Risk factors and aetiology of Social Phobia: perspectives of developmental psychology

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Risk factors and aetiology of Social Phobia
perspectives of developmental psychology

• Katarzyna Brzezinska
• University of Silesia /
• Technische Universität Dresden

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Developmental psychology perspective

• Behavioral Inhibition
• Attachment style

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Behavioral Inhibition-

• - is a temperamental characteristic defined by a
  constellation of behaviors including withdrawal,
  shyness, avoidance, and fear of unfamiliar people
  and objects.
• (Kagan 1988)?

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Behavioral Inhibition manifests as

• Irratibility in infants,
• Shyness,
• Fear behaviors in toddlers,
• Social withdrawal in school-age children.

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Studies (Hayward, Killen, Kreamer, Taylor 1998)?

• Hypothesis
• Behavioral Inhibition in children is a risk
  factor for the later development of social
  phobia.
• Method
• Sample of 2242 high school students.
• Period 4-year.
• Assessments self-report questionares,
  structured clinical interviews, mesurment of
  heart rate.
• Cox proportion hazard method used to evaluate
  risk.

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Results

• Social avoidance predicted onset of social
  phobia.
• Fearfullness incrase the risk of social phobia
  and depression.
• Social avoidance and fearful- 23 developed
  social phobia.

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Subject of different interpretation?

• Behavioral Inhibition ...
• 1) may be manifestation of social phobia,
• 2) cause poor development of social skills,
• 3) may be a marker for a differental response
  style to social anxiety-producing events.
• 4) may be the manifestation of a more complex
  personality style that is related to social
  phobia.

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Conclusion

• Behavioral Inhibition in childhood is associated
  with a higher risk for social phobia in
  adolescence.

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Attachment style-

• John Bowlby- 'a child needs to develop a
  relationship with at least one primary caregiver
  for social and emotional development to occur
  normally''
• Mary Ainsworth- three patterns of attachment
  secure, avoidant and anxious.

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Hazan and Shaver- measure of adult romantic
attachment.

• 55 of individuals were classified as secure
• 25 of individuals were classified as avoidant
• 20 of individuals were classified as anxious
• Attachment styles establish very early in life.
  They may predict later social outcomes in
  childhood, adolescence and adulthood.

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Adult attachment styles are related to

• -relationship functioning,
• -personality,
• -mental disorders,
• -social support,
• -religiosity,
• -substance use,
• -domestic violence,

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Disorders

• Two disorders are associated with the insecure
  attachment style
• Depresion,
• Anxiety,

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Studies (Bifulco, Kwon, Jacobs, Moran, Bunn,
Beer 2006)

• Hypotheses
• Insecure attachment styles are associated with
  incident anxiety disorders and/or major
  depression
• Childhood neglect/abuse is associated with
  insecure attachment style
• Insecure attachment styles mediate the
  relationship between childhood neglect/abuse and
  affective disorder

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Method

• Samplegroup of 154 high-risk community
  women(25-59 years old).
• Time Three years.
• Assessments Childhood Experience of Care and
  Abuse (CECA) Interview, Attachment Style
  Interview (ASI), Structured clinical interview
  for DSM-IV (SCID).

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Results
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Result

• Insecure attachment style was predictive of
  episodes of anxiety disorders and major
  depression in a
• high-risk series of community women within an
  intervening follow-up period. The relationship
  held
• for GAD and Social Phobia, but not for Panic
  Disorder
• and/or Agoraphobia.

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Result
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Summary

• There is a relation between behavioral inhibition
  and development of social phobia.
• There is a relation between attachment styles
  (anxious and avoidance) and social phobia.

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Bibliography

• Mickelson K. D., Kessler, R. C., Saver, P. R.
  (1997). Adult Attachment in Nationally
  Representative Sample. Journal of Social
  Psychology 73(5), 1092-1106.
• Hayward, C., Killen, J. D., Kreamer, H. C.,
  Taylor, C. B. (1998). Linking Self-Reported
  Behavioral Inhibition to Adolescent Social
  Phobia. Journal of the American Academy of Child
  and Adolescent Psychiatry, 27 (12), 1308-1316.
• Bifulco, A., Kwon, J., Jacobs, C., Moran, P. M.,
  Bunn, A., Beer, N. (2006). Adult attachment style
  as mediator between childhood
• neglect/abuse and adult depression and
  anxiety. Soc Psychiatry Psychiatr Epidemiol
  (2006) 41796805.
• Jerrold F. Rosenbaum, M.D., Joseph Biederman,
  M.D., Dina R., Hirshfeld-Becker, Ph.D., Jerome
  Kagan, Nancy Snidman, Deborah Friedman, Allan
  Nineberg, Daniel J., Gallery, Stephen V. Faraone
  (2000). A Controlled Study of Behavioral
  Inhibition in Children of Parents With Panic
  Disorder and Depression. Am J Psychiatry 2000
  15720022010.

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