Social Anxiety Disorder (SAD)

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Social anxiety disorder (SAD) is characterised as fear of negative evaluation by others during social events leading often to impaired work, school and relationship functioning (American Psychiatric Association, 2013). Therefore Socially anxious (SA) individuals avoid most social encounters or endure them with great discomfort, during which they experience cognitive (e.g. mental blanks) and somatic (e.g. sweating) anxiety symptoms (Stein & Stein, 2008). SAD typically occurs during childhood or early adolescence (Wittchen & Fehm, 2003) and makes up roughly 7-13% of the population (Furmark, 2002). The etiology of SAD has been attributed to a variety of factors including genetics and biology, cognitive factors, adverse life events, peer relations …show more content…

One might undertake safety behaviours (e.g. drinking alcohol before a presentation) where the outcome of the feared event is positive (e.g. didn’t shake and spoke smoothly). This is problematic because SA individuals don’t learn from the occasions where positive outcomes might occur without safety behaviours. Instead they infer “I only did well because I drank alcohol”, hence impeding new learning and maintaining negative appraisals.
Furthermore, Clark & Wells (1995) suggest that once the social phobic leaves the social situation they aren’t immediately relieved from distress. The interaction is reviewed in detail and is likely to be overpowered by distorted self-perceptions and evaluated as much more negative than it really was. Therefore, SA individuals experience great distress in expectation of similar events. Treatment should focus on reversing these maintaining features of …show more content…

There is also some evidence to suggest that combining exposure therapy with cognitive restructuring (testing of beliefs) is more effective than exposure therapy alone (no testing of beliefs). For example, Clark et al. (2006) randomized patients diagnosed with SAD to Clark and Wells (1995) CBT, exposure therapy (EXP), and a waitlist condition. On self-report anxiety measures, patients in both CBT and EXP improved SA significantly more than those in the waitlist condition (both of large effect size). However, CBT resulted in significantly greater improvements than EXP. These results were held at the 1-year follow up. These results support Clark and wells (1995) claim that repeated exposure alone is not as helpful in SAD treatment as it is in combination with cognitive restructuring. Cognitive change should be the core target of treatment, which involves using exposure to test the patient’s predictions (Clark and wells, 1995). However, Kaplan et al. (2018) conclude that consistent and strong support for these results are lacking across other CBT

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