Research helps people with social phobia face their fears

September 5, 2013 by Brooke Donald
A person suffering from a social anxiety disorder may fear going out in public or interacting with people. A new Stanford study finds that cognitive behavioral therapy reduces symptoms. Credit: Shutterstock

(Medical Xpress)—Social anxiety disorder – which can include being afraid of speaking in public, fear of interacting with people, and intense nervousness at being the center of attention – affects millions of people each year.

Those living with it suffer from distorted thinking, including false beliefs about social situations and the negative opinions of others. They feel judged, embarrassed and criticized. The disorder can interfere with school, work, activities and relationships.

A team of at Stanford's Clinically Applied Affective Neuroscience project at the Department of Psychology has been studying treatment options, using functional and clinical interventions to examine the factors that cause and maintain and imbalance.

A new study from the lab looked at one of the most popular non-drug methods to treat disorder – – to see what changes happen in the brain after a person receives this remedy.

Through a series of experiments, the researchers found that the therapy, a kind of mental health counseling that helps people learn to respond more skillfully to , indeed was effective in significantly reducing symptoms of social anxiety disorder.

Further, they found that the therapy increased in areas associated with emotion regulation.

Why does it work?

Philippe Goldin, one of the main researchers, said that understanding how the brain responds to and changes with the therapy can help elucidate how and why cognitive behavioral therapy works.

With that knowledge, Goldin said, future studies could investigate how different forms of the therapy – for example, group therapy versus individual therapy – influence the dynamics of brain networks involved in emotion regulation strategies.

In the study, published this month online in the journal JAMA Psychiatry, patients diagnosed with social anxiety disorder underwent 16 psychotherapy sessions over four months, during which they were trained to change the way they deal with certain negative emotions.

This training in "cognitive reappraisal or restructuring" allows a person to revisit his or her emotional response to a situation and change the reaction.

For example, Goldin said, imagine a person who fails a series of tests. He first thinks negatively about his performance. But once he reframes his response, he can later view the results as a way to challenge and better himself.

Another example, described in the study, would be someone thinking, "No one likes me." A way of reframing that thinking may be to tell oneself, "That's not always true," "Some people like me," or "This is only a thought, not a fact."

Prior neuroimaging studies have found that patients with social anxiety disorder show delays in regions of the brain associated with and abnormalities in neural circuitry there, compared with healthy people.

But those studies left questions about whether clinical interventions like psychotherapy could affect how the brain responds.

Reactions in the brain

For this study, patients were scanned using fMRI to investigate brain responses when reacting to and reframing negative-self-beliefs. During the scan, patients read autobiographical social situations with situation-specific beliefs embedded in the story that were used to probe reactivity and reappraisal.

After each negative self-belief came up, patients rated how they felt.

Goldin said the study further reveals that counseling is effective in changing the behavior of the brain, helping people respond to and reframe negative emotions more quickly.

The effectiveness of cognitive behavioral therapy gives hope to many of the sufferers of that there is a treatment that can last and endure without drugs.

Explore further: Brain scans could help doctors choose treatments for people with social anxiety disorder

Related Stories

Brain scans could help doctors choose treatments for people with social anxiety disorder

September 6, 2012
A new study led by MIT neuroscientists has found that brain scans of patients with social anxiety disorder can help predict whether they will benefit from cognitive behavioral therapy.

Stanford study vanquishes social anxieties without drugs

August 19, 2011
For most of his life, 24-year-old Steven Bringas so feared humiliating himself if he spoke that only an emergency would get him to enter a store.

Study shows that insomnia may cause dysfunction in emotional brain circuitry

May 22, 2013
A new study provides neurobiological evidence for dysfunction in the neural circuitry underlying emotion regulation in people with insomnia, which may have implications for the risk relationship between insomnia and depression.

Functional MRI can improve prediction of CBT success

January 4, 2013
(HealthDay)—Results of functional brain imaging can greatly improve prediction of which patients with social anxiety disorder (SAD) will benefit from cognitive behavioral therapy (CBT), according to a study published in ...

Recommended for you

Psychologists say our 'attachment style' applies to social networks like Facebook

July 24, 2017
A new investigation appearing this week in the Personality and Social Psychology Bulletin suggests a strong association between a person's attachment style—how avoidant or anxious people are in their close relationships—and ...

Higher cognitive abilities linked to greater risk of stereotyping

July 24, 2017
People with higher cognitive abilities are more likely to learn and apply social stereotypes, finds a new study. The results, stemming from a series of experiments, show that those with higher cognitive abilities also more ...

Neuroticism may postpone death for some

July 24, 2017
Data from a longitudinal study of over 500,000 people in the United Kingdom indicate that having higher levels of the personality trait neuroticism may reduce the risk of death for individuals who report being in fair or ...

World-first ketamine trial shows promise for geriatric depression

July 24, 2017
Australian researchers have completed the world's first randomised control trial (RCT) assessing the efficacy and safety of ketamine as a treatment for depression in elderly patients.

Musicians have high prevalence of eating disorders, study finds

July 24, 2017
They may live for the limelight and the call of their muse, but musicians may also be prone to eating disorders, according to new research.

Study examines effects of stopping psychiatric medication

July 20, 2017
Despite numerous obstacles and severe withdrawal effects, long-term users of psychiatric drugs can stop taking them if they choose, and mental health care professionals could be more helpful to such individuals, according ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

not rated yet Sep 05, 2013
"Those living with it suffer from distorted thinking, including false beliefs about social situations and the negative opinions of others. They feel judged, embarrassed and criticized. "

This is not right. It ignores the large cohort who have an anxious reaction to social situations not dissimilar to the reflex action that some people have at the sight of blood without having any actual fear of blood.

I have social anxiety which has just such a form. It is not triggered by internet/FB interaction at all, zero, which proves conclusively that the social anxiety that I have is not triggered by 'thinking' of any kind. It is a reflex.

Note that this is a subgroup which may represent many or few (needs to be empirically investigated; I assume many).

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.