scholarly journals The use of psycho-education based on the CBT protocol using a single-session virtual exposure within the psychological support of students with a fear of public speaking: results of a pilot study

2020 ◽  
Vol 5 (1) ◽  
pp. e0501224
Author(s):  
Oleksandr Avramchuk ◽  
Julija Ostryzhko

Introduction Anxiety and fear of public speaking are some of the common complaints of students during their studies. The prevalence and consequences for psychological well-being make it possible to discuss the fear of public speaking in the context of pathopsychological changes that contribute to or are a variant of a social anxiety disorder. At the same time, constant anxiety and emotional distress can contribute to the development of other comorbid pathologies such as depressive disorder, other anxiety disorders, or substance abuse as a way of coping anxiety. The development and implementation of effective psychological/psychotherapeutic interventions for self-help and psychological support with using a virtual environment has already proven itself in dealing with specific phobias and other anxiety states and can be applied in preventative measures for social anxiety disorder among students. Aim Investigate the impact of psychoeducation based on CBT protocol with a one-session virtual exposure on the level of students' social anxiety before public speaking and the features of social interaction during education. Methods Social anxiety assessment using the Social Phobia Inventory (SPIN), and Social Phobia Rating Scale (SPRS), clinical semi-structured interview, observation, and assessment of changes in virtual exposure. Results Compared with the control group, there was a statistically significant decrease in all indicators on the SPIN (p<0.001) and SPRS (p<0.001) scales in the experimental group 1 month after virtual exposure. Decreases in social anxiety on the SPIN scale before the intervention and one month after were statistically different depending on belonging to the experimental group (F = 5.06, p = 0.035) and time (F = 5.46, p = 0.029), and significantly from a baseline level of social anxiety (F = 124.8, p = 0.000). The significance of changes in the experimental group as a whole on the SPIN scale is achieved by reducing the indicator in the subgroup with a high level of social anxiety, where statistical significance is significant p<0.001. Differences in changes in the level of social anxiety on the SPRS scale before the intervention and one month after, depending on belonging to the experimental group (F = 9.39, p = 0.006), time (F = 12.33, p = 0.002) and baseline level of social anxiety (F = 12.06, p = 0.000) are also significant. According to the SPRS method, a statistically significant decrease in the rate of exhaustion and overall restriction imposing social anxiety (p<0.001) was found in the experimental group and a statistically significant decrease in the using of part of strategies avoidance behaviors and the influence of typical unproductive beliefs (p<0.05, in accordance). Conclusion Using psychoeducation based on CBT protocol with a one-session virtual exposure has proven to be an effective way of reducing the fear of public speaking. After 1 month undergoing a psychoeducational session using virtual exposure, a significant decrease in the intensity of anxious feelings, the impact of unproductive beliefs, and changes in behavior that underpinned them were revealed. It was noted that the most significant effect was achieved in the subgroup of participants with high input levels of social anxiety and manifest traits corresponding to the criteria of social anxiety disorder. Such changes may be explained by the need and timeliness of providing psychological support to this category of participants. Given that our findings are incomplete, they require further research and expansion of the experimental base.

2021 ◽  
Vol 85 (2) ◽  
pp. 100-122
Author(s):  
Mirjana Subotic-Kerry ◽  
Andrew J. Baillie ◽  
Lexine A. Stapinski ◽  
Maree J. Abbott ◽  
Jo MacDonald ◽  
...  

Comorbid social anxiety and alcohol use disorders (SAD-AUD) in the community and the complex interactions that occur between these disorders have emerged as a significant clinical, public health, and research issue. The authors examined (a) the rates of comorbid SAD-AUD, (b) the impact of comorbid SAD-AUD on outcomes targeting social anxiety disorder, and (c) the effect of pretreatment alcohol consumption and alcohol use before, during, and after social situations on a composite measure of social anxiety in 172 adults presenting with social anxiety disorder. There was low incidence of AUD in this sample of individuals with SAD. Results indicated that alcohol consumption did not lead to worse social anxiety symptoms; however, alcohol use before and during social situations was associated with more severe social anxiety symptoms. These findings suggest that the function of alcohol use may be more important than the overall level of alcohol use and has implications for treatment.


Author(s):  
Vladan Starcevic, MD, PhD

Social anxiety disorder (SAD) is conceptualized as an excessive and/or unreasonable fear of situations in which the person’s behavior or appearance might be scrutinized and evaluated. This fear is a consequence of the person’s expectation to be judged negatively, which might lead to embarrassment or humiliation. Typical examples of feared and usually avoided social situations are giving a talk in public, performing other tasks in front of others, and interacting with people in general. Although the existence of SAD as a psychopathological entity has been known for at least 100 years, it was only relatively recently, with the publication of DSM-III in 1980, that SAD (or social phobia) acquired the status of an ‘‘official’’ psychiatric diagnosis. The term social anxiety disorder has been increasingly used instead of social phobia, because it is felt that the use of the former term conveys more strongly the pervasiveness and impairment associated with the condition and that this term will promote better recognition of the disorder and contribute to better differentiation from specific phobia (Liebowitz et al., 2000). Like generalized anxiety disorder, social anxiety disorder is common and controversial. Unlike generalized anxiety disorder, which is described in different ways by different diagnostic criteria and different researchers and clinicians, SAD does not suffer from a ‘‘description problem.’’ It is not particularly difficult to recognize features of SAD; what may be difficult is making sense of these features. Main issues associated with SAD are listed below…. 1. Where are the boundaries of SAD? How well is SAD distinguished from ‘‘normal’’ social anxiety and shyness on one hand, and from severe psychopathology on the other? 2. Is there a danger of ‘‘pathologizing’’ intense social anxiety by labeling it a psychiatric disorder? How can the distress and suffering of people with high levels of social anxiety be acknowledged if they are not given the corresponding diagnostic label? 3. Is SAD a bona fide mental disorder? 4. Can the subtyping scheme (nongeneralized vs. generalized SAD) be supported? 5. Is there a spectrum of social anxiety disorders?


2005 ◽  
Vol 27 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Gabriela Bezerra de Menezes ◽  
Leonardo F. Fontenelle ◽  
Márcio Versiani

OBJECTIVE: To investigate possible differences in clinical and treatment response in patients suffering from early-onset (< 18 years) and late-onset (>18 years) social anxiety disorder. METHODS: Patients diagnosed with social anxiety disorder of early-onset (n = 47; 75.8%) were compared to those diagnosed with late-onset social anxiety disorder (n = 15; 24.2%) in terms of age, mode of onset, subtype, psychiatric comorbidities (according to the Structured Clinical Interview for DSM-IV), symptom severity and response (assessed according to the Clinical Global Impression scale) after at least ten weeks of drug treatment. The statistical analyses included chi² tests with Yates correction or Fisher's exact test, as well as Student's t-test or Mann-Whitney test. The level of statistic significance adopted was 5%. RESULTS: Patients presenting early-onset phobic symptoms more frequently: were inactive (chi² = 4.28; df = 1; p = 0.04); suffered from the generalized subtype of social phobia (chi² = 6.53; df = 1; p = 0.01); and presented psychiatric comorbidity (chi² = 6.71; df = 1; p = 0.01). No differences were observed between the groups in severity of symptoms and therapeutic response. CONCLUSION: The findings suggest the existence of a possible social anxiety disorder subtype characterized by early onset of symptoms, higher rates of absenteeism, a wider range of social phobia symptoms and psychiatric complications.


2014 ◽  
Vol 28 (8) ◽  
pp. 908-918 ◽  
Author(s):  
Deborah C. Beidel ◽  
Candice A. Alfano ◽  
Michael J. Kofler ◽  
Patricia A. Rao ◽  
Lindsay Scharfstein ◽  
...  

2007 ◽  
Vol 85 (9) ◽  
pp. 928-932 ◽  
Author(s):  
Craig Hudson ◽  
Susan Hudson ◽  
Joan MacKenzie

Until recently, intact protein that is rich in tryptophan was not seen as an alternative to pharmaceutical-grade tryptophan because protein also contains large neutral amino acids (LNAAs) that compete for transport sites across the blood–brain barrier. Recent evidence indicates that when deoiled gourd seed (a rich source of tryptophan with approximately 22 mg/g protein) is combined with glucose (a carbohydrate that reduces serum levels of competing LNAAs) a clinical effect similar to that of pharmaceutical-grade tryptophan is achieved. Objective and subjective measures of anxiety in those suffering from social phobia (also known as social anxiety disorder) were employed to measure changes in anxiety in response to a stimulus as part of a double-blind, placebo-controlled, crossover study with a wash-out period of 1 week between study sessions. Subjects were randomly assigned to start with either (i) protein-source tryptophan (deoiled gourd seed) in combination with carbohydrate or (ii) carbohydrate alone. One week after the initial session, subjects returned for a follow-up session and received the opposite treatment of that received at the first session. All 7 subjects who began the study completed the 2-week protocol. Protein-source tryptophan with carbohydrate, but not carbohydrate alone, resulted in significant improvement on an objective measure of anxiety. Protein-source tryptophan combined with a high glycemic carbohydrate is a potential anxiolytic to those suffering from social phobia.


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