:

( )



.



.
.

.

 /

/

/


/

 /

/


/

Social Phobia
()








.


)(Hippocrates 400 .
"





"

 ) ) Charles Darwin
)) physiology
social phobia
) )phobie des situations socials
( )
( ) social neurosis

) (Joseph Wolpe ( systematic
) desensitization


( ) Isaac Marks



" " (
Diagonstic and Statistical Manual of
Mental Disorders ),
1989


1985


) ) Michael Liebowitz
) ) Richard Heimberg
(DSM-
) IV ( social
) ) phobia ( social
anxiety disorder ),
) ) psychology ()


1990

 :

( 1426: )1
:
-%7
%14
2 1



..
% 13
.

 -



..






.

- -





.. .

 ()


%0.9 %1.7 %1.5
%2.6 .
7
%14
2 1 .

.





%13 .


.
:
12 17

.



.







.




.
%80
: %45
%59 %19
.%17

.


.


%70

%63 .




.

.
.



.

.





..
.





.
.


..
()

.. ..

.


..
..
..
.





.

..
.


.



!!..
:





. .



.

.






.







.



.



%90

.




.

-1 ( ) .

.
-2

.
-3

.

-4
.
-5
.
-6
.
-7
.
-8 .
-9

.
-10 .



\
observational
) )learning .
( )

30 50
" "


( Bruch and Heimberg 1994:
) Caster et al 1999
( ) Daniel and Plomin 1985


.

%15-10

.
.


.



( )
(Stemberg et al 1995
)



Beidel
) and Turner 1998) ,

) )Gilmartin 1987



.






( ) Leung et al 1994

-




.

 " "









"" ""


( )
( ) fight-or-flight





.



)(serotonin
) )dopamine neurotransmission D2



) ) Norepinephrine
) ) GABA


amygdada

) ) Anterior cingulated cortex

.


( )
( )




( schema ),





( safety
) behaviors ) ( clark & wells 1995



.


-:
-1


.



.

-2
.
-3

.
-4 .
-5 18
.
-6

.




.
"
"
"
" .






.


.








) ) unipolar depression
14263 24
166


panic disorder 33
% generalized anxietr disorder
%19 post traumatic stress
disorder % 36 substance abuse
disorder % 18 .% 23



%75 %61 %90
) ) Avoidant personality disorder


(bipolar disorder ),

cyclothymic-anxious-sensitive!


hypomania
.


" "

%90

.






.








" .



" ( 1414 ) .


(
)




.

)..

.



.







.. .


.

 B F Skinner

()

()



""




( )
(
)

2006
amygdala limbic system







:
( Cognitive-
) behavioral therapy CBT
.

 ) ) psychotherapy




:

:













Heimberg

interpersonal therapy

.


SSRIs
( Selective serotonin
) reuptake inhibitors SSRI



paroxetine
paxil seroxat

 1995
% 55
% 23.9
2004
fluoxetine


50.8 % 54.2
% 31.7 1 2
Clinical Global Impression-Improvement scale
,
.




2004

 1985
( ) monoamine oxidase inhibitors MAOI
.





(
Reversible inhibitors of monoamine oxidase subtype A
) RIMA
.

 alprzolam clonazepam






GABA

 mirtazapine



performance phobia
beta blockers


d-cycloserine DCS



agonist NMDA


.

 )1
.

.
)2 .
)3 .

...... .

 )4
....
.
)5
.
)6

)7

.
)8
.

 )9

.
)10

.
)11

.
.

 )12


.
)13

.....
.