Parental psychopathology and unfavorable family environment are established risk factors for onset of offspring social phobia (SP), but their associations with the further course, e.g., persistence of the disorder, remain understudied. A community cohort of 1395 adolescents and their parents was followed-up over almost 10 years using the DIA-X/M-CIDI. Parental diagnostic interviews were supplemented by family history data. Parental rearing was retrospectively assessed by the Questionnaire of Recalled Parental Rearing Behavior in offspring, and family functioning by the Family Assessment Device in parents. Persistence measures (proportion of years affected since onset) were derived from diagnostic interviews, using age of onset, age of recency, and course information. Lack of emotional warmth and dysfunctional family functioning characteristics were associated with higher SP persistence, particularly in interaction with parental psychopathology. Predictors for SP persistence differ from those predicting SP onset. Unfavorable family environment alone and in interaction with parental disorders predict higher SP persistence.

Although clinical hypnosis has been studied in a variety of ways, most of the research has focused on individual and evidence-based approaches; few have examined relational or systemic models. Influenced by Milton Erickson’s hypnosis methods and Gregory Bateson’s systemic concepts, relational hypnotherapists value the importance of both the intra- and interpersonal context in the treatment of problems, accentuating the significance of the mind and body connection (or relationship) in inviting non-volitional therapeutic change. The author of this research explored how Douglas Flemons, the developer of relational hypnosis, facilitated an enduring non-volitional shift with a client, “Grace,” who desired to have a baby but could not see or talk about blood, needles, or medical procedures without fainting. Using context-enriched conversation analysis (CECA), the author embraced his theoretical understanding of relational hypnosis as a guide to examine multiple sources of data, which included selected audio-recorded excerpts from Douglas and Grace’s hypnotherapeutic sessions; Grace’s descriptions of change in her email correspondence with Douglas; and Douglas’s case notes. Although there were a total of eight sessions, the author’s analysis revealed that the most influential and significant moments occurred during the first two sessions. Douglas’s initial interventions, or as he would say, intraventions, laid the foundation for a shift in Grace’s identity, which helped her embrace a variety of resourceful skills and attributes to overcome her problem. The author also discussed the clinical and research implications for relational hypnosis, brief and family therapy, and psychotherapy in general.

Die vorliegende Studie untersuchte emotionale Reaktionen im Experimentaldesign einer aversiven, differentiellen klassischen Konditionierung (CS = zwei männliche, neutral valente Gesichter; olfaktorischer UCS = vergorene Hefe) bei je vierzehn männlichen generalisierten Sozialphobikern (DSM-VI) und gesunden Kontrollpersonen. In Erwartung einer erhöhten Konditionierbarkeit, einer Extinktionsresistenz sowie einer Generalisierung auf störungsrelevante Fazialreize bei den Sozialphobikern wurden die konditionierten Reaktionen über subjektiv-verbale Urteile (Valenz, Erregung, Kontingenz), den Schreckreflex (M. orbicularis oculi links, Indikator subcorticaler Reizverarbeitung der Angst), die bilateral erhobene Aktivität des M. corrugator supercilii (Indikator für den negativ emotionalen Fazialausdruck) sowie die Herzrate (Indikator der allgemeinen psychophysiologischen Aktivierung) gemessen. Die Konditionierung verlief in beiden Experimentalgruppen erfolgreich (Valenz, Erregung, Kontingenz) und hypothesenkonform. Im Gegensatz zu den Gesunden resultierten für die Sozialphobiker eine erhöhte Konditionierbarkeit (Schreckreflexlatenz und -amplitude, Herzratendezeleration), eine Extinktionsresistenz (Erregung, Schreckreflexnullreaktionen, Corrugator) sowie eine Reizgeneralisierung (Erregung, Kontingenz, Schreckreflexlatenz, Corrugator, Herzratendezeleration). Die Befunde sprechen außerdem für eine unterschiedliche emotionale Reizverarbeitung über den Experimentalverlauf. Die Sozialphobiker reagierten in der Akquisition vorrangig in den Parametern Erregung, Kontingenz, Schreckreflex und Herzrate (Gesunde: Corrugator) sowie in der Extinktion hinsichtlich Erregung, Schreckreflex und Corrugator (Gesunde: Kontingenz). Das Valenzurteil ergab hingegen keine Gruppenspezifik. / The present study investigated the emotional responses of aversive differential Pavlovian conditioning with two male neutral faces as conditioned stimuli (CS) and a foul odor (fermented yeast) as unconditioned stimulus (UCS) in fourteen male generalized social phobics (DSM-VI) and healthy controls. The aim of this investigation was to examine the hypotheses of enhanced acquisition, delayed extinction and generalization of faces, as they represented socially relevant stimuli, concerning social phobics. Subjective indicators of conditioned response were valence, arousal and awareness. The startle reflex (recorded from left m. orbicularis oculi) was used as a measure of subcortical emotional processing. Bilaterally corrugator muscle activity (as an indicator of negative emotional facial response) and heart rate (as an indicator of general physiological activation) served as psychophysiological assessment of conditioning. Both groups were successfully conditioned as reflected by differential responses of all three subjective parameters. The results were consistent with the hypotheses. Compared to controls, social phobics showed an increased acquisition (startle latency and magnitude, heart rate deceleration), an extinction resistance (arousal, startle zero reactions, corrugator) as well as a generalization of CS types (arousal, awareness, startle latency, corrugator, heart rate deceleration). In addition the findings suggested that the emotional stimuli processing in participants are distinct. The social phobics in particular reacted to arousal, contingency awareness, startle and heart rate in acquisition (controls: corrugator) and to arousal, startle and corrugator in extinction (controls: awareness). There was no difference between groups regarding valence judgement.

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Background. To examine the role of parental psychopathology and family environment for the risk of social anxiety disorder (SAD) in offspring from childhood to early adulthood, covering an observational period of 10 years. Method. A community sample of 1,395 adolescents (aged 14 to 17 years at baseline) was prospectively followed-up over the core high risk period for SAD onset. DSM-IV offspring and parental psychopathology was assessed using the Munich-Composite International Diagnostic Interview; direct diagnostic interviews in parents were supplemented by family history reports from offspring. Parental rearing was assessed by the Questionnaire of Recalled Rearing Behavior in offspring, family functioning by the McMaster Family Assessment Device in parents. Results. Parental SAD was associated with the offspring’s risk to develop SAD (OR = 3.3, 95%CI: 1.4-8.0). Additionally, other parental anxiety disorders (OR = 2.9, 95%CI: 1.4-6.1), depression (OR = 2.6, 95%CI: 1.2-5.4) and alcohol use disorders (OR = 2.8, 95%CI: 1.3-6.1) were associated with offspring SAD. Offspring’s reports of parental overprotection, rejection and lack of emotional warmth, but not parental reports of family functioning were associated with offspring SAD. Analyses of interaction of parental psychopathology and parental rearing indicated combined effects on the risk for offspring SAD. Conclusions. These findings extend previous results in showing that both parental psychopathology and parental rearing are consistently associated with the risk for offspring SAD. As independent and interactive effects of parental psychopathology and parental rearing may have already manifested in early adolescence, these factors appear crucial and promising for targeted prevention programs.

Erythrophobie wird als klinische Bezeichnung für die Angst zu erröten verwendet, wenn das Einzelsymptom Erröten im Vordergrund einer Angstproblematik steht. Die vorliegende Übersicht beruht auf einer umfangreichen Literaturrecherche und wird ergänzt durch eigene klinische Beobachtungen aus einer Pilotstudie zur kognitiv-behavioralen Gruppentherapie der Errötungsangst. Wir referieren den aktuellen Kenntnisstand zu Erythrophobie in Bezug auf die differentialdiagnostische Einordnung, auf ätiologische und pathogenetische Konzepte sowie auf die Verhaltenstherapie der Störung. Insgesamt zeigt die Übersicht, dass Erythrophobie am sinnvollsten als Subsyndrom der Sozialen Phobie beschrieben werden kann. Patienten mit Errötungsangst als Hauptbeschwerde unterscheiden sich jedoch von anderen Patienten mit Sozialer Phobie im Hinblick auf Behandlungsanliegen, Inanspruchnahmeverhalten, Behandlungserwartung und Therapieziele sowie durch spezifische aufrechterhaltende Mechanismen der Störung, insbesondere durch eine übertriebene und inflexible Aufmerksamkeitsfokussierung auf körperliche Symptome. Der Einsatz eines Aufmerksamkeitstrainings als spezifisches Behandlungsmodul bei Errötungsangst ist vielversprechend und sollte in bekannte Ansätze zur Therapie der Sozialen Phobie integriert werden. Abschließend werden Impulse für weiterführende Forschungsaktivitäten skizziert. / Erythrophobia is the pathological form of fear of blushing. This review is based upon an extensive literature research and supplemented by clinical observations from a pilot study of a cognitive-behavioural group therapy for fear of blushing. Current knowledge about fear of blushing is reported regarding diagnostic considerations, aetiologic and pathogenetic mechanisms, and cognitive-behavioural therapy. In conclusion, this review indicates that fear of blushing should be classified as a sub-syndrome of social phobia. Patients suffering from fear of blushing as predominant complaint differ from other patients with social phobia in health-care utilisation, treatment expectation and treatment goals. However, the most prominent difference lies in the exaggerated and inflexible self-focused attention these patients direct to their arousal and bodily symptoms. Therefore, attention training as a specific treatment unit is promising and should be integrated in standard treatment approaches for social phobia. Finally, options for further research are outlined. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

[pt] O medo de voar é um problema real que afeta entre 10 porcento e 25 porcento da população mundial. Aproximadamente 25 porcento da população adulta experimenta um aumento significativo nos níveis de ansiedade ao serem solicitados a usar algum meio de transporte aéreo, e destes, 10 porcento evitam a situação. O tratamento que se mostrou mais efetivo no tratamento de fobias é a exposição in vivo. Porém, a dificuldade e o custo, e muitas vezes até o perigo, de usar aviões e voos reais para expor pessoas com medo de voar a esses estímulos assustam muitos pesquisadores, terapeutas e pacientes apesar da prevalência e do impacto do medo de voar. Neste trabalho é apresentada uma aplicação de realidade virtual que visa prover uma exposição sistemática a estímulos causadores de ansiedade relacionados ao medo de voar através de ambientes gerados por computador. Esta aplicação utiliza o conceito de imersão através do Oculus Rift, para prover uma experiência praticamente real aos pacientes. Para avaliar a aplicação proposta, em especial o sentimento de presença causado por ela, foram obtidos dados qualitativos a partir de entrevistas e questionários com seus meta-usuários, i.e., os psiquiatras que aplicarão o tratamento nos pacientes. / [en] Fear of flying is a real problem that affects 10 percent to 25 percent of the world s population. Approximately 25 percent of adults experience a significant increase in their anxiety levels when required to take any type of air transport and 10 percent of them avoid the situation. The approach that has proven to be the most effective in the treatment of phobias is in vivo exposure. However, the difficulty and the cost, and sometimes even the danger, of using real airplanes and real flights to expose people with fear of flying to these stimuli have daunted many researchers, therapists, and patients despite the prevalence and the impact of the fear of flying. We present in this study a virtual reality application that promotes a systematic exposure to the stimuli that causes significant increase in anxiety levels related to fear of flying through computer generated environments. This application uses the concept of immersion through the Oculus Rift to promote an almost real experience to the patients. To evaluate the proposed application, in special the sense of presence caused by it, we obtained qualitative data from interviews and questionnaires with its meta-users, i.e., the psychiatrists that will apply the treatment to their patients.

Anxiety disorders are among the most commonly diagnosed class of mental illness in the United States, and often involve abnormally high levels of stress and social fear. Despite high lifetime prevalence rates, social anxiety disorder (SAD) has remarkably low diagnosis and treatment rates. Furthermore, while individuals with other specific psychiatric disorders tend to exhibit significant neuropsychological deficits, neuropsychological functioning in individuals with SAD remains largely untested. A majority of the few existing studies concerning neuropsychological performance in SAD samples focus on specific functions, and their limited results are highly mixed. The primary objective of this investigation was to provide a more thorough, broad assessment of both auditory and visual working memory as related to psychometrically-defined social anxiety disorder. In addition, this study aimed to help clarify as to whether such deficits are related to the construct of social anxiety, or whether any potential deficits are better explained by generalized state and/or trait (in-the-moment) anxiety. The implications of a deficit in the visual and/or auditory working memory domains are multifaceted. For example, such a deficit may lead to the inability to detect visual cues in social situations. The inability to process these social cues has the potential to exacerbate some SAD- related symptoms, such as fear of humiliation and judgment. Twenty-nine college students completed both phases of this study, including an assessment of state and trait anxiety as well as social phobia and a four-part working memory battery. An analysis of the Phase II data indicates that individual scores on the four measures of both visual and auditory working memory did not relate to trait and/or state anxiety or psychometrically-defined social anxiety.; Thus, it appears that social, generalized trait, and generalized state anxiety do not relate to a neuropsychological deficit in either type of working memory in this sample population. However, we did find a statistical trend suggesting that as social anxiety increased, there was a relative decrease in visual vs. auditory working memory. This statistical trend remained after covarying for state and trait anxiety respectively. Therefore, future research in this area should examine the discrepancy in performance between the auditory and visual working memory domains as it relates to both diagnosed social phobia and psychometrically-defined social anxiety.

The object of the study was the fears of younger students. The subject of the study was the means of correcting fears in primary school children with the help of the developed methodological program. Master's thesis consists of an introduction, two chapters, conclusion, bibliography (65 sources). The volume of the master's thesis 71 pages, which contains 14 figures and 12 tables. In conclusion, the results of the theoretical and empirical parts of the work, as well as the conclusions on the hypotheses put forward, the practical significance of the study and the possible prospects for further development of this problem are presented in a generalized form. / Объектом исследования явились страхи у младших школьников. Предметом исследования стали средства коррекции страхов у младших школьников с помощью разработанной методической программы. Магистерская диссертация состоит из введения, двух глав, заключения, списка литературы (65 источника). Объем магистерской диссертации 71 страница, на которых размещены 14 рисунка и 12 таблиц. Во введении раскрывается актуальность проблемы исследования, разработанность проблематики, ставится цель и задачи исследования, определяются объект и предмет исследования, формулируются основная и дополнительные гипотезы, указываются методы и эмпирическая база. В заключении в обобщенном виде изложены результаты теоретической и эмпирической частей работы, а также выводы по выдвинутым гипотезам, обоснована практическая значимость исследования и описаны возможные перспективы дальнейшей разработки данной проблематики.

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