-
AnxietyEleven consecutive SCID-diagnosed generalized social phobias without major depression, other prominent anxiety disorders, substance abuse, alcoholism or organic mental...
Eleven consecutive SCID-diagnosed generalized social phobias without major depression, other prominent anxiety disorders, substance abuse, alcoholism or organic mental disorder, were treated, open label, with sertraline up to 200 mg daily for 12 weeks. There were seven completers. Of these, five showed substantial improvement, after being on sertraline 100 mg daily for two weeks (following no response to sertraline 50 mg daily for four weeks). There were few side effects among the completers. The four dropouts complained of side effects and loss of interest in continuing treatment. Final average dose for completers who responded was 170 mg daily.
Topics: 1-Naphthylamine; Adult; Dose-Response Relationship, Drug; Female; Humans; Male; Personality Inventory; Phobic Disorders; Selective Serotonin Reuptake Inhibitors; Sertraline; Treatment Outcome
PubMed: 9160574
DOI: 10.1002/anxi.3070010409 -
L'Encephale 1995Although social phobia is a real pathological condition, it has often been neglected. In fact, social phobia is among the least studies of the major anxiety disorders.... (Review)
Review
Although social phobia is a real pathological condition, it has often been neglected. In fact, social phobia is among the least studies of the major anxiety disorders. This is quite surprising, as approximately 2% of the population suffer from debilitating social phobia with devastating effects on career and quality of life, and as this disorder can now be considered as a treatable condition. After defining social phobia, the authors will describe the prevalence, clinical features and etiology of social phobia. Effective psychopharmacological and psychological treatments of social phobia will also be reviewed. The drugs that have been most studied are monoamine oxidase inhibitors and beta-blockers. Several controlled studies have also concluded that behavioral and cognitive therapies (exposure in vivo therapy, social skills training, cognitive restructuring) are beneficial for social phobics. The combination of psychopharmacotherapy and psychological interventions also seems promising. Finally, as it is necessary to distinguish among various subtypes of social phobia, further studies will have to investigate whether specific subtypes do better or worse with specific treatments.
Topics: Cognitive Behavioral Therapy; Combined Modality Therapy; Desensitization, Psychologic; Humans; Phobic Disorders; Psychotropic Drugs
PubMed: 7720617
DOI: No ID Found -
PloS One 2022Needle phobia is an overlooked condition that affects virtually all medical procedures. Our study aimed to identify how commonly needle phobia is experienced, its...
Needle phobia is an overlooked condition that affects virtually all medical procedures. Our study aimed to identify how commonly needle phobia is experienced, its underlying reasons, impacts, and potential mitigation strategies. A global survey was conducted in a general adult population using a questionnaire based on a targeted literature review that identified under-researched areas. The 21-item questionnaire was completed on a secure, web-based survey platform. Statistical analyses and models were utilized to identify relationships between participant characteristics and needle phobia. Of the 2,098 participants enrolled in the study, 63.2% (n = 1,325) reported experiencing needle phobia, and rated the intensity of their fear as 5.7 (±2.6) on average on a scale from 0 (no fear) to 10 (very strong/unreasonable fear or avoidance). According to the logistic regression model, other medical fears (odds coefficient = 2.14) and family history (1.67) were the most important factors associated with needle phobia. General anxiety (96.1%) and pain (95.5%) were the most common reasons for needle fear. Of the participants experiencing needle phobia, 52.2% stated avoiding blood draws, followed by 49.0% for blood donations, and 33.1% for vaccinations. While 24.3% of participants have seen a therapist, most have never sought help. The majority have shared their fear with nurses (61.1%) or physicians (44.4%); however, the provider helpfulness was rated as 4.9 (±3.1) on average on a scale from 0 (unhelpful) to 10 (extremely helpful). Utilizing non-invasive alternatives (94.1%) and smaller needles (91.1%) were most commonly identified as potential device-related solutions to alleviate fear; distractions (92.1%) and relaxation techniques (91.7%) were the top non-device-related approaches. Our findings highlight the prevalent nature of needle phobia and provide insights into its etiology and effects on patient care. Clinician responses were not perceived as helpful, emphasizing the need to address needle phobia, and improve patient experience.
Topics: Adult; Humans; Prevalence; Phobic Disorders; Surveys and Questionnaires; Causality
PubMed: 36409734
DOI: 10.1371/journal.pone.0276814 -
Journal of Behavior Therapy and... Jun 2012Modern learning theories suggest that particularly strong associative learning contributes to the etiology and maintenance of anxiety disorders, thus explaining why some...
BACKGROUND AND OBJECTIVES
Modern learning theories suggest that particularly strong associative learning contributes to the etiology and maintenance of anxiety disorders, thus explaining why some individuals develop an anxiety disorder after a frightening (conditioning) event, whereas others do not. However, associative learning has rarely been investigated experimentally in specific phobias. The current study investigated associative learning in patients with flying phobia and healthy controls using a modified version of Olson and Fazio's associative learning paradigm (Olson & Fazio, 2001).
METHODS
Under the guise of an attention task, patients with flying phobia (n = 33), and healthy controls (n = 39) viewed a series of distracters interspersed with pairings of novel objects (counterbalanced conditioned stimuli, CSs) with frightening and pleasant stimuli (unconditioned stimuli, USs).
RESULTS
After the conditioning procedure patients with flying phobia rated both CSs more frightening and showed stronger discrimination between the CSs for valence compared to healthy controls.
CONCLUSIONS
Our findings indicate a particularly stronger conditioning effect in flying phobia. These results contribute to the understanding of the etiology of specific phobia and may help to explain why only some individuals develop a flying phobia after an aversive event associated with flying.
Topics: Adult; Animals; Association Learning; Attention; Awareness; Chi-Square Distribution; Conditioning, Classical; Diptera; Discrimination, Psychological; Fear; Female; Generalization, Psychological; Humans; Linear Models; Male; Middle Aged; Phobic Disorders
PubMed: 22197755
DOI: 10.1016/j.jbtep.2011.11.003 -
American Family Physician Nov 1999
Topics: Family Practice; Humans; Phobic Disorders; Physician's Role; United States
PubMed: 10593317
DOI: No ID Found -
Collegium Antropologicum 2003Social anxiety disorder (social phobia) is an irrational fear of being observed and judged by other people in various social settings. The individual is afraid that he...
Social anxiety disorder (social phobia) is an irrational fear of being observed and judged by other people in various social settings. The individual is afraid that he or she will act in a way that will be humiliating or embarrassing. It is often a chronic, disabling condition that is characterized by a phobic avoidance of most social situations. Social anxiety disorder is the most frequent anxiety disorder (10-15%) that occurs in two subtypes--generalized and specific. It is a disorder that occurs during the adolescence and reflects negatively to the quality of life of an individual. Neurobiological basis of this disorder has not been explored yet. The disorder is frequently burdened with comorbidity with other anxiety disorders, depression and substance-related disorders. Only cognitive-behavioral techniques are desirable in the psychotherapeutic treatment of the disorder and the best results are achieved in combination with pharmacotherapy. The medicaments of choice in the treatment of social anxiety disorder are selective serotonin reuptake inhibitors. Anxiolytics should be used only as a supplementary in the acute phase. Treatment of social anxiety disorder should last at least 3 months up to one year.
Topics: Anxiety; Humans; Phobic Disorders; Social Behavior
PubMed: 12955904
DOI: No ID Found -
Bulletin of the Menninger Clinic 1994Despite the prevalence and psychological toll of social phobia, it has only recently been systematically studied. Although major advances in pharmacotherapy and... (Review)
Review
Despite the prevalence and psychological toll of social phobia, it has only recently been systematically studied. Although major advances in pharmacotherapy and cognitive-behavioral therapies have added to treatment options available for these patients, social phobia still goes unrecognized and untreated. The author examines how particular countertransference reactions to patients may interfere with the recognition and subsequent treatment of social phobia. She notes that the psychodynamic literature has also neglected this topic, although aspects of social phobia are imbedded in previously described neurotic or characterologically disturbed patients. Two case examples are presented that explore psychodynamic issues related to shame, aggression, trauma, and unresolved grief in the etiology of social phobia. The author believes that treatments that more fully integrate psychodynamic principles with pharmacological treatment and cognitive-behavioral methods will be efficacious in treating this diverse group of patients.
Topics: Adult; Cognitive Behavioral Therapy; Combined Modality Therapy; Countertransference; Diagnostic Errors; Female; Humans; Models, Psychological; Phobic Disorders; Psychotropic Drugs; Treatment Outcome
PubMed: 8044136
DOI: No ID Found -
The Journal of Family Practice Jul 1999Social phobia (social anxiety disorder) is a common disorder that is receiving more attention as new treatments become available. Little is known about social phobia as... (Comparative Study)
Comparative Study
BACKGROUND
Social phobia (social anxiety disorder) is a common disorder that is receiving more attention as new treatments become available. Little is known about social phobia as it appears in the primary care setting. The purpose of our study was to determine the prevalence of social phobia in a primary care clinic, the rates of comorbidity with other anxiety and mood disorders, the extent of disability, and patterns of healthcare utilization.
METHODS
A total of 511 English-speaking adults presenting for routine medical care participated in a 2-stage screening consisting of the administration of a self-report measure for social phobia followed by a structured diagnostic interview. We determined current (1-month) prevalence of social phobia, current comorbid disorders, and we ascertained use of health care in the previous 6 months. We also administered brief functional impairment and disability indices.
RESULTS
A lower-bound estimate of 7.0% of primary care attendees suffered from social phobia as defined in the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. Comorbidity with major depression (58.3% of cases of social phobia) was extensive, somewhat less so with panic disorder (27.8%) and generalized anxiety disorder (30.6%). Social phobics reported significantly more impairment in all functional domains than primary care patients without mental disorders; this was most pronounced in patients with the generalized subtype of social phobia. Social phobics made greater use of health care resources than patients who were not mentally ill, yet few (<20%) were receiving appropriate psychotropic medications.
CONCLUSIONS
Patients with social phobia frequently present to primary care medical settings, and manifest impairment in multiple functional domains. But, on the basis of the low rate of psychotropic prescription, it seems that social phobia is either undiagnosed or felt by physicians to be unlikely to benefit from such treatments. Social phobia is highly comorbid with major depression and with other anxiety disorders in the primary care setting. Attention by family physicians to the presence of depression or panic attacks should signal the need to query patients about possible social phobia.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anxiety Disorders; California; Depressive Disorder; Family Practice; Female; Health Services; Humans; Male; Middle Aged; Phobic Disorders; Prevalence; Psychotropic Drugs
PubMed: 10428248
DOI: No ID Found -
Revista Brasileira de Psiquiatria (Sao... Dec 2009
Topics: Comorbidity; Humans; Phobic Disorders
PubMed: 20098821
DOI: 10.1590/s1516-44462009000400002 -
Cognition & Emotion Dec 2018Several eye-tracking studies have revealed that spider phobic patients show a typical hypervigilance-avoidance pattern when confronted with images of spiders. The...
Several eye-tracking studies have revealed that spider phobic patients show a typical hypervigilance-avoidance pattern when confronted with images of spiders. The present experiment investigated if this pattern can be changed via placebo treatment. We conducted an eye-tracking experiment with 37 women with spider phobia. They looked at picture pairs (a spider paired with a neutral picture) for 7 s each in a retest design: once with and once without a placebo pill presented along with the verbal suggestion that it can reduce phobic symptoms. The placebo was labelled as Propranolol, a beta-blocker that has been successfully used to treat spider phobia. In the placebo condition, both the fixation count and the dwell time on the spider pictures increased, especially in the second half of the presentation time. This was associated with a slight decrease in self-reported symptom severity. In summary, we were able to show that a placebo was able to positively influence visual avoidance in spider phobia. This effect might help to overcome apprehension about engaging in exposure therapy, which is present in many phobic patients.
Topics: Adult; Animals; Anxiety; Eye Movements; Female; Humans; Phobic Disorders; Placebo Effect; Spiders; Young Adult
PubMed: 29303037
DOI: 10.1080/02699931.2017.1422698