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Social Phobia

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….

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Social Phobia

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  1. 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

  2. Social Phobia is NOT…. • Getting butterflies before you present your disease project or before a first date.

  3. Prevalence • most common anxiety disorder • third 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

  4. Physical Symptoms • Blushing • Difficulty talking • Nausea, diarrhea • Difficulty making eye contact • Profuse sweating • Trembling • Elevated blood pressure • Rapid heart rate, palpitations

  5. Symptoms • Can be situation specific or someone may experience symptoms anytime they are around people • Low self esteem • fear doing things that will embarrass them • worry for days or weeks before a dreaded situation

  6. Life with Social Phobia • high risk for alcohol or other drug dependence • Loneliness • Leads to depression/learned helplessness • Common fears include: • Attending parties, • Meeting new people, • Speaking in public, • Using public restrooms, • Eating, drinking and writing in public

  7. Risk Factors • Life experiences and events • bullying • Shyness • Increased stress • May be associated with overprotective parents or limited social opportunities • Genetics (10x) • Increasing among white, married, educated

  8. Fear Process: • Unconditioned threat • Acquisition • Extinction • Generalization The Fear Response GS3 neutral Thalamus Threat Which nodes in this system are th locasd of pathology will depend on what conditiining oprcesses are abnormal. Human Reference Stimuli CS+ Striatum BST Thalamus Medial prefrontal cortex Fear Circuitry Medial Prefrontal Cortex Hippocampus (schematic matching) Hippocampus & Sensory Cortex Presented stimulus CS+ (memory-trace) CS- CS+ GS3 pattern separation (DG) V Fear- Inhibition Glutamate vmPFC Input(La) CS+ Ca2+ Inhibitory control (ITC) Hypothalamus NMDAR CREB High Low MAPK Sensory cortex CS- GS1 GS2 Hippocampus CS+ Amygdala Hypo CS+ CS+ CS+ CS+ PAG BST Output (Ce) pattern completion (CA3) RPC RPC Striatum PAG Amygdala sustained anxiety avoidance hormones freezing autonomic arousal reflex potentiation • Unconditioned fear • Conditioned fear • = conditioned danger cue • = unconditioned stimulus • Extinction • Discrimination and generalization • = conditioned safety cue Provided by Dr. Lissek (Hipp to ACC connection via parahippocampal cortex to ACC or by way of a posterior cingulated-ACC connection (Musil & Olson, 1988)

  9. Current research • sensitivity to carbon dioxide, cholecystokinin, and caffeine • effectiveness of selective serotonin reuptake inhibitors- why? • Reduced striatal dopamine and uptake • Reduced GABA • adrenergic abnormalities

  10. 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)

  11. NIMH 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.

  12. Classroom implications • Create a safe climate • If a student is experiencing a fear response they are learning, but not what you want them to be • Skipping school

  13. Positive Lifestyle Changes • Regular exercise, adequate sleep, regularly scheduled meals • Reduce/avoid use of caffeine and other stimulants • Reduce alcohol intake • Avoid smoking

  14. Cognitive Behavioral Therapy • Based on the idea that our thoughts control our feelings and behaviors • Control physical symptoms with: • Relaxation and breathing techniques • Replacing negative thoughts with more balanced thoughts • Facing social situations that you fear in a gradual, systematic way • Building relationships by improving communication and taking initiative

  15. Medication • Beta blockers-blocks adrenaline production to reduce symptoms • Antidepressants- • Benzodiazepines-sedatives that reduce anxiety • Ex. valium • Highly addictive • Only successful with generalized/free floating anxiety

  16. Sources • 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

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