Social Anxiety Disorder Case Study
Social anxiety disorder, SAD, is a fairly common psychiatric condition in the United States. It is defined by excessive fear of judgment in social and performance situations. SAD is defined by emotional biases in addition to distorted and unrealistic negative self-beliefs. Patients diagnosed with SAD are plagued by internal cues, such as negative thoughts about one’s self, and external cues, such as other’s facial expressions (Goldin & Gross, 2010). Adults with SAD display abnormal attentional processes consisting of increased awareness of others opinions and perceptions followed by avoidance of social situations that may cause anxiety. Patients with SAD show reduced recruitment of brain networks that help in regulating thought processes during
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emotional reactivity to social threat stimuli (Goldin & Gross, 2010). The most studied form of mindfulness training in the United States is mindfulness-based stress reduction, MBSR, a program developed by Kabat-Zinn that is shown to reduce symptoms of stress, anxiety, and depression in people with anxiety and depression disorders. MBSR is believed to alter emotional responses in people with SAD by modifying cognitive-affective processes (Goldin & Gross, 2010). MBSR consists of several forms of mindfulness practice such meditation and hatha yoga. Breath-focused practice, attention to the transient nature of thoughts, and shifting attention to different objects comprise MBSR. These mindfulness practices focus on one’s ability to observe thoughts, emotion, mental images, and physical sensations and how they change with the right mindset (Goldin & Gross, 2010). Two forms of attention-focusing meditations are focused attention, defined as object based attention, and open monitoring, shifting attention into a state of monitoring of the present moment without direct focus on a specific object (Goldin & Gross, 2010). Stress and pain are nearly unavoidable in our daily lives. They are part of the human condition. This stress can often leave us feeling irritable, tense, and overwhelmed. The key to maintaining balance is responding to stress not with frustration and self-criticism. According to this article, people have to have mindful, nonjudgmental awareness of their bodies and minds. Although I do not agree with MSBR, Stanford University poses a good argument from the experiment they hypothesized. A recent study conducted by Stanford University focused on investigating MBSR-related changes in patients with SAD. It examined behavioral and neural bases of emotional reactivity to negative self-beliefs. 16 right-handed adult patients diagnosed with SAD met the needed criteria to be part of the experiment (Goldin & Gross, 2010). Some patients were also diagnosed with OCD, dysthymia, major depressive disorder, generalized anxiety disorder, and panic disorder. On average the patients were middle aged, college educated, and diverse in race (Goldin & Gross, 2010). In addition to a clinical diagnostic interview, the patients participated in self-reports and a brain imaging session. Patients also attended a 2.5-hour small group session once a week, a half-day meditation retreat, and home meditations. Classes were conducted by a team member who studied these MBSR practices in Buddhist monsasteries (Goldin & Gross, 2010). In a regulation task, the patients were told 18 social anxiety related negative self-beliefs. Patients reacted to these negative statements for 12 seconds and then were asked to focus on their breathing or another object. Patients then rated how negative their emotions were both before and after (Goldin & Gross, 2010). The results of this experiment showed reduced symptoms of social anxiety and depression. Patients also felt an increase in self-esteem. Patients reported reduced negative emotion experience when focusing on their breathing. Attention distraction did not receive the same results. No significant changes in activity were observed in neural responses in the amygdala or hippocampus (Goldin & Gross, 2010) In response to your article, I feel that there were certain aspects that could have been improved upon within the experiment.
Firstly, the experiment lacked a control group. Also, no other clinical trials were considered for comparison. The size of the experiment, 16 patients, is relatively small. It would be beneficial to the experiment to have a greater number of participants. That being said, the group was well diverse in race and sex. Most were college educated and middle aged therefore I feel it would benefit the experiment if teens, young children, or uneducated people diagnosed with SAD were included. In the regulation task, the patients were told 18 negative self-beliefs and were asked to respond. What were these questions? Did these questions attempt to address different aspects of SAD? Also would having multiple other people in the room during this task affect the participants and their responses? After all, social anxiety takes place in the presence of other people. A second regulation task at another point in time would be good for comparison. The patients were asked to practice what they learned at home. They were told to participate in at home meditations and deep breathing exercises. Whether or not the participants actually did this can affect results of the trial. As a result there is a large margin for error in this experiment. Having Social Anxiety Disorder affect so many important people in my life, it has given me a great interest to research …show more content…
it.
Works Cited:
Goldin , P. R., & Gross, J. J. (2010, February). Effects of mindfulness-based stress reduction (mbsr) on emotion regulation in social anxiety disorder. Retrieved from http://spl.stanford.edu/pdfs/Goldin2010EmotionJournal_MBSR_SocAnxiety_EmotReg.pdf
Katz, Marina. "Anxiety Disorders: Types, Causes, Symptoms, Diagnosis, Treatment, and Prevention." WebMD. WebMD, 20 Feb. 2012. Web. 06 Oct. 2013. .
Staff, Mayo Clinic. "Anxiety." Mayo Clinic. Mayo Foundation for Medical Education and Research, 30 June 2012. Web. 06 Oct. 2013. .
Larzelere, MM, and Jones, GN. "Health Guide." Stress and Anxiety. New York Times, 16 June 2011. Web. 06 Oct. 2013. .
"Stress Reduction Program." The Stress Reduction Program. Center for Mindfulness in Medicine, Health Care, and Society, n.d. Web. 06 Oct. 2013. .
Biblography:
Blair, K., Geraci, M., Devido, J., McCaffrey, D., Chen, G., Vythilingam, M., . . . Pine, D. S. (2008). Neural response to self- and other referential praise and criticism in generalized social phobia. Archives of General Psychiatry, 65, 1176–1184
Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15, 593–600.
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., . . . Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.
DiNardo, P.
A., Brown, T. A., & Barlow, D. H. (1994). Anxiety Disorders Interview Schedule for DSM–IV: Lifetime version (ADIS-IV-L). New York: Oxford University Press.
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 22, 716–721.
Furmark, T., Tillfors, M., Marteinsdottir, I., Fischer, H., Pissiota, A., Langstrom, B., & Fredrikson, M. (2002). Common changes in cerebral blood flow in patients with social phobia treated with citalopram or cognitive–behavioral therapy. Archives of General Psychiatry, 59, 425– 433.
Goldin, P. R., Manber, T., Hakimi, S., Canli, T., & Gross, J. J. (2009). Neural bases of social anxiety disorder: Emotional reactivity and cog- nitive regulation during social and physical threat. Archives of General Psychiatry, 66, 170–180.
Koszycki, D., Benger, M., Shlik, J., & Bradwejn, J. (2007). Randomized trial of a meditation-based stress reduction program and cognitive– behavior therapy in generalized social anxiety disorder. Behavior Re- search and Therapy, 45,
2518–2526.
Northoff, G., Heinzel, A., de Greck, M., Bermpohl, F., Dobrowolny, H., & Panksepp, J. (2006). Self-referential processing in our brain—A meta- analysis of imaging studies on the self. NeuroImage, 31, 440–457.
Stein, M. B., Goldin, P. R., Sareen, J., Zorrilla, L. T., & Brown, G. G. (2002). Increased amygdala activation to angry and contemptuous faces in generalized social phobia. Archives of General Psychiatry, 59, 1027– 1034.
emotional reactivity to social threat stimuli (Goldin & Gross, 2010). The most studied form of mindfulness training in the United States is mindfulness-based stress reduction, MBSR, a program developed by Kabat-Zinn that is shown to reduce symptoms of stress, anxiety, and depression in people with anxiety and depression disorders. MBSR is believed to alter emotional responses in people with SAD by modifying cognitive-affective processes (Goldin & Gross, 2010). MBSR consists of several forms of mindfulness practice such meditation and hatha yoga. Breath-focused practice, attention to the transient nature of thoughts, and shifting attention to different objects comprise MBSR. These mindfulness practices focus on one’s ability to observe thoughts, emotion, mental images, and physical sensations and how they change with the right mindset (Goldin & Gross, 2010). Two forms of attention-focusing meditations are focused attention, defined as object based attention, and open monitoring, shifting attention into a state of monitoring of the present moment without direct focus on a specific object (Goldin & Gross, 2010). Stress and pain are nearly unavoidable in our daily lives. They are part of the human condition. This stress can often leave us feeling irritable, tense, and overwhelmed. The key to maintaining balance is responding to stress not with frustration and self-criticism. According to this article, people have to have mindful, nonjudgmental awareness of their bodies and minds. Although I do not agree with MSBR, Stanford University poses a good argument from the experiment they hypothesized. A recent study conducted by Stanford University focused on investigating MBSR-related changes in patients with SAD. It examined behavioral and neural bases of emotional reactivity to negative self-beliefs. 16 right-handed adult patients diagnosed with SAD met the needed criteria to be part of the experiment (Goldin & Gross, 2010). Some patients were also diagnosed with OCD, dysthymia, major depressive disorder, generalized anxiety disorder, and panic disorder. On average the patients were middle aged, college educated, and diverse in race (Goldin & Gross, 2010). In addition to a clinical diagnostic interview, the patients participated in self-reports and a brain imaging session. Patients also attended a 2.5-hour small group session once a week, a half-day meditation retreat, and home meditations. Classes were conducted by a team member who studied these MBSR practices in Buddhist monsasteries (Goldin & Gross, 2010). In a regulation task, the patients were told 18 social anxiety related negative self-beliefs. Patients reacted to these negative statements for 12 seconds and then were asked to focus on their breathing or another object. Patients then rated how negative their emotions were both before and after (Goldin & Gross, 2010). The results of this experiment showed reduced symptoms of social anxiety and depression. Patients also felt an increase in self-esteem. Patients reported reduced negative emotion experience when focusing on their breathing. Attention distraction did not receive the same results. No significant changes in activity were observed in neural responses in the amygdala or hippocampus (Goldin & Gross, 2010) In response to your article, I feel that there were certain aspects that could have been improved upon within the experiment.
Firstly, the experiment lacked a control group. Also, no other clinical trials were considered for comparison. The size of the experiment, 16 patients, is relatively small. It would be beneficial to the experiment to have a greater number of participants. That being said, the group was well diverse in race and sex. Most were college educated and middle aged therefore I feel it would benefit the experiment if teens, young children, or uneducated people diagnosed with SAD were included. In the regulation task, the patients were told 18 negative self-beliefs and were asked to respond. What were these questions? Did these questions attempt to address different aspects of SAD? Also would having multiple other people in the room during this task affect the participants and their responses? After all, social anxiety takes place in the presence of other people. A second regulation task at another point in time would be good for comparison. The patients were asked to practice what they learned at home. They were told to participate in at home meditations and deep breathing exercises. Whether or not the participants actually did this can affect results of the trial. As a result there is a large margin for error in this experiment. Having Social Anxiety Disorder affect so many important people in my life, it has given me a great interest to research …show more content…
it.
Works Cited:
Goldin , P. R., & Gross, J. J. (2010, February). Effects of mindfulness-based stress reduction (mbsr) on emotion regulation in social anxiety disorder. Retrieved from http://spl.stanford.edu/pdfs/Goldin2010EmotionJournal_MBSR_SocAnxiety_EmotReg.pdf
Katz, Marina. "Anxiety Disorders: Types, Causes, Symptoms, Diagnosis, Treatment, and Prevention." WebMD. WebMD, 20 Feb. 2012. Web. 06 Oct. 2013. .
Staff, Mayo Clinic. "Anxiety." Mayo Clinic. Mayo Foundation for Medical Education and Research, 30 June 2012. Web. 06 Oct. 2013. .
Larzelere, MM, and Jones, GN. "Health Guide." Stress and Anxiety. New York Times, 16 June 2011. Web. 06 Oct. 2013. .
"Stress Reduction Program." The Stress Reduction Program. Center for Mindfulness in Medicine, Health Care, and Society, n.d. Web. 06 Oct. 2013. .
Biblography:
Blair, K., Geraci, M., Devido, J., McCaffrey, D., Chen, G., Vythilingam, M., . . . Pine, D. S. (2008). Neural response to self- and other referential praise and criticism in generalized social phobia. Archives of General Psychiatry, 65, 1176–1184
Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15, 593–600.
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., . . . Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.
DiNardo, P.
A., Brown, T. A., & Barlow, D. H. (1994). Anxiety Disorders Interview Schedule for DSM–IV: Lifetime version (ADIS-IV-L). New York: Oxford University Press.
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 22, 716–721.
Furmark, T., Tillfors, M., Marteinsdottir, I., Fischer, H., Pissiota, A., Langstrom, B., & Fredrikson, M. (2002). Common changes in cerebral blood flow in patients with social phobia treated with citalopram or cognitive–behavioral therapy. Archives of General Psychiatry, 59, 425– 433.
Goldin, P. R., Manber, T., Hakimi, S., Canli, T., & Gross, J. J. (2009). Neural bases of social anxiety disorder: Emotional reactivity and cog- nitive regulation during social and physical threat. Archives of General Psychiatry, 66, 170–180.
Koszycki, D., Benger, M., Shlik, J., & Bradwejn, J. (2007). Randomized trial of a meditation-based stress reduction program and cognitive– behavior therapy in generalized social anxiety disorder. Behavior Re- search and Therapy, 45,
2518–2526.
Northoff, G., Heinzel, A., de Greck, M., Bermpohl, F., Dobrowolny, H., & Panksepp, J. (2006). Self-referential processing in our brain—A meta- analysis of imaging studies on the self. NeuroImage, 31, 440–457.
Stein, M. B., Goldin, P. R., Sareen, J., Zorrilla, L. T., & Brown, G. G. (2002). Increased amygdala activation to angry and contemptuous faces in generalized social phobia. Archives of General Psychiatry, 59, 1027– 1034.