SOCIAL ANXIETY DISORDER

Amber Miller

WHAT IS IT?

Social anxiety disorder (also known as social phobia): Is one of the most common psychiatric disorders. Is often dismissed as shyness can cause crippling fear that

interferes with school attendance,

work performance, and

relationships. affects about 7% of Americans

in any given year, and about 12%

at some point in their lives

(Anonymous, 2010).

PSYCHOANALITIC APPROACH

Classical psychoanalytic theory: mental health problems arise as a result of repressed unconscious desires from childhood (Campbell, M., Schmidt, L., Santesso, D., Van Ameringen, M., Mancini, C., & Oakman, J., 2007).

Psychoanalysts treat social anxiety disorders by helping the

individual understand what is making them anxious.

Individuals talk freely about themselves and attempt to overcome inner conflicts (Campbell, et al., 2007).

EXAMPLE OF PSYCHOANALYSIS IN TREATING S.A.D

A woman anxious about dating may be frightened of intimacy. Psychoanalytic therapy will help her to learn more about why. Hopeful results:

that as she deepens her self-understanding, she will become less frightened and more open to entering into a loving relationship.

Theory: if the anxiety can be fully understood and resolved, it is less

likely to return (Khodarahimi, 2009).

PROS AND CONS OF PSYCHOANALYSIS

Pros: Some anxiety disorders are in fact rooted in past

experiences Cons:

The problem is not ALWAYS rooted in ones past, but sometimes in their current actions

Media plays a large role in lack of self-esteem, and this can lead to things like social anxiety disorder

TRAIT THEORY

Various traits combine = a personality that is unique to each individual.

Focused on identifying and measuring these individual personality characteristics (Alnæs, 2001).

People with characteristics that fall at an extreme on the chart are likely to have a psychological abnormality associated with that trait.

They are then likely to select their environment in such a way that this trait is brought out.

To keep this from happening, psychologists teach their patients to come to terms with the flawed trait, allowing the patient to break the cycle (Alnæs, 2001).

PROS AND CONS OF TRAIT THEORY

Pros: Taking the Big Five personality test can tell people if they

fall under any extremes improve on aspects that they want to improve on before it aids in the development of a disorder like social anxiety.

Cons: I do not know how reliable this is however when talking

about social anxiety disorder. There seems to be many faults to trait theory in terms of treatment, like telling a patient that they are flawed.

People with social anxiety disorder, or any disorder for that

matter, do not want to be told that they are flawed and need to come to terms with it in order to be happy.

BIOLOGICAL APPROACH

S.A.D sufferers: show increased activity in the amygdala (i.e., a structure

deep inside the brain that generally shows more activity in response to threatening or fearful events)

show decreased activity in cortical areas (i.e., the outer portion of the brain that is involved in planning and the complex interpretation of events).

People who are very sociable tend to have increased levels of

dopamine Generalized form of social anxiety disorder tends to run in

families (Schneier, F., Abi-Dargham, A., Martinez, D., Slifstein, M., Dah-Ren, H., Liebowitz, M., 2009).

BIOLOGICAL TREATMENT

There are a number of medications that have proven useful for treating social anxiety disorder. These medications include: antidepressants, antianxiety, gabapentin (Neurontin), and drugs that act on levels of serotonin and dopamine in

the brain (Schneier, et al., 2009).

BIOLOGICAL PROS AND CONS

Pros: there have been a good number of medications proven to

help with social anxiety disorder often these medications offer help almost immediately

Cons: medications only calm the symptoms of social anxiety, not

resolve it researchers are only now beginning to uncover the

underlying brain mechanisms associated with social anxiety disorder (Schneier, et al., 2009)

There have been many studies and tests conducted to decide whether or not this disorder is linked to biological factors, but many of those studies have been contradicted by another

HUMANISTIC APPROACH

Mission: point the individual in the direction of inbuilt potentials and

resources Hopeful Result:

help them to build a stronger personality and self-concept Therapist is considered a “guide” Mindfulness and acceptance techniques + traditional behavior

therapy (humanistic approach) = effective treatment (George, 2008)

PROS AND CONS OF HUMANISTIC APPROACH

Pros: Because it is based on the self and client-centered therapy, it

allows people to discover their personal capacity for self-direction and understand their own development.

Cons: This approach needs people to be aware of the root of their

problem first in order to build on fixing it = it may not work for everyone.

Patients must be at a stage where they know that they are responsible for themselves, but many people who seek help are not ready from the start to take on this personal responsibility.

COGNITIVE-BEHAVIORAL & SOCIAL LEARNING APPROACH (CBT)

Helps patients: uncover the underlying causes of your worries and fears; learn how to relax; look at situations in new, less frightening ways; develop better coping and problem-solving skills give patients the tools to overcome anxiety and teach them how

to use them (Würz, A., & Sungur, M., 2009) Medical University of South Carolina Study:

CBT was superior to biological

treatments (medication) in the long

run CBT had more successes than the

other four approaches (Würz, et al., 2009).

PROS AND CONS OF CBT Pros:

combines two key aspects of social anxiety: cognition treatment with behavioral treatment

Cognitive therapy examines how negative thoughts (cognitions) contribute to anxiety and behavior therapy examines how you behave and react in situations that trigger anxiety (Würz, et al., 2009).

allows patient to focus on this disorder from two different perspectives at once

Cons: would need to be combined with exposure* in order to be the

far superior approach

*Exposure: the introducing of the feared situation to the patient gradually in combination with therapy sessions.

CONCLUSION: BEST APPROACH

Cognitive-Behavioral Therapy: Why? 1. Past higher success rates2. Positive study results 3. More advantages compared to other

approaches4. fewer disadvantages compared to advantages5. No judgment, just programs geared towards

patient progress.

REFERENCES  

Alnæs, R. (2001). Social phobia: Research and clinical practice. Nordic Journal of Psychiatry, 55(6), 419-425. doi:10.1080/08039480152693327

Anon. (2010). Treating social anxiety disorder. Harvard Mental Health Letter, 26(9), 1-3. Retrieved from Academic Search Complete database.

Campbell, M., Schmidt, L., Santesso, D., Van Ameringen, M., Mancini, C., & Oakman, J. (2007). Behavioral and psychophysiological characteristics of children of parents with social phobia: a pilot study. International Journal of Neuroscience, 117(5), 605-616. doi:10.1080/00207450600773780.

George, C. (2008). Solution-focused therapy: strength-based counseling for children with social phobia. Journal of Humanistic Counseling, Education & Development, 47(2), 144-156. Retrieved from Academic Search Complete database.

KHODARAHIMI, S. (2009). Dreams in Jungian psychology: the use of dreams as an instrument for research, diagnosis and treatment of social phobia. Malaysian Journal of Medical Sciences, 16(4), 38-45. Retrieved from Academic Search Complete database.

Schneier, F., Abi-Dargham, A., Martinez, D., Slifstein, M., Dah-Ren, H., Liebowitz, M., et al. (2009). Dopamine transporters, D₂ receptors, and dopamine release in generalized social anxiety disorder. Depression & Anxiety (1091-4269), 26(5), 411-418. doi:10.1002/da.20543.

Würz, A., & Sungur, M. (2009). Combining cognitive behavioural therapy and pharmacotherapy in the treatment of anxiety disorders: True Gains or False Hopes?.Klinik Psikofarmakoloji Bulteni, 19(4), 436-446. Retrieved from Academic Search Complete database.