Social anxiety disorder. Neurobiological, cognitive-behavioural and psychodynamic models

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.