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Social Phobia. “Characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.”. http://www.nimh.nih.gov/health/topics/social-phobia-social-anxiety-disorder/index.shtml. Social Phobia is NOT…. - PowerPoint PPT Presentation
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Social PhobiaSocial Phobia
“Characterized by overwhelming anxiety and
excessive self-consciousness in everyday
social situations.”
“Characterized by overwhelming anxiety and
excessive self-consciousness in everyday
social situations.”
http://www.nimh.nih.gov/health/topics/social-phobia-social-anxiety-disorder/index.shtml
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Social Phobia is NOT….
Social Phobia is NOT….
Getting butterflies before you present your disease project or before a first date.
Getting butterflies before you present your disease project or before a first date.
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PrevalencePrevalence
most common anxiety disorderthird most common mental
disorder in the U.S., after depression and alcohol dependence.
An estimated 19.2 million Americans have social anxiety disorder.
most often surfaces in adolescence
most common anxiety disorderthird most common mental
disorder in the U.S., after depression and alcohol dependence.
An estimated 19.2 million Americans have social anxiety disorder.
most often surfaces in adolescence
Physical SymptomsPhysical Symptoms
BlushingDifficulty talkingNausea, diarrheaDifficulty making eye contactProfuse sweating TremblingElevated blood pressureRapid heart rate, palpitations
BlushingDifficulty talkingNausea, diarrheaDifficulty making eye contactProfuse sweating TremblingElevated blood pressureRapid heart rate, palpitations
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SymptomsSymptoms
Can be situation specific or someone may experience symptoms anytime they are around people
Low self esteem fear doing things that will embarrass themworry for days or weeks before a dreaded
situation
Can be situation specific or someone may experience symptoms anytime they are around people
Low self esteem fear doing things that will embarrass themworry for days or weeks before a dreaded
situation
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Life with Social Phobia
Life with Social Phobia
high risk for alcohol or other drug dependence
LonelinessLeads to depression/learned helplessnessCommon fears include:
Attending parties,Meeting new people, Speaking in public,Using public restrooms,Eating, drinking and writing in public
high risk for alcohol or other drug dependence
LonelinessLeads to depression/learned helplessnessCommon fears include:
Attending parties,Meeting new people, Speaking in public,Using public restrooms,Eating, drinking and writing in public
Risk FactorsRisk Factors
Life experiences and eventsbullying
Shyness Increased stressMay be associated with overprotective
parents or limited social opportunitiesGenetics (10x) Increasing among white, married, educated
Life experiences and eventsbullying
Shyness Increased stressMay be associated with overprotective
parents or limited social opportunitiesGenetics (10x) Increasing among white, married, educated
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Amygdala
The Fear ResponseThe Fear Response
SensoryCortex
CS-
CS+
Input(La)
Output (Ce)
Glutamate
Hypo
Inhibitory control
(ITC)
Stimuli
CS+
freezingreflex
potentiation
autonomic arousal
hormones
sustained anxiety
RPCPAGBST
Fear Circuitry
avoidance
Striatum
Medial prefrontal
cortex
Amygdala
Hypothalamus
Hippocampus
BSTThalamus
Sensory cortex
Human Reference
PAG
Striatum
RPC
Ca2+
MAPK
CREBNMDAR
Unconditioned fearUnconditioned fear Conditioned fearConditioned fear
= conditioned danger cue= conditioned danger cue
= unconditioned stimulus= unconditioned stimulus
ExtinctionExtinction Discrimination and Discrimination and
generalizationgeneralization= conditioned safety cue= conditioned safety cue
Unconditioned fearUnconditioned fear Conditioned fearConditioned fear
= conditioned danger cue= conditioned danger cue
= unconditioned stimulus= unconditioned stimulus
ExtinctionExtinction Discrimination and Discrimination and
generalizationgeneralization= conditioned safety cue= conditioned safety cue
Medial Prefront
al Cortex
Thalamus
Hippocampus
Provided by Dr. Lissek
Current researchCurrent research
sensitivity to carbon dioxide, cholecystokinin, and caffeine
effectiveness of selective serotonin reuptake inhibitors- why?
Reduced striatal dopamine and uptakeReduced GABAadrenergic abnormalities
sensitivity to carbon dioxide, cholecystokinin, and caffeine
effectiveness of selective serotonin reuptake inhibitors- why?
Reduced striatal dopamine and uptakeReduced GABAadrenergic abnormalities
Gentili et.al.Gentili et.al.
Increased activity in parts of brain when exposed to faces expressing various emotions (including neutral):Evaluation of intentions, personality traits
of others, expression, emotional responses, social evaluation of others (hypervigilance)
Decrease in areas for attention and processing identity (avoidant)
Increased activity in parts of brain when exposed to faces expressing various emotions (including neutral):Evaluation of intentions, personality traits
of others, expression, emotional responses, social evaluation of others (hypervigilance)
Decrease in areas for attention and processing identity (avoidant)
NIMH StudyNIMH Study
Heightened responses to negative comments in two brain areas: the medial prefrontal cortex
(MPFC), is involved in the sense and evaluation of self;
the amygdala, is central to emotional processing.
Heightened responses to negative comments in two brain areas: the medial prefrontal cortex
(MPFC), is involved in the sense and evaluation of self;
the amygdala, is central to emotional processing.
Classroom implications
Classroom implications
Create a safe climateIf a student is experiencing a
fear response they are learning, but not what you want them to be
Skipping school
Create a safe climateIf a student is experiencing a
fear response they are learning, but not what you want them to be
Skipping school
Positive Lifestyle Changes
Positive Lifestyle Changes
Regular exercise, adequate sleep, regularly scheduled meals
Reduce/avoid use of caffeine and other stimulants
Reduce alcohol intakeAvoid smoking
Regular exercise, adequate sleep, regularly scheduled meals
Reduce/avoid use of caffeine and other stimulants
Reduce alcohol intakeAvoid smoking
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy
Based on the idea that our thoughts control our feelings and behaviors
Control physical symptoms with:Relaxation and breathing techniquesReplacing negative thoughts with more
balanced thoughtsFacing social situations that you fear in
a gradual, systematic way Building relationships by improving
communication and taking initiative
Based on the idea that our thoughts control our feelings and behaviors
Control physical symptoms with:Relaxation and breathing techniquesReplacing negative thoughts with more
balanced thoughtsFacing social situations that you fear in
a gradual, systematic way Building relationships by improving
communication and taking initiative
Medication Medication
Beta blockers-blocks adrenaline production to reduce symptoms
Antidepressants-Benzodiazepines-sedatives
that reduce anxietyEx. valiumHighly addictiveOnly successful with
generalized/free floating anxiety
Beta blockers-blocks adrenaline production to reduce symptoms
Antidepressants-Benzodiazepines-sedatives
that reduce anxietyEx. valiumHighly addictiveOnly successful with
generalized/free floating anxiety
SourcesSources
www.pubmed.gov www.mayoclinic.com www.socialanxietyinstitute.org http://dbic.dartmouth.edu/haxby/papers/
Gentili_BRB_2008.pdf http://www.nimh.nih.gov/science-news/2008/social-
phobia-patients-have-heightened-reactions-to-negative-comments.shtml
http://www.webmd.com/anxiety-panic/guide/mental-health-social-anxiety-disorder
http://brainblogger.com/2010/04/22/the-neurobiology-of-social-anxiety-disorder/
http://psycnet.apa.org/psycinfo/1998-11070-001 Helpguide.org
www.pubmed.gov www.mayoclinic.com www.socialanxietyinstitute.org http://dbic.dartmouth.edu/haxby/papers/
Gentili_BRB_2008.pdf http://www.nimh.nih.gov/science-news/2008/social-
phobia-patients-have-heightened-reactions-to-negative-comments.shtml
http://www.webmd.com/anxiety-panic/guide/mental-health-social-anxiety-disorder
http://brainblogger.com/2010/04/22/the-neurobiology-of-social-anxiety-disorder/
http://psycnet.apa.org/psycinfo/1998-11070-001 Helpguide.org
