Transcript Social Phobia

Social Phobia
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“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….
Getting butterflies before you
present your disease project or
before a first date.
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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
Physical Symptoms
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Blushing
Difficulty talking
Nausea, diarrhea
Difficulty making eye contact
Profuse sweating
Trembling
Elevated blood pressure
Rapid heart rate, palpitations
Symptoms
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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
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
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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
The Fear Response
Human Reference
Striatum
BST
Stimuli
CS+
Thalamus
Medial
prefrontal
cortex
Fear Circuitry
Sensory
Cortex
CS-
Thalamus
CS+
Glutamate
Ca2+
Hypothalamus
Hippocampus
Amygdala
Sensory
cortex
Medial
Prefrontal
Cortex
Input(La)
NMDAR
Inhibitory
control
(ITC)
MAPK
CREB
Amygdala
Output (Ce)
PAG
Striatum
BST
RPC
Hippocampus
sustained
anxiety
PAG
Hypo
RPC
freezing
hormones
reflex
potentiation
Provided by Dr. Lissek
avoidance
autonomic
arousal
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
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)
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.
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
Positive Lifestyle
Changes
Regular exercise, adequate
sleep, regularly scheduled
meals
Reduce/avoid use of caffeine
and other stimulants
Reduce alcohol intake
Avoid smoking
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
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
Sources
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www.pubmed.gov
www.mayoclinic.com
www.socialanxietyinstitute.org
http://dbic.dartmouth.edu/haxby/papers/Gentili_BRB_2008.p
df
http://www.nimh.nih.gov/science-news/2008/social-phobiapatients-have-heightened-reactions-to-negativecomments.shtml
http://www.webmd.com/anxiety-panic/guide/mental-healthsocial-anxiety-disorder
http://brainblogger.com/2010/04/22/the-neurobiology-ofsocial-anxiety-disorder/
http://psycnet.apa.org/psycinfo/1998-11070-001
Helpguide.org