Social Phobic Group Research Articles

Specificity of interpretation and judgemental biases in social phobia versus depression

A body of studies shows that social phobia is characterized by content specific interpretation and judgmental biases. That is, they show bias in social situations but not in non-social situations. Comorbid depression, one of the major comorbid disorders in social phobia, might account for these biases in social phobia since depression also is characterized by cognitive distortions in social situations. This study hypothesized that, despite comorbid depression, patients with social phobia would suffer from contentspecific biases. Participants filled out the Interpretation and Judgmental Questionnaire (IJQ) to assess interpretation bias (using open-ended responses and forced-interpretations) and judgmental bias in social and non-social situations. Four groups participated: social phobic patients with high (N=38) and low (N=47) depressive symptoms, depressed patients (N=22) and normal controls (N=33). We found both social phobic groups to interpret social situations more negatively and judge social situations as more threatening than non-social situations relative to depressed patients and normal controls. As expected, depressive symptoms related to increased general interpretation and judgmental biases across social and non-social situations. In contrast to expectations, we did not find these patterns for the open-ended measure of interpretation bias. The content-specific biases for social situations distinguished social phobic patients from depressive patients. This speaks for the importance of establishing the primary diagnosis in patients with mixed depression and social anxiety complaints.

The role of life events in social phobia

The aim was to investigate the relationship between life events and social phobia. An inventory assessing life events during childhood, adulthood as well as life events experienced in relation to the onset of the disorder was administrated to 30 subjects with a DSM-IV diagnosis of social phobia. They were recruited by announcement and diagnosed by the Structured Clinical Interview for DSM-IV for axes I and II disorders. Seventy-five controls were selected by matching age and gender from the local population register. Individuals with social phobia reported significantly more life events during childhood and more life events with negative impact during the social phobia debuting year. Conversely, they described fewer events in the adult life than the controls. Close relatives with disabling conditions in the childhood, conflicts with wife/husband/cohabitant and divorces or similar were significantly more common in the debuting year in social phobic group. In adult life, the healthy individuals described significantly more often increased authority at work. A gender-specific analysis revealed significantly more experiences of a death of a relative/close friend during the year before the social phobia debut and significantly more negative life events in the women's adult life. In summary, the present results support that life events have a role in social phobia that may be gender influenced.

Is “shy bladder syndrome” (paruresis) correctly classified as social phobia?

Paruresis manifests in an inability to urinate in public restrooms followed by a considerable avoidance behavior. According to DSM-IV TR this disorder is classified as social phobia. A sample of N = 226 subjects completed different questionnaires concerning paruresis, social phobic symptoms, lower urinary tract symptoms and depressive symptoms. These individuals were divided into four groups: no symptoms, suffering primarily from paruresis, non-generalized social phobia and generalized social phobia. The paruretic group differs significantly in all symptom variables from both the non-generalized and the generalized social phobia groups. Regression analysis separated by groups shows that the interference with everyday life can be mainly explained by paruretic symptoms (in the paruretic group) or by social anxiety and depressive symptoms, respectively (in the social phobic groups). These results question the classification of paruresis as simply being a form of social phobia.

The causal role of self-awareness in blushing-anxious, socially-anxious and social phobics individuals

This study examined the effect of attentional focus on social anxiety in three groups of subjects: high versus low blushing-anxious participants ( n=48); high versus low socially anxious participants ( n=60); and social phobic patients compared to patients with other anxiety disorders ( n=48). Participants were asked to imagine two series of social situations, in which the hero was in the centre of others' attention. In the first series of stories, the type of feedback from the audience (positive, negative and neutral) and the direction of attention of the hero (self- versus task-focused) were manipulated, and in the second series of stories, the presence or absence of blushing and the direction of attention of the hero were manipulated. In line with the expectations, self-focused attention (SFA) led to more social anxiety than task-focused attention (TFA) in all the three experiments, and high blushing-anxious, socially anxious, and social phobic groups reported higher levels of self-awareness than their low-anxious comparison groups. No evidence was found for the idea that self-focusing is specifically detrimental for participants who are already socially anxious, blushing-anxious, or socially phobic. Also, attentional focus did not interact with the valence of social feedback. Finally, results provided some support for the hypothesis that fear of blushing is mediated by self-focusing. The results suggest that irrespective of trait social anxiety, and irrespective of the outcome of a social situation (positive, neutral or negative), SFA increases state social anxiety, or TFA decreases state social anxiety.

Reaction time to threat stimuli in panic disorder and social phobia

Two studies assessed response time among clinically anxious subjects and normal controls when presented with threat, positive and neutral stimuli under perceptual (lexical decision) and semantic (category decision) task conditions. In Study 1, panic disorder subjects' ( n = 14) performance was compared to that of matched normal controls ( n = 14) while in Study 2 social phobic subjects ( n = 24) were compared to matched normal controls ( n = 24). Relative to matched normal controls, panic disorder subjects but not social phobics tended to show greater slowing in performance on the more cognitively complex (category) task. A second finding, consistent across both studies was that, compared to the normal control groups, both panic and social phobic groups showed significantly slowed responses to threat words in both the perceptual and semantic tasks. Such findings are directly counter to the predictions of a mood congruence hypothesis. This apparent contradiction is resolved by a review of the literature which indicates that mood-related facilitation effects are obtained only in tasks which tap awareness of threat information rather than speed of response. It is suggested that while anxiety may produce enhanced awareness of threat, it may inhibit responsiveness to it. The results of these studies are seen as consistent with ethological theories of inhibited motoric responses under certain threat conditions. Furthermore, the findings suggest that caution is indicated in interpreting slowed reaction time to threat stimuli in tasks such as the Stroop color naming task as purely the result of attentional processes.

Subjectively rated physiological and cognitive symptoms in six different clinical phobias

The purpose of the present study was an attempt to describe clinical symptoms in terms of physiological reactions and negative cognitions experienced by phobic patients. A total of 267 clinical phobic patients divided among blood phobia, small animals phobia, dental phobia, claustrophobia, social phobia and agoraphobia, participated in the study. The patients within each phobic category were separated into a Conditioned and an Indirect Acquisition group, based on their answers to a set of specific questions concerning the etiology of the phobia. All patients rated (0–4) how intensively they experienced 11 specified physiological reactions and 10 negative cognitions when confronted with their phobic situation in vivo. A mean score was calculated for each item within each group, and an item rank-order hierarchy was set up for each group. Differences between items within each hierarchy were statistically evaluated by one-way ANOVAs and Turkey's HSD-tests. Results showed particular idiosyncratic patterns of responding for the blood phobic, agoraphobic and social phobic groups as well as several commonalities among all the groups concerning activation of specific physiological reactions and negative cognitions. A more fine-grained analysis of the data is best made by direct visual inspection of the figures in this paper.

Affective disorder and alcoholism in families of agoraphobics.

We examined the family histories of 68 agoraphobic patients, 35 subjects with miscellaneous-specific phobias, and ten subjects with social phobias. Of the 68 agoraphobic subjects, 26 had a positive family history of affective disorder based on our criteria. Five of the subjects with miscellaneous-specific phobias and none of the social phobic subjects had positive family histories of affective disorder. The difference between these categories is statistically significant. Family history of alcoholism was found to occur significantly more frequently in the agoraphobic vs the miscellaneous-specific phobic group, but not when compared with the social phobic group. A subpopulation in each phobic category was examined for past or present personal depressive illness, but no statistical difference was found. The increased incidence of affective disorder in first-degree relatives distinguishes agoraphobia from other phobic disorders.

Reported parental characteristics of agoraphobics and social phobics.

The clinical impression that phobic patients perceive their parents as being uncaring and overprotective was investigated in a controlled study of eighty-one phobic patients. Those assigned to a social phobic group scored both parents as less caring and as overprotected, while those assigned to an agoraphobic group differed from controls only in reporting less maternal care. Intensity of phobic symptoms in the pooled sample was examined in a separate analysis. Higher agoraphobic scores were associated with less maternal care and less maternal overprotection, while higher social phobic scores were associated with greater maternal care and greater maternal overprotection.