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Diagnosis of Social Phobia

Social Phobia is diagnosed based on a clinical assessment performed by a mental health professional, usually a psychologist or physician.  This assessment includes an interview with the patient and a review of any previous assessments in their medical records, and can also include an interview with the patient's family members or close friends.  The goal of this assessment is to determine whether the patient meets the clinical criteria for Social Phobia based on the information that they or their family members and friends provide. 

There are no laboratory tests or imaging tests (such as CT scans or MRI scans) that can help make a diagnosis of Social Phobia.

Diagnostic Tools of Social Phobia

There are certain questionnaires that have been developed that can help clinicians screen for this condition:

The Social Phobia Inventory (SPIN) [ref] is a quick self-report questionnaire; individuals who score above 19 on this test are likely to suffer from Social Phobia. A very brief version of the SPIN, that uses only 3 questions, has also been developed [ref].

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a questionnaire that can be completed by children ages 8-11, usually with the help of a parent. A score above 8 on items 3, 10, 26, 32, 39, 40 and 41 suggests that the child may have Social Phobia.

Differential Diagnosis of Social Phobia

In making a diagnosis of Social Phobia, this disorder must be distinguished from other conditions that also involve fear or avoidance of particular situations:

In Panic Disorder, Panic Attacks will occur in other contexts besides social or performance situations, and Agoraphobia, if present, will stem from the fear of being in a situation where one cannot escape or get help, and not from the fear of embarrassment or humiliation.

In Separation Anxiety Disorder, children may try to avoid social situations that involve a separation from their caretaker, but will feel comfortable in social situations and in interacting with strangers when they are at home.

In Body Dysmorphic Disorder, an individual will feel self-conscious because they believe that they are in some way physically disfigured.

In Autistic Spectrum Disorders and Schizoid Personality Disorder, social situations will be avoided because they are of no interest to the individual, and there may also be an absence of age-appropriate social relationships even with familiar people.

People with paranoid delusions (which can occur in the context of a Psychotic Disorder or a Mood Disorder) may fear social situations because they believe that they would be in physical danger in those situations, which is different than the self-consciousness and fear of embarrassment that is characteristic of Social Phobia.

If the individual has another medical or psychiatric condition that causes potentially embarrassing behaviors, such as stuttering, trembling in Parkinson's Disease, or abnormal eating behaviors in an Eating Disorder, then a diagnosis of Social Phobia should not be made if the fear and avoidance of social situations happens only in relation to these specific reasons.

There is a great deal of overlap between Generalized Social Phobia and Avoidant Personality Disorder, to the point where these may in fact be two names for the same condition [ref, ref, ref].


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Symptoms & Definition