Treating Social Phobias and Social Anxiety

Shyness And Social Anxiety System

The Shyness and Social Anxiety System is just as its name says. It is an e-book wherein in-depth discussions about the symptoms, causes and treatment for shyness and social anxiety are made. It is then written for individuals whose extreme shyness or social anxiety prevent them from enjoying a full life filled with social interactions among their family, friends and acquaintances in gatherings during holidays, outings and parties. The author Sean Cooper also suffered from shyness and social anxiety disorder so much so that he tried every trick in the book yet to no avail. And then he set out to conquer his own fears by researching into the psychology, principles and practices behind these two debilitating mental health issues. Read more here...

Shyness And Social Anxiety System Summary


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The writer has done a thorough research even about the obscure and minor details related to the subject area. And also facts weren’t just dumped, but presented in an interesting manner.

Purchasing this book was one of the best decisions I have made, since it is worth every penny I invested on it. I highly recommend this to everyone out there.

Social Anxiety Disorder

Social anxiety disorder (SAD) is characterized by fear of embarrassing oneself in social or performance situations. Subjects with generalized SAD fear several different social situations. SAD is a particularly prevalent and disabling anxiety disorder 59,60 . Thus, subjects with SAD are more likely to be single, are less likely to complete high school or tertiary studies, and are more likely to be unemployed and receive a lower income 6 . It seems reasonable to argue that early intervention for SAD, even in childhood and adolescence, may prevent the negative impact of this disorder. Long-term studies are, however, needed in this area. SAD has a relatively early onset, and can persist for many years. Comorbid disorders often begin later on 61 . These include major depression, other anxiety disorders and substance use disorders. Simple screening questions 62 or scales, such as the Liebowitz Social Anxiety Scale (LSAS) and the Mini-Social Phobia Inventory (SPIN), are useful for screening...

Generalized Social Phobia

Generalized social phobia (GSP) is a common and disabling disorder that affects many areas of a person's life. Situations commonly avoided include presentations to small or large groups, being observed while eating or drinking, and many forms of social interaction (e.g., initiating a conversation). Dysfunctional attitudes and extreme negative thinking appear to play an important role in the etiology and maintenance of the disorder. Phobic avoidance is a major feature of GSP and so exposure therapy is indicated. However, because of the way that people with GSP interpret their social interactions, even seemingly successful social encounters can be perceived as failures through a critical dissection or postmortem ruminative process. Accordingly, cognitive restructuring is an important component of treatment. Behavioral group therapy for social phobia was pioneered by Richard Heimberg and colleagues and is arguably the nonpharmacologic treatment of choice for this condition. Because of...

Social Isolation

Isolation of goats from their social group can cause increased emotional stress or fearfulness, as reflected by elevated cortisol concentrations. 6 Plasma cortisol concentration is a reliable indicator of stress in goats. To study the responses to social isolation in goats, Kannan et al. 6 conducted an experiment in which individual does were blood-sampled after imposing one of three isolation treatments a 15-min isolation with no visual contact with other does (I) a 15-min isolation with visual contact (IV) or no isolation (control, C). The stress levels, as indicated by plasma cortisol concentrations, were higher in the I group compared to the IV and C groups. Cortisol concentrations in the IV and C groups were not significantly different (Fig. 1). Social isolation also causes stress in sheep. However, based on social interactions initiated per unit time and on the behaviors exhibited when socially isolated, goats are more social than sheep. 7 Although plasma glucose and...

Social Phobia

Individuals with social phobia fear one or more social or performance situations because of a concern of being humiliated or embarrassed by performing poorly or displaying visible anxiety symptoms in front of others (APA, 2000). The social phobia may be generalized, in which the individual fears a multitude of social and performance situations, or it may be nongeneralized, in which only one or two social or performance situations are feared. The prevalence rate for social phobia has been found to be 13 (Kessler et al., 1994). The age of onset of social phobia is usually in the midteens, with a mean age of onset of approximately 16 (Barlow, 2002 Ost, 1987). Social phobia is typically more prevalent in women than in men, with the female-to-male ratio being approximately 3 2 (Den Boer, 2000 Kessler et al., 1994). Several treatments for social phobia have been found to be effective, including exposure, cognitive restructuring, social skills training, and psychopharmacology. Al-Kubaisy et...

Personality Differences by Gender

Aside from behaviors required in different roles, are there differences in the ways boys and girls and men and women behave Are there changes over the life cycle Particular areas considered are degree of nurturance, dominance, dependency, sociability, aggression, reticence or shyness, expressiveness, etc. What are cultural stereotypes of how males and females ought to be Do these stereotypes differ from reality Is there explicit research on gender differences in cognition, perception, or mental illness in the culture

Areas of High Prevalence

In Tanzania, Jilek and Jilek-Aall71 reported a prevalence of 20 1000 in a Bantu population in Mahenge region. This figure, based on voluntary attendance to their clinic, was considered an underestimate. Possible causes suggested for the high prevalence were birth related brain trauma, syphilis, malaria, parasitic infections, meningo-encephalitis, toxic enteritis in children, and chronic malnutrition. These factors, however important, do not fully explain the unusually high frequency of epilepsy observed in the tribal population. Owing to its marked geographical, cultural, and social isolation, the Wapogoro society is traditionally an endogamous system, which encourages marital union within the kin group, even between first cousins. This trend is more pronounced among families with epilepsy. Low social prestige and poor financial status prevent them from marrying brides from healthy families. Of the 201 patients, a family history of epilepsy was found in 154 (76.6 ).

Structural Location in Society

Guardians of cultural norms and traditions, including religion, in their maternal role. This role leads to some deprivation. Moberg (1962) suggested that the child-rearing duties of women actually lead to greater social isolation, relieved by the involvement in religious activities. A closely related explanation is that women will be more religious when involved in child-rearing. However, careful analysis in an Australian survey, comparing otherwise similar females with and without children, has found that children have no such effect (de Vaus & McAllister, 1987). The greatest gender difference in this study was found for single individuals the difference declined during the life cycle and was lowest after children had left home. However, in a study of 2,384 subjects in Holland, Steggarda (1993) found that men, but not women, engaged in child-rearing were more religious, so that there was no gender difference when they both shared this task.

Women Are More Deprived

This explanation looks at women's social status and power There is not a single society known where women-as-a-group have decision-making power over men or where they define the rules of sexual conduct or control marriage exchanges (Lerner, 1986, p. 30) It is easy to conclude that women are deprived and oppressed in many social situations. Reporting on the greater religiosity of women in the Soviet Union and then in post-communist Russia, Anderson quotes an unnamed Intourist guide, who explained that there were greater numbers of women in church 'because women suffer more' (Anderson, 1993, p. 209).

Attention Training Procedures

State (episode) versus trait (interepisode) related. Current medications and other treatments are reviewed with note made of how they are tolerated by the individual. Medication and electroconvulsive therapy (ECT) induced attention impairment is treated by titrating the dose, or changing drug class to minimize cognitively toxic effects. Assessment also includes educational and occupational history to identify baseline premorbid functioning. Current functioning is reviewed with an emphasis on identifying how attentional impairments are evidenced in everyday life. Ability to attend during therapeutic activities, at school, in work, and in social situations is evaluated. Some formal testing of attention is done to provide objective data on how the patient's attention compares to a normative group. This testing includes measures of different aspects of attention such as ability to encode, focus, and sustain attention. Some of the commonly used tests are Digit Span, Coding, Cancellation...

Brainlocalization Theory

The goal of the so-called brainwashing process procedure is the production of extreme changes in a person's beliefs and attitudes through the application of methods such as sleep deprivation, induced hunger, pain, social isolation, physical discomfort, use of good-cop versus bad-cop interrogations by alternating kind and cruel inquisitors, and use of sensory deprivation. Under conditions of sensory deprivation (SD), for example, the individual is cut off from almost all sensory stimulation from the external environment. The early SD experiments reported in the 1950s indicate that volunteer participants who remained in SD for two to four days exhibited undirected thinking accompanied by hallucinations and fantasies, as well as an inability to distinguish sleep from waking states. The concept of activation or arousal is central to most physiological theories of SD. Brainwashing as a mind-control or programming technique gained widespread attention...

Management of fatigue

Evidence is mounting that low intensity exercise programmes are safe and effective in patients with chronic stable heart failure in terms of improving symptoms of fatigue and breathlessness47'48 and prognosis.49 Patients often need reassurance as they may be very wary of inducing dyspnoea during physical exercise, believing it to precipitate further cardiac events. However rehabilitation programmes are an important and too often neglected part of optimal management. Encouraging patients to be more active can be very helpful with reduced social isolation and depression, and a management

Description Of Treatment

The next section provides a theoretical overview of BGT. Immediately following this overview we present two case illustrations of BGT. The first involves a protocol for panic disorder with agoraphobia, and serves to highlight different types of exposure techniques in BGT. The second BGT protocol has more cognitive components and is designed to treat generalized social phobia. The chapter concludes with a brief discussion of applications and exclusions for BGT, along with a summary of the current empirical knowledge base.

Empirical Studies

Numbers of outcome studies in order to evaluate the efficacy of various interventions. Research has revealed few differences between the efficacy of group versus individual protocols for treating specific disorders. The formats have been found to be equally effective for a variety of disorders, including social phobia, post-traumatic stress disorder, panic disorder, and other disorders. Thus, the average patient benefits as much from group as from individual therapy. Finally, although particular patients may benefit more from one format than another, research has revealed few ways of reliably identifying these patients. An important area for further research in CBT in general is the identification of individual differences in suitability for these treatment modalities.

Mirror neurons and the understanding of intentions

Monkeys may exploit the mirror neuron system to optimize their social interactions. My hypothesis is that monkeys might entertain a rudimentary form of 'tele-ological stance', a likely precursor of a full-blown intentional stance. This hypothesis extends to the phylogenetic domain, the ontogenetic scenario proposed by Gergely & Csibra (2003) for human infants. New experiments are being designed in my lab to test this hypothesis.

Leadership in Public Arenas

The mobility of men distinguishes them from women. Men in general, but young men especially, have many opportunities to take trips outside the reservation. When they are young, they travel out of curiosity, and when they are older, they go to Cuiaba, the capital of the state of Mato Grosso, and even to Brasilia, the nation's capital, for political and financial reasons. They also go to ranches to earn wages. They remain there for days or even weeks before returning home. Talking about their experiences is frequently converted into status and prestige in the village. Women are discouraged from traveling outside the reservation. Child-rearing responsibilities, their inability to speak Portuguese as well as men, and their alleged shyness prevent them from leaving the reservation. Recently this has changed among the Bakairi. In the late 1980s and 1990s, women began to work for wages both inside and outside the reservation. Some work in Cuiaba in shops and at FUNAI headquarters as domestic...

Relative Status of Men and Women

Do take part in many decision-making processes, they are rarely acknowledged as decision-makers. This negation is also linked to notions and norms of shyness and modesty, which are far more rigid for women than for men. These notions also play a role in defining women through men, as is evident, for example, from the markers that distinguish women, though not men, who are engaged or married.

Other Cross Sex Relationships

The importance of brother-sister ties has been discussed in the previous sections on Cultural Overview and Husband-Wife Relationship. While more information is needed in this regard, some feelings of reserve and shyness between adult sisters and brothers, and between various in-laws of opposite sex, probably limit the frequency of contact and work between such individuals (D. M. Smith, 1982, pp. 20-25). On the other hand, avoidance behaviors, as between mother-in-law and son-in-law, appear to be neither as formalized nor as stringent as among some Athapaskan peoples of the Yukon and Alaska. Themes in Chipewyan folklore suggest that strong feelings of self-sufficiency and dependency create a fundamental tension in personality which applies to both men and women (Cohen & VanStone, 1963). Interethnic lore and imagery portray the Chipewyan as more reserved, but also more provident and enterprising, than their Cree neighbors, but again there is no apparent variability by gender (Brumbach &...

N Psychosocial Aspects of Aphasia

The psychosocial consequences of aphasia represent one of the most significant effects of the condition since communication using language, especially speech, is one of the most fundamental of human behaviors. The effect of aphasia on the individual's sense of self, identity, and quality of life is considerable. The ability to initiate and maintain personal relationships, which are dependent on communication, often leads to social isolation for the person with aphasia. Generally, those with nonfluent disorders tend to be more aware, frustrated, and depressed than those with aphasia of the fluent type.

Darwins Theory Of Emotions

Pleasure when this was not sufficient to excite the more violent reaction of laughter. In the animal realm, on the phylogenetic scale, vocal laughter-like sounds are used either as a call or a signal by one sex for the other and they may be employed, also, as the means for a joyful meeting between parents and their offspring or between the affiliated members of the same social unit. Darwin's instinct-physiological theory of humor assumes that the reaction of laughter is universal and widespread throughout the world as an expression of satisfaction, although other expressions of this same feeling exist as well. Darwin maintains, also, that laughter may be used in a forced way to conceal other emotions such as derision, contempt, shyness, shame, or anger (e.g., in derision, a real or feigned smile or laugh is blended with an expression of contempt whose function is to show the offending person that he or she evokes only amusement). Thus, Darwin's theory of laughter humor contains...

Psychiatric Disorders

Epidemiologic studies of patients infected with HIV and AIDS show a high lifetime prevalence of psychiatric disorders compared to the general population. Persons at highest risk for HIV infection (i.e., injected drug users and homosexual men) frequently suffer from mood disturbances prior to contracting HIV. Infection with HIV produces brain injury and is associated with a variety of CNS and metabolic disturbances that can produce psychiatric symptoms. HIV infection is also a significant psychosocial stressor, leading to social isolation, poverty, and hopelessness.

Graded in Vivo Exposure

Sometimes it is necessary to develop more than one hierarchy to reduce all the patient's fears. For a person with generalized social phobia, a patient might work through a public speaking hierarchy, a hierarchy of situations involving one-to-one conversations with people of the opposite sex, and a hierarchy involving asserting oneself to authority figures. The disadvantage of graded in vivo exposure is that it is slower than the more intensive flooding method. The advantage of graded exposure is that it teaches patients a skill for overcoming their phobias in a simple, step-by-step fashion. By progressively working up a hierarchy, patients can overcome their phobias gradually, without enduring extreme fear or distress. After a formal course of therapy ends, patients can continue to devise hierarchies on their own for overcoming any remaining fears.

Third Country Resettlement

Specific effects on health of these contextual issues during resettlement have been well documented (Shrestha et al., 1998 Silove & Kinzie, 2001 Silove, Mcintosh & Becker, 1993 Silove & Steel, 2002 Sinnerbrink et al., 1996 Sundquist & Johansson, 1996). Most consistent are the mental health problems, which correlate highly with torture and trauma experiences, postmigration stressors such as detention, unemployment, family disharmony, social isolation, and other acculturation difficulties. The inability to trust has an important impact on the establishment of social capital which in turn has negative effects on health. The most common conditions reported include post-traumatic stress disorder, anxiety, and depression (Shalev et al., 2001 Silove & Kinzie, 2001 Silove et al., 1997 Silove et al., 1998). Debates in cross-cultural mental health, however, have raised questions about the universal application of diagnoses based on psychiatric conditions that may not translate well...

Advantages of the Group

Therapy groups simulate the real world of natural friendship groups more accurately than does individual therapy if the therapist permits and even encourages such simulation. Individual therapy consists solely of a high-status therapist and a low-status client. Due to the greater similarity of the group to other social situations in the real world, the group setting facilitates transfer of newly learned behavior from the therapeutic setting to the community.

Frequency Length and Duration of Group Sessions

Meet from 1 to 3 hours daily from their onset until termination, which is usually about 3 to 6 weeks. Only modest research exists to point the way to differences in the number of sessions. In adult groups in the therapy of social anxiety, D'Alelio and Murray in 1981 demonstrated that eight 2-hour sessions was significantly more effective in reducing social anxiety than four 2-hour sessions, perhaps because there is more extragroup time to practice what is learned in the group. In anger management groups for adolescents, Lochman in 1985 demonstrated the greater effectiveness of 16 sessions over 8 in increasing the control of anger by the youth.

Data Collection as Social Exchange

The social exchanges between interviewers and their respondents resemble familiar everyday social interactions in some respects. Some people participate in surveys because they feel they need to. This motivation is rapidly disappearing given informed consent and overload from market surveys residents of the United States appear increasingly unwilling to participate in person-to-person interviews of any sort (Atrostic et al. 1999). Some participate in interviews because they hope to get something from it the pleasure of having someone really listen to their opinions, the sense that they are helping others learn or benefit from their knowledge or condition, a way to fill up an otherwise dull day in a hospital or a waiting room. No matter what their original motivation is, when they participate in a survey, respondents react to the words and sentiments of the interviewer. They may want to obscure or minimize characteristics or practices deemed sensitive, such as household income or...

Gender over the Life Cycle

The Lahu category that is similar to puberty and adolescence is unmarried young men and or young women. The major markers of the onset of this stage are shyness in front of members of the opposite sex and the ability to understand the talk between boys and girls, including romantic conversations, love songs, and sexual jokes. Most Lahu enter adolescence at 12 or 13 years of age, although the physical and social development of an individual, rather than calendrical age, serves as the essential index for the category. Socialization at this stage

The Settings of Socialization

Just as the activities in which children engage contribute to gender socialization, where children work and play also has important implications. The settings in which children spend their time shape those behaviors they can observe, try out, rehearse, and master. The impact on socialization is directly related to the strength of the setting. Some contexts of development are considered strong and other situations weak (Snyder & Ickes, 1985). In strong contexts, the range of behaviors that an individual is permitted to display is limited. The situation almost dictates the individual's response. Weak contexts allow more variability the situation does not demand a specific behavioral or emotional response. With regard to gender socialization, many social situations are relatively strong, particularly for older children who are more aware of gender stereotypes and expectations. These strong contexts demand gender-appropriate behaviors,

Empirical Status Of Metacognitive Theory

Research on patients with GAD and worry-prone non-patients support several central aspects of this model. Individuals meeting criteria for GAD give positive reasons for worrying such that it contributes to motivation, preparation, and avoidance. Proneness to pathological worrying is positively associated with metacognitive factors including positive and negative beliefs about worrying. Patients with DSM-III-R-diagnosed GAD, compared to patients suffering from social phobia, panic disorder, or nonpatient controls, report significantly greater scores on negative beliefs about worrying and Type 2 worry. In discriminant analysis, patients with GAD were characterized by high levels of negative metacognitions while other patients were better characterized by the content of their Type 1 worries (Wells & Carter, 2001). Type 2 worry is a better predictor of pathological worry than Type 1 worry frequency and negative metacognitions predict the subsequent development of GAD 12-14 weeks later in...

Asch Conformity Effect

Judgment task, only about one-fourth of the subjects completely resisted the confederates' answers and made no errors. Other subjects followed the unanimous, but incorrect, opinion on every trial, showing complete acquiescence to the group's pressure (cf., the bandwagon effect technique - the tendency for people, in political and social situations, to align themselves or their opinions with the perceived majority's opinions). In later debriefing sessions, the subjects greatly under-estimated their degree of conformity. Similar experiments with French, Norwegian, Arabian, and British students supported Asch's findings with American subjects. The Asch effect, then, refers to the powerful influence of a unanimous group and its decisions on the behavior of an individual that results in conformity to that group. Conformity, for better or worse, is defined as the tendency for people to adopt the behaviors, attitudes, and values of other members of a reference group. In subsequent studies,...

Psychological studies of anxiety and attention

Beginning in the 1980s, many studies using the emotional Stroop task provided evidence that anxiety enhances attention to threatening information. When instructed to name the ink color of a word stimulus, anxious subjects are delayed when the word's meaning is threatening, suggesting that their attention is drawn to the irrelevant but threatening information. Some of these studies suggest that the attentional bias can be quite specific. For example, patients suffering from social phobia were delayed primarily by socially-threatening words (e.g., 'rejection' Hope, Rapee, Heimberg & Dombeck, 1990), patients with physical concerns or panic disorder were distracted by words conveying physical threat (e.g., 'injury' Mogg, Mathews & Weinman, 1989), and spider phobics were slow in naming the color of spider-related words (e.g., 'web' Watts, McKenna, Sharrock & Trezise, 1986). Such specificity is consistent with engagement of the defensive circuitry by highly processed semantic information,...

Neuroimaging and the intentional stance

In a recent study (Mar et al 2006), we examined whether the brain responds differently to complex dynamic videos of social interactions presented in either a cartoon or realistic fashion. Footage for the film Waking Life (Linklater 2001) was shot using real actors, and later transformed by computer animators into a cartoon. Motion kinematics from the real footage were thus preserved in the animated version, and although both versions had numerous cues for animacy and inten-tionality (e.g. self-propelled movement, faces and other biological features) one was obviously realistic while the other was a cartoon (see Fig. 1). Equivalent content was shown in both versions, and shots within scenes alternated between cartoon and real. Participants were not prompted to make any social judgement,

Telling the Truth about Cancer and Its Treatment

In light of these and other contrasting cultural norms, oncologists practicing in diverse ethnic environments may need to approach their commitment to truth telling with special sensitivity and cultural competence (Flores). They may have to enlist the support of social workers, interpreters, and other appropriate support personnel to counteract the fear of social isolation and loss of hope that may strike some cancer patients harder than others.

Clinical Features

Impairment of memory, particularly recent memory, is gradual and progressive. Remote memories are often preserved. Impairment of memory and orientation with preservation of motor and speech abilities is said to be characteristic of the onset of Alzheimer's disease. 10 Degenerative dementias, such as Alzheimer's disease, may be divided into early, middle, and late stages.11 Early in the disease, complaints of memory loss, naming problems, or forgetting items are common. The middle stage shows progression of these problems plus loss of reading, decreased performance in social situations, and losing directions. Late stage of the illness may include extreme disorientation, inability to dress and perform self-care, and personality change. Typically, the onset of symptoms is slow and gradual if the onset of symptoms is acute the possibility of a reversible process (T ble,.221-Z) is increased. Clinical features of Alzheimer's disease or other dementias may include affective symptoms such as...

Subjects with focal amygdala damage

How does the presence of socially relevant information in the environment influence our perception and judgment of other people We have investigated how we direct our gaze to other people's faces, how we use specific features from faces to make social judgments about the presumed internal states of others, and how these mechanisms are disrupted following pathology. Studies of patients with damage to the amygdala have demonstrated a specific impairment in the ability to direct gaze towards, and to use information from, the eyes in others' faces. This basic impairment may explain the deficient recognition of basic emotions and deficient social judgment seen in such patients. Ongoing studies in our laboratory examine face-to-face social interactions with real people in an attempt to link the above impairments in the laboratory to the dysfunctional social cognition seen in everyday life.

Oppositional Defiant Disorder Odd And Conduct Disorder Cd

It is extremely rare that ODD does not appear at home, but it does definitely happen that its expression in other frameworks is minor. Generally the start of the clinical expression is at home, and at a later stage it spreads to educational and social frameworks outside the home. In this case, the child is likely to suffer from relatively lower academic achievement than his her ability warrants and social isolation. Then, damage to self-esteem, mood disorders and substance abuse are liable to appear.

Requirement for a Dating System

When did they die continues to be one of the major questions during a death investigation and is one of the main questions posed during an inquest into the fatal events presided over by Her Majesty's Coroner.2 Therefore the chronologic dating of events is of great importance to forensic investigators (as with ancillary scientific studies such as geology and archaeology), that is, the ability to create a theoretical timeline upon which the social interactions and events of a person's last days assists in either eliminating or incriminating others from an inquiry.

Applications And Exclusions

The patient should be a willing participant in the process of exposure therapy, with complete control over the nature and timing of any exposure exercises. Exposure may be traumatizing if it is forced on an unwilling patient. Exposure should be used only if the patient is able to tolerate some degree of distress, and is sufficiently motivated to overcome his or her fears. Patients should be told about the side effects of exposure treatment (e.g., transient increases in irritability), so that they can make an informed choice about whether or not to participate in treatment. The therapist needs to consider the patient's other problems before initiating a course of exposure. If a patient had social phobia and alcohol abuse, then one would need to consider whether the distress caused by exposure therapy would cause an increase in alcohol abuse. If this is likely, then the alcohol problem would need to be treated first.

Treatment For Children And Adolescents

One of the few interventions that was designed specifically for children with social fears is Social Effectiveness Therapy for Children (SET-C), a multifaceted behavioral treatment comprised of basic social skills training as well as individual and group exposure sessions (Beidel, Turner, & Morris, 2000). Compared to those who received a nonspecific intervention, children (ages 8 to 12) who received SET-C improved significantly more on child and parent ratings of anxiety, as well as on ratings of skill and anxiety in simulated social situations (Beidel et al., 2000). Approximately 67 of treated children no longer met criteria for SAD after treatment, compared with only 5 of those who received the nonspecific intervention. Furthermore, treatment gains were maintained 6 months after treatment ended. There is also evidence that the benefits of social skills-based CBT for children with SAD can be significantly enhanced when parents are systematically involved in treatment. Spence,...

Factors That Affect Treatment Outcome

The presence of concurrent psychopathology is also known to affect treatment outcome for individuals with SAD. In one study, patients whose SAD was accompanied by a mood disorder were compared to patients with either uncomplicated SAD or a comorbid anxiety disorder. Those with comorbid mood disorders had more severe SAD symptoms and were more impaired before and after receiving CBGT (Erwin, Heimberg, Juster, & Mindlin, 2002). As was the case with subtype, patients with comorbid depression benefited from CBT to the same degree as those without comorbid depression. However, they remained relatively worse off following treatment. In an earlier study, patients who presented with high levels of depression at pretreatment were less likely to improve on measures of social anxiety and social skill following treatment with CBT (Chambless, Tran, & Glass, 1997). These findings highlight the importance of conducting a careful assessment of depressive symptoms among individuals seeking treatment...

Recommended Readings

E. (Eds.). (2001). International handbook of social anxiety Concepts, research and interventions relating to the self and shyness. New York Wiley. Heimberg, R. G., & Becker, R. E. (2002). Cognitive behavioral group therapy for social phobia Basic mechanisms and clinical strategies. New York Guilford Press. Hofmann, S. G., & DiBartolo, P. M. (Eds.). (2001). From social anxiety to social phobia Multiple perspectives. Needham Heights, MA Allyn & Bacon.

Environmental Factors

Child-Rearing Practices, Family Sociability, and Attachment Styles. Research has examined the association of various child-rearing practices with the development of SAD. Two types of parenting styles that have been associated with SAD include low levels of warmth and high levels of control and overprotection. Some studies have found that adults with SAD rated their parents as less warm and more controlling than nonclinical controls. Similarly, some studies have reported that insecure attachment styles are related to increased risk of anxiety disorders. Family sociability is another environmental factor that may be related to the development of SAD. Research indicates that individuals with social anxiety recall their parents as being socially isolated and encouraging family isolation and limiting contact with others. Parents may also model fear responses when in social situations by providing and reinforcing avoidant responses, highlighting information about risk, and expressing doubt...

Clinician Administered Measures

One of the most frequently used clinician-administered measures is the Liebowitz Social Anxiety Scale (LSAS). This scale measures the severity of fear and avoidance separately for several interaction and performance situations, and has been shown to possess good psychometric properties. Another common measure is the Brief Social Phobia Scale (BSPS), which assesses fear and avoidance of seven common social situations, as well as the severity of four physiological symptoms. The BSPS has good psychometric properties as well, including adequate test-retest reliability and interrater reliability.

Behavioral Assessment

Behavioral assessment tests (BATs) comprise a systematic way of evaluating behavior in social situations. As applied to SAD, BATs frequently take the form of role-play tasks, and are helpful in observing social skills and anxiety responses (e.g., physiological responses, avoidance behaviors). Ratings of anxiety and thoughts can be recorded to augment information that is provided in self-report questionnaires. Typical situations used in BATs for SAD include conversations with same- or opposite-gender strangers and impromptu speeches. BATs can be standardized to compare performance across individuals or can be individually tailored. There is sufficient evidence for the reliability and validity of social skills ratings obtained from BATs.

Chimpanzees may recognize motives and goals but may not reckon on them

Psychological states play a fundamental role in mediating human social interactions. We interpret identical actions and outcomes in radically different ways depending on the motives and intentions underlying them. Moreover, we take reckoning of ourselves stacked up against others, and ideally make moral decisions with others in mind. Recently, evidence has been accumulating suggesting that our closest relatives are also sensitive to the motives of others and can distinguish intentional from accidental actions. These results suggest that chimpanzees interpret the actions of others from a psychological perspective, not just a behavioural perspective. However, based on recent studies, it is not clear whether chimpanzees have any regard for others, calling into the question the point at which fairness and other-regard were used as building blocks for full-fledged human morality.

Cognitivebehavioral Assumptions And Aggression

The cognitive-behavioral framework assumes that aggression is not merely triggered by environmental events, but rather through the way in which these events are perceived and processed by the individual. This processing refers to the child's appraisal of the situation, anticipated reactions of others, and self-statements in response to particular events. A variety of cognitive and attributional processes have been found in aggressive youths. Deficits and distortions in cognitive problem-solving skills, attributions of hostile intent to others, and resentment and suspi-ciousness illustrate a few cognitive features associated with conduct problems. Individuals who engage in aggressive behaviors show distortions and deficiencies in various cognitive processes. These deficiencies are not merely reflections of intellectual functioning. A variety of cognitive processes have been studied, such as generating alternative solutions to interpersonal problems (e.g., different ways of handling...

Treatment Procedures And Formats

Skills and (c) a related tendency to respond impulsively to both external and internal stimuli, which has also been described as an inability to regulate emotion and behavior (Lochman et al., 2000). Accordingly, the child-focused CBT approach to treating child conduct problems targets the disturbed cognitive processes and behavioral deficits thought to produce aggressive and disruptive behaviors. They help the child identify stimuli that typically precede aggressive and antisocial behaviors and perceive ambiguous social situations in a nonhostile manner, challenge cognitive distortions, generate more assertive (versus aggressive) responses to possible social problems and develop more effective problem-solving skills, and tolerate feelings of anger and frustration without responding impulsively or aggressively (Nock, 2003).

Irene Henriette Oestrich

Social situations, the less incompetent and anxious we feel in those and related social situations. The development of coping strategies is influenced by both behavioral and thinking processes. Avoidance and safety-seeking behaviors are a hindrance to the development of social skills, problem solving, and competence inasmuch as the lack of social engagement leads to a deficit in social skills.

Background And Research

Social skills training has been shown to be effective for a variety of mental health problems. It has been used in different forms throughout the past 20 years in the treatment of social anxiety, panic, depression, shyness, and low self-esteem as well as schizophrenia. The more severe the psy-chopathology is, the more structured and behavioral the interventions would be. Likewise in anxiety disorders, social skills training is highlighted when working with personality disturbance, where the training is focused on relationships and communication. Social anxiety in schizophrenia is often treated in groups, leading to improvement on anxiety, social

Prestroke Nutritional Status

The prevalence of protein-energy malnutrition at the time of hospital admission following stroke has been variably reported as 8-30 . More detailed information obtained within 4 days of hospital admission has classified 9 of stroke patients as undernourished, 16 as overweight, and 75 as of normal nutritional status, based on a range of observational and nutritional assessment techniques. In relation to stroke outcomes at 6 months, the presence of under-nutrition shortly after admission has been independently associated with a significantly greater mortality and increased likelihood of developing pneumonia, other infections, and gastrointestinal bleeds before hospital discharge. Furthermore, patients of normal nutritional status have been found to be less likely to develop pressure sores than those who were undernourished or overweight. Specifically, a low serum albumin concentration has been found to be a significant predictor of post-stroke functional impairment, morbidity, and...

Suggestion Laws Of See Frequency Law Of

In his study of suicide (the act of killing oneself deliberately), the French sociologist Emile Durkheim (18581917) suggests that egoistic suicide - deriving from feelings of depression, failure, and self-reproach - results from a lack of personal-social cohesion and is more common among single persons than among married people. Another theoretical approach, called altruistic suicide, proposes that suicide is carried out for the benefit of other people and derives from one's sense of failure to one's society (e.g., many suicides in Japan are based on this notion). A third theoretical orientation, called anomic suicide, derives from one's sense that life is meaningless and is the result of the perceived absence of social norms and rules and occurs, often, after an unfavorable change in financial or social situations, causing despair bout maintaining a former lifestyle. Thus, according to Durkheim, the cause of suicide - whether it be egoistic, altruistic, or

Some Other Objections

A few other objections are sometimes raised against the self-perception account of feelings. One is that there seems to be no room for hiding or disguising one's feelings, or for pretending. If self-perception theory is correct, then if we pretend to feel something, we should feel it. Of course, we have all had many experiences of hiding or simulating feelings in order to meet the demands of social situations. Does this mean that self-perception theory is somehow wrong The answer is probably not, for at least four reasons. First of all, the necessary movements of, for example, facial expressions may be extremely subtle. In one study that very nicely matches some of the conditions of everyday pretense, participants were induced to adopt facial expressions that were so small that they were un-detectable by observers, although they were revealed by EMG recordings (McCanne & Anderson, 1987). Despite being undetectable, these miniexpressions were sufficient to produce changes in feelings....

Assessment of Antecedents

For example, a client might describe anxiety in social situations that is exacerbated by an evaluative component in the social interaction. In this example, social interaction is the context (SD) in which escape is reinforced by the termination of the aversive stimulus (e.g., the social interaction, aversive thoughts, emotional, and bodily states associated with such interactions). Adding an evaluative component to such an interaction would constitute an establishing operation (EO), because it would alter the probability of escape and the reinforcing value of that escape.

Change in Attitudes Beliefs and Practices Regarding Gender

Contact with the Venezuelan society is increasing and the need to interact with non-Yanomami has become unavoidable in accessible areas. Names are traditionally tabooed, but it has become customary to use Christian names to address others in the context of the mission stations or schools. This is a decisive step toward a cultural change. Traditionally, every person is placed in particular relationships within social interactions by referring to one another using kinship terms. These are intimately linked with gender meanings, as every term specifies a certain form of conduct and commitment. Now other forms of social distinction have been introduced, like jobs with different salaries or diverse access to modern resources these will inevitably lead to a higher level of social inequality.

Applying an Integrated Cultural Epidemiological Approach

From the point of view of epidemiology, epilepsy offers a lesson for how measurement tools themselves can raise the status of some medical conditions and ignore others. Epilepsy was relatively unimportant on the worldwide disease priority list when diseases were ranked according to their contribution to infant or child mortality because it rarely kills. Epilepsy also was neglected because its symptoms resemble some stigmatized types of mental illness. The condition began to get increased research attention and funding following development of new ranking systems for diseases, particularly the Disability-Adjusted Life Year, or DALY, developed by the World Bank in 1993. Because the DALY measured the disabling potential of diseases in addition to their mortality and duration, epilepsy jumped to prominence. The World Bank labeled it as one of the 10 most important diseases among all children 5 to 14 years of age in developing countries (World Bank 1993). It exacted its toll through school...

The Interrelationship Between Psychopharmacology and Psychoneuroimmunology

The adverse effects of stress and depression, the effects of bereavement, unemployment and social isolation on mental and physical health have been known since antiquity. Aristotle advised physicians, ''Just as you ought not to attempt to cure eyes without head or head without body, so you should not treat body without soul.'' One of the fathers of modern medicine put it more scientifically in the 19th century when he recommended that when attempting to predict health outcomes from tuberculosis in patients, it is just as important to know what is going on in a man's head as it is in his chest.

Restricted Range of Interests Repetitive Behaviors and Stereotyped Patterns

Attention abnormalities may contribute to clinical features in autism. As described earlier, a cardinal feature of autism is failure to engage in joint social attention and it is among the first striking deficits noticed in the autistic infant. In normal development, from joint social interactions between infants and mothers spring social knowledge and many higher cognitive, affective, and communicative functions. Tronick writes successful regulation of joint interchanges results in normal cognitive, affective, and social development. The crucial element is that the infant and mother share the same focus of attention during the interaction. To do so, an infant must do more than focus his or her attention on a single, captivating aspect of an object or person The infant must follow the rapid and unpredictable ebb and flow of human social activity, such as words, gestures, touching, postures, facial expressions, and actions on objects. By being able to smoothly, selectively, and rapidly...

The Physiological Differences of Addiction

Defining drugs as substances other than those required for normal health is a way of finessing this attribution of unnaturalness (Johns 1990 5). As I have argued elsewhere, it puts in place a distinction between therapeutic substances like insulin, which work to restore health in cases of disease, and recreational drugs. However, identifying normal health and normal biology, and assessing whether a drug is being used to restore or disrupt function, is based on normative judgments about proper and improper bodies as well as proper and improper substances (Keane 2002 18-19). Is a body in pain functioning normally or in a disrupted state Is pain relief a disruption of normality or a restoration of normal functioning Does it depend on whether the analgesic is aspirin or heroin and whether it has been medically prescribed or self-prescribed How are drug therapies for conditions like social anxiety different from the routine use of alcohol and cocaine to deal with lack of self-esteem and...

Winnie Eng and Richard G Heimberg

CBT has also been shown to be as effective as alternative treatments for social phobia, when delivered in either individual or group format. Richard G. Heimberg, Michael R. Liebowitz, and their colleagues have compared the efficacy of cognitive behavioral group therapy (CBGT) to that of the monoamine oxidase inhibitor phenelzine. For comparison, some participants in this study were assigned to either pill placebo or to a psychotherapy control condition (educational supportive group therapy). The general finding from their study was that clients taking phenelzine improved more quickly than did clients who received CBGT, but CBGT seemed to be more effective in terms of long-term efficacy once treatment had ended. The same research team is now exploring the efficacy of combined treatment (CBGT and phenelzine) for social phobia. Hope, D. A., Heimberg, R. G., Juster, H., & Turk, C. L. (2000). Managing social anxiety A cognitive-behavioral therapy approach (client workbook). San Antonio, TX...

The Origins and Meanings of Disease Pattern Categories

Disease clusters offer another opportunity to see the interplay among person, place, and time. Yet the very concept of a cluster depends partly on a series of political and social conventions. The way that boundaries are drawn around administrative space can determine the denominator. For example, six cases of childhood leukemia counted within a residential block looks more like a cluster than six cases in a census tract or town. These conventions also affect which diseases are thought to be rare, based, for example, on individuals or governments deliberately misleading people about disease status. Social interactions may influence whether knowledge of common diseases is shared in the first place (illness reported within members of a church or students in a school versus illness unknown because it occurs among isolated or marginalized individuals). Finally, political and social conventions influence the period of time over which a cluster is studied, as well as the duration and...

Hasan Aziz and Zarin Mogal

Epilepsy is a worldwide problem with a major impact on the personal, family, and social life of the affected individual and also on the society. The reported prevalence rates of epilepsy in various epidemiological studies vary from 1.5 to 19.5 per 1,000 population with higher prevalence rates in developing countries.1-5 The average accepted prevalence rate is 5 per 1000.2 Stigmatization, low literacy, sub-optimal employment, and social and economical marginalization are the commonly faced problems by people with epilepsy, both in developed and developing countries. This attitude of the public significantly contributes to high rates of anxiety, depression, dejection, feeling of deprivation, and low self-esteem in people with epilepsy.6,7 This is much more so in developing countries.8-11 Even in the present era when the civic sense of tolerance and acceptance to accommodate people with handicaps is high, people with epilepsy are socially isolated and discriminated.12,13 However, in the...

Jesse H Wright and D Kristen Small

Virtual reality programs have been developed for height phobia (Rothbaum et al., 1995), fear of flying (Muehlberger, Herrmann, Wiedemann, Ellgring, & Pauli, 2001 Rothbaum et al., 2000), claustrophobia (Botella, Villa, Banos, Perpina, & Garcia-Palacios, 2000 Wiederhold & Wiederhold, 2000), social phobia (North, North, & Coble, 1998 Petraub, Slater, & Barker, 2001 Wiederhold & Wiederhold, 2000), spider phobia (Carlin, Hoffman, & Weghorst, 1997), agoraphobia (Wiederhold & Wiederhold, Gruber et al. (2001) have reported similar findings in a study of a hand-held computer program for social phobia. Their computer program was designed to assist in group cognitive therapy by reinforcing the material taught in group sessions, giving prompts to confront fears, involving users in exercises to modify automatic thoughts, and providing progress reports. In a study comparing standard group CBT and computer-assisted CBT (with reduced therapist contact), there were advantages on some measures for...

Classical Conditioning

A more popular application of classical conditioning is the exposure therapies. These treatments are used to help people overcome specific phobias and other anxiety disorders in which excessive fear plays a prominent role, such as agoraphobia, social phobia, posttraumatic stress disorder, and obsessive-compulsive disorder. Given that exposure therapies for treating phobias are the most widely used applications of classical conditioning, these treatments and their theoretical bases will be the focus of this chapter. The treatment of fears is not a trivial undertaking. Severe phobias can produce extreme distress and can severely impair a person's functioning. Driving phobia, arising after a motor vehicle accident, for example, may prevent the person from earning a living and may lead to social isolation if the person lives in a remote area. Even common phobias such as spider phobias can be debilitating. One patient reported being too afraid to enter rooms of her house in which she had...

Free Running Rhythms Entrainment and Masking

If circadian clocks free-ran in the natural environment they would be of little use to the organism. Evolution has ensured that the circadian system can be synchronized to certain environmental time cues or zeitgebers. The process by which circadian rhythms are synchronized to periodic environmental time cues is called entrainment. The light-dark cycle is the predominant environmental entraining agent in most plants and animals, including humans. However, daily cycles of food availability, social interactions, and ambient temperature have also been shown to be effective entraining agents in some species. Environmental synchronization is adaptive because it confers on an organism the ability to maintain appropriate phase relationships with the external environment throughout the year. From an evolutionary perspective, the ability to perform certain behaviors at the appropriate time of day or the appropriate season confers a strong selective advantage to an organism. In effect,...

Exposure in Vivo Therapy versus Cognitive Therapy

Overall, the literature suggests that cognitive therapy does not enhance the effects of exposure in vivo. For example, results of several studies showed that exposure with and without cognitive modification was equally effective in social phobia. Similarly, studies with acropho-bics revealed that exposure with self-statement training was as effective as exposure alone. Further, a number of studies found cognitive-behavioral packages not more effective than exposure in vivo for panic disorder with agoraphobia. In addition, in obsessive-compulsive disorder,

How To Measure A Heuristics Success

The two kinds of criteria, coherence and correspondence, can sometimes be at odds with each other. For instance, in social situations, including some competitive games and predator-prey interactions, it can be advantageous to exhibit inconsistent (and hence noncoherent) behavior in order to maximize adaptive unpredictability (and hence correspondence with real-world goals) and avoid capture or loss. As another example, the Minimalist heuristic violates the coherence criterion of transitivity but nevertheless makes fairly robust and accurate inferences in particular environments. Thus, intransitivity does not necessarily imply high levels of inaccuracy, nor does transitivity guarantee high levels of accuracy Logic and adaptive behavior are logically distinct.

Cultural Consonance Stress and Blood Pressure

One of the challenges in trying to examine more direct (as opposed to contextual) effects of culture on disease risk is finding a definition of culture that is both theoretically satisfying and yet can be used to understand how individuals come to be at risk. The problem of linking culture to the individual is one that has been prominent throughout the history of anthropological theory however, employing a cognitive definition of culture suggests a resolution (Dressler & Bindon, 2000). Cognitive approaches define culture as the knowledge one must possess to function as a member of society. Culture is composed of sets of schematic, representational models of cultural domains that individuals learn. These models consist of the elements within domains and the relationships among those elements. From mundane social interactions to the most symbol-laden rituals, we as individuals and groups learn and share cultural models of how any given social context is constituted, the meaning of...

Pervasive Developmental Disorders PDD

The differentiation between pervasive developmental disorders (PDD) and ADHD may appear obvious. However, many children who have these disorders in various degrees of severity also exhibit symptoms of ADHD and even respond well to psychostimulants. This is especially true of Asperger's syndrome, which is more elusive from a diagnostic point of view than the other syndromes belonging to this group. Since the main characteristics of Asperger's syndrome include severe and persistent disturbances in social interactions and development of limited and repetitive behavioural patterns, interests and activities, these children show a significant clinical impairment in important functional areas such as the social or occupational sphere. An example of the confusion in this area is given by the work of Ghaziuddin et al. 57 , which describes comorbidities of Asperger's syndrome and shows that the most common comorbidity in these children is that with ADHD.

Reality Monitoring Hypothesis

Is determined by behavioral intentions that, in turn, are determined both by attitudes to behavior and subjective norms. The theory of reasoned action is a variant of expectancy-value theory in which behavior is influenced by the values of the possible outcomes weighted by the estimated probabilities of those outcomes, and first studied by the German-born American psychologist Kurt Lewin (1890-1947) in the 1940s. In reasoned action theory, an attitude to behavior is the individual's evaluation of the goodness or badness of performing the target action (that is, attitudes to behavior are determined by the person's beliefs about the consequences of the behavior multiplied by the evaluation of each consequence, and then summed) and a subjective norm is the person's perceived social pressure that is derived from perception of the degree to which significant others would prefer the person to perform the target action. The two components of attitude to behavior and subjective social norm...

Description Of Treatment Processes

Comprehensive treatment for eating disorders generally requires attention to four distinct features of these disorders (1) biological aspects, particularly nutritional status and the deleterious consequences of semistarva-tion and undernutrition on the one hand, or serious obesity on the other (2) eating disorders related behaviors including restrictive and idiosyncratic eating patterns, eating binges, purging, ordinarily by means of vomiting or use of laxatives, and excessive, compulsive exercise (3) eating disorder related thoughts, attitudes, and emotions, which may include distorted self-perceptions, overvalued ideas, and self-disparagement, all related to shape and weight, diminished cognitive complexity and increased obsessionality and perfectionistic thinking accompanying malnutrition, and increased nutrition-related emotional fragility with mood and anxiety symptoms and (4) associated psychopathological and interpersonal problems, the frequent comorbid conditions of mood,...

Christine Maguth Nezu and Michelle A Peacock

Other studies have found positive results that focus on skills that enhance interpersonal functioning. For example, in comparison to a wait-list control group, participants with moderate to borderline mental retardation who received social skills training with an emphasis on dating skills demonstrated improvement in heterosocial interactions and social-sexual knowledge (Valenti-Hein, Yarnold, & Mueser, 1994). The results of this study, however, did not reveal reductions in social anxiety. Mildly mentally retarded adults have also benefited from assertiveness training provided in a group setting that consisting of focused instructions, modeling, behavioral rehearsal, and response feedback (Gentile & Jenkins, 1980). The results indicated increased use of appropriate verbal responses (i.e., making requests and refusing unreasonable requests).

Biofeedbackassisted Cultivated Low Arousal Relaxation Procedures

In everyday, nonemergency stress situations. Porges points out that a branch of the Xth cranial nerve (vagus nerve) in the PNS has a distinct anatomy that has evolved in mammals more recently than the more vegatative tracts in the vagal system. This tract seems to be involved in subtle, socially based, heart and lung regulation on an ongoing basis. When a true emergency is perceived, this system moves to the background and allows sympathetic recruitment to occur to meet the challenge. During ordinary experiences when we are negotiating complex social situations, the vagal system is dominant. In biofeedback this can be seen by analyzing the rhythms occurring in the time periods between heart beats. There is a characteristic speeding and slowing of the heart rate with inspiration and expiration called respiratory sinus arrhythmia (RSA). The vagus nerve systematically brakes the heart pacemaker during inspiration and releases the brake during expiration. Biofeedback is based on the...

Personalityjob Fit Theory

Sonality itself seems to be so resistant to a consensual-agreement statement, and so broad in usage, that most psychology textbooks (other than textbooks on personality theories) use it strategically as the title of a chapter and then expound freely on it without incurring any of the definitional or positivistic responsibilities attached to it (cf., implicit personality theory lay personality theory and implicit theory of personality - first described by J. S. Bruner, R. Tagiuri, and L. J. Cronbach, which refers to the unconsciously held ideas that most laypeople have about the personalities of others, where they establish a complex web of assumptions about the traits and behaviors of others and assume that they will act in accordance with those assumptions). One approach toward understanding the term personality is to examine it according to the role it has played in psychological theory, in general, rather than to list its numerous definitions. Thus, the following roles, or...

James D Herbert and Kristy Dalrymple

Keywords social anxiety, social phobia, cognitive-behavior therapy, social skills, group therapy Social Anxiety Disorder (SAD also known as Social Phobia) is defined by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a marked and persistent fear of social or performance situations in which embarrassment may occur. These situations may include public speaking, eating in public, writing in public, speaking with authority figures, conversations, dating, as well as many others. The fear must be excessive or unreasonable, lead to avoidance and or significant distress, and must interfere with occupational, academic, or social functioning. A cardinal feature of the disorder is fear of negative evaluation by others. Persons with SAD tend to hold negative beliefs about themselves (e.g., thoughts of inadequacy), and engage in excessive self-focus during social interactions. Descriptions of social anxiety date back to antiquity, but the first modern...

Social Avoidance And Anxiety

Beliefs about being defective and the importance of appearance to the self will drive varying degrees of social anxiety and avoidance. Thus, depending on the nature of their beliefs, patients will tend to avoid a range of public or social situations or intimate relationships because of the fear of negative evaluation of the imagined defects. Many patients endure social situations only if they use camouflage (for example, excessive makeup) and various safety behaviors. These are often idiosyncratic and depend on the perceived defect and cultural norms. Behaviors such as avoidance of eye contact or using long hair or excessive makeup for camouflage are obvious but others are subtler and are more difficult to detect unless the patient is asked or observed as to how they behave in social situations. For example, a BDD patient preoccupied by his nose avoided showing his profile in social situations and only stood face on to an individual. A patient preoccupied by blemishes under her eye...

Gamma Movement Effect

The American psychologist John Garcia (1917-1986) and his colleagues conducted extensive work in the area of learning, specifically on classically conditioned taste aversion. The Garcia effect (also called bait-shyness effect, toxicosis effect, flavor-aversion effect, conditioned food taste aversion, food avoidance learning conditioning, taste-aversion effect, and learned taste flavor aversion), refers to an acquired syndrome in which an organism learns to avoid a particular food because of a conditioned aversion response to its smell or taste. A toxicosis reaction can be formed in a single trial during which consumption of a novel food is followed by nausea and sickness - even when the toxic reaction itself is not experienced for some hours after eating (cf., cheese effect - acute attack of hypertension in a person taking a monoamine oxidase inhibitor drug who eats cheese, caused by an inter

General Theory Of Behavior In

And inadequate terms of the biology of the first two-thirds of the 20th century. According to Alexander, failure of the behavioral sciences to develop an adequate general theory of behavior is seen as a result of the difficulty in deriving a sub-theory or set of sub-theories, from evolutionary theory. Alexander's recommendation, and prescriptive first step, is to combine the approaches and data of biologists and social scientists in analyzing the notion of reciprocity in social interactions. See also EVOLUTIONARY THEORY. REFERENCE

A social interaction analysis

What does it mean to adopt a social interaction analysis to empathy and fairness It means at least four things. First, it means that it conceptualizes these tendencies in terms of social interactions, which are defined in terms of persons and situations (see Kelley et al 2003). Specifically, for a dyad, social interaction is defined as Second, a social interaction analysis provides a fairly inclusive analysis, in that it allows us to focus on both distal and proximal determinants of social interactions. Examples of distal determinants are personality variables (e.g. differences in prosocial, individualistic and competitive orientations, Van Lange et al 1997), relational variables (e.g. differences in trust in the partner differences in relational commitment e.g. Rusbult & Van Lange 2003), and situational variables (e.g. climates of trust versus distrust group size). Examples of proximal mechanisms (which often are both a determinant and a consequence of social interactions) are...

Talia I Zaider and Richard G Heimberg

Keywords social anxiety disorder, social phobia, anxiety disorders, adults, children Social Anxiety Disorder (SAD), also known as social phobia, is characterized by an excessive and persistent fear of one or more social or performance situations. Individuals suffering from SAD endure these situations with acute discomfort, and a great many avoid them altogether. The anxiety and associated avoidance behavior can be crippling, making it difficult for those affected to sustain relationships or function adequately at work, school, or in daily activities.

Piano Theory Of Hearing

Malinowski's theory of needs and W. L. Warner's theory of species behavior as a foundation for inclusion in his humor theory of both the biological needs and the psychological drives upon which social behaviors (such as kinship and family) are based. Piddington's treatment of laughter is neither entirely psychological nor entirely biological, and he attempts to assess the psychology of the original reaction of laughter and to relate this to the various functions that it subserves in society. Piddington's humor theory may be called the two contradictory social situations theory, whereby the ludicrous basically involves two contradictory social evaluations in which the laughter that is aroused is a socially-conditioned reaction that signifies satisfaction under some otherwise socially-disturbing conditions. See also HUMOR, THEORIES OF SOCIAL COMMUNICATION THEORY OF LAUGHTER. REFERENCES

Selfcategorization Theory

Image of the infant's self in the parent's mind), the nuclear self' (the first organization of the self that is revealed at about two years of age), the cohesive self (a consistent structure that represents the normally functioning individual), and the grandiose self (the normally exhibitionistic and self-centered persona of the infant). In his self-presentation theory, also called role-role theory (in which roles are used to explain and account for the patterns and regularities of social interactive behavior), the Canadian-born American sociologist Erving Goffman (1922-1982) asserts that individuals exercise conscious and or unconscious control of the impression that they create in social interactions and situations. Self-presentation is a significant form of impression management (i.e., the control and regulation of information in order to affect the attitudes opinions of target persons). Whereas impression management may focus on shaping other people's impressions of an individual...

Handling Bulls And Boars

Research has shown that bull calves reared in physical isolation from their own species are more likely to be aggressive and dangerous after they mature than bull calves reared on a cow in a herd. 10 Dairies have learned from experience that bucket-fed Holstein bull calves can be made safer by rearing them in group pens after they reach six weeks of age. Young male calves must learn at a young age that they are cattle. If they grow up without social interactions with their own species, they may attempt to exert dominance over people instead of fighting with their own kind. Young bulls that are reared with other cattle are less likely to direct dangerous behaviors toward people.

Paternal and Maternal Parenting and Outcomes in Sons and Daughters

Researchers have also found ethnic variations in gender-related outcomes of paternal behavior. For example, McAdoo's (1993) research of African American families suggests that middle-income African American fathers tend to demand immediate obedience, suppression of children's feelings, and constraint of children's assertive and independent behavior. However, Baumrind (1972, 1991) found African American fathers to exhibit a combination of firm control, warmth, and encouragement of autonomy in her observational study of African American and European American fathers' interactions with preschool children. African American and European American fathers exhibited similar expectations concerning the behaviors of sons, encouraging their independence, while African American fathers tended to discourage independence or individuality in daughters. Nevertheless, Baumrind found that these same African American daughters were actually independent and positively involved in social interactions at...

Iiiempirical Studies

And quantity of her social interactions. For example, in trying to interest the client in joining a hiking club, the therapist asked her to imagine the following scene Both the client and the staff working with her reported positive gains from the covert reinforcer sampling procedure. The content of the imagery scenes selected by the client stimulated discussion about the places depicted in them. They provided an occasion for the client to demonstrate her interests and showed her to have more socially endearing qualities than had been noticed previously by staff, which resulted in a reduction of the client's social isolation.

Schizophrenia and Other Psychotic Disorders

Mood Disorder Children Decision Tree

Schizophrenia usually starts in late adolescence or early adulthood, although the onset can occur at any age. The childhood history of schizophrenics often is marked by shyness, oddness or eccentric behavior, school difficulties, or paranoid behaviors, but such features are not always present. A prodromal phase, in which a gradual deterioration of function is noted, usually precedes the development of active delusions or hallucinations. Such deterioration usually includes the worsening of social withdrawal or the new onset of social withdrawal, odd behavior or speech, and difficulty in functioning in school or work. Patients or their families rarely seek care until the onset of the active phase of psychosis. Schizophrenics seldom seek care at all because they lack insight they do not realize that their perception, thoughts, and behavior are abnormal.

Dysfunctional Beliefs

Theories of fear have become increasingly complex in recent years. Classical conditioning and many other factors are thought to be involved. Consistent with the neo-conditioning and emotional processing models, some theorists have proposed that exaggerated beliefs about the probability and severity of danger may play an important role in motivating fear and avoidance. Such dysfunctional beliefs play a prominent role in contemporary theories of agoraphobia and social phobia, and may play a more important role in these disorders compared to specific phobia. People with social phobia tend to be preoccupied with their social presentation and have heightened public self-consciousness. They also tend to be self-critical, to excessively worry about being criticized or rejected by others, and to overestimate the likelihood of aversive social events. This suggests that such dysfunctional beliefs may be important in maintaining generalized social phobia. These beliefs appear to persist because...

Katie M Castille and Maurice F Prout

Anxiety disorders have been identified as the most prevalent mental health problem in the United States. According to the Epidemiologic Catchment Area (ECA) study sponsored by the National Institute of Mental Health, the 1-month prevalence rate for anxiety disorders is 7.3 (Regier et al., 1998). Among anxiety disorders, phobic disorders are the most common, with a prevalence rate of 6.2 . According to the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR American Psychiatric Association APA , 2000), phobias are classified into three categories agoraphobia with or without panic attacks, social phobia, and specific phobia. discriminates these two responses by the presence or absence of an external cue, whereby an unexpected, or uncued, panic attack occurs in the context of panic disorders, while situationally bound or situationally predisposed panic attacks occur in the context of specific phobias and social phobias. Thus, fear and panic are beginning to...

Well Being Assessment Concepts and Definitions

The idea that animals have a just or moral claim or privilege to certain items such as lack of abuse or neglect, life, or freedom. Repeated behaviors shown in sequence that vary only slightly in sequence may be caused by the environment genetics, or a combination. Examples chewing, suckling. Behavior repeated in a very constant way. The term generally is used to refer to behavior that develops as a consequence of a problem situation such as extended social isolation, low level of environmental complexity, deprivation, etc. Stereotypy also may arise from genetic predispositions, or from disease of, or damage to, the brain. Stereotyped behavior that serves no apparent function often associated with disease or adaptation to a stressful environment. Example navel sucking in weaned piglets.

Types Of Consequences

Gradual approach without fear is a common example of shaping, but many other examples are available. For children with school refusal behavior, for example, shaping often involves requiring a child to attend one class hour per day and gradually increasing the number of classes hours attended over time. For persons with depression, shaping could involve asking a client to make two calls a week to friends, and subsequently increasing his or her number of social contacts. For couples with sexual dysfunction, shaping could involve reconstructing the sexual repertoire so that only certain areas of the body are initially touched as therapy progresses, more intimate contact is allowed and reinforced. Shaping generally involves only those steps that resemble the final overall goal (e.g., active social interactions).

Case Illustration

Michelle K. was a 32-year-old single woman working as an administrative assistant in a large corporation. She had a long-standing history of generalized social phobia Michelle suffered for many years until she saw a television program describing cognitive-behavior therapy for social phobia. When she presented for treatment, at age 32, her major problems were eating in public, giving oral presentations at work, and initiating and maintaining conversations with men. Whenever she had to eat in public, her hands trembled and she worried that others would think she was weird. While giving oral presentations, she would tremble, blush, and sweat profusely, and sometimes would have a panic attack. As a result of these problems, she recently turned down a promotion because it would have required her to give speeches and to attend business dinners. Although Michelle very much wanted to be in an intimate relationship, she rarely dated because of fear of being rejected. She believed it would be...

Outcome Research On Cbgt

The research tends to provide support of the effectiveness of CBGT in the treatment of social phobias. For example, Heimberg in 1990 conducted a study comparing CBGT with a credible placebo control in the treatment for social phobias of 49 participants. Groups met weekly for twelve 2-hour sessions. The CBGT condition (n 25) consisted of exposure to simulated phobic events, cognitive restructuring of maladaptive thoughts, and homework for self-directed exposure and cognitive restructuring between sessions. The educational supportive psychotherapy comparison group (ES) (n 24), which acted as a control, consisted of lecture-discussion and group support. While both groups demonstrated significant pretreatment-to-posttreat-ment change, CBGT patients' phobias were rated as significantly less severe than those of ES patients at posttest assessment. Six-month follow-up data revealed a similar pattern. In another study Mattick and Peters in 1988 conducted a study to assess the effectiveness of...

Barriers to Meeting Recommended Nutrient Intakes and Healthful Dietary Intake Patterns by Older Persons

Elderly persons face a number of challenges in meeting their recommended nutrient intakes. In the first instance, they are likely to be those with the least sophisticated or available knowledge of the nutrients required and the food sources to provide them. The social, economic, and physiological changes imposing on the lives of persons surviving to advanced age pose logistical problems for their selecting and purchasing a diet. Economic dependency and the limited incomes of older persons may restrict their access to high-quality foods. Social isolation, depression, and impaired mobility, as well as chewing difficulties may limit the variety of items included in the diet with advancing age. In some circumstances, it may be that free-living and independent elders are relatively less able to optimize their nutrient intake and dietary pattern compared to more dependent individuals served or fed in institutional settings.

Endocrine and Metabolic Mechanisms

It is well established that prenatal stress can influence the development of neural systems that control endocrine responses to stress and regulate behavioural traits.59'62 Maternal glucocorticoid administration or prenatal stress in rats leads to development of decreased locomotor activity and increased defecation and avoidance behaviour in an 'open field' test.63'64 An animal model of fetal programming by maternal tumour necrosis factor (TNF)-a administration showed reduced locomotor activity of offspring.10 While recent studies in the rat have focused on maternal behaviour during the neonatal period which influences the HPA axis activity and anxiety behaviour59 there is little published experimental information on the effects of maternal nutrition on offspring behaviour. One group reported that maternal low protein nutrition during pregnancy in the rat lead to changes in exploratory behaviour, social interactions and avoidance behaviour in offspring.65'66 Since it is well...

Prevalence Of Anxiety Disorders

The American Psychiatric Association first recognized anxiety disorders in 1980 as a separate group of psychiatric disorders. The concept of neurosis (neurasthenic neurosis, anxiety neurosis, phobic neurosis, and obsessive-compulsive neurosis) in previous classifications was abandoned because it was considered too vague. Anxiety disorders now include PD, PTSD, social phobia, specific phobia, OCD, and GAD. Anxiety disorders are by far the most common of psychiatric disorders (25 ), followed by affective disorders (17 ). In the past decade, large epidemiological studies have provided information about the prevalence of anxiety disorders in the general population. A landmark epidemiological study in the United States in 1994 found lifetime prevalence rates for all anxiety disorders combined to be 19.2 for men and 30.5 for women. Phobic disorders are the most common diagnosis in broad-based assessments of psychiatric disorders in the community (affecting about 13 of individuals at any...

Cognitive Behavior Therapy

In the first manualized between-group study, Kendall and his colleagues compared the outcome of a 16-session CBT treatment to a wait-list control condition. Children and their families were treated individually. Forty-seven 9- to 13-year-olds were assigned randomly to treatment or waitlist conditions. All of the children met diagnostic criteria for overanxious disorder, separation anxiety disorder, or social phobia and over half of them were comorbid with at least one other psychiatric disorder or an affective disorder. Treated children improved on a number of dimensions perhaps the most dramatic difference was the percentage of children not meeting criteria for an anxiety disorder at the end of treatment 64 of treated cases versus 5 of the wait-list children. At follow-up 1 and 3 years later, and then again 7 years later, improvements were maintained and, in fact, were enhanced. Kendall and colleagues have reaffirmed the efficacy of this procedure with 94 children (aged 9-13)...

Psychological Treatments For Depression

Interpersonal therapy (IPT) attempts to reduce depressive symptoms by focusing on current interpersonal problems. Specifically, IPT examines grief, role conflicts in relationships, role transitions, and social deficits, all in the context of problematic relationships. Depressed individuals are asked to pay close attention to all of their social interactions and social disappointments. By carefully examining their own role, patients become better able to reconstruct (or construct new) relationships more productively.

Cognitivebehavioral Treatment Of Perfectionism

Although there are hundreds of studies examining the efficacy of cognitive-behavioral therapy (CBT) for psychological problems that are known to be associated with perfectionism (e.g., social phobia, depression, obsessive-compulsive disorder, eating disorders Nathan & Gorman, 2002), there are no controlled studies examining the use of CBT for treating perfectionism directly (Shafran & Mansell, 2001). Instead, there are a few case studies examining the effects of CBT on perfectionism, a few studies examining the impact of perfectionism on CBT outcome, and a few studies on the effects of CBT for anxiety on perfectionism. The results of these studies are summarized below. Preliminary case studies (e.g., Ferguson & Rodway, 1994 Hirsch & Hayward, l994) suggest that CBT may be useful for reducing symptoms of perfectionism. In addition, Di Bartolo, Frost, Dixon, and Almodovar (2001) found that cognitive restructuring is an effective intervention for reducing cognitions associated with public...

Summary And Conclusions

Phobias can be distressing and debilitating disorders. Individuals with agoraphobia, specific phobia, and social phobia experience fear in particular situations or around particular objects that often manifests itself in a panic attack or paniclike symptoms. The experience of panic leads to anticipatory anxiety about having future symptoms of panic, resulting in avoidance of the phobic situation. CBT has been found to be effective in treating these phobias through a combination of exposure, cognitive therapy, and psychopharma-cology. Continued research on treatments for phobias will help to find the most cost-effective treatments that can be generalizable across various patients and settings.

Symptom Profile And Neural Bases A Social Abnormalities 1 Characteristics

Associated with a particular area of expertise, such as faces. In autism, limited social interactions, and eye contact in particular, could then explain decreased rates of fusiform activation. If so, early intervention strategies could be developed to help autistic toddlers and children acquire the necessary expertise for more normal utilization of this cortical region.

Efficacy Of Problemsolving Therapy

If effective problem-solving skills serve as an important buffering factor regarding the stress process, training individuals in such skills should lead to a decrease in emotional distress and improvement in psychological functioning. In fact, PST has been shown to be effective regarding a wide range of clinical populations, psychological problems, and the distress associated with chronic medical disorders. These include unipolar depression, geriatric depression, distressed primary care patients, social phobia, agoraphobia, obesity, coronary heart disease, adult cancer patients, schizophrenia, mentally retarded adults with concomitant psychiatric problems, HIV risk behaviors, drug abuse, suicide, childhood aggression, and conduct disorder (see Nezu, D'Zurilla, Zwick, & Nezu, in press, for a review of this literature).

Overview Of Intervention Applications

General behavioral target areas common to most caregiving populations include increasing coping skills, problem-solving skills, time management, prosocial and health behaviors, relaxation, assertiveness, and communication skills. Cognitive targets may focus on decreasing mal-adaptive thoughts and beliefs in connection with feelings of depression, anxiety, or guilt, and increasing positive coping and self-efficacy or self-affirming statements. Services may be structured as therapy, support, psychoeducation, respite, self-enhancement, or a combination of these approaches. Interventions may focus on interpersonal (social isolation, competing work, family, and recreational demands) or intrapersonal (finances, emotional and physical well-being, changes in identity or future goals and expectations) variables, preexisting stressors or problems further complicated by the caregiving role, symptom management, and grief and loss issues. Contrary to many theorists' and researchers'

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