Paste your essay in here…Ever feel shy in a public place or have anxiety when giving a speech at school or at work? How about distressed when you meet someone new and avoidant of approaching that person because you may be apprehensive of the fact that they might judge you? Well if this is a persistent act of behavior that occurs frequently and for an extended period of time, about six months (Diagnostic, 2013, p. 203), then these may be signs of having Social Anxiety Disorder(SAD). According to the DSM-V, Social Anxiety Disorder is currently defined as “Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation, meeting unfamiliar people), being observed (e.g., eating or drinking), and performing in front of others (e.g., giving a speech)” (Diagnostic, 2013, p. 202). Though this is the current description of Social phobia, it has originated from as long as the Classical Greece era and has seen a turn of various diagnosis and classifications through our history and is still being heavily researched today. This is due to the lack of specificity in criteria for diagnosis, therapies and treatments invented, issues of comorbidity, genetic factors, and the overall amount of research being done for someone who has Social Anxiety Disorder.
Origin of Social Anxiety Disorder
Social Anxiety Disorder dates back long ago to the classical Greece Era where it was originally seen as a mere construct than an actual illness. It was a concept described as “Social Fear” which had been recognized by the ancient Greek philosopher Hippocrates. The qualities seen in someone with social fear would be distinguished as withdrawal from society, being excessively shy, and autonomic arousal (Alfano, 2011). Autonomic arousal being an increase in heart rate, respiratory issues, and stomach issues such as inadequate digestion (Heyer, 2018). This form of anxiety was also seen by one of Hippocrates patients who he describes to have not “ come into company for fear he must be misused, disgraced, overshoot himself in gestures or speeches, or be sick; he thinks every man observeth him” (Burton, 2017). This historical context revealed that a phobia existed for people who feared having this social anxiety as well as the physical symptoms that came along with it. In the early 20th century, social fear was starting to be recognized widely by people as being a phobia. An important figure by the name of Paul Hartenberg wrote a book by the name of Les Timides et la Timidité, that was published in the year 1921. This book helped give insight on not only a description of what social phobia was but also what its symptoms were and what the approach to treatments should have been. The description of social phobia was defined as “a strong desire to make a positive impression of oneself to others, accompanied by significant insecurity that one will fail to do so” which would later be found to be very similar with the more contemporary classifications for social phobia (Hartenberg, 1921). The cause/explanation for what the etiology is for Social Phobia is as described by Hartenberg (1921). He at that point presumes that we can distinguish three reasons for social fear: (1) inclining causes (i.e., inborn inclination or heredity), (2) deciding causes (i.e., physical or mental hindrances), and (3) situational causes (i.e., the circumstances, people, and places that normally incite uneasiness in the socially phobic individual). He proceeds to portray the circumstances, people, and places that he accepts generally incite social nervousness.
Symptoms and Treatments
The symptoms observed by Hartenberg were classified in four different categories, each as follows; psychological symptoms, vascular symptoms, sensitive symptoms and motor symptoms. Sensitive symptoms being increased heart rate, body temperature changes, and shortage of respiration. Psychological symptoms being lack of concentration, amnesia, and sensory issues. Vascular symptoms include stomach pain, nausea, and excessive perspiration. Lastly, motor symptoms include, muscle dysfunction and speaking properly (Fairbrother, 2002). These being the recognized symptoms, one could see how there had to have been treatments to ongoing symptoms that could ultimately have a large effect on one’s life. Medical treatment is important just for individuals who can't defeat their social tension by their own methods. Hartenberg (1921) proposes making common suggestions relating to cleanliness and diet. He also proposes adequate rest and customary physical exercise as well as carry on as though they feel sure regardless of whether they are not, work on keeping up great stance, holding their head up, talking at an ordinary volume. At long last, the doctor should utilize verbal recommendation with an end goal to stir in the social phobic sentiments of pride, aspiration, vanity, and love. The doctor should give the social phobic individual a huge number of motivations to raise their confidence. These treatments are only the beginning of what future therapies and treatments that would eventually be used in present day psychology.
Present Day Social Anxiety Disorder
The current definition for Social Anxiety Disorder has gained some more specificity since first described in the early 20th century. It now mentions a duration which is for the anxiety, fear and avoidance to regularly persist for at least six months. Additional modifications include exceptions to things that may cause similar signs of social phobia but aren’t actually attributed to it; such as medical conditions and symptoms of other “mental disorders such as panic disorder, and autism spectrum disorder” (Diagnostic, 2013).
Genetics and Comorbidity
This presents the notion of comorbidity which appears to share similarities with other neurotic disorders as well as surveys of Social phobia distributed to the general public. There are also categories and specifications for children who are diagnosed with the disorder as well. The “National Comorbidity Survey, 81% of those with a diagnosis of social phobia also met criteria for another disorder” (Magee, 1996). The role of genetics in Social anxiety’s etiology has also seen its share of research. It was found that children who were diagnosed with Social phobia were more likely to have parents with the disorder than children who didn’t have the disorder. There is also further evidence which proves this with twin studies that were done to show heritability of the disorder which is around 65 percent (Rapee, 2004). Research across disorders such as depression, alcohol abuse and social phobia, began to show that a common genetic component was present which may explain high comorbidity amongst them. These common genetic factors suggest that adolescents with social anxiety have a high rate of suffering from alcohol abuse and depression (Stein et al., 2001). Therefore, genetics take part in not only if a child can be diagnosed with social anxiety disorder but the genetic factors can influence the child's well being in life as well.
Current Symptoms and Treatments
The symptoms described today are nearly the same as they were when they were first discovered except the main difference is prevalence and persistence that have to exist while these symptoms occur (Jefferson, 2001). The treatments however have developed dramatically since the course of 100 years through the advancement of psychotherapy. Some of which include Social skills training, Exposure therapy, Cognitive therapy, and Cognitive-behavioral therapy. Social skills training includes showing patients the basic verbal and nonverbal skills important to successfully and easily cooperate with others. Role-playing and practicing with exposure are basic components. It is also a “central component of an intervention known as social effectiveness training” (Jefferson, 2001). Exposure therapy (as cited in Jefferson, 2001) involves the patient to be exposed by a fearful situation would ultimately result in anxiety by habituation. For instance, working as a greeter at a retail store would give exposure to an environment where you would have to be constantly talking to people. As you repeat this process you would feel much more comfortable and slowly overcome your anxiety. In Cognitive therapy, irrational and negative thoughts about the self are challenged so that unwanted behavior can change and the patient may become more sociable. Lastly, Cognitive-behavioral therapy(CBT) is a combination of both Cognitive therapy and Exposure therapy in which you recognize the thought process you have which creates your anxiety and then you reevaluate them in reality (Jefferson, 2001). Though there has been the development of therapies and treatments to deal with social anxiety disorder, further research can be done to improve its treatments.
Future Directions in Social Phobia Research
There are many ways in which research can be done to further investigate the development of social anxiety in children and research that improves treatment for those diagnosed with the disorder. It is suggested that the parents and their child’s interactions be studied to explore the risk of developing social phobia. A study at Murray and Cooper Reading University is currently in progress to explore future roles of parenting that may be done to prevent it from developing. Mothers with infants with and without social phobia are being studied under conditions of “social and non-social stress” (Bögels, 2004). Research of other psychiatric disorders should also be evaluated in regards to social anxiety because they may lead to negative a negative social fear like embarrassment. Another challenge would be to measure preventive effects of other disorders when given treatment to a patient diagnosed with social phobia. This could help analyze the long-term effects of something like exposure therapy and see if it lowers the chances of developing future disorders (Bögels, 2004). Lastly, researchers are unsure whether the treatments work equally the same on all patients. It is unknown that symptoms of social phobia being reduced in the patient can improve their quality of life, and some patients may require a shorter or longer duration of treatment. The duration of treatment creates cost-effectiveness as a factor and should also be further researched (Bögels, 2004).
Discussion