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PubMed1998

Paroxetine treatment of generalized social phobia (social anxiety disorder): a randomized controlled trial.

CONTEXT: The generalized type of social phobia (social anxiety disorder) is a severe and often disabling form of social anxiety that affects approximately 5% of the general population. Earlier research has shown monoamine oxidase inhibitors or benzodiazepines to be effective in treating this condition, but neither has achieved widespread use. OBJECTIVE: To compare the efficacy of paroxetine, a selective serotonin reuptake inhibitor, with placebo in adults with generalized social phobia. DESIGN: Twelve-week, multicenter, randomized, double-blind trial. SETTING: Thirteen centers across the United States and 1 in Canada. PARTICIPANTS: Between April 13, 1995, and February 28, 1996, 187 persons meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for generalized social phobia were randomized (and 183 returned for at least 1 efficacy assessment) to treatment. INTERVENTION: After a 1-week, single-blind, placebo, run-in period, patients received a double-blind, 11-week course of either paroxetine or matching-image placebo. The initial daily dosage of paroxetine (or placebo) was 20 mg with increases of 10 mg/d weekly (flexible dosing to a maximum of 50 mg/d) permitted after the second week of treatment. MAIN OUTCOME MEASURES: Number of responders based on the Clinical Global Impression Global Improvement Item ("much improved" or "very much improved"); mean change from baseline on the Liebowitz Social Anxiety Scale total score. RESULTS: Fifty (55.0%) of 91 persons taking paroxetine and 22 (23.9%) of 92 persons taking placebo were much improved or very much improved at the end of treatment (odds ratio [OR], 3.88; 95% confidence interval [CI], 2.81-5.36). Mean Liebowitz Social Anxiety Scale total scores were reduced by 39.1% (the mean baseline score of 78.0 declined by a mean of 30.5 points at follow-up) in the paroxetine group compared with 17.4% (the mean baseline score of 83.5 declined 14.5 points at follow-up) in the placebo group, a difference of 21.7% (95% CI, 8.7%-34.7%) favoring paroxetine. CONCLUSIONS: Paroxetine is an effective treatment for patients with generalized social phobia. Short-term (ie, 11-week) treatment results in substantial and clinically meaningful reductions in symptoms and disability. Future research should test whether these may be further reduced by extended treatment or supplementation with specific educational-cognitive-behavioral techniques.

Adult↗
PubMed2004

Skills for social and academic success: a school-based intervention for social anxiety disorder in adolescents.

This paper describes Skills for Academic and Social Success (SASS), a cognitive-behavioral, school-based intervention for adolescents with social anxiety disorder. Clinic-based treatment studies for socially anxious youth are reviewed, and a strong rationale for transporting empirically-based interventions into schools, such as SASS, is provided. The SASS program consists of 12, 40-min group sessions that emphasize social skills and in-vivo exposure. In addition to group sessions, students are seen individually at least twice and participate in 4 weekend social events with prosocial peers from their high schools. Meetings with teachers provide information about social anxiety and facilitate classroom exposures for socially anxious participants. Parents attend 2 psychoeducational meetings about social anxiety, its treatment, and approaches for managing their child's anxiety. Initial findings regarding the program's effectiveness are presented. We conclude by discussing the challenges involved in implementing treatment protocols in schools and provide suggestions to address these issues.

Adolescent↗
PubMed2005

Transmission of social anxiety from mother to infant: an experimental study using a social referencing paradigm.

In this experiment we investigated the impact of indirect expressions of maternal social anxiety on infant interactions with a stranger. A social referencing paradigm was used in which infants first observed their mothers interacting with a stranger and then interacted with the stranger themselves. Mothers made no direct communicative gestures to the infant concerning the stranger throughout the procedure. There were two experimental conditions experienced by all mother-infant pairs (N = 24; 12 boys)-non-anxious and socially anxious-and there were two male strangers. Infants were between 12 and 14 months (M = 12.8, SD = .76). Order of condition and stranger presentation were counter-balanced. Before testing, mothers, none of whom were significantly socially anxious, were trained to behave in a non-anxious and a socially anxious manner on the basis of clinical and empirical descriptions of social phobia. The results showed that, compared to their responses following their mothers interacting normally with a stranger, following a socially anxious mother-stranger interaction, infants were significantly more fearful and avoidant with the stranger. Infant-stranger avoidance was further modified by infant temperament; high fear infants were more avoidant in the socially anxious condition than low-fear infants. We discuss these findings in light of the possible mechanisms underpinning infant affective and behavioral responsiveness.

Affect↗
PubMed2005

Hiding anxiety versus acknowledgment of anxiety in social interaction: relationship with social anxiety.

According to cognitive and interpersonal models, safety behaviors in social phobia (e.g., avoiding eye contact, hiding blushing) erroneously induce negative evaluation by interaction partners. Presumably, a bias about the social outcome of safety behaviors causes this negative interaction cycle. Such a bias might be subject to double standard in social phobia (i.e., having more stringent rules for oneself than for others). Female students (n=81) predicted more negative social outcomes for a prominent type of safety behavior, hiding anxiety, than for the opposite behavior, acknowledgment of anxiety and ongoing behavior (control condition) in scripts of self- and other-target persons. The relation between social anxiety and double standard was robust. Social anxiety did not relate to a cognitive bias regarding hiding ones anxiety, as we expected, but was associated with the belief that acknowledgment of anxiety has negative social outcomes specifically for them. These results are evaluated in light of the interpersonal consequences anxiety-related behaviors have in social interactions.

Adolescent↗
PubMed2003

The social phobia diagnostic questionnaire: preliminary validation of a new self-report diagnostic measure of social phobia.

BACKGROUND: The development and validation of the Social Phobia Diagnostic Questionnaire (SPDQ), a new self-report diagnostic instrument for social phobia is described in three separate studies. STUDY 1: The participants were 125 undergraduates seeking help for an anxiety disorder of whom 60 had social phobia. Receiver operating characteristics (ROC) analysis was conducted comparing SPDQ diagnoses and clinician-based Anxiety Disorder Interview Schedule-IV (ADIS-IV) diagnoses of social phobia. Diagnoses made by the SPDQ showed an 85% specificity, an 82% sensitivity and kappa agreement with the ADIS-IV of 0.66. STUDY 2: The participants were 462 undergraduates who completed the SPDQ and a battery of additional questionnaires. The SPDQ had good internal consistency (alpha=0.95), good split-half reliability (r=0.90) and strong convergent and discriminant validity. STUDY 3: The participants were 145 undergraduates who completed the SPDQ at two time points separated by 2 weeks as well as several additional questionnaires. Scores on the SAD, FNE and SISST of SPDQ categorized undergraduates were also compared to scores on these measures from 35 clinical community participants to determine the clinical validity of the SPDQ. The SPDQ had strong 2-week test-retest reliability and good convergent and discriminant validity. Undergraduates diagnosed with social phobia by the SPDQ were not significantly different on the SAD, FNE and SISST from the socially phobic community sample, but both groups had significantly higher scores than undergraduates identified by the SPDQ as not meeting criteria for social phobia, demonstrating clinical validity of the SPDQ. CONCLUSIONS: These three studies provide preliminary evidence of the strong psychometric properties of the SPDQ as a measure to identify socially phobic participants.

Adolescent↗
PubMed2002

Prefrontocortical dopamine loss in rats delays long-term extinction of contextual conditioned fear, and reduces social interaction without affecting short-term social interaction memory.

Prefrontal dopamine loss delays extinction of cued fear conditioning responses, but its role in contextual fear conditioning has not been explored. Medial prefrontal lesions also enhance social interaction in rats, but the role of prefrontal dopamine loss on social interaction memory is not known. Besides, a role for subcortical accumbal dopamine on mnesic changes after prefrontal dopamine manipulation has been proposed but not explored. The objective was to study the involvement of dopaminergic neurotransmission in the medial prefrontal cortex (mPFC) and nucleus accumbens in two mnesic tasks: contextual fear conditioning and social interaction memory. For contextual fear conditioning, short- and long-term freezing responses after an electric shock were studied, as well as extinction retention. Regarding social interaction memory, the recognition of a juvenile, a very sensitive short-term memory test, was used. Dopamine loss was carried out by injection of 6-hydroxydopamine, and postmortem catecholamine levels were analyzed by high-performance liquid chromatography. Prefrontocortical dopamine loss (>76%) led to a reactive enhancement of accumbal dopamine content (p<0.01), supporting the hypothesis that a hyperdopaminergic tone emerges in the nucleus accumbens after prefrontocortical dopamine loss. In lesioned rats, long-term extinction of contextual fear conditioning was significantly delayed and extinction retention was impaired without changes in acquisition and short-term contextual fear conditioning and, on the other hand, acquisition and short-term social interaction memory were not affected, although time spent on social interaction was significantly reduced. Added dopamine loss in the nucleus accumbens (>76%) did not alter these behavioral changes. In summary, the results of the present study indicate that the dopaminergic network in the mPFC (but not in the nucleus accumbens) coordinates the normal long-term extinction of contextual fear conditioning responses without affecting their acquisition, and it is involved in time spent on social interaction, but not acquisition and short-term social interaction memory.

Animals↗
PubMed1997

Social relations and health assessments among older people: do the effects of integration and social contributions vary cross-culturally?

Research on health assessments has shown the importance of social relations as a factor influencing health, especially among older people. Drawing upon sociological theories of social integration and social exchange, this research examines two domains of social relations which are expected to influence assessed health. In addition, the study uses a cross-national sample (N = 3,407) of noninstitutionalized older people from the Republic of Korea, Fiji, Malaysia, and the Philippines to determine if modernization conditions the relationships between social relations and health. Results indicate that social integration has a positive effect on subjective health assessments in all nations, whereas social contributions are significant only in Korea. Findings suggest that health assessments by elders in the most modernized nations appear to be much more influenced by the contributions they make to the social order than is the case in nations which are less modernized.

Age Factors↗
PubMed1994

Setting diagnostic thresholds for social phobia: considerations from a community survey of social anxiety.

OBJECTIVE: The goal of this study was to gain a broader perspective on social anxiety in the community than has been achieved by epidemiologic surveys to date. METHODS: The authors conducted a telephone survey of social anxiety among 526 randomly selected respondents in a medium-sized Canadian city. RESULTS: Sixty-one percent of the respondents reported being much or somewhat more anxious than other people in at least one of the seven social situations surveyed. Speaking to a large audience (i.e., public speaking) was the most frequently feared situation (endorsed by 55.0% of the respondents), followed by speaking to a small group of familiar people (24.9%), dealing with people in authority (23.3%), attending social gatherings (14.5%), speaking to strangers or meeting new people (13.7%), and eating (7.1%) or writing (5.1%) in front of others. When the threshold for caseness was systematically modified--by altering the required level of psychosocial interference or distress or by including or excluding subjects with pure public speaking phobia--the rate of "social anxiety syndrome" in the community varied from 1.9% to 18.7%; 7.1% was the prevalence when the criteria were set to conform with DSM-III-R. CONCLUSIONS: Social anxiety is common in the community, but precise delineation of the prevalence of "social phobia" depends heavily on where the diagnostic threshold is set. If DSM-III-R criteria had been applied in previous epidemiologic studies, it is likely that those studies would have documented prevalences of social phobia that are several times as high as the currently accepted rates.

Adolescent↗
PubMed1999

Asch's social psychology: not as social as you may think.

This article discusses 2 commonly held ideas about Solomon Asch's work in social psychology: (a) Asch was primarily interested in social phenomena in general and in group processes in particular, and (b) Asch was a forerunner of social cognition. Asch's studies on social influence were translations of strictly perceptual experiments. For him, social stimuli had no specificity relative to physical ones provided that the perceptual context presented similar structural properties. Moreover, and contrary to Kurt Lewin (e.g., 1948) Asch focused his attention at the individual level and may have slowed down interest in social interactions or group processes. Asch's studies on impression formation presaged the social cognition approach. In his work, he foresaw the importance of online processing of information, the existence of implicit theories of personality, as well as perception based on exemplars and prototypes. However, Asch's reliance on immediate perceptual experience, on isomorphism between the properties of the external object and the phenomenal experience of this object, and his holistic and dynamic perspective clash with the main stream of social cognition research.

Journal Article↗
PubMed2002

Is social phobia related to lack of social skills? Duration of skill-related behaviours and ratings of behavioural adequacy.

OBJECTIVES: The aim of the current study was to investigate whether social phobics differ from clinically anxious and non-clinical comparison groups with regard to either the duration of skill-related behaviours displayed during a social conversation or their behavioural adequacy as perceived by observers. DESIGN: A between-group design was used for the first part of the study. The duration of specified skill-related behaviours of a group of socially phobic participants was compared with the behaviours of clinically anxious and non-clinical participants. A within-group design was used for the second part of the study. Observers' ratings of the adequacy of the behaviour of a subgroup of the participants from the three groups were evaluated. METHODS: Fifty-four participants, 18 socially phobic, 18 clinically anxious but not socially phobic and 18 who formed a non-clinical comparison group, took part in a 9-min conversation with a confederate of the experimenters. Participants were screened by diagnostic interview. Each conversation was videotaped, and from these recordings, the percentage time spent talking, spent in silence, smiling, maintaining eye contact while talking and while listening and while making manipulative gestures was extracted. A subset of 30 participants, 10 from each of the three groups, provided stimulus material for the second part of the study. The sixth minute of each of these 30 participants' recorded conversations was shown to 21 observers who rated the performance for adequacy of gestures, adequacy of eye contact, adequacy of smiling, clarity of speech, fluency of speech and overall adequacy of performance. Observers were also asked to categorize the participants based on the observed behaviour into one of three diagnostic groups: socially phobic, clinically anxious or non-clinical. RESULTS: Social phobics exhibited significantly less eye contact while talking in comparison with the non-clinical participants and significantly more manipulative gestures than either the clinically anxious or non-clinical participants. There were no other between-group differences in duration of skill-related behaviours. With regard to ratings of perceived behavioural adequacy for gestures, speech fluency and overall performance, the social phobic group was rated as significantly less adequate than both comparison groups. With regard to ratings of perceived adequacy of eye contact and speech clarity, while the anxious groups did not differ from each other, both were rated as significantly less adequate than the non-clinical comparison group. There was also a marked within-group variation in perceived adequacy of behaviour and wide variation in ratings provided by observers. CONCLUSIONS: Possible competing explanations for the results are discussed; these include the skills deficit hypothesis and the possibility that group differences in both duration of skill-related behaviour and observed behavioural adequacy reflect awkward, anxious behaviours and/or safety behaviours.

Adult↗
PubMed2005

Social-ecological resilience and social conflict: institutions and strategic adaptation in Swedish water management.

Dealing with uncertainty and complexity in social-ecological systems is profoundly dependent on the ability of natural resource users to learn and adapt from ecological surprises and crises. This paper analyzes why and how learning processes are affected by strategic behavior among natural resource users and how social conflict is affected by social and ecological uncertainty. The claim is that social conflict among natural resource users seriously inhibits the possibilities of learning and adaptation in social-ecological systems. This is done combining insights from political science, experimental economics, and social-psychology and an analytical case study elaborating social conflict and institutional change in Swedish water management institutions. This paper also discusses the crucial role the institutional context plays in defining the outcome of learning processes in Swedish water management institutions and hence highlights previously poorly elaborated political aspects of learning processes and institutional change in social-ecological systems.

Community Participation↗
PubMed1996

[1995 Berlin social structure atlas--a planning instrument for health and social planning within the scope of administrative reform in Berlin].

Social unequality and social differences of a population can be defined as social structure. The objective of this study is the construction of indices with which an analysis of space-related social disparities from their spacious dimensions can be made. Each dimension has to be described with a multitude of space-related social indicators first, and then identified and calculated with a multivariate statistic procedure (Factor Analysis). With the existing analysis basic dates are provided. This information about the social situation of Berlin districts as well as the resulting political plannings shall contribute to the reduction of existing differences, in particular to the reduction of social disadvantages. In general, decisions regarding allocation on the private as well as on the public sector should be supported by the social structure analysis.

Atlases as Topic↗
PubMed1999

Social support, social adjustment, and recovery status in bulimia nervosa.

OBJECTIVE: To examine recovery status in bulimia nervosa (BN) and its relation to social support and social adjustment. METHOD: Using a cross-sectional design, we administered the modified Social Support Questionnaire and the Social Adjustment Scale-Self-Report (SAS-SR) to 40 women, each of whom was actively bulimic (ABN), was in remission from BN (RBN), or had no history of eating disturbance (comparison). RESULTS: In terms of social support, relative to RBN and comparison subjects, the ABN group had significantly fewer persons in their friendship and kinship networks available to provide emotional support, although the groups were equivalent in number of persons available to provide things and advice. Relative to the comparison group, both bulimic groups were significantly dissatisfied with the quality of emotional support provided by relatives. On the SAS-SR, women in the ABN group displayed the poorest overall social functioning. The RBN group was functioning significantly better than the ABN group, but significantly more poorly than the comparison group. DISCUSSION: Our results suggest that the social functioning of RBN women lies between ABN women and non-eating-disordered women, indicating both gains relative to the active phase and residual deficits.

Adult↗
PubMed1994

Global social skill ratings: measures of social behavior or physical attractiveness?

Calvert reviewed the literature on social skills and physical attractiveness and concluded that many ratings of social skill may be confounded by the physical attractiveness of the target individual, possibly due to a general perception that physical attractiveness and social competence are positively correlated. In order to examine the influence of physical attractiveness on social skill ratings, Ss made global ratings of social skill and attractiveness for a confederate whose appearance and behavior had been altered to appear attractive or unattractive and socially skilled or unskilled in an assertiveness and heterosocial vignette. The results indicated that the same skilled behavior was viewed as more competent when performed by an attractive person compared to an unattractive person. Attractiveness had no influence on ratings of generally incompetent behavior. Thus, it appears that physical attractiveness does not compensate for poor interpersonal skills, but a skilled, attractive individual may be judged to have particularly good skills. Implications for the assessment of social skills are discussed.

Adult↗
PubMed1982

Social anxiety, daily moods, and alcohol use over time among heavy social drinking men.

To investigate the tension reduction hypothesis of alcohol use in the natural environment and with several forms of tension, 36 heavy social drinking young men kept daily records of their drinking, anxiety, unhappiness, and anger for 3 months and for 1 month from 6 to 7 months from the start of the study. No significant correlations were found between the frequency and intensity of any of the daily moods and drinking rates or intoxication frequency, either concurrently or within a few days or weeks. Drinking was also unrelated to general trait anxiety, depression, stressful life experiences, and locus of control. However, trait social anxiety had a consistent but unexpected relationship to drinking--the less socially anxious the men were, the more they drank over time. Drinking and/or intoxication rates were also related to having more social supports and to traditionally masculine interests. The results cast doubt on the tension reduction hypothesis and suggest that having a strong social group and indifference to the social consequences of intoxication are more important predictors of heavy drinking rates in young social drinking men.

Adult↗
PubMed2006

An islet of social ability in Asperger Syndrome: judging social attributes from faces.

We asked adults with Asperger Syndrome to judge pictorial stimuli in terms of certain social stereotypes to evaluate to what extent they have access to this type of social knowledge. Sixteen adults with Asperger Syndrome and 24 controls, matched for age and intelligence, were presented with sets of faces, bodies and objects, which had to be rated on a 7-point scale in terms of trustworthiness, attractiveness, social status, and age, or, in the case of objects, price. Despite impaired performance on two important aspects of social cognition (second-order mentalizing and face recognition) the social judgements of the individuals with Asperger Syndrome were just as competent and consistent as those of their matched controls, with only one exception: there was a trend for them to be less able to judge the attractiveness of faces if they were the same sex. We explain this difference in terms of a weakness in mentalizing, specifically the ability to take a different point of view: While all other stereotypic attributions could be made from an egocentric point of view, judging the attractiveness of faces of one's own sex requires taking the perspective of someone of the opposite sex, a challenge for people with mentalizing problems. We conclude that individuals with Asperger Syndrome show preserved aspects of social knowledge, as revealed in the attribution of stereotypes to pictures of people. These findings suggest that there are dissociable subcomponents to social cognition and that not all of these are compromised in Asperger Syndrome.

Adult↗
PubMed1998

Social information-processing patterns as predictors of social adaptation and behavior problems among maltreated children in foster care.

OBJECTIVE: The goal of this investigation was to determine if social information-processing patterns were predictive of later social adaptation and behavior problems within a group of maltreated children in foster care. METHOD: A longitudinal design was used to address the study hypotheses. The sample consisted of 124 maltreated children ages 5 to 10 who had been placed into foster care. Twelve months following entrance into foster care, children were presented with age-relevant hypothetical vignettes to assess the quality of the way in which they process social information. Six to 8 months following this assessment, caregivers completed the Vineland Adaptive Scales and the Child Behavior Checklist. RESULTS: Measures reflecting unbiased and competent processing were predictive of social adaptation, whereas measures reflecting biased and incompetent processing were predictive of behavior problems. In aggregate, processing measures accounted for a significant proportion of the variance in the outcome measures. CONCLUSIONS: The findings suggest that the manner in which maltreated children process social information has a bearing on their later social adaptation and behavioral adjustment. Therefore, maltreated children in foster care may benefit from interventions that target the manner in which they process social information.

Child↗
PubMed2002

Individual and neighbourhood determinants of social participation and social capital: a multilevel analysis of the city of Malmö, Sweden.

The aim of this study was to analyse the impact of neighbourhood on individual social capital (measured as social participation). The study population consisted of 14,390 individuals aged 45-73 that participated in the Malmö diet and cancer study in 1992-1994, residing in 90 neighbourhoods of Malmö, Sweden (population 250,000). A multilevel logistic regression model, with individuals at the first level and neighbourhoods at the second level, was performed. The study analysed the effect (intra-area correlation and cross-level modification) of the neighbourhood on individual social capital after adjustment for compositional factors (e.g. age, sex, educational level, occupational status, disability pension, living alone, sick leave, unemployment) and, finally, one contextual migration factor. The prevalence of low social participation varied from 23.0% to 39.7% in the first and third neighbourhood quartiles, respectively. Neighbourhood factors accounted for 6.3% of the total variance in social participation, and this effect was reduced but not eliminated when adjusting for all studied variables (-73%), especially the occupational composition of the neighbourhoods (-58%). The contextual migration variable further reduced the variance in social participation at the neighbourhood level to some extent. Our study supports Putnam's notion that social capital, which is suggested to be an important factor for population health and possibly for health equity, is an aspect that is partly contextual in its nature.

Aged↗