Social Phobia Workup
- Author: Bettina E Bernstein, DO; Chief Editor: Eduardo Dunayevich, MD more...
Basic laboratory studies are prudent to detect contraindications to medication treatment, as well as to screen for comorbid conditions such as anemia, low ferritin levels (especially in the presence of a sleep disorder), and hypothyroidism. Such studies might include a serum CBC count with differential, an electrolyte evaluation, liver function tests, and thyroid function tests.
Neither single-photon emission computed tomography (SPECT) nor functional MRI (fMRI) is clinically helpful in the diagnosis or treatment response in individuals with social phobia. However, these techniques are useful for excluding structural brain disease (tumor or infection). These techniques are also being used investigationally in research protocols; it has been shown that social anxiety is a different disorder from generalized anxiety disorder in terms of symptomology and brain structure.
Cognitive distortions and self-monitoring in social situations result in hyperawareness of internal cues and intense arousal to the perceived negative aspects of social interactions. Studies have shown that the fear associated with the hyperawareness may be decreased or not occur at all with lesions in the area of the amygdala.
During adolescence, brain changes may increase risk for development of social anxiety disorder due to increased insular sensitivity to negative reward prediction error processing.
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