nog niet af -Review Social Anxiety and Social Anxiety Disorder

Question 1

Social anxiety (SA) is a common human experience characterized by an intense fear of evaluation from others in social situations. When it reaches a pinnacle of severity such that functioning is impaired, we refer to it as social anxiety disorder (SAD) or social phobia

Answer 1

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Question 2

The Heimberg et al. model van SA/SAD

Answer 2

1. perception of an audience (dus het idee dat er iemand is die gaat evalueren, whether this is true or not)
2. mental representation of the self as seen by the audience
3. negative self-imagery due to negative social experiences and/or distorted self-perception
4. concludes that audiences opinion is poor, but at the same time they have high standards
5. dissonance between what they think audience sees and expects
6. anxiety
7. vicious cycle, as it feeds back into the mental representation of the self as seen by the audience -> weer meer anxiety

Question 3

dus hoe leidt attentional bias tot een vicieuze cirkel

Answer 3

Attention bias toward threat virtually assures that visible or perceived displeasure on the part of the audience, visible signs of anxiety e.g., reduced eye contact or fidgety behavior; blushing), and aspects of anxiety knowable only by the person (elevated heart rate or the sense that one’s mind is going blank, which may signal an impending loss of control of behavior) are negatively applied to the mental representation of the self as seen by the audience. This vicious cycle repeats as the person remains in the situation and is carried forward in time as the person anticipates similar future situations.

Question 4

Studies manipulated attention bias and anxiety decreased thereafter, therefore there is evidence that attention bias to social threat plays a causal role in the maintenance of SA. However, the magnitude of this effect may be smaller than originally proposed

Answer 4

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Question 5

Attention bias toward social threat may be
accompanied by …

Answer 5

a bias away from positive social information

(dus geen positieve dingen registreren)

Question 6

In addition, the tendency to allocate attention away from positive social stimuli mediated the effect of SA on change in state anxiety in response to a social stressor, implicating the role of diminished processing of positive social information in the persistence of SA

Answer 6

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Question 7

wat gaven Mathews and MacLeod voor reden voor de verschillende resultaten in attentional bias research

Answer 7

Mathews & MacLeod (1994) argued that the occasionally contradictory findings in the attention bias literature suggest that normal individuals high in trait anxiety may have the ability to effortfully compensate for their tendency to shift attention toward threat-relevant stimuli. In contrast, clinically anxious individuals may be unable to effortfully regulate their attention. Moreover, individuals vary in the ease with which they can be trained to exhibit an attention bias toward threat (e.g., Clarke et al. 2008), which suggests that there may also be differences in how easily attention bias toward threat develops naturalistically.

Question 8

SA was inversely related to self-reported attentional control after controlling for depression and state anxiety (Moriya
& Tanno 2008).

Answer 8

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Question 9

There is also evidence of a relationship between SA and reduced attentional control using an antisaccade task in which participants are instructed to immediately look straight to the opposite, mirror-image location on the screen of a peripherally presented cue, which requires inhibition of a reflexive saccade as well as generation of a volitional saccade. In an emotional antisaccade task in undergraduates low, moderate, and high in SA, Weiser et al. (2009) observed significantly higher antisaccade error rates for individuals with high SA than for individuals with moderate SA. There was no evidence of greater threat interference, however, implying the deficit in attentional control was generalized

Answer 9

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Question 10

Children’s attentional control was inversely related to appropriate social responding. This finding may hold particular relevance for SA in which anxiety-related impairments in self-regulatory mechanisms such as attentional control may adversely affect interpersonal behavior, thereby confirming the individual’s fears of poor social performance

Answer 10

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Question 11

wat is nu de stance van treatment van SAD door middel van CBT enzo

Answer 11

Tobon et al. (2011) reviewed the literature
on the effects of cognitive-behavioral therapy (CBT) on attention bias toward threat and found that 10 of 13 studies across various anxiety disorders demonstrated a treatment-related reduction in bias. Further research on SAD in particular is warranted, but current findings suggest CBT is effective at mitigating such biases. In contrast, much less is known about whether effective psychotherapy modifies attention to positive stimuli. Additionally, research should consider whether changes in attention bias to threat or positive stimuli mediate treatment outcome or predict long-term treatment outcomes.

Question 12

Some examples include Bogels’s Task Concentration Training (e.g., B ¨ ogels 2006), ¨
Rapee and colleagues’ attention retraining augmentation of CBT (Rapee et al. 2009), and mindfulness-based interventions. Of these approaches, mindfulness-based interventions have perhaps received the most empirical support. Several open trials have suggested the efficacy of these interventions for SAD, mostly mindfulness-based stress reduction (MBSR; e.g., Goldin & Gross 2010). Evidence to date also suggests MBSR results in increased activity in attention-related brain areas (Goldin & Gross 2010). Therefore, MBSR, including its effects on attention bias toward threat and away from positive information as well as attentional control deficits, appears worthy of further investigation.

Answer 12

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Question 13

interpretation bias =

Answer 13

the tendency to interpret ambiguous or neutral stimuli as threatening

Question 14

Studies of “online” measures of interpretation bias (i.e., those that assess relatively automatic processes) typically find that individuals with SA …

Answer 14

lack the nonthreat/positive bias typical of nonanxious individuals

Question 15

SA has been associated with threat interpretations of positive social events (Alden et al. 2008) and failure to accept others’ positive reactions at face value

Answer 15

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Question 16

wat is het verschil van mensen met SAD versus mensen met andere anxiety disorders

Answer 16

Individuals with SAD also endorsed more negative interpretations of positive events than individuals with other anxiety disorders, including panic disorder and generalized anxiety disorder (GAD), but not obsessive-compulsive disorder

Question 17

wat is er met SAD en perfectionisme

Answer 17

Laposa et al. (2010) also reported that, among
individuals with SAD, negative interpretation of positive events was correlated with perfectionism and severity of interpersonal fears.

Question 18

These biases in interpretation of positive social information may also contribute to diminished positive affect in SA

Answer 18

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Question 19

wat is er met SA en facial expressions

Answer 19

Studies have generally reported no difference in the accuracy of detecting different facial emotions using static facial stimuli (e.g., Mullins & Duke 2004). However, these studies did find evidence of variations in detection speed. For example, SA was associated with quicker detection of high-intensity anger and fear under conditions of moderate threat (Mullins & Duke 2004). In contrast, in the no-threat condition, SA was associated with slower detection of low-intensity sadness and anger, suggesting the relationship between SA and facial emotion detection may vary according to both state anxiety and intensity of the facial expression.

dus:
quicker detection of high-intensity anger and fear under threat, slower detection of sadness and anger under no-threat

Question 20

there is no evidence that SA is associated with biases in interpretation accuracy, but there are differences in speed

Answer 20

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