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1.
JAMA Netw Open ; 3(6): e206777, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32496566

RESUMO

Importance: Findings suggest that the efficacy of D-cycloserine (DCS) for enhancing exposure therapy may be strongest when administered after sessions marked by low fear at the conclusion of exposure practice. These findings have prompted investigation of DCS dosing tailored to results of exposure sessions. Objective: To compare tailored postsession DCS administration with presession DCS administration, postsession DCS administration, and placebo augmentation of exposure therapy for social anxiety disorder. Design, Setting, and Participants: This double-blind randomized clinical trial involved adults with social anxiety disorder enrolled at 3 US university centers. Symptom severity was assessed at baseline, weekly during treatment, and at 1-week and 3-month follow-up. Data analysis was performed from September 2019 to March 2020. Interventions: Participants completed a 5-session treatment and received pills commensurate with their condition assignment at sessions 2 through 5, which emphasized exposure practice. Main Outcomes and Measures: Symptom severity was evaluated by the Liebowitz Social Anxiety Scale and Social Phobic Disorders-Severity Form as administered by independent evaluators. Results: A total of 152 participants were enrolled (mean [SD] age, 29.24 [10.16] years; 84 men [55.26%]). Compared with placebo, presession and postsession conditions showed greater symptom improvement (b = -0.25; 95% CI, -0.37 to -0.13; P < .001; d = 1.07; and b = -0.20; 95% CI, -0.32 to -0.07; P = .002; d = 0.85) and lower symptom severity (b = -0.51; 95% CI, -0.81 to -0.21; P < .001; d = 0.76; and b = -0.49; 95% CI, -0.80 to -0.18; P = .002; d = 0.72) at 3-month follow-up. No differences were found between presession and postsession conditions. The tailored condition showed no advantage over placebo. Compared with the tailored condition, presession and postsession conditions evidenced greater decreases (b = -0.22; 95% CI, -0.34 to -0.10; P < .001; d = 0.94; and b = -0.17, 95% CI, -0.29 to -0.04; P = .008; d = 0.72) and lower symptom severity (b = -0.44, 95% CI, -0.73 to -0.14; P = .004; d = 0.64; and b = -0.41, 95% CI, -0.72 to -0.11; P = .008; d = 0.61) at 3-month follow-up. Conclusions and Relevance: Administration of DCS enhanced exposure therapy for social anxiety disorder when given before or after the exposure session. However, the study failed to achieve the aim to develop a tailored clinical application. Trial Registration: ClinicalTrials.gov Identifier: NCT02066792.


Assuntos
Antibióticos Antituberculose/administração & dosagem , Ciclosserina/administração & dosagem , Terapia Implosiva/métodos , Fobia Social/tratamento farmacológico , Adulto , Antibióticos Antituberculose/uso terapêutico , Estudos de Casos e Controles , Ciclosserina/uso terapêutico , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Masculino , Fobia Social/psicologia , Fobia Social/terapia , Placebos/administração & dosagem , Índice de Gravidade de Doença
2.
Cyberpsychol Behav Soc Netw ; 23(7): 495-499, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32551867

RESUMO

Social anxiety disorder (SAD) involves intense fear of being scrutinized, judged, or embarrassed in public. Virtual reality exposure therapy (VRET) is an exposure tool for SAD. Previous studies have developed computer-generated avatars and virtual environments, but this method is time-consuming and expensive. Preliminary evidence shows that 360-degree virtual reality (VR) videos with real-life situations may be an easy, relatively cheap, and effective alternative. This study aimed to develop VR videos with real-life content from a shopping situation and to evaluate participants' anxiety responses and feelings of presence. Three 360-degree VR videos were filmed in a shopping center. Nine patients with SAD and nine controls matched on gender and age participated in the study. The participants' levels of anxiety during the VR videos were assessed using the Subjective Unit of Discomfort Scale and through semistructured interviews. The SAD patients reported higher levels of presence and significantly increased anxiety levels before, during, and after the videos, whereas controls reported no symptom of anxiety. The patients found the videos authentic and recommended VRET to be integrated into the early stages of treatment before in vivo exposure. Anxiety responses can be triggered in patients with SAD by 360-degree shopping videos. Further studied are needed to investigate the potential of using 360-degree videos for VRET in anxiety disorders.


Assuntos
Medo , Fobia Social , Terapia de Exposição à Realidade Virtual , Humanos , Fobia Social/psicologia , Fobia Social/terapia , Projetos Piloto , Gravação em Vídeo
3.
J Med Internet Res ; 22(5): e16875, 2020 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-32348284

RESUMO

BACKGROUND: Social anxiety disorder is a highly prevalent and burdensome condition. Persons with social anxiety frequently avoid seeking physician support and rarely receive treatment. Social anxiety symptoms are frequently underreported and underrecognized, creating a barrier to the accurate assessment of these symptoms. Consequently, more research is needed to identify passive biomarkers of social anxiety symptom severity. Digital phenotyping, the use of passive sensor data to inform health care decisions, offers a possible method of addressing this assessment barrier. OBJECTIVE: This study aims to determine whether passive sensor data acquired from smartphone data can accurately predict social anxiety symptom severity using a publicly available dataset. METHODS: In this study, participants (n=59) completed self-report assessments of their social anxiety symptom severity, depressive symptom severity, positive affect, and negative affect. Next, participants installed an app, which passively collected data about their movement (accelerometers) and social contact (incoming and outgoing calls and texts) over 2 weeks. Afterward, these passive sensor data were used to form digital biomarkers, which were paired with machine learning models to predict participants' social anxiety symptom severity. RESULTS: The results suggested that these passive sensor data could be utilized to accurately predict participants' social anxiety symptom severity (r=0.702 between predicted and observed symptom severity) and demonstrated discriminant validity between depression, negative affect, and positive affect. CONCLUSIONS: These results suggest that smartphone sensor data may be utilized to accurately detect social anxiety symptom severity and discriminate social anxiety symptom severity from depressive symptoms, negative affect, and positive affect.


Assuntos
Biomarcadores/metabolismo , Fobia Social/psicologia , Smartphone/instrumentação , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
4.
PLoS One ; 15(4): e0232187, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348331

RESUMO

Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.


Assuntos
Personalidade , Fobia Social/psicologia , Adulto , Estudos de Casos e Controles , Análise por Conglomerados , Feminino , Humanos , Masculino , Determinação da Personalidade , Inventário de Personalidade , Fobia Social/classificação , Suécia , Adulto Jovem
5.
Proc Natl Acad Sci U S A ; 117(8): 4385-4391, 2020 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-32041879

RESUMO

Social-anxiety disorder involves a fear of embarrassing oneself in the presence of others. Taijin-kyofusho (TKS), a subtype common in East Asia, additionally includes a fear of embarrassing others. TKS individuals are hypersensitive to others' feelings and worry that their physical or behavioral defects humiliate others. To explore the underlying neurocognitive mechanisms, we compared TKS ratings with questionnaire-based empathic disposition, cognitive flexibility (set-shifting), and empathy-associated brain activity in 23 Japanese adults. During 3-tesla functional MRI, subjects watched video clips of badly singing people who expressed either authentic embarrassment (EMBAR) or hubristic pride (PRIDE). We expected the EMBAR singers to embarrass the viewers via emotion-sharing involving affective empathy (affEMP), and the PRIDE singers to embarrass via perspective-taking involving cognitive empathy (cogEMP). During affEMP (EMBAR > PRIDE), TKS scores correlated positively with dispositional affEMP (personal-distress dimension) and with amygdala activity. During cogEMP (EMBAR < PRIDE), TKS scores correlated negatively with cognitive flexibility and with activity of the posterior superior temporal sulcus/temporoparietal junction (pSTS/TPJ). Intersubject correlation analysis implied stronger involvement of the anterior insula, inferior frontal gyrus, and premotor cortex during affEMP than cogEMP and stronger involvement of the medial prefrontal cortex, posterior cingulate cortex, and pSTS/TPJ during cogEMP than affEMP. During cogEMP, the whole-brain functional connectivity was weaker the higher the TKS scores. The observed imbalance between affEMP and cogEMP, and the disruption of functional brain connectivity, likely deteriorate cognitive processing during embarrassing situations in persons who suffer from other-oriented social anxiety dominated by empathic embarrassment.


Assuntos
Fobia Social/psicologia , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Mapeamento Encefálico , Cognição , Constrangimento , Emoções , Empatia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Fobia Social/diagnóstico por imagem , Fobia Social/fisiopatologia , Adulto Jovem
6.
Behav Ther ; 51(1): 135-148, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32005331

RESUMO

Rumination is thought to play a central role in affective disorders such as social anxiety disorder (SAD). Past research indicates that rumination tends to exacerbate negative emotions and increase the risk of engaging in maladaptive coping behaviors (e.g., avoiding social activities). However, little is known on how to effectively protect against the negative outcomes of rumination. Previously, Zaki, Coifman, Rafaeli, Berenson, and Downey (2013) found that negative emotion differentiation (NED) protected against rumination and nonsuicidal self-injury in borderline personality disorder. Nevertheless, it is unclear whether this protective effect would extend to other populations and behaviors. Therefore, the present investigation sought to replicate and extend Zaki et al.'s (2013) findings in the context of SAD. In two studies, we examined if NED would moderate the positive association between rumination and frequency of social avoidance. Study 1 involved 29 individuals who met criteria for SAD with or without co-occurring major depressive episode, while Study 2 involved a nonclinical sample of 190 college students. All participants completed a measure of rumination and an experience-sampling diary which provided indices of NED and social avoidance. The results from both studies were unanimous: NED significantly moderated the relationship between rumination and social avoidance such that the positive association between rumination and social avoidance was significant for low but not moderate to high NED. Overall, the findings provide a conceptual replication of Zaki et al. (2013) and further evidence for the protective effects of NED against the maladaptive behavioral consequences of rumination across populations.


Assuntos
Adaptação Psicológica/fisiologia , Emoções/fisiologia , Fobia Social/psicologia , Fobia Social/terapia , Ruminação Cognitiva/fisiologia , Adolescente , Adulto , Medo/fisiologia , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Comportamento Social , Estudantes/psicologia , Adulto Jovem
7.
Behav Ther ; 51(1): 99-112, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32005343

RESUMO

Computerized interpretation bias modification (IBM) programs show promise for the treatment of anxiety disorders, though they have rarely been compared to active treatments. The goal of the present study was to compare the efficacy of IBM to progressive muscle relaxation (PMR) for the treatment of social anxiety disorder (SAD). Sixty-four participants with SAD were recruited from across the United States and randomly assigned to 8 internet-delivered twice-weekly sessions of IBM or PMR. Participants were administered assessments of primary symptom outcomes and interpersonal suicide risk factors at posttreatment and 3-month follow-up. IBM led to significantly lower negative interpretation bias than PMR at posttreatment but not follow-up. Both conditions experienced comparable reductions in social anxiety from pretreatment to follow-up (IBM d = 1.37, PMR d = 1.28). They also experienced significant reductions in depression and general anxiety that did not differ from one another. Additionally, IBM led to greater reductions in thwarted belongingness than PMR at posttreatment but not follow-up. Overall, these findings suggest IBM is not more effective than PMR for reducing social anxiety, though there was some evidence of its superiority in decreasing suicide risk. Limitations and directions for future research are discussed.


Assuntos
Treinamento Autógeno/métodos , Terapia Cognitivo-Comportamental/tendências , Internet/tendências , Relaxamento Muscular/fisiologia , Fobia Social/terapia , Telemedicina/tendências , Adolescente , Adulto , Terapia Cognitivo-Comportamental/métodos , Feminino , Humanos , Masculino , Motivação/fisiologia , Fobia Social/psicologia , Autorrelato , Telemedicina/métodos , Resultado do Tratamento , Adulto Jovem
8.
J Nerv Ment Dis ; 208(3): 245-251, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31929466

RESUMO

This research examined the efficacy of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of social anxiety disorder (SAD) and compared the therapeutic outcomes of ISTDP when feeling focus or defense work is emphasized. A three-group randomized design with 6-month follow-up was used. Forty-one subjects were selected among volunteer college students diagnosed with SAD. They were assigned randomly into three groups; 14 cases to feeling-focused ISTDP (FF-ISTDP) group, 14 cases to defense-focused ISTDP (DF-ISTDP) group, and 13 cases to a control group. All subjects were evaluated at pretest, posttest, and six-month follow-up through clinical interviewing using DSM-5 criteria for SAD along with the Liebowitz Social Anxiety Scale. Each experimental group had a course of 8 to 10 sessions of ISTDP treatment. Analysis of variance showed that ISTDP is an effective treatment for SAD compared with a control group. No outcome differences were found between FF-ISTDP and DF-ISTDP in treating SAD.


Assuntos
Mecanismos de Defesa , Emoções , Fobia Social/terapia , Psicoterapia Breve/métodos , Psicoterapia Psicodinâmica/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Fobia Social/psicologia , Escalas de Graduação Psiquiátrica , Resultado do Tratamento , Adulto Jovem
9.
Artigo em Alemão | MEDLINE | ID: mdl-31920179

RESUMO

Cognition in children with social anxiety disorder experiencing stress Abstract. Empirical data on cognitions of children with social anxiety disorder (SAD) are inconclusive. Objective: The present study examines the significance of cognition in children with SAD. Method: Thirty children suffering from SAD and 30 control children free of diagnosis (HC) aged between 9 and 15 years took part in an experiment. Their cognition was assessed before, during, and after a stress-inducing social situation. The assessment method was a self-report measurement. Coping perception was also assessed. Results: Children with SAD did not report a higher level of negative or coping cognition than those in the HC group. An interaction was apparent on the positive cognition scale: Older children (11-12 or 13-15 years) with SAD reported less positive cognition than those in the HC group, and younger children with SAD (9-10 years) reported more than those in the HC group. No group differences were found for perceived coping. Conclusions: The findings are important to the cognitive model and for the psychological treatment of SAD in children.


Assuntos
Cognição , Fobia Social/complicações , Fobia Social/psicologia , Estresse Psicológico/complicações , Adaptação Psicológica , Adolescente , Criança , Humanos
10.
Psychol Psychother ; 93(1): 88-104, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-30656823

RESUMO

OBJECTIVES: The general objective of this article is to study the unclear and overlapping relationship between social anxiety disorder (SAD) and avoidant personality disorder (AvPD) from an interpersonal perspective. The first specific objective is to compare the disorders with regard to interpersonal problems and general symptom distress. The second specific objective is to examine interpersonal subgroups and pathoplasticity. DESIGN: In a cross-sectional design, patients from an outpatient psychotherapy clinic diagnosed with social anxiety disorder (SAD, n = 299), avoidant personality disorder (AvPD, n = 180), or the comorbid condition of both disorders (AvPD + SAD, n = 29) were assessed before treatment. METHODS: Patients filled out the Inventory of Interpersonal Problems (IIP-64) and the Symptom Checklist-Revised (SCL-R-90) before treatment. RESULTS AND CONCLUSIONS: From an interpersonal perspective, the relationship between the diagnostic groups is well described by the severity continuum hypothesis, with similar interpersonal problems related to Nonassertiveness and lower levels of general interpersonal stress in the SAD group compared to the two AvPD groups. However, other differences in severity do not fit the severity continuum hypothesis, as there are no differences in severity on the global severity index, and, moreover, the SAD group has the most severe problems on the SCL-90 phobic anxiety scale. Interpersonal pathoplasticity is not found in the diagnostic groups or in the full sample. However, three interpersonal subgroups are identified in the full sample, designated as Nonassertive, Friendly-submissive, and Cold-submissive. Implications for treatment are discussed. PRACTITIONER POINTS: SAD is characterized by a lower level of interpersonal distress compared to AvPD, but the two disorders are similar in having Nonassertiveness as their general interpersonal problem. Contrary to expectation, SAD and AvPD did not differ in general level of symptom severity, and patients with SAD reported more problems with phobic anxiety than AvPD patients did. When understanding SAD and AvPD as different conceptualizations of the same disorder and analysing all patients together, three distinct interpersonal subgroups emerge, which can be identified as Nonassertive, Friendly-submissive, and Cold-submissive.


Assuntos
Ansiedade/psicologia , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Fobia Social/diagnóstico , Fobia Social/psicologia , Adulto , Estudos Transversais , Dinamarca , Medo/psicologia , Feminino , Humanos , Masculino , Apego ao Objeto , Escalas de Graduação Psiquiátrica , Adulto Jovem
11.
Perspect Psychiatr Care ; 56(2): 280-289, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31353477

RESUMO

PURPOSE: To describe the generation and validation of the Lebanese fear of relationship commitment scale (LFRC) and factors associated with FRC in a representative sample of the Lebanese population. DESIGN AND METHODS: This cross-sectional study, conducted between January and May 2018, enrolled 568 single community dwelling participants. RESULTS: The scale items converged over a solution of four factors, explaining 50.46% of the variance (Cronbach's α = 0.789). Higher social phobia (ß = 0.073) and higher general trust score (ß = 0.393) were associated with higher FRC, whereas higher self-esteem (ß = -0.275) was associated with lower FRC. PRACTICE IMPLICATIONS: The LFRC-17 is a valid and reliable measure of fear of relationship commitment and a highly efficient tool both for research and clinical practice. It gathers social, physical, and psychological aspects related to gamophobia.


Assuntos
Medo/psicologia , Casamento/psicologia , Fobia Social/psicologia , Autoimagem , Confiança/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Líbano , Modelos Lineares , Masculino , Modelos Psicológicos , Análise Multivariada , Amostragem , Inquéritos e Questionários , Adulto Jovem
12.
J Ment Health ; 29(1): 84-91, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30741047

RESUMO

Background and aims: There is evidence to suggest that biogenetic explanations for symptoms of mental disorders have become increasingly popular. Research suggests that such explanations provokes mixed blessings: biological explanations may reduce blame but also encourage prognostic pessimism and promote perceptions of pharmacological treatment over psychotherapy. The goal of this study was to evaluate the impact of different causal explanations on social anxiety disorder.Method: About 205 adults completed an experiment where they read a vignette describing an individual with social anxiety disorder and were randomly assigned to a symptom explanation that was: (1) biological, (2) biopsychosocial, (3) psychosocial, or (4) no explanation.Results: The psychosocial condition yielded the highest perceived credibility and lowest attributions of blame. The biological condition promoted positive expectations for medication effectiveness compared to other conditions. Conditions did not differ on prognostic expectations.Conclusions: Calls attention to the risk of generalizing from previous research to mental disorders as a whole.


Assuntos
Fobia Social/psicologia , Fobia Social/terapia , Estigma Social , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Psicoterapia
13.
J Consult Clin Psychol ; 88(1): 82-89, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31682137

RESUMO

OBJECTIVE: Data from the EVIDENT trial were reanalyzed to examine whether specific anxiety-related comorbidities moderate the effect of an Internet intervention on depression outcome. METHOD: The EVIDENT study is a randomized controlled trial that included N = 1,013 participants with mild to moderate depressive symptoms (i.e., scores between 5 and 14 on the Patient Health Questionnaire-9 [PHQ-9]) who were randomized to a control group with access to care-as-usual (n = 504) or to an intervention group, which accessed the Internet intervention Deprexis adjunctively to care-as-usual (n = 509). Anxiety-related comorbidities (generalized anxiety disorder, social phobia, panic disorder, agoraphobia, panic disorder with agoraphobia, specific phobia, posttraumatic stress disorder, obsessive-compulsive disorder) were assessed with the Web Screening Questionnaire at baseline. Multilevel models were performed. RESULTS: Twelve potential moderators (8 specific anxiety-related comorbidities, depression severity, and 3 previously identified moderators in the EVIDENT trial) were examined within 1 multilevel model, and only social phobia moderated the intervention effect on depression outcome (in favor of Deprexis). This moderating effect of social phobia did not depend on the other moderators' being included in the model. These results emerged for continuous PHQ-9 scores as well as for clinically important PHQ-9 changes as outcome (p < .05). However, moderating effects did not reach small effect sizes, accounted for less than 1% of the variance in change in depressive symptoms, and showed limited reproducibility in randomly selected split halves. CONCLUSIONS: Deprexis appears to be most effective for participants with mild to moderate depressive symptoms and comorbid social phobia, but further replications of this finding are necessary. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Fobia Social/psicologia , Adolescente , Adulto , Idoso , Transtorno Depressivo/complicações , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Fobia Social/complicações , Reprodutibilidade dos Testes , Adulto Jovem
14.
J Abnorm Psychol ; 129(1): 108-113, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31697138

RESUMO

Social anxiety interferes with accurate perceptions of others' thoughts and intentions, yet studies examining the association between social anxiety and social cognition have resulted in mixed findings. We examined the association between dimensional levels of social anxiety and assessments of lower- and higher-level social cognition. In Study 1 (n = 1485), we found that social anxiety was negatively related to accuracy in an assessment of higher-level social cognition (i.e., theory of mind) across all stimuli. However, no consistent association was found between social anxiety and accuracy in an assessment of lower-level social cognition (i.e., emotion recognition). In Study 2 (n = 363), we found that social anxiety was negatively associated with another higher-level form of social cognition, empathic accuracy, for positive but not negative stimuli. These findings demonstrate that social anxiety is negatively associated with higher-level social cognition but not lower-level social cognition, and this association appears to be more consistent for positive stimuli. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Ansiedade/psicologia , Empatia/fisiologia , Fobia Social/psicologia , Percepção Social , Teoria da Mente/fisiologia , Adolescente , Adulto , Idoso , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Comportamento Social , Adulto Jovem
15.
J Abnorm Psychol ; 129(1): 82-91, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31697140

RESUMO

As proposed in a prominent developmental model, social anxiety has different manifestations: social fear, shy temperament, anxious cognitions, and avoidance of social situations. Drawing from this model, we used the network approach to psychopathology to gain a detailed understanding of specific social anxiety components and their associations. The current article investigated (a) how social anxiety components are interconnected within a network, and (b) the consistency of the network over time, in a community sample of children and adolescents. Data from 3 waves of a longitudinal study were used. At Time 1 (T1) the total sample comprised 331 participants (Mage = 13.34 years); at Time 3 (T3) there were 236 participants (Mage = 17.48 years). Social anxiety components were assessed with self-report questionnaires. Networks of 15 nodes (i.e., components) were estimated. Network analysis of T1 components revealed 4 communities: cognitive, social-emotional, avoidance of performance, and avoidance of interaction situations. There were no direct connections between the cognitive and behavioral communities; social-emotional nodes appeared to act as bridge components between the 2 communities. A similar pattern of component associations and communities was found in the T2 and T3 networks, and the longitudinal network incorporating node change trajectories. Networks were estimated on group-level observational data and conclusions about cause-effect relationships are tentative. Although the sample size decreased across the 3 waves, the reliability of parameter estimates were minimally affected. Findings attest to the potential value of applying the network approach to investigate the pattern of associations among social anxiety components in youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Ansiedade/psicologia , Medo/psicologia , Fobia Social/psicologia , Comportamento Social , Temperamento , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Reprodutibilidade dos Testes , Autorrelato , Adulto Jovem
16.
Behav Cogn Psychother ; 48(2): 172-184, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31647048

RESUMO

BACKGROUND: Previous studies have indicated that people with social anxiety disorder (SAD) often experience spontaneous, recurrent images (SRI). It was assumed that Koreans with interdependent self-views may contain more features related to social contexts in their self-images than those reported in Western cultures. AIMS: In the present study, we aimed to explore the prevalence and content of SRIs in individuals with SAD in Korea. Furthermore, we investigated the relationship between features of SRIs and variables of SAD. METHOD: Sixty-four individuals with SAD (27.00 ± 7.42 years, 64.1% female), diagnosed with SAD, completed self-report questionnaires related to social anxiety. Afterwards, a semi-structured interview was used to assess features and content of the individuals' SRI. RESULTS: Thirty (47%) of the participants reported experiencing SRIs in social situations. The content of the SRIs were classified under three themes: negative self-images, negative images of others, and abstract images. The distress level of SRIs was positively associated with social phobia scales (r = .385, p < .05) and physical anxiety symptoms (r = .478, p < .05). Frequency of SRIs was positively associated with avoidance scores (r = .402, p < .05). CONCLUSIONS: The results demonstrated differences in the prevalence and content of the SRIs between Western and non-Western cultures. Fewer individuals with SAD in Korea reported having SRIs, and the content of these SRIs involved people other than the self. Some features of SRIs were associated with variables of SAD.


Assuntos
Imaginação , Fobia Social/epidemiologia , Fobia Social/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Medo , Feminino , Humanos , Masculino , Prevalência , República da Coreia/epidemiologia , Autoimagem , Inquéritos e Questionários
17.
J Autism Dev Disord ; 50(3): 730-740, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31729598

RESUMO

This study examined differences in generalized and social anxiety symptoms across two age groups of children with autism spectrum disorder (ASD) while accounting for overall anxiety level, gender, and intellectual functioning. Older children (12-18 years) expressed more overall and social anxiety symptoms than younger children (6-11 years), and social anxiety symptoms were predominant in the older group. Younger children expressed more generalized anxiety symptoms than the older youth, and there was a trend for generalized anxiety symptoms to be more dominant in the younger group. Findings are consistent with theory of differential expression of specific anxiety symptoms across different ages seen with typically developing children, yet social evaluative concerns may be even stronger for adolescents with ASD.


Assuntos
Desenvolvimento do Adolescente , Transtorno do Espectro Autista/diagnóstico , Desenvolvimento Infantil , Fobia Social/diagnóstico , Adolescente , Transtorno do Espectro Autista/psicologia , Criança , Feminino , Humanos , Masculino , Fobia Social/psicologia
18.
Trials ; 20(1): 757, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864383

RESUMO

BACKGROUND: Social anxiety disorder (SAD) is a common disorder in adolescence associated with extensive distress and long-term impairment. Generic cognitive behavior therapy (CBT) programs for anxiety disorders have shown poorer outcomes for adolescents with SAD than for other anxiety disorders. AIM: The aim of the present study is to investigate the efficacy of a disorder-specific group cognitive behavior therapy (G-CBT) program for youth SAD, the Cool Kids Anxiety Program - Social Enhanced (CK-E), developed at Macquarie University, Sidney, Australia. METHODS: The study is a randomized controlled trial comparing CK-E to a generic G-CBT program for anxiety disorders. Approximately 96 adolescents aged 12 to 17 years are included with data points at pre- and post-treatment, and at 3 months and 1 year follow-ups. DISCUSSION: The current study will provide more information about the efficacy of diagnosis-specific G-CBT treatment for youth SAD. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03986827. Registered on 14 June 2019.


Assuntos
Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Fobia Social/terapia , Psicoterapia de Grupo/métodos , Adolescente , Transtornos de Ansiedade/psicologia , Austrália/epidemiologia , Criança , Seguimentos , Humanos , Fobia Social/psicologia , Resultado do Tratamento
19.
Trials ; 20(1): 748, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856903

RESUMO

BACKGROUND: While the efficacy of cognitive therapy (CT) has been well established for social anxiety disorder (SAD) in several randomized controlled trials, there are still large differences between trials with respect to effect sizes. The present study investigates the question of whether enhanced training and the use of behavioral experiments (BEs) increases the efficacy of traditional CT, based on verbal methods of cognitive restructuring. METHODS/DESIGN: A mixed within/between conditions design will be applied, with therapists and patients being randomly allocated to one of two conditions: (1) training of CT plus BEs, (2) training of CT "as usual". Sixty patients with the primary diagnosis of SAD will be recruited and treated in the outpatient clinic of the Department of Psychology, University of Frankfurt. To ensure adherence to therapist protocols, all therapists will be trained and supervised by the project coordinators. In addition, videotaped treatment sessions will be independently evaluated to guarantee both adherence to protocols and the quality of the intervention. Treatment effects will be assessed by independent SAD symptom ratings using the Liebowitz Social Anxiety Scale as the primary outcome measure and self-report measures as secondary outcome measures. DISCUSSION: The present cognitive behavioral therapy (CBT) trial will be the first to clarify the contribution of BEs to the efficacy of CT in a randomized controlled design. Study results are relevant to clinical training and implementation of evidence-based treatments. TRIAL REGISTRATION: German Clinical Trials Register International Clinical Trials Registry Platform (ICTRP) identifier: DRKS00014349. Trial status: recruiting.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Fobia Social/terapia , Adolescente , Adulto , Idoso , Ensaios Clínicos Fase IV como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fobia Social/diagnóstico , Fobia Social/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Autorrelato , Resultado do Tratamento , Adulto Jovem
20.
BMC Psychiatry ; 19(1): 418, 2019 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-31882002

RESUMO

BACKGROUND: Childhood adversities, especially emotional abuse, emotional neglect, and peer victimization are considered to be crucial risk factors for social anxiety disorder (SAD). We investigated whether particular forms of retrospectively recalled childhood adversities are specifically associated with SAD in adulthood or whether we find similar links in other anxiety or depressive disorders. METHODS: Prevalences of adversities assessed with the Childhood Trauma Questionnaire (CTQ) and a questionnaire of stressful social experiences (FBS) were determined in N = 1091 outpatients. Adversity severities among patients with SAD only (n = 25), specific phobia only (n = 18), and generalized anxiety disorder only (n = 19) were compared. Differences between patients with anxiety disorders only (n = 62) and depressive disorders only (n = 239) as well as between SAD with comorbid depressive disorders (n = 143) and SAD only were tested. RESULTS: None of the adversity types were found to be specifically associated with SAD and severities did not differ among anxiety disorders but patients with depressive disorders reported more severe emotional abuse, physical abuse, and sexual abuse than patients with anxiety disorders. SAD patients with a comorbid depressive disorder also reported more severe adversities across all types compared to SAD only. CONCLUSION: Findings indicate that particular forms of recalled childhood adversities are not specifically associated with SAD in adulthood. Previously established links with SAD may be better explained by comorbid depressive symptoms.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Bullying/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Grupo Associado , Fobia Social/epidemiologia , Fobia Social/psicologia , Adolescente , Adulto , Transtornos de Ansiedade/psicologia , Comorbidade , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
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