Social Anxiety: A Case Study

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Social anxiety (SAD) is a disorder that affects many different individuals and is one of the most common health disorder after depression and substance abuse. These individuals experience extreme distress in public settings. These individuals face high levels of panic in seemingly normal situations. For example, individuals with SAD have extreme anxiety in situations like public speaking or even having a conversation with another individual. SAD disorder can occur in adolescence or early adulthood, but can occur at any time. Also it is more common in women than in men1. This study will attempt to find a way to treat this disorder by having one group participate in cognitive behavioral therapy, one group taking serotonin reuptake
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SIAS has a scale range from 0 to 80 and LSAS-SR is between 0 and 144. These two tests will be used as continuous measures of social anxiety.
Depressive Symptoms
In order to measure depressive symptoms of SAD the Beck Depression Inventory (BDI) will be used. The range for BDI is 0 to 63 and has a very high test-retest reliability and high internal consistency2.
Diagnostic Assessment
Participants in the clinical sample has to meet diagnostic criteria for SAD the Structural Clinical Interview for DSM-IV Axis l-disorders (SCID). For the healthy controls a Mini-Social Phobia Inventory (Mini-SPIN) will be used and studies have shown that it is very reliable and can detect SAD with 90% precision. The cutoff for this assessment was a 6 on a scale from 0-12.
The amygdala, striatum, and hippocampus are very important in SAD and will be examined using magnetic resonating imaging (MRI) and positive emission transmission (PET) and examine dopamine in all three regions4. This will be carried out before the study begins and after the study
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CBT entailed a) deriving an individualized version of the cognitive model using patient’s thoughts, images, anxiety symptoms, and dysfunctional assumptions, b) train to externally focus attention rather internally focus it, e) conduct behavioral experiments and enable the patients to test the validity of the negative predictions in various types of social situations, f) identify and modify dysfunctional assumptions and problematic anticipation/ post event negative processing. The CBT sessions will be conducted in groups of 6 and will comprise of 16 sessions in an 8 week time period. All sessions will be led by a group of psychologists, a nurse and a psychiatrist. In order to maintain integrity of the experiment all therapists will be supervised and the group sessions will be videotaped.

Aim 2 The second group of participants will be administered SSRI treatment for a period of 8 weeks. After treatment is completed these participants will be given the previous tests and a brain scan to determine whether or not the treatment was better compared to CBT.
Aim 3 The last goal is to test if the CBT or SSRI treatment has a long term effect on the participants. Both groups will be asked to come back 1 year after treatment ended will be asked to take the assessments and a brain

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