Social Anxiety Disorder (SAD) - Pathophysiology 

Excessive fear of one or more social situations

 • Safety Behaviors and Avoidance - Control or limit one's experience of a social situation (fear maintenance not elimination)

 • Negative Biases - Interpret neutral or positive social interactions negatively: negative self evaluations and perceived negative evaluations by others.

 • Unrealistic Standards of Performance - Overestimate likelihood of being negatively evaluated by others

 • Activation of Autonomic Nervous System & HPA axis - In response to social situations/thoughts

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 • Drug and Alcohol Abuse - Substances may be used to reduce social anxiety

 • Impairment of academic, occupational, and/or social functioning

 • Behavioral Symptoms: Panic Attacks, avoidance

 • Cognitive Symptoms of Anxiety: Mind going blank, difficulty speaking, loss of concentration, depersonalization, derealization

 • Physical Symptoms of Anxiety: Blushing, trembling, heart palpitations, muscle tension, diaphoresis, shortness of breath, dry throat, hot or cold flashes, headaches, nausea, dizziness, insomnia



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