Week 5 - Social Anxiety Disorder

Question 1

What is SAD?

Answer 1

• A specific type of anxiety disorder characterized by an intense fear of social situations and of being humiliated, judged, and/or rejected
• Different from being shy or introverted
• Causes clinically significant distress and dysfunction in daily living

Question 2

SAD Epidemiology:

Answer 2

• Lifetime prevalence in canada is 8-13%
• 12 month prevalence is 2.6% in men and 3.4% in women-
• Avg. onset is 13y
• Duration - life long

Question 3

Common co-morbidities?

Answer 3

• COPD
• Substance-use disorder
• Depressive disorder
• Cardiovascular disorder

Question 4

Diagnosis?

Answer 4

1) Assess risk factors
- Environmental
- Parenting
- Socioeconomic status
- Sex

2) Screening tools
- Leibowitz SAS

3) DSM-V
- Marked fear of one or more situation where exposed to scrutiny by others
- Fear will act/show anxiety that leads to being negatively evaluated
- Social situation provoke anxiety
- Social situations avoided/endured with intense fear of anxiety
- Fear/anxiety is out of proportion to actual threat
- Fear/anxiety/avoidance 6+ months
- Fear/anx/avoidance leads to sig. distress/functional impairment
- Fear/anx/avoidance is not due to a medical condition/drug
- Fear/anx/avoidance is not due to another mental disorder
- Fear/anx/avoidance is unrelated to or excessing considering existing medical condtion

Question 5

SAD symptoms?

Answer 5

1) Cognitive
- Fear of being judged
- Fear of embarrassing themselves
- Overestimate negative consequences of social situations

2) Physiological
- Blushing
- Nausea
- Racing heart
- SOB
- Trembling
- Dizziness
- Sweating
- Muscle tension

3) Behavioural
- Quiet
- Avoid centre of attention
- Avoid eye contact
- Leaves events early
- Drink to settle anxiety
- Analyze previous situations to identify flaws in interactions

Question 6

Treatment? (4)

Answer 6

1) Psychotherapy
2) Pharmacotherapy
3) Alternative - CBD, herbs, exercise/nutrition
4) Consideration
- combined therapeutics
- co-morbidities
- youth (psychotherapy > pharmacotherapy)
- future treatments

Question 7

Nursing considerations:

Answer 7

1) Screening
- Anxiety is most common
- Onset adolescence
- Risk = children/adults, women > men, pregnant/post-partum, comorbid, health challenges, older adults

2) Assessment
- Biological
- Psychological
- Sociological

3) Interventions
- Biological
- Psychological

Question 8

Looking forward?

Answer 8

• Reduce stigma
• Increase health professional training
• Online consultations
• Virtual reality therapy