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特集 遠隔認知行動療法

People with social anxiety disorder experience extreme fear of being criticized by others for their abilities or performance, and subsequently avoid social exposure. It has been highlighted that there is a low diagnostic rate, since the symptoms appear in interpersonal situations, and it is difficult to connect to social resources. In this paper, we reviewed the following: the current situation and issues of the support available for social anxiety, the barriers to accessing social resources among those with social anxiety, and clinical psychological support. Consequently, the following were considered as challenges in the support provision for individuals with social anxiety: high dropout rate in cognitive-behavioral therapy, not knowing what kind of psychological experience is causing the security behavior, and the lack of consideration given to their environmental factors and social resources. For providing clinical psychological support, it was inferred that increasing social support, modifying the environment, and enhancing social resources such as self-help groups may prove effective.

特集 様々な分野における認知行動療法の近年の動向

This article includes three studies. In Study 1, a case study of a college student is reported. The student was diagnosed as social anxiety disorder caused by inadequate school lunch education in primary school. In Study 2, retrospective research on school lunch education in primary schools was administered to college students, and 80-students completed for a series of questions. Many students reported that school lunch was comfortable, but five students reported that school lunch education were inadequate and felt distress. In Study 3, observation of school lunch education in a primary school was administered. In the school, school lunch education was gently and good constructed. The conclusion of this article is that dietary education through school lunch should be gentle to the needs of each child. We must not force foods that children feel they are not good at.

A self-focused attention(SFA)is pointed out as one of the factors that social anxiety is maintained. The aim of the present study was to examine the effect of attentional focus on social anxiety in a group of high and low blushing-anxious partcipants.368 university students were screened. A high blusing-anxious and a low blushing-anxious have been extracted for the blush fear score based on mean value ±0.5SD.Final analysis objects were 16 high blushing-anxious people,and 19 low blushing-anxious people.Participants were randomly allocated to either SFA condition or a task focused attention(TFA)condition.They were asked to engage in a 5 min conversation with a university student,and were instructed to either self-focus(SFAcondition)or task-focus(TFAcondition).Level of state social anxiety, self-awareness and negative automatic thought were measured. SFA increased state social anxiety and a negative automatic thought,and a clear result that TFA was effective in the decrease of state social anxiety and a negative automatic thought was not able to be obtained in the study.

対人問題を理由に中学や高校で不登校となったり，中退した生徒が通信制高校に通学できることを臨床上経験する。なぜ通信制高校なら通学できるのかについてその理由を検討した。不登校または退学の後，通信制高校に入り1年以上通学している，または卒業した生徒10人に対してアンケート調査を行なった。内容は, 1）通学の時間的・距離的負担度，2）勉強の難易度，3）何故通うことができるのか(できたのか)。精神医学的診断は社会不安障害が7人，過食症が2人，強迫性障害1人であった。通学の時間的・距離的負担については，全例が負担はないと答えた。勉強の難易度については7人が簡単で負担はないと答えた。通学できる理由については，9人が「精神的に楽」と人間関係の負担が少ないことを述べた。, 通信制高校は学校の特性上，教室における集団への帰属意識も少なく，空間的な圧迫感が少ないようである。それゆえ，生徒は「気楽に行ける」ことになる。対人関係に自信がなく，不安や緊張のため不登校に至る社会不安障害などのケースでは，通信制高校への進路もひとつの選択肢になりうると思われた。

社交不安障害は,人から注目を浴びるかもしれない社会的状況で顕著で持続的な恐怖が存在するのが特徴である。大学生などの若年に発症する者も多く,学業上の困難や対人関係での問題を抱え,メンタルヘルス相談に訪れる学生も多い。社交不安障害では,不登校や引きこもりとなり,社会生活への適応が困難となる事例もあるため,支援のあり方を検討することが重要である。われわれは,本学の教養科目を受講した大学生を対象に,質問紙による社交不安障害に関する調査を実施した。社交場面での強い不安や緊張を自覚している学生は多く存在し,治療の必要性を感じている学生も認めた。社交不安障害の多くの症例で,二次的な気分障害が報告されており,抑うつ症状の悪化は社交不安障害の増悪要因であるため,早期発見や適切な治療導入が必要である。保健管理センターでは,学生に対して社交不安障害に関する知識や情報の提供,早期の支援が必要であると思われた。, Social anxiety disorder is an important cause of psychosocial morbidity in adolescents and young adults. Problems in adolescents and young adults with social anxiety disorder would be a topic in recent years in campus mental health. We examined the opinion of social anxiety disorder on university students. We found that many students felt anxiety in various social scenes, and some students were worried about their anxiety. Most of the students understood the importance of mental treatment for social anxiety disorder. Several studies reported that social anxiety disorder would be risk factors of subsequent mood disorders, and the age of onset of social anxiety disorder predicted subsequent depression. Our study suggested that further efforts aim to proffer the information of social anxiety disorder and to improve mental health services.