Problem 4: Social anxiety

Question 1

what is the Clark and Wells model of SAD

Answer 1

exposure alone is not enough to heal SAD, they mainly focus on what happens during and after social encounters.
social situation –> activates assumptions –> perceived social danger –> processing of self as a social object (self conscious) –> safety behaviours + somatic and cognitive symptoms

Question 2

explain Rapee and Heimberg’s cognitive behavioural model of SAD:

Answer 2

-SAD is continuum

Question 3

what influences the interpretations of social situations as threatening? according to Rapee and Heimberg

Answer 3

-inherited tendencies
-parent behaviours
-peer experiences
-life events
-culture
–> the longer the duration and exposure –> the higher your risk at anxiety

Question 4

similarities between the models:

Answer 4

• attention goes toward threat
  -maladaptive safety behaviours
  -dysfunctional cognitions
  -both think that social skills may be intact

Question 5

differences between the models:

Answer 5

-in clark and wells safety behaviours are the core problem, in the Rapee and heimberg not
-in clark and wells, attention is inward on how they feel, in rapee and heimberg attention is both inwards and outwards

Question 6

typical cognitive biases in SAD:

Answer 6

-negative interpretation bias
-selective attention bias (focus on negative stimuli compared to neutral)
-unconscious selective bias: pre-consciously attending to danger
-post-event processing and memory: focus on performance after situations
-implicit associations (association between social cues and bodily sensations with negative outcome)

Question 7

behavioural issues in SAD

Answer 7

-interpersonal distance and personal space (more space)
-behavioural mimicry (mimic less and do not notice when others mimic them )
-social skills deficits: skill acquisition, social performance, fluency
-avoidance and anxious behaviour

Question 8

how can you treat sad with exposure therapy

Answer 8

-by direct and indirect engagement with feared stimulus, a context in which negative beliefs can be disconfirmed
criticism: long term effects?

Question 9

other treatment approaches:

Answer 9

• cognitive structuring, effective
  -CBT, group more effective, medication did not help
  -relaxation techniques (how to cope with somatic symptoms)
  -mindfulness, good but not as efficient as CBT
  -interpersonal psychotherapy
  -social skills training
  -medication: not that effective, may be used in combination with other treatment

Question 10

subtypes of SAD

Answer 10

-generalised: any social situation is feared
-non-generalized: fear of specific situations, more related to performance