Mechanisms of Action in the Treatment of Social Anxiety Disorder

Michael W. Otto, Bridget A. Hearon, Steven A. Safren

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

This chapter argues that successful treatment of social anxiety disorder (SAD) is achieved by interruption of the ongoing cycle of the negative social expectations, and vigilance to negative outcomes, rising symptoms, negative interpretations of symptoms and outcomes, and avoidance and escape behaviors that characterize the disorder. Pharmacological, cognitive, and exposure-based interventions are hypothesized to intervene at different points in this cycle, attending to different "linchpins" in disrupting the self-perpetuating cycle of social anxiety. Both pharmacological and psychosocial interventions work. Exposure is obviously not the central element of change in pharmacotherapy as it is in CBT. Nonetheless, exposure as an important element of change has earned attention in both modalities of treatment. Exposure is designated in Gray's neuropsychologic theory of anxiety as a tool to achieve more enduring changes in neurophysiologic systems maintaining anxiety. Exposure also ranks as an important context for the application of pharmacological treatment. Exposure effects are conceptualized as being far from a passive process of loosening fear associations.

Original languageEnglish (US)
Title of host publicationSocial Anxiety
PublisherElsevier Inc.
Pages577-598
Number of pages22
ISBN (Print)9780123750969
DOIs
StatePublished - Dec 1 2010
Externally publishedYes

ASJC Scopus subject areas

  • Neuroscience(all)

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