CBT & SAD

Question 1

Social anxiety disorder

Answer 1

A marked fear or anxiety about one or more social situations in which the individuals is exposed to possible scrutiny

Question 2

Symptoms

Answer 2

Fear that they will show anxiety or act in a way that = be negatively evaluated
Social situations almost always provoke anxiety
Avoidance of social situations
Persistent last 6 months
Safety behaviour

Question 3

CBT four stages

Answer 3

Exposure, cognitive restructuring, relaxation training and social skills training

Question 4

Hope 1995

Answer 4

Superior to waiting list patients

Question 5

Heimberg 1995

Answer 5

Has more fret than placebo

Question 6

Heimberg 1993

Answer 6

Those treated with CBGT maintained their gains 4-6 years later

Question 7

Predictors of the outcome of CBT Heimberg

Answer 7

Pretreatment severity
Compliance with homework assignments
Frequency of negative thoughts during social interaction
Expectancy of treatment outcome

Question 8

Brown et al 1995

Answer 8

Found that higher rate of response to CBT with non pgeneralised social anxiety disorder

Question 9

Brown 1995; Hope 1995

Answer 9

Neither found that a co-morbid diagnosis of avoidant personality disorder affect CBT outcomes

Question 10

Quality of life

Answer 10

Person’s subjective judgement if the satisfaction that they gain from their experiences in every dat life

Question 11

Sabres et al 1997

Answer 11

Those with SAD reported much lower quality of life but showed substantial improvement after CBT. Maintained 6 months after treatment Eng et al 2001

Question 12

Gelernter et al 1991

Answer 12

Compared CBGT with MAOI phenelzine, benzodiazepine alprazolam and placebo. All treatments including placebo showed significant improvements

Question 13

Heimberg et al., 1998; Leibowitz et al., 1999

Answer 13

133 patients randomly assigned to CBGT, Phenelzine & pill placebo. Phenelzine responded after 12 weeks, achieved gains by 6 weeks but less common in CBGT.

But 50% of Phenelzine users relapsed compared to 17% CBGT patients.

Question 14

Exposure

Answer 14

Help patients face the situations they fear and stay psychologically engaged so habituation/extinction can occur. 1. Rank order of anxiebprovoking situations 2. Work on least feared scenario 3. Engage with situation until fear subside.

Question 15

Problem with exposure

Answer 15

Anxious orients may find this hard to do as they may used maladaptive efforts to engage with their fears icy as distracting themselves or another paying full attention.

Instructions may help over come this issue though

Question 16

Cognitive restructuring

Answer 16

Exam their thoughts and fear that underlie them.
SAD arises from inaccurate beliefs about potential thrusts from social situations, negative predictions and biased processing.
1) identify thoughts that occur
2) evaluate thoughts
3) derive alternative rational thoughts

Question 17

Behavioural experiments

Answer 17

To get patients to engage in activities that will undermine their beliefs

Question 18

Relaxation training

Answer 18

Helps patient learn to attend to and control the degree of physiological arousal experienced during or prior to feared events.

Patients learn to scan bodies to find tension

Cue controlled relaxation “relax” repeat word in head

Question 19

Problems with relaxation training

Answer 19

Not effective unless applied to identified feelings of anxiety

Question 20

Social skills training

Answer 20

SAD sufferers usually exhibit for social skills such as lack of eye contact and poor conversational skills

This helps to reduce the anxiety