Social Anxiety Disorder EDWARDO MORENO AND ALFREDO PATINO

Etiology Terms: Biological  Biological: SAD has genetic causes. According to The American Psychiatric Association: "anxiety disorders run in families. For example, if one identical twin has an anxiety disorder, the second twin is likely to have an anxiety disorder as well, which suggests that genetics-possibly in combination with life experiences-makes some people more susceptible to these illnesses"  In addition to genetic causes, there is also evidence that SAD is caused by chemical disturbances in the brain

Etiology Terms: Cognitive  Cognitive: A key factor is a shift in focus of attention and a particular type of negative self-processing. When individuals with social phobia believe they are in danger of negative evaluation by others, they shift their attention to detailed monitoring and observation of themselves.  Feeling anxious is equated with looking anxious. This can lead to marked distortions.  For example, an individual may have a strong shaky feeling and assume that others must be able to see his or her hand shaking violently, when all that can be observed by others is a mild tremor or nothing at all.  Many see images in which they see themselves as if viewed from an observer’s perspective. Unfortunately, what they see in the image is not what the observer would see but rather their fears visualized.  Third, more diffuse types of “felt sense” can also contribute to the negative impression of one’s social self

Etiology Terms: Sociocultural  The defining feature of social anxiety disorder (SAD) is the fear of negative evaluation by others.  Therefore, SAD is directly linked to social standards and role expectations, which are culture dependent.  Recognizing the intricate interplay between culture and social anxiety, some research has focused on psychopathologic manifestations of SAD across cultures  An individual's social concerns need to be examined in the context of the person's cultural, racial, and ethnic background in order to adequately assess the degree and expression of social anxiety and social anxiety disorder

Symptoms  Many people with social anxiety disorder feel that there is "something wrong," but don't recognize their feeling as a sign of illness. Symptoms of social anxiety disorder can include:  Intense anxiety in social situations.  Avoidance of social situations.  Physical symptoms of anxiety, including confusion, pounding heart, sweating, shaking, blushing, muscle tension, upset stomach, and diarrhea.  Children with this disorder may express their anxiety by crying, clinging to a parent, or throwing a tantrum.

Prevalence  Estimates of the number of people who suffer with SAD have varied depending on the study, however the majority of research indicates that it is one of the most common mental disorders  According to the NIMH report, "The Numbers Count: Mental Disorders in America (2008)", 6.8% of the population aged 18 and older (approximately 15 million Americans) suffer with social anxiety disorder

Diagnosis  In community samples the most common additional diagnosis include specific phobia, agoraphobia, major depression, and alcohol abuse and dependence.  Other situations that commonly provoke anxiety include:  Eating or drinking in front of others.  Writing or working in front of others.  Being the center of attention.  Interacting with people, including dating or going to parties.  Asking questions or giving reports in groups.  Using public toilets.  Talking on the telephone.  Presenting a project about Social Anxiety Disorder in Psychology Class

Cultural Factors  In collectivistic cultures, harmony within the group is the highest priority and individual gain is considered to be less important than improvement of the broader social group. Thus, it is possible that in collectivistic countries more overt social norms exist to maintain social harmony. In contrast, in individualistic societies, individual achievements and success receive the greatest reward and social admiration.  Embarrassment is more common in collectivistic cultures because it is induced by external sanctions, whereas guilt and self-blame are more common in individualistic cultures because they are induced by internal sanctions  Self-construals - are overarching schemata that define how people relate to others and the social context.  Individuals from the US and other individualistic societies tend to construct and promote independent self-construals, which are characterized by one's tendency to view oneself as autonomous and separate from the social context  Shame has a more important effect on social anxiety in the Chinese culture compared to its effect on Americans.

Gender Variations  Gender Role and Gender Role Identification are constructs that are closely related to self-construal.  femininity being associated with shyness and social subordination, and masculinity with social dominance and aggression.  Bem SL (1984) challenged this traditional belief by reasoning that a single individual can be, “both masculine and feminine, both assertive and yielding, both instrumental and expressive”  On the other hand, sex-typed individuals are motivated to restrict their behavior in accordance with cultural definitions of gender appropriateness, and perform poorly on tasks that require them to act in ways that are incongruent with their self-defined sex-type

Treatment Approaches  Two types of formal treatment are available to people with social anxiety disorder: pharmacotherapy (medication) and psychotherapy (psychological counselling).  is commonly treated by either psychotherapy or certain types of psychiatric medications.  Cognitive-behavioral therapy and medication are the two primary methods of treating social anxiety disorder (SAD). When used alone or in combination, these forms of treatment have been shown to greatly improve symptoms of social anxiety.

Relationship between Etiology and Therapeutic Approaches  The different etiologies in SAD require different Therapeutic Approaches  Such as for the etiology for the biological aspect of SAD  If is chemical disturbances in the brain, medication may be more suitable  If it is a result of genetic, a combination of therapy and medication may be the best option  For the sociocultural and cognitive aspect of it, people are more likely to use therapy to understand and overcome the anxiety felt.

Walker Tessner Model