SOCIAL ANXIETY DISORDER (SOCIAL PHOBIA) AB Psych Chapter 3

SOCIAL ANXIETY DISORDER

marked fear or anxiety focused on one or more social or performance situations

• Can be anxious in any interaction with people

• Can be anxious during specific performance situations in public (Performance Anxiety)
  

PERFORMANCE ANXIETY

 a subtype of SAD; the individual is very anxious only while others are present and maybe watching and, to some extent, evaluating their behavior

• Individuals typically have no difficulty with regular social interaction

• Anxiety arises when required to perform a specific task in front of others

• Focus of fear: possibility of embarrassment

• Common Performance Anxiety Situations:

  • Public speaking (most common)

  • Eating in a restaurant

  • Signing a paper/check in public

• Physical Symptoms of Anxiety:

  • Blushing

  • Sweating

  • Trembling

  • For males: Using a public restroom (paruresis or “bashful bladder”)

OLFACTORY REFERENCE SYNDROME

A condition where individuals are preoccupied with the belief that they are embarrassing or offending others due to a foul body odor

• Has been reported in North America as well as other regions

• Shares features with social anxiety disorder, but more closely resembles obsessive-compulsive disorder (OCD)

• Often responds well to psychological treatments used for OCD

CAUSES OF SOCIAL ANXIETY DISORDER

• Evolutionary Preparedness

• Temperamental Vulnerability

Evolutionary Preparedness

• Humans seem biologically prepared to fear angry, critical, or rejecting people

• People with SAD are more likely to notice and remember angry or critical expressions

• They also show stronger brain responses (e.g., amygdala activation, less cortical control) to threatening faces, especially the eyes

• This fear may have evolutionary roots—avoiding hostile or dominant individuals increased survival chances

Temperamental Vulnerability

• Some infants are born with a temperament of behavioral inhibition or shyness, evident as early as 4 months old

• These infants react more strongly (crying, agitation) to new stimuli

• Excessive behavioral inhibition increases the risk of developing phobic behavior and SAD

model of SAD

THREE PATHWAYS TO SOCIAL ANXIETY DISORDER

1. Inherited Vulnerabilities

2. Conditioned False Alarm

3. True Alarm (Real Social Trauma)

1. Inherited Vulnerabilities

• Generalized biological vulnerability:

  • Inherited tendency to develop anxiety

• Biological tendency to be socially inhibited

• Generalized psychological vulnerability:

  • Belief that stressful events are uncontrollable

  • Under stress → anxiety + excessive self-focused attention → disrupted performance

2. Conditioned False Alarm

• Under stress, a person may have an unexpected panic attack in a social situation

• This becomes conditioned to social cues

Result: Person grows anxious about future social situations where panic might occur

3. True Alarm (Real Social Trauma)

• Person experiences a real social trauma (e.g., rejection, bullying, humiliation)

• Anxiety becomes conditioned in the same or similar social settings

• Childhood and early adolescence (ages 12–15) are high-risk periods because of teasing and bullying

  • Example: 92% of adults with SAD reported severe childhood bullying (versus 35–50% in other anxiety disorders)

ADDITIONAL FACTORS THAT STRENGTHEN SAD

initial pathways explain the onset of social anxiety, but additional factors are needed to show why it persists, generalizes, and deepens into a chronic disorder

• Learned Alarm

• Anxious Apprehension

• Specific Psychological Vulnerability

• Family and Genetic Influence

PSYCHOLOGICAL TREATMENTS

• Cognitive Therapy

• Cognitive Behavioral Therapy

• Adolescent Adaptations

• Exposure Therapy (Social Mishap Exposures)

DRUG TREATMENTS

• Beta-blockers (e.g., Inderal)

• SSRIs approved for SAD: Paxil, Zoloft, Effexor

• D-Cycloserine (DCS)

SELECTIVE MUTISM

A rare childhood anxiety disorder marked by the consistent failure to speak in specific social situations where speech is expected, despite being able to speak in other settings (e.g., speaks at home but not at school)