SAD and other Anxiety disorders

Question 1

What percentage of South African’s suffer from anxiety?

Answer 1

15.8%

Question 2

What is the global prevalence of SAD?

Answer 2

2.8%

Question 3

Broadly speaking, SAD can be described as…

Answer 3

the fear of being negatively evaluated and humiliated

Question 4

What are the 4 categories of aetiological factors for SAD

Answer 4

Social
Environmental
Biological
Psychological

Question 5

Outline the Social aetiological factors for SAD

Answer 5

Parenting Factors:
- parenting styles (controlling, authoritative)
- attachment quality (insecure-avoidant, insecure-anxious)
- behaviour modelling

Negative peer interactions:
- bullying and humiliation
- avoidance behaviour and negative cognitive alterations

Question 6

Outline the environmental aetiological factors for SAD
(3 subsections)

Answer 6

Infancy:
- unmet needs
- trauma
- under-stimulation

Traumatic events:
- abuse/death etc

Cultural Factors:
- norms and stigmas

Question 7

Outline the biological aetiological factors for SAD (3 subsections)

Answer 7

Temperament:
- avoidance
- behavioral inhibition

Genetics:
- strong heritability

Development:
- chronic adversity in sensitive dev periods

Question 8

Outline the cognitive aetiological factors for SAD

Answer 8

• negative social evaluations
• cognitive distortions

Question 9

The relationship between aetiological factors for SAD and maintaining factors for SAD can be described as:

Answer 9

• cyclical and reinforcing

Question 10

List 4 maintaining factors for SAD?

Answer 10

• anticipatory and post-event processing
• avoidance and escape behaviour
• attentional biases
• performance deficits

Question 11

What are the 5 diagnostic criteria for SAD and their specifiers?

Answer 11

• fear of being judge in soc sit
• fear that others will notice anx
• avoidant behaviours
• soc sit almost always invoked anxiety
• fear/anx is out of proportion

Specifiers
- for 6 months or more
- not explicable by another illness

Question 12

What are the two major types of symptoms that exist within SAD?

Answer 12

• Soc observation anxiety (fear of public scrutiny)
• Soc interaction anxiety (soc avoidance/withdrawal)

Question 13

What are the differnent treatment options for SAD?

Answer 13

PT: CBT, specifically ACT and Exposure therapy

Meds: SSRIs, Benzo’s, Beta-blockers

Lifestyle: sleep, exercise, alcohol & diet, mindfulness

Question 14

From a pharmacological POV, what is considered best treatment for SAD?

Answer 14

• SSRIs: decreases amygdala (emotional processes) reactivity
• Benzos
• Beta-blockers

Question 15

What are some of the controversial factors and myths about SAD?

Answer 15

• they are just shy, or prefer to be alone
• sad is not debilitating

Question 16

What are the other anxiety disorders beyond SAD

Answer 16

1. GAD
   - anx about a variety of topics that interferes w daily life (sleep disturbance, worry etc)
2. Panic disorder
   - recurrent and unexpected panic attacks (palpitations, choking etc)
   - fear of more attacks, change of behaviour
3. Agoraphobia
   - anxiety about situations where escape is difficult or help unavailable in event of symptomatic attack (avoids this situations, public transport, outside alone etc)
4. Specific phobias
   - intense, irrational fear of specific objects/situation (can lead to avoidance)
5. Separation anxiety
   - excessive fear over separation from attachment figures (worrying about losing them, refusing to leave them etc)
6. Selective mutism
7. Anxiety that is due to medical condition or substance use