Adult Anxiety Clinic of Temple

Socially anxious college students are at increased risk for engaging in problematic drinking (i.e. heavy or risky drinking) behaviors that are associated with the development of an alcohol use disorder. The present study examined whether post-event processing (PEP), repeatedly thinking about and evaluating one’s performance in a past social situation, strengthens the association between social anxiety and vulnerability to problematic drinking among college students. Eighty-three college drinkers with high or low social anxiety participated in a social interaction task and were exposed to a manipulation that either promoted or inhibited PEP about the social interaction. Among participants randomized to the PEP promotion condition, those with high social anxiety exhibited a greater urge to use alcohol after the social interaction and greater motivation to drink to cope with depressive symptoms over the week following the manipulation than did those with low social anxiety. These findings suggest that targeting PEP in college drinking intervention programs may improve the efficacy of such programs for socially anxious students.

This chapter discusses the evidence for the role of genetic factors in the etiology of anxiety disorders, and summarizes the genetic study designs used in research on anxiety disorders. Molecular genetic study designs used to investigate the genetics of anxiety disorders include linkage analysis and candidate gene association studies. Twin studies support a heritability estimate between 30% and 40%. More recently, regulators of G-protein signaling have been investigated regarding anxiety-related phenotypes including panic disorder. Family studies suggest that risk of social anxiety disorder (SAD) to first-degree relatives of SAD probands ranges from 16% to 26%. Investigations of panic disorder, specific phobias, SAD, and obsessive-compulsive disorder (OCD) have produced some evidence of linkage to specific regions. Two exciting yet mostly unexplored areas in anxiety disorder research are gene-environment interaction and epigenetic studies. Epigenetic research examines the dynamic heritable changes in the function of a gene.

Cognitive-behavioural models of social phobia (Clark & Wells, 1995; Rapee & Heimberg, 1997) propose that biased information processing contributes to the maintenance of social phobia. Given the importance of facial expressions in social interactions, recent investigations of these information-processing biases have increasingly used facial stimuli. The current study utilised schematic faces of emotional expressions to investigate interpretations of facial expressions and specific facial features in individuals with high and low social anxiety. Individuals with elevated social anxiety demonstrated biases in their perceptions of negative valence from the faces, whereas group differences were not observed for perceptions of activity or potency. Further, although the two groups generally utilised the same facial features to interpret facial expressions, the results suggested that individuals with high social anxiety may be more lenient in perceiving threat in faces than individuals without social anxiety.

Once considered to be a disorder associated with minimal impairment, the link between generalized anxiety disorder (GAD) and impairment across a broad constellation of domains is now well established. However, less is known about how comorbidity affects these relationships or how GAD impacts one's perceived life satisfaction or quality of life. To investigate these questions, data from 52 treatment-seeking individuals with GAD (33 with comorbid Axis I diagnoses) were compared to data from 55 nonanxious controls. Individuals with GAD reported more impairment at work and in their social functioning than they did with home and family responsibilities. They also reported lower quality of life than nonanxious controls, particularly in regard to self-esteem, goals and values, money, work, play, learning, creativity, friends, and relatives. Trait worry was positively correlated with impairment and inversely related to life satisfaction within the clinical sample. Individuals with GAD, with and without comorbid Axis I diagnoses, showed few differences on measures of impairment (differing only on impairment in social functioning). However, individuals with GAD and comorbid disorders perceived their lives as less satisfying than did individuals with GAD without comorbid diagnoses.

The purpose of this paper is to present a review of research on the efficacy of psychotherapeutic interventions for children, adolescents and adults with social anxiety disorder. Data are presented on the relative efficacy of cognitive-behavioral therapies (CBTs), pharmacotherapy and combination treatments. We also discuss research on specific clinical conditions that are likely to influence treatment success. Relevant studies were identified through literature searches, reference lists and research databases. Non-pharmacologic treatments for social anxiety disorder, particularly CBTs, have gained substantial empirical support over the last two decades. However, questions remain about how to maximize the benefit of available treatments. New directions for future research in this area are discussed.

Worry and rumination are cognitive processes, often represented as verbal or linguistic activities. Despite similarities in definition and description, worry has been most closely examined in relation to anxiety whereas rumination has traditionally been related to depression. This distinction remains in spite of high rates of comorbidity between anxiety and depression. This study sought to better understand the distinct and overlapping features of worry and rumination as well as their relationship to anxiety and depression. Seven hundred eighty-four unselected college students completed self-report measures of worry, rumination, anxiety, and depression. Items from the respective worry and rumination scales were submitted to factor analysis, which revealed a four-factor solution comprised of 2 worry factors and 2 rumination factors. A Worry Engagement factor as well as a Dwelling on the Negative factor emerged as distilled measures of worry and rumination, respectively. Scores on these factors were highly correlated with each other and demonstrated equally strong relationships to both anxiety and depression. Findings from this study suggest that worry and rumination represent related but distinct cognitive processes that are similarly related to anxiety and depression.