Advertisement

Social Anxiety Disorder

  • Timothy M. Emge
  • Debra A. Hope
Reference work entry

Abstract:

Social anxiety disorder is a common and debilitating disorder, often leading to complications such as depression, substance abuse and increased suicide risk. During the past two decades, research on the cognitive, behavioral, interpersonal and physiological aspects of social anxiety and subsequent theoretical models have greatly increased our understanding of the nature and maintaining factors for social anxiety disorder. Well-validated assessment procedures including self-report, interview and behavioral measures, are now available. Therapeutic exposure, typically combined with cognitive interventions, is the most established evidence-based treatment. Comparisons of psychosocial treatment to pharmacotherapy and some promising innovative treatment approaches are discussed as well. Emerging work on mechanisms of change suggest that changes in judgments about the probability and costs of negative outcomes are key to clinical change. Competencies for clinicians include expertise with basic cognitive and behavioral therapies, therapeutic exposure and adaptations for the unique characteristics of social anxiety disorder. Especially important is the impact of socially anxious individuals’ fears in interpersonal relationships on the therapeutic relationship. Expert competencies include treatment of more severe cases, overcoming extreme social isolation, complex presentations and social anxiety disorder that presents within the context of serious mental illness. Working in a multicultural context, particularly with language differences and sexual minorities are also discussed. Transition to expert competency relies on traditional educational venues, written material and utilizing expert consultation that is available on electronic venues.

Keywords

Anxiety Disorder Social Anxiety Social Anxiety Disorder Cognitive Therapy Cognitive Restructuring 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Alden, L. E., & Wallace, S. T. (1995). Social phobia and social appraisal in successful and unsuccessful social interactions. Behaviour Research and Therapy, 33, 497–505.PubMedCrossRefGoogle Scholar
  2. Allen, L. B., McHugh, R. K., & Barlow, D. H. (2008). Emotional disorders: A unified protocol. In Barlow, D. H. (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (4th ed., pp. 216–249). New York: Guilford.Google Scholar
  3. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., Rev.). Washington, DC: Author.Google Scholar
  4. American Psychiatric Association. (2001). Diagnostic and statistical manual of mental disorders (4th ed., Rev.). Washington, DC: Author.Google Scholar
  5. Amir, N., Foa, E. B., & Coles, M. E. (1998). Automatic activation and strategic avoidance of threat-relevant information in social phobia. Journal of Abnormal Psychology, 107, 285–290.PubMedCrossRefGoogle Scholar
  6. Asmundson, G. J. G., & Stein, M. B. (1994). Selective processing of social threat in patients with generalized social phobia: Evaluation using a dot-probe paradigm. Journal of Anxiety Disorders, 8, 107–117.CrossRefGoogle Scholar
  7. Bailey, J. E., Papadopoulos, A., Lingford-Hughes, A., & Nutt, D. J. (2007). D-cycloserine and performance under different states of anxiety in healthy volunteers. Psychopharmacology, 193, 579–585.PubMedCrossRefGoogle Scholar
  8. Baker, S. R., & Edelmann, R. J. (2002). Is social phobia related to lack of social skills? Duration of skill-related behaviours and ratings of behavioural adequacy. British Journal of Clinical Psychology, 41, 243–257.PubMedCrossRefGoogle Scholar
  9. Baker, S. L., Heinrichs, N., Kim, H., & Hofmann, S. G. (2002). The Liebowitz Social Anxiety Scale as a self-report instrument: A preliminary psychometric analysis. Behaviour Research and Therapy, 40, 701–715.PubMedCrossRefGoogle Scholar
  10. Barlow, D. H. (2001). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford.Google Scholar
  11. Barlow, D. H., & Beck, J. G. (1984). The psychosocial treatment of anxiety disorders: Current status, future directions. In Williams, J. B., & Spitzer, R. L. (Eds.), Psychotherapy research: Where are we and where should we go? (pp. 29–44). New York: Guilford.Google Scholar
  12. Barlow, D. H., & Craske, M. G. (2006). Mastery of your anxiety and panic. New York: Oxford University Press.Google Scholar
  13. Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.Google Scholar
  14. Beck, A. T., & Emery, G. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.Google Scholar
  15. Beesdo, K., Bittner, A., Pine, D. S., Stein, M. B., Hofler, M., Lieb, R. et al. (2007). Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Archives of General Psychiatry, 64, 903–912.PubMedCrossRefGoogle Scholar
  16. Bögels, S. M. (2006). Task concentration training versus applied relaxation for social phobic patients with fear of blushing, trembling and sweating. Behaviour Research and Therapy, 44, 1199–1210.PubMedCrossRefGoogle Scholar
  17. Bouton, M. E. (2002). Context, ambiguity, and unlearning: Sources of relapse after behavioral extinction. Biological Psychiatry, 52, 976–986.PubMedCrossRefGoogle Scholar
  18. Bouton, M. E., & King, D. A. (1986). Effect of context on performance to conditioned stimuli with mixed histories of reinforcement and nonreinforcement. Journal of Experimental Psychology. Animal Behavior Processes, 12, 4–15.CrossRefGoogle Scholar
  19. Bradford, J., & Ryan, C. (1988). The National Lesbian Health Care Survey: Final report. Washington, DC: National Lesbian and Gay Health Foundation.Google Scholar
  20. Brendle, J. R., & Wenzel, A. (2004). Differentiating between memory and interpretation biases in socially anxious and nonanxious individuals. Behaviour Research and Therapy, 42, 155–171.PubMedCrossRefGoogle Scholar
  21. Brown, T. A., Di Nardo, P., & Barlow, D. H. (2004). Anxiety disorders interview schedule for DSM-IV: Adult version. Oxford: Oxford University Press.Google Scholar
  22. Brown, T. A., Di Nardo, P., Lehman, C. L., & Campbell, L. A. (2001). Reliability of DSM-IV anxiety and mood disorders: Implications for the classification of emotional disorders. Journal of Abnormal Psychology, 110, 49–58.PubMedCrossRefGoogle Scholar
  23. Brown, E. J., Turovsky, J., Heimberg, R. G., Juster, H. R., Brown, T. A., & Barlow, D. H. (1997). Validation of the social interaction anxiety scale and the social phobia scale across the anxiety disorders. Psychological Assessment, 9, 21–27.CrossRefGoogle Scholar
  24. Buckner, J. D., Schmidt, N. B., Lang, A. R., Small, J. W., Schlauch, R. C., & Lewinsohn, P. M. (2008). Specificity of social anxiety disorder as a risk factor for alcohol and cannabis dependence. Journal of Psychiatric Research, 42, 230–239.PubMedCrossRefGoogle Scholar
  25. Bui, K. T., & Takeuchi, D. T. (1992). Ethnic minority adolescents and the use of community mental health care services. American Journal of Community Psychology, 20, 403–417.PubMedCrossRefGoogle Scholar
  26. Butler, G. (1985). Exposure as a treatment for social phobia: Some instructive difficulties. Behaviour Research and Therapy, 23, 651–657.PubMedCrossRefGoogle Scholar
  27. Chambless, D. L., & Hope, D. A. (1996). Cognitive approaches to the psychopathology and treatment of social phobia. In Salkovskis, P. M. (Ed.), Frontiers of cognitive therapy (pp. 345–382). New York: Guilford.Google Scholar
  28. Clark, D. M. (1997). Cognitive therapy for social phobia: Some notes for therapists. Unpublished manuscript.Google Scholar
  29. Clark, D. M. (2001). A cognitive perspective on social phobia. In Crozier W. R., & Alden, L. E. (Eds.), Concepts, research and interventions relating to the self and shyness (pp. 405–4300). New York: Wiley.Google Scholar
  30. Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In Heimberg, R. G., Liebowitz, M. R., Hope, D. A., & Schneier F. R. (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). New York: Guilford.Google Scholar
  31. Clark, D. M., Ehlers, A., McManus, F., Hackmann, A., Fennell, M., Campbell, H. et al. (2003). Cognitive therapy versus Fluoxetine in generalized social phobia: A randomized placebo-controlled trial. Journal of Consulting and Clinical Psychology, 71, 1058–1067.PubMedCrossRefGoogle Scholar
  32. Cloitre, M., Cancienne, J., Heimberg, R. G., & Holt, C. S. (1995). Case histories and shorter communications: Memory bias does not generalize across anxiety disorders. Behaviour Research and Therapy, 33, 305–307.PubMedCrossRefGoogle Scholar
  33. Collins, K. A., Westra, H. A., Dozois, D. J. A., & Stewart, S. H. (2005). The validity of the brief version of the Fear of Negative Evaluation Scale. Journal of Anxiety Disorders, 19, 345–359.PubMedCrossRefGoogle Scholar
  34. Connor, K. M., Kobak, K. A., Churchill, L. K., Katzelnick, D., & Davidson, J. R. T. (2001). Mini-SPIN: A brief screening assessment for generalized social anxiety disorder. Depression and Anxiety, 14, 137–140.PubMedCrossRefGoogle Scholar
  35. Cox, B. J., Direnfeld, D. M., Swinson, R. P., & Norton, G. R. (1994). Suicidal ideation and suicide attempts in panic disorder and social phobia. American Journal of Psychiatry, 151, 882–887.PubMedGoogle Scholar
  36. Davidson, J. R., Hughes, D. L., George, L. K., & Blazer, D. G. (1993). The epidemiology of social phobia: Findings from the Duke Epidemiological Catchment Area Study. Psychological Medicine, 23, 709–718.PubMedCrossRefGoogle Scholar
  37. Davidson, J. R., Foa, E. B., Huppert, J. D., Keefe, F. J., Franklin, M. E., Compton, J. S. et al. (2004). Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in Generalized Social Phobia. Archives of General Psychiatry, 61, 1005–1013.PubMedCrossRefGoogle Scholar
  38. Davis, M., Ressler, K., Rothbaum, B. O., & Richardson, R. (2006). Effects of d-cycloserine on extinction: Translation from preclinical to clinical work. Biological Psychiatry, 60, 369–375.PubMedCrossRefGoogle Scholar
  39. Den Boer, J. A., & Dunner, D. L. (1999). Physician attitudes concerning diagnosis and treatment of social anxiety disorder in Europe and North America. International Journal of Psychiatry in Clinical Practice, 3, S13–S19.Google Scholar
  40. Dodge, C. S., Hope, D. A., Heimberg, R. G., & Becker, R. E. (1988). Evaluation of the social interaction self-statement test with a social phobic population. Cognitive Therapy and Research, 12, 211–222.CrossRefGoogle Scholar
  41. Fedoroff, I. C., & Taylor, S. T. (2001). Psychological and pharmacological treatments of social phobia: A meta-analysis. Journal of Clinical Psychopharmacology, 21, 311–324.PubMedCrossRefGoogle Scholar
  42. Feske, U., & Chambless, D. L. (1995). Cognitive behavioral versus exposure only treatment for social phobia: A meta-analysis. Behavior Therapy, 26, 695–720.CrossRefGoogle Scholar
  43. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B.W. (1997). Structured clinical interview for DSM-IV axis I disorders (SCID-I), clinical version. Washington, DC: American Psychiatric Publishing.Google Scholar
  44. Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35.PubMedCrossRefGoogle Scholar
  45. Foa, E. B., Franklin, M. E., Perry, K. J., & Herbert, J. D. (1996). Cognitive biases in generalized social phobia. Journal of Abnormal Psychology, 105, 433–439.PubMedCrossRefGoogle Scholar
  46. Foa, E. B., Gilboa-Schechtman, E., Amir, N., & Freshman, M. (2000). Memory bias in generalized social phobia: Remembering negative emotional expressions. Journal of Anxiety Disorders, 14, 501–519.PubMedCrossRefGoogle Scholar
  47. Foa, E. B., Franklin, M. E., & Moser, J. (2002). Context in the clinic: How well do cognitive-behavioral therapies and medications work in combination? Biological Psychiatry, 52, 989–997.CrossRefGoogle Scholar
  48. Foa, E. B., Huppert, J. D., & Cahill, S. P. (2006). Emotional Processing Theory: An update. In Rothbaum, B. O. (Ed.), Pathological anxiety: Emotional processing in etiology and treatment (pp. 3–24). New York: Guilford.Google Scholar
  49. Fresco, D. M., Coles, M. E., Heimberg, R. G., Liebowitz, M. R., Hami, S., Stein, M. B. et al. (2001). The Liebowitz social anxiety scale: A comparison of the psychometric properties of self-report and clinician-administered formats. Psychological Medicine, 31, 1025–1035.PubMedCrossRefGoogle Scholar
  50. Glass, C. R., & Furlong, M. (1990). Cognitive assessment of social anxiety: Affective and behavioral correlated. Cognitive Therapy and Research, 14, 365–384.CrossRefGoogle Scholar
  51. Gould, R. A., Buckminster, S., Pollack, M. H., Otto, M. W., & Tap, L. (1997). Cognitive-behavioral and pharmacological treatment for social phobia: A meta-analysis. Clinical Psychology: Science and Practice, 4, 291–306.CrossRefGoogle Scholar
  52. Gross, R., Olfson, M., Gameroff, M. J., Shea, S., Feder, A., Lantigua, R. et al. (2005). Social anxiety disorder in primary care. General Hospital Psychiatry, 27, 161–168.PubMedCrossRefGoogle Scholar
  53. Guastella, A. J., Richardson, R., Lovibond, P. F., Rapee, R. M., Gaston, J. E., Mitchell, P. et al. (2008). A randomized controlled trial of d-cycloserine enhancement of exposure therapy for social anxiety disorder. Biological Psychiatry, 63, 544–549.PubMedCrossRefGoogle Scholar
  54. Harvey, A. G., Clark, D. M., Ehlers, A., & Rapee, R. M. (2000). Social anxiety and self-impression: Cognitive preparation enhances the beneficial effects of video feedback following a stressful social task. Behaviour Research and Therapy, 38, 1183–1192.CrossRefGoogle Scholar
  55. Hayes, S. A., Miller, N. A., Hope, D. A., Heimberg, R. G., & Juster, H. R. (2008). Assessing client progress session-by-session in the treatment of social anxiety disorder: The social anxiety session change index. Cognitive and Behavioral Practice, 15, 203–211.CrossRefGoogle Scholar
  56. Hedges, D. W., Brown, B., Schwalb, D. A., Godfrey, K., & Larcher, A. M. (2007). The efficacy of selective serotonin reuptake inhibitors in adult social anxiety disorder: A meta-analysis of double-blind, placebo-controlled trials. Journal of Psychopharmacology, 21, 102–111.PubMedCrossRefGoogle Scholar
  57. Heimberg, R. G., & Becker, R. E. (2002). Cognitive-behavioral group therapy for social phobia: Basic mechanisms and clinical strategies. New York: Guilford.Google Scholar
  58. Heimberg, R. G., & Holaway, R. M. (1999). Examination of the known-groups validity of the Liebowitz Social Anxiety Scale. Depression and Anxiety, 24, 447–454.CrossRefGoogle Scholar
  59. Heimberg, R. G., Becker, R. E., Goldfinger, K., & Vermilyea, J. A. (1985). Treatment of social phobia by exposure, cognitive restructuring and homework assignments. Journal of Nervous and Mental Disease, 173, 236–245.PubMedCrossRefGoogle Scholar
  60. Heimberg, R. G., Dodge, C. S., Hope, D. A., Kennedy, C. R., Zollo, L., & Becker, R. E. (1990). Cognitive behavioral group treatment for social phobia: Comparison with a credible placebo control. Cognitive Therapy and Research, 14, 1–23.CrossRefGoogle Scholar
  61. Heimberg, R. G., Salzman, D. G., Holt, C. S., & Blendell, K. A. (1993). Cognitive-behavioral group treatment for social phobia: Effectiveness at five-year followup. Cognitive Therapy and Research, 17, 325–339.CrossRefGoogle Scholar
  62. Heimberg, R. G., Liebowitz, M. R., Hope, D. A., Schneier, F. R., Holt, C. S., Welkowitz, L. A., et al. (1998). Cognitive behavioral group therapy vs phenelzine therapy for social phobia: 12-week outcome. Archives of General Psychiatry, 55, 1133–1141.PubMedCrossRefGoogle Scholar
  63. Herbert, J. D., Hope, D. A., & Bellack, A. S. (1992). Validity of the distinction between avoidant personality disorder and generalized social phobia. Journal of Abnormal Psychology, 101, 332–339.PubMedCrossRefGoogle Scholar
  64. Herbert, J. D., Gaudiano, B. A., Rheingold, A. A., Myers, V. H., Dalrymple, K., & Nolan, E. M. (2005). Social skills training augments the effectiveness of cognitive behavioral group therapy for social anxiety disorder. Behavior Therapy, 36, 125–138.CrossRefGoogle Scholar
  65. Hofmann, S. G. (2004). Cognitive mediation of treatment change in social phobia. Journal of Consulting and Clinical Psychology, 72, 393–399.PubMedGoogle Scholar
  66. Hofmann, S. G. (2007). Enhancing exposure-based therapy from a translational research perspective. Behaviour Research and Therapy, 45, 1987–2001.PubMedCrossRefGoogle Scholar
  67. Hofmann, S. G., & Barlow, D. H. (2004). Social phobia (Social Anxiety Disorder). In Barlow, D. H. (Ed.), Anxiety and its disorders (2nd ed., pp. 454–476). New York: Guilford.Google Scholar
  68. Hofmann, S. G., Meuret, A. E., Smits, J. A. J., Simon, N. M., Pollack, M. H., Eisenmenger, K. et al. (2006). Augmentation of exposure therapy with d-cycloserine for social anxiety disorder. Archives of General Psychiatry, 63, 298–304.PubMedCrossRefGoogle Scholar
  69. Holt C. S., Heimberg, R. G., Hope, D. A., & Liebowitz, M. R. (1992). Situational domains of social phobia. Journal of Anxiety Disorders, 6, 63–77.CrossRefGoogle Scholar
  70. Hope, D. A., Heimberg, R. G., & Bruch, M. A. (1995). Dismantling cognitive-behavioral group therapy for social phobia. Behaviour Research and Therapy, 33, 637–650.PubMedCrossRefGoogle Scholar
  71. Hope, D. A., Heimberg, R. G., Juster, H. A., & Turk, C. L. (2004). Managing social anxiety: A cognitive-behavioral therapy approach client workbook. Oxford: Oxford University Press.Google Scholar
  72. Hope, D. A., Heimberg, R. G., & Turk, C. L. (2006). Managing social anxiety: A cognitive-behavioral approach therapist guide. Oxford: Oxford University Press.Google Scholar
  73. Hope, D. A., Burns, J. A., Hayes, S. A., Herbert, J. A., & Warner, M. D. (in press). Automatic thoughts and cognitive restructuring in cognitive behavioral group therapy for social anxiety disorder. Cognitive Therapy and Research.Google Scholar
  74. Hope, D. A., Rapee, R. M., Heimberg, R. G., & Dombeck, M. S. (1990). Representations of the self in social phobia: Vulnerability in social interaction. Cognitive Therapy and Research, 14, 177–189.CrossRefGoogle Scholar
  75. Hopko, D. R., McNeil, D. W., Zvolensky, M. J., & Eifert, G. H. (2001). The relation between anxiety and skill in performance-based anxiety disorders: A behavioral formulation of social phobia. Behavior Therapy, 32, 185–227.CrossRefGoogle Scholar
  76. Hsu, L., & Alden, L. E. (2008). Cultural influences on willingness to seek treatment for social anxiety in Chinese- and European-heritage students. Cultural Diversity and Ethnic Minority Psychology, 14, 215–223.PubMedCrossRefGoogle Scholar
  77. Human Rights Campaign. (2009). Federal legislation: Employment nondiscrimination act. Retrieved April 29, 2009, from http://www.hrc.org/laws_and_elections/4732.htm
  78. Jack, M. S., Heimberg, R. G., & Mennin, D. S. (1999). Situational panic attacks: Impact on social phobia with and without panic disorder. Depression and Anxiety, 10, 112–118.PubMedCrossRefGoogle Scholar
  79. Kashdan, T. B., & Roberts, J. E. (2007). Social anxiety, depressive symptoms, and post-event rumination: Affective consequences and social contextual influences. Journal of Anxiety Disorders, 21, 284–301.PubMedCrossRefGoogle Scholar
  80. Kessler, R. C. (1994). The National Comorbidity Survey of the United States. International Review of Psychiatry, 6, 365–376.CrossRefGoogle Scholar
  81. Kessler, R. C., McGonagle, K. A., Zhao, S., & Nelson, C. B. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Study. Archives of General Psychiatry, 51, 8–19.PubMedCrossRefGoogle Scholar
  82. Kimbrel, N. A. (2008). A model of the development and maintenance of generalized social phobia. Clinical Psychology Review, 28, 592–612.PubMedCrossRefGoogle Scholar
  83. Leary, M. R. (1983). A brief version of the fear of Negative Evaluation Scale. Personality and Social Psychology Bulletin, 9, 371–375.CrossRefGoogle Scholar
  84. Ledley, D. R., Heimberg, R. G., Hope, D. A., Hayes, S. A., Zaider, T. I., Van Dyke, M. et al. (in press). Efficacy of a manualized and workbook-driven individual treatment for social anxiety disorder. Behavior Therapy.Google Scholar
  85. Lee, H., & Telch, M. J. (2008). Attentional biases in social anxiety: An investigation using the inattentional blindness paradigm. Behaviour Research and Therapy, 46, 819–835.PubMedCrossRefGoogle Scholar
  86. Liddle, B. J. (1996). Therapist sexual orientation, gender, and counseling practices as they relate to ratings on helpfulness by gay and lesbian clients. Journal of Counseling Psychology, 43, 394–401.CrossRefGoogle Scholar
  87. Liebowitz, M. R. (1988). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173.Google Scholar
  88. Liebowitz, M. R., Gorman, J. M., Fyer, A. J., & Klein, D. F. (1985). Social phobia: Review of a neglected anxiety disorder. Archives of General Psychiatry, 42, 729–736.PubMedCrossRefGoogle Scholar
  89. Liebowitz, M. R., Heimberg, R. G., Schneier, F. R., Hope, D. A., Davies, S., Holt, C. S. et al. (1999). Cognitive-behavioral group therapy versus phenelzine in social phobia: Long-term outcome. Depression and Anxiety, 10, 89–98.PubMedCrossRefGoogle Scholar
  90. Lochner, C., Mogotsi, M., du Toit, P. L., Kaminer, D., Niehaus, D. J., & Stein, D. J. (2003). Quality of life in anxiety disorders: A comparison of obsessive-compulsive disorder, social anxiety disorder, and panic disorder. Psychopathology, 36, 255–262.PubMedCrossRefGoogle Scholar
  91. Lucas, R. A., & Telch, M. J. (1993, November). Group versus individual treatment of social phobia. Paper presented at the annual meeting of the Association for Advancement of Behavior Therapy, Atlanta, GA.Google Scholar
  92. Lucock, M. P., & Salkovskis, P. M. (1988). Cognitive factors in social anxiety and its treatment. Behaviour Research and Therapy, 26, 297–302.PubMedCrossRefGoogle Scholar
  93. Lundh, L., & Öst, L. (1996). Stroop interference, self-focus, and perfectionism in social phobics. Personality and Individual Differences, 20, 725–731.CrossRefGoogle Scholar
  94. MacLeod, C., Mathews, A., & Tata, P. (1986). Attentional bias in emotional disorders. Journal of Abnormal Psychology, 95, 15–20.PubMedCrossRefGoogle Scholar
  95. Magee, W. J., Eaton, W. W., Wittchen, H., McGonagle, K. A., & Kessler, R. C. (1996). Agoraphobia, simple phobia, and social phobia in the national comorbidity survey. Archives of General Psychiatry, 53, 159–168.PubMedCrossRefGoogle Scholar
  96. Mathews, A., & MacLeod, C. (1985). Selective processing of threat cues in anxiety states. Behaviour Research and Therapy, 23, 563–569.PubMedCrossRefGoogle Scholar
  97. Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455–470.PubMedCrossRefGoogle Scholar
  98. Mattick, R. P., & Peters, L. (1988). Treatment of severe social phobia: Effects of guided exposure with and without cognitive restructuring. Journal of Consulting and Clinical Psychology, 56, 251–260.PubMedCrossRefGoogle Scholar
  99. Mattick, R. P., Peters, L., & Clarke, J. C. (1989). Exposure and cognitive restructuring for social phobia: A controlled-study. Behavior Therapy, 20, 3–23.CrossRefGoogle Scholar
  100. McManus, F., Clark, D. M., & Hackman, A. (2000). Specificity of cognitive biases and their role in recovery. Behavioral and Cognitive Psychotherapy, 28, 201–209.CrossRefGoogle Scholar
  101. McManus, F., Sacadura, C., & Clark, D. M. (2008). Why social anxiety persists: An experimental investigation of the role of safety behaviours as a maintaining factor. Journal of Behavior Therapy and Experimental Psychiatry, 39, 147–161.PubMedCrossRefGoogle Scholar
  102. McNeil, D. W., Ries, B. J., & Turk, C. L. (1995). Behavioral assessment: Self-report, physiology, and overt behavior. In Heimberg, R. G., Liebowitz, M. R., Hope, D. A., & Schneier, F. R. (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 202–231). New York: Guilford.Google Scholar
  103. Morgan, K. S. (1992). Caucasian lesbians’ use of psychotherapy: A matter of attitude? Psychology of Women Quarterly, 16, 127–130.CrossRefGoogle Scholar
  104. Mörtberg, E., Clark, D. M., Sundin, Ö., & Wistedt, A. A. (2007). Intensive group cognitive therapy and individual cognitive therapy vs. treatment as usual in social phobia: A randomized controlled trial. Acta Psychiatrica Scandinavica, 115, 142–154.PubMedCrossRefGoogle Scholar
  105. Mower, O. H. (1947). On the dual nature of learning – a re-interpretation of “conditioning” and “problem solving.” Harvard Educational Review, 17, 102–148.Google Scholar
  106. Nelson, E. C., Grant, J. D., Bucholz, K. K., Glowinski, A., Madden, P. A. F., Reich, W. et al. (2000). Social phobia in a population-based female adolescent twin sample: Co-morbidity and associated suicide-related symptoms. Psychological Medicine, 30, 797–804.PubMedCrossRefGoogle Scholar
  107. Norton, P. J., & Hope, D. A. (2001). Kernels of truth or distorted perceptions: Self and observer ratings of social anxiety and performance. Behavior Therapy, 32, 765–786.CrossRefGoogle Scholar
  108. Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79–97.PubMedCrossRefGoogle Scholar
  109. Oakman, J., Van Ameringen, M., Mancini, C., & Farvolden, P. (2003). A confirmatory factor analysis of a self-report version of the Liebowitz Social Anxiety Scale. Journal of Clinical Psychology, 59, 149–161.PubMedCrossRefGoogle Scholar
  110. Otto, M. W., Smits, J. A. J., & Reese, H. E. (2005). Combined psychotherapy and pharmacotherapy for mood and anxiety disorders in adults: Review and analysis. Clinical Psychology: Science and Practice, 12, 72–86.CrossRefGoogle Scholar
  111. Pachankis, J. E., & Goldfried, M. R. (2004). Clinical issues in working with lesbian, gay, and bisexual clients. Psychotherapy: Theory, Research, Practice, Training, 41, 227–246.CrossRefGoogle Scholar
  112. Pachankis, J. E., & Goldfried, M. R. (2006). Social anxiety in young gay men. Journal of Anxiety Disorders, 20, 996–1015.PubMedCrossRefGoogle Scholar
  113. Persons, J. B. (2008). A case formulation approach to cognitive-behavioral therapy. New York: Guilford.Google Scholar
  114. Rapee, R. M., & Hayman, K. (1996). The effects of video feedback on the self-evaluation of performance in socially anxious subjects. Behaviour Research and Therapy, 34, 315–322.PubMedCrossRefGoogle Scholar
  115. Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741–756.PubMedCrossRefGoogle Scholar
  116. Rapee, R. M., & Lim, L. (1992). Discrepancy between self- and observer ratings of performance in social phobics. Journal of Abnormal Psychology, 101, 728–731.PubMedCrossRefGoogle Scholar
  117. Rapee, R. M., McCallum, S. L., Melville, L. F., Ravenscroft, H., & Rodney, J. M. (1994). Memory bias in social phobia. Behaviour Research and Therapy, 32, 89–99.PubMedCrossRefGoogle Scholar
  118. Riskin, J. H., & Williams, N. L. (2006). The looming cognitive style: A cognitive vulnerability for anxiety disorders. Journal of Social & Clinical Psychology, 25, 779–801.CrossRefGoogle Scholar
  119. Rodebaugh, T. L., & Heimberg, R. G. (2005). Combined treatment of social anxiety disorder. Journal of Cognitive Psychotherapy: An International Quarterly, 19, 331–345.CrossRefGoogle Scholar
  120. Rodebaugh, T. L., Holaway, R. M., & Heimber, R. G. (2004). The treatment of social anxiety disorder. Clinical Psychology Review, 24, 883–908.PubMedCrossRefGoogle Scholar
  121. Rodebaugh, T. L., Woods, C. M., Thissen, D. M., Heimberg, R. G., Chambless, D. L., & Rapee, R. M. (2004). More information from fewer questions: The factor structure and item properties of the original and Brief Fear of Negative Evaluation Scale. Psychological Assessment, 16, 169–181.PubMedCrossRefGoogle Scholar
  122. Roth, D., Antony, M. M., & Swinson, R. P. (2001). Interpretations for anxiety symptoms in social phobia. Behaviour Research and Therapy, 39, 129–138.PubMedCrossRefGoogle Scholar
  123. Ruscio, A. M., Brown, T. A., Chiu, W. T., Sareen, J., Stein, M. B., & Kessler, R. C. (2008). Social fears and social phobia in the USA: Results from the National Comorbidity Survey Replication. Psychological Medicine, 38, 15–28.PubMedCrossRefGoogle Scholar
  124. Saluck, R. G., Herbert, D., Rheingold, A. A., & Harwell, V. (2000, November). Validity of the brief and full versions of the FNE scales. Paper presented at the meeting of the Association for Advancement of Behavior Therapy, New Orleans.Google Scholar
  125. Sareen, J., Cox, B. J., Afifi, T. O., de Graaf, R., Asmundson, G. J. G., Ten Have, M. et al. (2005). Anxiety disorders and risk for suicidal ideation and suicide attempts: A population-based longitudinal study of adults. Archives of General Psychiatry, 62, 1249–1257.PubMedCrossRefGoogle Scholar
  126. Schneier, F. R., Hornig, C. D., Liebowitz, M. R., & Weissman, M. M. (1992). Social Phobia: Comorbidity and morbidity in an epidemiologic sample. Archives of General Psychiatry, 49, 282–288.PubMedCrossRefGoogle Scholar
  127. Schneier, F. R., Johnson, J., Hornig, C. D., & Liebowitz, M. R. (1992). Social phobia: Comorbidity and morbidity in an epidemiologic sample. Archives of General Psychiatry, 49, 282–288.PubMedCrossRefGoogle Scholar
  128. Scholing, A., & Emmelkamp, P. M. G. (1993). Exposure with and without cognitive therapy for generalized social phobia: Effects of individual and group treatment. Behaviour Research and Therapy, 31, 667–681.PubMedCrossRefGoogle Scholar
  129. Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Janavs, J., Weiller, E., Keskiner, A. et al. (1997). The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. European Psychiatry, 12, 232–241.CrossRefGoogle Scholar
  130. Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E. et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.PubMedGoogle Scholar
  131. Simon, N. M., Otto, M. W., Korbly, N. B., Peters, P. M., Nicolaou, D. C., & Pollack, M. H. (2002). Quality of life in social anxiety disorder compared with panic disorder and the general population. Psychiatric Services, 53, 714–718.PubMedCrossRefGoogle Scholar
  132. Smits, J. A. J., Rosenfield, D., & Telch, M. J. (2006). Cognitive mechanisms of social anxiety reduction: An examination of specificity and temporality. Journal of Consulting and Clinical Psychology, 74, 1203–1212.PubMedCrossRefGoogle Scholar
  133. Stein, M. B., & Stein, D. J. (2008). Social anxiety disorder. Lancet, 371, 1115–1125.PubMedCrossRefGoogle Scholar
  134. Stopa, L., & Clark, D. M. (1993). Cognitive processes in social phobia. Behaviour Research and Therapy, 31, 255–267.PubMedCrossRefGoogle Scholar
  135. Stopa, L., & Clark, D. M. (2000). Social phobia and interpretation of social events. Behaviour Research and Therapy, 38, 273–283.PubMedCrossRefGoogle Scholar
  136. TADS Team. (2007). The Treatment for Adolescents with Depression Study (TADS): Long-term effectiveness and safety outcomes. Archives of General Psychiatry, 64, 1132–1144.CrossRefGoogle Scholar
  137. Taylor, S. (1996). Meta-analysis of cognitive-behavioral treatments for social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 27, 1–9.PubMedCrossRefGoogle Scholar
  138. Tompkins, M. A. (2004). Using homework in psychotherapy: Strategies, guidelines and forms. Guilford: New York.Google Scholar
  139. Trower, P., Yardley, K., Bryant, B. M., & Shaw, P. (1978). The treatment of social failure: A comparison of anxiety-reduction and skills-acquisition procedures on two social problems. Behavior Modification, 2, 41–60.CrossRefGoogle Scholar
  140. Turner, S. M., Beidel, D. C., Dancu, C. V., & Keys, D. J. (1986). Psychopathology of social phobia and comparison to avoidant personality disorder. Journal of Abnormal Psychology, 95, 389–394.PubMedCrossRefGoogle Scholar
  141. Turner, S. M., Beidel, D. C., Dancu, C. V., & Stanley, M. A. (1989). An empirically derived inventory to measure social fears and anxiety: The Social Phobia and Anxiety Inventory. Psychology Assessment, 1, 35–40.CrossRefGoogle Scholar
  142. Turner, S. M., Beidel, D. C., Cooley, M. R., Woody, S. R., & Messer, S. C. (1994). A multicomponent behavioral treatment for social phobia: Social effectiveness therapy. Behaviour Research and Therapy, 32, 381–390.PubMedCrossRefGoogle Scholar
  143. Turner, S. M., Beidel, D. C., & Jacob, R. G. (1994). Social phobia: A comparison of behavior therapy and atenolol. Journal of Consulting and Clinical Psychology, 62, 350–358.PubMedCrossRefGoogle Scholar
  144. Turner, S. M., Beidel, D. C., & Cooley-Quille, M. R. (1995). Two-year follow-up of social phobics treated with Social Effectiveness Therapy. Behaviour Research and Therapy, 33, 553–555.PubMedCrossRefGoogle Scholar
  145. Turner, S. M., Beidel, D. C., & Cooley-Quille, M. R. (1997). Social-effectiveness therapy: A program for overcoming social anxiety and social phobia. New York: Multi-Health Systems.Google Scholar
  146. Veljaca, K., & Rapee, R. M. (1998). Detection of negative and positive audience behaviours by socially anxious subjects. Behaviour Research and Therapy, 36, 311–321.PubMedCrossRefGoogle Scholar
  147. Vermani, M. (2007). The PCMAD (Primary Care Mood & Anxiety Diagnoser): The development of a diagnostic tool to detect social anxiety disorder, generalized anxiety disorder, panic disorder, bipolar disorder and depression. Dissertation Abstracts International: Section B: The Sciences and Engineering, 68, 4171.Google Scholar
  148. Walsh, K., & Hope, D. A. (in press). LGB affirmative cognitive behavioral treatment for social anxiety: A case study applying evidence-based practice principles. Cognitive and Behavioral Practice.Google Scholar
  149. Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (1995). Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behavior Therapy, 26, 153–161.CrossRefGoogle Scholar
  150. Zhang, A. Y., Snowden, L. R., & Sue, S. (1998). Differences between Asian and White Americans’ help seeking and utilization patterns in the Los Angeles area. Journal of Community Psychology, 26, 317–326.CrossRefGoogle Scholar
  151. Zimmerman, M., & Mattia, J. I. (2000). Principal and additional DSM-IV disorders for which outpatients seek treatment. Psychiatric Services, 51, 1299–1304.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • Timothy M. Emge
    • 1
  • Debra A. Hope
    • 1
  1. 1.University of Nebraska-LincolnLincolnUSA

Personalised recommendations