Social anxiety disorder is among the popular psychosomatic disorders which affect children, adolescents, and adults. The primary characteristic of the disorder is anxiety level which impairs an individual's ability to function properly. Social phobia falls under social anxiety disorders. It is, therefore, another term which is commonly used in referring to the condition. According to Hofmann and Otto (2017), the sub-categories of the condition relies on the excess levels of stress, and inhibition of an individual's interactions with social settings which involves individual assessment and attention. Individuals with social anxiety usually feel that others are observing them. As a result, they are typically afraid of interacting and socializing with other persons. The condition is common in contemporary society because many people with the condition are fearful of hanging out with others. The condition is stressful for the individuals, especially if they fail to receive the required treatment. There are possibilities of such persons getting depressed.
Predominant Symptoms of Social Phobia
There are various symptoms which are associated with individuals with social anxiety disorder. The individuals experience difficulties in starting/initiating and maintaining a conversation. They also find it difficult to meet people. Concerning this, they have dating problems. The individuals do not attend parties and social events, do not behave assertively and do not like engaging in telephone calls. They also do not talk with authority figures and are afraid of making direct eye contacts with strangers. They fear attending meetings and social gatherings, and also do not engage in public speaking. People with social phobia do not drink or eat in public and do not like working while other people are observing them. They are also usually afraid of using public washrooms. The persons also exhibit fear of symptoms which are likely to cause embarrassment. Some of these include sweating, trembling, blushing and having a shaky voice. Mostly, they avoid situations where they are the center of attention and endure social conditions with intense anxiety and fear.
Characteristics of Disorder
According to von Dawans, et al. (2017), there are three primary characteristics of social anxiety disorder. These are sweating, panic attacks and gateway disorder. Hofmann and Otto (2017), explain that sweating is a body response from heat, stress, and exertion. An individual suffering from the disorder is likely to sweat since the individual attempts to stay calm, and the body gradually responds to the stress by sweating. Panic attacks also ensue due to the stressful environment. Gateway disorder is common in alcohol and other courage drugs which are used to reduce inhibition and worry. Gateway disorder emerges as a result of drug and alcohol abuse.
Mahmoud, Staten, Lennie and Hall (2015) assert that in the United States, social anxiety disorders are among the popular disorders which distress approximately 40 million adults who are above 18 years old. The condition affects about 18.1% annually. Treating the condition is possible. However, Hofmann and Otto (2017) observe that only 36.9% of the individuals suffering from a social anxiety disorder receive the required treatment. According to von Dawans, et al. (2017), such individuals are three to five times likely to visit health facilities and are six times more likely to be hospitalized for psychiatric disorders as compared to those who are not suffering from anxiety disorders. von Dawans, et al. (2017) also explain that social anxiety disorder affects 7.1% of the adult inhabitants in the USA. There are more prevalent cases among females (8.0%) than males (6.1%). Mahmoud, Staten, Lennie and Hall (2015) explain that social phobia is more common among white Americans. There are however frequent panic attacks among Hispanic Americans, African Americans and Asian Americans. The disorder is also highest among people between 18-29 years, and 30-44 years. The anxiety rates are more common in the urban and suburban areas of America as compared to other regions.
The most essential and common contributing factors include negative experiences, family history, temper, social or job obligations and also experiencing a condition which draws attention. These include stuttering, facial disfigurement, and tremors caused by Parkinson disease. These increase emotions of self-awareness which triggers social anxiety among some individuals. Temperament is among those individuals who are shy, withdrawn and timid; they are usually restrained when approaching new situations. One is also likely to develop social anxiety when the siblings and biological parents have the condition as well. Examples of negative experiences also include bullying, rejection, humiliation, teasing, and ridicule. Family conflicts, abuse, and trauma are also part of the negative experiences which cause a social phobia.
Brief History of Social Anxiety Disorder
Goldin, Morrison, Jazaieri, Brozovich, Heimberg and Gross, (2016) observe that there are three critical stages which are applicable in describing the historical perspective of Social Anxiety Disorder. These are pre-development, initial development and recent development periods. Before the definition of the term anxiety, social anxiety disorder was perceived to be nerves or stress disorder. People and health professionals found it very hard to describe the condition. The situation, therefore, limited the number of individuals who received treatment.
Hippocrates first defined social anxiety in the early 400 BC as "shyness." The term "shyness" referred to individuals who thought that they were frequently being observed, and they loved darkness as life. The Greek coined the term "phobia to convey the various types of fear. The initial forms of social phobia were scopophobia which refers to the fear of being observed or watched. There was also anthropophobia which refers to the fear of people, and xenophobia which refers to the fear of strange people.
Psychologists, psychiatrists, and authors conducted more research and came up with various perceptions and views. The study shed more light on the actual meaning of social phobia. The condition was officially recognized as a discipline and a condition in the 20th century. During this time, doctors employed terminologies which include social neurosis and social phobia to refer to shy patients.
Initial Development Period
In 1903, Liji Thomas (2017) explain that Janet was the first scholar who introduced the term, "social phobia" as a distinct section in her reference when she researched the classification of phobias. Hartenberg also described various forms of social anxiety in1910 where he used the term "shyness" to refer to timidity, anxiety and personality disorder. Schindler used the term "social neurosis" to describe a condition of extreme shyness among patients in 1938.
South African psychiatrist, Joseph Wolpe conducted more research in the 1950s which contributed to the knowledge of phobias (Liji Thomas, 2017). The study advanced the use of behavioral therapy to treat social phobia. He also managed to develop a systematic desensitization technique which was applied in managing phobia.
British Psychiatrist, Isaac Marks also proposed that people should consider social phobia as a discrete category which is different from other phobias, in the 1960s. The American Psychologists Association issued the second edition of DSM-II in 1968. The edition narrowly defined social anxiety as "a precise phobia in social circumstances, or extensive fear of being scrutinized or observed by others." APA also recognized social anxiety as a form of psychiatric diagnosis in 1980 when it published the third edition of DSM. The edition defined social phobia as "the fear of performance situations." The edition failed to include situations such as the fear of less formal conditions which include casual conversations. DSM-111 found it hard to diagnose patients with avoidant personality disorder and social anxiety.
Richard Heimberg and Michael Liebowitz initiated research in 1985 concerning social anxiety where they considered social anxiety to be "a neglected anxiety disorder" since there were no adequate studies on the topic (Liji Thomas, 2017). APA revised in 1987 to the third edition of DSM (DSM-111) and integrated more adjustments in the criteria for diagnosis. The third edition failed to consider the symptoms of "significant stress" for diagnosis. The third edition added "marked distress and interference" symptoms, and integrated the procedure for diagnosing social anxiety and avoidant personality disorder. The edition also introduced a new "term-generalized social phobia" which was used to refer to distributive and more intense forms of the disorder.
The association published the fourth edition of DSM in 1994 (DSM-IV). In this edition, APA replaced the term social phobia with "social anxiety disorder." The reason for adopting the term was because social anxiety disorder described the disorder into finer details, as "marked and persistent fear of one or more social or performance situations in which an individual is exposed to unfamiliar individuals and possible scrutiny by other individuals." The association also made some modifications to the criteria for diagnosing the condition (Liji Thomas, 2017).
The fifth edition of DSM (DSM-IV), which is the latest revision, provided more changes in diagnosing social anxiety disorder. American Psychologists Association updated and published the fifth edition in 2013. The latest version made little changes to the diagnosis. The only area which the edition adjusted was the wording and diagnosis time frame.
Formal Treatment Approaches
The most common treatment approach for Social cognitive disorder is Cognitive Behavioral Therapy (CBT). The therapy provides the patients with an opportunity to identify appropriate ways of learning, recognizing and questioning maladaptive thoughts. The treatment engages the patients in exposures of freed conditions in determining the accuracy of biased beliefs. The therapy also focuses on acceptance based approach and being mindful of others as a way of treating social anxiety disorder. The strategy also helps the patient to concentrate on living a meaningful life depending on the identified values. Other approaches include interpersonal therapy, acceptance-based therapy, and psychodynamic conceptualizations. Interpersonal therapy connects social anxiety disorder to the actual interpersonal problem with an objective of reducing the symptoms through targeting interpersonal complications. Psychodynamic conceptualization concentrates on the identification of unsettled battles which leads to social anxiety disorder.
Cognitive Behavioral Approach (Empirical Evaluation)
Richa Priyamvada, Jai Prakash, Sapna Kumari, and Suprakash Chaudhury are the authors of the journal, "Cognitive Behavioral Therapy in the Treatment of Phobia." The Association of Industrial Psychiatry of India published the journal in 2009 (Priyamvada, Kumari, Prakash, & Chaudhury, 2009). The journal identifies Cognitive behavioral therapy as the prominent therapeutic method which medical practitioners, psychiatrists, and psychologists have applied for a long time in the treatment of patients with social anxiety disorder. The Journal attempted to give therapeutic intermediation program on a 27-year old individual. The person is single and is a victim of social anxiety disorder. In the study, the patient received treatment through cognitive behavioral therapy. The thera...
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