BATANGAS STATE UNIVERSITY

MARAWOY, LIPA CITY

LIPA CAMPUS

COLLEGE OF ARTS AND SCIENCES

SOCIAL ANXIETY DISORDER

AND NEW TRENDS

Submitted by:

Vincent Jones Ceballos

BSPSY 3202
SOCIAL ANXIETY DISORDER

The defining feature of social anxiety disorder, also called social phobia, is intense

anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance

situation. People with social anxiety disorder may worry about acting or appearing visibly

anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward, or boring.

As a result, they often avoid social or performance situations, and when a situation cannot be

avoided, they experience significant anxiety and distress. Many people with social anxiety

disorder also experience strong physical symptoms, such as a rapid heart rate, nausea, and

sweating, and may experience full-blown attacks when confronting a feared situation. Although

they recognize that their fear is excessive and unreasonable, people with social anxiety disorder

often feel powerless against their anxiety.

Social anxiety disorder affects approximately 15 million American adults and is the

second most commonly diagnosed anxiety disorder following specific phobia. The average age

of onset for social anxiety disorder is during the teenage years. Although individuals diagnosed

with social anxiety disorder commonly report extreme shyness in childhood, it is important to

note that this disorder is not simply shyness. Read about the difference.

Social anxiety disorder can wreak havoc on the lives of those who suffer from it. For

example, individuals may decline a job opportunity that requires frequent interaction with new

people or avoid going out to eat with friends due to a fear that their hands will shake when eating

or drinking. Symptoms may be so extreme that they disrupt daily life and can interfere

significantly with daily routines, occupational performance, or social life, making it difficult to
complete school, interview and get a job, and have friendships and romantic relationships.

People with social anxiety disorder are also at an increased risk for developing major depressive

disorder and alcohol use disorders.

Despite the availability of effective treatments, fewer than 5% of people of with social

anxiety disorder seek treatment in the year following initial onset and more than a third of people

report symptoms for 10 or more years before seeking help.

SYMPTOMS OF SOCIAL ANXIETY DISORDER ACCORDING TO DSM-V

A. A persistent fear of one or more social or performance situations in which the person is

exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she

will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.

B. Exposure to the feared situation almost invariably provokes anxiety, which may take the form

of a situationally bound or situationally pre-disposed Panic Attack.

C. The person recognizes that this fear is unreasonable or excessive.

D. The feared situations are avoided or else are endured with intense anxiety and distress.

E. The avoidance, anxious anticipation, or distress in the feared social or performance

situation(s) interferes significantly with the person's normal routine, occupational (academic)

functioning, or social activities or relationships, or there is marked distress about having the

phobia.

F. The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.

G. The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs,

medications) or a general medical condition not better accounted for by another mental disorder.

CAUSES OF SOCIAL ANXIETY DISORDER

GENETICS

If you are diagnosed with SAD, you probably have specific genes that made you more

prone to developing the disorder. If you have a first degree relative with SAD, you may also be 2

to 6 times more likely to develop the disorder.

The genetic component of social anxiety disorder is also known as the “heritability” of

the disorder. Although heritability rates can vary a great deal in studies, it has been estimated at

around 30 to 40 percent, meaning that roughly one-third of the underlying causes of SAD comes

from your genetics.

Heritability is the proportion of variation in a phenotype (trait, characteristic, or physical

feature) that is thought to be caused by genetic variation among individuals. The remaining

variation is usually attributed to environmental factors. Studies of heritability typically estimate

the proportional contribution of genetic and environmental factors to a particular trait or feature.

So far, researchers have not found a particular genetic makeup linked to SAD. They have,

however, found specific chromosomes linked to other anxiety disorders such as agoraphobia and

panic disorder.
 The genetic component of social anxiety disorder is also known as the “heritability” of

the disorder. Although heritability rates can vary a great deal in studies, it has been estimated at

around 30 to 40 percent, meaning that roughly one-third of the underlying causes of SAD comes

from your genetics.

ENVIRONMENTAL

The psychosocial causes of social anxiety disorder (SAD) include factors in the

environment that influence you as you grow up. If one of your parents has social anxiety disorder

(SAD), then you are more likely to develop the disorder yourself.

Psychologists have developed theories about how children may become socially anxious

through learning.

- Direct Conditioning: Did you forget your lines in the class play? Did other kids make

fun of you or were you the victim of constant teasing or bullying? While it is not a necessary

trigger, going through an early traumatic event may have an impact on the development of social

anxiety, sometimes years later.

- Observational Learning: If you did not experience a traumatic event yourself, did you

see someone else in a traumatic social situation? For those already vulnerable to the disorder, this

may have the same impact as going through the situation firsthand.
 - Information Transfer: Fearful and socially anxious parents unknowingly transfer verbal

and non-verbal information to their children about the dangers of social situations. If your

mother worries a lot about what other people think of her, chances are you have developed some

of this same anxiety yourself.

BIOLOGICAL

Just as x-rays are used to “see inside” your body, the same can be done for your brain.

Medical researchers use a technique called “neuroimaging” to create a picture of the brain.

Newer techniques can look not only at brain structure but at types of functions in specific regions

of the brain.

For mental disorders, researchers may look differences in blood flow in specific areas of

the brain for people who are known to have a particular disorder.

- The brain stem (controls your heart rate and breathing)

- The limbic system (effects your mood and anxiety level)

- The prefrontal cortex (helps you to appraise risk and danger)

- The motor cortex (controls your muscles)

One study of blood flow in the brain found differences in the brains of social phobics

when speaking in public. For this study, they used a type of neuroimaging called “Positron

Emission Tomography” (PET).

 The PET images showed that people with social anxiety disorder had increased blood

flow in their amygdala, a part of the limbic system associated with fear.

In contrast, the PET images of people without SAD showed increased blood flow to the

cerebral cortex, an area associated with thinking and evaluation. It seems that or people with

social anxiety disorder, the brain reacts to social situations differently than people without the

disorder.

NEUROTRANSMITTERS

If you have social anxiety disorder, there are likely imbalances of certain chemicals in

your brain, known as neurotransmitters. These neurotransmitters are used by your brain to send

signals from one cell to another.

Neurotransmitters Involved in Anxiety

- Norepinephrine

- Serotonin

- Dopamine

- Gamma-aminobutyric acid (GABA)

 People with social anxiety disorder have been shown to have some of the same

imbalances of these neurotransmitters as people with agoraphobia and panic disorder.

Researchers are just starting to understand exactly how these chemicals are related to SAD.

Understanding how these brain chemicals relate to social anxiety disorder is important to

determine the best medications for treatment.

TREATMENT

The best way to treat social anxiety is through cognitive behavioral therapy or medication

and often both.

You generally need about 12 to 16 therapy sessions. The goal is to build confidence,

learn skills that help you manage the situations that scare you most, and then get out into the

world. Teamwork is key in social anxiety therapy. You and your therapist will work together to

identify your negative thoughts and start to change them. You'll need to focus on the present

instead of what happened in the past. You might do role-playing and social skills training as part

of your therapy. Maybe you'll get lessons in public speaking or learn how to navigate a party of

strangers. Between sessions, you'll practice on your own. A big part of getting better is taking

care of yourself. If you exercise, get enough sleep, and limit alcohol and caffeine, you'll be more

focused for the mental challenges of therapy.

MEDICATIONS

Your doctor may suggest antidepressants to treat your social anxiety disorder. For

instance, he may prescribe drugs known as SSRIs (selective serotonin reuptake inhibitors), such

as:

Fluoxetine (Prozac)

Paroxetine (Paxil)

Sertraline (Zoloft)

Your doctor may also suggest antidepressants called SNRIs (selective serotonin and

norepinephrine reuptake inhibitors). Some examples are:

Duloxetine (Cymbalta)

Venlafaxine (Effexor)

Keep in mind that medicine alone won't be a quick fix for your anxiety. You'll have to

wait for it to take effect -- 2 to 6 weeks is a good guideline. And it might take a while to figure

out side effects and find the right fit. Some people are able to wean off medication after a few

months, and others need to stay on it if their symptoms start to come back.

You might find that the first course of treatment eases all of your anxiety. Or it might be

a longer journey. But taking those first steps will lead you to a less stressful life.
 NEW TREND ABOUT SOCIAL ANXIETY DISORDER

The Effect of Social Anxiety Disorder on Alcoholism

For the study, researchers assessed alcoholism, social anxiety disorder, generalized

anxiety disorder, panic disorder, agoraphobia, and specific phobias through interviews with

2,801 adult Norwegian twins.

Social anxiety disorder had the strongest association with alcoholism, and it predicted

alcoholism over and above the effect of other anxiety disorders. In addition, social anxiety

disorder was linked with a higher risk of later developing alcoholism, whereas other anxiety

disorders were not.

The findings suggest that interventions aimed at prevention or treatment of social anxiety

disorder may have an additional beneficial effect of preventing alcoholism.

"Many individuals with social anxiety are not in treatment. This means that we have an

underutilized potential, not only for reducing the burden of social anxiety, but also for preventing

alcohol problems," said lead author Dr. Fartein Ask Torvik, of the Norwegian Institute of Public

Health. "Cognitive behavioral therapy with controlled exposure to the feared situations has

shown good results."