social anxiety disorder Flashcards
t or f: SAD diagnosis is given if patient has at least 5/7 symptoms
false, all 7
the primary fear of SAD is ____
the negative evaluation from others
SAD DSM criteria
- marked fear/anx abt 1+ social situations in which person is exposed to possible scrutiny of others
- person fears that they will act in a way or show anx symptoms that will b neg evaluated
- social sitches almost always provoke fear/anx
- social sitches are avoided or endured w intense fear/anx
- fear or anx is out of proportion to the actual threat posed by social sitch and sociocultural context
- the fear, anx, or avoidance is persistent (6+ months)
- fear, anx, or avoidance causes clin sig distress or impairment in social, occupational, or other important areas of functioning
canadian prevalence of SAD
- lifetime: 8-13%
- 1 year: 6.7%
t or f: SAD is twice as common n women than men
true
SAD age of onset and comorbidity rate
- childhood/early adolescence, 66.2%
most comorbid disorder w SAD
MDD, also substance abuse
cognitive behavioural model of SAD
- social situation>activates assumption>perceived social danger <>processing self as a social object OR/THEN >Safety behaviours OR/THEN>somatic cognitive symptoms
processing self as social object
- not just you, you in relation to others
- place high value on others opinions
- on display for everyone to perceive
example of avoidance when in a social situation for SAD
- substance abuse
- only helps in short term
- fuels fear of social sitch
- negative reinforcement
in a study attempting to see SAD’s association w increased vigilance to social threat cues, what was the difference between participants with and w out SAD
- those w SAD had more eye movement between eyes and mouth than those without
- those w SAD focused more on eyes than others
What can be an early indicator that SAD may develop
- behaviour inhibition (early childhood temperament factor that involves fear of novelty, related to shyness and social reserve in pre/elementary school)
- not all get SAD but it is the biggest risk factor
- personality is not determined by birth but risks can be
diathesis stress model
- psychopathology results from interaction of internal vulnerability factors (ex genetic, temperament) and external triggers (ex stress learning/modeling)
environmental moderators of SAD
- parental anxiety (diathesis and/or stress)
- insecure attachment (high parental rejection/low warmth)
- stressful social experiences (ex rejection, victimization)
paediatric anxiety treatment
treatment of a parent’s anxiety
environmental moderators: minority stress theory
- adverse mental health outcomes in individual identifying as sexual minorities result from:
- external stressors (discrimination, rejection, and violence, non affirmation of gender identity)
- internal stressors (fear of future discrimination, mistrust of others, internalized neg beliefs abt identity, stress of concealment)
gender minority stress and SAD
- repeated exposure to discrimination, victimization, and rejection>expectations of future neg experience
- non-affirmation of gender identity>embarrassment, shame or threat>avoidance of social interactions
- internalized transphobia>expectations of rejection>avoidance of social situations
in vivo exposure
gradual exposure to fear situations in order to extinguish fear
- ex for SAD: eating in front of others, performing, talking to others, public speaking, etc
- ex for panic disorder: driving, public transportation, bridges, crowds, waiting in line, elevators, etc
fear avoidance hierarchy
- a technique used in CBT to collaboratively tackle fear from small to large
- list fear in order from biggest to smallest and indicate units of distress for each one
- for SAD/PD also indicate avoidance rating
common elements of CBT therapy for anxiety disorders
- encourage clients to take a third person, observer perspective
- what is the evidence that maladaptive thoughts are true?
- catastrophizing: whats the worst that can happen
- probability overestimation: how likely is (xyz) to happen
- cultural competence: explore and validate thought and feelings around sexual identity and exposure to minority stress, link thoughts and feelings to current avoidance
Interoceptive exposure for panic disorder
- fully induce panic attack symptoms (ex rapid breathing, running in place)
- exposure to the psychological symptoms of panic
- purpose is to remove conditioned response that physical sensations cause panic
- removes ‘fear of fear’
