The Israel journal of psychiatry and related sciences, 2009
Social phobia (SP, or social anxiety disorder, SAD) is among the most common of all psychiatric d... more Social phobia (SP, or social anxiety disorder, SAD) is among the most common of all psychiatric disorders. SP typically begins early in life and provokes a great deal of impairment and reduction in quality of life. Despite its high prevalence and associated impact, SP has only recently become the focus of clinical research. We review the current CBT literature on SP, focusing on its main components, such as exposure, safety behaviors, cognitive restructuring, post-event processing, attentional retraining and social skills training. We suggest that although CBT for SP is effective, with effect sizes ranging from .6 to 2.6, much room for improvement remains. We conclude by reviewing some new and promising directions in the development of CBT for SP.
The Israel journal of psychiatry and related sciences, 2003
This review examines CBT as a leading evidence-based psychotherapy. It describes briefly the majo... more This review examines CBT as a leading evidence-based psychotherapy. It describes briefly the major components of CBT: exposure, reduction of safety behaviors, attention focus modification and cognitive restructuring. Specific CBT strategies suited for the main anxiety disorders are reported (specific phobias, panic disorder and agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder and post-traumatic stress disorder). The review emphasizes the efficiency of the use of CBT as a psychotherapeutic method in anxiety disorders. Finally, it points to the lack of the use of CBT in Israel and recommends its wide use in the mental health service here.
Musical hallucinations have been considered a rare manifestation of psychotic states or brain and... more Musical hallucinations have been considered a rare manifestation of psychotic states or brain and hearing abnormalities. However, an obsessive-compulsive disorder (OCD) assessment tool refers to musical hallucinations and our preliminary study showed that about one third of OCD patients experienced musical hallucinations. To elucidate the lifetime prevalence of musical hallucinations among psychotic and nonpsychotic psychiatric outpatients. Lifetime experience of musical hallucinations was examined with a specially designed structured interview in 190 consecutive outpatients with diagnoses of anxiety, affective, and schizophrenia disorders. Musical hallucinations occurred in more than one fifth of all diagnoses. The prevalence of musical hallucinations was highest in OCD patients (41%). Musical hallucinations were significantly more frequent with more comorbid disorders, and logistic regression revealed that this finding was mainly due to OCD combined with either social phobia or schizophrenia. Musical hallucinations are more common among psychiatric patients than previously reported and are more suggestive of OCD than of other mental disorders.
Body dysmorphic disorder falls under the category of obsessive-compulsive and related disorders, ... more Body dysmorphic disorder falls under the category of obsessive-compulsive and related disorders, yet research has suggested it may also be highly associated with social anxiety disorder. The current study examined body image variables among 68 outpatients with primary obsessive-compulsive disorder (OCD; n=22), social anxiety disorder (SAD; n=25), and panic disorder (PD; n=21). Participants filled out self-report measures of body image disturbance, attitudes toward one's appearance, and anxiety. Body image disturbance and attitudes toward appearance did not significantly differ between the groups. However, SAD symptoms predicted body image disturbance, Appearance Evaluation and Body Areas Satisfaction, and OCD symptoms predicted Appearance Orientation. These findings suggest that SAD and OCD may be associated with different facets of body image. Implications for the treatment of anxiety disorders and for future research are discussed.
ABSTRACT We examined cognitive behavior treatment (CBT) for social phobia (SP) in large groups (1... more ABSTRACT We examined cognitive behavior treatment (CBT) for social phobia (SP) in large groups (17-24 members) in a naturalistic setting. Individuals (n = 212) seeking treatment for SP in a large public clinic filled out self-report measures upon contacting the clinic (T1), at first session (T2, average 8.2 months after T1), immediately following treatment termination (T3), and 3 months after treatment termination (T4). The attrition rate was 5.7% from initial contact to treatment initiation, and an additional 30% during treatment. CBT for SP in large groups resulted in modest reductions in social anxiety (effect size = 0.55 for the entire sample, and 0.87 for completers). Clinically significant reductions in social anxiety during treatment were observed (30.0% during treatment vs. 10.2% during wait-list). Advantages and disadvantages of CBGT in large groups for social anxiety are discussed
Social phobia is a type of performance and interpersonal anxiety disorder and as such may be asso... more Social phobia is a type of performance and interpersonal anxiety disorder and as such may be associated with sexual dysfunction and avoidance. The aim of the present study was to evaluate sexual function and behavior in patients with social phobia compared with mentally healthy subjects. Eighty subjects participated in the study: 40 consecutive, drug-free outpatients with social phobia (DSM-IV) attending an anxiety disorders clinic between November 1997 and April 1999 and 40 mentally normal controls. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Liebowitz Social Anxiety Scale were used to quantitatively and qualitatively assess sexual function and behavior. Men with social phobia reported mainly moderate impairment in arousal, orgasm, sexual enjoyment, and subjective satisfaction domains. Women with social phobia reported severe impairment in desire, arousal, sexual activity, and subjective satisfaction. In addition, compared with controls, men with social phobia reported significantly more frequent paid sex (p < .05), and women with social phobia reported a significant paucity of sexual partners (p < .05). Patients with social phobia exhibit a wide range of sexual dysfunctions. Men have mainly performance problems, and women have a more pervasive disorder. Patients of both genders show difficulties in sexual interaction. It is important that clinicians be aware of this aspect of social phobia and initiate open discussions of sexual problems with patients.
The Israel journal of psychiatry and related sciences, 2009
Social phobia (SP, or social anxiety disorder, SAD) is among the most common of all psychiatric d... more Social phobia (SP, or social anxiety disorder, SAD) is among the most common of all psychiatric disorders. SP typically begins early in life and provokes a great deal of impairment and reduction in quality of life. Despite its high prevalence and associated impact, SP has only recently become the focus of clinical research. We review the current CBT literature on SP, focusing on its main components, such as exposure, safety behaviors, cognitive restructuring, post-event processing, attentional retraining and social skills training. We suggest that although CBT for SP is effective, with effect sizes ranging from .6 to 2.6, much room for improvement remains. We conclude by reviewing some new and promising directions in the development of CBT for SP.
The Israel journal of psychiatry and related sciences, 2003
This review examines CBT as a leading evidence-based psychotherapy. It describes briefly the majo... more This review examines CBT as a leading evidence-based psychotherapy. It describes briefly the major components of CBT: exposure, reduction of safety behaviors, attention focus modification and cognitive restructuring. Specific CBT strategies suited for the main anxiety disorders are reported (specific phobias, panic disorder and agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder and post-traumatic stress disorder). The review emphasizes the efficiency of the use of CBT as a psychotherapeutic method in anxiety disorders. Finally, it points to the lack of the use of CBT in Israel and recommends its wide use in the mental health service here.
Musical hallucinations have been considered a rare manifestation of psychotic states or brain and... more Musical hallucinations have been considered a rare manifestation of psychotic states or brain and hearing abnormalities. However, an obsessive-compulsive disorder (OCD) assessment tool refers to musical hallucinations and our preliminary study showed that about one third of OCD patients experienced musical hallucinations. To elucidate the lifetime prevalence of musical hallucinations among psychotic and nonpsychotic psychiatric outpatients. Lifetime experience of musical hallucinations was examined with a specially designed structured interview in 190 consecutive outpatients with diagnoses of anxiety, affective, and schizophrenia disorders. Musical hallucinations occurred in more than one fifth of all diagnoses. The prevalence of musical hallucinations was highest in OCD patients (41%). Musical hallucinations were significantly more frequent with more comorbid disorders, and logistic regression revealed that this finding was mainly due to OCD combined with either social phobia or schizophrenia. Musical hallucinations are more common among psychiatric patients than previously reported and are more suggestive of OCD than of other mental disorders.
Body dysmorphic disorder falls under the category of obsessive-compulsive and related disorders, ... more Body dysmorphic disorder falls under the category of obsessive-compulsive and related disorders, yet research has suggested it may also be highly associated with social anxiety disorder. The current study examined body image variables among 68 outpatients with primary obsessive-compulsive disorder (OCD; n=22), social anxiety disorder (SAD; n=25), and panic disorder (PD; n=21). Participants filled out self-report measures of body image disturbance, attitudes toward one's appearance, and anxiety. Body image disturbance and attitudes toward appearance did not significantly differ between the groups. However, SAD symptoms predicted body image disturbance, Appearance Evaluation and Body Areas Satisfaction, and OCD symptoms predicted Appearance Orientation. These findings suggest that SAD and OCD may be associated with different facets of body image. Implications for the treatment of anxiety disorders and for future research are discussed.
ABSTRACT We examined cognitive behavior treatment (CBT) for social phobia (SP) in large groups (1... more ABSTRACT We examined cognitive behavior treatment (CBT) for social phobia (SP) in large groups (17-24 members) in a naturalistic setting. Individuals (n = 212) seeking treatment for SP in a large public clinic filled out self-report measures upon contacting the clinic (T1), at first session (T2, average 8.2 months after T1), immediately following treatment termination (T3), and 3 months after treatment termination (T4). The attrition rate was 5.7% from initial contact to treatment initiation, and an additional 30% during treatment. CBT for SP in large groups resulted in modest reductions in social anxiety (effect size = 0.55 for the entire sample, and 0.87 for completers). Clinically significant reductions in social anxiety during treatment were observed (30.0% during treatment vs. 10.2% during wait-list). Advantages and disadvantages of CBGT in large groups for social anxiety are discussed
Social phobia is a type of performance and interpersonal anxiety disorder and as such may be asso... more Social phobia is a type of performance and interpersonal anxiety disorder and as such may be associated with sexual dysfunction and avoidance. The aim of the present study was to evaluate sexual function and behavior in patients with social phobia compared with mentally healthy subjects. Eighty subjects participated in the study: 40 consecutive, drug-free outpatients with social phobia (DSM-IV) attending an anxiety disorders clinic between November 1997 and April 1999 and 40 mentally normal controls. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Liebowitz Social Anxiety Scale were used to quantitatively and qualitatively assess sexual function and behavior. Men with social phobia reported mainly moderate impairment in arousal, orgasm, sexual enjoyment, and subjective satisfaction domains. Women with social phobia reported severe impairment in desire, arousal, sexual activity, and subjective satisfaction. In addition, compared with controls, men with social phobia reported significantly more frequent paid sex (p < .05), and women with social phobia reported a significant paucity of sexual partners (p < .05). Patients with social phobia exhibit a wide range of sexual dysfunctions. Men have mainly performance problems, and women have a more pervasive disorder. Patients of both genders show difficulties in sexual interaction. It is important that clinicians be aware of this aspect of social phobia and initiate open discussions of sexual problems with patients.
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