社交恐惧谱系障碍

平一指

Psychiatr Clin North Am. 2002 Dec;25(4):757-74.  Related Articles, Links  


The social anxiety spectrum.

Schneier FR, Blanco C, Antia SX, Liebowitz MR.

Anxiety Disorders Clinic, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA. frs1@columbia.edu

Social anxiety disorder is well suited to the spectrum concept because it has trait-like qualities of early onset, chronicity, and no empirically derived threshold that demarcates normal from clinically significant trait social anxiety. Social anxiety disorder has been shown to respond to relatively specific pharmacologic and cognitive-behavioral therapies, which makes identification of other conditions that may lie on the social anxiety disorder spectrum important because of possible treatment implications. Biologic markers associated with social anxiety disorder also may be shared by similar but nonidentical traits, such as behavioral inhibition and detachment. Clarification of the trait spectrums associated with specific biologic systems offers an opportunity for improving the understanding of the origin of these conditions. Strong evidence exists that at least some forms of shyness, avoidant personality disorder, and selective mutism lie on a social anxiety disorder spectrum. For several other disorders that share a prominent focus on social comparison, significant subgroups of patients seem to have features of social anxiety disorder. These disorders include major depression (especially the atypical subtype), body dysmorphic disorder, and eating disorders. Several other disorders marked by social dysfunction or inhibition, including substance use disorders (especially alcoholism), paranoid disorder, bipolar disorder, autism, and Asperger's disorder, also may show some overlap with social anxiety disorder features (e.g., social anxiety as a cause or complication of substance abuse, social avoidance in paranoid disorder, social disinhibiton in bipolar disorder, and social communication deficits in autism and Asperger's disorder). Social anxiety disorder also is associated with other anxiety disorders in general and other phobias in particular. In respect to traits, a growing body of evidence links behavioral inhibition to the unfamiliar to a social anxiety disorder spectrum with some specificity. Biologic measures of dopamine system hypoactivity have been linked to social anxiety disorder, trait detachment, and general deficits in reward and incentive function. It remains to be clarified, however, whether this brain system function is best characterized by a social anxiety disorder spectrum or some variant that incorporates social reward deficits or social avoidance behavior. Social anxiety disorder, shyness, and behavioral inhibition all seem to have a genetic component, but more research is needed to attempt to identify a more specifically heritable temperament associated with these conditions. Finally, the emergent concept of a social anxiety spectrum needs maturation. Although the notion of a single social anxiety disorder spectrum currently has some clinical use, the authors believe that exclusive focus on the notion of a single continuum with two extremes--from social disinhibition in mania to the most severe form of social anxiety, avoidant personality disorder--is premature and limiting in respect to etiologic research. An alternative approach is to conceptualize multiple, probably overlapping spectra in this area of social psychopathology. Individual dimensions might be based on various core phenomenologic, cognitive, or biologic characteristics. A bottom-up biologic approach holds promise for identifying spectra with a common etiology that might respond to specific treatments. Taking a pluralistic view of the concept of spectrum at this stage may help accelerate our understanding of social anxiety and related disorders.

Publication Types:
Review
Review, Tutorial

PMID: 12462859 [PubMed - indexed for MEDLINE]

暗夜星光

老弟，这是在中国。

你不会拿这个来显示你的高深吧！

毕竟，还是普通人多！

平一指

没关系，这里的翻译也很多的。：）再说中文的文章实在不如英文啊，不发点英文的怎么提高论坛的学术水准呢？

平一指

J Clin Psychiatry. 1999;60 Suppl 9:4-8.  Related Articles, Links  


The history, epidemiology, and differential diagnosis of social anxiety disorder.

Moutier CY, Stein MB.

Anxiety and Traumatic Stress Disorders Research Program, University of California, San Diego, La Jolla 92037, USA.

Social anxiety disorder has only recently garnered recognition as a unique anxiety disorder. Although social anxiety disorder is distinguishable from other psychiatric disorders, there are several areas in which this distinction is not straightforward. Furthermore, social anxiety disorder is associated with considerable comorbidity with other disorders, which may render differential diagnosis a challenging endeavor. This article will review those disorders that must be differentiated from social anxiety disorder, including major depression, panic disorder with agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, and body dysmorphic disorder. In addition, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides specific examples of disorders, e.g., verbal dysfluency (stuttering) and Parkinson's disease, in the context of which social anxiety disorder is not to be diagnosed. Social anxiety disorder is also frequently comorbid with the Axis II avoidant personality disorder. Interestingly, this may present a prime example of "comorbidity by committee," because it is growing increasingly clear that much avoidant personality disorder as defined by DSM-IV merely denotes a subgroup of patients with generalized social anxiety disorder. Because social anxiety disorder has a chronic course and is associated with significant morbidity, it is critical that patients receive an accurate diagnosis and appropriate treatment.

Publication Types:
Review
Review, Tutorial

PMID: 10335673 [PubMed - indexed for MEDLINE]

暗夜星光

哈哈！

dupeng981

我只知道social anxiety。这俩单词
我还不知道我是不是写错了，好象错了。