1. Analyze etiologies (in terms of biological, cognitive,
and/or sociocultural factors) of two disorders.
Social Anxiety Disorder (SAD) and Depression
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2. Anxiety Disorders
• one of the most common psychiatric disorders; prevalence of anxiety
disorders from 87 studies across 44 countries show a prevalence range
between 0.9% and 28.3% (Baxter AJ, Scott KM, Vos T, Whiteford HA
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3. Social Anxiety Disorder: Symptoms
• excessive blushing
• sweating
• trembling
• palpitations (rapid or irregular heartbeat due to stress or tension)
• nausea
• stammering and/or rapid speech
• panic attacks
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4. Social Anxiety Disorder:
BLOA Etiology
• Hypersensitive amygdala:
Furmark et al. (2004) found that social phobia
patients with a short allele of the serotonin
transporter polymorphism had greater
amygdala responses during public speaking
than ones with long alleles.
• Other parts: media prefrontal
cortex, insular cortex, stratium
• Jerome Kagan (Harvard) found
evidence that people are born
with SAD.
• “Exact neuroanatomical region
that stores fear memory traces,
or the exact role of a particular
process still debated”
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5. Social Anxiety Disorder:
CLOA Etiology
• previous negative social experience can trigger already existing genetic
predisposition
• secondary experience such as hearing or observing negative experiences of others
can also contribute to social anxiety
• Sternberg et al. (1995), Beidel and Turner (1998)
• There are “core” or “unconditional” negative beliefs and “conditional beliefs”. These
develop according to personality, and anxiety interferes with social performance which creates more social
problems, strengthening the schema.
• Are these factors simply a result of the biological factors or can certain experience
cause SAD to anyone?
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6. Social Anxiety Disorder:
SCLOA Etiology
• society’s attitude towards shyness and avoidance (Refer to Hoffmann with Uncertainty
Avoidance measurements across cultures)
• parenting across culture: American children more likely to develop SA if their parents emphasize
importance of others’ opinions (Leung et al, 1994). Chinese children, on the other hand, are more accepted by
their peers if they are shy-inhibited.
• emphasis on assertiveness and competitiveness is making social anxiety
problems more common
• The family unit is the first social structure the child receives from birth. Parenting is then a big part of SAD, and
cultural considerations or the way parents implement them can cause SAD.
• With globalization, are we going down the path towards a society with more prevalence of SAD?
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7. Depression
• affects around 15% of people at some time in their life (Charney and
Weismann 1988)
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8. Depression: Symptoms
• insomnia
• aches and pain that have no
physical explanation
• appetite disturbances
• lethargy and lack of energy
• feelings of worthlessness
• thoughts of suicide
• difficulty concentrating
• irritability or anxiety
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9. Depression: BLOA Etiology
• Nurnberger and Gershon (1982)
found that the concordance rate for
major depressive disorder was
consistently higher for MZ twins
than for DZ twins.
• This seems to support the
hypothesis that genetics play a role
in the prevalence of depression,
and that biological factors strongly
dictate if one will have depression.
• Researcher Duenwald (2003)
claimed that a short variant of the
5-HTT gene may be associated
with a higher risk of depression.
• However, Caspi et al. (2003) says
that genetic factors might only play
a part in controlling the responses
to environmental factors.
• The data might also be simply
correlational and show no causal
relation.
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10. Depression: BLOA Etiology
• Catecholamine hypothesis
(Schildkraut, 1965) is about low
levels of noradrenaline. This has
been developed into the “serotonin
hypothesis”. Low levels of
adrenaline might result into
depression.
• Rampello et al. (2000) claims
imbalance of neurotransmitters
such as noradrenaline, serotonin,
dopamine, and acetylcholine are
present with patients.
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• Cortisol Hypothesis: higher levels of
this stress hormone may lower
density of serotonin receptors and
impair function of receptors for
noradrenaline.
• Again, this data can simply be
correlational and there shows no
clear causal relationship.
• Researchers such as Burns (2003)
or Lacasse and Leo (2005) criticize
these causes as reductionist and a
leading factor to the use of drugs.

11. Depression: CLOA Etiology
• Irrational and illogical thinking results
into depression. People may have
unrealistic expectations or false
conclusions. (Ellis, 1962).
• Beck (1976) based a theory on
cognitive distortions and biases in
information processing. The schema
processing of these patients may
include overgeneralization based on
negative events, non-logical inference
about the self, and dichotomous
thinking. Depressed patients’
attributional style, and pessimism.
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• It is clear that people with depression
do not think as “normal people” do.
There is a pattern of thinking that leads
to unrealistic or pessimistic perception
of the world.
• We do not know if that is a symptom
or a cause of depression.
• Establishing something as a “norm”
goes back to Jahoda’s set of
characteristics. It may not be accurate.

12. Depression: SCLOA Etiology
• Brown and Harris (1978): a
vulnerability model of depression
including life events such as lacking
employment away from home,
absence of social support, having
several young children at home, lost of
mother at an early age, or history of
childhood abuse.
• WHO (1983) found universal
symptoms between sad affect, loss of
enjoyment, anxiety, tension, lack of
energy, loss of interest, inability to
concentrate, and ideas of insufficiency,
inadequacy, and worthlessness
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• Prince (1968) claimed that there was
no depression in Africa and various
regions of Asia, but found that rates of
reported depression rose with
westernization in the former colonial
countries.
• Different societies may expression
depression differently, making it
complicated to judge causes across
the world or record depressive rates.

13. Depression: Diathesis-stress Model
• interactionist approach to explain
psychological disorders, saying that
depression may be the result of a
hereditary predisposition, with
precipitating events in the
environment.
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14. Discuss cultural and gender variations in
prevalence of disease.
Social Anxiety Disorder (SAD) and Depression
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15. • “Emotions can be considered
as essentially cultural since no
human response or experience
occurs in the absence of
culturally defined situations or
meanings.” -Cross-Cultural Studies of
Depression.
• The Ifaluk people of Micronesia (Lutz 1985,
1988). They believe emotions are not located
in persons but in relationships between
persons or within events and situations.
However, they do acknowledge that
sometimes it can be “about our inside”.
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16. Prevalence of Social Anxiety Disorder in Adults (%)
10
7.5
5
2.5
0
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US
Chile
Brazil Taiwan Korea
China
Japan Mexico Europe

17. Social Anxiety Disorder: Cultural Considerations
• Prevalence ranges from 5.3% in African cultures to 10.4% in Euro/Anglo
cultures
• onset to occur around ages 12-15 and usually affects 3 to 5% of youths
• Asian cultures typically shows the lowest rates, whereas Russian and US
samples show the highest rates. Defining feature is the fear of negative
evaluation by others -> social standards and role expectations
• Some cultures have different variations of SA, such as the Taijin Kyufusho
prevalent in Japan and Korea or the aymat zibur - “fear of the community” in ultra-orthodox Jews
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18. Social Anxiety Disorder: Gender Factors
• Girls had higher anxiety than boys. (Garcia-Lopez, Ingles, Garcia-Fernandez)
• In a cross-cultural study, women (50.7%) had higher rates than men (35.6%).
• Schwartz et al. explored temperament or personality characters in different
genders and found that as SAD can be more noticeable in boys, they receive
treatment faster.
• Behavior inhibition is manifested differently.
• While causes of SAD for girls include parental conflicts, childhood physical
abuse, maternal mania, and failure to complete high school, causes of SAD
for boys are just absence of a parent or adult confidant. Thus, there are many
more risk factors for girls.
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19. Depression: Cultural Considerations
• “Based on detailed interviews with over 89,000 people, the results showed that 15% of the population from highincome countries (compared to 11% for low/middle-income countries) were likely to get depression over their
lifetime with 5.5% having had depression in the last year (2010).” -BioMed Central
• Conceptions of emotions are embedded within notions of the self egocentric versus sociocentric. The nature of collectivist/individualist society
can influence this. Depression, as a disorder related to loneliness, may be
more prevalent in individualistic societies.
• social stress is seen as a trigger for depression
• If depression can be experienced differently, is it correct to label it as
abnormal? How has this raised the use OR misuse of drugs?
Sunday, February 16, 14

20. Depression: Gender Factors
• Women are two to three times more likely to become clinically depressed than
men (Williams and Hargreaves, 1995).
• Women are more naturally emotional than men. Is that submitting to the
fundamental error of attribution? If we look at situational factors instead,
perhaps society is more favorable towards men.
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21. Bibliography
•
Shin, Lisa M. Liberzon, Israel. “The Neurocircuitry of Fear Stress, and Anxiety Disorders.” US National Library of Medicine Institutes of Health.
ncbi.nlm.nih. 22 July 2009. web. 16 Feb 2014.
•
Baxter, AJ. KM, Scott. Vos, T. Whiteford, HA. “Global prevalence of anxiety disorders: a systematic review and meta-regression.” US National
Library of Medicine Institutes of Health. ncbi.nlm.nih. May 2013. web. 12 Feb 2014.
•
Hofmann, Stefan G. Asnaani, Anu. “Cultural Aspects in Social Anxiety and Social Anxiety Disorder.” US National Library of Medicine Institutes of
Health. ncbi.nlm.nih. 1 Dec 2011. web. 16 Feb 2014.
•
Jenkins, Janis H.; Kleinman, Arthur; Good, Byron J. “Cross-Cultural Studies of Depression.”
•
Garcia-Lopez, Luis-Joaquin; Ingles, Candido J.; Garcia-Fernandez, Jose M. “Exploring the Relevance of Gender and Age Differences in the
Assessment of Social Fears in Adolescence.”
•
Wardy, Adrienne. “The Science of Shyness: The Biological Cause of Social Anxiety Disorder.” Bryn Mawr College. serendip.brynmawr. 2002.
web. 16 Feb 2014.
•
BioMed Central. “Global depression statistics.” Science Daily: your source for the latest research news. sciencedaily. 26 July 2011. web. 16 Feb
2014.
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