Social Anxiety and Separation Anxiety Disorder

Separation Anxiety

• Clinical Description
    * Characterized by unrealistic and persistent worry that something will happen to self or loved ones when apart (e.g., kidnapping, accident) as well as anxiety about leaving loved ones
    * 4.1% of children meet criteria, 6.6% for adults

Clinical Description of Social Anxiety

• Extreme/irrational concern about being negatively evaluated by other people
• Sometimes (not always) manifests as shyness
• Leads to significant impairment and/or distress
• Avoidance of feared situations, or endurance with extreme distress
• Subtype
    * Performance only: Anxiety only in performance situations (e.g. public speaking)
• Statistics
    * 12.1% (life); 6.8% (year)
    * Female : Male = 1:1
    * Onset = usually adolescence
      * Peak age of onset = 13
    * More common in people who are young (18 to 29 years), undereducated, single, and of low socioeconomic class,
    * 13.6% prevalence in ages 18 to 29
    * 6.6% prevalence in ages 60+

Social Anxiety Across Cultures

• Japan—taijin kyofusho
    * Fear of offending others or making them uncomfortable
    * Concern about aspects of personal appearance (e.g., stuttering, blushing, body odor)
    * More common in males

Causes of Social Anxiety

• Generalized psychological vulnerability
    * E.g., belief that threatening events are uncontrollable
• Generalized biological vulnerability
    * E.g., propensity toward anxiety

Treatment of Social Anxiety

• Medications
    * Beta blockers
    * Benzodiazepines
    * SSRI (Paxil, Zoloft, and Effexor)
    * D-cycloserine
• Psychological
    * Cognitive-behavioral treatment
      * Challenging of anxious thoughts about the consequences of social judgment
      * Exposure to anxiety-provoking situations
      * Rehearsal
      * Role-play
    * Highly effective