What is it?
Social Anxiety Disorder is a combination of 5 things.
1. A consistent and constant fear of social situations with people who are unfamiliar or who they feel will ridicule them. This person feels that their actions will result in humiliation or embarrassment.
2. Being in these feared situations will cause anxiety which may show itself in many forms including crying, freezing, or shying away from uncomfortable social situations.
3. Adults and teens have the ability to recognize their actions as illogical and unnecessary.
4. Social situations that are feared and produce these symptoms are avoided or else suffered through with much stress and agony.
5. The anticipation of the anxiety and embarrassment felt due to their fear of public and social situations result in encumbrance of accomplishment in school, ability to perform, daily routines, etc.
Social Anxiety Disorder is caused by a combination of genetics and environment. Genetically, Social Anxiety Disorder can be passed down from any anxiety disorder of a parent. It does not have to be specifically Social Anxiety. Environmentally, anything can cause social anxiety disorder from abuse to speech and language issues to disfiguring diseases or even traumatizing past social situations.
Selective Mutism is a more sever form of Social Anxiety Disorder where children are unable to talk in social settings but very verbal with close family and friends.
What is the incidence?
14% of Adults and .1% (or 1 in every thousand) children
- Can be seen as soon as 1 year old.
How can it be treated in school age children?
Social Anxiety Disorder has 2 treatments: Behavior Modification or Medication.
Behavior Modification:
Exposure to new and feared social situations is the first step in treatment. Understand that your student will need to do this in baby steps so as not to overwhelm them with anxiety. If a child is afraid to get involved in drama because of fear of talking in front of crowds, he or she may start by talking to one person he or she does not know and gradually move to performing for this person. Then increase to two, and so on until the student builds confidence in self to perform for a group he or she knows. Then, begin adding one stranger at a time to this audience until comfort allows for uninhibited activity.
The other part of Behavior Modification is preventing the known response to the distress-driving situation. Although this has proven to be very difficult, it is indeed possible. Use a reward system when the unwanted response is delayed in the beginning, and gradually move the student to rewards for completely avoiding the stress response.
These treatments have worked well in adults, however, have not been proven in children. They take a lot of motivation and patience. When people have successfully overcome social anxiety, the result is a renewed and overwhelming feeling of accomplishment.
Medication:
Serotonin Reuptake Inhibitors: Of the SRIs,the only tested and proven medications that work in children for social anxiety disorder would be Prozac and Luvox. The side effects of these drugs are restlessness, insomnia, nausea, diarrhea, and behavioral disinihibition ( silliness, uncharacteristic outbursts, etc.). These medications react severely to other drugs and must be monitored closely. Doctors should be consulted when any other medication (even over the counter) is being given to a child on these medications. Although these drugs require less motivation, they take longer to work and are expensive.
Prognosis?
For all drug groups, the drug is usually taken for 6-12 months before it is tapered off. If relapse occurs once off medications, a new round can be commenced. For most cases of children, improvement will be seen with one of the above drugs, a combination of 2 of the above drugs, behavior modification, or a combination of the three. For each child, the treatment may differ in effectiveness. It is important that the psychologist who is working with the child create a unique combination of treatments to best benefit the child in question.
Sources:
http://www.klis.com/chandler/pamphlet/socphob/socphobpamphlet.htm#about
http://www.klis.com/chandler/pamphlet/socphob/socphobpamphlet.htm#treatment
http://socialanxiety.factsforhealth.org/
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