Antony / Rowa Social Anxiety Disorder

1. Auflage 2008
ISBN: 978-1-61676-311-4
Verlag: Hogrefe Publishing
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 111 Seiten

Reihe: Advances in Psychotherapy - Evidence-Based Practice

Social anxiety is characterized by excessive anxiety or discomfort in situations where a person might feel judged or evaluated by others, including performance situations (e.g., being the center of attention, public speaking, working under observation, playing sports or music in front of an audience) and situations involving interpersonal contact with others (e.g., making small talk, meeting new people, dating). According to large-scale epidemiological studies, social phobia is one of the most prevalent psychological disorders. Although prevalence estimates vary, recent studies suggest that approximately 7% of Americans suffer from this disorder. In addition to the high percentage of people with symptoms meeting criteria for this disorder, many other individuals experience social anxiety or shyness to a lesser, but still impairing degree. Social phobia is also a common comorbid condition, often diagnosed along with other anxiety disorders. Taken together, this information suggests that practitioners are likely to encounter patients displaying some degree of social anxiety, no matter what specialty service or setting they occupy. Although social anxiety is a widely encountered problem, there are few resources available to provide straightforward, accessible assessment and treatment information for practitioners. This book aims to fill that gap. 

Over the past 20 years, effective tools have been developed to identify and treat individuals with social anxiety. The current book provides up-to-date information on the diagnosis, identification, conceptualization, and treatment of social anxiety and social phobia. This book is aimed at practitioners who practice in a broad range of settings, from specialty clinics to general practice, as well as students. Existing books tend to focus on the psychopathology of social anxiety, address multiple disorders in one volume, or provide extensive and detailed protocols for treating this disorder. In contrast, this book is a more concise guide to identification and treatment that is accessible for the busy practitioner. It focuses specifically on social phobia and social anxiety, making it an attractive reference book for professionals who require clear, easy to follow guidelines on treatments for social anxiety.

Autoren/Hrsg.

Antony, Martin M.

Rowa, Karen

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie
• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie

Inhaltsverzeichnis

1;Preface;6
2;Dedication;8
3;Table of Contents;10
4;1. Description;12
4.1;1.1 Terminology;12
4.2;1.2 Definition;12
4.3;1.3 Epidemiology;14
4.4;1.4 Course and Prognosis;15
4.5;1.5 Differential Diagnosis;16
4.6;1.6 Comorbidity;20
4.7;1.7 Diagnostic Procedures and Documentation;20
5;2. Psychological Approaches to Understanding Social Anxiety Disorder;25
5.1;2.1 The Cognitive Model of Clark and Wells;25
5.2;2.2 The Cognitive Behavioral Model of Rapee and Heimberg;28
5.3;2.3 Negative Learning Experiences and Social Anxiety;30
5.4;2.4 Temperamental Bases of SAD;31
5.5;2.5 Implications for Treatment;32
6;3. Diagnosis and Treatment Indications;33
6.1;3.1 Key Features to be Assessed;33
6.2;3.2 Overview of Effective Treatment Strategies;38
6.3;3.3 Factors That Influence Treatment Decisions;40
7;4. Treatment;44
7.1;4.1 Methods of CBT;44
7.2;4.2 Mechanisms of Action;65
7.3;4.3 Efficacy;67
7.4;4.4 Combination Treatments;73
7.5;4.5 Overcoming Barriers to Treatment;77
7.6;4.6 Adapting Treatment for Different Age Groups;81
7.7;4.7 Adapting Treatment for Different Cultures;83
8;5. Case Vignettes;85
8.1;Case 1: Susan’s Public Speaking Fears;85
8.2;Case 2: Jeremy’s Generalized Social Fears;88
9;6. Further Reading;92
10;7. References;93
11;8. Appendix: Tools and Resources;102

Leseproben

1.3 Epidemiology (p. 3)

SAD appears to be one of the most common psychological disorders, though prevalence rates in the literature vary across studies. For example, lifetime prevalence estimates for SAD based on large community samples in the United States range from 3 to 13% (Antony &, Swinson, 2000, Kessler et al., 2005, Somers, Goldner, Waraich, &, Hsu, 2006). One factor that may account for the variability across studies is the diagnostic instrument used to assess SAD. For example, older studies based on DSM-III criteria (e.g., Eaton, Dryman, &, Weissman, 1991), tended to assess fear in a relatively small number of social situations, compared to newer studies based on DSM-III-R (Kessler et al., 1994) or DSM-IV (Kessler et al., 2005) criteria. When a greater number of social situations are provided as prompts for individuals, prevalence rates tend to be higher. Prevalence rates also vary depending on ways in which distress and impairment are measured in SAD, the age composition of the sample, and the cultural composition of the sample (Wittchen &, Fehm, 2003).

SAD tends to begin in adolescence (i.e., mid to late teens), but can also occur earlier in childhood. In fact, significant numbers of adults report that they have had problems with social anxiety for their entire lives or as long as they can remember. A large-scale study of individuals presenting at an anxiety clinic found a mean age of onset of 15.7 years, a number that was younger than the age of onset of the other anxiety disorders (Brown, Campbell, Lehman, Grisham, &, Mancill, 2001). Studies suggest that SAD is associated with similar or related problems in childhood, including selective mutism, school refusal, separation anxiety, and shyness (Albano &, Detweiler, 2001). Since most studies employ retrospective data from adults, it is unclear whether SAD, per se, would have been diagnosed in childhood for these individuals or whether individuals believe that they had SAD in childhood because they were dealing with a host of related problems that later developed into SAD. Nevertheless, SAD is routinely diagnosed in specialty anxiety clinics for children, validating the fact that this disorder commonly begins in childhood or adolescence. Cases of SAD beginning in later adulthood are rare and may actually be social anxiety secondary to another mental disorder (e.g., social withdrawal in depression, avoidance of eating in public in an eating disorder).

Epidemiological studies suggest that SAD is slightly more common in women than in men (Fehm, Pelissolo, Furmark, &, Wittchen, 2005), though these differences appear especially small when compared to gender differences for other anxiety disorders where women are commonly overrepresented (e.g., panic disorder, specific phobias, generalized anxiety disorder). Gender differences in clinical samples are negligible, and some evidence even suggests that men may be more likely to present for treatment (Hofmann &, Barlow, 2002).