Thesis (M.A.)--State University of New York at New Paltz, 2006. / Also issued in electronic version. Includes bibliographical references (leaves 30-35). Online version available via the SUNY New Paltz Sojourner Truth Library : http://hdl.handle.net/1951/36491

Thesis (M.S.)--Florida State University, 2006. / Advisor: Gary Peterson, Florida State University, College of Education, Dept. of Educational Psychology and Learning Systems. Title and description from dissertation home page (viewed Sept. 15, 2006). Document formatted into pages; contains v, 64 pages. Includes bibliographical references.

Introdução O transtorno de ansiedade social (TAS) é um transtorno muito prevalente e incapacitante em crianças e adolescentes. Esse estudo foi delineado para avaliar a eficácia e a tolerabilidade de um inibidor seletivo da recaptação de serotonina altamente potente, o escitalopram, no tratamento do TAS em crianças e adolescentes. Métodos Vinte pacientes ambulatoriais com um diagnóstico principal de TAS foram tratados com escitalopram em um ensaio clínico aberto por 12 semanas. A medida de desfecho primária foi a mudança basal em comparação à final na Clinical Global Impression – Improvement Scale (CGI-I). As medidas de desfecho secundárias foram a CGI – Severity scale (CGI-S), a Social Phobia and Anxiety Inventory for Children (SPAI-C), a Screen for Child and Anxiety Related Emotional Disorders (SCARED) – Child and Parent version, e a The Youth Quality of Life Instument- Research Version (Y-QOL-R). Resultados Na escala CGI-I, 13 dos 20 pacientes (65%) tiveram um escore ≤ 2, correspondendo a uma resposta ao tratamento. Todas as medidas sintomáticas e de qualidade de vida mostraram melhoras significativas da avaliação basal à semana 12, com grandes tamanhos de efeito, variando de 0.9 a 1.9 (todos p < 0.01). O escitalopram foi geralmente bem tolerado. Conclusões Esses resultados sugerem que o escitalopram pode ser um tratamento eficaz e seguro no tratamento do TAS pediátrico. Futuros ensaios clínicos randomizados, placebo-controlados, fazem-se necessários. / Introduction Social anxiety disorder (SAD) is a highly prevalent and disabling disorder in children and adolescents. This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonergic reuptake inhibitor, escitalopram, in the treatment of SAD in children and adolescents. Methods Twenty outpatients with a primary diagnosis of SAD were treated in a 12-week open trial with escitalopram. The primary outcome variable was the change from baseline to endpoint in Clinical Global Impression – Improvement scale (CGI-I). Secondary efficacy measures included the CGI – Severity scale (CGI-S), the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Screen for Child and Anxiety Related Emotional Disorders (SCARED) – Child and Parent version, and The Youth Quality of Life Instument-Research Version (Y-QOL-R). Results On the CGI-I scale, 13 of 20 patients (65%) had a score ≤ 2, meaning response to treatment. All symptomatic and quality of life measures showed improvements from baseline to week-12, with large effect sizes ranging from 0.9 to 1.9 (all p < 0.01). Escitalopram was generally well-tolerated. Conclusion These results suggest that escitalopram may be an effective and safe treatment for pediatric SAD. Future placebo-controlled randomized clinical trials are warranted.

New technology provides the possibility of delivering exposure therapy for socially anxious individuals through virtual environments. This study investigated whether emotional responses and empathy can be experienced for virtual characters (avatars) and whether the evaluations differ depending on level of social anxiety. Six scenes depicting avatars interacting were created through the consumer story scripting software Plotagon and then replicated with real humans. 102 participants viewed the scenes and appraised their emotional response and level of empathy. Results revealed the avatars varied in ability to elicit positive emotions, yet were equally successful in the negative conditions. An association was found between high social anxiety and a more negative emotional response of the scenes with humans but not with avatars. In conclusion it was found possible to feel emotions and empathy for virtual characters in a manner somewhat similarly to that for humans.

Introdução O transtorno de ansiedade social (TAS) é um transtorno muito prevalente e incapacitante em crianças e adolescentes. Esse estudo foi delineado para avaliar a eficácia e a tolerabilidade de um inibidor seletivo da recaptação de serotonina altamente potente, o escitalopram, no tratamento do TAS em crianças e adolescentes. Métodos Vinte pacientes ambulatoriais com um diagnóstico principal de TAS foram tratados com escitalopram em um ensaio clínico aberto por 12 semanas. A medida de desfecho primária foi a mudança basal em comparação à final na Clinical Global Impression – Improvement Scale (CGI-I). As medidas de desfecho secundárias foram a CGI – Severity scale (CGI-S), a Social Phobia and Anxiety Inventory for Children (SPAI-C), a Screen for Child and Anxiety Related Emotional Disorders (SCARED) – Child and Parent version, e a The Youth Quality of Life Instument- Research Version (Y-QOL-R). Resultados Na escala CGI-I, 13 dos 20 pacientes (65%) tiveram um escore ≤ 2, correspondendo a uma resposta ao tratamento. Todas as medidas sintomáticas e de qualidade de vida mostraram melhoras significativas da avaliação basal à semana 12, com grandes tamanhos de efeito, variando de 0.9 a 1.9 (todos p < 0.01). O escitalopram foi geralmente bem tolerado. Conclusões Esses resultados sugerem que o escitalopram pode ser um tratamento eficaz e seguro no tratamento do TAS pediátrico. Futuros ensaios clínicos randomizados, placebo-controlados, fazem-se necessários. / Introduction Social anxiety disorder (SAD) is a highly prevalent and disabling disorder in children and adolescents. This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonergic reuptake inhibitor, escitalopram, in the treatment of SAD in children and adolescents. Methods Twenty outpatients with a primary diagnosis of SAD were treated in a 12-week open trial with escitalopram. The primary outcome variable was the change from baseline to endpoint in Clinical Global Impression – Improvement scale (CGI-I). Secondary efficacy measures included the CGI – Severity scale (CGI-S), the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Screen for Child and Anxiety Related Emotional Disorders (SCARED) – Child and Parent version, and The Youth Quality of Life Instument-Research Version (Y-QOL-R). Results On the CGI-I scale, 13 of 20 patients (65%) had a score ≤ 2, meaning response to treatment. All symptomatic and quality of life measures showed improvements from baseline to week-12, with large effect sizes ranging from 0.9 to 1.9 (all p < 0.01). Escitalopram was generally well-tolerated. Conclusion These results suggest that escitalopram may be an effective and safe treatment for pediatric SAD. Future placebo-controlled randomized clinical trials are warranted.

Introdução O transtorno de ansiedade social (TAS) é um transtorno muito prevalente e incapacitante em crianças e adolescentes. Esse estudo foi delineado para avaliar a eficácia e a tolerabilidade de um inibidor seletivo da recaptação de serotonina altamente potente, o escitalopram, no tratamento do TAS em crianças e adolescentes. Métodos Vinte pacientes ambulatoriais com um diagnóstico principal de TAS foram tratados com escitalopram em um ensaio clínico aberto por 12 semanas. A medida de desfecho primária foi a mudança basal em comparação à final na Clinical Global Impression – Improvement Scale (CGI-I). As medidas de desfecho secundárias foram a CGI – Severity scale (CGI-S), a Social Phobia and Anxiety Inventory for Children (SPAI-C), a Screen for Child and Anxiety Related Emotional Disorders (SCARED) – Child and Parent version, e a The Youth Quality of Life Instument- Research Version (Y-QOL-R). Resultados Na escala CGI-I, 13 dos 20 pacientes (65%) tiveram um escore ≤ 2, correspondendo a uma resposta ao tratamento. Todas as medidas sintomáticas e de qualidade de vida mostraram melhoras significativas da avaliação basal à semana 12, com grandes tamanhos de efeito, variando de 0.9 a 1.9 (todos p < 0.01). O escitalopram foi geralmente bem tolerado. Conclusões Esses resultados sugerem que o escitalopram pode ser um tratamento eficaz e seguro no tratamento do TAS pediátrico. Futuros ensaios clínicos randomizados, placebo-controlados, fazem-se necessários. / Introduction Social anxiety disorder (SAD) is a highly prevalent and disabling disorder in children and adolescents. This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonergic reuptake inhibitor, escitalopram, in the treatment of SAD in children and adolescents. Methods Twenty outpatients with a primary diagnosis of SAD were treated in a 12-week open trial with escitalopram. The primary outcome variable was the change from baseline to endpoint in Clinical Global Impression – Improvement scale (CGI-I). Secondary efficacy measures included the CGI – Severity scale (CGI-S), the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Screen for Child and Anxiety Related Emotional Disorders (SCARED) – Child and Parent version, and The Youth Quality of Life Instument-Research Version (Y-QOL-R). Results On the CGI-I scale, 13 of 20 patients (65%) had a score ≤ 2, meaning response to treatment. All symptomatic and quality of life measures showed improvements from baseline to week-12, with large effect sizes ranging from 0.9 to 1.9 (all p < 0.01). Escitalopram was generally well-tolerated. Conclusion These results suggest that escitalopram may be an effective and safe treatment for pediatric SAD. Future placebo-controlled randomized clinical trials are warranted.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Mental disorders have an important socio-economic impact on the world. Among the different types of mental disorders, anxiety ones are among the most prevalent, being that social anxiety disorder (SAD) stands out as one of the most limiting anxiety disorders for individuals and is associated with poor academic performance, which directly impacts university students. In addition, your treatment is still a challenge. Alternative treatments considered effective, such as meditation, are often inaccessible to lots of people, especially for students. An interesting alternative came in the attempt to resolve this issue, the Natural Stress Relief (NSR) meditation, via a simple and self-administered program, in a more accessible way. Therefore, the aims of this study were to evaluate the effect of NSR meditation on anxiety of university students with SAD. For that, we selected university students of both sexes, diagnosed with SAD by SPIN. The volunteers were allocated to one of two groups: NSR (n = 18) or Waiting list (n = 18). NSR group individuals performed two sessions per day of NSR meditation (15 min per session) during four weeks, in which first and last sessions were performed in the Laboratório de Fisiologia do Comportamento. Individuals belonging waiting list group did not practice any technique. All volunteers had their general symptoms of anxiety and social anxiety symptoms assessed by the hospital scale of anxiety and depression (HADS-A) and SPIN, respectively. Levels of state anxiety were also evaluated by the numerical tension scale (NTS), the state-trait anxiety inventory (STAI), and physiological indicators records (electromyographic gastrocnemius muscle activity, heart rate, temperature of extremity and skin conductance); and trait anxiety levels were assessed by the trait subscale of the STAI. In addition, One day after last session, volunteers were individually submitted to a social anxiety induction test. Data were analyzed by means of appropriate statistical tests. The results showed that the practice of NSR meditation reduced trait anxiety levels after four weeks (STAI-T); reduced weekly general anxiety symptoms (HADS-A) and social anxiety symptoms (SPIN); and reduced subjective levels of state anxiety (STAI-S and NTS) after the first and last session, but no changes were observed in the physiological indicators of anxiety. In addition, data analysis revealed that four weeks of meditative practice were not sufficient to prevent changes in levels of state anxiety (STAI-S, NTS and physiological indicators) elicited by a social anxiety induction test. At the end of the fourth week, most of NSR group volunteers were classified as presenting normal anxiety symptoms and were no longer categorized as presenting with SAD. Finally, this study showed the anxiolytic effect of NSR meditation in university students diagnosed with SAD according to SPIN. / Os transtornos mentais causam um importante impacto sócio-econômico no mundo. Dentre os diferentes tipos de transtornos mentais, os de ansiedade estão entre os mais prevalentes, sendo que o transtorno de ansiedade social (TAS) se destaca como um dos transtornos ansiosos mais limitantes para os indivíduos, sendo associado também a um baixo desempenho acadêmico, o qual impacta diretamente os estudantes universitários. Além disso, seu tratamento ainda é um desafio. Tratamentos alternativos considerados eficazes como a meditação são, muitas vezes, de difícil acesso para a população geral, em especial, para os estudantes. Na tentativa de resolver essa questão, surgiu a meditação Natural Stress Relief (NSR) como uma interessante alternativa, pois pode ser aprendida por um método simples, autoexplicativo e de baixo custo. Sendo assim, o objetivo do presente estudo foi avaliar o efeito da meditação NSR na ansiedade de estudantes universitários com TAS. Para tanto, foram selecionados estudantes universitários, de ambos os sexos, diagnosticados com TAS pelo inventário de fobia social (SPIN). Os voluntários foram alocados em um dos dois grupos: NSR (n = 18) ou Espera (n = 18). Os indivíduos do grupo NSR realizaram duas sessões por dia da meditação NSR (15 min por sessão), durante quatro semanas, sendo que a primeira e a última sessões foram realizadas no Laboratório de Fisiologia do Comportamento. Os indivíduos pertencentes ao grupo Espera não praticaram técnica alguma, mas realizaram os mesmos procedimentos que o grupo NSR. Todos os voluntários tiveram seus sintomas gerais de ansiedade e de ansiedade social avaliados a partir da escala hospitalar de ansiedade e depressão (HADS-A) e do SPIN, respectivamente. Também foram avaliados os níveis de ansiedade-estado a partir da escala numérica de tensão (ENT), do inventário de ansiedade traço/estado (IDATE) e de registros de indicadores fisiológicos (atividade eletromiográfica do músculo gastrocnêmio, frequência cardíaca, temperatura de extremidade e condutância da pele); e os níveis de ansiedade-traço a partir da subescala traço do IDATE. Além disso, no dia seguinte à última sessão, os voluntários foram individualmente submetidos a um teste de indução de ansiedade social. Os dados obtidos foram analisados por meio de testes estatísticos apropriados, sendo que os resultados mostraram que a prática da meditação NSR reduziu os níveis de ansiedade-traço após quatro semanas (IDATE-T); reduziu semanalmente os sintomas gerais de ansiedade (HADS-A) e os sintomas de ansiedade social (SPIN); e reduziu os níveis subjetivos de ansiedade-estado (IDATE-E e ENT) após a primeira e última sessão, no entanto, não foram observadas mudanças nos indicadores fisiológicos de ansiedade-estado. Além disso, a análise dos dados revelou que quatro semanas de prática meditativa não foram suficientes para prevenir as alterações nos níveis de ansiedade-estado (IDATE-E, ENT, indicadores fisiológicos) eliciadas por um teste de indução de ansiedade social. E ao final da quarta semana, a maioria dos voluntários do grupo NSR passaram a ser classificados como apresentando sintomas normais de ansiedade e deixaram de ser categorizados como apresentando o TAS. Por fim, este estudo mostrou o efeito ansiolítico da meditação NSR em estudantes universitários com diagnóstico do TAS de acordo com o SPIN.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-19T19:24:39Z No. of bitstreams: 1 deborapereirapaiva.pdf: 3487935 bytes, checksum: f76d26a3bf79c0cd09fcfcb0fb518ccc (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:23:38Z (GMT) No. of bitstreams: 1 deborapereirapaiva.pdf: 3487935 bytes, checksum: f76d26a3bf79c0cd09fcfcb0fb518ccc (MD5) / Made available in DSpace on 2016-09-26T20:23:38Z (GMT). No. of bitstreams: 1 deborapereirapaiva.pdf: 3487935 bytes, checksum: f76d26a3bf79c0cd09fcfcb0fb518ccc (MD5) Previous issue date: 2010-11-08 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A fobia social é definida como ansiedade clinicamente significativa provocada pela exposição a certos tipos de situações sociais ou de desempenho, freqüentemente levando ao comportamento de esquiva. A associação entre fobia social e alcoolismo é bem documentada na literatura recente, neste sentido, a dissertação de mestrado em questão teve como objetivo investigar a prevalência de fobia social entre pacientes internados em um Hospital de parceria pública na cidade de Juiz de Fora – MG. A população alvo constituiu-se de sujeitos, maiores de 18 anos, que estavam internados em decorrência de problemas relacionados ao consumo de álcool. Foram utilizados três instrumentos de pesquisa: Inventário de Ansiedade e Fobia Social (SPAI); Inventário de Ansiedade de Beck (BAI), cujo objetivo é avaliar a presença de sintomas ansiosos e o Teste para Identificação de problemas relacionados ao Uso de Álcool (AUDIT). Os resultados encontrados apontaram uma prevalência de provável fobia social em 13% da amostra, 23% da amostra apresentaram ansiedade grave e 14% ansiedade moderada. Com relação ao consumo de álcool, 81% da amostra apresentaram dependência de álcool e 11% uso nocivo. Os dados indicaram que 34% da amostra apresentam de um provável quadro de agorafobia. A agorafobia, diferente da fobia social, caracteriza-se por uma ansiedade acerca de estar em locais ou situações das quais escapar poderia ser difícil (ou embaraçoso) ou nas quais o auxílio pode não estar disponível. O estudo confirma a associação entre fobia social e dependência de álcool em 11% da amostra e chama atenção para a alta prevalência de agorafobia (34%). A associação entre ansiedade grave e alcoolismo foi encontrada em 23% da amostra. / Social phobia is defined as clinically significant anxiety provoked by exposure to certain types of social or performance situations, often leading to avoidance behavior. The association between social phobia and alcoholism is well documented in recent literature, in this sense, the dissertation in question aimed to investigate the prevalence of social phobia among patients admitted to a hospital public partnership in the city of Juiz de Fora - MG. The target population consisted of subjects aged over 18 years who were hospitalized due to problems related to alcohol consumption. We used three research instruments: Inventory of Social Phobia and Anxiety (SPAI), Beck Anxiety Inventory (BAI), whose objective is to assess the presence of anxiety symptoms and the Alcohol Use Disorders Identification Test (AUDIT). The results indicate a probable prevalence of social phobia in 13% of the sample, 23% had severe anxiety and 14% moderate anxiety. With respect to alcohol consumption, 81% had alcohol dependence and harmful use 11%. The data indicated that 34% of the sample has a likely part of agoraphobia. Agoraphobia, different from social phobia, is characterized by an anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available. The study confirms the association between social phobia and alcohol dependence in 11% of the sample and draws attention to the high prevalence of agoraphobia (34%). The association between severe anxiety and alcoholism was found in 23% of the sample.

Abstract The purpose of this study was to explore the development and course of social phobia by analysing qualitatively all the textual material obtained about the persons with treatment-resistant social phobia who, during the years 1995-2000, underwent a surgical procedure called endoscopic sympathetic block (ESB) to alleviate their phobic symptoms. In the other part of this study, the effect of this surgical procedure on social phobia was assessed quantitatively. The qualitative part of the study was based on the phenomenologic-existential philosophy and the principles of grounded theory. The qualitative analysis revealed four kinds of parenthood in the families of socially phobic persons: a violent, alcoholic type, a dominant type with high demands, a negligent type and a good enough type. A "vicious circle of social phobia" was formulated as a substantial category. The quantitative part of the study was an open, prospective follow-up study, where 169 patients operated on for social phobia during the years 1995–2000 were followed up for 5 years, and the changes in their symptoms were estimated using a modified version of Davidson's brief social phobia scale and the Liebowitz quality of life scale. The quantitative and qualitative parts of the study were linked together by investigating each person's family background with a semi-structured interview. According to variation analysis of the results, all symptoms of social phobia seemed to be alleviated highly significantly by ESB, and the results remained similar throughout the follow-up. Reflex sweating of the trunk was the only significant side effect. Overall satisfaction with the operation was estimated to be 3.5 on a five-point scale, representing the description "some help of the operation". Thus, ESB can be regarded as an additional treatment method for social phobia if traditional treatment with medication and psychotherapy has not provided any help for the patient.

This study examined several aspects of the anxiety program described in the Clark and Wells' (1995; Clark, 2001) cognitive model of social phobia, and provided information about the relationship between some of these variables. This study also examined the effect of social appraisals on cognition, affect, and self-protection. Positive and negative interpersonal appraisals were manipulated in 42 patients with social phobia and 42 community control participants. Participants then engaged in a social interaction with a confederate based on the reciprocity self-disclosure paradigm. Participants completed measures of cognitive appraisal, focus of attention, recall, affect, and self-disclosure. Personnel completed similar measures. Results revealed that, consistent with the cognitive model, individuals with social phobia displayed more self-focused attention, more negative affect, and more selfprotective behaviours, i.e. were less self-disclosive, than non-phobic control participants. There were no differences on the recall measure. The results suggested that it was possible to manipulate social appraisals. Interestingly, the largest discrepancy between participants with social phobia and controls occurred for self-disclosure in the positive social appraisal condition. The results also provided some clarification about the temporal sequence among the components of the anxiety program, and the role of self-focused attention in social phobia. / Arts, Faculty of / Psychology, Department of / Graduate