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PubMedDate not supplied

[Social phobia: historical and conceptual perspectives].

Social phobia is individualized in international classifications only since 1980 with the DSM III, ten years after the publication by Marks of its phobic disorders classification. Nevertheless, many european authors, psychiatrists or psychologists, have raised the question of social anxiety as far back as the eighteenth century, with various points of view and appellations. The first report of an ereutophobia observation is due to Casper, in 1846, which described a serious social anxiety affecting a young man. Ereutophobia has been especially studied by Pitres and Regis, in 1807 and 1902, and by Claparede in a comprehensive review published in the same period. Janet has also proposed, in 1903, a classification of phobia including a section for social phobia. In 1910, Hartenberg has described several forms of social anxiety under the generic term of shyness (timidity, performance anxiety, personality disorders, etc.). Then, there is a relative silent period until 1960 even if the names of Kontaktneurosen or social neurosis are punctually mentioned in british and german literatures, and if Morita, in Japan, has taken an interest in social anxiety around 1930. The existence of social phobia as a valid syndrome A has been confirmed in the successive classifications since the DSM III. Several structured interview schedules or self-rating scales have been proposed for assessment of social phobia, such as Liebowitz or Davidson scales, but at present no one instrument has demonstrated superiority and the use of a battery of several scales is recommended. Moreover, some diagnostic issues are not yet completely solved, in particular concerning the validity of different subtypes of social phobia. To date, only the generalized type has been individualized in the classifications when circumscribed and performance types remain disputed. Delineation of social phobia with avoidant personality, shyness, performance and test anxiety, other phobic disorders and complications like alcoholism are discussed. Clinical, epidemiological and therapeutical implications of these questions are of importance from a theoretical but also practical point of view.

Comorbidity↗
PubMed2006

The influence of trait anxiety on autonomic response and cognitive performance during an anticipatory anxiety task.

The interaction between emotion and cognition is thought to be intimately involved in the development and maintenance of anxiety disorders. In a set of studies, we investigated whether trait anxiety modulates cognitive performance and autonomic activity during an anticipatory anxiety task. Participants completed a letter-size decision-making task with two alternating 28-32 s background screen color-blocks. One of the colors was associated with the presentation of an aversive noise [unconditioned stimulus (UCS)]. Participants were aware of the background color that would (CTX+) and would not (CTX-) be paired with the UCS but did not know when or how often the UCS would be presented. Two experiments were conducted. In Experiment 1, the UCS was presented during the decision-making task in the CTX+ color-blocks using a partial reinforcement schedule. Different noises were presented each time to increase unpredictability and prevent habituation. In Experiment 2, the UCS was never presented during the decision-making task. Results suggested that only the paradigm used in Experiment 1 was successful in eliciting anticipatory anxiety. In Experiment 1, continuously measured skin conductance response (SCR) data suggested that anxiety was significantly greater during CTX+ compared to CTX- trials; no SCR differences were found between high and low trait-anxious participants. Results further indicated that high trait-anxious participants responded significantly faster on the decision-making task during CTX+ compared to CTX- trials, whereas low trait-anxious participants displayed the opposite pattern. Our results reveal an interesting dissociation between the effects of individual differences in trait anxiety on autonomic activity and cognitive performance during an anticipatory anxiety task.

Adult↗
PubMed1990

Sexual confusion among certain college males.

In dealing with college age (18-22) males, clinical observations have shown a fairly common inability to successfully form intimate relationships with same-age females. This problem often appears to be due to an inability to bond and trust that is rooted in the formative years in the nuclear home. When this happens, the young male frequently develops a fear of being sexually abnormal, perhaps even homosexual. This manifests itself in shame, anxiety, depression, denial, reaction formation, performance anxiety, concern about being found out, isolation, substance abuse and, occasionally, acting out. Getting such persons to admit these fears is generally extremely difficult, requiring gentle and empathetic, but persistent, probing on the part of the therapist. Therapy consists of understanding and acceptance by the client that these fears are most often reactive, that they are commonly held, and that when they are seen in proper perspective, they often diminish. The present paper reviews some of the literature on sexual developmental issues of the adolescent male as a backdrop for this problem. The specific difficulties related to reactive homophobia are explored, and some therapeutic approaches suggested.

Adolescent↗
PubMed1995

Path analysis examining relationships among antecedents of anxiety, multidimensional state anxiety, and triathlon performance.

The study explored predictive paths for antecedents of anxiety, state anxiety responses, and performance. Male triathletes (N = 175) completed a modified Competitive State Anxiety Inventory-2 which included the original intensity scale and a direction scale of Jones and Swain. They also completed a 23-item Prerace Questionnaire which measured antecedents of anxiety among triathletes. Factor analysis of intercorrelations for the Prerace Questionnaire identified six factors similar to those found in 1995 by the present authors. Path analysis to predict state anxiety from antecedents of anxiety indicated that rated intensity of anxiety was predicted by the perceived difficulty of race goals and by perceived readiness. Direction of anxiety was predicted by coach's influence, recent form, and perceived readiness. Path analysis to predict performance from state-anxiety scores and antecedents of anxiety indicated that recent form predicted performance directly without mediation of anxiety responses. Anxiety scores did not predict performance. The findings support the notion that intensity and direction of anxiety responses have different antecedents.

Adolescent↗
PubMed2002

Is "shy bladder syndrome" a subtype of social anxiety disorder? A survey of people with paruresis.

Paruresis is characterized by the fear of not being able to urinate in public bathrooms and has been classified by some to be a sub-type of social anxiety disorder (social phobia). Despite the existence of a consumer advocacy organization, the "Intentional Paruresis Association (www.paruresis.org)," there is sparse literature on this condition. A survey of people affiliated with the "International Paruresis Association" was undertaken using a self-report questionnaire with items that addressed demographic variables, the phenomenology of paruresis, comorbid disorders, and the impact of symptoms on quality of life. Sixty-three patients (59 M, 4 F) completed the questionnaire. The mean age of the subjects was 38.1+/-12 years, with the mean duration of symptoms being 24.5+/-13 years. Paruresis impacts significantly on sufferers' lives, with approximately one third limiting or avoiding parties, sports events, or dating and just over half of the sample limiting the job they choose to do. Social anxiety disorder (SAD) and depression are the most common comorbid disorders and the most common disorders in family members. Analysis of Liebowitz Social Anxiety Scale (LSAS) scores showed higher performance than social interaction subscale scores across the whole sample (whether suffering from SAD or not.) However, compared to subjects without co-morbid SAD, those with comorbidity had higher total, performance, and social interaction scores. Thus, paruresis can be a chronic and disabling symptom, and there seems to be an association between paruresis and other performance anxieties. Further research to characterize paruresis and to determine effective treatments is needed.

Adult↗
PubMed2004

Social anxiety in outpatients with schizophrenia: a relevant cause of disability.

OBJECTIVE: Social anxiety is a frequent but often unrecognized feature in schizophrenia and is associated with a severe level of disability. To precisely define the assessment, impact, clinical correlates, and consequences of social anxiety in schizophrenia, the authors conducted a survey of schizophrenia patients and a comparison cohort of patients with social anxiety disorder. METHOD: A consecutively enrolled group of 80 outpatients with DSM-IV schizophrenia and a consecutive comparison group of 27 patients with social anxiety disorder were recruited from an institutional psychiatric practice and assessed with the Liebowitz Social Anxiety Scale, Scale for the Assessment of Negative Symptoms, Scale for the Assessment of Positive Symptoms, Social Adjustment Scale, and the Medical Outcomes Study 36-item Short-Form Health Survey. RESULTS: Social anxiety scores of schizophrenia patients with comorbid social anxiety disorder (N=29, 36.3%) did not differ from those of subjects with social anxiety disorder as their primary diagnosis. Schizophrenia patients without social anxiety disorder had significantly lower total scores on the Liebowitz Social Anxiety Scale and lower social and performance anxiety subscale scores than did the other two groups. No differences in negative and positive symptom rates were found between schizophrenia patients with and without social anxiety disorder. Schizophrenia patients with social anxiety disorder had a higher lifetime rate of suicide attempts, greater lethality of suicide attempts, more past substance/alcohol abuse disorder, lower social adjustment, and lower overall quality of life. CONCLUSIONS: Social anxiety is a highly prevalent, disabling condition in outpatients with schizophrenia that is unrelated to clinical psychotic symptoms. The Liebowitz Social Anxiety Scale appeared adequate and reliable in assessing social anxiety disorder in patients with schizophrenia. If these data are confirmed, this study will make a contribution to the search for operational guidelines and adequate next-step treatments for social anxiety disorder in schizophrenia patients.

Adult↗
PubMed2002

Relation of test-specific motivation and anxiety to test performance.

The relations between consequence of test scores and motivation, anxiety, and test performance were studied with 112 persons in four undergraduate educational psychology courses. Students were given two versions of an hourly course examination that varied in consequence, with one counting for part of their grade and the other not counting. Each student completed the Learning and Study Strategies Inventory prior to taking the examination. Afterwards students completed a measure of test anxiety and test motivation specific to the examination they had just taken. Significant main effects were found for consequence of test with scores for test anxiety, test performance, and test motivation. Also, the subscales showed a consistent pattern of relations with test performance and test anxiety across the two conditions, but not for test motivation for which few relations were found under the condition with no consequence.

Adult↗
PubMed1989

Task performance and perceptions of anxiety: averaging and summation in an evaluative setting.

Suggests that individuals' "stage fright," or perceptions of anxiety and performance, is a function of tendencies to both average and summate the impact of audience members. We found that under certain conditions adding an evaluative member to an audience decreased anxiety, whereas in other conditions the addition of evaluative members increased anxiety. These results are not expected from social impact theory or social facilitation research and suggest that individuals do not react to groups of individuals in a manner analogous to the way in which trait information is typically averaged in forming impressions of individuals (Anderson, 1981). An averaging-summation model that does account for these findings is presented. This research has implications for research on crowding, stress, social influence, and affective responses.

Adolescent↗
PubMed1999

Perceived competence, social anxiety about physique, and enjoyment in testing situations among groups of mixed sex and girls only.

The purpose of the present study was to assess whether there are differences in agility and coordination performance, anxiety about physique, perceived competence, and enjoyment between girls (n = 56) performing within mixed-sex versus all-female high school classes in physical education. A series of between-group comparisons yielded no significant differences between groups on measures of performance, perceived competence, and anxiety about physique; however, the mixed-sex group reported significantly greater enjoyment on both psychomotor tests than the all-female group (ps < or = .05). Results are discussed within other contexts such as sport motivation and Weiss and Chaumeton's (1992) theory of youth sport development.

Adolescent↗
PubMed1986

State-trait anxiety and motocross performance.

The prediction from state-trait theory that subjects low in anxiety will perform better than highly anxious subjects on a more difficult task was tested on a motocross competition. We analyzed the relationships among the entire rank order of finish and state and trait anxiety measured by State-Trait Anxiety Inventory for 32 motocross riders (males whose age ranged from 16 to 27 yr.) participating in a national competition in Italy. A negative correlation between performance (measured by rank at the finish of the competition) and state anxiety was noted. The r for state and trait anxiety scores was also negative, but that between performance and trait anxiety was nonsignificant. Additional studies of high level sport competition will provide data relevant to planning interventions to control athletes' anxiety.

Adolescent↗
PubMed1998

Factor structure of the Social Interaction Anxiety Scale and the Social Phobia Scale.

In the study of social anxiety, it is common to differentiate between social interaction versus performance anxiety. The Social Interaction Anxiety Scale was designed to assess social interaction anxiety, and the Social Phobia Scale to assess fear of scrutiny by others (Mattick and Clarke, 1989). In common use, these scales are typically administered together and treated as subscales of a larger measure. However, the joint factor structure of these instruments has never been examined; therefore, it is unclear whether or not the items on these scales actually represent distinct aspects of social anxiety. In the present study, a confirmatory factor analysis of the pooled items from the SIAS and SPS failed to adequately fit the data. An exploratory factor analysis yielded three factors: (1) interaction anxiety, (2) anxiety about being observed by others, and (3) fear that others will notice anxiety symptoms. However, hierarchical factor analysis suggested that these factors all load on a single higher-order factor, social anxiety. Relationships of the first-order factors to other measures of social and performance fear and avoidance are examined, and implications of our findings for the assessment of social phobia are discussed.

Adult↗
PubMed2002

The effects of depression and anxiety on memory performance.

The effects of depression and anxiety, as assessed by MMPI D and Pt scales, on memory performance was examined in 3999 veterans who completed the California Verbal Learning Test (CVLT). Depressive symptoms (without anxiety) had an adverse effect on immediate recall of new information and the total amount (but not rate) of acquisition; however, retrieval and retention were unaffected. On the other hand, high levels of anxiety did not have significant detrimental effects on any aspect of memory functioning assessed including immediate recall, total amount acquired, retention, and retrieval of novel information. However, when depression was compounded by anxiety, there was not only an adverse effect on immediate recall and amount (but not rate) of acquisition, but also on the retrieval of newly learned information. We conclude that the presence of comorbid anxiety may, in part, account for the variability in previous research findings regarding the effects of depression on memory functioning.

Journal Article↗
PubMedDate not supplied

The new and newer antianxiety agents.

Anxiolytic drugs are adjuncts to non-pharmacological treatments for anxiety. Alcohol and tobacco remain the major psychoactive agents that are used in our community. Benzodiazepine drugs are the agents of choice if an acute reduction in anxiety or intermittent therapy is needed and are helpful for long-term use in a few patients. For panic disorders, alprazolam is effective for short- and long-term treatment, although it needs a slow reduction in dosage and carries a risk of withdrawal reactions in about 30% of sufferers. Clonazepam also may help panic attacks and possibly other benzodiazepine agents would show similar effects at equivalent doses. Antidepressant drugs, including monoamine-oxidase inhibitor agents, although more toxic and sometimes less tolerated than is alprazolam, have antipanic effects in high doses and are of use for prolonged therapy for panic disorders. Neuroleptic agents' general usefulness as anxiolytic drugs is restricted because of their acute and long-term toxicity. There is no place for the use of antidepressant or neuroleptic drugs as treatments of first choice in uncomplicated generalized anxiety. beta-blocking agents have limited adjunctive use for performance anxiety and social phobias. Buspirone heralds a new class of anxiolytic agents. Buspirone has advantages in patients who can tolerate its slow onset of action, with reduced psychomotor effects, lower interactive effects with cortical depressant substances and a seeming lack of dependency or any withdrawal syndrome.

Anti-Anxiety Agents↗