Introduction
A person suffering from a social anxiety disorder (SAD), commonly called social phobia, is diagnosed with a mental disease defined by an extreme and persistent fear of social settings. The individual may feel judged, assessed, or humiliated. Individuals who suffer from SAD may try to avoid or flee social settings, which can cause severe emotional suffering and functional impairment in their day-to-day lives (Koyuncu et al., 2019). This research paper examines the behaviors related to SAD and the influence that such activities have on people.
Behaviors and Symptoms Related to SAD
Hector has SAD-like signs like those listed below: They first show signs of social anxiety or worry when confronted with circumstances where they are likely to be the center of attention and may be ridiculed or condemned. People with social anxiety avoid or suffer during interactions with others (Birk et al., 2019). Anxiety or fear that is overwhelming, chronic, and severely impairs his everyday life, making it hard for him to work, study, or interact socially (Nordgreen et al., 2018). Physical symptoms such as flushing, sweating, shaking, palpitations, and so on may be signs of social anxiety and feelings of humiliation or shame.
Anxiety and avoidance are reinforced by their fixation on possible negative judgment or results, such as rejection, criticism, or mockery. For example, Hector does not go to career fairs or networking events because he dislikes conversing with strangers. They avoid social situations where they could feel awkward, such as parties and restaurants, unless trusted friends or family members accompany them. They are anxious, uncomfortable, and self-conscious during social gatherings; therefore, they refuse invites or depart early. They often worry about what others will think of them and spend time preplanning or writing down what they want to say or do.
These symptoms are associated with social anxiety disorder, as described in DSM-5. Anxiety or worry that lasts for at least six months in response to being in one or more social settings when one is at risk of being judged by others. There is no medical cause for the fear or anxiety, and it is not attributable to drug abuse or another mental disease such as OCD, PTSD, or schizophrenia. It is bad enough that many avoid going to work, school, or social events because of how much it affects them emotionally or how difficult it is for them to function normally (Gros et al., 2015). No other mental condition, such as Asperger’s syndrome, bipolar disorder, or borderline personality disorder, more adequately describes the individual’s symptoms.
Physical feelings such as blushing, sweating, shaking, nausea, or diarrhea, and mental emotions such as concern, negative self-talk, or the expectation of damage are all possible. The symptoms can be more severe or infrequent in specific social contexts, such as during public performance or interpersonal engagement. Depending on the nature and extent of the anxiety, the illness may be classified as either Generalized or Performance Only. Depending on the prevalence and severity of additional symptoms, the illness may be further specified as being linked with Panic Attacks, Agoraphobia, or Selective Mutism.
Comorbid illnesses, such as substance abuse, depression, or other anxiety disorders, might make diagnosis and treatment more difficult (Koyuncu et al., 2019). Hector exhibits some of these signs but not all of them. Over at least six months, they have shown persistent fear or anxiety in several social contexts. They do not suffer from panic episodes, agoraphobia, or selective mutism, and their physical symptoms are less frequent. Generalized anxiety or negative self-talk may be present, although they are not the most prominent symptoms.
Hector’s symptoms fit those of Generalized Social Anxiety Disorder, which includes worry about interacting with others in general, rather than the Performance-Only subtype, which is focused on concern about performing in front of an audience. Further evaluation and therapy may be necessary for Hector’s likely co-occurring problems, which include depression, given his poor mood and lack of pleasure, and perfectionism, given his rehearsing and ruminating activities.
Causes for This Disorder
Hector, age 14, suffers from social anxiety that has negatively impacted his schoolwork. From what people can see, Hector grew up in a loving home with his mom, dad, brother, and sister. Hector’s struggles in school and social anxiety stem from a horrific event they had as a youngster. Because they fear being assessed poorly, they also have problems communicating effectively with customers and coworkers. Hector’s condition arose because they internalized stigmas and judgments about their worth, reinforced by their surroundings. They have been through a lot of pain because of their social anxiety, which shows in their grades and general happiness.
Hector is from a suburban, middle-class household. His parents worked hard but were not well-educated, so they frequently went hungry. Hector was the eldest of their three siblings, and their younger brother and sister also exhibited sociability and the ability to make friends quickly. Hector was an introverted and withdrawn youngster who frequently felt left out of their siblings’ playgroups. Hector, meanwhile, was raised in a household where they always felt safe and loved.
When Hector was eight, his family was engaged in a road accident that forever altered their lives. Hector’s body was hurt in the collision, but the psychological damage was far worse. Hector’s helplessness and fear caused them to lose faith in their abilities. They were terrified to leave the house when Hector was in the treatment center. Thus, SAD developed as the fear became more persistent.
Hector’s phobia of interacting with new people stems from a severe road accident they encountered when they were eight. The person’s surroundings reinforced their already-held negative self-beliefs after the road crash, causing them to acquire social anxiety disorder. One-third of the risk of developing the illness may be attributable to hereditary factors (Birk et al., 2019).
As a youngster, Hector may have been predisposed to social anxiety due to his shyness and avoidance. The fact that both of Hector’s parents also suffer from anxiety suggests a hereditary component to his condition. Hector’s familial history may have made him more prone to anxiety problems. Hector’s younger siblings may also influence them.
Hector’s social anxiety might be exacerbated by thoughts that they are less extroverted than their siblings. Hector’s view of the world’s unpredictability may have been influenced by how their disability altered their personality. Hector’s negative thinking patterns are a frequent symptom of social anxiety, and they may have developed partly because of his perception that the world is unpredictable. Hector’s development of social anxiety disorder may have resulted from their persistent worry that they would be negatively evaluated by others in social settings (Brown & Naragon-Gainey, 2013). They may have suffered from a more severe case of social anxiety because of the stress of pitching in at home and worrying about how others would see them.
Evaluation of the unique and specific contributions of dimensions of the triple vulnerability model to the prediction of DSM-IV anxiety and mood disorder constructs. (Brown & Naragon-Gainey, 2013). The study conducted by Brown and Naragon-Gainey (2013) attempted to investigate the distinct and particular contributions of the dimensions of the triple vulnerability model to the prediction of anxiety and mood disorder components based on the DSM-IV.
The triple vulnerability model has three dimensions: The first kind of vulnerability is known as Generalized Biological Vulnerability (GBV), the second type is known as Generalized Psychological Vulnerability (GPV), and the third type is known as Particular Psychological Vulnerability (SPV). A hereditary or constitutional predisposition to anxiety and mood disorders is called GBV. The general propensity to feel unpleasant emotions or arousal is referred to as GPV, and the particular beliefs or cognitions related to anxiety or mood disorders are referred to as SPV.
The research involved 700 undergraduate students who had experienced at least one traumatic incident. Participants completed self-report questionnaires, participated in clinical interviews, and took physiological measurements. The study methodology used a cross-sectional approach. According to the findings, GPV had a significant association with all the anxiety and mood disorder components, but GBV had a considerable association solely with depression. There was no significant association between SPV and generalized anxiety disorder; however, there was a significant association with social anxiety disorder, panic disorder, and depression.
The research results indicate that the GPV component of the triple vulnerability model is connected with anxiety and mood disorders to a greater extent than the GBV or SPV dimensions. The authors hypothesize that therapies focusing on GPV may be more successful in treating various anxiety and mood disorders than programs concentrating mainly on GBV or SPV. The fact that this research was carried out with a sample of undergraduate students who had a previous experience with traumatic events, however, is a crucial point to keep in mind since it may restrict the generalizability of the results.
The paper by Birk et al. (2019) explores the role of fear of positive and negative assessment in social anxiety disorder and the brain reactions to social evaluation. Fifty-six people participated in the research; 35 suffered from a social anxiety disorder, while the remaining 21 did not. All of the people in this study had experienced at least one traumatic incident, ranging in age from 21 to 53.
Researchers utilized fMRI scans to examine how the brain reacted to social judgment tasks. Participants completed activities within the scanner that their peers rated as either excellent or negative. The individuals also completed the Fear of Positive Evaluation Scale (FPES) and Fear of Negative Evaluation Scale (FNES) self-report questionnaires.
Independent samples t-tests were employed to examine the study’s cross-sectional data. The anterior cingulate cortex (ACC) and insula exhibited increased activity in people with social anxiety disorder responding to an unfavorable social appraisal than those without social anxiety. Additionally, there was a positive correlation between the apprehension of a favorable review and activity in the anterior cingulate cortex and the insula and the suspicion of a negative evaluation and activity in the amygdala.
Overall, the research sheds light on the function that worries about being judged favorably or unfavorably plays in social anxiety disorder. Positive social evaluation aversion may also play a role in social anxiety disorder, as shown by the increased activity in brain areas linked with positive social assessment in patients with social anxiety disorder. Two of the study’s most vital points are that fMRI was used and that clinical and non-clinical samples were included. Unfortunately, due to its small sample size and cross-sectional methodology, the research cannot draw any firm conclusions regarding causation or the direction of effects.
Cognitive Behavioral Therapy Treatment
Cognitive behavioral therapy (CBT) is quite beneficial for those suffering from SAD. It is a psychotherapy that targets the interconnections among one’s thoughts, feelings, and actions (Nordgreen et al., 2018). This approach teaches people how to recognize unhelpful thinking patterns so that they may substitute more constructive ones.
CBT is generally delivered in sessions between 12 and 20 and follows a predetermined schedule (Kodal et al., 2018). During therapy, the therapist helps the patient see distorted ways of thinking, called cognitive distortions, that hold them back. All-or-nothing thinking, overgeneralization, catastrophizing, and over-individualization are all examples of cognitive distortions.
The therapist and patient then work together to replace these unhelpful thinking methods with more constructive ones. The ultimate objective is to change dysfunctional ways of thinking into healthier, more productive ones. In the behavioral part of CBT, the therapist helps the patient pinpoint particular actions that may trigger or exacerbate their mental health problems. This might include learning to recognize and avoid circumstances that tend to bring on undesirable emotions and activities, or it could entail learning to cope with these emotions and actions when they occur (Gros et al., 2015). CBT’s efficacy in treating various mental health problems, such as anxiety disorders, depression, PTSD, and eating disorders, is well-established. It is typically combined with additional therapies like medicine or group therapy to treat mental health problems thoroughly.
CBT for social anxiety disorder uses various therapies. Exposure therapy is one kind of cognitive behavioral therapy used to help people with anxiety by progressively exposing them to things they fear. The therapist provides a safe space in which this may occur. The patient develops skills for overcoming their anxieties head-on (Gros et al., 2015). The second method, cognitive restructuring, recognizes and alters unhelpful ways of thinking about interpersonal interactions.
CBT aims to help patients see and question their erroneous ideas, replacing them with more sensible ones (Kodal et al., 2018). Social skills training helps patients improve their communication and social abilities via social skills training. They gain mastery in socialization, emotional regulation, and relationship formation (Nordgreen et al., 2018). Relaxation methods, such as deep breathing, meditation, and progressive muscle relaxation, are taught to patients to alleviate the physical manifestations of anxiety.
Overall, cognitive behavioral therapy is highly effective and evidence-based for treating a wide variety of mental health conditions. In particular, it is an effective therapy for seasonal affective disorder, with trials showing a 50-75% reduction in symptoms. (Koyuncu et al., 2019). Patients may require further therapy sessions after a few weeks/months of treatment to sustain their gains. Social anxiety is treatable, and people who put in the effort may go on to live productive lives.
The purpose of the research carried out by Gros et al. (2015) was to determine if CBT is helpful in treating SAD. The sample consisted of 123 persons over 18 diagnosed with SAD and treated with CBT. The participants’ ages varied from 18 to 62, and the majority of the sample was composed of females (51.7%).
The Multidimensional Assessment of Social Anxiety (MASA) and other psychometric measures were employed in the research to evaluate the intensity of symptoms before and after the CBT session. These approaches were utilized to compare the results of the two periods. Evaluation of the participants’ symptoms before and after receiving therapy formed the basis of the study design. Cognitive behavioral therapy consists of 12 weekly sessions, primarily aimed at recognizing and altering negative thinking patterns and behaviors associated with social anxiety.
The research findings demonstrated that cognitive behavioral therapy reduced the intensity of symptoms associated with SAD. After the intervention, those who received CBT therapy had substantially lower scores on the MASA and other psychometric measures, suggesting decreased anxiety levels and enhanced social functioning. This research demonstrates the efficacy of CBT in treating SAD. It shows the need to apply psychometric measures to assess treatment results.
The purpose of the study by Kodal et al. (2018), which focused on social anxiety disorder, was to determine whether or not CBT had any lasting effects on young patients. The study included 179 young people between the ages of 11 and 21 who were treated for anxiety disorders in community clinics with cognitive behavioral therapy. The sample included people from different racial and socioeconomic backgrounds.
Assessments were repeated 6 and 12 months after treatment ended, making this a longitudinal trial. The clinical Global Impression-Improvement Scale (CGI-I), Multidimensional Anxiety Scale for Children (MASC), and Child Behavior Checklist (CBCL). were used to assess the efficacy of CBT. Variables such as age, gender, symptom intensity, comorbid disorders, and family functioning were also investigated as possible predictors of treatment results.
Significant improvements were seen at the 6- and 12-month follow-ups, suggesting that CBT therapy for SAD in young people is efficacious. The study also found that age, co-occurring conditions, and family functioning were all significant predictors of long-term outcomes. In particular, more vital family functioning was mainly linked to better treatment results, whereas increasing age and the prevalence of comorbid diseases were related to worse outcomes.
Ultimately, the research gives credibility to using CBT to treat anxiety disorders in young people, notably SAD. Moreover, the results emphasize the significance of individual and environmental variables that may impact treatment outcomes when planning and implementing treatments for teenage anxiety disorders.
Conclusion
SAD is a typical kind of mental disease that impacts a significant number of people all over the globe. The behaviors linked with SAD may substantially influence an individual’s life, leading to avoidance, self-consciousness, physical symptoms, drug misuse, and procrastination, among other undesirable outcomes. If one or someone people know exhibits any of these behaviors, it is essential to seek the assistance of a qualified expert since effective therapy is available. The symptoms of SAD may be managed, and the individual’s quality of life improved via cognitive behavioral therapy, medication, and other therapeutic strategies. Those diagnosed with SAD can learn how to control their anxiety and lead meaningful lives if they get the appropriate treatment and support.
References
Birk, S. L., Horenstein, A., Weeks, J., Olino, T., Heimberg, R., Goldin, P. R., & Gross, J. J. (2019). Neural responses to social evaluation: The role of fear of positive and negative evaluation. Journal of Anxiety Disorders, 67, 102114. Web.
Brown, T. A., & Naragon-Gainey, K. (2013). Evaluation of the unique and specific contributions of dimensions of the triple vulnerability model to the prediction of DSM-IV anxiety and mood disorder constructs. Behavior therapy, 44(2), 277-292. Web.
Gros, D. F., Farmer, A. S., McCabe, R. E., & Antony, M. M. (2015). Psychometric evaluation of the multidimensional assessment of social anxiety before and after cognitive behavioral therapy for social anxiety disorder. Journal of Psychopathology and Behavioral Assessment, 37, 144-152. Web.
Kodal, A., Fjermestad, K.W., Bjelland, I., Gjestad, R., Öst, L.G., Bjaastad, J.F., Haugland, B.S., Havik, O.E., Heiervang, E.R. & Wergeland, G.J.H., (2018). Predictors of long-term outcome of CBT for youth with anxiety disorders treated in community clinics. Journal of Anxiety Disorders, 59, 53-63. Web.
Koyuncu, A., İnce, E., Ertekin, E., & Tükel, R. (2019). Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs in context, 8. Web.
Nordgreen, T., Gjestad, R., Andersson, G., Carlbring, P., & Havik, O. E. (2018). The effectiveness of guided internet-based cognitive behavioral therapy for social anxiety disorder in a routine care setting. Internet interventions, 13, 24-29. Web.