Multimodal Comparisons of Social Phobia Subtypes and Avoidant Personality Disorder

Boone, Martin L.; McNeil, Daniel W.; Masia, Carrie L.; Turk, Cynthia L.; Carter, Leslie E.; Ries, Barry J.; Lewin, M. R.

doi:10.1016/s0887-6185(99)00004-3

Cited by 100 publications

(74 citation statements)

References 33 publications

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“…The remaining participants (44%) were assigned a "nongeneralized" subtype of social phobia because they did not meet criteria for the "generalized" subtype. Furthermore, 22% of the total sample could be classified as having "circumscribed" social phobia (Boone, McNeil, Masia, Turk, Carter, Ries, & Lewin, 1999) 2 .…”

Section: Methodsmentioning

confidence: 99%

An instrument to assess self-statements during public speaking: Scale development and preliminary psychometric properties

2000

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Section: Methodsmentioning

confidence: 99%

An instrument to assess self-statements during public speaking: Scale development and preliminary psychometric properties

2000

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“…Both reviews [8,25] concluded based on four studies [28][29][30][31] that individuals with performance anxiety show greater heart rate response when delivering a speech compared to those with GSAD. The one additional study that did not support these findings was limited by reliance on intermittent (versus continuous) heart rate recordings and that performance anxiety was not the main fear of all participants.…”

Section: Depression and Anxietymentioning

confidence: 99%

Social anxiety disorder: questions and answers for the DSM-V

et al. 2010

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Background: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. Method: A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V. Results/Conclusions: Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a ''predominantly performance'' variety of SAD. A specifier based on ''fear of showing anxiety symptoms'' (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options. Depression and Anxiety 27:168-189, 2010. Key words: DSM-V; social anxiety disorder; social phobia; subtypes; classification; interpersonal; performance; test anxiety; selective mutism; avoidant personality disorder INTRODUCTIONThis review evaluates several issues pertaining to the diagnostic criteria for social phobia or social anxiety disorder (SAD) (Table 1), in light of empirical evidence gathered since DSM-IV. The review was guided by questions posed in the DSM-IV Sourcebook (Vol. 2), chapters titled ''Social phobia'' [1] and ''Social phobia subtypes,''[2] a review conducted as part of the DSM-V Stress Induced and Fear Circuitry Disorders Workgroup Conference, titled ''Social Phobia: Towards DSM V, '' [3] by questions posed by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group and by issues raised by consulted experts and advisors. The main issues to be addressed are the generalized specifier and its alternatives, the overlap with avoidant personality disorder, and developmental issues including the relationship that SAD shows in childhood with selective mutism (SM) and test anxiety. STATEMENT OF THE ISSUESThis review addresses the following questions, using the validators provided by the DSM-V Task Force: (1) What is the evidence/utility of the DSM-IV generalized specifier? If there is insufficient evidence/utility for a generalized specifier, what is the utility/evidence for alternative sub...

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“…Others have found differences in physiological arousal as measured by heart rate during behavioral tests between generalized and nongeneralized SP (Heimberg et al, 1990;Levin et al, 1993;Hofmann et al, 1997;Boone et al, 1999). It is possible that such differences in responsiveness extend to the flushing response between SP subtypes.…”

Section: Discussionmentioning

confidence: 98%

Methyl Nicotinate-Induced Vasodilation in Generalized Social Phobia

Katzman

Cornacchi

Coonerty-Femiano

et al. 2003

Neuropsychopharmacol

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Elevated vasodilatory response (blushing) to social situations is characteristic of social phobia (SP). A relatively unexplored basis for this phenomenon is alteration in underlying vasodilatory mechanisms. To investigate this possibility, we evaluated the vasodilatory response induced by methyl nicotinate (niacin ester derivative) in 31 generalized SP patients and 41 matched healthy volunteers (HV). A patch impregnated with 0, 0.1, 0.5, 1, and 10 mM methyl nicotinate was applied to the forearm or face of subjects for 1 min, followed by 20-min laser Doppler spectroscopy blood flow monitoring. Blood flow stimulation with 1 and 10 mM methyl nicotinate was significantly reduced in SP patients by 35 and 17%, respectively. Induced blood flow was negatively correlated with patients' Leibowitz Social Phobia Scale (LSAS) at 1 and 10 mM doses. Furthermore, the maximal rate of change of vasodilatory reaction was correlated with symptom scores at 1 and 10 mM doses. Induced increases in the arm and face blood flow measurements correlated, supporting the external validity of the former location. Generalized SP patients vasodilate less to topical methyl nicotinate challenges, with effect amplification in severely ill patients. Although the mechanism for this is unclear, we propose desensitization of the prostaglandin-mediated vasodilating system as an explanation.

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Multimodal Comparisons of Social Phobia Subtypes and Avoidant Personality Disorder

Cited by 100 publications

References 33 publications

An instrument to assess self-statements during public speaking: Scale development and preliminary psychometric properties

An instrument to assess self-statements during public speaking: Scale development and preliminary psychometric properties

Social anxiety disorder: questions and answers for the DSM-V

Methyl Nicotinate-Induced Vasodilation in Generalized Social Phobia

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