Treating Social Phobias and Social Anxiety

Shyness And Social Anxiety System

The Shyness and Social Anxiety System is just as its name says. It is an e-book wherein in-depth discussions about the symptoms, causes and treatment for shyness and social anxiety are made. It is then written for individuals whose extreme shyness or social anxiety prevent them from enjoying a full life filled with social interactions among their family, friends and acquaintances in gatherings during holidays, outings and parties. The author Sean Cooper also suffered from shyness and social anxiety disorder so much so that he tried every trick in the book yet to no avail. And then he set out to conquer his own fears by researching into the psychology, principles and practices behind these two debilitating mental health issues. More here...

Shyness And Social Anxiety System Overview

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Author: Sean Cooper
Official Website: shynesssocialanxiety.com
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My Shyness And Social Anxiety System Review

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It is pricier than all the other ebooks out there, but it is produced by a true expert and is full of proven practical tips.

Overall my first impression of this ebook is good. I think it was sincerely written and looks to be very helpful.

Dissolve Social Anxiety Home Recovery Program

Here are the benefits youll receive when you sign up for the Dissolve Social Anxiety Program: Get to the Root of your Social Anxiety so you can fully recover. Find out why its Not You thats the cause of your Social Anxiety Disorder. Breakdown Beliefs that fuel social anxiety, to start making changes immediately. Discover how emotions are controlling you, and learn how to stop emotions from controlling your life. Create a new belief system and life story that will become an unshakable foundation so social anxiety never controls you, ever again. Develop new Life Skills, not only to conquer social anxiety, but dissolve virtually Any chronic anxiety or depression that comes along with your social phobia. Get Social Confidence in the way that works best for you, not someone else (this is not a cookie cutter approach Im teaching here). Learn and sharpen social skills to have great social interactions with anyone. Program Features: Instant Access to Twelve (12) life-changing modules to build the skill set to finally dissolve your social anxiety. Practical & Experiential Learning guided exercises to help create new awareness, anxiety reduction/elimination, and new possibilities for Self-Confidence And Social Action. Each module has homework to help reinforce the learning, along with practices to support you in your recovery and transforming your life. Customization for Your specific social anxiety issues and recovery goals. Complete with streaming Video Modules, downloadable MP3 Audio files, Pdf handouts (Just your web browser and Adobe Reader are required) Immediately delivery with a personal membership login for the modules (and question submissions if you purchase a higher level package) More here...

Dissolve Social Anxiety Home Recovery Program Overview

Contents: Online Course
Author: David Hamilton
Official Website: socialexpression.net

Social Isolation Model

The post-weaning social isolation of rats produces a model that exhibits behavioral abnormalities with some potential relevance to schizophrenia, including hyperactivity in response to novelty and amphetamine, disruption in PPI, and decreased social interactions. These abnormal behaviors are at least partially responsive to atypical antipsychotics.50 Social isolation is known to produce a variety of alterations in biochemical, electrophysiological, and anatomical measures. For example, stimulation of the ventral tegmental area in rats subjected to post-weaning social isolation produces typical evoked plateau depolarizations in prefrontal cortex that is accompanied by an abnormal firing or a short hyperpolarization that is not observed in control animals.51 This suggests that social isolation may alter mesocortical dopaminergic modulation of the prefrontal cortex. While social isolation produces an interesting behavioral model with some face validity, there are clear issues regarding...

Social Anxiety Disorder

SAD or social phobia is a common anxiety disorder often associated with serious role impairment. The 12-month prevalence rate for all types of SAD was estimated to be 8 with a lifetime prevalence of 13 . SAD is a chronic disease with a slightly higher prevalence in females than males (15 versus 11 , respectively), with retrospective studies showing an average duration of 25 years. Overall, females with poor baseline functioning at the time of diagnosis have the greatest risk of disease chronicity. DSM IV-TR defines SAD as a marked and persistent fear of social or performance situations in which embarrassment may occur. The diagnosis of SAD is only made when the fear, avoidance, or anxious anticipation of the event persists for at least 6 months and the phobia directly interferes with daily function or when the individual is distressed about having the phobia. Although SAD can relate to a specific set of circumstances (i.e., public speaking), there are cases in which there can be a...

Attending To Interpersonal Processes In Treatment

Behavioral psychology has, of course, a rich history of attention to the interpersonal context of behavior problems, a focus that is seeing increasing development related to PTSD. In this book, interventions that focus on couples concerns are described in Chapter Fourteen by Leonard, Follette, and Compton. Deblinger, Thakkar-Kolar, and Ryan in Chapter Sixteen describe interventions that work conjointly with both children and parents in addressing child traumatic experiences. Group psychotherapy, an important component of treatment for many trauma survivors, is reviewed in Chapter Fifteen by Foy and Larsen. The latter authors point to the advantages for trauma survivors, whose experiences so commonly involve social isolation, social alienation, perceptions of being ostracized from the larger society, shame, and diminished feelings for others, of working toward recovery with other survivors.

Disease State Diagnosis

More recently, it has been argued that comorbid mood disorders are sufficiently common in schizophrenic patients to justify a fourth set of characteristic symptoms. Depression and bipolar disorder are highly comorbid in schizophrenia and are one of the key factors contributing to the increased risk for suicide in this disorder. Individuals with schizophrenia attempt suicide more often than people in the general population, and a high percentage, in particular younger adult males, succeeds in the attempt. Controversy remains over whether these mood disorders are in fact a manifestation of the disorder (i.e., share a common etiology), or an epiphenomenon associated with either the disease state or treatment. Regardless of the actual cause, comorbid mood disorders represent a clear risk in treating the schizophrenic patient population and are carefully considered along with the more traditional positive, negative, and cognitive symptoms. Schizophrenia is usually diagnosed in adolescence...

Historical and Social Context of Psychoactive Substance Use Disorders

Psychoactive substances subserve several human functions that can enhance both individual and social existence. On the individual level, desirable ends include the following relief of adverse mental and emotional states (e.g., anticipatory anxiety before battle and social phobia at a party), relief of physical symptoms (e.g., pain and diarrhea), stimulation to function despite fatigue or boredom, and time-out from day-to-day existence through altered states of consciousness. Socially, alcohol and drugs are used in numerous rituals and ceremonies, from alcohol in Jewish Passover rites and the Roman Catholic Mass, to peyote in the Native American Church and the serving of opium at certain Hindu marriages. To a certain extent, the history of human civilization parallels the development of psychoactive substances (Westermeyer, 1999).

Primary Nursing Diagnosis

Learn new coping behaviors, decrease social isolation, develop a realistic perception of body image, and learn age-appropriate behaviors. Concurrently, both the individual patient and the family are involved in sessions to educate them on the nature and processes of the disease and the prognosis and treatment plan. Family therapy facilitates learning new ways of handling conflict, solving problems, and supporting the patient's move toward independence.

Common Features Of Cognitive Vulnerability Models A Framework Encapsulating Relationships

A critical element of many cognitive models is that specific biases of information processing and proximal cognitions are assumed to differ with different disorders (Beck & D. A. Clark, 1997 J. M. G. Williams et al., 1988). For example, the bias in social phobia is for information relevant to the threat of public humiliation, and is accompanied by proximal thoughts like I'll make a fool of myself (see chap. 10, this vol.). The specific bias in panic disorder is for information relevant to unusual bodily sensations that might signal impending heart attacks or other feared calamities, and is accompanied by thoughts such as I'm having a heart attack (see chap. 8, this vol.). Such disorder-specific information-processing biases are presumably instigated when cognitive vulnerabilities (the distal factors) are put into play or engaged that were present long before the symptoms or episode. Hence, the specific vulnerability hypothesis of cognitive models is that the vulnerabilities to...

Obsessive Compulsive Disorder

OCD is a chronic and often disabling disorder that affects 2-3 of the US population. OCD has been labeled a 'hidden epidemic' and is ranked 20th in the Global Burden of Disease studies among all diseases as a cause of disability-adjusted life years lost in developed countries. OCD is often associated with substantial quality of life impairment especially in individuals with more severe symptoms. The disease usually begins in adolescence or early adulthood with 31 of first episodes occurring at 10-15 years of age and 75 by the age of 30. The essential features of OCD are recurrent obsessions or compulsions that are severe enough to be time consuming (i.e., take more than 1 h per day) and or cause significant levels of distress or interference with normal daily activities. OCD can have comorbidity with major depression and social phobia, as well as other mental disorders such as eating disorders and schizophrenia.9

Variations on a Theme Studies of Other Exposure Protocols

In sum, although PE has not been tested directly in samples of combat veterans, studies using variations of exposure therapy with veterans have consistently revealed significant benefits for this treatment approach. However, the magnitude of the improvement has been somewhat limited. Furthermore, the benefits of exposure treatment appear to be greater for symptoms of intrusion and arousal than for avoidance and numbing. These studies represent very strict tests of exposure therapy. In all of the trials, exposure was compared to other treatments focused on PTSD symptoms either a continuation of treatment that the veterans were already receiving or focused PTSD interventions. An important consideration in evaluating the results of these studies is the well-recognized reality that there are incentives for veterans to emphasize their symptoms and to minimize treatment gains (e.g., gaining or losing service-connected disability compensation for additional discussion, see Frueh, Hamner,...

Static versus Dynamic Management of the Paralyzed Face

The facial muscles are the only muscles of the human body that have direct connections to the overlying integument. Using these connections, the facial muscles are able to perform a variety of functions of both physiologic and sociologic importance. Physiologically, the facial muscles provide sphincters for the eye and mouth that are crucial for eye protection, eating, drinking, and speaking. The facial muscles also function to modify the diameter of the nostrils, affecting breathing through the nose. Although these functional considerations are important, they are perhaps overshadowed by the role played by the human face in social interactions. The human face is unique across the animal kingdom because of its ability to express a wide range of emotions and intents. In lower animals, facial expressions are used primarily to express anger or aggression. The human face is capable of clearly signaling to other humans the four major emotions fear, anger, happiness, and sadness as well as...

Multivariate Behavior Genetic Studies of Mood and Anxiety Disorder Symptoms

Kendler et al. (1992c) reported that additive genetic influences largely explained the observed covariation of symptoms of GAD and major depression in women and were entirely shared between the two disorders nonshared environmental influences accounted for the remaining unique liability variance for these disorders. The finding of a common genetic factor for GAD and major depression (with no unique genetic influences) was replicated by Roy, Neale, Pedersen, Mathe, and Kendler (1995) in an extension to a mixed male and female adult sample. Kendler et al. (1993c) also found that the observed covariation of major depression and phobia symptoms in women was largely attributable to additive genetic influences and that nonshared environmental influences contributed to the unique variance in liability to each of the two disorders. When the same authors investigated sources of overlap among phobias (agoraphobia, social phobia, animal phobia, and situational phobia Kendler et al.,...

In Search and Discovery of Potential New Therapeutic Indications

Based on the low potential of addiction and dependence, a preliminary study provided evidence that modafinil improved clinical outcome when combined with psychosocial treatment for cocaine dependence.101 An anecdotal story in a woman outpatient with social phobia and comorbid amphetamine dependence reported that her craving for amphetamines diminished and her anxiety and depression improved without the same 'high' with modafinil that she experienced with amphetamines.102

Experimental Disease Models

Many of the measures used to evaluate human obesity, such as BMI or waist-to-hip ratio, are not useful to evaluate small-animal obesity. However, recent advances have allowed the measurements of body composition in small animals using dual-energy x-ray absorptiometry (DEXA) scanning or nuclear magnetic resonance (NMR), allowing a sensitive measure of adiposity and lean mass in living animals. Using rats and mice, a number of laboratories have sought to mimic the western diet by using chow consisting of highly palatable, energy-dense foods which can also induce obesity in these species. In addition, the sedentary lifestyles that are also believed to be an important contribution to the obesity epidemic can be easily attained in rodents. What is not accurately mimicked are the heterogeneous genetics, lifestyles, and schedules of human obesity. Rats and mice are typically from controlled strains and specific breeders and are individually housed in small cages that preclude social...

Four Content Areas Cognitive Behavioral Interpersonal and Case Management

CBT is the basis for this treatment, because it so directly meets the needs of first-stage treatment through its high degree of structure, focus on problem solving in the present, educational emphasis, and time-limited framework. Moreover, in outcome studies CBT has been found to be one of the most promising approaches for the treatment of each of the disorders (PTSD and substance abuse) when treated separately (Najavits et al., 1996). The cognitive domain of Seeking Safety addresses beliefs and meanings associated with PTSD and SUD and explores how to rethink these in an adaptive way. The behavioral domain addresses how to take concrete actions in one's life, such as taking good care of one's body. The interpersonal domain is an area of special need because most PTSD arises from trauma inflicted by others (e.g., in contrast to natural disasters or accidents Kessler et al., 1995). Whether the trauma involved childhood physical or sexual abuse, combat, or crime victimization, all have...

And Significant Others

In a study of 61 family members of people with terminal cancer, Chapman and Pepler (1998) found that those family members who lacked hope were more likely to experience somatic distress, loss of control, and social isolation. Based on their results they suggest that health professionals (they specify nurses in particular) should be more aware of family members' somatic concerns. They further suggest that a way of fostering hope, and ultimately health, is to address expressed feelings of anticipatory grief and facilitate coping. Once the grief responses are dealt with, the level of hope would be expected to increase, providing an incentive for constructive coping with loss.

The Developmental Basis of Psychotherapeutic Processes

The DIR model is based on relatively recent insights about three interrelated processes that contribute to a child's development. The first process involves early stages in a child's presym-bolic functional emotional development (the building blocks of ego functioning and intelligence). These capacities include regulation and shared attention relating with intimacy gestural, affective reciprocal and social interactions and creating and connecting symbols. The second process involves each child's individually different underlying processing capacities, such as sensory modulation, auditory and visual-spatial processing, and motor planning. Infants and young children differ significantly in their sensory reactivity, auditory and visual-spatial processing, and motor planning and sequencing, and these differences are important contributors to ego structure, character, and symptom formation. The third process involves the role of relationships and affective interactions in facilitating a...

Nottingham Health Profile

The Nottingham Health Profile contains two parts Part I contains 38 items that cover 6 domains of experience pain, physical mobility, sleep, emotional reactions, energy, and social isolation. Part II includes perceived problems in 7 areas of life paid employment, jobs around the house, personal relationships, social life, sex life, hobbies, and holidays. Social isolation (5 items)

Persistent Avoidance of Stimuli Associated with the Trauma

The types of avoidance described above could have serious impact on the development of relationship skills involved in ordinary, day-to-day, social interactions as well as those required for intimate relationships, including therapy relationships. Healthy adult functioning involves being able to describe and identify the behavior of others as well as one's own internal reactions. Coping with trauma in a manner that involved externally focused perceptual avoidance could lead to problems such as revictimization. Perceptual avoidance that is directed inward distorts the ability to experience, identify, and describe internal states and may lead to problems of the self and personality disorders (primarily borderline personality disorder Kohlenberg & Tsai, 1991, Ch. 6 Kohlenberg & Tsai, 1993). Finally, the ability to tolerate the arousal that is required for exposure might also be affected, because the person would simply avoid the exposure experience.

Severe Mental Illness And Hiv Risk

The positive features include episodes of psychosis in which patients develop hallucinations (usually auditory), delusions (often paranoid and bizarre), and disordered thinking. These intrusive experiences are often disturbing and can lead to unpredictable and bizarre behavior that alienates patients from others and may be dangerous to the patient or others. These experiences and behaviors are considered positive symptoms because they add to the patient's otherwise normal experience. Over time, most patients develop apathy, withdraw from social functioning, and become increasingly disconnected in social interactions.

As Sources Of Distress

Other factors causing distress are the multiple complications resulting from immunological suppression, including visual loss, neurological illness, and fears of progressive health decline and changes in one's ability to care for one's self independently. Cytomegalovirus (CMV) retinopathy is one of the most distressing complications of HIV disease, as it results in vision loss with accompanying social isolation, loss of independence, and loss of function. Fatigue also plays an important role in HCV infection, as fatigue is a common complaint among sufferers of HCV both prior to and during treatment with biological agents such as interferon-based therapies. Four hundred and eighty-four HIV-seropositive subjects participated in a self-report trial which confirmed that HCV-coinfected patients demonstrated significantly more elements of distress compared to the HIV-only group in social, psychological, and biological arenas. The patients were also more likely to be in unstable social...

Treatment Of Distress Occurring In The Context Of Hiv Infection

Use of HAART has dramatically improved the lives of millions of patients living with HIV AIDS and has transformed HIV into a chronic illness. Few studies have investigated adequately the impact of HAART on the psychological well-being of infected individuals, but currently available evidence does suggest the beneficial role of HAART on psychological well-being (Rabkin et al., 2000). The effect of HAART on reducing distress has been shown in other studies as well (BeLow-Beer et al., 2000). Other interventions can begin by identifying distress through routine use of screening instruments. Prompt identification and treatment of comorbid psychiatric disease can allow initiation of effective interventions and minimize suffering. Attention to psychological coping mechanisms and bolstering of social and spiritual supports can limit the impact of loneliness and social isolation, thus enabling a higher quality of life in this vulnerable population.

Club Drugs and the Circuit Scene

Amine and alcohol are the most frequently used substances. Recent studies by Mansergh and colleagues (2001), Mattison, Ross, Wolfson, Franklin, and San Diego HIV Neurobehavioral Research Center Group (2001), and Lee, Galanter, Dermatis, and McDowell (2003) indicate high rates of simultaneous drug use at circuit parties the average number of substances ingested by responders on the day of the circuit party studied by Lee and colleagues was 2.4, with a range of 0 to 7. Most people report that using drugs during a circuit party enhances the dancing experience, relieves inhibitions, and improves sex. Others describe multiple substance use as self-medication for depressed mood, anxiety, social isolation, or stress associated with living with HIV disease or AIDS. Some participants report a synergistic effect between drugs, as in the case of the MDMA and ketamine combination some users believe that it results in a more intense high, while others feel that ketamine prolongs the effect of MDMA.

The Self Medication Hypothesis

Two fundamental assumptions underlie this hypothesis first, that substances are abused to relieve psychological pain, not just to create euphoria and second, that there is specificity between patients' drug of choice preference and the specific intolerable emotions or symptoms that they are attempting to alleviate. For example, patients with social anxiety may be drawn to alcohol to decrease their symptoms, while patients who are prone to violence and anger outbursts may prefer the calming effects of opioids to the potentially disinhibit-ing effects of alcohol.

Other Psychiatric Populations

In non-SPMI populations, integrated treatment models have also been developed for other patient subpopulations with psychiatric disorders and SUDs such as bipolar disorder (Weiss et al., 2000), personality disorders (Ball, 1998 Linehan et al., 2002), and anxiety disorders such as PTSD (Brady, Dansky, Back, Foa, & Carroll, 2001 Najavits, Weiss, Shaw, & Muenz, 1998), obsessive-compulsive disorder (Fals-Stewart & Schafer, 1992), and social phobia (Randall, Thomas, & Thevos, 2001). With the exception of social phobia, for which integrated CBT for social phobia and alcohol use disorders has yielded worse anxiety and drinking outcomes compared to group CBT geared toward alcohol relapse prevention alone (Randall et al., 2001), preliminary evidence suggests that these new treatments are generating some positive results.

Schizophrenia Spectrum Disorders

The notion of a spectrum of schizophrenic disorders first arose nearly a hundred years ago, when psychiatrists and practitioners began to notice an excess of eccentric personality and character traits among the relatives of their patients with schizophrenia (e.g., Bleuler, 1911 1950 Kraepelin 19091913 1971). This less severe, nonpsychotic, familial syndrome was characterized by social anxiety, aloofness, limited emotional response, and odd or disordered thinking. Thus, Bleuler reasoned that schizophrenia might manifest itself in alternate forms and coined the term latent schizophrenia, which he applied to individuals who evidenced affective flattening, social withdrawal, and related characteristics, in the absence of psychotic symptoms. He noted that such a dimensional construct might be important for studies of the hereditary basis of schizophrenia. ria, only eccentricity, affective constriction, and excessive social anxiety are genetically related to schizophrenia (Torgersen, 1994)....

Univariate Studies of Mood and Anxiety Disorder Symptoms

In the case of phobias, Kendler et al. (1992d) reported that liability to any phobia (agoraphobia, social phobia, animal phobia, or situational phobia) in women drawn from the Virginia population-based sample was attributable solely to additive genetic and nonshared environmental influences, and the heritability was .32. The only phobia subtype for which shared environmental influences contributed significantly to liability was situational phobias (e.g., phobias of tunnels, bridges, and airplanes). No significant heritable influences were found for this phobia subtype. Shared environmental influences, it was estimated, accounted for 27 of the variance in liability to situational phobias, and the remaining variance was attributable solely to non-shared environmental influences. Heritabilities were moderate (and similar) for agoraphobia (h2 .39), social phobia (h2 .32), and animal phobias (h2 .32). report. Similarly, Feigon et al. (1997a) found moderate genetic...

Psychiatric Comorbidity And Sequelae

More than one-half of all cocaine abusers meet criteria for a current psychiatric diagnosis and nearly three-fourths for a lifetime psychiatric diagnosis (Ziedonis, Rayford, Bryant, Kendall, & Rounsaville, 1994). The most common comor-bid psychiatric diagnoses among cocaine abusers include alcohol dependence, affective disorders, anxiety disorders, and antisocial personality disorder (Kleinman et al., 1990 Marlowe, Husband, Lamb, & Kirby, 1995 Mirin, Weiss, Griffin, & Michael, 1991 Rounsaville et al., 1991 Weiss, Mirin, Griffin, Gunderson, & Hufford, 1993). For most cocaine users, co-occurring psychiatric disorders (including agoraphobia, alcohol abuse, alcohol dependence, depression, posttraumatic stress disorder (PTSD), simple phobia, and social phobia) precede cocaine use (Abraham & Fava, 1999 Shaffer & Eber, 2002).

Application to Anxiety Disorders

Gray's BIS theory readily accounts for the association between anxiety, on the one hand, and such characteristics as shyness, social withdrawal, sensitivity to punishments, a tendency to be easily discouraged, and a failure to develop active means of coping with situations, on the other hand a dimension of internalizing disorders identified in multivariate studies of children (Achenbach & McConaughy, 1997 Quay, 1986). These are the characteristics to be expected in an individual in whom the balance between the BIS and the BAS has shifted heavily toward dominance of the BIS. The more reactive BIS would generate anxiety in situations that are only moderately threatening. On the assumption that other people dispense both rewards and punishments, much social interaction can be seen as involving an approach-avoidance conflict. The dominance of the BIS over the BAS would, in this case, result in passive avoidance (shyness and social withdrawal). Similarly, the dominance of passive...

Anxiety

Anxiety disorders (see 6.04 Anxiety) are characterized by an abnormal or inappropriate wariness. There are several disorders that fall under the heading of anxiety including panic disorders, phobias, generalized anxiety disorder (GAD), acute stress disorder, and posttraumatic stress disorder (PTSD). Panic disorder is characterized by rapid and unpredictable attacks of intense anxiety that are often without an obvious trigger. Phobias are examples of life-disrupting anxiety or fear associated with an object or situation, including social phobias. GAD develops over time and involves the generalization of fears and anxieties to other, usually inappropriate situations until they ultimately result in an overwhelming anxiety regarding life in general. Acute stress disorder involves the response to a threatened or actual injury or death and is characterized by dissociation, detachment, and depersonalization. Acute stress disorder usually resolves within a few weeks however it can progress...

Negative Mood

Lending support to the clinical relevance of decrements in immune status are findings highlighting the association between depressive symptoms and disease end points. Specifically, depressive symptoms have been related to faster progression to AIDS (PageShafer et al., 1996 Leserman et al., 1999) and development of an AIDS-related clinical condition (Leserman et al., 2002). Other investigations have determined that chronically elevated depressive symptoms are associated with hastened mortality among HIV-positive men (Mayne et al., 1996) and women (Ickovics et al., 2001). Again, the majority of studies reporting no effect of depressive symptoms on hastened mortality used only baseline measures (Burack et al., 1993 Lyketsos et al., 1993 Page-Shafer et al., 1996). Interestingly, in a follow-up to one study in which no effects of baseline depressive symptoms were observed on HIV disease progression, participants reported a dramatic increase in depressive symptoms 6 to 18 months before an...

Health

Health may be defined as the quality of a person's physical, psychological, and sociological functioning in a variety of personal and social situations (Bedworth & Bedworth, 1992). Health is also the ability to survive or adapt to disruptions among the structural, social, and personal components of the individual's health system, as well as to the environment in which the person lives.

Bereavement

Persons with HIV experience loss in many different ways over the course of their illness, including loss of friends, primary support networks, and physical integrity, and the continuing social stigmata of HIV and AIDS. Unfortunately for many, the loss of family and friends may occur at a time when they are most needed, which may further compound the loss of occupational and recreational capabilities across the course of the disease through both social isolation and physical impairment. Importantly, though, studies have demonstrated that group interventions designed to target maladaptive bereavement processes not only counter psychological distress and improve health-related quality of life but also may have a direct impact on HIV illness progression.

Definition

Acne is one of the most common skin diseases that physicians see in everyday clinical practice. It is a follicular eruption which begins with a horny impaction within the sebaceous follicle, the comedo. The rupture of the comedo leads to a foreign body inflammatory reaction which clinically presents as papules, pustules and nodules. The morphological expressions of acne are variable. Acne can affect persons of all ages, including neonates, infants and mature adults, being most prevalent and most severe during adolescence. Significant psychosocial disabilities can arise as a consequence of the disease. Patients may frequently experience poor self-image, anxiety, depression and social isolation employment opportunities also seem to be influenced by the presence of acne. As a consequence, an effective management of acne can have a relevant impact on the acne patient's life.

Social Ecology

A way of looking at how people interact with their physical, social, and cultural environments. Ecology refers to the study of relationships between an organism (any individual life form) and its environment. The social ecology approach involves the identification of physical and social characteristics of the environment that may affect a person's health. These characteristics may include stress influenced by change of residence, noise in the neighborhood, social isolation, access to health care facilities, and safety. A consideration of these factors may lead to the development of health promotion programs focusing on change (Kaplan, Sallis, & Patterson, 1993).

Phobias

There are three major types of phobias specific phobias, social phobias, and agoraphobia. Specific phobias are those triggered by fear of a specific object, such as snakes or spiders. Claustrophobia (fear of enclosed spaces), acrophobia (fear of heights), and fear of flying or driving also fall into this category. About 8 percent of American adults experience one or more specific phobias in any given year. Typically developing in childhood, many specific phobias disappear by adulthood. Those that last into adulthood usually require treatment. Social phobia describes persistent anxiety in social situations, based on fear of embarrassment or ridicule. People with a social phobia become preoccupied with concern that other people will notice their anxious symptoms such as blushing, sweating, or trembling or that their mind will go blank when speaking to someone else. Like stage fright, social phobia causes intense fear when the person is aware that other people can observe him or her...

Group Interventions

In many posttrauma environments, group-administered early intervention activities are a staple element of care. This is especially true when (1) large numbers of persons are exposed to the same traumatic event (e.g., terrorist attacks, industrial accidents, mass violence, community disasters), (2) preexisting groups are exposed to trauma (e.g., a workplace exposed to a violent assault), and (3) workgroups are exposed to trauma as part of their job duties (e.g., military personnel, emergency response workers, police, forensic investigators). Groups would appear to be well-suited to challenging common distressing perceptions of survivors (e.g., feeling alone, different, misunderstood by those around them), reducing social isolation, and providing social support and may also be useful in helping survivors address the worries associated with traumas that are particularly difficult to talk about with family and friends (e.g., sexual assault), due to perceived social stigma, embarrassment...

Social Adjustment

Because the social environment is a major source of reinforcement, it is essential to identify the reward contingencies, role models, and contextual factors associated with alcohol or drug use. It should be recognized that the individual not only responds to the particular social environment but also seeks out an environment that has reinforcing value. Hence, during the course of the psychological assessment, an attempt should be made to learn why the substance abusing client seeks out social interactions that have maladaptive consequences.

Anxiety Disorders

Compared to depressive disorder, it is usually easier to determine whether or not an anxiety disorder is independent of alcohol use. For example, posttrau-matic stress disorder (PTSD) does require a specific traumatic event. Panic attacks are typically clearly recalled by individuals and are therefore easier to separate from possible anxiety symptoms that have resulted from alcohol use, intoxication, or withdrawal. There is a strong comorbidity between alcohol use disorders and anxiety disorders nearly 37 of individuals with alcohol dependence have met criteria for an anxiety disorder during the previous year. Generalized anxiety disorder accounts for 11.6 , panic disorder for 3.9 , and PTSD for 7.7 . Another way to appreciate these comorbidities is that the alcohol-dependent person is 4.6 times more likely to have generalized anxiety disorder, 2.2 times more likely to have PTSD, and 1.7 times more likely to have panic disorder than the non-alcoholic-dependent individual. The...

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