Development Of Social Anxiety Disorder Research Articles

Cognitive Behavioral Therapy In Posttraumatic Stress Disorder and Social Anxiety Disorder: A Case Report

Domestic violence is common in Turkey and can lead to the development of post-traumatic stress disorder (PTSD). Cognitive behavioral therapy (CBT) is an effective approach for treating posttraumatic stress disorder (PTSD). It has been found that there are various reasons for the development of social anxiety disorder. Therefore, it can be evaluated by considering details such as life history, personal characteristics, the environment in which anxiety is experienced, and a lack of skills. CBT has also been found to be an effective method of reducing social anxiety. In this study, a 16-year-old patient who developed PTSD after witnessing long-term violence against her mother and recovered as a result of CBT is presented. In addition to PTSD symptoms, the patient reported that she felt significant anxiety and fear in many social situations where she could be evaluated by people, and that she engaged in safety and avoidance behaviors. CBT was administered for these complaints, and her symptoms improved significantly.

A virtual reality social conditioned place preference paradigm for humans: Does trait social anxiety affect approach and avoidance of virtual agents?

Approach and avoidance of positive and negative social cues are fundamental to prevent isolation and ensure survival. High trait social anxiety is characterized by an avoidance of social situations and extensive avoidance is a risk factor for the development of social anxiety disorder (SAD). Therefore, experimental methods to assess social avoidance behavior in humans are essential. The social conditioned place preference (SCPP) paradigm is a well-established experimental paradigm in animal research that is used to objectively investigate social approach–avoidance mechanisms. We retranslated this paradigm for human research using virtual reality. To this end, 58 healthy adults were exposed to either a happy- or angry-looking virtual agent in a specific room, and the effects of this encounter on dwell time as well as evaluation of this room in a later test without an agent were examined. We did not observe a general SCPP effect on dwell time or ratings but discovered a moderation by trait social anxiety, in which participants with higher trait social anxiety spent less time in the room in which the angry agent was present before, suggesting that higher levels of trait social anxiety foster conditioned social avoidance. However, further studies are needed to verify this observation and substantiate an association with social anxiety disorder. We discussed the strengths, limitations, and technical implications of our paradigm for future investigations to more comprehensively understand the mechanisms involved in social anxiety and facilitate the development of new personalized treatment approaches by using virtual reality.

Mitigating the impact of adolescence isolation on the development of social anxiety: A potential role for oxytocin.

Exposure to isolation can lead to the development of social anxiety disorder (SAD), which affects 13% of Americans. There are sex differences in the prevalence of anxiety disorders, as women experience higher rates of SAD relative to men. Importantly, isolation experienced during adolescence increases the likelihood of developing SAD in adulthood. Unfortunately, the current treatments for SAD are only effective in 50–65% of patients. As such, it is critical to identify therapeutic targets for the treatment and prevention of SAD, particularly in women. Here, we discuss the links between childhood isolation and adulthood SAD. Next, we examine the preclinical models used to study the impact of isolation on social anxiety-like behaviors in rodents. Increasing evidence from both clinical and pre-clinical studies suggests oxytocin signaling is a potential target to modify social anxiety-like behaviors. We present the evidence that sex hormones influence the oxytocin system. Finally, we highlight future directions for both clinical and pre-clinical studies to further evaluate the efficacy of oxytocin as a treatment for isolation-induced SAD.

The role of adverse childhood experiences and attachment styles in social anxiety disorder in adolescents.

Social Anxiety Disorder (SAD) is one of the most common disorders of adolescence and results in marked impairments in social and academic/occupational activities that likely to persist into adulthood. Multiple etiological factors contribute to the development of social anxiety disorder. Two critical factors in presenting with a primary diagnosis of SAD might be adverse childhood experiences (ACEs) and attachment styles. The current study examined how ACEs and attachment styles may be related to SAD in adolescents. 60 participants with ages ranging from 11 to 18 (M = 14.6; female = 36), who have a primary diagnosis of SAD and 60 control group adolescents (M = 14.6; female = 30) were included in the study. Both groups completed the Liebowitz Social Anxiety Scale (LSAS), the Childhood Trauma Questionnaire (CTQ), and the Adolescent Relationship Scales Questionnaire (A-RSQ). After controlling adolescent gender and parental education levels, childhood emotional neglect and income significantly predicted an increased risk for adolescents' SAD diagnosis. Attachment styles did not significantly contribute to predicting adolescents' SAD diagnosis after controlling childhood emotional neglect. The high predictive value of emotional neglect in childhood emphasizes its importance as a risk factor of SAD in adolescence.

Familial Factors in the Development of Social Anxiety Disorder

The purpose of the current article is to explore familial factors that influence the development of social anxiety disorder (SAD) in children and adolescents, including parenting, sibling relationships, and family environment. A multitude of interrelated genetic and familial factors have been found to cause and maintain SAD in children and adolescents. There are many challenges in diagnosing and treating the disorder. Knowledge and awareness of familial factors provide insight on targeted treatments that prevent or ameliorate SAD. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 23-34.].

Disturbed Social Information Processing as a Mechanism in the Development of Social Anxiety Disorder

AbstractSocial anxiety disorder (SAD) is one of the most common mental disorders and becomes chronic if left untreated. Even when it is treated, outcomes are less promising than for other anxiety disorders. Thus, many are interested in preventing SAD and in the mechanisms involved in the development of SAD. In this article, I propose in a new model that disturbances in social cognition (cognitive biases, emotion recognition and understanding, negative expectations) and dysregulated social emotions (social fear and self‐conscious emotional arousal) in toddlerhood and early childhood lead to avoidance and high levels of anxiety in social situations. When repeated over time, these impair daily functioning and result in a disorder. Biological factors (e.g., fearful temperament), environmental factors (e.g., parental mentalizing), and past experiences may be distal factors that contribute to the development of SAD via disturbed sociocognitive processing and dysregulated emotions. Based on this model, I conclude by describing clinical implications and recommendations for research.

Behavioral Inhibition in Childhood as A Risk Factor for Development of Social Anxiety Disorder: A Longitudinal Study.

Previous research has suggested the association between behavioral inhibition (BI) and the development of social anxiety disorder in childhood. However, there is scarce research using longitudinal methodology in Spanish-speaking populations. To cover this gap, the sample comprised 73 children ranging from six to eight years who had been examined for BI two years earlier in home and school settings. Children and their parents were administered the Anxiety Disorders Interview Schedule for DSM-5-Child and Parent Versions to assess the presence of possible anxiety disorders. The results revealed the stability of BI symptomatology over time. Data also showed that BI children were almost ten times more likely to develop social anxiety disorder two years later, compared to no-BI children. As a result, findings suggest behavioral inhibition strongly predicts social anxiety disorder, making BI a logical focus for selective preventive interventions. Therefore, screening for behavioral inhibition holds promise for primary prevention.

Mitigating adolescent social anxiety symptoms: the effects of social support and social self-efficacy in findings from the Young-HUNT 3 study

Adolescents’ exposure to negative life events (NLEs) and potentially traumatic events is highly prevalent and increases their risk of developing psychological disorders considerably. NLE exposure has also been linked to the development of social anxiety disorder (SAD) among older children and young adolescents. Despite the relatively low treatment efficacy reported for children and adolescents suffering from SAD, few studies have addressed the extent to which resilience factors, such as social support and social self-efficacy, are associated with SAD symptoms. This study examined whether social support and social self-efficacy predict, and buffer against SAD symptoms using a large, population-based sample of adolescents, among whom a large proportion have experienced NLEs. The results reveal that NLEs are significantly associated with SAD symptoms, while social support and social self-efficacy are both negatively associated with SAD symptoms. Only the NLEs × social support interaction significantly predicted SAD symptoms, with social support attenuating the association between NLEs and SAD symptoms. Moreover, increases in both social self-efficacy and social support were associated with reduced SAD symptoms, over and above variance explained by social support alone. Our cumulative results suggest that interventions that can modify both social support and social self-efficacy may help reduce SAD symptoms in at-risk adolescents.

Social emotions and social cognition in the development of social anxiety disorder

ABSTRACT Social anxiety disorder (SAD) is one of the most prevalent mental disorders with serious individual impairments and societal costs. Little is known about the mechanisms involved in SAD development. Here, I propose that dysregulated social emotions (social fear and shyness) are crucial for SAD development and that these dysregulated social emotions originate in the disturbances in socio-cognitive abilities. The research from our lab confirmed this. It showed that behavioural and physiological indices of social fear contribute to the development of SAD in toddlerhood and early childhood. Later in childhood, between ages 4.5 and 7.5, we found a new risk factor for SAD―dysregulated shyness. Specifically, we found that negative shy expressions and prolonged physiological blushing (temperature increase) contribute to SAD development. Whereas elevated fear may be rooted in deficits in socio-cognitive skills, dysregulated shyness may be rooted in advanced socio-cognitive abilities. These findings imply that dysregulated social emotions play an important role in SAD and should be explicitly targeted in clinical treatments of SAD.

Ameliorating Effects of Quercetin in a Diabetic Rat Model with Social Anxiety Disorder

Objective The present study aimed to investigate the effects of quercetin on diabetes-induced behavioural, metabolic and histopathological alterations in a rat model that mimics the development of social anxiety disorder in diabetic humans.

Social Anxiety and the Accuracy of Memory for Childhood Teasing Frequency.

Adults' recollections of how often they were teased as children are positively associated with their social anxiety symptoms. It has therefore been suggested that childhood teasing may play a role in the development of social anxiety disorder (SAD). However, existing studies have not determined whether adults with SAD were actually teased more as children or whether their current symptoms have distorted their memories of childhood events. This study examined reports of childhood teasing in adults with SAD before and after cognitive behavioral therapy (CBT). If recollections of childhood teasing are colored by SAD symptoms, then reported frequency of teasing might be more likely to decrease as symptoms improve after CBT. However, if individuals' memories of teasing are unbiased, they should not substantially change with the reduction of symptoms after CBT. Ninety-one participants with SAD completed the Teasing Questionnaire-Revised (TQ-R) before and after 12 sessions of group CBT. CBT was effective in reducing SAD symptoms, whereas recollections of the frequency of childhood teasing did not change significantly after treatment. These results are consistent with the possibility that recollections of childhood teasing are not substantially biased by symptoms of SAD, and they lend support to previous studies which suggest that adults with SAD endured higher frequencies of teasing as children compared to controls.

Bridging the Gap between Aetiological and Maintaining Factors in Social Anxiety Disorder: The Impact of Socially Traumatic Experiences on Beliefs, Imagery and Symptomatology.

A number of key environmental factors during childhood have been implicated in the aetiology of social anxiety disorder (SAD), including aversive social experiences, traumatic life events and parent-child interaction. However, understanding the nature, interactions and relative contributions of these factors remains unclear. Furthermore, the relation of aversive social experiences to the development of key maintaining factors in SAD requires elucidation. The current study aimed to extend previous research regarding the aetiology of SAD by investigating the relationship between key environmental factors in childhood, negative beliefs and self-imagery, and the development of SAD. Social anxiety disorder individuals (n = 40, 87.5% female, Mage = 20.25 years) completed self-report measures of social anxiety symptomatology, traumatic experiences and parenting style. In addition, participants were administered interviews assessing various domains of childhood trauma, as well as negative self-imagery and associated socially traumatic memories. Participants reported a high frequency of early traumatic experiences across all domains (physical, emotional, sexual, social and non-relational), as well as a high degree of parental overcontrol. However, social anxiety symptomatology was most strongly correlated with socially traumatic experiences, and mediation analyses suggest that appraisal of aversive social/peer experiences accounts for the relationship of SAD symptomatology with negative self-beliefs and imagery. These outcomes suggest that social trauma may be a key proximal cause of SAD development, leading to the development of negative beliefs and imagery that subsequently maintain the disorder. These findings have implications for understanding SAD aetiology, and improving treatment outcomes for the disorder. Copyright © 2016 John Wiley & Sons, Ltd. Negative social experiences have been implicated in the development of social anxiety disorder (SAD), but the role of this predisposing factor remains unclear. Compared with other risk factors for SAD, social anxiety symptomatology was most strongly correlated with socially traumatic experiences. Mediation analyses suggested that appraisal of aversive social experiences accounted for the relationship of SAD symptomatology with negative self-beliefs and imagery. These outcomes suggest that SAD individuals would benefit from interventions targeted at processing socially traumatic memories (e.g., imagery rescripting).

Heritability of social anxiety disorder: a systematic review of methodological designs

Background The investigation of heritability stands out as an important means to establish the weight of genetic and environmental factors in the development of social anxiety disorder. Objective This study aims to make a critical review of methodological designs used in the investigation of the social anxiety disorder (SAD) heritability. Methods We reviewed 31 research articles published until October 2015 and found through the electronic search bases PubMed, Web of Science, and Scopus and manual searches in the reference lists of the selected references. Most of the investigations involved adult samples and twins to assess heritability. Results There was great variability in the screening and diagnostic instruments used in the studies, leading to different outcomes. Structural equation models proved to be the most adequate to assess SAD heritability, allowing better estimates of this aspect of the disorder. SAD heritability rates varied between 13% and 76% in the articles reviewed. Discussion We discuss methodological aspects that may affect the quality and the development of improved studies to investigate SAD heritability such as sample size, quality of screening instruments, and use of diagnostic interviews. More homogeneous investigations involving larger samples and standardized instruments and methods are desirable and opportune.

The role of emotional maltreatment and looming cognitive style in the development of social anxiety symptoms in late adolescents

ABSTRACTBackground: Social looming constitutes a specific cognitive vulnerability that acts as a danger schema and biases the processing of threat-related information associated with the development of social anxiety disorder. This model characterizes early negative experiences as critical to the formation of looming cognitive style. Furthermore, research has found links between parental emotional abuse and peer victimization and social anxiety. Design: A three-wave longitudinal design was used to analyze the role of parents’ emotional abuse and peer victimization in the onset of social anxiety symptoms through the development of this cognitive style. Methods: The final sample was made up of 307 females and 243 males (Mage = 16.97, SDage = .81). Perceived parents’ emotional abuse and peer victimization by participants were measured at Time 1, social looming was measured at Time 1 and 2, and social anxiety symptoms were measured at Times 1, 2, and 3. Results: Parents’ emotional abuse and peer victimization were related to social anxiety cross-sectionally. Longitudinally, social looming acted as a mediator in the relationship between parents’ emotional abuse and social anxiety. Conclusions: These findings highlight the need to better understand the mechanisms through which emotional abuse and peer victimization impact social looming and contribute to social anxiety.

A Translational Neuroscience Approach to Understanding the Development of Social Anxiety Disorder and Its Pathophysiology

This review brings together recent research from molecular, neural circuit, animal model, and human studies to help understand the neurodevelopmental mechanisms underlying social anxiety disorder. Social anxiety disorder is common and debilitating, and it often leads to further psychopathology. Numerous studies have demonstrated that extremely behaviorally inhibited and temperamentally anxious young children are at marked risk of developing social anxiety disorder. Recent work in human and nonhuman primates has identified a distributed brain network that underlies early-life anxiety including the central nucleus of the amygdala, the anterior hippocampus, and the orbitofrontal cortex. Studies in nonhuman primates have demonstrated that alterations in this circuit are trait-like in that they are stable over time and across contexts. Notably, the components of this circuit are differentially influenced by heritable and environmental factors, and specific lesion studies have demonstrated a causal role for multiple components of the circuit. Molecular studies in rodents and primates point to disrupted neurodevelopmental and neuroplastic processes within critical components of the early-life dispositional anxiety neural circuit. The possibility of identifying an early-life at-risk phenotype, along with an understanding of its neurobiology, provides an unusual opportunity to conceptualize novel preventive intervention strategies aimed at reducing the suffering of anxious children and preventing them from developing further psychopathology.

All eyes on me? Role of Negative Parenting in the Development of Social Anxiety Disorder among Children and Adolescents

All eyes on me? Role of Negative Parenting in the Development of Social Anxiety Disorder among Children and Adolescents

Testing the diathesis‐stress model: 5‐HTTLPR, childhood emotional maltreatment, and vulnerability to social anxiety disorder

Regarding the development of social anxiety disorder (SAD), a diathesis-stress paradigm including biological vulnerabilities and environmental stressors can be assumed. However, studies dealing with the etiology of SAD did not integrate both aspects so far. We examined a particular diathesis-stress model for SAD in which we included a functional polymorphism of the serotonin transporter (5-HTTLPR) as a genetic vulnerability factor and childhood emotional maltreatment (CEM) as an environmental stressor. Current analyses were based on individuals who participated in the Study of Health in Pomerania. Psychiatric disorders were assessed with diagnostic interviews according to DSM-IV criteria. The triallelic genotype of 5-HTTLPR was determined. Statistical analyses were performed in 78 individuals with SAD and 1,035 without an axis I disorder. Logistic regression analysis revealed that the experience of CEM (odds ratio [OR] 4.56; 95% confidence interval [CI] 2.65-7.84), the l/l genotype of 5-HTTLPR (OR 2.13; 95% CI 1.31-3.48), female gender (OR 3.03; 95% CI 1.80-5.08) and younger age (OR 1.04; 95% CI 1.02-1.06) increased the odds for SAD. The data suggest that CEM, the l/l genotype of 5-HTTLPR, female gender and younger age are risk factors for SAD. This is in favor of the tested diathesis-stress model.

Dysregulated Fear Predicts Social Wariness and Social Anxiety Symptoms during Kindergarten

Fearful temperament is associated with risk for the development of social anxiety disorder in childhood; however, not all fearful children become anxious. Identifying maladaptive trajectories is thus important for clarifying which fearful children are at risk. In an unselected sample of 111 two-year-olds (55% male, 95% Caucasian), Buss (2011) identified a pattern of fearful behavior, dysregulated fear, characterized by high fear in low threat situations. This pattern of behavior predicted parent- and teacher-reported withdrawn/anxious behaviors in preschool and at kindergarten entry. The current study extended original findings and examined whether dysregulated fear predicted observed social wariness with adults and peers, and social anxiety symptoms at age 6. We also examined prosocial adjustment during kindergarten as a moderator of the link between dysregulated fear and social wariness. Consistent with predictions, children with greater dysregulated fear at age 2 were more socially wary of adults and unfamiliar peers in the laboratory, were reported as having more social anxiety symptoms, and were nearly 4 times more likely to manifest social anxiety symptoms than other children with elevated wariness in kindergarten. Results demonstrated stability in the dysregulated fear profile and increased risk for social anxiety symptom development. Dysregulated fear predicted more social wariness with unfamiliar peers only when children became less prosocial during kindergarten. Findings are discussed in relation to the utility of the dysregulated fear construct for specifying maladaptive trajectories of risk for anxiety disorder development.

1068 – The influence of family and school environment on the development of social anxiety disorder

The prevalence of Social anxiety disorder (SAD) is believed to be underestimated, although it is a very common condition. The subjects suffering from it often have trouble to search for support. The onset occurs mainly in early adolescence. The aim of this paper was to evaluate the impact of school and family background on the development of SAD. Our questionnaire available on a popular social network site, was divided into 4 parts: 1) demographic data (gender, age, site of residence), 2) genetic and organic background (comorbid mental disorders, addictions), 3) situation at school and in the family environment during adolescence, 4) the part designed to define the group that may suffer from SAD with the use of the Mini-Social Phobia Inventory (Mini- SPIN). 226 people were recruited. The age range was 16–61, with the average of 25,8. 71% of the respondents lived in cities with a population of more than 100 000. Male to female ratio was 3:1. According to Mini-SPIN 26,5% of the interviewees might suffer from SAD (28.2% of women and 21.4% of men). Our study showed, that both family and school environment factors have an influence on the development of SAD. The amount of internet community users that are likely to suffer from SAD, significantly exceeds the clinical data. Both family and school environment factors were shown to be risk factors for the development of this disorder.

Early traumatic life events, parental rearing styles, family history of mental disorders, and birth risk factors in patients with social anxiety disorder

Childhood traumatic experiences, rearing styles, familial mental disorders and birth risk factors have been associated with the development of social anxiety disorder. Patients with social anxiety disorder (n=50) and healthy controls (n=120) were investigated using a retrospective interview with 203 questions. The frequency of reports of traumatic childhood experiences was significantly higher in patients than in controls, including separation from parents, parents' marital discord, sexual abuse, familial violence, childhood illness, and other factors. On a 0-10 point 'severe trauma scale' patients had significantly higher mean scores (2.0; SD 1.28) than control subjects (0.82; SD 1.1; p<0.0001). Only 6 (12%) of the social phobic patients, but 63 (52.5%) of the controls did not report any severe traumatic events at all (chi2=24.0; p<0.0001). Compared to controls, patients described their parents' rearing styles as significantly more unfavourable. Patients reported higher rates of psychiatric disorders in their families in general, in particular anxiety disorders, depression, and suicidality. Birth risk factors did not differ between patients and controls. In a logistic regression model, the highest contribution was noted for familial anxiety disorders. Separation from parents also had a significant, but smaller influence. There was only a trend towards a significant contribution of childhood sexual abuse. Violence in the family, parental rearing styles and birth risk factors did not contribute significantly. The present data suggest that the aetiology of social anxiety disorder is multifactorial and that familial mental disorders and separation experiences are the most important contributing factors.