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Soziale Phobie

Neurobiologische, kognitiv-verhaltenstherapeutische und psychodynamische Modelle

Social anxiety disorder

Neurobiological, cognitive-behavioural and psychodynamic models

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Zusammenfassung

Die soziale Phobie ist durch eine exzessive Furcht vor sozialen Interaktionen oder vor Leistungssituationen gekennzeichnet und stellt mit einer Lebenszeitprävalenz von mehr als 13% und hohen Rückfallquoten eine häufige, stark einschränkende und chronisch verlaufende psychische Störung dar. Mit kognitiv-verhaltenstherapeutischen, psychodynamischen und neurobiologischen Erklärungsmodellen existieren Grundlagen für vielversprechende psychotherapeutische und pharmakologische Behandlungsansätze. Neurobiologische Ansätze geben Hinweise auf Vulnerabilitätsfaktoren und mögliche körperliche Mechanismen. Kognitiv-verhaltenstherapeutische Ansätze beschreiben die Ausbildung dysfunktionaler Grundüberzeugungen und erklären die Aufrechterhaltung sozialphobischen Verhaltens. Psychodynamische Modelle verweisen vor allem auf ein gestörtes Selbstkonzept sowie auf die Internalisierung negativer Beziehungserfahrungen. Störungsbezogene Behandlungsansätze liegen aus der kognitiv-verhaltentherapeutischen Therapie, neuerdings auch aus der psychodynamischen Psychotherapie vor. In der vorliegenden Arbeit werden die neurobiologischen, kognitiv-verhaltenstherapeutischen und psychodynamischen Erklärungsansätze vorgestellt und mögliche Implikationen für die Therapie erörtert.

Abstract

Social anxiety is characterised by overwhelming fears in social interactions or performance situations. Its life-time prevalence is high (about 13%) and relapses are quite common. Social anxiety disorder is a chronic disease with a high impairment for the persons afflicted. Cognitive-behavioural, psychodynamic and neurobiological models have promising implications for psychotherapy and pharmacological treatment. Neurobiological approaches have identified risk factors and possible somatic mechanisms. Cognitive-behavioural models explain the development of dysfunctional beliefs and the maintenance of social anxiety. Psychodynamic approaches refer to a disturbed self-concept and underline the importance of prior negative interpersonal relationships. Manualised treatments exist for the cognitive-behavioural approach and a manual for psychodynamic psychotherapy was recently developed. This paper presents the different approaches (neurobiological, cognitive-behavioural, psychodynamic) to social anxiety disorder and possible implications for therapy are discussed.

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Authors and Affiliations

  1. Klinik für Psychosomatische Medizin und Psychotherapie, Johannes-Gutenberg-Universität, Untere Zahlbacher Str. 8, 55131, Mainz, Deutschland

    Antje Haselbacher, Manfred E. Beutel &  Jörg Wiltink

  2. Klinik für Psychosomatik und Psychotherapie, Justus-Liebig-Universität, Gießen, Deutschland

    Falk Leichsenring

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  1. Antje Haselbacher
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  2. Manfred E. Beutel
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  3. Falk Leichsenring
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  4. Jörg Wiltink
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Correspondence to Jörg Wiltink.

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Haselbacher, A., Beutel, M., Leichsenring, F. et al. Soziale Phobie. Psychotherapeut 53, 168–176 (2008). https://doi.org/10.1007/s00278-008-0604-z

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