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Social Phobia “Characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.”

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Presentation on theme: "Social Phobia “Characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.”"— Presentation transcript:

1 Social Phobia “Characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.”

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

3 Prevalence Fmost common anxiety disorder Fthird most common mental disorder in the U.S., after depression and alcohol dependence. FAn estimated 19.2 million Americans have social anxiety disorder. Fmost often surfaces in adolescence Fmost common anxiety disorder Fthird most common mental disorder in the U.S., after depression and alcohol dependence. FAn estimated 19.2 million Americans have social anxiety disorder. Fmost often surfaces in adolescence

4 Physical Symptoms FBlushing FDifficulty talking FNausea, diarrhea FDifficulty making eye contact FProfuse sweating FTrembling FElevated blood pressure FRapid heart rate, palpitations FBlushing FDifficulty talking FNausea, diarrhea FDifficulty making eye contact FProfuse sweating FTrembling FElevated blood pressure FRapid heart rate, palpitations

5 Symptoms FCan be situation specific or someone may experience symptoms anytime they are around people FLow self esteem Ffear doing things that will embarrass them Fworry for days or weeks before a dreaded situation FCan be situation specific or someone may experience symptoms anytime they are around people FLow self esteem Ffear doing things that will embarrass them Fworry for days or weeks before a dreaded situation

6 Life with Social Phobia Fhigh risk for alcohol or other drug dependence FLoneliness FLeads to depression/learned helplessness FCommon fears include: FAttending parties, FMeeting new people, FSpeaking in public, FUsing public restrooms, FEating, drinking and writing in public Fhigh risk for alcohol or other drug dependence FLoneliness FLeads to depression/learned helplessness FCommon fears include: FAttending parties, FMeeting new people, FSpeaking in public, FUsing public restrooms, FEating, drinking and writing in public

7 Risk Factors FLife experiences and events Fbullying FShyness FIncreased stress FMay be associated with overprotective parents or limited social opportunities FGenetics (10x) FIncreasing among white, married, educated FLife experiences and events Fbullying FShyness FIncreased stress FMay be associated with overprotective parents or limited social opportunities FGenetics (10x) FIncreasing among white, married, educated

8 Amygdala The Fear Response Hippocampus Presented stimulus CS+ ( memory-trace) & (Hipp to ACC connection via parahippocampal cortex to ACC or by way of a posterior cingulated-ACC connection (Musil & Olson, 1988) (schematic matching) Sensory Cortex CS- GS 3 Fear- Inhibition vmPFC pattern completion (CA3) CS+ GS 1 GS 2 CS+ CS- CS+ GS 3 CS+ V pattern separation (DG) Low High CS+ Input(La) Output (Ce) Glutamate Hypo Inhibitory control (ITC) Stimuli CS+ freezing reflex potentiation autonomic arousal hormones sustained anxiety RPC PAG BST Fear Circuitry Threat avoidance Striatum Medial prefrontal cortex Amygdala Hypothalamus Hippocampus BST Thalamus Sensory cortex Human Reference PAG Striatum RPC neutral Which nodes in this system are th locasd of pathology will depend on what conditiining oprcesses are abnormal. Ca 2+ MAPK CREBNMDAR Fear Process: 1)Unconditioned threat 2)Acquisition 3)Extinction 4)Generalization FUnconditioned fear FConditioned fear F = conditioned danger cue F = unconditioned stimulus FExtinction FDiscrimination and generalization F= conditioned safety cue Medial Prefrontal Cortex Thalamus Hippocampus Provided by Dr. Lissek

9 Current research Fsensitivity to carbon dioxide, cholecystokinin, and caffeine Feffectiveness of selective serotonin reuptake inhibitors- why? FReduced striatal dopamine and uptake FReduced GABA Fadrenergic abnormalities Fsensitivity to carbon dioxide, cholecystokinin, and caffeine Feffectiveness of selective serotonin reuptake inhibitors- why? FReduced striatal dopamine and uptake FReduced GABA Fadrenergic abnormalities

10 Gentili et.al. FIncreased activity in parts of brain when exposed to faces expressing various emotions (including neutral): FEvaluation of intentions, personality traits of others, expression, emotional responses, social evaluation of others (hypervigilance) FDecrease in areas for attention and processing identity (avoidant) FIncreased activity in parts of brain when exposed to faces expressing various emotions (including neutral): FEvaluation of intentions, personality traits of others, expression, emotional responses, social evaluation of others (hypervigilance) FDecrease in areas for attention and processing identity (avoidant)

11 NIMH Study FHeightened responses to negative comments in two brain areas: Fthe medial prefrontal cortex (MPFC), is involved in the sense and evaluation of self; Fthe amygdala, is central to emotional processing. FHeightened responses to negative comments in two brain areas: Fthe medial prefrontal cortex (MPFC), is involved in the sense and evaluation of self; Fthe amygdala, is central to emotional processing.

12 Classroom implications FCreate a safe climate FIf a student is experiencing a fear response they are learning, but not what you want them to be FSkipping school FCreate a safe climate FIf a student is experiencing a fear response they are learning, but not what you want them to be FSkipping school

13 Positive Lifestyle Changes FRegular exercise, adequate sleep, regularly scheduled meals FReduce/avoid use of caffeine and other stimulants FReduce alcohol intake FAvoid smoking FRegular exercise, adequate sleep, regularly scheduled meals FReduce/avoid use of caffeine and other stimulants FReduce alcohol intake FAvoid smoking

14 Cognitive Behavioral Therapy FBased on the idea that our thoughts control our feelings and behaviors FControl physical symptoms with: FRelaxation and breathing techniques FReplacing negative thoughts with more balanced thoughts FFacing social situations that you fear in a gradual, systematic way F Building relationships by improving communication and taking initiative FBased on the idea that our thoughts control our feelings and behaviors FControl physical symptoms with: FRelaxation and breathing techniques FReplacing negative thoughts with more balanced thoughts FFacing social situations that you fear in a gradual, systematic way F 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  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 Fwww.pubmed.govwww.pubmed.gov Fwww.mayoclinic.comwww.mayoclinic.com Fwww.socialanxietyinstitute.orgwww.socialanxietyinstitute.org Fhttp://dbic.dartmouth.edu/haxby/papers/Gentili_BRB_2008.p dfhttp://dbic.dartmouth.edu/haxby/papers/Gentili_BRB_2008.p df Fhttp://www.nimh.nih.gov/science-news/2008/social-phobia- patients-have-heightened-reactions-to-negative- comments.shtmlhttp://www.nimh.nih.gov/science-news/2008/social-phobia- patients-have-heightened-reactions-to-negative- comments.shtml Fhttp://www.webmd.com/anxiety-panic/guide/mental-health- social-anxiety-disorderhttp://www.webmd.com/anxiety-panic/guide/mental-health- social-anxiety-disorder Fhttp://brainblogger.com/2010/04/22/the-neurobiology-of- social-anxiety-disorder/http://brainblogger.com/2010/04/22/the-neurobiology-of- social-anxiety-disorder/ Fhttp://psycnet.apa.org/psycinfo/ http://psycnet.apa.org/psycinfo/ FHelpguide.org Fwww.pubmed.govwww.pubmed.gov Fwww.mayoclinic.comwww.mayoclinic.com Fwww.socialanxietyinstitute.orgwww.socialanxietyinstitute.org Fhttp://dbic.dartmouth.edu/haxby/papers/Gentili_BRB_2008.p dfhttp://dbic.dartmouth.edu/haxby/papers/Gentili_BRB_2008.p df Fhttp://www.nimh.nih.gov/science-news/2008/social-phobia- patients-have-heightened-reactions-to-negative- comments.shtmlhttp://www.nimh.nih.gov/science-news/2008/social-phobia- patients-have-heightened-reactions-to-negative- comments.shtml Fhttp://www.webmd.com/anxiety-panic/guide/mental-health- social-anxiety-disorderhttp://www.webmd.com/anxiety-panic/guide/mental-health- social-anxiety-disorder Fhttp://brainblogger.com/2010/04/22/the-neurobiology-of- social-anxiety-disorder/http://brainblogger.com/2010/04/22/the-neurobiology-of- social-anxiety-disorder/ Fhttp://psycnet.apa.org/psycinfo/ http://psycnet.apa.org/psycinfo/ FHelpguide.org


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