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Anxiety : meditations on the anxious mind
Far more than we tend to realise, we're all - in private - deeply anxious. This is a guide to our anxious minds, offering a route to calm, self-compassion and mental well-being.
BOOK
Social Anxiety
Affecting millions of people in the United States, social anxiety, according to DSM-5-TR, refers to the condition of persisting intense fear or anxiety about being severely embarrassed or humiliated in social situations where such fear is out of proportion to any actual threat. This compelling new guide calls for an expanded definition, one that involves the persistent fears and shame of individuals related to what others might think of them if certain actions or thoughts in their past or present were ever to become known—even when there may be no actual interaction with those other people. At the heart of the case made by Social Anxiety: Hidden Fears and Shame in Teens and Adults are 22 case examples featuring individuals from age 14 to age 52. These revealing vignettes underscore that • Social anxiety does not correspond merely to transient fears such as meeting new people or public speaking but can be chronic and persistent• Social anxiety does not involve only fears of potentially challenging behaviors; for many it also manifests as fears or shame about past or present wishes or thoughts considered unacceptable• A significant percentage—as many as half—of individuals struggling with social anxiety avoid seeking help Opening with a description of what the research has to say about the nature, causes, and effects of social anxiety, this book also examines the wide variety of treatment interventions, including psychotherapy, medications, and family interventions. With a depth of information that will prove clinically useful to medical and mental health professionals, Social Anxiety is also written in an engaging style that will be easily accessible to laypeople—including those suffering from social anxiety themselves, as well as their family and community.
eBook
Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study
Rationale
Standard therapeutic approaches to reduce social anxiety in autistic adults have limited effectiveness. Since 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy shows promise as a treatment for other anxiety disorders, a blinded, placebo-controlled pilot study was conducted.
Objectives
To explore feasibility and safety of MDMA-assisted psychotherapy for reduction of social fear and avoidance that are common in the autistic population.
Methods
Autistic adults with marked to very severe social anxiety were randomized to receive MDMA (75 to 125 mg,
n
= 8) or inactive placebo (0 mg,
n
= 4) during two 8-h psychotherapy sessions (experimental sessions) in a controlled clinical setting. Double-blinded experimental sessions were spaced approximately 1 month apart with 3 non-drug psychotherapy sessions following each. The primary outcome was change in Leibowitz Social Anxiety Scale (LSAS) Total scores from Baseline to one month after the second experimental session. Outcomes were measured again six months after the last experimental session.
Results
Improvement in LSAS scores from baseline to the primary endpoint was significantly greater for MDMA group compared to the placebo group (
P
= 0.037), and placebo-subtracted Cohen’s
d
effect size was very large (
d
= 1.4, CI − 0.074, 2.874). Change in LSAS scores from baseline to 6-month follow-up showed similar positive results (
P
= 0.036), with a Cohen’s
d
effect size of 1.1 (CI − 0.307, 2.527). Social anxiety remained the same or continued to improve slightly for most participants in the MDMA group after completing the active treatment phase.
Conclusions
This pilot trial demonstrated rapid and durable improvement in social anxiety symptoms in autistic adults following MDMA-assisted psychotherapy. Initial safety and efficacy outcomes support expansion of research into larger samples to further investigate this novel treatment for social anxiety.
Trial registration
clinicaltrials.gov
identifier, NCT02008396
Journal Article
Efficacy and safety of an alpha 7-nicotinic acetylcholine receptor agonist, VQW-765, in subjects with performance anxiety: randomised, double-blind, placebo-controlled trial
Despite the high prevalence of social and performance anxiety, current treatments do not meet the full needs of patients. Development of novel anxiolytics with rapid onset of action for on-demand treatment of social and performance anxiety is an active area of clinical research.
To examine the anxiolytic effect of VQW-765, an α7-nAChR agonist, in subjects with performance anxiety.
We conducted a randomised, double-blind, placebo-controlled trial of 230 adults with a history of public speaking anxiety. Participants were randomly assigned to receive a single oral dose of 10 mg VQW-765 (
= 116) or placebo (
= 114), followed by a Trier Social Stress Test (TSST). Anxiety levels were assessed by the Subjective Units of Distress Scale (SUDS). Heart rate was monitored during the TSST. Plasma concentration of VQW-765 was measured after the TSST.
Subjects receiving VQW-765 showed a trend of improvement in intensity of anxiety, as measured by the SUDS, during the performance phase of a TSST compared with placebo (
= 0.1443). Females showed a larger magnitude and significant response to VQW-765 (
= 0.034). The pharmacokinetic/pharmacodynamic analysis observed an inverted U-shaped exposure-response relationship. Subjects in the middle 50% quantiles of VQW-765 plasma concentration showed significant improvement in the SUDS rating compared with placebo (
= 0.033); however, subgroup analysis revealed this was true only for females (
= 0.005). VQW-765 was safe and well tolerated.
This is the first study showing anxiolytic effect of an α7-nAChR agonist in humans. VQW-765 is a promising candidate to be developed for on-demand treatment of social anxiety disorder.
Journal Article
American nightmares : social problems in an anxious world
\"In an accessible and droll style, best-selling author Joel Best shines a light on how we navigate these anxious, insecure social times. While most of us still strive for the American Dream--to graduate from college, own a home, work toward early retirement--recent generations have been told that the next generation will not be able to achieve these goals, that things are getting--or are on the verge of getting--worse. In American Nightmares, Best addresses the apprehension that we face every day as we are bombarded with threats that the social institutions we count on are imperiled. Our schools are failing to teach our kids. Healthcare may soon be harder to obtain. We can't bank on our retirement plans. And our homes--still the largest chunk of most people's net worth--may lose much of their value. Our very way of life is being threatened! Or is it? With a steady voice and keen focus, Best examines how a culture develops fears and fantasies and how these visions are created and recreated in every generation. By dismantling current ideas about the future, collective memory, and sociology's marginalization in the public square, Best sheds light on how social problems--and our anxiety about them--are socially constructed\"--Provided by publisher.
Book
Social media burnout and social anxiety as antecedents of discontinuous usage in the stressor-strain-outcome framework
This study aims to examine the structural relationships between problematic social media use (PSMU), social anxiety on social networking sites (SNSs), social media burnout (SMB), and discontinuous use from a stress-strain-outcome (SSO) framework. The research sample is 715 college students in Türkiye (58.5% female, M
age
: 21.71). Based on the SSO framework, PSMU and users’ social anxiety on SNSs were identified as stressors. In response to these stressors, users’ experience of SMB was determined as strain. As a result of this strain, users’ discontinuous use of SNSs was identified as the outcome. Moderated mediation analyses revealed that SMB mediated the negative effect of PSMU on discontinuous use. The mediating effect of SMB was moderated by users’ social anxiety on SNSs. Users’ social anxiety on SNSs had a buffering moderating effect on the relationship between PSMU and discontinuous use. The moderating effect of users’ social anxiety on SNSs was significant in the positive relationship between SMB and discontinuous use. SMB was positively correlated with both PSMU and discontinuous use. Similarly, self-evaluation anxiety and shared content anxiety were positively correlated with both PSMU and discontinuous use. These findings provide empirical evidence for the relatively new “SMB paradox” literature and extend the “paradox of social anxiety” phenomenon, which reveals contradictions in the face-to-face socialization process, to social media. The results demonstrate complex relationships between the antecedents of discontinuous use from the SSO framework.
Journal Article
Social phobia : an interpersonal approach
\"Social phobia is a disorder involving an intense fear of being judged by others and it affects the lives of many people. This book takes a critical stance towards the received view of social phobia as a disease of sorts, characterized by abnormal anxiety and caused by an inner mental or physical defective mechanism. Ariel Stravynski adopts an alternative approach to social phobia - as a purposeful interpersonal pattern protective against public humiliation or private rebuff. In this conception, fearfulness is the emotional facet of the socially phobic interpersonal pattern, rather than its driving force. This theoretical framework emphasizing dynamic transactions is articulated in terms of an anthropological psychology and Stravynski argues that social phobia can only be formulated and understood in interpersonal terms. He integrates all available knowledge on social phobia into his proposed framework and exemplifies its application by extending it to the assessment and treatment of the disorder\"-- Provided by publisher.
Book
Virtual Reality Therapy in Social Anxiety Disorder
Purpose of Review
This review provides an overview of current methods and important aspects to consider when applying virtual worlds in the treatment of social anxiety disorder (SAD).
Recent Findings
Different aspects such as dialogs between avatars and patients have been investigated as well as virtual audiences, emotional facial expression, and verbal interaction with avatars. Results of these studies are promising. Few randomized controlled trials (RCTs) have investigated the efficacy of virtual reality exposure therapy (VRET) in SAD. Unfortunately, most RCTs into the efficacy of VRET in comparison with exposure in vivo in SAD have been conducted with a combination of cognitive interventions and VRET. No differences between these conditions were found, but the pure effect of VRET as a stand-alone treatment has only been investigated in one RCT, wherein VRET was not superior to exposure in vivo.
Summary
Current research into different facets of SAD and VRET has produced promising results with respect to technological aspects. No differences in efficacy between cognitive behavior therapy and VRET were found, but there is a clear need for studies investigating the efficacy of VRET as a stand-alone treatment and the therapeutic processes involved before this therapy can be disseminated in routine clinical practice.
Journal Article