An evolutionary view of social anxiety disorder in its original occurrence of function and adaptive design helps us understand why SAD(social anxiety disorder)exists in the first place.In this paper,we found social an...An evolutionary view of social anxiety disorder in its original occurrence of function and adaptive design helps us understand why SAD(social anxiety disorder)exists in the first place.In this paper,we found social anxiety can be a useful strategy to acquire better resources and maintain harmony in interpersonal relationships in ancestral environments.This finding helps us reveal how the mismatch between the ancestral and modern world may cause the overreaction we see in SAD in contemporary contexts.In addition,alcohol seems to be a short-term solution to ease the negative impact of SAD,but its long-term effectiveness requires further research.The paper also introduces compassion therapy to encourage patients to rekindle their passion for themselves by connecting with a friendly social environment.To better understand SAD,we encouraged future research to focus on rebuilding inner values and group relationships.展开更多
OBJECTIVE Social anxiety disorder,also known as social phobia,is the most common of all anxiety disorders.Despite the seriousness of this disorder,it has rarely been studied and as a consequence,little is known about ...OBJECTIVE Social anxiety disorder,also known as social phobia,is the most common of all anxiety disorders.Despite the seriousness of this disorder,it has rarely been studied and as a consequence,little is known about its underlying neurobiology.Growing evidence suggests that inhibitory neurons dysfunction could affect the balance of neuronal activity in psychotic disorders including anxiety,SAD,etc.Ephrin-B(EB) proteins were previously demonstrated to ensure normal distribution and function of inhibitory interneurons in the brain.We thus proposed that deletion of EB2 in inhibitory neurons might destroy the homeostasis of excitatory neurons and inhibitory neurons,and induce behavioral deficits associated with psychotic diseases.METHODS(1)Mice.We generated conditional EB2 knockout mice as a model of SAD and characterized the behaviors and the biochemical changes in the brains of the knockout mice.We also generated a mouse line with a selective deletion of EB2 from vGAT neurons by breeding a v GAT-Cre line with a loxP-flanked alleles in EB2.For EB2 detection,we crossed vGAT-Cre;EphrinB2 loxp/loxp mice with Rosa26-STOP-tdTomato Cre indicator(Ai9) mice to label the vGAT neurons with tdTomato.Mice were maintained in a mixed CD1/129 genetic background.Al experiments involving mice were carried out in accordance with the Shanghai Jiaotong University.Genotypes were unlocked only after completion of analysis.(2) General procedures for behavioral testing.Open field test:Locomotor activity was measured using an open field test.The size of the open field box was 44 cm×44 cm×44 cm.Each mouse was placed in the corner of the open-field apparatus at the beginning of the test,and allowed to explore it for 15 min.The total distance traveled(in cm) and counts for stereotyped behaviors were recorded and analyzed.The total distance traveled was used as an index of locomotor activity.The percentage of center zone entries was considered as anxiety indexes.EPM test:The elevated plus maze apparatus was made of dark gray plastic and comprised two open arms(30 cm×7 cm×0.25 cm) opposed to two enclosed arms(30 cm × 7 cm × 15 cm) elevated60 cm from the floor.Animals were placed in the central area of the apparatus with their head facing an enclosed arm(test duration,5 min).Digitized video recordings with EthoVision software were used for behavioral analysis.The percentage of time spent in open arms and the percentage of open-arm entries were calculated.Social behaviors:Briefly,a top open acrylic box was divided into three compartments by two clear acrylic glass partitions with an opening in the bottom.Wire mesh cages that are either empty or have social stimulus mouse in it were put in the center of each outer compartment.Unfamiliar naive CD1/129 mice of the same age were used as stimulus mice.Prior to the test,the mouse was introduced into the center chamber for 5 min,with both gates closed.Gates were then open and the test mouse was acclimated to explore the empty three-chambered apparatus freely for another 10 min.After the initial 15 min habituation session,mice were placed in the center compartment and allowed to explore freely all the three compartments.To examine the social contact,the following activities were recorded via a video surveillance for 10 min.The number of entries to each compartment,the time spent in each compartment as well as the time and frequency each mouse spent in sniffing were analyzed with EthoVision XT 8.5(Noldus,Wageningen,Netherlands).RESULTS(1)Social preference assays were performed in WT-vGATCre,EB2-flox,and EB2-vGATCre mice respectively.To evaluate social approach behavior,we used a three-chamber social arena to evaluate animals for their social interaction.The control groups of WTvGATCre,EB2-flox mice showed a significant preference for spending time in the social chamber(P<0.05);whereas the EB2-vGATCre mice did not show this preference and spent roughly equal time in the social and nonsocial chambers.(2)To determine if the decrease in social preference could result from changes in locomotion,we compared locomotor activity in EB2-vG ATCre mice and control mice.We did not observe a significant lower locomotive activity in mice.Hence,EB2 deletion caused a change in social preference but not in locomotion.Taken together,EB2 deletion exerts abnormal psychotogenic activity of social deficits which was often considered as an important feature of SAD.(3) The time spent in the open arms is widely used to measure anxiety in mice,with greater time spent in the open arm being considered as less anxious behavior.To normalize for individual differences in overall activity level,the time spent in the open arms was divided by the total time.The ratio was higher for WT-vGATCre mice and EB2-loxp mice as compared to the EB2-vG ATCre mice(P=0.0112,P=0.0197).Thus,results showed that there was a change in anxiety levels from in EB2-vGATCre mice as compared with control mice.CONCLUSION EB2 may be a candidate risk gene for SAD and that the EB2 conditional knockout model could be a tool for studying the underlying mechanisms in SAD.展开更多
AIM: To investigate the influence of ethnicity in social anxiety disorder(SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences' students.METHODS: This was a c...AIM: To investigate the influence of ethnicity in social anxiety disorder(SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences' students.METHODS: This was a cross-sectional survey of 112 1st, 2nd and 3rd year students from the Faculty of Medicine and Health Sciences at Stellenbosch University, Cape Town, South Africa. The self-reported Social Anxiety Spectrum questionnaire was used to assess for SAD. The Social Phobia Inventory(SPIN) was adapted to a version called the E-SPIN(Ethnic-SPIN) in order to evaluate the effects of ethnicity. Two sub-questions per stem question were included to assess whether SAD symptoms in social interactions were ethnicity dependent. Substance use was assessed with the Alcohol UseDisorders Identification Test and Drug Use Disorders Identification Test, and depression with the Centre for Epidemiological Studies Depression Scale.RESULTS: Of 112 students who completed the E-SPIN questionnaire, 54.4%(n = 61) met criteria for SAD, with significantly more females than males meeting criteria. Ethnicity had a significant effect on SAD symptomatology, but there was no effect of ethnicity on the rates of drug and alcohol abuse in students with and without SAD. Overall significantly more students with SAD met criteria for depression compared with students without the disorder. CONCLUSION: Among university students, SAD is prevalent regardless of whether interactions are with individuals of the same or different ethnic group. However, ethnicity may be an important determinant of social anxiety for some ethnic groups. SAD was significantly associated with major depression but not significantly associated with drug or alcohol abuse.展开更多
Purpose: Several studies have demonstrated that the measurement of salivary alpha-amylase (sAA) levels is a useful tool for evaluating the autonomic nervous system. Psychosocial stress increases the release of sAA as ...Purpose: Several studies have demonstrated that the measurement of salivary alpha-amylase (sAA) levels is a useful tool for evaluating the autonomic nervous system. Psychosocial stress increases the release of sAA as a useful marker for autonomic nervous system (ANS). To our knowledge, although some studies have evaluated sAA levels under psychosocial stress, no studies have investigated the changes in sAA activity that occur in junior high school students who are not attending school due to social anxiety disorder (SAD). We aimed to investigate the relationship between the sAA levels and psychiatric states of such patients. Methods: The study subjects consisted of SAD patients (n = 39) and healthy controls (n = 57). We used a portable hand-held monitor to measure the level of sAA and State-Trait Anxiety Index (STAI) to evaluate the psychiatric state. Results: The patients’ sAA activity was significantly higher than that of the controls (n = 57) (p < 0.001). Significant differences in heart rate (HR) (76.10 ± 11.96 vs. 68.69 ± 10.61, respectively, p < 0.01) and STAI scores (both the STAI-State and STAI-Trait scores) (49.35 ± 10.57 vs. 41.24 ± 8.59, respectively, p < 0.01;55.69 ± 10.44 vs. 45.61 ± 9.36, respectively, p < 0.001) were detected between the patients and healthy controls. Conclusions: These results indicated that junior high school students with SAD exhibit a higher state of anxiety and high autonomic activity, probably due to changes in the sympathetic nervous system. As a result, junior high school students with SAD are expected to exhibit high levels of sAA accompanied by anxiety symptoms.展开更多
The prevalence of persons with social anxiety disorder (SAD) in Japan remains unknown. This study examined 293 patients with age between 20 and 60 at first visit on the outpatient clinic of psychiatry by the section o...The prevalence of persons with social anxiety disorder (SAD) in Japan remains unknown. This study examined 293 patients with age between 20 and 60 at first visit on the outpatient clinic of psychiatry by the section of social phobia of M.I.N.I. and DSM-IV. After that, 10 patients with both SAD out of 16 patients (trial recruited) completed 12 weeks of treatment with paroxetine. Among 63 patients with 4 points and 40 patients with 3 points on the M.I.N.I., 21 patients (33%) and 16 patients (40%) were diagnosed as SAD on DSM-IV criteria, respectively. Together, 37 patients (12.6%) were diagnosed as SAD out of the 293 outpatients. Among 37 patients with SAD, 23 patients (62%) had comorbid depression. As for 10 patients after treatment with paroxetine, 8 patients improved from the point of recovery of depression (HAM-D scores below 10), whereas only 4 patients improved from the point of recovery of social phobia (L-SAS scores below 30). Three points as well as 4 points on the M.I.N.I. is meaningful for the diagnosis of SAD. For a while, paroxetine exerted less beneficial effects on SAD rather than on depression.展开更多
Introduction: The Liebowitz Social Anxiety Scale (LSAS), used to assess the severity of social anxiety disorder (SAD), requires considerable effort and time to complete. The aims of this study were: 1) to investigate ...Introduction: The Liebowitz Social Anxiety Scale (LSAS), used to assess the severity of social anxiety disorder (SAD), requires considerable effort and time to complete. The aims of this study were: 1) to investigate whether a visual analogue scale (VAS) could be linear with the LSAS and substitute for the LSAS, 2) to relate such a VAS instrument to patient demographics. Methods: Fifty SAD patients were assessed using the LSAS and VAS instruments completed by both patients and doctors at the same session. We then drew distributions and calculated the Spearman’s ρ and κ coefficient values (divided at the median for each scale) between patient and doctor assessments. Next, each pair among the scores for the LSAS, the patient VAS and the doctor VAS was compared using Wilcoxon rank sum tests according to patient life profile data. Results: Scatter plots of pairs of scores were obtained. Spearman’s ρ was 0.661 between the LSAS and the patient VAS, 0.461 between the LSAS and the doctor VAS, and 0.494 between VAS scores of patients and doctors. The κ coefficients were 0.501 between the LSAS and patient VAS, 0.251 between the LSAS and doctor VAS, and 0.425 between patient VAS and doctor VAS (for all six, p < 0.001). The Wilcoxon rank sum tests indicated a significant difference between the groups with/ without “employment” (LSAS, patient/doctor VAS), with/without “graduation from junior college/university” (doctor VAS) (p < 0.05) and with/without marital history (the age of first consultation) (p < 0.01). Conclusions: A patient VAS may substitute for the LSAS and offer the versatility necessary to capture patient states and life profiles.展开更多
This case is a complex presentation of Body Dysmorphic Disorder (BDD), social phobia and unresolved grief in a 23 year old male with no social support. He appears to have benefitted immensely from a combination of Cog...This case is a complex presentation of Body Dysmorphic Disorder (BDD), social phobia and unresolved grief in a 23 year old male with no social support. He appears to have benefitted immensely from a combination of Cognitive Behavioral Therapy (CBT), antidepressant medication and Occupational Therapy. Identification of patients with BDD presenting in surgical and medical practices is essential and can be facilitated by validated screening tools such as the Body Dysmorphic Disorder Questionnaire (BDDQ). At the moment, the best evidence-based treatment is CBT and Selective Serotonin Reuptake Inhibitors (SSRIs). Nonetheless, novel approaches to therapeutic applications include the investigation of eye-tracking focus on body parts in BDD.展开更多
Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed...Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.展开更多
Great progress has been observed in the literature over the last decade regarding the validation of instruments for the assessment of Social Anxiety Disorder in the Brazilian context. Particularly outstanding in this ...Great progress has been observed in the literature over the last decade regarding the validation of instruments for the assessment of Social Anxiety Disorder in the Brazilian context. Particularly outstanding in this respect is the production of a group of Brazilian investigators regarding the psychometric study of the following instruments: Liebowitz Social Anxiety Scale, Social Phobia Inventory, Brief Social Phobia Scale, Disability Profile, Liebowitz Self-Rated Disability Scale, Social Phobia Safety Behaviors Scale and Self-Statements During Public Speaking Scale, which have proved to be appropriate and valid for use in the adult Brazilian population, representing resources for the assessment of social anxiety in clinical and experimental situations.展开更多
Taijin-Kyofu-Sho (TKS) has long been considered as a Japanese culture-bound form of social anxiety disorder, although subsequent case-reports from countries outside Japan have dispelled this notion. There are subtle y...Taijin-Kyofu-Sho (TKS) has long been considered as a Japanese culture-bound form of social anxiety disorder, although subsequent case-reports from countries outside Japan have dispelled this notion. There are subtle yet distinct differences between TKS and DSM-defined social anxiety disorder (SAD). For instance, the TKS subject fears causing offence to others, whereas the SAD subject is more fearful of causing embarrassment to him/herself. Four sub-categories of TKS have been recognised of which the Jikoshu-kyofu variety resembles the olfactory reference syndrome (ORS) known to Western psychiatrists. There are two TKS subtypes, general (or simple) and offensive (delusional). The general subtype resembles social anxiety disorder, whereas the offensive subtype is characterised by delusions. True community-wide prevalence is unknown, although clinic studies estimate between 7.8% to 45.5% patients have a diagnosis of TKS, with a slight male preponderance. Cultural and societal norms engendering guilt, shame, and embarrassment are likely etiological factors. Treatment may consist of antidepressant and/or antipsychotic medications, while some patients may also benefit from cognitive behavior therapy.展开更多
Chronic social defeat stress induces diverse effects in mice of different strains and even in animals of the same strain. This paper aims to study the effect of repeated social defeats and, for contrast, repeated aggr...Chronic social defeat stress induces diverse effects in mice of different strains and even in animals of the same strain. This paper aims to study the effect of repeated social defeats and, for contrast, repeated aggression in daily agonistic interactions on the behaviors of CD-1 male mice. The behavior of animals that have the same winning and losing track record during 3, 10, 21 days is studied in different tests. The level of aggressiveness, as estimated by the number and total time of attacks, decreases;nevertheless, direct and indirect forms of aggression demonstrated by the aggressive mice (winners) remain significantly high. The number of stereotypic behaviors (rotations and jumps) and total time of digging behaviors are significantly increased in the winners after 21 days compared to 3 and 10 days of intermale confrontations. Among the losers, chronic experience of social defeats is accompanied by the development of pronounced anxiety and a depression-like state estimated by the elevated plus-maze and the Porsolt test scores, respectively. Both groups of male mice with alternative social behaviors demonstrate abnormal locomotor and exploratory behaviors in the open-field test. This phenomenon may be viewed as hyperactivity developed under chronic agonistic interactions and specific for the outbred CD-1 mice. We believe that these animals may be potentially used for modeling the key symptoms of bipolar disorder.展开更多
Aim: Resilience refers to the human ability to adapt to tragedy, trauma, adversity, and significant stressors. Recently, resilience has been defined as a potentially modifiable factor that can be improved through inte...Aim: Resilience refers to the human ability to adapt to tragedy, trauma, adversity, and significant stressors. Recently, resilience has been defined as a potentially modifiable factor that can be improved through intervention. Here, we examined resilience during a 3-month period as patients experienced their first episode of major depressive disorder (MDD). We hypothesized that despite MDD, resilient people could recover from depressive states more quickly than less resilient people. Methods: Twelve patients experienced their first MDD episode and 21 healthy control individuals participated in the study. Data from the Hamilton Depression Rating Scale (HAM-D), S-H Resilience Scale (S-HRS), and State-Trait Anxiety Index (STAI) were collected at two time points. Time 1 was the first visit after registration and Time 2 was 12 weeks later. Based on the symptoms described by the HAM-D results, the MDD group was divided into MDD-remission and MDD-residual subgroups. Results: Compared with controls, patients showed significantly lower resilience (low scores for Factor-A, Factor-B, and total S-HRS). Moreover, total SHRS scores for the MDD-remission group increased significantly from the Time 1 to Time 2, while those in MDD-residual group did not change. No significant differences in STAI scores were observed between MDD-remission and MDD-residual groups at either time point. Conclusion: This is the first report to show that patients experiencing their first episode of MDD show low resilience, and that a resilience scale might be a good index for estimating recovery from depression.展开更多
Background:Brain structural alterations of the striatum have been frequently observed in internet gaming disorder(IGD);however,the replicability of the results and the associations with social-affective dysregulations...Background:Brain structural alterations of the striatum have been frequently observed in internet gaming disorder(IGD);however,the replicability of the results and the associations with social-affective dysregulations such as social anxiety remain to be determined.Methods:The present study combined a dimensional neuroimaging approach with both voxel-wise and data-driven multivariate approaches to(i)replicate our previous results on a negative association between IGD symptom load(assessed by the Internet Gaming Disorder Scale-Short Form)and striatal volume,(ii)extend these findings to female individuals,and(iii)employ multivariate and mediation models to determine common brain structural representations of IGD and social anxiety(assessed by the Liebowitz Social Anxiety Scale).Results:In line with the original study,the voxel-wise analyses revealed a negative association between IGD and volumes of the bilateral caudate.Going beyond the earlier study investigating only male participants,the present study demonstrates that the association in the right caudate was comparable in both the male and the female subsamples.Further examination using themultivariate approach revealed regionally different associations between IGD and social anxiety with striatal density representations in the dorsal striatum(caudate)and ventral striatum(nucleus accumbens).Higher levels of IGD were associated with higher social anxiety and the association was critically mediated by the multivariate neurostructural density variations of the striatum.Conclusions:Altered striatal volumes may represent a replicable and generalizable marker of IGD symptoms.However,exploratory multivariate analyses revealed more complex and regional specific associations between striatal density and IGD as well as social anxiety symptoms.Variations in both tendencies may share common structural brain representations,which mediate the association between increased IGD and social anxiety.展开更多
目的观察电针辅助帕罗西汀和舒必利治疗社交恐惧症的临床疗效及对神经电生理和预后的影响。方法将90例社交恐惧症患者用随机数字表法分为试验组和对照组,每组45例。两组均采取心理疏导,对照组予口服帕罗西汀和舒必利治疗,试验组在对照...目的观察电针辅助帕罗西汀和舒必利治疗社交恐惧症的临床疗效及对神经电生理和预后的影响。方法将90例社交恐惧症患者用随机数字表法分为试验组和对照组,每组45例。两组均采取心理疏导,对照组予口服帕罗西汀和舒必利治疗,试验组在对照组药物治疗基础上另予电针治疗。比较两组临床疗效和不良反应发生情况,观察两组治疗前后神经电生理指标(MMN波幅、MMN潜伏期和N2靶潜伏期)、自主神经功能指标[RR间期平均值标准差(SDANN)、相邻两正常窦性RR间期差值50 ms个数所占百分率(PNN50)和相邻RR间期差值的均方根(RMSSD)]、Liebowitz社交焦虑量表(Liebowitz social anxiety scale,LSAS)评分、自评焦虑量表(self-rating anxiety scale,SAS)评分以及生活质量综合评定问卷(generic quality of life inventory-74,GQOLI-74)评分的变化。结果试验组总有效率高于对照组,组间差异具有统计学意义(P<0.05)。治疗1个月后和治疗后,试验组MMN潜伏期、N2靶潜伏期、LSAS评分和SAS评分低于对照组,MMN波幅及SDANN、RMSSD和PNN50高于对照组(P<0.05);治疗后,试验组躯体功能、心理功能、社会功能和物质生活评分高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论电针辅助帕罗西汀和舒必利治疗社交恐惧症的疗效优于单纯药物治疗,可改善临床症状,调节神经电生理和自主神经功能,改善预后。展开更多
文摘An evolutionary view of social anxiety disorder in its original occurrence of function and adaptive design helps us understand why SAD(social anxiety disorder)exists in the first place.In this paper,we found social anxiety can be a useful strategy to acquire better resources and maintain harmony in interpersonal relationships in ancestral environments.This finding helps us reveal how the mismatch between the ancestral and modern world may cause the overreaction we see in SAD in contemporary contexts.In addition,alcohol seems to be a short-term solution to ease the negative impact of SAD,but its long-term effectiveness requires further research.The paper also introduces compassion therapy to encourage patients to rekindle their passion for themselves by connecting with a friendly social environment.To better understand SAD,we encouraged future research to focus on rebuilding inner values and group relationships.
基金National Natural Science Foundation of China (8150115381571326).
文摘OBJECTIVE Social anxiety disorder,also known as social phobia,is the most common of all anxiety disorders.Despite the seriousness of this disorder,it has rarely been studied and as a consequence,little is known about its underlying neurobiology.Growing evidence suggests that inhibitory neurons dysfunction could affect the balance of neuronal activity in psychotic disorders including anxiety,SAD,etc.Ephrin-B(EB) proteins were previously demonstrated to ensure normal distribution and function of inhibitory interneurons in the brain.We thus proposed that deletion of EB2 in inhibitory neurons might destroy the homeostasis of excitatory neurons and inhibitory neurons,and induce behavioral deficits associated with psychotic diseases.METHODS(1)Mice.We generated conditional EB2 knockout mice as a model of SAD and characterized the behaviors and the biochemical changes in the brains of the knockout mice.We also generated a mouse line with a selective deletion of EB2 from vGAT neurons by breeding a v GAT-Cre line with a loxP-flanked alleles in EB2.For EB2 detection,we crossed vGAT-Cre;EphrinB2 loxp/loxp mice with Rosa26-STOP-tdTomato Cre indicator(Ai9) mice to label the vGAT neurons with tdTomato.Mice were maintained in a mixed CD1/129 genetic background.Al experiments involving mice were carried out in accordance with the Shanghai Jiaotong University.Genotypes were unlocked only after completion of analysis.(2) General procedures for behavioral testing.Open field test:Locomotor activity was measured using an open field test.The size of the open field box was 44 cm×44 cm×44 cm.Each mouse was placed in the corner of the open-field apparatus at the beginning of the test,and allowed to explore it for 15 min.The total distance traveled(in cm) and counts for stereotyped behaviors were recorded and analyzed.The total distance traveled was used as an index of locomotor activity.The percentage of center zone entries was considered as anxiety indexes.EPM test:The elevated plus maze apparatus was made of dark gray plastic and comprised two open arms(30 cm×7 cm×0.25 cm) opposed to two enclosed arms(30 cm × 7 cm × 15 cm) elevated60 cm from the floor.Animals were placed in the central area of the apparatus with their head facing an enclosed arm(test duration,5 min).Digitized video recordings with EthoVision software were used for behavioral analysis.The percentage of time spent in open arms and the percentage of open-arm entries were calculated.Social behaviors:Briefly,a top open acrylic box was divided into three compartments by two clear acrylic glass partitions with an opening in the bottom.Wire mesh cages that are either empty or have social stimulus mouse in it were put in the center of each outer compartment.Unfamiliar naive CD1/129 mice of the same age were used as stimulus mice.Prior to the test,the mouse was introduced into the center chamber for 5 min,with both gates closed.Gates were then open and the test mouse was acclimated to explore the empty three-chambered apparatus freely for another 10 min.After the initial 15 min habituation session,mice were placed in the center compartment and allowed to explore freely all the three compartments.To examine the social contact,the following activities were recorded via a video surveillance for 10 min.The number of entries to each compartment,the time spent in each compartment as well as the time and frequency each mouse spent in sniffing were analyzed with EthoVision XT 8.5(Noldus,Wageningen,Netherlands).RESULTS(1)Social preference assays were performed in WT-vGATCre,EB2-flox,and EB2-vGATCre mice respectively.To evaluate social approach behavior,we used a three-chamber social arena to evaluate animals for their social interaction.The control groups of WTvGATCre,EB2-flox mice showed a significant preference for spending time in the social chamber(P<0.05);whereas the EB2-vGATCre mice did not show this preference and spent roughly equal time in the social and nonsocial chambers.(2)To determine if the decrease in social preference could result from changes in locomotion,we compared locomotor activity in EB2-vG ATCre mice and control mice.We did not observe a significant lower locomotive activity in mice.Hence,EB2 deletion caused a change in social preference but not in locomotion.Taken together,EB2 deletion exerts abnormal psychotogenic activity of social deficits which was often considered as an important feature of SAD.(3) The time spent in the open arms is widely used to measure anxiety in mice,with greater time spent in the open arm being considered as less anxious behavior.To normalize for individual differences in overall activity level,the time spent in the open arms was divided by the total time.The ratio was higher for WT-vGATCre mice and EB2-loxp mice as compared to the EB2-vG ATCre mice(P=0.0112,P=0.0197).Thus,results showed that there was a change in anxiety levels from in EB2-vGATCre mice as compared with control mice.CONCLUSION EB2 may be a candidate risk gene for SAD and that the EB2 conditional knockout model could be a tool for studying the underlying mechanisms in SAD.
基金Supported by The South African Research Chairs Initiative of the Department of Science and Technology and the National Research Foundation
文摘AIM: To investigate the influence of ethnicity in social anxiety disorder(SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences' students.METHODS: This was a cross-sectional survey of 112 1st, 2nd and 3rd year students from the Faculty of Medicine and Health Sciences at Stellenbosch University, Cape Town, South Africa. The self-reported Social Anxiety Spectrum questionnaire was used to assess for SAD. The Social Phobia Inventory(SPIN) was adapted to a version called the E-SPIN(Ethnic-SPIN) in order to evaluate the effects of ethnicity. Two sub-questions per stem question were included to assess whether SAD symptoms in social interactions were ethnicity dependent. Substance use was assessed with the Alcohol UseDisorders Identification Test and Drug Use Disorders Identification Test, and depression with the Centre for Epidemiological Studies Depression Scale.RESULTS: Of 112 students who completed the E-SPIN questionnaire, 54.4%(n = 61) met criteria for SAD, with significantly more females than males meeting criteria. Ethnicity had a significant effect on SAD symptomatology, but there was no effect of ethnicity on the rates of drug and alcohol abuse in students with and without SAD. Overall significantly more students with SAD met criteria for depression compared with students without the disorder. CONCLUSION: Among university students, SAD is prevalent regardless of whether interactions are with individuals of the same or different ethnic group. However, ethnicity may be an important determinant of social anxiety for some ethnic groups. SAD was significantly associated with major depression but not significantly associated with drug or alcohol abuse.
文摘Purpose: Several studies have demonstrated that the measurement of salivary alpha-amylase (sAA) levels is a useful tool for evaluating the autonomic nervous system. Psychosocial stress increases the release of sAA as a useful marker for autonomic nervous system (ANS). To our knowledge, although some studies have evaluated sAA levels under psychosocial stress, no studies have investigated the changes in sAA activity that occur in junior high school students who are not attending school due to social anxiety disorder (SAD). We aimed to investigate the relationship between the sAA levels and psychiatric states of such patients. Methods: The study subjects consisted of SAD patients (n = 39) and healthy controls (n = 57). We used a portable hand-held monitor to measure the level of sAA and State-Trait Anxiety Index (STAI) to evaluate the psychiatric state. Results: The patients’ sAA activity was significantly higher than that of the controls (n = 57) (p < 0.001). Significant differences in heart rate (HR) (76.10 ± 11.96 vs. 68.69 ± 10.61, respectively, p < 0.01) and STAI scores (both the STAI-State and STAI-Trait scores) (49.35 ± 10.57 vs. 41.24 ± 8.59, respectively, p < 0.01;55.69 ± 10.44 vs. 45.61 ± 9.36, respectively, p < 0.001) were detected between the patients and healthy controls. Conclusions: These results indicated that junior high school students with SAD exhibit a higher state of anxiety and high autonomic activity, probably due to changes in the sympathetic nervous system. As a result, junior high school students with SAD are expected to exhibit high levels of sAA accompanied by anxiety symptoms.
文摘The prevalence of persons with social anxiety disorder (SAD) in Japan remains unknown. This study examined 293 patients with age between 20 and 60 at first visit on the outpatient clinic of psychiatry by the section of social phobia of M.I.N.I. and DSM-IV. After that, 10 patients with both SAD out of 16 patients (trial recruited) completed 12 weeks of treatment with paroxetine. Among 63 patients with 4 points and 40 patients with 3 points on the M.I.N.I., 21 patients (33%) and 16 patients (40%) were diagnosed as SAD on DSM-IV criteria, respectively. Together, 37 patients (12.6%) were diagnosed as SAD out of the 293 outpatients. Among 37 patients with SAD, 23 patients (62%) had comorbid depression. As for 10 patients after treatment with paroxetine, 8 patients improved from the point of recovery of depression (HAM-D scores below 10), whereas only 4 patients improved from the point of recovery of social phobia (L-SAS scores below 30). Three points as well as 4 points on the M.I.N.I. is meaningful for the diagnosis of SAD. For a while, paroxetine exerted less beneficial effects on SAD rather than on depression.
文摘Introduction: The Liebowitz Social Anxiety Scale (LSAS), used to assess the severity of social anxiety disorder (SAD), requires considerable effort and time to complete. The aims of this study were: 1) to investigate whether a visual analogue scale (VAS) could be linear with the LSAS and substitute for the LSAS, 2) to relate such a VAS instrument to patient demographics. Methods: Fifty SAD patients were assessed using the LSAS and VAS instruments completed by both patients and doctors at the same session. We then drew distributions and calculated the Spearman’s ρ and κ coefficient values (divided at the median for each scale) between patient and doctor assessments. Next, each pair among the scores for the LSAS, the patient VAS and the doctor VAS was compared using Wilcoxon rank sum tests according to patient life profile data. Results: Scatter plots of pairs of scores were obtained. Spearman’s ρ was 0.661 between the LSAS and the patient VAS, 0.461 between the LSAS and the doctor VAS, and 0.494 between VAS scores of patients and doctors. The κ coefficients were 0.501 between the LSAS and patient VAS, 0.251 between the LSAS and doctor VAS, and 0.425 between patient VAS and doctor VAS (for all six, p < 0.001). The Wilcoxon rank sum tests indicated a significant difference between the groups with/ without “employment” (LSAS, patient/doctor VAS), with/without “graduation from junior college/university” (doctor VAS) (p < 0.05) and with/without marital history (the age of first consultation) (p < 0.01). Conclusions: A patient VAS may substitute for the LSAS and offer the versatility necessary to capture patient states and life profiles.
文摘This case is a complex presentation of Body Dysmorphic Disorder (BDD), social phobia and unresolved grief in a 23 year old male with no social support. He appears to have benefitted immensely from a combination of Cognitive Behavioral Therapy (CBT), antidepressant medication and Occupational Therapy. Identification of patients with BDD presenting in surgical and medical practices is essential and can be facilitated by validated screening tools such as the Body Dysmorphic Disorder Questionnaire (BDDQ). At the moment, the best evidence-based treatment is CBT and Selective Serotonin Reuptake Inhibitors (SSRIs). Nonetheless, novel approaches to therapeutic applications include the investigation of eye-tracking focus on body parts in BDD.
文摘Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.
文摘Great progress has been observed in the literature over the last decade regarding the validation of instruments for the assessment of Social Anxiety Disorder in the Brazilian context. Particularly outstanding in this respect is the production of a group of Brazilian investigators regarding the psychometric study of the following instruments: Liebowitz Social Anxiety Scale, Social Phobia Inventory, Brief Social Phobia Scale, Disability Profile, Liebowitz Self-Rated Disability Scale, Social Phobia Safety Behaviors Scale and Self-Statements During Public Speaking Scale, which have proved to be appropriate and valid for use in the adult Brazilian population, representing resources for the assessment of social anxiety in clinical and experimental situations.
文摘Taijin-Kyofu-Sho (TKS) has long been considered as a Japanese culture-bound form of social anxiety disorder, although subsequent case-reports from countries outside Japan have dispelled this notion. There are subtle yet distinct differences between TKS and DSM-defined social anxiety disorder (SAD). For instance, the TKS subject fears causing offence to others, whereas the SAD subject is more fearful of causing embarrassment to him/herself. Four sub-categories of TKS have been recognised of which the Jikoshu-kyofu variety resembles the olfactory reference syndrome (ORS) known to Western psychiatrists. There are two TKS subtypes, general (or simple) and offensive (delusional). The general subtype resembles social anxiety disorder, whereas the offensive subtype is characterised by delusions. True community-wide prevalence is unknown, although clinic studies estimate between 7.8% to 45.5% patients have a diagnosis of TKS, with a slight male preponderance. Cultural and societal norms engendering guilt, shame, and embarrassment are likely etiological factors. Treatment may consist of antidepressant and/or antipsychotic medications, while some patients may also benefit from cognitive behavior therapy.
文摘Chronic social defeat stress induces diverse effects in mice of different strains and even in animals of the same strain. This paper aims to study the effect of repeated social defeats and, for contrast, repeated aggression in daily agonistic interactions on the behaviors of CD-1 male mice. The behavior of animals that have the same winning and losing track record during 3, 10, 21 days is studied in different tests. The level of aggressiveness, as estimated by the number and total time of attacks, decreases;nevertheless, direct and indirect forms of aggression demonstrated by the aggressive mice (winners) remain significantly high. The number of stereotypic behaviors (rotations and jumps) and total time of digging behaviors are significantly increased in the winners after 21 days compared to 3 and 10 days of intermale confrontations. Among the losers, chronic experience of social defeats is accompanied by the development of pronounced anxiety and a depression-like state estimated by the elevated plus-maze and the Porsolt test scores, respectively. Both groups of male mice with alternative social behaviors demonstrate abnormal locomotor and exploratory behaviors in the open-field test. This phenomenon may be viewed as hyperactivity developed under chronic agonistic interactions and specific for the outbred CD-1 mice. We believe that these animals may be potentially used for modeling the key symptoms of bipolar disorder.
文摘Aim: Resilience refers to the human ability to adapt to tragedy, trauma, adversity, and significant stressors. Recently, resilience has been defined as a potentially modifiable factor that can be improved through intervention. Here, we examined resilience during a 3-month period as patients experienced their first episode of major depressive disorder (MDD). We hypothesized that despite MDD, resilient people could recover from depressive states more quickly than less resilient people. Methods: Twelve patients experienced their first MDD episode and 21 healthy control individuals participated in the study. Data from the Hamilton Depression Rating Scale (HAM-D), S-H Resilience Scale (S-HRS), and State-Trait Anxiety Index (STAI) were collected at two time points. Time 1 was the first visit after registration and Time 2 was 12 weeks later. Based on the symptoms described by the HAM-D results, the MDD group was divided into MDD-remission and MDD-residual subgroups. Results: Compared with controls, patients showed significantly lower resilience (low scores for Factor-A, Factor-B, and total S-HRS). Moreover, total SHRS scores for the MDD-remission group increased significantly from the Time 1 to Time 2, while those in MDD-residual group did not change. No significant differences in STAI scores were observed between MDD-remission and MDD-residual groups at either time point. Conclusion: This is the first report to show that patients experiencing their first episode of MDD show low resilience, and that a resilience scale might be a good index for estimating recovery from depression.
基金This work was supported by the National Natural Science Foundation of China(NSFC,no.8221101268,no.82271583,no.32250610208)the National Key Research and Development Program of China(grant no.2018YFA0701400).
文摘Background:Brain structural alterations of the striatum have been frequently observed in internet gaming disorder(IGD);however,the replicability of the results and the associations with social-affective dysregulations such as social anxiety remain to be determined.Methods:The present study combined a dimensional neuroimaging approach with both voxel-wise and data-driven multivariate approaches to(i)replicate our previous results on a negative association between IGD symptom load(assessed by the Internet Gaming Disorder Scale-Short Form)and striatal volume,(ii)extend these findings to female individuals,and(iii)employ multivariate and mediation models to determine common brain structural representations of IGD and social anxiety(assessed by the Liebowitz Social Anxiety Scale).Results:In line with the original study,the voxel-wise analyses revealed a negative association between IGD and volumes of the bilateral caudate.Going beyond the earlier study investigating only male participants,the present study demonstrates that the association in the right caudate was comparable in both the male and the female subsamples.Further examination using themultivariate approach revealed regionally different associations between IGD and social anxiety with striatal density representations in the dorsal striatum(caudate)and ventral striatum(nucleus accumbens).Higher levels of IGD were associated with higher social anxiety and the association was critically mediated by the multivariate neurostructural density variations of the striatum.Conclusions:Altered striatal volumes may represent a replicable and generalizable marker of IGD symptoms.However,exploratory multivariate analyses revealed more complex and regional specific associations between striatal density and IGD as well as social anxiety symptoms.Variations in both tendencies may share common structural brain representations,which mediate the association between increased IGD and social anxiety.
文摘目的观察电针辅助帕罗西汀和舒必利治疗社交恐惧症的临床疗效及对神经电生理和预后的影响。方法将90例社交恐惧症患者用随机数字表法分为试验组和对照组,每组45例。两组均采取心理疏导,对照组予口服帕罗西汀和舒必利治疗,试验组在对照组药物治疗基础上另予电针治疗。比较两组临床疗效和不良反应发生情况,观察两组治疗前后神经电生理指标(MMN波幅、MMN潜伏期和N2靶潜伏期)、自主神经功能指标[RR间期平均值标准差(SDANN)、相邻两正常窦性RR间期差值50 ms个数所占百分率(PNN50)和相邻RR间期差值的均方根(RMSSD)]、Liebowitz社交焦虑量表(Liebowitz social anxiety scale,LSAS)评分、自评焦虑量表(self-rating anxiety scale,SAS)评分以及生活质量综合评定问卷(generic quality of life inventory-74,GQOLI-74)评分的变化。结果试验组总有效率高于对照组,组间差异具有统计学意义(P<0.05)。治疗1个月后和治疗后,试验组MMN潜伏期、N2靶潜伏期、LSAS评分和SAS评分低于对照组,MMN波幅及SDANN、RMSSD和PNN50高于对照组(P<0.05);治疗后,试验组躯体功能、心理功能、社会功能和物质生活评分高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论电针辅助帕罗西汀和舒必利治疗社交恐惧症的疗效优于单纯药物治疗,可改善临床症状,调节神经电生理和自主神经功能,改善预后。
