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Symptoms and Definition of Social Phobia

Social Phobia, also known as Social Anxiety Disorder, involves a marked and persistent fear of social or performance situations. Examples of these kinds of situations include:

  • Initiating and maintaining conversations, especially with unfamiliar people
  • Speaking in public
  • Interacting with authority figures, including bosses, teachers, interviewers, police officers, judges, and even doctors.
  • Dating and flirting
  • Attending parties
  • Participating in meetings and small groups

Individuals will feel very self-conscious in these situations and will be wary of the scrutiny of others or of interacting with unfamiliar people. Their fear is of being judged or of acting in a way that will be humiliating or embarrassing. For example, individuals with this condition may feel uncomfortable speaking to others because they think that anything they say will come across as sounding stupid or uninteresting. They may also worry about showing signs of anxiety in these situations, lest others to see them as weak or "crazy."

When faced with these feared social situations, these individuals will experience marked anxiety. This can often include physical symptoms of anxiety, such as blushing, trembling, sweating, cold and clammy hands, shaky voice, nausea, diarrhea, heart palpitations, or feeling confused. Panic Attacks can also occur.

These individuals will recognize that their fears are excessive and unreasonable, yet will find it difficult to control them. As a result, they will try to avoid these feared situations or else will endure them with intense anxiety or distress.

This condition will thus interfere in a significant way with a person's normal routine, their ability to function in work or academic settings, in social activities, or in relationships. (If none of these interferences occur, then the individual will at least feel very distressed about having the phobia.)

Although not part of the official DSM-IV-TR criteria, these individuals will often be very sensitive to criticism, have difficulty being assertive, and will tend to feel inferior and have low self-esteem.

In children, a diagnosis of Social Phobia should not be made unless there is evidence that they are able to have age-appropriate social relationships with familiar people. The anxiety must also occur in peer settings, and not just when interacting with adults. Young children may express their social anxieties by crying, throwing tantrums, freezing, or shrinking from these situations. They may also not recognize that their fears are excessive or unreasonable. In individuals under age 18, the symptoms of this disorder must be present for at least 6 months before a diagnosis can be made.

A diagnosis of Social Phobia should not be made if the fear or avoidance of the social situations is due mainly to another medical or psychiatric disorder (see here for further information).

The term Generalized Social Phobia is used when an individual experiences the symptoms of this condition in most social situations. Individuals who do not have the Generalized type of Social Phobia may be able to tolerate some of the social situations described above.

Generalized Social Phobia shares many similarities with Avoidant Personality Disorder, and the two likely represent varying degrees of the same condition [ref].

 

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Overview

Diagnosis