Manual Extreme Fear, Shyness, and Social Phobia (Series in Affective Science)

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Furthermore, shyness is a condition many view as a normal personality trait that should not be confused with social phobia see Carducci, ; Stein, Accordingly, those with social phobia have more severe symptoms and are more impaired by their discomfort in social situations than shy persons. This conceptualization is consistent with the notion that shyness is a subclinical condition or a normal facet of personality that is not pathological Carducci, According to this hypothesis, shyness and social phobia may be qualitatively different in some regards, rather than varying only in degree.

Some empirical investigations have begun to define the boundary between shyness and social phobia. However, only half of the highly shy persons in the study had generalized social phobia, lower than would be expected based on a continuum model. In addition, a significant proportion of shy persons had no psychiatric diagnoses. Both prior studies suggest that higher levels of shyness are associated with increasing rates of social phobia, but that the conditions are not the same.

Both studies also suggest that the relationship between shyness and social phobia is limited to those with generalized social phobia, with little to no association between shyness and specific social phobia. In summary, past research indicates that, although shyness and social phobia are related, most shy persons do not meet criteria for social phobia. The pertinent question becomes: are there dimensions that distinguish the subset of highly shy persons with generalized social phobia from other highly shy persons who do not meet criteria for social phobia?

The purpose of this study was to determine what factors, if any, discriminate generalized social phobia from shyness, restricting the analysis to highly shy individuals. The sample for this study consisted of 78 individuals. The other 17 participants were recruited from persons seeking participation in a social phobia treatment study being conducted at the Maryland Center for Anxiety Disorders at the University of Maryland, College Park.

Ten of these treatment seeking participants were also students at the University of Maryland, College Park. The other seven were members of the general community. The sample consisted of 34 women Their ages ranged from 18 to 41, with a mean age of Of the 78 participants, For ease of presentation, these groups are referred to hereafter as the social phobia group, the shy group, and the non-shy group, respectively.

Psychiatric diagnoses were determined through use of a structured or semi-structured interview schedule. Specifically, participants recruited from introductory psychology courses were assessed with the Composite International Diagnostic Interview-Automated, Version 2. Information on social fears, social avoidance, and physical symptoms was gathered via these interview schedules.

Participants were included in the social phobia group if they met DSM-IV criteria for generalized social phobia. Seven of the individuals with social phobia Participants in the other two groups were only included if they did not have psychiatric disorders. Skin conductance and heart rate were monitored continuously throughout a series of behavioral assessment tasks using the Biopac MP Data Acquisition System. Heart rate was measured using the noninvasive NIBP for the first 25 participants.

This device provides a measurement of heart rate via assessment of blood pressure. The device uses a wrist sensor that applies variable pressure directly above the radial artery, continuously measuring pulse pressure. Because calibration of this device for each participant proved to be more time consuming than anticipated, for the remaining participants heart rate was measured using two pre-gelled disposable electrodes placed by the participant on his or her rib cage.

For all participants, palmar sweat gland activity skin conductance level was measured in microSiemens with the Biopac GSRC using a constant voltage method. One ground was placed on the lower arm. The shyness scale the RCBS was completed by 1, introductory psychology students. The mean score was Students with a shyness score equal to one standard deviation above or below the mean scores of 24 and below and 43 and above were eligible to participate in the study. Students were informed of their eligibility for the study by electronic mail and if interested, they volunteered for the study using an electronic system.

Informed consent was obtained from all participants prior to the start of the study. Participants who met criteria for one of the three groups based on their diagnostic status then participated in the behavioral assessment tasks and completed the self-report measures. Seventeen participants, ten of whom were students at the University of Maryland, were recruited from a social phobia treatment study being conducted at the Maryland Center for Anxiety Disorders.

The study recruited participants through newspaper and radio advertisements. Individuals who responded to the advertisements and were appropriate for the treatment study came to the Maryland Center for Anxiety Disorders for an assessment.


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Individuals who met criteria for generalized social phobia using the ADIS-IV were invited to participate in this study in addition to the treatment study. Participants completed the consent process for this study and then participated in the study as described above. Prior to the behavioral tasks, baseline levels of physiological arousal were assessed during a five minute resting period. Participants rated their distress during the baseline period using a Subjective Units of Distress Scale SUDS that ranged from zero to eight, with zero being no anxiety and eight being intense anxiety.

Heart rate and skin conductance levels were recorded continuously during the baseline and the behavioral assessment tasks. After the baseline period, participants engaged in two unstructured three minute conversation tasks, one with an opposite sex confederate and one with a same sex confederate. Confederates were trained to remain neutral during the interaction, leaving the conversation burden to the participant. After these tasks, participants rated their distress using the SUDS scale.

In addition, they provided ratings of perceived anxiety and effectiveness using Likert scales. After the conversation tasks, participants engaged in an impromptu speech task. The participants selected three topics from among a list of five potential topics and had three minutes to prepare for the speech.

Participants then delivered a five minute speech. The two confederates and the experimenter served as the audience. At the end of the task, participants provided a SUDS rating and ratings of their perceived anxiety and effectiveness using the Likert scales. The participants then completed the self-report measures.

The behavioral tasks were videotaped and rated by independent raters who were unaware of group status. The raters were trained so that interrater reliability was. Twenty-five percent of the behavioral assessments were rated by two trained raters to assess interrater reliability, which was.

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Comparisons of demographic characteristics across the three groups were conducted. The percentage of females was Slightly over half The shy and non-shy groups did not differ in terms of age. An alpha level of. The mean shyness score among the shy group was at the 93 rd percentile of the recruitment sample, indicating successful recruitment of this group from the pool of eligible participants.

Key symptoms of social phobia were examined among the three groups in the study Table 1. The core feature of social phobia is a marked and persistent fear of social situations. By definition, all of those with social phobia in the present study reported having social fears. Among the shy group, however, only Thus, about one-third Because they did not endorse the presence of any social fears, they did not meet criteria for social phobia. Among the non-shy group, Common fears reported by the shy and social phobia groups were fear of participating in conversations, meetings or classes, and parties, and fear of public speaking.

Another diagnostic feature of social phobia is the avoidance of feared social situations. Among the social phobia group, almost all Among the shy group, half When examining only the shy who reported social fears, the majority A small proportion of the non-shy group 7. Commonly reported symptoms included racing heart, sweating, stomach upset, blushing and trembling. Among the shy group, About one-fifth A between-subjects multivariate analysis of covariance MANCOVA examined group differences in the average number of feared social situations, avoided social situations, and somatic symptoms.

Pairwise comparisons using the Bonferroni correction revealed that those with social phobia reported more social fears, avoidance of social situations, and somatic symptoms than the shy group, which in turn reported more of these symptoms than the non-shy group. Pairwise comparisons Bonferroni correction indicated significant differences across all three groups.

There was no significant main effect for task. Bonferroni adjusted pairwise comparisons revealed that the social phobia and shy groups reported similar ratings of anxiety for the baseline and the conversation tasks and their ratings were significantly higher than those of the non-shy group. For the speech task, however, the social phobia group reported significantly higher anxiety than the shy group, which in turn reported significantly higher anxiety than the non-shy group. In addition to the anxiety ratings reported above, both participants and independent observers completed ratings of anxiety and effectiveness for the behavioral tasks.

Bonferroni-adjusted pairwise comparisons revealed that the social phobia and shy groups were rated as equally anxious across raters and tasks ; both groups were also rated as significantly more anxious than the non-shy group. For effectiveness, the social phobia group was rated as least effective across raters and tasks , followed by the shy group and then the non-shy group.

Bonferroni-adjusted pairwise comparisons indicated that the social phobia and shy groups had significantly poorer voice quality and higher levels of discomfort compared to the non-shy group. The social phobia group also had significantly poorer facial gaze, conversation flow, and length of responses compared to the non-shy group.

The shy group did not differ significantly on these measures from either the social phobia or non-shy groups. Based on Bonferroni-adjusted pairwise comparisons, the social phobia and shy groups had significantly poorer facial gaze and voice quality during the speech task compared to the non-shy group. The social phobia group exhibited significantly more discomfort e. The covariate age was significant for facial gaze and voice quality, with older participants having better gaze and voice quality.

As noted previously, two methods were used to measure heart rate. All Rights Reserved. OSO version 0. University Press Scholarship Online. Sign in. Not registered? Sign up. Publications Pages Publications Pages. Search my Subject Specializations: Select Users without a subscription are not able to see the full content.

Schmidt and Jay Schulkin Abstract This book assembles a group of researchers to discuss the origins, development, and outcomes of extreme fear and shyness. More This book assembles a group of researchers to discuss the origins, development, and outcomes of extreme fear and shyness. Authors Affiliations are at time of print publication. In interpreting findings, we must consider that the current study differed from others in several important ways. First, an important methodological difference is that previous studies examining emotional processing or attention to emotion, particularly to threat, typically generate scores based on reaction times on a task involving attentional competition between threat and neutral stimuli, such as the dot probe or emotional Stroop Bar-Haim et al.

In contrast, in the current study, the LPP was generated in response to passive viewing of individual images with no task demands, and thus reflect performance-independent aspects of emotional processing. Indeed, in one study using an emotional interruption task in children age 8—13, the LPP was not consistently associated with behavioral responses Kujawa et al. Another important methodological difference was that the previous studies use a range of stimuli to measure emotional processing tendencies, most notably human faces, threat-relevant words, and, in the case of appetitive processing, rewards.

Moreover, some appetitive images in the present study e. Overall, however, IAPS may be more evocative and have more robust effects on both behavior and electrocortical activity compared to face Kujawa et al. Thus, the relatively high salience of the IAPS images used in the current study may have strengthened measurement of individual differences in emotional processing.

Limitations of this current research study include a relatively small sample size, which restrict the statistical power of our analysis, although we did meet sample size requirements to test for interactions. Additionally, we did not include any self-report data on the children's subjective ratings of both the valence and the arousal level of the IAPS images, given that in previous studies in our lab, children were unable to reliably rate the images Derryberry and Rothbart, Thus, we are unable to determine the degree to which the children found the aversive images to be threatening, although previous research using these images shows that like adults, children perceive these images as aversive and arousing Sharp et al.

Since this is a normative group of children, results are inconclusive in terms of the utility of the LPP for measuring emotional processing sensitivities in clinically anxious and inhibited children. This is a crucial direction for future research, but the current study is an important first step in pursuit of this goal. The current study is the first study how the LPP as a measure of attention to aversive and appetitive stimuli interacts with the socialization context to predict inhibited behavior.

This question is particularly important for the target age group, school-aged children, which is a developmental period during which behavioral inhibition may trigger a cascade of biopsychosocial processes that create risk for later anxious psychopathology Fox et al. Taken together, results suggest that the LPP holds promise as a biomarker for biased emotional processing of aversive and appetitive stimuli which may shape the developmental trajectory of inhibition, and that parenting that is motivationally-relevant is an important social context in which to examine this development.

Future research should test this model in the context of pediatric anxiety, tracking whether individual differences in the LPP in response to aversive and appetitive stimuli and parental focus on approach and avoidance predict change and continuity in anxiety symptoms and atypical behavioral inhibition over time. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Amir, N. Automatic activation and strategic avoidance of threat-relevant information in social phobia.

How To Completely Lose Social Anxiety - It's Quite Shocking

Asendorpf, J. Beyond social withdrawal: shyness, unsociability, and peer avoidance. CrossRef Full Text. Banaschewski, T. Annotation: what electrical brain activity tells us about brain function that other techniques cannot tell us - a child psychiatric perspective. Child Psychol. Psychiatry 48, — Bar-Haim, Y. Neural correlates of reward processing in adolescents with a history of inhibited temperament. Life-threatening danger and suppression of attention bias to threat.

Psychiatry , — Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Belsky, J. Beyond diathesis stress: differential susceptibility to environmental influences.


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    Negative affects deriving from the behavioral approach system. Emotion 4, 3— Action, emotion, and personality: emerging conceptual integration. Davidson, R. Affective style, psychopathology, and resilience: brain mechanisms and plasticity. Cole, P. Mutual emotion regulation and the stability of conduct problems between preschool and early school age. Decicco, J. Neural correlates of cognitive reappraisal in children: an ERP study. Degnan, K. Temperament and the environment in the etiology of childhood anxiety.

    Psychiatry 51, — Dennis, T. Emotional self-regulation in preschoolers: the interplay of child approach reactivity, parenting, and control capacities. The late positive potential: a neurophysiological marker for emotion regulation in children. Psychiatry 50, — Derryberry, D. Reactive and effortful processes in the organization of temperament. Cohen and D. Foti, D. Deconstructing reappraisal: descriptions preceding arousing pictures modulate the subsequent neural response.

    What is a phobia?

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    Extreme Fear, Shyness, and Social Phobia by Louis A. Schmidt (ebook)

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    Louis A. Schmidt and Jay Schulkin

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