Abnormal Psychology

288 CHAPTER 7

opportunity to practice making both spontaneous speeches and planned ones. (For

more information, go to http://www.toastmasters.org.)

FEEDBACK LOOPS IN TREATMENT: Social Phobia

When medication is discontinued, symptoms of social phobia often recur. Such re-

lapse is less likely after CBT. From a neuropsychosocial approach, CBT changes the

way a patient thinks about and behaves in social situations (psychological factors).

Viewing these situations more realistically and with less anxiety means that the pa-

tient does not get as physically aroused (neurological factor). This lowered arousal,

along with positive or neutral expectations about the previously feared social situ-

ations, leads the patient to enter more willingly into a social situation (social fac-

tor), with less negative expectations. When such social experiences are positive, the

patient feels increasing mastery (psychological factor) and less arousal (neurologi-

cal factor), and perhaps receives reinforcement from others (social factor) for these

changes. Figure 7.10 illustrates these factors and their feedback loops.

Key Concepts and Facts About Social Phobia (Social Anxiety Disorder)

• Social phobia is an intense fear of public humiliation or em-
  barrassment, together with an avoidance of social situations
  likely to cause this fear. When such social situations cannot be
  avoided, they trigger panic or anxiety. Social phobia may be lim-
  ited to specifi c types of performance-related situations or may
  be generalized to most social situations.
  
  
  • The anxiety about performing poorly and being evaluated by
    others can, in turn, impair an individual’s performance, creating
    a vicious cycle. The symptoms of social phobia may lead indi-
    viduals with this disorder to be less successful than they could
    otherwise be, because they avoid job-related social interactions
    that are required for advancement.
  
  
  
  

P S

N

Figure 7.10

7.10 • Feedback Loops in Treating Social Phobia

Treatments Targeting

Neurological Factors

Medication: Beta-

blockers, SSRIs, SNRIs

Changes neural

activity

Changes social

interactions

Treatments Targeting

Social Factors

Group therapy: Exposure

to social stimuli

Changes thoughts,

feelings,

and behaviors

CBT: Exposure,

cognitive restructuring

Treatments Targeting

Psychological Factors