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PubMed1997

Social phobia and positive social events: the price of success.

Patients with generalized social phobia (N = 32; 16 men, 16 women) and nonclinical control participants (N = 32; 16 men, 16 women) took part in a social interaction that was manipulated to be successful or unsuccessful. Participants rated their ability, perceptions of others' standards, social goals, and emotional responses before and after the interactions. As predicted, the successful social interaction produced a somewhat negative response in patients with social phobia. Social success led to self-protective social goals, negative emotional states and perceptions that others would expect more in future interactions. These results indicate that positive social events may not be processed in a way that leads to a revision of negative self- and social judgments in patients with social phobia.

Adult↗
PubMed1997

Social processing correlates of nonverbal social perception in schizophrenia.

This study examines the relationship of nonverbal social perception to other areas of social functioning in schizophrenia. One model of interpersonal problem-solving skills presents a sequence of receiving, processing, and sending skills. Social perception skills best fit the first stage in this model: receiving skills. As expected, schizophrenic subjects (N = 29) were less skillful than normal subjects (N = 15) on measures of social problem solving, understanding of social sequences, and social judgment. In addition, performance on these tasks was significantly related to nonverbal social perception, but only for the schizophrenic group. Thus, deficits in nonverbal social perception are related to other measures of social functioning in schizophrenia. Implications of these findings for understanding and treating social deficits in schizophrenia are discussed.

Adult↗
PubMed1997

Elderly persons' social network and need for social support after their first myocardial infarction.

Social network and social support are phenomena suggested to be of importance to successful recovery from myocardial infarction. However, very few studies have been carried out, especially among the elderly, focusing on their social network and its ability to provide adequate support after myocardial infarction. The aim of this study was to examine elderly persons' social network and need for social support three months after their first myocardial infarction. The sample consisted of 128 persons between 65 and 94 years of age who answered a questionnaire. The results showed that the subjects, even the oldest ones, had an available social network and that they were satisfied with the support it provided. There was an increased need for social support after the myocardial infarction, especially for emotional support and appraisal, but also for instrumental aid and information. Despite these positive results indicating that elderly persons with myocardial infarction have a social network, whose members provide them with support, there may be a need for support also from persons outside this network. Assessment of social network characteristics and the need for social support as well as the provision of adequate information about additional support networks are important tasks for all health professionals.

Adaptation, Psychological↗
PubMed1995

A measurement of social support in epidemiological research: the social experiences checklist tested in a general population in The Netherlands.

STUDY OBJECTIVE: This study aimed to examine in a general population the psychometric qualities of an instrument designed to measure positive and negative social experiences that had been developed in a clinical setting. DESIGN: The Netherlands monitoring project on cardiovascular disease risk factors, a large scale population based study (comprising 36,588 men and women aged 20 to 59 years) carried out in three Dutch towns (Amsterdam, Doetinchem, and Maastricht) offered the possibility of testing the strength of this instrument cross sectionally. MEASUREMENTS AND MAIN RESULTS: The social experiences checklist (SEC) which resulted from a research project on the quality of life of cancer patients was used. The independence of positive and negative experiences was confirmed. The reliability of both the positive and negative experiences dimension was good (Cronbach's alpha = 0.82 and 0.72 respectively). In accordance with the results of a study on cancer patients, the theoretically derived four dimensions in the experience of social support did not seem to be independent. The validity of the SEC was confirmed by Pearson correlations with neuroticism and coping styles. Neuroticism seemed to be negatively correlated with positive social experiences and was positively correlated with negative social experiences. The coping style of seeking information and direct action was positively correlated with positive social experiences. Coping by withdrawal was negatively correlated with negative social experiences. Women and highly educated people seemed to have more positive and fewer negative social experiences than men and people with less education. Younger people had more positive social experiences than older people. The oldest group in the study, those aged 50 to 59, reported fewer negative social experiences than any other age group. CONCLUSIONS: Similar results were found in a study of cancer patients. This underlines the usefulness of the instrument not only for cancer patients but also in survey research in a general population.

Adaptation, Psychological↗
PubMed2006

Health inequality in adolescence. Does stratification occur by familial social background, family affluence, or personal social position?

BACKGROUND: Two new sets of stratification indicators--family's material affluence and adolescent's personal social position- were compared with traditional indicators of familial social position based on parental occupation and education for their ability to detect health inequality among adolescents. METHODS: Survey data were collected in the Adolescent Health and Lifestyle Survey in 2003 from nationally representative samples of 12-, 14- and 16-year-old Finns (number of respondents 5394, response rate 71%). Indicators of the familial social position were father's socio-economic status, parents' education, parents' labour market position. Indicators of material affluence were number of cars, vacation travels, and computers in the family, own room and amount of weekly spending money. Adolescent's personal social position was measured as school performance. Measures of health were long-standing illness, overweight, use of mental health services, poor self-rated health and number of weekly health complaints. Ordinal logistic regression analysis was applied to study the associations between stratification indicators and health variables. RESULTS: All three groups of indicators of social stratification showed inequality in health, but the strongest associations were observed with the adolescent's personal social position. Health inequality was only partly identifiable by the traditional indicators of familial social position. The direction of the inequality was as expected when using the traditional indicators or personal social position: adolescents from higher social positions were healthier than those from lower positions. The indicators of family's material affluence showed mainly weak or no association with health and some of the indicators were inversely associated, although weakly. CONCLUSION: In addition to traditional indicators describing the socio-structural influences on the distribution of health among adolescents, indicators of family's material affluence should be further developed. Adolescents' personal social position should be included in the studies of health inequalities.

Adolescent↗
PubMed1977

The role of social anxiety in social interaction difficulties.

Social anxiety was found to be the most common complaint in a sample of psychiatric patients reporting social interaction difficulties. High social anxiety was shown to be associated with impairments to social behaviour in socially anxious psychiatric patients and non-psychiatric volunteers. A comparison was made of systematic desensitization and a form of social skills training in the treatment of social interaction difficulties associated with high social anxiety. This indicated that while both therapies were effective in the reduction of social anxiety, the training programme was the more effective in reducing problem behaviour, but desensitization appeared to lead to a wider generalization of improvement as indicated by increases in social participation.

Adolescent↗
PubMed1996

Social support, social networks and coronary artery disease rehabilitation: a review.

OBJECTIVE: To provide information to the medical community about the importance of social support and networks through examination and definition of social support and network variables, and by reviewing the evidence found in the literature showing a relationship among social support, social networks, coronary artery disease (CAD) and rehabilitation. DATA SOURCES: Psyclit and Sociofile were searched for September 1979 through December 1994. STUDY SELECTION: All publications covering social support, social networks and rehabilitation from CAD as well as large mortality studies. Fifty-one articles were reviewed. DATA EXTRACTION: Original articles were summarized. DATA SYNTHESIS: Individuals who benefit from social support are less likely to become disease-stricken and live longer than those with less support. Social support and networks may have a substantial influence on the speed and quality of recovery following myocardial infarction (MI). CONCLUSIONS: A review of the literature indicates that social support plays an important role in recovery from and adaptation to chronic disease such as CAD and is of equal importance to the primary and secondary prevention of MI. Future research should pay special attention to what types of functional support are of most importance to recovery from MI and bypass surgery, thus allowing for the development of rehabilitation programs and interventions that will emphasize functions that are most needed. Interventions may involve the patient's natural support group to enhance the potential support providers' awareness of the patient's support needs. Social support may be especially important for maintaining compliance with rehabilitation programs for patients with CAD.

Adult↗
PubMed2003

Social experience alters the response to social stress in mice.

Individual differences in the response to stressful stimuli have been documented in humans and in a variety of animal species. Recently, we demonstrated that social stress induced a state of glucocorticoid (GC) resistance in mouse splenocytes, however this response was highly variable among cage mates. Since these studies were conducted using inbred mice (C57BL/6), it was suggested that environmental factors were the source of this variability. The following study examined possible factors that may have contributed to the development of individual differences in the susceptibility of mice to social stress. First, the effect of rearing conditions was studied by comparing the development of GC resistance in mice reared in isolation or in groups. In addition, the effect of previous social experiences was studied in mice that were re-housed to facilitate the formation of new social hierarchies in the cages. The results indicated that isolation altered the behavior of the mice during the social stress, but did not affect the development of GC resistance in response to the stress. Re-housing and the resulting loss of social status increased the susceptibility of mice to the development of GC resistance following social stress. Together, these findings indicate that environmental factors, such as previous social experiences, may alter the susceptibility to the effects of future social stress in inbred mice.

Adaptation, Physiological↗
PubMed1985

Social contract and social integration in adolescent development.

Eighty-nine subjects from two high schools were tested during the spring of their sophomore and senior years, when their mean ages were 16 years, 1 month, and 18 years, 1 month, respectively. Composites measured social contract with: (a) independence, (b) implicit social contract, societal norms and expectations, and (c) explicit social contracts, rules. Composites and single items measured social integration with: (d) role commitment, (e) social-American Dream, accepting the belief in the American Dream that hard work would lead to social success, (f) self-American Dream, belief that hard work will produce personal satisfaction and success, (g) raw deal, perceptions of being treated unfairly, (h) self-blame, and (i) feelings of hopelessness. The results of the cross-lagged panel correlations generally support the hypothesis that students respond to implicit social contracts through role commitment, which is further expressed by a belief in the American Dream for social fulfillment, while responding to the perception of explicit social contracts by not believing in the benefits of the American Dream for personal fulfillment. These results were interpreted as supporting Dienstbier's theory of moral development.

Adolescent↗
PubMed1998

Social support and adjustment to a novel social environment.

The present article aims to examine the ways in which social support may affect the adaptation of individuals to a novel social environment. A distinctive feature of this research was the assessment of social support both before and after entering a completely new network of social relationships. A cohort of international exchange high school students (N = 242) was administered a battery of self-report questionnaires dealing with personality traits, perceived social support, coping behaviors and emotional distress before leaving Japan and six months after living with a host family in a foreign community. Perceived social support abroad contributed to less emotional distress. This health-promoting effect of social support was found to be mediated by adaptive coping behaviours, and was not due to confounding by personality traits. Perceived social support at home was predictive of more emotional distress abroad. Subjects who reported high levels of social support at home were particularly vulnerable when they entered the completely new environment and found that such support was no longer available.

Adaptation, Psychological↗
PubMed2006

Social-defeat stress suppresses scent-marking and social-approach behaviors in male Mongolian gerbils (Meriones unguiculatus).

In many species, social-defeat stress induces behavioral changes in subordinate individuals. The present study examined how social-defeat stress affected scent-marking and approach behaviors in male Mongolian gerbils and whether socially defeated males selectively avoided dominant males. In Experiment 1, each of 11 gerbils was defeated by a dominant gerbil during a short social confrontation (10 min in total). For Experiment 2, the same animals were used two weeks after the end of Experiment 1. Each subject was again similarly defeated, but the two gerbils were then kept in the same cage, separated by a wire mesh for 24 h. Behavioral changes in socially defeated males were observed after social defeat; both experiments were replicated three times. After acute social defeat in Experiment 1, male gerbils did not change their scent-marking activity and frequently approached the dominant males. In contrast, males decreased scent-marking activity and approach behavior toward dominant males in Experiment 2. The amount of time defeated males approached unfamiliar males was also reduced, suggesting that social-defeat stress reduces scent-marking motivation and conspecific approach behavior rather than inducing social avoidance toward a specific individual. These findings showed that the severity of social-defeat stress is an important factor in subsequent behavioral changes in male Mongolian gerbils.

Animals↗
PubMed2000

Social phobia and interpretation of social events.

It has been suggested that social phobia may be characterized by two interpretation biases. First, a tendency to interpret ambiguous social events in a negative fashion. Second, a tendency to interpret unambiguous but mildly negative social events in a catastrophic fashion. To assess this possibility, patients with generalized social phobia, equally anxious patients with another anxiety disorder, and non-patient controls were presented with ambiguous scenarios depicting social and non-social events, and with unambiguous scenarios depicting mildly negative social events. Interpretations were assessed by participants' answers to open-ended questions and by their rankings and belief ratings for experimenter-provided, alternative explanations. Compared to both control groups, patients with generalized social phobia were more likely to interpret ambiguous social events in a negative fashion and to catastrophize in response to unambiguous, mildly negative social events.

Adult↗
PubMed1998

[Frequency and comorbidity of social anxiety and social phobia in adolescents. Results of a Bremen adolescent study].

Using data from the Bremen Adolescent Study, this report presents findings on the frequency, comorbidity and psychosocial impairment of social phobia and social fears among 1035 German adolescents of 12-17 years of age. The adolescents were randomly selected from 36 schools in the city and provincial government area of Bremen, Germany. Social phobia and other psychiatric disorders were coded based on DSM-IV criteria using the computerized personal interview of the Munich version of the Composite International Diagnostic Interview. Seventeen (1.6%) of the adolescents had met the DSM-IV criteria for social phobia at some time in their life. More girls than boys were diagnosed as suffering from social phobia. The incidence of the disorder increased with age. The lifetime frequency of social fears is much higher. The most common types of feared social situations were fear of doing something in front of other people, followed by public speaking. Social phobia very often co-occurred with depressive disorders, somatoform disorders and disorders caused by excessive or inappropriate consumption of substances. Over 94% of those with social phobia and 54.4% with any social fears were severely impaired in their daily life during the worst episode. Despite the high level of psychosocial impairment, only a small portion of the cases received professional help.

Adolescent↗
PubMed1999

Fluvoxamine treatment of social phobia (social anxiety disorder): a double-blind, placebo-controlled study.

OBJECTIVE: The purpose of this study was to determine the efficacy of fluvoxamine for the treatment of social phobia (social anxiety disorder). METHOD: In a 12-week multicenter, double-blind, randomized, placebo-controlled trial, 92 patients with social phobia were treated with the selective serotonin reuptake inhibitor fluvoxamine; 91.3% of the patients had the generalized subtype of the disorder. The primary criterion for response was a rating of "much improved" or "very much improved" on the Clinical Global Impression of Improvement scale. Secondary response criteria were changes on three specialized rating scales for social phobia symptoms: the Brief Social Phobia Scale, the Social Phobia Inventory, and the Liebowitz Social Anxiety Scale. Psychosocial impairment was assessed in three domains (disruption of work, social life, and home/family life) by using the Sheehan Disability Scale. RESULTS: The mean daily dose of fluvoxamine was 202 mg (SD = 86). At study end or with the last observation carried forward, within the evaluable subjects (N = 86) there was a significantly higher proportion of responders in the fluvoxamine group (42.9%, N = 18) than in the placebo group (22.7%, N = 10). Similarly, fluvoxamine was superior to placebo on all social phobia rating scales at week 8 and beyond. Fluvoxamine also resulted in significantly greater decreases in measures of psychosocial disability than did placebo. Overall, fluvoxamine was well tolerated and safe. CONCLUSIONS: These findings indicate that fluvoxamine is efficacious in the pharmacologic management of serious forms of social phobia.

Adolescent↗
PubMed1999

A double-blind placebo-controlled trial of paroxetine in the management of social phobia (social anxiety disorder) in South Africa.

BACKGROUND: Social phobia, also known as social anxiety disorder, is a highly prevalent disorder with significant morbidity. Patients with social phobia frequently develop co-morbid psychiatric disorders such as depression and substance abuse, and the disorder impacts significantly on social and occupational functioning. It has been suggested that the selective serotonin reuptake inhibitors (SSRIs) are useful in the management of this disorder, but few controlled trials have been undertaken in this regard. There are also few data on the pharmacotherapy of social phobia in South Africa. METHODS: A double-blind randomised placebo-controlled multi-site flexible-dose trial of paroxetine was undertaken over 12 weeks among patients with a primary diagnosis of social phobia. Primary response measures were the Global Improvement item on the Clinical Global Impression scale (CGI) and mean change from baseline in the patient-rated Liebowitz Social Anxiety Scale (LSAS) total score. Ninety-three patients participated at 9 South African sites; their data are reported here. RESULTS: There was a significant drug effect on both the CGI Global Improvement score and the LSAS at 12 weeks. In addition, there was no significant difference in overall rate of adverse experiences between those on paroxetine and those on placebo. CONCLUSIONS: Paroxetine is both effective and safe in the acute treatment of social phobia. The findings here are consistent with those of previous controlled studies of the SSRIs as well as with previous work done in the USA on the use of paroxetine in the treatment of this disorder. Early diagnosis and treatment of social phobia should be encouraged. However, further research on long-term pharmacotherapy of social phobia is needed.

Adult↗
PubMed2005

Recent developments in research and treatment for social phobia (social anxiety disorder).

PURPOSE OF REVIEW: This review covers three themes of research that brought fresh data useful for clinical practice in a handicapping anxiety disorder: social phobia. Recent findings deriving from basic biological research, new forms of psychological therapies, and recent psychopharmacology controlled trials are reviewed. RECENT FINDINGS: The basic neuroimaging research suggests that greater activation of the amygdala to novel versus familiar faces may be an underlying trait marker for social phobia. Social phobia may represent a phenotype that expresses a genetically driven trait of social withdrawal, which may be related to infantile inhibited temperament (Kagan's syndrome). The development of virtual reality therapy as therapeutic tool for social phobia appeared promising in one controlled, but not randomized, study. A controlled study suggests that social phobias in children can be effectively treated with cognitive behavioural therapy. This represents an extension of the work done with adults. Venlafaxine appears an effective short-term treatment for social anxiety disorder in two controlled studies. A new compound, pregabalin, appeared clearly effective in a positive controlled study. This trial marks the advent of a new pharmacological lineage for social phobia. Both venlafaxine and pregabalin, however, have been studied in short-term studies. Longer follow-up and relapse prevention studies are warranted. SUMMARY: Neuroimaging research points to a temperamental basis for social phobia. Virtual reality therapy is an emerging tool to carry out exposure treatment. Group cognitive behavioural therapy can be extended successfully to children. Venlafaxine and pregabalin have a proven short-term effectiveness in social phobia.

Journal Article↗
PubMed1989

Psychiatric morbidity in clients of social workers: social outcome.

141 clients referred to social service department local social work teams (area workers) and general practice attachments were interviewed to assess their levels of psychiatric morbidity. 101 cases received clinical and social reassessment at twelve months. A substantial proportion (63%) had a positive social outcome according to the client and social worker, a finding confirmed by an independent social assessment. Family break up, more common in the area setting, was associated with a better clinical outcome. Attachment clients had significantly higher levels of psychiatric morbidity, and in clinical terms improved more frequently than area cases, but not significantly so. Clinically improved cases had a higher number of GP-social worker contacts. Both social and clinical variables contributed to the prediction of clinical outcome. By reducing the availability of attached workers, social services departments are removing a valuable source of help for people with psychiatric disorders.

Affective Symptoms↗
PubMed2006

Social support, social problem-solving abilities, and adjustment of family caregivers of stroke survivors.

OBJECTIVE: To determine contributions of social support and social problem-solving abilities in prediction of adjustment of family caregivers of stroke survivors. DESIGN: Descriptive. SETTING: Two rehabilitation facilities (1 private, 1 state) in the southeastern United States. PARTICIPANTS: Fifty-two family caregivers (46 women, 6 men) of stroke survivors (28 women, 24 men). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Predictor variables were social support and social problem-solving abilities. Outcome measures of caregiver adjustment were depressive symptomatology, well-being, and general health. Participants completed these measures 1 to 2 days before discharge from inpatient rehabilitation and at 5, 9, and 13 weeks postdischarge in the home. RESULTS: Trajectory analysis indicated higher levels of social support were associated with lower levels of caregiver depressive symptomatology and higher levels of well-being and general health, independent of social problem solving. A greater negative problem orientation was associated with higher levels of depressive symptomatology and lower levels of well-being. A more positive problem orientation was associated with greater increases in general health. The strength or slope of this positive relation lessened over time. CONCLUSIONS: Social support and the emotion-focused component of social problem solving, problem orientation, independently contribute to caregiver adjustment. Interventions that provide social support and assist caregivers to develop more adaptive abilities toward problem solving may be beneficial.

Adaptation, Psychological↗