Block 2.6. Stress and Anxiety: Problem 4 Social Anxiety Disoder, English Summary
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Course
2.6 Clinical Psychology Stress & Anxiety
Institution
Erasmus Universiteit Rotterdam (EUR)
Block 2.6. Anxiety & Stress: Problem 4 SAD (Social Anxiety Disorder) English Summary
Summary of everything discussed in the tutorials and the literature, The grade obtained for the course was 8.1
Cognitive Behavioral Models of SAD (Wong, Gordon,
Heimberg)
Models of Social Anxiety
SAD develops as a result of an interaction between innate behavioral
predispositions and life experiences, leading individuals to perceive
the social world as dangerous ones that have little ability to
navigate.
Self-representational models > Sense risk of behaving in an
unacceptable way > catastrophic consequences (loss of status,
rejection, loss of value)
Dysfunctional Processes
1. Processing of self as social object (attentional inward bias
interoceptive info as feedback that confirms their
ineffectiveness, imagine self as others see them)
Clark and Wells (1995)-
Cognitive Model 2. Safety Behaviors : use them to prevent negative evaluation but
prevents the person from disconfirming neg. beliefs
3. Overestimate negative evaluations of others: cognitive
distortions might further impair their social performance and
lead to others perceiving them us unskilled
4. Anticipatory anxiety: before or after a social situation; before
the situation previous negative experiences are recalled >
avoidance
During the situation > self-focused processing, reduced capacity
of noticing others.
After the situation > review of performance, colored by biases
and distortions, maintenance of neg. schemas
Rapee and Heimberg Social anxiety continuum > SAD is the higher end
(1997)- Cognitive- Difference between ppl with and without SAD is the extent to
Behavioral Model which ppl appraise cues as predictive of threat and the
extent of the threat.
i. Genetic tendency that interacts with experiences
ii. Importance of others’ views (discrepancy bt mental
representations of self as seen by others –
expectations of others)
Dysfunctional Processes
1. Social situations: negative true or imagery, cause anxiety and
influence self-representations and leads to maintenance of
SAD.
, PROBLEM 4. SOCIAL ANXIETY DISORDER 2
2. Fear: fear of any kind evaluation, FPE of maintaining high
performance, they want to maintain their low status and not
drawing attention
3. Post-event processing (PEP): person’s review and recall of
situation that is often bias and distorted >fear of future
situations
Comparison Between Models
Similarities:
Excessive mental resource focus of attentional resources on threat cues, avoidance
behaviors and dysfunctional cognitions.
Both mention that the lack of social skills is not a universal characteristic of SAD patients
> the negative cognitions, anxiety and safety behaviors give that appearance.
Clark & Wells Rapee & Heimberg
Attention is directed externally in Attentional bias of shifting attention to
search of threat cues- how the others monitor internal cues- how I feel
feel Safety behaviors
Safety behaviors not more problematic Treatment through identifying safety
than overt avoidance behaviors and compare experiences
Treatment through training socially with or without them
anxious ppl to direct attention away
from mental representations of self
and indications of evaluation
Recent Cognitive-Behavioral Models
Social goals: Difficulty defining (achievable) goals other than
making an impression, difficulty in planning & attaining them
Emotional control: low emotional control, causing fear of
Hofmann (2007) anxiety esp. when others will witness their loss.
Cognitive Factors Similarities to other models: self-monitoring & external threat
detection with heightened self-focused attention (Clark & Wells),
negative self-perception and high-costs of loss, intact social skills but
poor perception of them, PEP.
Moschovitch (2009) Previous models did not represent core fear accurately > feared
Core Fear in SAD stimulus is not the evaluation/ embarrassment but the self-
attributes that might be perceived as deficient based on social
expectations.
Four dimensions of feared stimuli:
1. Perceived flaws in social skills
2. Perceived flaws in concealing visible anxiety
3. Perceived flaws in physical appearance
4. Characterological flaws
Treatment: Focus from situational to dimension-specific exposure,
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