Social Anxiety Disorder

What is the diagnostic criteria?

• fear or anxiety about one or more social situations in which the individuals is exposed to possible scrutiny by others

• fear of negative evaluation

• social situations:

  • almost always provoke anxiety

  • are avoided or endured with intense fear

• fear is out of proportion to the actual threat

• persistent (6+ months)

• causes significant distress or impairment

How many situations can it be associated with?

• may only be associated with one type of situation (but usually with more than one)

• the concern is about acting in a way that will be judged by others

• patients may report concerns about physical symptoms first (sweating, blushing, trembling)

• withdrawal from many aspects of life

What is the onset?

• may occur in early childhood, usually between 8-15 years of age

• it can be gradual or happen after a stressful or humiliating social experience

What are the gender differences?

More common among women than men un community samples, no differences in clinical samples

What is the comorbidity?

• other anxiety disorders

• depression

• substance abuse

• avoidant personality disorder

What do the levels of shyness show.

• low level of shyness → no social phobia

• moderate level of shyness → still normal

• high level of shyness → specific social phobia (fear is limited to certain situations)

• higher level of shyness → generalized social phobia (Social Anxiety Disorder) (fear occurs across many social situations)

• extreme level → avoidant personality disorder (broader and more pervasive than social anxiety disorder)