Phobia: Understanding a Complex Behavioural Response

    ERIC Educational Resources Information Center

    Chitiyo, Morgan; Wheeler, John J.

    2006-01-01

    School phobia affects about 5% of the school-age population. If left untreated, school phobia can have devastating long-term consequences in children challenged by this condition. Various treatment approaches have been used to explore this complex behavioural response, major among them being the psychoanalytic, psychodynamic, pharmacological and…

  1. School Phobia: Understanding a Complex Behavioural Response

    ERIC Educational Resources Information Center

    Chitiyo, Morgan; Wheeler, John J.

    2006-01-01

    School phobia affects about 5% of the school-age population. If left untreated, school phobia can have devastating long-term consequences in children challenged by this condition. Various treatment approaches have been used to explore this complex behavioural response, major among them being the psychoanalytic, psychodynamic, pharmacological and…

  2. Simple techniques to treat medical phobias.

    PubMed Central

    Taylor, C. B.; Ferguson, J. M.; Wermuth, B. M.

    1977-01-01

    Participant modelling, a behaviourally-orientated treatment technique, is an effect method of treating phobias associated with minor medical procedures or apparatus such as needles or intravenous catheters. The steps in this technique are described and two cases of severe needle phobias successfully treated with participant modelling are presented to illustrate further its application. PMID:876910

  3. School Phobia: Etiology, Evaluation and Treatment.

    ERIC Educational Resources Information Center

    Heath, Charles P.

    School phobia is an irrational fear or anxiety about attending school. Definite distinctions can be made between the school phobic and the truant, both of whom miss school on a regular basis. It appears that the incidence of school phobia is evenly distributed between the sexes and among age levels from 5 through 15 years, and is not significantly…

  4. Cephalalgiaphobia: a possible specific phobia of illness.

    PubMed

    Peres, Mario F P; Mercante, Juliane P P; Guendler, Vera Z; Corchs, Felipe; Bernik, Marcio A; Zukerman, Eliova; Silberstein, Stephen D

    2007-02-01

    Psychiatric comorbidity, mainly anxiety and depression, are common in chronic migraine (CM). Phobias are reported by half of CM patients. Phobic avoidance associated with fear of headache or migraine attack has never been adequately described. We describe 12 migraine patients with particular phobic-avoidant behaviours related to their headache attacks, which we classified as a specific illness phobia, coined as cephalalgiaphobia. All patients were women, mean age 42, and all had a migraine diagnosis (11 CM, all overused acute medications). Patients had either a phobia of a headache attack during a pain-free state or a phobia of pain worsening during mild headache episodes. Patients overused acute medication as phobic avoidance. It is a significant problem, associated with distress and impairment, interfering with medical care. Cephalalgiaphobia is a possible specific phobia of illness, possibly linked to progression of migraine to CM and to acute medication overuse headache.

  5. Phobias, other psychiatric comorbidities and chronic migraine.

    PubMed

    Corchs, Felipe; Mercante, Juliane P P; Guendler, Vera Z; Vieira, Domingos S; Masruha, Marcelo R; Moreira, Frederico R; Bernik, Marcio; Zukerman, Eliova; Peres, Mario F P

    2006-12-01

    Comorbidity of chronic migraine (CM) with psychiatric disorders, mostly anxiety and mood disorders, is a well-recognized phenomenon. Phobias are one of the most common anxiety disorders in the general population. Phobias are more common in migraineurs than non-migraineurs. The clinical profile of phobias in CM has never been studied. We investigated the psychiatric profile in 56 patients with CM using the SCID I/P interview. Lifetime criteria for at least one mental disorder was found in 87.5% of the sample; 75% met criteria for at least one lifetime anxiety disorder and 60.7% of our sample fulfilled DSM-IV criteria for lifetime phobic avoidant disorders. Mood and anxiety scores were higher in phobic patients than in non-phobic CM controls. Number of phobias correlated with higher levels of anxiety and depression. Phobias are common in CM. Its recognition may influence its management. Early treatment may lead to better prognosis.

  6. Acceptability of Virtual Reality Interoceptive Exposure for the Treatment of Panic Disorder with Agoraphobia

    ERIC Educational Resources Information Center

    Quero, Soledad; Pérez-Ara, M. Ángeles; Bretón-López, Juana; García-Palacios, Azucena; Baños, Rosa M.; Botella, Cristina

    2014-01-01

    Interoceptive exposure (IE) is a standard component of cognitive-behavioural therapy (CBT) for panic disorder and agoraphobia. The virtual reality (VR) program "Panic-Agoraphobia" has several virtual scenarios designed for applying exposure to agoraphobic situations; it can also simulate physical sensations. This work examines patients'…

  7. Anxiety Sensitivity: A Missing Piece to the Agoraphobia-without-Panic Puzzle

    ERIC Educational Resources Information Center

    Hayward, Chris; Wilson, Kimberly A.

    2007-01-01

    This article reviews the controversy surrounding the diagnosis of agoraphobia without panic attacks and proposes a key role for anxiety sensitivity in explaining agoraphobic avoidance among those who have never experienced panic. Although rare in clinical samples, agoraphobia without panic is commonly observed in population-based surveys,…

  8. Anxiety Sensitivity: A Missing Piece to the Agoraphobia-without-Panic Puzzle

    ERIC Educational Resources Information Center

    Hayward, Chris; Wilson, Kimberly A.

    2007-01-01

    This article reviews the controversy surrounding the diagnosis of agoraphobia without panic attacks and proposes a key role for anxiety sensitivity in explaining agoraphobic avoidance among those who have never experienced panic. Although rare in clinical samples, agoraphobia without panic is commonly observed in population-based surveys,…

  9. Acceptability of Virtual Reality Interoceptive Exposure for the Treatment of Panic Disorder with Agoraphobia

    ERIC Educational Resources Information Center

    Quero, Soledad; Pérez-Ara, M. Ángeles; Bretón-López, Juana; García-Palacios, Azucena; Baños, Rosa M.; Botella, Cristina

    2014-01-01

    Interoceptive exposure (IE) is a standard component of cognitive-behavioural therapy (CBT) for panic disorder and agoraphobia. The virtual reality (VR) program "Panic-Agoraphobia" has several virtual scenarios designed for applying exposure to agoraphobic situations; it can also simulate physical sensations. This work examines patients'…

  10. Radiation: facts, fallacies and phobias.

    PubMed

    Wigg, D R

    2007-02-01

    There is frequent debate in the media and the scientific published reports about the use of radiation for diagnosis and treatment, the benefits and risks of the nuclear industry, uranium mining and the storage of radioactive wastes. Driving this debate is increasing concern about reliance on fossil fuels for power generation for which alternatives are required. Unfortunately, there is generally a poor understanding of the relevant basic sciences compounded by widespread irrational fear of irradiation (radiation phobia). Radioactivity, with special reference to uranium and plutonium is simply described. How radiation affect tissues and the potential hazards to individuals and populations are explained. The origins of radiation phobia and its harmful consequences are examined. Whether we like it or not, Australia is heavily involved in the uranium industry by virtue of having one-third of the world's known reserves, exports of which are worth approximately $470m annually. As this paper has been written as simply as possible, it may also be of interest to readers who may have had little scientific training. It may be downloaded from the web using references provided in this article. It is concluded that ignorance and fear are major impediments to rational debate on radiation issues.

  11. A comparison of treated and untreated simple phobia.

    PubMed

    Chapman, T F; Fyer, A J; Mannuzza, S; Klein, D F

    1993-05-01

    The authors compared 25 treated and 58 untreated subjects with simple phobia uncomplicated by other lifetime anxiety disorders. The treated individuals reported more phobias involving dogs and cats, elevators, and transportation; most had multiple phobias; and many experienced panic attacks in the context of their phobias. The untreated individuals typically reported only one phobia, which was often related to blood-injury and was seldom complicated by panic symptoms.

  12. [Anxious School Absenteeism: Cognitive-Behavioral Treatment of School Phobia at a Psychological Counseling Center].

    PubMed

    Diegel, Klaus

    2015-01-01

    Resulting from a shortage of possibilities in the ambulant treatment of school phobia behavior-therapeutic interventions were established at a psychological counseling center for families twenty years ago, which have been in existence to this day. The criteria of anxiety-based absenteeism as well as problems of terminology and classification will be presented with emphasis on school phobia as a combination of separation anxiety and social anxiety ("Schulphobie"). The multimodal treatment focuses on cognitive interventions, graduated exposition and close cooperation with teachers. The counselor is also in charge of the networking and cooperation of all people concerned. A short case study is used to illustrate the process. Measures such as training and information for teachers and school social workers and a manual for the comprehension and the treatment of school phobia, which was edited in cooperation with a psychological counseling center for schools complement the treatment.

  13. Fear or disgust? The role of emotions in spider phobia and blood-injection-injury phobia.

    PubMed

    Çavuşoğlu, Merve; Dirik, Gülay

    2011-01-01

    According to the literature, it is assumed that fear and anxiety are basic emotions in anxiety disorders. Many recent studies report that disgust, as well as fear, has an important role in the etiology and maintenance of anxiety disorders. Evaluation of the role of disgust in anxiety disorders has led the theoretical and empirical literature in a new direction, beyond the traditional emphasis on fear. Most of this basic research has focused on specific phobias, such as blood-injection-injury phobia and spider phobia. Findings obtained from evaluation of physiological and cognitive processes, and subjective and behavioral experiences clearly show that in addition to fear, emotional reactions to phobic stimuli also include disgust; however, empirical studies show that disgust and fear have different relative impacts on specific phobias. To illustrate, individuals experience disgust as the basic emotion in blood-injection-injury phobia, whereas both fear and disgust are experienced in spider phobia. Nevertheless, it is concluded that fear has a more fundamental role in the latter. Yet, research indicates that basic emotions different from those identified from neural structures or physiological responses, such as heart rate, can be identified if facial expressions and cognitive appraisals are taken into account. In the present review the role of fear and disgust in blood-injection-injury phobia vs. spider phobia are discussed, based on the relationship between the phobias and disgust sensitivity, disgust as part of phobic responses, and disgust-motivated avoidance behavior.

  14. The epidemiology of panic disorder and agoraphobia in Europe.

    PubMed

    Goodwin, R D; Faravelli, C; Rosi, S; Cosci, F; Truglia, E; de Graaf, R; Wittchen, H U

    2005-08-01

    A literature search, in addition to expert survey, was performed to estimate the size and burden of panic disorder in the European Union (EU). Epidemiologic data from EU countries were critically reviewed to determine the consistency of prevalence estimates across studies and to identify the most pressing questions for future research. A comprehensive literature search focusing on epidemiological studies in community and clinical settings in European countries since 1980 was conducted (Medline, Web of Science, Psychinfo). Only studies using established diagnostic instruments on the basis of DSM-III-R or DSM-IV, or ICD-10 were considered. Thirteen studies from a total of 14 countries were identified. Epidemiological findings are relatively consistent across the EU. The 12-month prevalence of panic disorder and agoraphobia without history of panic were estimated to be 1.8% (0.7-2.2) and 1.3% (0.7-2.0) respectively across studies. Rates are twice as high in females and age of first onset for both disorders is in adolescence or early adulthood. In addition to comorbidity with agoraphobia, panic disorder is strongly associated with other anxiety disorders, and a wide range of somatoform, affective and substance use disorders. Even subclinical forms of panic disorder (i.e., panic attacks) are associated with substantial distress, psychiatric comorbidity and functional impairment. In general health primary care settings, there appears to be substantial underdiagnosis and undertreatment of panic disorder. Moreover, panic disorder and agoraphobia are poorly recognized and rarely treated in mental health settings, despite high health care utilization rates and substantial long-term disability.

  15. Agoraphobia: nurse therapist-facilitated self-help manual.

    PubMed

    Lovell, Karina; Cox, Debbie; Garvey, Rachel; Raines, David; Richards, David; Conroy, Patrick; Repper, Dean

    2003-09-01

    Agoraphobia is a common and disabling mental health disorder. Substantial evidence supports the use of cognitive behaviour therapy (CBT), in particular the intervention termed exposure therapy, as the treatment of choice. However, although the evidence base for cognitive-behaviour therapy is extensive, the service delivery evidence base is poor, and alternative ways of delivering therapy are required if mental health services are to achieve standards set out by the National Service Framework in the United Kingdom. The study had two aims: (1) to develop a self-help manual, which could be facilitated by a nurse trained in CBT, for clients suffering from agoraphobia and (2) to pilot the self-help manual and evaluate its effectiveness. The self-help manual was piloted with experienced nurses trained in CBT on three clinical sites for 10 weekly sessions of 30 minutes duration. A range of clinical outcome measures was administered by an independent assessor before and after treatment and at 1-month follow-up. A total of 18 clients completed treatment and results showed improvement on all clinical measures; improvement was maintained at 1-month follow-up. Importantly, 89% of clients were clinically significantly improved at post-treatment assessment. Clients were satisfied with their treatment and the self-help manual, and therapists found facilitated self-help an acceptable way to deliver treatment. Nurses can deliver effective support to patients using a self-help manual for agoraphobia. Although the results are promising, further work is required with larger numbers, longer follow-up and economic evaluation under controlled conditions. The work could also be adapted to different psychological conditions. Variation in the amount of specialist educational training is necessary to determine how many nurses are needed to support patients using self-help.

  16. Diagnosis and treatment of agoraphobia with panic disorder.

    PubMed

    Perugi, Giulio; Frare, Franco; Toni, Cristina

    2007-01-01

    Agoraphobia with panic disorder is a phobic-anxious syndrome where patients avoid situations or places in which they fear being embarrassed, or being unable to escape or get help if a panic attack occurs. During the last half-century, agoraphobia has been thought of as being closely linked to the recurring panic attack syndrome, so much so that in most cases it appears to be the typical development or complication of panic disorder. Despite the high prevalence of agoraphobia with panic disorder in patients in primary-care settings, the condition is frequently under-recognised and under-treated by medical providers. Antidepressants have been demonstrated to be effective in preventing panic attacks, and in improving anticipatory anxiety and avoidance behaviour. These drugs are also effective in the treatment of the frequently coexisting depressive symptomatology. Among antidepressant agents, SSRIs are generally well tolerated and effective for both anxious and depressive symptomatology, and these compounds should be considered the first choice for short-, medium- and long-term pharmacological treatment of agoraphobia with panic disorder. The few comparative studies conducted to date with various SSRIs reported no significant differences in terms of efficacy; however, the SSRIs that are less liable to produce withdrawal symptoms after abrupt discontinuation should be considered the treatments of first choice for long-term prophylaxis. Venlafaxine is not sufficiently studied in the long-term treatment of panic disorder, while TCAs may be considered as a second choice of treatment when patients do not seem to respond to or tolerate SSRIs. High-potency benzodiazepines have been shown to display a rapid onset of anti-anxiety effect, having beneficial effects during the first few days of treatment, and are therefore useful options for short-term treatment; however, these drugs are not first-choice medications in the medium and long term because of the frequent development

  17. Phobias

    MedlinePlus

    ... nervous and have a panic attack. What's a Panic Attack Like? Panic attacks can be really scary and may make someone ... sweat, and breathe quickly. Some people who have panic attacks might have chest pains, feel dizzy, or feel ...

  18. ADad 8: School Phobia and Anxiety Disorders among adolescents in a rural community population in India.

    PubMed

    Nair, M K C; Russell, Paul Swamidhas Sudhakar; Subramaniam, Vinod Shanmukham; Nazeema, Suma; Chembagam, Neethu; Russell, Sushila; Shankar, Satya Raj; Jakati, Praveen Kumar; Charles, Helen

    2013-11-01

    School Phobia (SP), although is not a formal psychiatric diagnosis, is widely prevalent debilitating phenomenon with a gamut of underlying psychiatric conditions in an overwhelming majority of cases. This study documents the prevalence, symptom presentation and the relationship between the various subtypes of Anxiety Disorders (AD) and School Phobia. In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime to identify SP and subtype of AD respectively. Descriptive statistics for the prevalence and symptom presentation, Spearman's Correlation test, Independent t tests, on-way ANOVA and Chi-square tests were done to compare the prevalence and severity of School Phobia among various age groups and gender. Univariate and multivariate analyses were done for documenting the relationship between the School Phobia and Anxiety Disorders. School Phobia was noted in 4.8% of adolescents. Although age was related to SP, gender, school grade the adolescent was attending and family structure were not related to SP. Somatic symptoms were more often noted than cognitive-emotional symptoms among adolescents with SP. Panic Disorder (OR = 8.62), Social Anxiety Disorder (OR = 8.63), and Separation Anxiety Disorder (OR = 6.26), were significantly related to SP. School Phobia is noted in a significant proportion of adolescents in the community. Anxiety Disorder is a major underlying factor resulting in SP. Community and clinical intervention and service models should include anxiety alleviation methods in adolescents with School Phobia.

  19. Hospital phobia: a rapid desensitization technique.

    PubMed Central

    Waxman, D.

    1978-01-01

    The less disabling phobias do not normally present a problem in that the stimulus may be avoided. This would also apply to hospital phobia until an acute medical or surgical problem might arise, when avoidance could constitute a direct threat to life. Although phobic illness is a common problem the small number of cases of hospital phobia recorded may represent the tip of the iceberg beneath which could be many phobic patients who deny their symptoms and risk their health because of their irrational fear. A case of hopsital phobia in a pregnant patient with suspected disproportion was treated by a rapid desensitization technique using hypnosis. After five sessions of 30 min each, the patient was symptom free. This simple method of desensitization, if more widely known would considerably minimize the risk caused by concealment of the phobic problem. PMID:27775

  20. Anxiety, Fears, and Phobias (For Parents)

    MedlinePlus

    ... For Kids For Parents MORE ON THIS TOPIC Obsessive-Compulsive Disorder Helping Kids Cope With Stress Helping Kids Handle ... Disorders Childhood Stress Separation Anxiety Relax & Unwind Center Obsessive-Compulsive Disorder Phobias Kids Talk About: Feeling Scared Talking About ...