nog niet af -Review Social Anxiety and Social Anxiety Disorder Flashcards
Social anxiety (SA) is a common human experience characterized by an intense fear of evaluation from others in social situations. When it reaches a pinnacle of severity such that functioning is impaired, we refer to it as social anxiety disorder (SAD) or social phobia
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The Heimberg et al. model van SA/SAD
- perception of an audience (dus het idee dat er iemand is die gaat evalueren, whether this is true or not)
- mental representation of the self as seen by the audience
- negative self-imagery due to negative social experiences and/or distorted self-perception
- concludes that audiences opinion is poor, but at the same time they have high standards
- dissonance between what they think audience sees and expects
- anxiety
- vicious cycle, as it feeds back into the mental representation of the self as seen by the audience -> weer meer anxiety
dus hoe leidt attentional bias tot een vicieuze cirkel
Attention bias toward threat virtually assures that visible or perceived displeasure on the part of the audience, visible signs of anxiety e.g., reduced eye contact or fidgety behavior; blushing), and aspects of anxiety knowable only by the person (elevated heart rate or the sense that one’s mind is going blank, which may signal an impending loss of control of behavior) are negatively applied to the mental representation of the self as seen by the audience. This vicious cycle repeats as the person remains in the situation and is carried forward in time as the person anticipates similar future situations.
Studies manipulated attention bias and anxiety decreased thereafter, therefore there is evidence that attention bias to social threat plays a causal role in the maintenance of SA. However, the magnitude of this effect may be smaller than originally proposed
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Attention bias toward social threat may be
accompanied by …
a bias away from positive social information
(dus geen positieve dingen registreren)
In addition, the tendency to allocate attention away from positive social stimuli mediated the effect of SA on change in state anxiety in response to a social stressor, implicating the role of diminished processing of positive social information in the persistence of SA
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wat gaven Mathews and MacLeod voor reden voor de verschillende resultaten in attentional bias research
Mathews & MacLeod (1994) argued that the occasionally contradictory findings in the attention bias literature suggest that normal individuals high in trait anxiety may have the ability to effortfully compensate for their tendency to shift attention toward threat-relevant stimuli. In contrast, clinically anxious individuals may be unable to effortfully regulate their attention. Moreover, individuals vary in the ease with which they can be trained to exhibit an attention bias toward threat (e.g., Clarke et al. 2008), which suggests that there may also be differences in how easily attention bias toward threat develops naturalistically.
SA was inversely related to self-reported attentional control after controlling for depression and state anxiety (Moriya
& Tanno 2008).
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There is also evidence of a relationship between SA and reduced attentional control using an antisaccade task in which participants are instructed to immediately look straight to the opposite, mirror-image location on the screen of a peripherally presented cue, which requires inhibition of a reflexive saccade as well as generation of a volitional saccade. In an emotional antisaccade task in undergraduates low, moderate, and high in SA, Weiser et al. (2009) observed significantly higher antisaccade error rates for individuals with high SA than for individuals with moderate SA. There was no evidence of greater threat interference, however, implying the deficit in attentional control was generalized
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Children’s attentional control was inversely related to appropriate social responding. This finding may hold particular relevance for SA in which anxiety-related impairments in self-regulatory mechanisms such as attentional control may adversely affect interpersonal behavior, thereby confirming the individual’s fears of poor social performance
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wat is nu de stance van treatment van SAD door middel van CBT enzo
Tobon et al. (2011) reviewed the literature
on the effects of cognitive-behavioral therapy (CBT) on attention bias toward threat and found that 10 of 13 studies across various anxiety disorders demonstrated a treatment-related reduction in bias. Further research on SAD in particular is warranted, but current findings suggest CBT is effective at mitigating such biases. In contrast, much less is known about whether effective psychotherapy modifies attention to positive stimuli. Additionally, research should consider whether changes in attention bias to threat or positive stimuli mediate treatment outcome or predict long-term treatment outcomes.
Some examples include Bogels’s Task Concentration Training (e.g., B ¨ ogels 2006), ¨
Rapee and colleagues’ attention retraining augmentation of CBT (Rapee et al. 2009), and mindfulness-based interventions. Of these approaches, mindfulness-based interventions have perhaps received the most empirical support. Several open trials have suggested the efficacy of these interventions for SAD, mostly mindfulness-based stress reduction (MBSR; e.g., Goldin & Gross 2010). Evidence to date also suggests MBSR results in increased activity in attention-related brain areas (Goldin & Gross 2010). Therefore, MBSR, including its effects on attention bias toward threat and away from positive information as well as attentional control deficits, appears worthy of further investigation.
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interpretation bias =
the tendency to interpret ambiguous or neutral stimuli as threatening
Studies of “online” measures of interpretation bias (i.e., those that assess relatively automatic processes) typically find that individuals with SA …
lack the nonthreat/positive bias typical of nonanxious individuals
SA has been associated with threat interpretations of positive social events (Alden et al. 2008) and failure to accept others’ positive reactions at face value
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