5.5: Social Anxiety Disorder

SAD Social Anxiety Disorder

Extreme irrational fear and endurance of social situations and performance
Social Interaction and or Performance

Performance anxiety can include

excessive blushing and sweating during

public speaking, eating in a restaurant, signing a paper in front of people, difficultly urinating in public

SAD Diagnostic Criteria

situations where possibility scrutinized

(conversation, meeting unfamiliar people), performing inform of others

showing anxiety symptoms will be embarrassing, or offend others

social situations almost always provoke fear or anxiety

situations are avoided or endured

persistent lasting for 6 months or more

impairment in social, job, or clinically significant distress

not explained better by another disorder

not explained by a medical condition
(speficy is symptoms are only related to public speaking/performance)

SAD Prevelance in population and gender, age

13% in US population at some point n their life

more common in women (little bit)

more prevent in young people 18-29 young adulthood

undereducated, low income

prev across ethinic groups

culturally more common in white, russian us

SAD onset

adolesence peaks at 15

Olfactory reference syndrome

anxiety, fear around giving off a foul body odor that is offending others

respnds to OCD treatmetns

SAD cultural factors

collectivistic cultures were more accpeting of social avoidance, than individualistic countriesand had higher levels of SAD, blsuing fear

Some children are born with inhibition or shyness

these children with excesive shyness are at risk for developing phobias

SAD causual model

1. Biological: inherreit vulnerablity for anxiety and or a biologcial tendency to socially inhibt

2. generalized psychological vulernability: can’t control stressful invents increasing vulnerability

3. under stress could have panic attack in social situation and is conditioned by social cues to feel fear

4. real social trauma gives true alarm (fear) anxiety is conditioned. can extend frrom early childhood

5. early adoelscen bulyling, dominating behaviour produces anxiety, panic that carries on in future socialing

90%  of people with SAD were bullied

SAD maladaptive beahviours

those with social anxiety have biased perception that social interaction will go negatively so they cope through avoidant behaviours.

these behaviours then make that expected reaction come true

SAD self flawed apart of psychological vulnerablity

anxious to reveal their personal traits, as they view them as flaws

psychological vulenrabiltiy with parents connects to gentic vulernability

parents concern for what others think they pass onto children and this has a biologcal basis since it is moderately heritable

Treatment of SAD

roleplaying situation effective

more than social support and education

intensive cognitive therapy is good
VR therapy

Clark therapy program SAD

real life experiences during therapy to reduce automatic feeling of danger

very high rate of success, maintained after 1 year follow up

Offman therapy practices SAD

tagets factors that maintain SAD. ex repeated exposure to social msihaps to show nothing bad happens when you do smth embarrazing

pretty high patient respone rate and high completion rate

Treating SAD in adolescents

gets parents involved. helps significantly esp if they have an axiety disorder as well

if teen has CBT they can function pretty well in school, other social settings

Medication SAD

is condsidered effetive doesnt do much for performance anxiety

combination of meds and psyc treatments dispute not more effective than individual

Selective mutism

a rare disorder where child is mute by choice in one or more environments where speaking is expected.
they know how to speak, dont have any physical difficulties

related or commorbid with SAD

needs 1 month or longer to qualify