Social anxiety disorder and generalized anxiety disorder: Serotonergic and dopaminergic neurocircuitry

Awareness that an amygdala-based fear circuit plays a crucial role in mediating fear conditioning as well as anxiety symptoms is growing. The efficacy of selective serotonin reuptake inhibitors in certain anxiety disorders has been argued to reflect their ability to modulate this circuit. Whether additional neurocircuits play a differentiating role in specific anxiety disorders, such as social anxiety disorder and generalized anxiety disorder (GAD), is an ongoing subject of investigation. A review of the literature suggests that in social anxiety disorder, dopaminergically mediated striatal circuits may also be important, while in GAD, there may be abnormalities of prefrontal areas. Future work will undoubtedly clarify how genetic and environmental factors interact to fashion the neurocircuitry that mediates anxiety symptoms.Conference Pape

Social anxiety disorder in DSM-5

With the publication of DSM-5, the diagnostic criteria for social anxiety disorder (SAD, also known as social phobia) have undergone several changes, which have important conceptual and clinical implications. In this paper, we first provide a brief history of the diagnosis. We then review a number of these changes, including (1) the primary name of the disorder, (2) the increased emphasis on fear of negative evaluation, (3) the importance of sociocultural context in determining whether an anxious response to a social situation is out of proportion to the actual threat, (4) the diagnosis of SAD in the context of a medical condition, and (5) the way in which we think about variations in the presentation of SAD (the specifier issue). We then consider the clinical implications of changes in DSM-5 related to these issues

Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale

Item does not contain fulltextObjective: This study examined whether the self-report version of the Liebowitz Social Anxiety Scale (LSAS-SR) could accurately identify individuals with social anxiety disorder and individuals with the generalized subtype of social anxiety disorder. Furthermore, the study sought to determine the optimal cutoffs for the LSAS-SR for identifying patients with social anxiety disorder and its generalized subtype. Methods: Two hundred and ninety-one patients with clinician-assessed social anxiety disorder (240 with generalized social anxiety disorder) and 53 control participants who were free from current Axis-1 disorders completed the LSAS-SR. Results: Receiver Operating Characteristic analyses revealed that the LSAS-SR performed well in identifying participants with social anxiety disorder and generalized social anxiety disorder. Consistent with Mennin et al.'s [2002: 1 Anxiety Disord 16:661-673] research on the clinician-administered version of the LSAS, cutoffs of 30 and 60 on the LSAS-SR provided the best balance of sensitivity and specificity for classifying participants with social anxiety and generalized social anxiety disorder; respectively. Conclusions: The LSAS-SR may be an accurate and cost-effective way to identify and subtype patients with social anxiety disorder, which could help increase the percentage of people who receive appropriate treatment for this debilitating disorder