SOCIAL PHOBIA

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DSM-IV CRITERIA
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Marked, persistent fear of social situations Person recognizes the fear as unreasonable Feared social situations are avoided Interference or distress Specify generalized if it includes most social situations
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COMMON SOCIAL PHOBIA SITUATIONS
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speaking in public Seating or drinking in public writing in the presence of others using public toilets being in a social situation in which the individual may say foolish things
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CLINICAL FEATURES
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Fear of negative evaluation Belief that others see them as inept, stupid, foolish Often demonstrate a vicious cycle of anxiety „³ social deficits „³ anxiety Hypersensitive to criticism Non-assertive Low self-esteem
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CLINICAL FEATURES (CONT
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Comorbid anxiety common Often lack intimate relationships Safety behaviours common (e.g., avoiding eye contact, covering face with hair) Information processing biases (Clark & McManus, 2002) Biases in: interpretations of social events, detection of positive responses of others, anticipatory and post-event processing
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SOCIAL PHOBIA Prevalence
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12% lifetime Equally prevalent in males and females (in clinical populations) Onset typically in late adolescence Appears in all cultures, although influenced by social norms
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DIFFERENTIAL DIAGNOSIS Panic Disorder=
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fear of panic NOT social evaluation
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Don’t diagnose SP if person
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fears having panic attacks seen by others
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PD typically has salient onset but SP
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is insidious
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Severe cases may indicate comorbid SP
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and APD
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APD may be more severe SP
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continuum: shyness –>social phobia–> APD; Rapee & Heimberg, 1997
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COGNITIVE MODEL OF SOCIAL PHOBIA
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FEAR OF SEEMING ANXIOUS ANXIETY SYMPTOMS BELIEF THAT SYMPTOMS ARE VISIBLE FEAR/CONVICTION OF NEGATIVE EVALUATION
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Social anxiety is maintained by:
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Increased self-focused attention Use of misleading internal information Use of safety behaviours Pre- and post-event processing
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Observer perspective
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Distorted image of public self is central Increase in self-focused attention/self-monitoring in social situations –>see self from observer perspective But observer images = excessively negative, distorted ¡V feared not actual performance
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According to Clark & Wells (1995), when social phobia patients become concerned that they may fail to make their desired impression on others
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their attention shifts from observation of others to detailed monitoring and observation of themselves
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Do people with social phobia have an attentional bias in high-threat situations? Compared high vs low socially anxious individuals in high threat (speech) and low threat (computer task) situations
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Compared to low socially anxious individuals, high socially anxious individuals showed an internal attentional bias that was specific to conditions of social-evaluative threat.

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