Social Anxiety (eBook)

Clinical, Developmental, and Social Perspectives

Patricia M. DiBartolo, Stefan G. Hofmann (Herausgeber)

eBook Download: PDF | EPUB

2014 | 3. Auflage
844 Seiten
Elsevier Science (Verlag)
978-0-12-397819-6 (ISBN)

The third edition of Social Anxiety: Clinical, Developmental, and Social Perspectives integrates examinations of social anxiety, shyness, and embarrassment with the research on social anxiety disorder subtypes, biological theories and cognitive-behavioral or pharmacological treatment outcome studies.Clinicians, social and developmental psychologists and behavioral geneticists have all conducted research over the past ten years which is essential to furthering our understanding and treatment of social anxiety disorders. This book weaves together research findings gathered by renowned minds across these various disciplines, and deals with both theory and research. It explores what constitutes social anxiety, assesses the condition and its relationship to other psychological disorders, exploring the biological basis and treatment approaches as well. Coverage includes key issues not discussed fully by other books, including related disorders in adults and children, relationship to social competence and assertiveness, perfectionism, social skills deficit hypothesis, comparison between pharmacological and psychosocial treatments, and potential mediators of change in the treatment of social anxiety disorder.From the Author: Although social anxiety disorder (social phobia) is widely researched topic in psychiatry, other disciplines, such as social and developmental psychology, have independently been studying the same phenomena for many years. Yet, there has been very little cross-discipline communication and integration. The main objective of the book is to integrate the findings on social anxiety from various disciplines, including clinical psychology, psychiatry, social psychology, neuroscience, and developmental psychology. - The most comprehensive source of up-to-date data, with review articles covering a thorough delineation of social anxiety, theoretical perspectives, and treatment approaches - Consolidates broadly distributed literature into single source - Each chapter is written by an expert in the topic area, providing more fully vetted expert knowledge than any existing work - Integrates findings from various disciplines - clinical, social and developmental psychology, psychiatry, neuroscience - rather than focusing on only one conceptual perspective - Provides a complete understanding of a complex phenomenon, giving researchers and clinicians alike a better set of tools for furthering what we know

The third edition of Social Anxiety: Clinical, Developmental, and Social Perspectives integrates examinations of social anxiety, shyness, and embarrassment with the research on social anxiety disorder subtypes, biological theories and cognitive-behavioral or pharmacological treatment outcome studies.Clinicians, social and developmental psychologists and behavioral geneticists have all conducted research over the past ten years which is essential to furthering our understanding and treatment of social anxiety disorders. This book weaves together research findings gathered by renowned minds across these various disciplines, and deals with both theory and research. It explores what constitutes social anxiety, assesses the condition and its relationship to other psychological disorders, exploring the biological basis and treatment approaches as well. Coverage includes key issues not discussed fully by other books, including related disorders in adults and children, relationship to social competence and assertiveness, perfectionism, social skills deficit hypothesis, comparison between pharmacological and psychosocial treatments, and potential mediators of change in the treatment of social anxiety disorder.From the Author: Although social anxiety disorder (social phobia) is widely researched topic in psychiatry, other disciplines, such as social and developmental psychology, have independently been studying the same phenomena for many years. Yet, there has been very little cross-discipline communication and integration. The main objective of the book is to integrate the findings on social anxiety from various disciplines, including clinical psychology, psychiatry, social psychology, neuroscience, and developmental psychology. - The most comprehensive source of up-to-date data, with review articles covering a thorough delineation of social anxiety, theoretical perspectives, and treatment approaches- Consolidates broadly distributed literature into single source- Each chapter is written by an expert in the topic area, providing more fully vetted expert knowledge than any existing work- Integrates findings from various disciplines clinical, social and developmental psychology, psychiatry, neuroscience rather than focusing on only one conceptual perspective- Provides a complete understanding of a complex phenomenon, giving researchers and clinicians alike a better set of tools for furthering what we know

Chapter 1

Conceptualizing and Describing Social Anxiety and Its Disorders

Daniel W. McNeil

Cameron L. Randall Department of Psychology, West Virginia University, Morgantown, WV

Abstract

Social anxieties and fears exist along continua of intensity, ranging from the helpful and adaptive (e.g., keeping one on one’s “social toes” in uncertain social situations) to the disabling and impairing (e.g., being unable to develop or maintain close relationships in spite of loneliness). Unpleasant emotional states and maladaptive behaviors associated with social situations can be significant, life-affecting problems for many people. Given the social nature of human beings, and the functional nature of social relationships (e.g., social support), discomfort associated with interacting with others is particularly difficult, as socialization cannot easily be avoided on a consistent basis. Revisions to the SAD definition and diagnostic criteria in DSM-5 represent a shift toward more accurately portraying the disorder. Nevertheless, additional changes are needed in the DSM and ICD diagnostic systems toward dimensional categorizations.

Keywords

social anxiety

social phobia

social anxiety disorder

social fears

circumscribed

generalized

Introduction

Social anxieties and fears exist along continua of intensity, ranging from the helpful and adaptive (e.g., keeping one on one’s “social toes” in uncertain social situations) to the disabling and impairing (e.g., being unable to develop or maintain close relationships in spite of loneliness). Unpleasant emotional states and maladaptive behaviors associated with social situations can be significant, life-affecting problems for many people. Given the social nature of human beings, and the functional nature of social relationships (e.g., social support), discomfort associated with interacting with others is particularly difficult, as socialization cannot easily be avoided on a consistent basis. In other phobias or phobic-like disorders, avoidance often can be effective in the short term, to prevent or reduce anxiety, albeit temporarily in many situations.

Social anxieties and fears were described by Hippocrates and were systematically delineated with other phobias beginning in the 1870s (Marks, 1970, 1985). Over the past 40 years, the social psychological focus on shyness (e.g., Zimbardo, 1977), the work of Marks and others in the 1960s and 1970s, and the identification of social phobia as a distinct disorder in the Diagnostic and Statistical Manual–III (e.g., American Psychiatric Association [APA], 1980) and subsequent revisions, including the new Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5; APA, 2013), have been part of a massive growth in the related scientific and self-help literatures.

This general arena of problems includes several somewhat overlapping constructs; the scientific language has many different terms that apply or relate, including: shyness, social anxiety, social withdrawal, social phobia, social anxiety disorder, behavioral inhibition, communication apprehension, and introversion. In both everyday and scientific language, these states have been described in a myriad of ways. Leitenberg (1990), in introducing his book in the area, states:

Social anxiety has been studied in various guises. Shyness, performance anxiety, social phobia, avoidant personality disorder, social withdrawal, social isolation, public speaking anxiety, speech anxiety, communication apprehension, fear of interpersonal rejection, dating anxiety, separation anxiety, stage fright, fear of strangers, shame, embarrassment, social inhibition, social timidity – all of these and more fall under the umbrella of social anxiety. (p. 2)

Other anxiety-related syndromes, such as test anxiety and selective mutism, also likely have a strong social component, and may be instantiations of social anxiety disorder (SAD) (Bögels et al., 2010). Body dysmorphic disorder, highly comorbid with SAD, similarly is socially determined, at least in part, in that the perception of others regarding (imagined) defects may be an underlying feature.

There also are a variety of terms that suggest, at least somewhat, deficient social skills, such as nerd, geek, and wall flower. Masia and Morris (1998) identify terms related to social distress in children across areas of psychology: developmental (i.e., peer neglect, social withdrawal), personality (i.e., shyness), and clinical (i.e., social phobia, avoidant personality disorder [APD]). Stranger anxiety and separation anxiety likely are related constructs as well (Thompson & Limber, 1990). Masia and Morris note that this varying “psychological language” (p. 212) creates problems in investigating phenomena (e.g., parental behavior and its relation to child social anxiety) that span across subdisciplines in psychology, and presumably across related disciplines (e.g., psychiatry).

It should be noted that comparative psychology has contributions to this area as well. Social anxieties are not solely human phenomena; such social/emotional problems are shared by other primates (Mineka & Zinbarg, 1995; Suomi, Chaffin, & Higley, 2011), and lower animals. Social dominance and submissiveness hierarchies have been suggested as important determinants of socially anxious behavior across species of primates, including humans (Schneier & Welkowitz, 1996; Trower & Gilbert, 1989). Facial expressions, for example, provide important social interactional cues in humans and other primates, including both aggression and appeasement related to anxiety (Mogg & Bradley, 2002; Öhman, 1986). Early learning history, particularly mother-offspring interaction, also has been suggested as an important determinant of socially anxious behavior in primates (e.g., Schino, Speranza & Troisi, 2001).

One of the issues that continues to be an albatross for the field is the everyday language basis of the most frequently used terms: shyness, stage fright, and social anxiety. Some years ago, Harris (1984) detailed a number of problems inherent in using the lay language of “shyness” in scientific discourse, a problem that still exists today. Clinically-oriented scientists may try to “distance” SAD from shyness, perhaps to emphasize that individuals who meet criteria for the disorder suffer with impairment in social and occupational functioning that can be quite terrible, leading to chronic suffering. Issues related to the terminology used to describe social fears and anxieties can obfuscate the already complex and sometimes controversial task of understanding and defining SAD (Dalrymple, 2012). Adding further complexity, some degree of social anxiety can be adaptive (Schneier & Welkowitz, 1996). Moreover, the social consequences of some socially anxious behaviors are quite positive. One example is a “bashful” child who hides his or her face by planting it directly in a part of his or her parent’s body, resulting in adult laughter and encouragement to socialize. A further example is a distant, detached person who is regarded as “coy,” “interesting,” or even “mysterious,” relating to his or her lack of social initiation or response.

Defining social anxieties and fears, and specifying what types or degrees of behavior are most appropriately classified as pathological or a “disorder,” is an involved and often perplexing undertaking. The definitions we create are informed by research and clinical experience, and indeed inform future research and clinical intervention. The National Institute of Mental Health (NIMH) recently initiated the Research Domain Criteria project (RDoC) in an effort to “develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures” (NIMH, 2013). Research that transcends standard diagnosing and steps away from strict definitions of mental illness based on diagnostic criteria, such as those presented in the DSM-5, now is preferred by the NIMH. This effort represents an understanding that the task of defining any psychological disorder indeed is complex. SAD is no exception. Research in the area of SAD that considers definitional issues and acknowledges the limits of even new diagnostic criteria allows for a more comprehensive understanding of its psychopathology and more appropriate translation of research findings to clinical work.

This chapter provides a perspective on conceptual, definitional, and diagnostic nosology issues for the field, including a focus on the DSM-5. It is proposed that social anxieties and fears, like other phobic disorders, exist along a continuum across the general population, as explicated later in this chapter, and as shown in Figure 1.1. The range of social anxieties/fears along this continuum is from no anxiety/fear, to...

Erscheint lt. Verlag	15.7.2014
Sprache	englisch
Themenwelt	Geisteswissenschaften ► Psychologie ► Allgemeine Psychologie
	Geisteswissenschaften ► Psychologie ► Klinische Psychologie
	Geisteswissenschaften ► Psychologie ► Test in der Psychologie
	Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie
ISBN-10	0-12-397819-X / 012397819X
ISBN-13	978-0-12-397819-6 / 9780123978196

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