• 대한불안의학회지
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• 제12권1호
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• pp.42-46
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• 2016

The therapeutic effect of cognitive behavioral therapy (CBT) for patients with Social Anxiety Disorder (SAD) is supported by evidence from numerous studies. This article provides an overview of cognitive models and major techniques (i.e., cognitive restructuring and exposure) of CBT for SAD, developed by the study group of SAD in the Korean Academy of Anxiety Disorder. Korean-culture specific factors and new trends such as a third wave of CBT are also described.

• 대한불안의학회지
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• 제8권2호
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• pp.146-152
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• 2012

Objective : Individuals with anxiety disorders experience a wide range of time to seeking treatment (TST) as well as various comorbid mental disorders. The present study examined the TST in social anxiety disorder (SAD) and panic disorder. This study aimed to find out the influence of comorbid mental disorder on TST of anxiety disorder through the comparison of SAD and panic disorder. Methods : This study included 311 SAD and 378 panic disorder patients at the initial visit of psychiatric clinic. Contribution of clinical (number of comorbidity, comorbid type and onset age) and demographic (current age) factors to TST were investigated by multivariate analysis. Results : The median length of TST was 14.03 years in SAD and 2.26 years in panic disorder. In social anxiety disorder, fewer comorbidity, younger onset age, and older age were factors associated with delayed TST. In panic disorder, only younger onset age was associated with delayed TST. In both disorders, comorbid depressive disorder was associated with shorter TST. Conclusion : Our data provided the differences in illness behavior needing help based on comorbid mental disorders between SAD and panic disorder. In addition to comorbid disorder, factors affecting TST of anxiety disorder requires future investigation.

• 생물정신의학
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• 제22권4호
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• pp.216-222
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• 2015

Objectives The principal aim of the present study was to investigate the characteristic depressive symptoms in patients with social anxiety disorder (SAD) and panic disorder in comparison to patients with depressive disorder. Methods This study included 132 patients with SAD, 128 panic disorder and 64 depressive disorder (major depressive disorder, dysthymia etc.) patients without comorbid psychiatric disorders. The Beck Depressive Inventory (BDI) is used to measure depressive symptoms. We divided BDI into three categories originally described by Shafer AB, including negative attitude toward self, performance impairment, and somatic symptoms. We compared the depressive symptoms of SAD, panic disorder and depressive disorder by using ANOVA. Results Negative attitude toward self was noticeable in SAD (SAD $0.54{\pm}0.23$, panic disorder $0.41{\pm}0.17$, depressive disorder $0.46{\pm}0.11$, p < 0.001). Performance impairment and somatic symptoms were remarkable in panic disorder than in SAD and depressive disorder (performance impairment : SAD $0.39{\pm}0.21$, panic disorder $0.44{\pm}0.14$, depressive disorder $0.40{\pm}0.09$, p = 0.009 ; somatic symptoms : SAD $0.07{\pm}0.10$, panic disorder $0.15{\pm}0.12$, depressive disorder $0.14{\pm}0.08$, p < 0.001). Conclusions The results facilitate an approach to optimal treatment for patients with comorbidity of anxiety disorder and depression.

• 대한불안의학회지
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• 제16권2호
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• pp.106-112
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• 2020

Objective : Social anxiety disorder (SAD) is characterized by fear of social threat and exhibits limbic hyper-reactivity toward social stimuli such as emotional faces. A previous study identified the uncinate fasciculus (UF) sub-tract as particularly related to facial memory. To explore the white matter tract relating to face-specific brain regions, we investigated the UF sub-tract in SAD. Methods : The diffusion tensor images of 22 patients with SAD and 20 healthy controls were analyzed with tractography. The UF sub-tract was delineated using the regions of interest of face patches in the anterior temporal lobe and the orbitofrontal cortex, and fractional anisotrophy (FA) and total number of streamlines (ST) were analyzed. We examined the group comparison of FA and ST of the UF sub-tract and correlations of FA and ST with the social anxiety symptoms such as the Liebowitz Social Anxiety Scale (LSAS), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS) and the Fear of Negative Evaluation scale (FNE) in SAD. Results : There were no group differences in FA and ST of the UF sub-tract. However, negative correlations were observed between ST of the right UF sub-tract and severity of social anxiety symptoms (LSAS, r_s=-0.480, p=0.024; SIAS, r_s=-0.580, p=0.005; SPS, r_s=-0.590, p=0.004; FNE, r_s=-0.675, p=0.001) in patients with SAD. Conclusion : Although patients with SAD did not show quantitative abnormalities in the UF sub-tact connecting face-specific brain regions, this structure seems to play a role in the symptom severity of SAD.

• Psychiatry investigation
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• 제15권11호
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• pp.1079-1086
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• 2018

Objective The pathophysiology of social anxiety disorder (SAD) is not yet well understood, but previous research has suggested that oxytocin is associated with social behavior and may play a role in human anxiety states and anxiety-related traits. The aim of this study was to investigate the possible relationship between social anxiety symptoms and plasma oxytocin levels. Methods Twenty-three male patients with SAD and 28 healthy male controls participated in this study. All participants were assessed using the Mini International Neuropsychiatric Interview (MINI) and the Liebowitz Social Anxiety Scale (LSAS). Multivariate regression analysis was performed to identify associations between plasma oxytocin levels and SAD. Results In multiple regression models, after controlling for age and years of education, we found that higher oxytocin levels were significantly associated with higher total LSAS scores ($R^2=0.157$, coefficient=0.145, 95% CI=-0.0005-0.291, p=0.051) and fear subscale scores ($R^2=0.134$, coefficient=0.083, 95% CI=0.007-0.159, p=0.034) in the SAD group. Conclusion In this study, increased plasma oxytocin levels were associated with higher social anxiety symptoms among SAD patients, but not among controls. This might be because among SAD patients, higher oxytocin (OT) secretion is an insufficient compensatory attempt to reduce social anxiety symptoms.

• 대한불안의학회지
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• 제16권2호
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• pp.98-105
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• 2020

Objective : The purpose of this study was to investigate the prevalence of social anxiety disorder (SAD) and its association with psychosocial factors including self-esteem, ego-resiliency, and social support in a sample of medical students. Methods : A total of 405 medical students were included in this study. Subjects were asked to complete a self-reported questionnaire, measures of the Social Phobia Inventory (SPIN), the Rosenberg's Self-Esteem Scale (RSES), the Ego-Resiliency Scale (ERS), and the Duke-UNC Functional Social Support Questionnaire (DUFSS). The SAD and non-SAD group were defined using the SPIN score of 25 as a cut-off. The multiple regression analyses were performed to examine the association of self-esteem, ego-resiliency, and social support with SAD symptoms. Results : A total of 79 subjects (19.5%) were identified with SAD. The total RSES score, ERS score, and DUFSS score were significantly lower in the SAD group than the non-SAD group. The total SPIN score negatively correlated with the total RSES score (r=-0.481, p<0.001), the ERS score (r=-0.417, p<0.001), and the DUFSS score (r=-0.406, p<0.001). In the multiple regression, SAD symptoms were associated with self-esteem (β=-0.549, p<0.001), ego-resiliency (β=-0.395, p<0.001), and social support (β=-0.346, p<0.001). Conclusion : This study revealed the prevalence of SAD and its negative association with self-esteem, ego-resiliency, and social support among medical students. Our findings indicate that improving self-esteem and ego-resiliency as well as perceived social support may contribute to the management of SAD symptoms among medical students.

• 대한불안의학회지
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• 제14권2호
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• pp.63-70
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• 2018

It has been suggested that aberrant self-referential processing (SRP) is one of the important components of the explanatory models of social anxiety disorder (SAD). The default mode network (DMN), which reflects intrinsic brain functions, is known to play a critical role in SRP. Recently, resting state functional magnetic resonance imaging (fMRI) research on the functional connectivity in the brain network has gained greater attention as a tool to elucidate the neurobiological basis of various psychiatric disorders. We reviewed resting state fMRI studies that investigated the resting state functional connectivity (RSFC) of the DMN in SAD. Despite of the heterogeneity of the analytic methods and occasional negative findings, most studies consistently reported abnormalities of RSFC within the DMN, suggesting that the DMN may be significant neural correlates of aberrant SRP in SAD. Also, changes in RSFC of the DMN are associated with clinical improvements of therapeutic interventions. Moreover, emerging findings provide the basis for potential use of RSFC as a complementary method in diagnosis of SAD. Ongoing and future research to investigate RSFC of the DMN could broaden our understanding regarding the neurobiological basis of SAD, and contribute to the development of novel treatments for SAD.

• 아동학회지
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• 제30권4호
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• pp.99-117
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• 2009

This study examined the effectiveness of the Filial Therapy program for children with Separation Anxiety Disorder (SAD). Subjects were 8 mother-child dyads each in the experimental and comparison groups. Mann-Whitney U-test and the Wilcoxon Matched-Pairs Signed-Ranks Test were performed following the therapeutic program. After application of the Filial Therapy program, results showed that, compared to the control group, (1) parents of SAD children in the experimental group significantly increased their level of empathic interactions with their children. AND (2) the experimental group children significantly reduced level of somatic complaints, anxious/depressed, and social problems. Conclusions were that Filial Therapy is an effective program for improvement of parent-child relationship of SAD children but not for changing problem behavior of SAD children.

• 동의신경정신과학회지
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• 제34권1호
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• pp.33-42
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• 2023

Objectives: This study was conducted to observe the progression of symptoms according to the treatment period of patients with social anxiety disorder who received complex Korean medicine treatment. Methods: The medical records of 25 patients who were diagnosed with social anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and received complex Korean medicine treatment (herbal medicine, acupuncture, and Korean psychotherapy) for 12 weeks were analyzed. The State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Korean-Social Avoidance and Distress scale (K-SAD), and the Korean-Fear of Negative Evaluation (K-FNE) were measured at the initial hospital visit and during the 4, 8, and 12 weeks of treatment to evaluate the effectiveness of treatment. Missing values were replaced with the average evaluation index value at that time. Results: 1) Statistically significant changes in STAI-X1, STAI-X2, BDI-II, BAI, K-SAD, and K-FNE scores were seen according to the time of treatment. 2) When scores were compared between each treatment time point, STAI-X2 and BDI-II showed statistically significant changes between the initial visit and four weeks of treatment, the initial visit and eight weeks of treatment, and the initial visit and 12 weeks of treatment. STAI-X1 and K-FNE showed statistically significant changes between the initial visit and eight weeks of treatment and the initial visit and 12 weeks of treatment. There was a statistically significant change in BAI scores between the initial visit and the 12th week of treatment. Conclusions: Complex Korean medicine treatment alleviated anxiety, depression, fear, and avoidance of social situation symptoms in patients with social anxiety disorder. The longer the treatment period, the more symptoms tended to be alleviated. However, the evidence should be supplemented with prospective, controlled research.

• 대한불안의학회지
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• 제7권1호
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• pp.22-28
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• 2011

Objective : Social anxiety disorder (SAD) has been characterized by a marked sense of anxiety provoked by exposure to one or more social situations. It has been well-known that the cultural characteristics of a society strongly affect the expression of SAD symptoms. The current study attempted to explore clinical and cultural characteristics of social anxiety symptoms in the Korean nonclinical population. Methods : 801 volunteers who participated in the national social anxiety screening day, which was held by Korean academy of anxiety disorders, were invited to complete the self-report version of Liebowitz social anxiety scale (LSAS-SR). A total of 691 participants completed the LSAS-SR and other information related to this study. Results : Social anxiety symptoms were reported by a great percentage of subjects, as displayed by the relatively high mean LSAS scores (44.58 ; SD=25.60). There were no significant differences in total LSAS score according to sex, education, or marital status. The three most fearful or avoided situations for participants, as measured by the percentage of subjects who had a score of more than 3 on each LSAS item were as follows: item 6 (acting, performing, or giving a talk in front of an audience ; 29.67% for fear and 22.72% for avoidance), item 16 (speaking up in a meeting ; 25.62% for fear and 21.56% for avoidance), and item 15 (being the center of attention; 13.89% for fear and 9.70% for avoidance). Conclusion : The Korean participants in this study demonstrated a high level of SAD symptoms. Our subjects reported that they were more likely to be fearful or avoid passive situations such as being the center of attention as compared with results from a study of western society which indicated that western people were more likely to be fearful or avoid active situations. These findings emphasize the importance of considering a patient's cultural background when evaluating SAD symptoms.