11/14/2023 0 Comments G endurance![]() If help is sought, the most widely used and most effective treatment approach is cognitive behavioral therapy (CBT), which is in many cases accompanied by drug treatment of the anxiety symptoms (Gould et al., 1997 Rowa and Antony, 2005 Pontoski et al., 2010). Particularly, the avoidance behavior-as another core symptom of SAD-makes it challenging to find suitable therapeutic treatments. This fear and other SAD symptoms are often accompanied by physiological arousal (e.g., blushing, sweating, trembling, fast heart rate, upset stomach, nausea, or muscle tension Kessler et al., 1999 Rösler et al., 2021), which are related to physiological and psychological stress. Social anxiety (SA) can be perceived as extremely stressful and is often accompanied by avoidance behavior or facing social situations with intense fear. Furthermore, in many cases, people with SAD hold firm beliefs about the importance of making good impressions to others while believing that they come across badly (Leary, 2001). In most cases, people with SAD have problems to perform well in social situations (Wells et al., 1995) and have altered social cognitive abilities, such as dysregulated shyness (Nikolić, 2020) as well as selective attention and reporting bias for negative social stimuli (Amir et al., 2003 Garner et al., 2006 Bublatzky and Alpers, 2017). One of the core symptoms of SAD is fear of negative evaluation (FNE Hartmann et al., 2010). Social anxiety disorder often occurs comorbidly with other psychiatric disorders, such as depression and substance dependency (Ruscio et al., 2008 Ohayon and Schatzberg, 2010 Stein et al., 2017 Prior et al., 2019 Rozen and Aderka, 2020). Furthermore, prevalence increases in adolescence (Wright et al., 2020). Social anxiety disorder can be found in all age groups (Ohayon and Schatzberg, 2010 Karlsson et al., 2016 Grenier et al., 2019 Mohammadi et al., 2020) and often has its onset in childhood (Otto et al., 2001). This social phobia or social anxiety disorder (SAD DSM-V 300.23, ICD-10: F40.1) is one of the most common anxiety disorders worldwide (Bandelow and Michaelis, 2015 Stein et al., 2017) with a lifetime prevalence of 1.8% (Mohammadi et al., 2020) and a point prevalence of 4.4% (Camuri et al., 2014). The fear of being in the focus of attention in social situations and of being embarrassed can develop into a clinically relevant mental disorder. Furthermore, open questions with respect to moderating variables (e.g., age, sex, BMI, type of intervention, stress, amount of regular PA before the intervention, and comorbidities) remain still open. We conclude that PA is a promising means for the (additional) treatment of SAD or to reduce SA in general in non-clinical samples, but more research in which high-quality studies with randomized controlled trial designs are used is needed. For cross-sectional studies, a small negative association between SA symptoms and the amount of PA was found, i.e., lower SA was found for people who were more physically active ( r = −0.12, p = 0.003). The effect of PA on SA was stronger for adults than for children and adolescents ( p = 0.003). For studies with longitudinal designs, significantly lower SA symptoms were found after PA treatments ( d = −0.22, p = 0.001). For studies with randomized controlled trial designs, a not statistically significant effect of medium size toward lower general SA symptomatology was found in the PA group in comparison with the control group ( d = −0.24, p = 0.377). Our aim was to investigate whether PA interventions are a suitable treatment for SAD and whether PA is suitable for reducing social anxiety (SA) in general. CRD42020191181) as well as two additional searches. We conducted a pre-registered systematic review and meta-analysis (PROSPERO registration no. A promising alternative treatment is physical activity (PA) interventions, because regular PA has been shown to be suitable for reducing anxiety in general. ![]() The classical treatment for SAD is cognitive behavioral therapy, which is in many cases accompanied by drug treatments. The fear of being in the focus of attention in social situations can develop into a social anxiety disorder (SAD).
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