Treating Social Phobias and Social Anxiety

Shyness And Social Anxiety System

The Shyness and Social Anxiety System is just as its name says. It is an e-book wherein in-depth discussions about the symptoms, causes and treatment for shyness and social anxiety are made. It is then written for individuals whose extreme shyness or social anxiety prevent them from enjoying a full life filled with social interactions among their family, friends and acquaintances in gatherings during holidays, outings and parties. The author Sean Cooper also suffered from shyness and social anxiety disorder so much so that he tried every trick in the book yet to no avail. And then he set out to conquer his own fears by researching into the psychology, principles and practices behind these two debilitating mental health issues. Continue reading...

Shyness And Social Anxiety System Summary


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The author has done a thorough research even about the obscure and minor details related to the subject area. And also facts weren’t just dumped, but presented in an interesting manner.

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Social Anxiety In Children And Adolescents

Social anxiety is often evident early in life and may be diagnosed in children as young as eight years old (Beidel & Turner, 1998). Furthermore, when the social fears of children continue to be expressed through late adolescence they are more likely to be associated with a poor prognosis for recovery (Davidson et al., 1993 Mannuzza et al., 1995). The clinical presentation of social anxiety in children is similar to that of adults, with comparable somatic symptoms and feared situations. However, because of the limited cognitive development of younger children, they may not report specific negative cognitions (Beidel & Turner, 1998). Social anxiety in children is also associated with significant distress and impairment, including poor school achievement, greater loneliness, and difficulties with social relationships (Albano, Chorpita & Barlow, 1996a). Socially anxious children and adolescents may also suffer from elevated rates of general anxiety, depression, and secondary...

Social Phobia

In some cultures, social demands may lead to symptoms of Social Phobia. For example, in Japan and Korea an individual may develop persistent and excessive fears of giving offense to others in social situations, instead of being embarrassed (DSM-IV, 1994, p. 413). These fears may be expressed in terms of

Iiiacculturation Defined

Acculturation was defined by Redfield, Linton, and Herskovits (1936) as a process represented by all the changes that occur as a result of individuals from two distinct cultures coming into continuous first-hand contact with one another, but particularly those changes that result in changes in the original cultural patterns of either or both groups. If the result of two cultures coming together is that one or both cultures change, then it is said that those changes are the result of acculturation processes. If a culture changes, it has to be that the people of that culture changed in some way as well. This ecological perspective holds that culture is an external variable and an internal variable, with both having influence on behavior. Culture is a multilevel phenomena that operates at various levels simultaneously. Acculturation is an ecological, transactional process that occurs at various levels of human organization and functioning. Acculturation is a stimulus or a causative agent...

Cognitive Therapy for Anxiety Disorders

Cognitive therapy has been adapted for the full range of anxiety disorders generalised anxiety disorder (Beck & Emery with Greenberg, 1985) panic disorder (Clark, 1986 Craske & Barlow, 2001) social phobia (Heimberg & Becker, 2002) and obsessive-compulsive disorder (Frost & Steketee, 2002 Salkovskis, 1985). For generalised anxiety disorder, Chambless & Gillis (1993) computed effect sizes across five studies in which cognitive therapy was compared with one of several control conditions non-directive therapy (Borkovec & Costello, 1993) or waiting list (Butler etal., 1987, 1991). Substantial effect sizes (1.5-2) at post-test and follow up suggest that cognitive therapy is an efficacious intervention for generalised anxiety disorder. A review of 12 trials of cognitive therapy for panic suggested that 80 of patients achieved full remission at the end of treatment (Barlow & Lehman, 1996). De Rubeis & Crits-Christoph (1998) reviewed 11 outcome studies of cognitive...

Health Disparities The Role Of Race Socioeconomic Status And The Urban Environment

Racial ethnic minority populations tend to have worse health outcomes than the white majority population. However, minority groups, specifically blacks and latinos, also tend to be over represented in the lowest stratum of education and income in our society. Therefore, poverty and racial ethnic minority status tend to cluster nationwide regardless of region and urbanization. This clustering refers to what has been coined by Williams J. Wilson as 'the concentration effects' or the concentration of the most disadvantaged segments of minority groups in a particular geographic area (Wilson, 1987). In addition, this clustering leads to social isolation from mainstream America, which in turn amplifies the effects of living in a poverty area.

Integumentary form and function

Teeth Herbivore Carnivore Adaptation

Scent glands are odoriferous glands used for social interactions, territory marking, and defense. One type of secretion is a pheromone, which elicits a behavioral or physiological effect on a conspecific (member of the same species). During Hair is often described as a unique mammalian characteristic that has no structural homologue in any other vertebrate. Its distribution varies from heavy, thick pelages (fur coats) on many mammals to just a few sensory bristles (e.g., on the snout of whales or seacows). Mammalian hair originates in the epidermis, although it grows out of a tubular follicle that protrudes into the dermis. Growth occurs by rapid replication of cells in the follicle. As the shaft pushes toward the surface the cells fill with keratin and die. Each hair is composed of an outer scaly layer called the cuticle, a middle layer of dense cells called the cortex, and (in most hair shafts) an inner layer of cuboidal cells called the medulla. Each hair is associated with a...

Cultural Determinants Of Obesity

Culture influences all human behavior and dialectically shapes social institutions and social interactions among populations groups and individuals. Culture has many definitions, but all embody the underlying concept of implicit and explicit guidelines that are inherited and shared by members of a particular society or societal subgroup (6,7). These guidelines define''how to view the world, how to experience it emotionally, and how to behave in it in relation to other people, to supernatural forces or gods, and to the natural environment'' (7). These cultural perspectives are identifiable and transmitted from one generation to the next through distinctive symbols, language, and rituals. Of particular relevance to cross-cultural treatment issues, cultural influences on behavior tend to be relatively invisible. Certain types of behavior seem universal, natural, and nonnegotiable to those influenced by a given culture (7). In fact, the influence of culture often becomes evident As shown...

From Philosophy To Theory

The evolutionary thesis may also be seen to provide a basis for deriving the so-called clinical syndromes of Axis-II, as well. To illustrate briefly, consider the anxiety disorders. Without explicating its several variants, a low pain threshold on the pleasure-pain polarity would dispose such individuals to be sensitive to punishments that, depending on covariant polarity positions, might result in the acquisition of complex syndromal characteristics, such as ease of discouragement, low self-esteem, cautiousness, and social phobias. Similarly, a low pleasure threshold on the same polarity might make such individuals prone to experience joy and satisfaction with great ease again, depending on covariant polarity positions, such persons might be inclined toward impulsiveness and hedonic pursuits, be intolerant of frustration and delay, and, at the clinical level, give evidence of a susceptibility to manic episodes.

Human Olfactory Phenotype Variability

Human beings are considered microsmatic organisms (organisms with a more feeble sense of smell). Although we are less dependent on olfactory cues for survival, we utilize them extensively in enjoying perfumes, food, and beverage, avoiding poisons and stale food, as well as in subtle social interactions. It stands to reason that the relative small number of OR genes in the human genome, as opposed to other macrosmatic mammals (animals with enhanced sense of smell, e.g., mouse and dog) (8-10,20), is the reason for our somewhat poor olfactory sensitivity. Nevertheless, a recent study demonstrated that in human and other primates, typical detection thresholds toward various odorants are comparable to those of rodents (21). It appears that the massive OR gene loss in human could underlie more subtle olfactory deficits.

Causes and symptoms

The cause of avoidant personality disorder is not clearly defined, and may be influenced by a combination of social, genetic, and biological factors. Avoidant personality traits typically appear in childhood, with signs of excessive shyness and fear when the child confronts new people and situations. These characteristics are also developmentally appropriate emotions for children, however, and do not necessarily mean that a pattern of avoidant personality disorder will continue into adulthood. When shyness, unfounded fear of rejection, hyper-sensitivity to criticism, and a pattern of social avoidance persist and intensify through adolescence and young adulthood, a diagnosis of avoidant personality disorder is often indicated. The person is inhibited in unfamiliar social situations due to feelings of inadequacy. Low self-esteem undermines their confidence in meeting and conversing with new acquaintances.

Neurotransmitters mental disorders and medications

Substantial research evidence also suggests a correlation of neurotransmitter imbalance with disorders such as borderline personality disorders, schizotypal personality disorder, avoidant personality disorder, social phobia, histrionic personality disorder, and somatization disorder.

The Therapeutic Relationship

A 46 year-old woman suffered from social anxiety and agoraphobia. Initially, treatment (exposure in vivo) appeared to be going smoothly, but as the exercises progressed treatment halted. The patient started cancelling appointments and when she did show up she had not completed the assignments. In view of the initial smooth progress, the therapist hypothesized that the stagnation might have to do with fears associated with definitive improvement of the complaints. Inquiry revealed that the patient dreaded having to go back to work for her father, whom she described as an authoritarian man whom she felt unable to stand up to. As a result of this discussion, the functional analysis and treatment plan were revised and patient and therapist agreed to include assertiveness training as part of the treatment.

Surgery 421 Cosmetic Effects

Most apparent but not always sufficiently addressed are the cosmetic effects of surgery. Patients may be embarrassed by their own distress from a seemingly minor problem with an otherwise good outcome and consequently may not bring forth their concerns. Nonetheless, visible scars from cancer surgery can result in some cases in social isolation. Other patients find the sight and smell of an ostomy to be repugnant and greatly overestimate how much it is apparent to others around them. It is incumbent on providers caring for these patients to explore these issues with them to ensure that they are as satisfied as possible with long-term cosmesis. If distress is identified, they should look for ways to optimize the cosmetic result, and where this is not possible, try to help the patient best cope with their situation.

Malodorous Necrotic Ulcers

These ulcers are a major concern for cancer patients and can lead to social isolation and reduced QOL because current treatments inadequately reduce the foul smell to acceptable levels. A paper recently published reported that rinsing the ulcers twice a 2007 Elsevier Australia

Experimental Procedures And Manipulations

Members of a social group, honeybees are greatly affected by their social environment, and individuals readily adjust their life history to environmental conditions (Schulz et al., 1998 Pankiw, 2003). For this reason, experimental handling and stress (including social isolation) ought to be minimized or at least carefully controlled.

Management of Depressed Mood

Inactivity being one of Dianne's most salient high-risk situations, we introduced activity training as an intervention to tackle negative mood as well as her drinking problem. Activation training is a fairly common behavioural technique in treating depression, derived from Lewinson's theory of depression. We encouraged Mick to help his wife in organizing her week combining basic daily activities (like getting dressed in the morning), taking care of neglected activities (such as cleaning up the bedroom) and increasing the amount of pleasant activities (listening to music, going out for a cup of coffee with a friend). Given Dianne's social anxiety, a gradual approach was used in having her engage in social situations.

Communication Training

Communication training was introduced from session nine onwards. During this training both partners' personalities became more salient, this may be due to the fact the drinking and depressive symptoms had lessened. In addition, we addressed assertiveness, not only because of Dianne's social anxiety but also because both partners found it difficult to express disapproval and make a request. During these sessions it became clear that Mick had great

Summary And Conclusions

Exposure therapies are the treatment of choice in adult specific phobia, social phobia, agoraphobia, and obsessive-compulsive disorder (Emmelkamp, 2004) and have also been found quite effective in phobic children (Nauta et al., 2003). Studies of the behavioural treatment of depression have come to a standstill due to the rise of cognitive therapy in this area but the lack of further research into the behavioural treatment of depression is not justified by the data. There are still a number of important issues that need to be addressed. For example, we have no idea why cognitive therapy, behavioural interventions, IPT and pharmacotherapy work equally well with depressed patients, although various researchers provide various theoretical explanations. Unfortunately, to date there is no evidence that

Glucocorticoids and Behavioral States Reciprocal Determinism

Their functional outputs represent a close interplay across levels of organization. Consequently, manipulations at one point may have diverse effects throughout these circuits. The central CRH system, in addition to its regulation of pituitary ACTH release, is considered to be a general orchestrator of the cognitive, affective, behavioral, autonomic, and neuroendocrine aspects of stress. Local intracerebro-ventricular infusions of CRH in primates results in an activation of stress-related brain circuits, induces anxiety- and depressive-like reactions, and decreases social interactions (Strome et al., 2002). Because glucocorticoid administration alters central CRH activity, it is not immediately apparent whether the effects of this manipulation reveal the direct actions of glucocorticoids or indirect effects on CRH systems. Dissecting reciprocally interacting systems requires multiple experimental approaches and converging data that can provide a more comprehensive perspective than a...

Loneliness and Health Nonadditive Determinism

The utility of multilevel analysis to understanding psychological processes and psychosomatic relations is illustrated by our recent work on loneliness. Social isolation and loneliness are potent but little understood risk factors for broad-based morbidity and mortality (Seeman, 2000). Although loneliness has a heritable component, differences in social cognition provide a better explanation for the physiological characteristics of lonely versus nonlonely individuals than does a model based on invariant traits or genetic determinism. Lonely individuals tend to construe their world, including the behavior of others, as punitive or potentially punitive. Consequently, lonely individuals are more likely to be socially anxious and to adopt a prevention focus rather than a promotion focus in their social interactions (Ernst & Cacioppo, 1999). Lonely individuals are more likely to appraise stressors as threats rather than challenges and to cope in a passive, isolative fashion rather than...

Comparative analysis

It is clear that oxytocin plays a role in maternal-infant interactions, and that it also plays a role in adult social interactions in a manner independent of estrogen priming, at least in monogamous prairie voles. Even though the presence of a mother-infant interaction is a conserved feature of mammals, female bonding with other conspecifics is not universal. Diversity in social behavior among closely related species can be utilized to investigate the neural and genetic mechanisms that contribute to social bonding. Specifically, microtine rodents

The Existence of Lexical Syntax in Nonhuman Species Is Problematical

Given the widespread use of many subtly different, acoustically distinct vocalizations in different social situations, it seems logical to ask whether nonhuman primates or any other species ever combine vocalizations into compound utterances, and, if they do, whether they do so in accordance with a particular set of rules, or grammar

Performance Subtests Wechsler Scales

Thus, the performance subtests of the Wechsler intelligence scales sample a variety of cognitive and personality variables, including both short-term and practical, working memory, planning, abstraction, conceptualization, the need for structure, the ability to learn new material, perception of details, perceptual analysis, visual-motor coordination, identifying patterns, and sensitivity to social interactions. Because most of the performance subtests are timed, the subject's functioning in relation to speed can yield indications about a variety of diagnostic possibilities. For example, two broad diagnostic implications include depressive possibilities because of psychomotor slowness and impulsive conditions that cause a variety of errors. In addition, maintaining qualities of focus, planning and persistence in these visually oriented areas requires that subjects control anxiety, overcome confusion, tolerate frustration and limit distraction, oppositionalism, obsessionalism,...

Cognitive remediation

Tions attention and concentration memory planning monitoring one's work or behavior and making adjustments based on feedback. Remediation is also used to help children and adults cope with learning disabilities. Learning disabilities can interfere with progress in reading in understanding and communicating through spoken language in writing in arithmetic in understanding such nonverbal information as telling time or understanding visual information and in comprehending social interactions and cues. Difficulties with concentration, problem-solving, organization, identifying errors, and using feedback effectively are also areas that can be treated with cognitive remediation.

Noncognitive Functions and Aging in the

Although cognitive decline is the most common and frequently studied hallmark of aging and dementia, a number of noncognitive impairments are observed in elderly and demented subjects. The term noncognitive will refer to a range of diverse behaviors that do not explicitly involve testing for learning and memory but could be related to cognitive status. Such behaviors include general activity, social interaction, and psychotic and aggressive behaviors. A similar distinction is made in the case of humans (Folstein and Blysma, 1999). Using the dog as a model system to study aging, we have reported several noncognitive behavioral changes, which correlate with changes in cognitive functioning. The specific noncogni-tive behaviors examined include locomotor activity, activity rhythms, social interactions, and exploratory behavior.

Social Information Processing

Of cues, (c) clarification of goals, (d) response access and construction, (e) response decision and evaluation and (e) behavioural enactment. For example, they perceive more aggressive stimuli in social situations, interpret the intentions of others more frequently as being hostile, set more egocentric goals for actions, retrieve more aggressive reaction patterns from their memory, evaluate the consequences of aggressive actions more positively, and possess fewer non-aggressive interaction skills. Such modes of information processing make aggression a subjectively adequate reaction in social interactions. They are important mediators between long-term social influences, personality factors, and situational conditions of delinquent behaviour. However, more research on the relations between the various phases of information processing, social experiences and antisocial behaviour is necessary (Losel et al., in press). There are also not only unidirectional influences but more complex...

Mood and Behavioral Disturbances

Lesions and may lead to patients' engaging in activities that they cannot safely perform (Hoffman & Platt, 2000). Because of their apathetic behavior, demented individuals also tend to interact less frequently and withdraw from social situations. In a study that compared individuals with AD to those who had either ischemic vascular disease or MD (the authors combined these two groups), decreased affect and withdrawal were more prevalent and more severe in the vascular disease MD group (Hargrave, Geck, et al., 2000).

Latino Cultural Selfconstrual

Alternately, the collectivistic culture is more representative of Latino culture, and construes the self as more interdependent with other important people within one's social realm. Social roles are highly important and are central identities of the self. Typically, the Latino culture has been described as being defined by traditional gender roles for men and women, and a high regard for parental roles, which is consistent with the collectivistic nature (Delgado-Gaitan, 1994). Other traditional Latino values of respeto (respect) and dignidad (dignity) are complementary to the use of social roles, because they help establish the role boundaries and allow individuals to maintain their roles through respect and consideration of dignity (Molina & Aguirre-Molina, 1994). Also, collectivist individuals will be more likely to focus on the importance of relationships and connectedness between individuals. For example, Latino social interactions are guided by personalismo or the...

Commonly Occurring Disorders

Indian and Native youth and adults are at high risk for or have a high prevalence of the following mental retardation, speech impediments, learning disabilities, developmental disabilities, Attention Deficit Hyperactivity Disorder, Conduct Disorder, psychoactive substance abuse and dependence, depression, simple phobias, social phobias, separation anxiety, overanxious disorder, obsessive-compulsive disorder, and posttraumatic stress disorder (Manson et al., 1997 Manson & Brenneman, 1995 Manson, Walker, & Kivlahan, 1987). In addition, American Indian and Alaska Native youth experience high rates of Fetal Alcohol Effects or Fetal Alcohol Syndrome, otitis media, which can contribute to language and speech delays (McShane, 1982), suicide (Blum, Harmon, Harris, Bergeisen, & Resnick, 1992), and child abuse and neglect (Manson et al., 1997).

Parentinfant Recognition

We have also found (Beauchamp et al., 1994) that mice can be trained to discriminate among genetically identical pregnant females that are carrying fetuses that differ only according to H-2 type. Evidently, the odortype of a pregnant female is made up of the combination of her own odortype and those of her fetuses this appears to be the case for humans as well (Beauchamp et al., 1995). Fetal odortypes may thus play a functional role in social interactions among mice (Beauchamp et al., 1994, 2000 Yamazaki and Beauchamp, 2005).

Sex Differences in Friendships

Not only do women of all ages have more friends than men, but the nature and functions of those friendships are different. Women are more likely to initiate social interactions both within and outside the family and to develop deeper and longer-lasting friendships than men (Dickens & Perlman, 1981 Wright, 1989). Compared with men, women are more socially interdependent and more likely to engage in self-disclosure (Gilligan, 1982). Their friendships are characterized by the sharing of feelings and concerns and the giving and receiving of emotional support and suggestions (Fox, Gibbs, & Auerbach, 1985 Reisman, 1981). They talk more often and more openly and intimately to their friends, using conversation to make connections and share

Does Levodopa Cause Motor Fluctuations

In a retrospective study, Lesser et al. (62) collected data from 131 PD patients relating to severity of disease and late complications and assessed whether these problems were attributed to duration of disease or levodopa therapy. A relationship was seen between the presence of fluctuations and duration of therapy, since those with fluctuations tended to be treated for four years or more. This was not true for dyskinesia. They, therefore, associated fluctuations with levodopa therapy but did not rule out the possibility that those receiving levodopa longer had a more progressive disease. It was recommended that initiation of therapy be delayed until the patient begins to function unsatisfactorily in occupational or social situations. This is perhaps the most frequently quoted paper on the subject however, the authors themselves pointed out the flaws in a retrospective study and indicated the need for a prospective evaluation of the problem.

Psychological Wellbeing And Quality Of Life

Decreased psychological well-being has been reported in hypopituitary adults despite replacement of all hormone deficiencies with the exception of GH (2). In studies comparing adults with long standing GH-deficiency with matched controls the patients reported lower openness, less assertiveness, less energy, greater emotional lability, more difficulties with sexual relationships and a greater sense of social isolation (2,3). Evi

Psychological Assessment As A Tool For Treatment Planning

Similarly, knowledge of the patient's weaknesses or deficits may also affect the type of treatment plan that is devised. Greene and Clopton (1999) provided numerous types of deficit-relevant information from the MMPI-2 content scales that have implications for treatment planning. For example, a clinically significant score (T > 64) on the Anger scale should lead one to consider the inclusion of training in assertiveness or anger control techniques as part of the patient's treatment. On the other hand, uneasiness in social situations, as suggested by a significantly elevated score on either the Low Self-Esteem or Social Discomfort scale, suggests that a supportive approach to the intervention would be beneficial, at least initially. The ability to predict outcomes is going to vary from test to test and even within individual tests, depending on the population being assessed and what one would like to predict. For example, Chambless, Renneberg, Goldstein, and Gracely (1992) were able...

The fundamentalist approach

Gavison asserts that privacy consists of three elements secrecy, anonymity and solitude.8 The functions served bythis combination are considerable and include the development of individual autonomy, the growth and deepening of personality, the establishment of human relations, the promotion of liberty of action, and general support for the desirable ends of a free society.90 Finally, Feldman has argued that privacy should best be seen as a civil liberty that consists of the following features secrecy (which he considers is concerned with control of personal information), autonomy (which he classifies as being concerned with choosing the direction of one's life and social interactions) and dignity (which involves the giving and receiving of respect towards the choices and standards of oneself and others).91

Schizoid personality disorder

A person with schizoid personality disorder has little or no interest in developing close interpersonal relationships. They appear aloof, introverted and prefer being alone. Those who know them often label them as shy or a loner. They turn inward in an effort to shut out social relationships. It is common for a person with schizoid personality disorder to avoid groups of people or appear disinterested in social situations even when they involve family. They are often perceived by others as socially inept.

Schizotypal personality disorder

A person with schizotypal personality disorder has odd behaviors and thoughts that would typically be viewed by others as eccentric, erratic, and bizarre. They are known on occasion to have brief periods of psychotic episodes. Their speech, while coherent, is marked by a focus on trivial detail. Thought processes of schizotypals include magical thinking, suspiciousness, and illusions. These thought patterns are believed to be the schizotypal's unconscious way of coping with social anxiety. To some extent, these behaviors stem from being socially isolated and having a distorted view of appropriate interpersonal relations. Odd beliefs or magical thinking. These individuals may be superstitious or preoccupied with the paranormal. They often engage in these behaviors as a desperate means to find some emotional connection with the world they live in. This behavior is seen as a coping mechanism to add meaning in a world devoid of much meaning because of the social isolation these...

Venous Leg Ulceration

Chronic venous leg ulceration (VLU) is a common recurrent problem in the elderly population and may result in immobility, with 45 of patients being housebound (Baker & Stacey 1994). As a result, individuals with VLU frequently experience depression, anxiety, social isolation, sleeplessness and reduced working capacity (Leach 2004). CVI, which is characterised by an increase in capillary permeability, inflammatory reactions, decreased lymphatic reabsorption, oedema and malnutrition of tissues, is a precursor to VLU. As HCSE increases venous tone while reducing venous fragility and capillary permeability and possesses anti-oedematous and antiinflammatory properties, it has been speculated that by improving microcirculation, ulceration may be delayed or prevented (Blaschek 2004).

Relative brain size and intelligence

Using other primates for comparison, many researchers argue that human brain size increase is associated with social intelligence, driven by complex social interactions and the ability to predict and manipulate the behavior of other members of the social group (Machiavellian intelligence). However, tool behavior also must be a factor that contributes to human technical intelligence and innovation. Furthermore, humans have an ability to understand and manipulate the behavioral ecology of other species, and understand the physical properties of inanimate objects. This ability distinguishes humans from other primates, whose intelligence is oriented towards conspecifics.

The Role Of Social Structures In The Treatment Of Patients With Personality Disorders

The social factors affecting personality disorders are structurally rooted in modern society and cannot be changed by clinicians. Thus, patients with personality disorders have difficulty in finding social roles and are more likely to recover if they establish such roles. But there is no way to provide a full range of opportunities for patients. Nor can we offer them the structures provided by traditional families and communities. Nonetheless, personality-disordered patients usually benefit from establishing better social networks and supports. Therefore, clinicians can encourage their patients to establish more connections with community organizations. Support groups, often based on the model of Alcoholics Anonymous, target individuals suffering from social isolation.

Emotion Attached Dependent Types Dependent Personality

In addition, decision making becomes problematic and the person may find it difficult to initiate customary social interactions. The person may also behave in an unusually deferential manner to gain acceptance. Such a person can also feel deeply diminished by disapproval and can be profoundly hurt by any threat of separation or abandonment.

The Strategy Intersection Repair 41 An Urban Intervention

The objective of this health-promoting neighborhood intervention is to engage residents in neighborhood stewardship in the interest of public health. It is an urban revitalization strategy that directly engages communities in urban design, a field that has traditionally been dominated by professional planners, architects, and developers. The community-initiated neighborhood-enhancement project is intended to dynamically connect individuals by involving them in the planning and implementation of creative and attractive urban places. These interactive communities intentionally design vibrant places that are restorative to mental and physical health. This health-promoting neighborhood intervention creates sustainable communities by creating gathering places with environmentally conscious construction that benefit both the liv-ability of the neighborhood and the well-being of its residents. Improvements in the physical environment have positive ripple effects across social indicators,...

Schizotypal Personality

This character disposition, which was newly introduced in the third edition of the DSM, encompasses various eccentricities and unusual personality qualities although these are not equivalent to typical schizophrenic or psychotic processes. Typical behavior in the schizotypal character type involves social isolation, constricted affect expression, and a variety of idiosyncratic behavioral peculiarities that together restrict usual interpersonal experiences. Thus, the amalgam of these schizotypal symptoms associated with limited social interactions contributes to the definition of the schizotypal personality as an emotion-avoidant type. Additional traits encompassed by this characterology include suspiciousness, and even ideas of reference of the paranoid, and a strong attraction to magical beliefs and special sensitivities which, at times, dissolve into manneristic rituals. Ideas of reference do not reach the proportion of full-fledged delusions, nor does magical wishing regress to the...

Cognitive and Psychiatric Disturbances

Earlier literature described euphoria as a feature of MS (120). However, depression is now recognized much more commonly, with 50 or more of patients experiencing this affective disturbance in some form during the course of the illness (121-123). Although this is usually relatively mild, major depression can occur (123). Suicide may be a major cause of mortality, accounting for 15 of adult deaths in one series (124). Recently, Feinstein (125) identified warning signs that include living alone, having a family history of mental illness, and reporting social isolation. Patients with a prior history of major depression, anxiety disorder, or alcohol abuse are also particularly vulnerable. The so-called euphoria is actually the inability to inhibit emotional expression, resulting in inappropriate laughing and crying. This occurs with subcortical forebrain lesions (126). Other instances of apparent euphoria seem to be associated with evidence of significant cognitive decline. Euphoria is...

Description Of The Disorder

Social anxiety disorder, also referred to as social phobia (Liebowitz et al., 2000), has as its essential feature an extreme fear of appearing anxious or doing or saying something embarrassing in social or performance situations, accompanied by a fear of negative evaluation by others (American Psychiatric Association, 1994). For a diagnosis to be made in adults, the individual must recognize that the fear is excessive. Frequently feared situations include public speaking, going to parties, meeting strangers and talking to people in authority (Holt et al., 1992). The individual becomes anxious in anticipation of feared situations and often avoids them, leading to significant distress and interference in the person's life. When the person's anxiety is experienced in most social situations, he or she is further described as having the generalized subtype of social anxiety disorder. The majority of persons presenting for treatment for social anxiety disorder are of the generalized...

Cognitive And Behavioural Therapies

Over the past decade, a number of studies have examined the efficacy of psychological (mostly cognitive-behavioural) treatments for social anxiety disorder. The most commonly investigated treatments have been in vivo exposure (with or without the addition of cognitive restructuring techniques), social skills training, and relaxation training. The International Consensus Group on Depression and Anxiety's 'Consensus Statement on Social Anxiety Disorder' concluded that there is good evidence for the efficacy of exposure-based cognitive-behavioural interventions for social anxiety (Ballenger et al., 1998). Accordingly, these interventions receive the bulk of our attention in this review. Exposure to feared situations is a central component of most treatments for social anxiety disorder. Exposure can be conducted either imaginally, in role plays or in vivo, to help clients habituate to anxiety-provoking situations and to provide an opportunity to gather disconfirmatory information and...

Comparisons And Combinations Of Cbt And Medication

The few studies that have compared the efficacy of CBT to that of medication treatments have been difficult to interpret because of a variety of methodological problems. One study indicated that CBT was more effective than buspirone for socially anxious musicians (Clark & Agras, 1991) and another reported that combined imaginal and in vivo exposure was more effective than the beta-adrenergic blocker atenolol (Turner, et al., 1994a). However, neither atenolol nor buspirone has surpassed placebo in the treatment of social anxiety disorder (Liebowitz et al., 1992 van Vliet et al., 1997). Phenelzine has long been considered the best established pharmacological treatment for social anxiety, demonstrating the largest effect size across controlled trials (Blanco et al., 2003). However, it is not considered a first-line medication because of the risk of hypertensive reaction and the associated need for dietary restrictions. In a large, multisite collaborative study, Heimberg et al. (1998)...

Brain Evolution And Behavior A Role For Genomic Imprinting

Some mammals have developed complex sociobehavior, which reflects the different reproductive strategies of males and females. Reproductive success in males is determined through competition with other males to mate with as many females as possible, with emphasis on same sex aggressive social interactions. Females form strong social bonds with their infants and female-female relationships are affiliative among matrilineal kin who often assist with infant care. These differences are reflected in the evolutionary development of certain neuropep-tides. The invertebrate nanopeptide representing the oxytocin-vasopressin complex is phylogenetically old and was coded for by a single gene which underwent duplication to give rise to the mammalian oxytocin and vasopressin (Gilligan et al., 2003 Van Kesteren et al., 1995). In male mammals, vasopressin is important for influencing male courtship and aggressive behavior, while oxytocin plays a dominant role in maternal behavior and female social...

Developing Emotions And Sociability

It is difficult to conceive of early social development apart from the emotions that color social interactions in infancy. Emotions have been called the language of infancy, and infants as emotion detectors (Tronick, 2001). Infants signal their emerging social discriminations and preferences according to which partners can most readily evoke smiles and cooing, and adults become engaged in social play with babies because of the animated, exuberant responses that they receive. Caregivers attune to the preemptory sound of the infant cry and the hunger, pain, or startled fear it reflects, and the baby's developing sensitivity to the emotional expressions of others reflects achievements in an emerging understanding of people. In short, the study of socioemo-tional development reflects how interwoven are the processes of early social and emotional growth, each of which provides a window into psychological development.

Interpersonal Psychotherapy

A review of the literature suggests that a small number of non-cognitive or behavioural treatment alternatives exist for the treatment of social anxiety (for a review see Lipsitz & Marshall, 2001). These studies show promising results but are limited by a lack of rigorous methodology, such as incorporation of control groups or larger sample sizes. Promising results come from a recent uncontrolled trial applying interpersonal psychotherapy (IPT) to nine individuals with social anxiety disorder (Lipsitz et al., 1999). IPT is a time-limited treatment approach that focuses on disruptions in the psychosocial and interpersonal context which may underlie psychological disorders. Treatment includes the identification and exploration of primary interpersonal problems, examination of communication styles, decisions analysis and role playing. Following 14 weeks of treatment, seven (78 ) clients were classified as responders by independent evaluators and general symptom improvement was found...

Gaps In The Evidence Base

An important issue in treatment outcome is that many clients do not achieve as much change as would be desirable, either in terms of symptoms or in terms of the impact of symptom change in other areas of life. Previous research on the clinical significance of symptom change immediately following a course of CBGT for social anxiety demonstrated a significant improvement in clients' self-perceived quality of life (Safren et al., 1997). Further, improvements from CBGT were shown to be maintained for several months after treatment (Eng et al., 2001). However, these improved ratings still fell below the normative average at post-test and follow-up. Of major concern is the limited number of therapists who can recognize and effectively treat social anxiety disorder. Clinicians are most likely to recognize and diagnose a psychological problem in socially anxious persons who present with a comorbid condition -typically major depressive disorder or alcoholism - and are most likely to treat the...

Reproductive biology

Little is known regarding mating behavior of most molos-sids. Chaerephon pumila is reported to roost and mate in stable harem groups of about 20 females attended by a single male. Evidence suggests that Tadarida brasiliensis mates promiscuously during a brief period in spring when males and females assemble at specific sites. Many reports of the use by molos-sids of low-frequency vocal communication, the abundance of scent glands, and the existence of obvious structures for social displays such as head crests all suggest that molossids engage in a diversity of social interactions and mating systems that are, as yet, unstudied.

Historical Considerations

He believed that possible means to counteract such an infection (e.g., yogurt) would be helpful to delay aging. Given the strong biological and medical orientation of early gerontology, the explicit consideration of the socio-physical environment was an important step in its historical development toward a strong interdisciplinary research field. This paradigm shift was mainly driven by the growing role of a social and behavioral science perspective within gerontology and life course research, which began evolving since the late 1920s. For instance, Hall (1922) and Hollingsworth (1927) in the United States provided early contributions to aging research from a developmental psychologist's view, promoting the idea that improved understanding of life-span development is possible only when considering the social situations of aging individuals. Similarly, developmental psychologist Charlotte Biihler (1933) argued in her key work, The Human Life Course as a Psychological Problem, that the...

Internalizing Disorders Anxiety Disorders

Social phobia (social anxiety disorder) A marked and persistent fear of social or performance situations that expose the child to unfamiliar adults and peers, scrutiny, and possible humiliation or embarrassment fear persists for at least 6 months. Social Phobia (Social Anxiety Disorder) Social phobia occurs in 1-3 of children, affecting slightly more girls than boys (Essau, Conradt, & Petermann, 1999). Girls may experience more social anxiety because they are more concerned with social competence than are boys and attach greater importance to interpersonal relationships (Inderbitzen-Nolan & Walters, 2000). Among children referred for treatment for anxiety disorders, as many as 20 have social phobia as their primary diagnosis, and it is also the most common secondary diagnosis for children referred for other anxiety disorders (Albano et al., 1996). Even so, many cases of social phobia are overlooked because shyness is common in our society and because these children are not...

Social Responsiveness In Aging Dogs

Together, the results from the four tests indicate that as in humans, social behaviors change with age in dogs. Old dogs, like elderly people, continue to be social creatures with age but become more passive in their social interactions compared to young dogs. As cognitive functions become increasingly impaired, however, social behaviors change from normal, appropriate responses to disrupted and inappropriate reactions.

Prevalence Of Latelife Depression And Anxiety

Social phobia, simple phobia) are considered more common than other anxiety disorders such as panic disorder, obsessive-compulsive disorder and post-traumatic disorder (Stanley & Beck, 2000). Although phobias are the most common form of anxiety disorder among older people, social anxiety is much less prevalent in older people when compared to younger people (Gretarsdottir et al., 2004). As with depression, there is a suggestion that sub-syndromal levels of anxiety, particularly GAD, are common in older people and that minor GAD symptoms may cause enough problems to merit attention from clinicians (Carter et al., 2001 Diefenbach et al., 2003 Wetherell, LeRoux & Gatz, 2003).

Betweenmethod Replication

We should also note that experimentation itself need not be seen as the be-all and end-all as general research strategy. A weakness of experimentation, especially in laboratory settings, is that it can fail to capture the complex interaction of variables that are sometimes the major determinants of behavior. Indeed, many social psychological research traditions, such as those that focus on cross-cultural issues (e.g., Diener & Suh, 2000), use correlational methods more typically. Correlational research strategies seem to address the inherent complexities of social interactions in a more satisfying way than experimental approaches and represent a varied set of effective, alternative methodological approaches to tackling social psychological phenomena.

Role Of The Physical Environment As People

Most essential for the ecology of aging. That is, the consideration of the impact of the interaction between the aging person (P) and the environment (E) on a variety of behavioral outcomes such as well-being and functioning has been added to the isolated consideration of the person and his or her environment (Behavior P, E, P X E). Environmental gerontology primarily considers the relevance of the full range of physical components of the environment for aging processes, but also acknowledged is the strong, integrated role of the social dimension. For example, the home environment is not only a physical structure, but also a place punctuated by pronounced intimacy with one's partner, social interactions, and the symbolization of attachment, normalcy, and loss (Rubinstein and Parmelee, 1992).

Framing The Problem 21 Life in the Grid City

Ordinance did not provide for public centers, parks, or open landscapes since it carved the land into squares of private property and virtually omitted the public realm, except streets. The monotony of the rectangular pattern did not consider topography or the natural curvilinear layout of the land and was imposed over the undeveloped landscape to neutralize the environment. The lack of open space deprived the urban population of recreational sites with fresh air and abundant light, and fostered monotonous housing standards. Furthermore, the omission of public squares, ceremonial places, and public structures as nodes of community life was a serious limitation of the relentless grid design it could potentially be the source of social isolation and alienation in urban centers. The grid layout fulfilled a number of technocratic goals, but fell short to take into account a number of human qualities. Aristotle criticized the Hippodamian approach to city planning stating that every city...

Cognitive Therapy for Different Populations and in Different Settings

Individual cognitive therapy is the most common format, although couples, family, groups and organisational consultancy formats have also been developed. In individual therapy it is common to involve spouses, friends, parents or others, either as informants or as people who can help the client change (see Baucom et al., 1998). Cognitive couple therapy has been shown to be acceptable and effective in depression in one spouse, chronic interpersonal problems, and marital problems (Baucom et al., 1998 Dattilio & Padesky, 1990 Epstein & Baucom, 1989). Cognitive therapy in group format has been shown to be acceptable and effective for depression (Robinson, Berman & Neimeyer, 1990) and social phobia (Heimberg etal., 1993).

Vulvar Vestibulitis Syndrome

Vulvar Vestibulitis Treatment

Factors such as psychological distress, anxiety, depression, low sexual self-esteem, harm avoidance, somatization, shyness, and pain catastrophization (41,55,56,60,68,69) have been found in women with vulvar vestibulitis. Whether they precede or develop subsequent to the pain remains to be elucidated however, it is crucial to investigate the role of these factors in the maintenance of dyspareunia as negative affect has been shown to modulate pain intensity (70). Negative affect is also associated with an increase in attention towards pain stimuli, otherwise known as hypervigilance (71), which in turn can increase perceived pain intensity (72). In a recent study (73), hypervigilance for pain stimuli was examined in women with vestibulitis and matched control women. Results indicated that women with vulvar vestibulitis syndrome reported hypervigilance to coital pain and exhibited a selective attentional bias towards pain stimuli, an effect mediated by anxiety and fear of pain. These...

Dysmorphology clinics

Siblings may also be affected (Lansdown et al., 1991). Being different puts the child at risk of being teased but it is interesting to note that the relationship between facial deformity and psychological effect is not linear (McGregor, 1970). The mild, rather than severe deformity, is harder to cope with (Lansdown et al., 1991). A possible explanation could be that the more obvious deformity has to be acknowledged, whereas the nearly normal may stimulate the desire and anxiety to be accepted as normal. The subject is difficult to research as asking a child or a parent whether or not they are stared at, or how they cope with looking different is a sharp and potentially hurtful reminder of the problem. The reports of the existing studies are conflicting with self-esteem being reported as lower and also higher than normal. The latter is explained by the experience of having to cope with adversity (Brantley and Clifford, 1979). Bradbury (1993) considers that children and their parents...

Multiple Methods and Personality Traits

Spain et al. (2000) used a similar design to both replicate Kolar et al. (1996) and extend the design to see if self-reports might be superior in specific settings, such as when one is predicting emotion rather than behavior. Consistent with expectations, self-reported personality ratings were more strongly related to experience sampling assessments of emotion than observer ratings of personality traits. This presumably derives from the fact that emotions are internal events that are not always shared with others as overt, visible behaviors. Their private nature makes them a natural target for self-reports rather than observer ratings. Interestingly, self-reported personality ratings did better than observer ratings of personality in predicting social interactions. For example, self-reported extraversi n was correlated with demonstrating social skills, as judged by a set of trained raters, whereas a composite of acquaintance ratings was essentially uncorrelated with the same behavior....

Community Organizing In Urban Neighborhoods

This particular intervention has been designed to enhance the urban core of American grid cities which tend to have been planned without any provisions of significant public gathering places. Community organizing in urban neighborhoods can reverse alienation and foster a sense of responsibility that counteracts urban blight it encourages residents to take initiative against social disorder and physical deterioration (Wilson, 1996). Neighborhood stewardship manifested in physical improvements of the urban environment is a direct consequence of the community organizing capacity this capacity that can directly be translated into concrete action such as physical improvements to solve local problems (Perkins, et al., 1990). Often residents have little control over the demographic composition of their neighborhood nor over transient populations that may be involved in drug trafficking and crime however, residents can revitalize their built urban environment. Factors that determine...

Pharmacological Toxicological Effects

A study using rats to measure the anxiolytic activity of Hypericum was conducted with efficacy being measured by several means. In this study, rats were given either Hypericum extract 100 or 200 mg kg or lorazepam 0.5 mg kg. Using the open-field observation test and the maze test to measure anxiety, the Hypericum treatment groups showed anxiolytic efficacy and were superior to placebo, whereas the lorazepam was either equivalent to or superior to the Hypericum groups. With respect to social interaction, both treatment groups with Hypericum increased the amount of time the animals spent in social interactions with respect to control animals. Lorazepam-treated rats were comparable to the higher dose Hypericum group (21).

Eriksons Psychosocial Stages

Unlike classical psychoanalysis, which viewed personality as essentially complete by adolescence, Erik Erikson (1963) maintained that personality continues developing throughout an individual's lifetime. Also unlike Freudian theory, Erikson's stages are psychosocial rather than psychosexual. Erikson emphasized the importance of social interactions in the resolution of the crisis or conflict at each stage. The first five stages in his model of development are temporally parallel to Freud's five psychosexual stages. However, Erikson extended the range of personality development to include three additional stages in adulthood. These stages are similar in certain respects to Robert Havighurst's (1953) description of the developmental tasks of early adulthood, middle age, and later maturity.

Other Informants Child and Infant Temperament

Using other reports has some advantages over using self-report or observational data. Compared to children and adolescents, adults are more skilled in answering questions, and parents and teachers have the opportunity to observe children over time and in a variety of social situations. Although adults' reports on children probably are more objective (on average) than children's reports about themselves, adults' reports are subject to certain biases. Parents' reports may be influenced by social desirability, and there is some evidence that teachers may rate academically skilled children more positively in general (Underwood, 1997). One way often used to assess the validity of parents' and teachers' reports is to examine agreement among informants. However, results regarding rater agreement are often inconsistent. For example, Guthrie et al. (1997) reported that the relation between teachers' and parents' assessments of children's reactivity were modest at best. In contrast, Eisenberg...

Definitions of the Variables

As described above, the types of knowledge and skills (and motivation) that are most predictive of a certain dimension of performance will largely depend on the nature of the performance domain (Motowidlo et al., 1997). For example, an individual's social skills (i.e., procedural knowledge and skills related to interpersonal relationships and social interactions) will be more predictive of contextual performance whereas an individual's technical knowledge and skills will better predict his or her task performance. Similarly, self-knowledge and emotional-control skills might be more highly predictive of adaptive performance behaviors. Currently, evidence for these suppositions is indirect or theoretical (Borman & Motowidlo, 1993 Motowidlo & Van Scotter, 1994). Future research modeling these effects will greatly contribute to our understanding of the components of performance and their immediate determinants. Examples of such research as it relates to the modeling of the effects...

Zyprexa see Olanzapine

Schizotypal personality disorder separation anxiety disorder sleep terror disorder social phobia specific phobias substance abuse substance intoxication Apathy personality disorder schizotypal personality disorder of sex hypoactive sexual desire disorder schizoid personality disorder sexual aversion disorder of social situations avoidant personality disorder seasonal affective disorder separation anxiety disorder may occur with tic disorders of specific feared situations social phobia

Limitations of Etic and Emic Approaches

In contrast, emphasizing that all therapeutic transactions, and in fact all human perceptions and social interactions, occur within the context of culture, the emic approach alerts the clinician to the impact of culture in all aspects of mental health services. In particular, it highlights the importance for the clinician to be aware of his or her own culture and worldview, and to take the client's culture and worldview into objective consideration, in defining the presenting problem as well as the intervention strategies. This is especially crucial when clinicians are providing service to clients from cultural backgrounds different from themselves. For example, clinicians must make every effort to see how the client might behave and reason in certain ways as related to the identified problem. Unless the clinician tries to walk in the client's shoes and perceive the situation through the client's lenses, the emic perspective would indicate that one is not professionally able to really...

Special Populations Of Urban Lgbt People

Although less is known about their health care needs, like youth, elder LGBT people face unique barriers to receiving quality care. Nearly one in five people in a same-sex couple is at least 55 years old (Gates and Ost, 2004), and estimates of the number of LGBT people over 65 range from one to three million (Cahill, et al., undated). This number will surely increase as the baby boomer generation continues to age. Isolation and lack of mobility are problems for all seniors, and LGBT seniors, particularly those who have migrated to cities, may be without the traditional support of family and community (Office of Gay and Lesbian Health, 1999). One study of LGB seniors in New York City found that 65 were living alone compared to 36 of New York's general senior population (Assistive housing needs for elderly gays and lesbians in New York City, 1999). In addition to social isolation, institutional barriers, which will be discussed below, make LGB seniors particularly vulnerable to...

Current Limitations And Future Directions

It remains to be seen whether the traditional cost and reward measures (such as dollars, life years, and QALYs) in their present forms are appropriate or if researchers need to modify current measures or develop new ones to match the unique aspects of bioterrorist attacks and epidemics. After all, many of these current measures originally arose in the context of more well circumscribed medical events, such as individual acute and chronic diseases. Such measures may not capture the complex scientific, economic, and social interactions that occur when the ambient environment is threatened and changed. For example, how does surrounding panic or loss of faith in daily business operations affect quality of life Will existing measures adequately represent psychological distress What is the cost of losing or damaging the life of a person, such as a healthcare worker, who is essential to mounting an adequate response to the outbreak Do potential future earnings fully represent costs from a...

Basic Concepts And Fundamental Psychological Principles

Lay and scientific epistemics have much in common (Kruglanski, 1989a). Ordinary people and scientists share a desire for knowledge, use similar methods for acquiring knowledge, need knowledge for similar purposes, collect similar data, and use similar criteria for judging the usefulness of data. Lay and academic psychologists alike want to describe individuals and social situations in psychological terms. Both construct theories for the explanation of behavior and rules for its prediction. Both try to maximize the accuracy and simplicity of theories and predictive rules. Both compromise between accuracy and simplicity because of the inverse relation of those two qualities. Both are more sensitive to variability than to constancy. Both use the principle of replication to ascertain lawfulness and reliability. All of these commonalities are fundamental for understanding the psychological and conceptual foundations of the multimethod approach.


Manage the emotions of day-to-day life. Feelings such as anxiety, depression, shame, discomfort in social situations, and anger are often believed to be causes of substance abuse. In this sense, many experts believe that addicts self-medicate, that is, use destructive substances to ease their painful emotions.


Displays are used by many animals, including bovids, to communicate in a range of social interactions. Lateral displays are common in many Bovidae, and often emphasized by adaptations that enhance the size (real and apparent) of the lateral profile. In the American bison (Bison bison) and gaur (Bos gaurus), the thoracic spines are elongated, permanently increasing the dimensions of their body profile. Other morphological adaptations that enlarge the lateral profile include dewlaps, the flap of skin hanging from the neck and chest of eland (Taurotragus oryx) and the zebu breed of domestic cattle (Bos taurus), and manes of long hairs. In greater kudu (Tragelaphus strepsiceros) and urial sheep (Ovis vignei), for example, the mane falls from the underside of the neck, and in nyala (Tragelaphus angasii), it extends along the underside of the belly as well. A temporary increase in lateral profile is achieved in some species such as the roan antelope (Hippotragus equinus) and chamois...

Social Factors

People with such disorders experience innumerable social disadvantages, ranging from poverty, limited access to employment, social isolation, neglect, and unequal treatment by statutory services to financial, verbal and physical, and sexual, victimisation (Sobsey, 1994 Brown et al., 1995 Hirsch and Vollhardt, 2002 Mencap, 1999 Williams andKeating, 1999 Glendenning, 1999 British Psychological Society, 2000 Davis and Hill, 2001 Nosek et al., 2001). The extent of different forms of victimisation among the three groups is unclear, and reported rates vary greatly. In part this is likely to reflect different definitions of victimisation and variation in the ways in which the populations are defined. (See Brown and Turk (1992) for a discussion of these issues in relation to the sexual abuse with people with intellectual disabilities.) Furthermore the likelihood of sexual, and other, victimisation coming to light in people with a mental disorder may be much lower than for the general...

Case Example

Thomas was a 68-year-old married man, diagnosed with Parkinson's disease four years previously. As a consequence of the disease he had become uncertain and fearful of others' reactions to him in professional and social situations and had increasingly avoided such situations. This had profoundly affected his self-concept he was experiencing many features of depression. The onset and progression of the Parkinson's disease had activated Thomas's beliefs about his acceptability as a person as conditional on being respected and regarded as competent, because it had compromised his competence in what he believed were key areas. He had begun to doubt his self-worth and acceptability as he put it, 'people will think I am at the end of the pier a lesser person if they know about the Parkinson's disease.' Because Thomas tried to 'camouflage' the disease and its impact on him from friends and family, he had started to avoid many social situations. This had in turn maintained the social fears and...

Simple schizophrenia

'Simple schizophrenia' (another term now seldom used) is characterized by negative symptoms, with gradual deterioration of the personality, flattening of affect, withdrawal from reality, and loss of drive, resulting in a lifestyle of social isolation and self-neglect. Positive symptoms may be few therefore, in some cases, it is debatable whether a diagnosis of schizophrenia is actually justified. However, such patients can be among the most disabled patients with schizophrenia, unable to function independently. Response to medication is often poor. They will clearly stand in need of mental health services such as supported accommodation. So the question of whether or not a particular diagnosis is appropriate may be somewhat academic.

Communicable Disease

A study of suicides from 1970 through 1992 among persons aged 15 to 34 in California found that immigrants were underrepresented among the 32,928 deaths (Sorenson and Shen, 1996b). Firearms were the most common method of suicide among both immigrants and U.S.-born individuals, and the home was the most common site for suicide among both groups. Foreign-born latinos, who came primarily from Mexico, appeared to account for the apparent lower risk of suicide. They appeared to be at higher risk of suicide than their counterparts in Mexico, but at lower risk than their counterparts born in the U.S. (Sorenson and Shen, 1996b). It has been hypothesized that the tendency of immigrants to settle in ethnic enclaves in large cities, close to other immigrants as well as family and friends, may serve as a preventive factor for suicide by reducing social isolation


With a more general approach involving family members and caregivers. Teaching children with this disorder specific communication skills so that they can interact with their peers is important, as problems in this area may lead to later social isolation, depression, or behavioral problems. Children who are diagnosed early and taught reading skills may benefit especially, because problems with reading are often associated with mixed receptive-expressive language disorder and can cause serious long-term academic problems. There is little information comparing different treatment methods often several are tried in combination.

Other Applications

The success of IPT in treating unipolar mood disorders has led to its expansion to treat other psychiatric disorders. Frank and colleagues in Pittsburgh have been assessing a be-haviourally modified version of IPT as a treatment adjunctive to pharmacotherapy for bipolar disorder. Further, IPT is increasingly being applied for a range of non-mood disorders. There are intriguing applications of IPT as treatment for bulimia (Agras et al., 2000 Fairburn et al., 1993 Wilfley et al., 1993, 2000) and anorexia nervosa social phobia (Lipsitz et al., 1999), posttraumatic stress disorder, borderline personality disorder and other conditions. Life events, the substrate of IPT, are ubiquitous, but how useful it is to focus on them may vary from disorder to disorder. There have been two negative trials of interpersonal therapy for substance disorders (Carroll, Rounsaville & Gawin, 1991 Rounsaville et al., 1983), and it seems unlikely that an outwardly focused treatment such as IPT would be...

Why Innovate

These innovative items can have very high face validity authenticity. For example, some situational judgment tests used in preemployment testing use written passages that describe social situations. However, in the real world we are dependent on interpersonal cues such as verbal tone and facial expression for information regarding the situation. Full-motion video simulations are able to capture such subtle nuances and convey a more natural experience of the situation. On the other hand, written passages must rely on explicit description of otherwise subtle nuances to convey the situation. This may compromise validity because directing the attention of the respondent to particular cues makes it impossible to assess the candidate's ability to notice those nuances.


Older adults have a great fear of street crime, although young people are victimized more often. Fear of violence or intimidation has been reported to limit physical activity and promote social isolation. Factors such as loneliness are associated with fear of crime in the neighborhood as well as in the home (Bazargan, 1994). Older adults living in cities are also frequent targets for fraud, from telemar-keters and others. Twenty-seven percent of 200 Houston senior center participants reported being victimized by fraud (Otiniano, et al., 2002). Such victimization increases feelings of fear, guilt, and self-doubt. Finally, the terrorist attack of September 11, 2001 traumatized the nation's populace, including older adults, and reminds us of a new threat to urban communities. The different ways that older adults, and children, are particularly vulnerable to threats of bioterrorism and as well as targeted methods to safeguard these groups, remain to be addressed.

Anxiety Epidemiology

In addition to generalized anxiety disorder (GAD), patients with PD regardless of sex also experience panic disorders and social phobias with a prevalence of approximately 30 . (17,19,20). The presence of anxiety not only contributes to mental and somatic discomfort, but may also contribute to existing motor symptoms or fluctuations (7). For example, patients will report that episodic states of anxiety will aggravate preexisting tremor or dyskinesia, and fear of falling has been associated with impaired postural stability (21). Additionally, an internal tremor is frequently associated with anxiety (22). Consequently, in patients with high levels of anxiety or significant episodic anxiety, the initiation of appropriate anxiolytic therapy may improve motor symptoms as well as mental and psychosocial functioning.

Operant Techniques

Treatments derived from Lewinsohn's theory encourage the patient to participate in constructive and pleasurable activities. Activities that patients used to enjoy but ceased doing are now scheduled as homework assignments. Activities are ordered in a hierarchical fashion. Less challenging activities are scheduled first more challenging activities follow later on in treatment. A number of studies have investigated whether this reinforcement of pleasant and constructive activities would, by itself, lead to a decrease in negative affect. The evidence demonstrated that the increase in pleasant activities indeed gave rise to mood improvement (Emmelkamp 1994). Another way to achieve reinforcement from social interactions is social skills training, which is discussed later.


Figure 8.14 Given a large area, dogs and pigs may be held together. Outdoor pens such as the one shown here stimulate the animals to exercise and to engage in social interactions. Figure 8.14 Given a large area, dogs and pigs may be held together. Outdoor pens such as the one shown here stimulate the animals to exercise and to engage in social interactions.

Delusional Disorders

Delusions sometimes form part of the symptom picture in schizophrenia, particularly in younger patients, but delusions without schizophrenia are more common. The frequency of delusional disorders tends to increase with age, being exceeded only by dementia and depression in older adults. The delusions of older patients are often accompanied by a chronic hearing loss, which makes it difficult for them to understand what other people are saying and invites suspiciousness, and by cognitive disturbances, as in Alzheimer's disease. Older loners who have lived most of their lives in relative isolation from other people are more likely to be delusional than individuals with normal social interactions (Berger & Zarit, 1978).

Affective Disorders

Feelings of intense sadness, hopelessness, pessimism, low self-esteem, loss of appetite and interest, insomnia, fatigue, aches and pains, and memory problems that are symptomatic of depression can also occur as a reaction to the loss of a loved one, physical disorders, financial insecurity, social isolation, or any other serious problem. Unlike psychotic depression, in which guilt, self-deprecation, and bodily complaints are extreme and grossly unrealistic, the apathy, inertia, and withdrawal seen in neurotic or reactive depression are less bizarre and more closely associated with external circumstances.

Social cognition

Visual social signals provide information in social interactions. The simplest signals are threat or appeasement gestures. Visual social signals that guide another animal's attention to an object or event require more complex cognitive skills. For example, monkeys and apes will join another animal to investigate jointly an object of interest. Referential pointing and referential gazing are social signals that call attention to an object or event removed from the actor. Chimpanzees and orangutans can interpret pointing in humans. They also point and vocalize to draw a human's attention to a distant object or event. However, these apes do not typically use pointing to communicate with one another and their use and interpretation of pointing varies with the amount of human contact they have had.

Families and Friends

A person's first social experiences usually take place in a family setting. These early encounters with other people condition the individual to expect certain things and to behave in specific ways in preparation for entry into the larger society. As representatives of that society, parents, siblings, and other family members can instill a sense of personal confidence and capability in the individual on the one hand, or feelings of insecurity and anxiety on the other. These feelings, initiated in a family setting, generalize to other social situations and set the stage for the person's lifestyle in adulthood.

Qualityof Life

Ferrell (18) uses four domains to define QOL (1) physical well-being, (2) psychological well-being, (3) social well-being, and (4) spiritual strength. Physical well-being includes the ability to maintain functional activities, self care, exercise tolerance, ability to work, appearance, overall physical health, degree of independence, sleep and rest, and symptom control. Psychological well-being provides a sense of control in the face of illness, altered life priorities, and fear ofthe unknown. Diagnosis can causes anxiety, depression, fear, stress, and mood swings. Psychological well-being includes enjoyment of life, intellectual function, adjustment to the disease as well as confidence, acceptance, and satisfaction with treatment. Social well-being includes family issues, adjustment of children, changes in roles and relationships, family stress, patient's social appearance, social isolation, ability to communicate, ability to work, and financial situation. Also included is sexual...

Judith V Jordan

The DSM-III-R (American Psychiatric Association APA , 1987) defines personality traits as enduring patterns of perceiving, relating to and thinking about the environment and oneself, which are exhibited in a wide range of important social and personal contexts (p. 335). It further states that personality disorders develop when personality traits are inflexible and maladaptive and cause either significant functional impairment or subjective distress (p. 335). DSM-IV (APA, 1994) adds attention to cultural factors in its revision An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture and the enduring pattern is inflexible and pervasive across a broad range of personal and social situations (p. 275). It continues, The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood (p. 276). From the point of view of the relational-cultural model of development and...

Consensus Panels

The panel concluded that early behavioural intervention for children was strongly recommended and should include at least 20 hours per week. Applied behaviour analysis was also identified as an effective method for young children with autism. The panel made recommendations concerning clear operational definitions of target behaviours, use of reinforcer assessments, functional assessments, planning for generalisation, parents and peer training and so on. They also recommended that ABA was an effective intervention to reduce mal-adaptive behaviours, to teach social interactions and promote language skills. The strength of the evidence for specific conclusions varied widely from a strong evidence base - at least to well-designed studies - to panel consensus. This is perhaps unsurprising given the very narrow age range that the panel reviewed.


The onset of symptoms in schizophrenia may be either abrupt (sudden) or insidious (gradual). Often, however, it goes undetected for about two to three years after the onset of diagnosable symptoms, because the symptoms occur in the context of a previous history of cognitive and behavioral problems. The patient may have had panic attacks, social phobia, or substance abuse problems, any of which can complicate the process of diagnosis. In most cases, however, the patient's first psychotic episode is preceded by a prodromal (warning) phase, with a variety of behaviors that may include angry outbursts, withdrawal from social activities, loss of attention to personal hygiene and grooming, anhedonia (loss of one's capacity for enjoyment), and other unusual behaviors. The psychotic episode itself is typically characterized by delusions, which are false but strongly held beliefs that result from the patient's inability to separate real from unreal events and hallucinations, which are...

Clitic Assimilation

Adults are able to maintain the viewpoint of the initial subject (Gernsbacher, 1990) even in the complement clause. However, children (Franks & Connell, 1996) process (87-91) in a very different way, being more likely to shift to the perspective of Dorothy. Adults reason that it makes little sense for Minnie to tell Dorothy about what she knows, since Dorothy should already have a pretty good view of the contents of her own mind. These social perspectives are nicely encoded in verbs such as tell, ask, or remind. For example, it does make sense to remind Dorothy about her knowledge, since reminding implies the possibility of forgetting. These various speech act verbs thus serve as models to the child of ways of structuring social interactions and theories of mind (Bartsch & Wellman, 1995).

Sex chromosomes

Fragile X (Martin-Bell syndrome) is the next most common genetic cause of LD after Down's syndrome. The long arm of the X chromosome appears to have a fragile tip when grown in special media, due to a gene with multiple abnormal DNA triplicate repeat sequences (of CGG). Fragile X syndrome is a common cause of severe LD in males, and causes lesser degrees of disability in some carrier females. Affected males have large testes (macroorchidism), 'bat ears', and long faces. Psychotic symptoms, aggressive or socially impaired behaviour associated with social anxiety, and language impairments are common. Screening in pregnancy for women from affected families offers the possibility of aborting foetuses with Fragile X.

Design Process

This design process is the basis for the development of plans for structures that foster walking activity, social interactions and cultural development. Furthermore, the actual process of collectively constructing a feature in the public right of way empowers communities and builds social networks.

Making the Diagnosis

Symptoms (vs. five for a major depressive episode), do not require the presence of the symptoms every day, include added criteria for irritability and social isolation, and incorporate criteria for loss of interest revised to reflect decreased positive affect in response to social contact activities.


Preparation for social skills training requires tact on the therapist's part, as patients with such disorders as social phobia or paranoid personality disorder may be discouraged or upset by being told that they need help with their social skills. One possible approach is through reading. The social skills therapist may recommend some self-help books on social skills in preparation for the treatment. Second, the therapist can ease the patient's self-consciousness or embarrassment by explaining that no one has perfect social skills. An additional consideration before starting treatment is the possibility of interference from medication side effects. The therapist will usually ask the patient for a list of all medications that he or she takes regularly.

Causes of stress

Social changes that have increased the stress level of modern life include increased population mobility and the sprawling size of modern cities. It is not unusual for adults to live hundreds of miles away from parents and siblings and it is hard to make and keep friendships when people move every few years. In most large cities, many people live in apartment buildings where they do not know their neighbors. Social isolation and loneliness can produce chronic stress. A study done in Norway between 1987 and 1993 found that social support networks made a significant difference in lowering the impact of both acute and chronic stress on mental health.

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