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Course and Prevalence of Social Phobia

Prevalence of Social Phobia Spectrum

Having fears of social and performance situations is a very common and normal feature of being human. As many as 40% of people in the general population will report fears in at least one social situation, such as speaking in public, participating in meetings, speaking with strangers, or walking into a room where others are already seated [ref]. The more of these fears that an individual will have, the more difficulties that they will experience in work, school, and interpersonal areas [ref].

Social Phobia thus represents an extreme along this continuum, where a person's social fears have reached a level of causing a significant interference in their quality of life. Yet even Social Phobia is very common, with about 7-10% of all individuals in the population suffering from this condition in any given year, and 12-14% of all individuals having this condition at some point in their lifetimes [ref].

Generalized Social Phobia, which lies even farther along this continuum, and which involves still more symptoms of social anxiety and greater levels of impairment, probably accounts for about half of all individuals with Social Phobia [ref]. At the most extreme point on this continuum would be Avoidant Personality Disorder [ref].

Course and Prognosis of Social Phobia

Social Phobia begins early in life, with about half of all cases becoming apparent by age 13, and over 90% appearing by age 23 [ref]. Thereafter, the condition tends to run a chronic course. One important study found that 12 years after starting treatment for Social Phobia, over two thirds of people showed some improvement in their symptoms, but only about a third recovered fully [ref]. Moreover, among those who recovered, close to 40% relapsed back into the condition after some time. These findings show that Social Phobia is a more chronic condition and with a lower response to treatment than other Anxiety Disorders or Depression [ref].

Social Phobia interferes significantly with people's quality of life. It will put individuals at a significant disadvantage in work and school settings by preventing them from interacting effectively with their peers and superiors, from sharing their ideas and from asserting their points of view. Some individuals with this condition will simply avoid altogether certain jobs or career opportunities that could otherwise have been fulfilling, simply because these would involve a lot of social interactions. As a result, studies have shown that people with Generalized Social Phobia are less likely to graduate from college, and on average tend to earn less and to hold lower status jobs than people in the general population [ref].

Making new friends or dating are also areas that can be very difficult for people with Social Phobia. Children and adolescents with this condition are at heightened risk for being rejected, ignored and teased by their peers [ref, ref]. Yet individuals with Social Phobia will want to have relationships as much as anyone else. They will thus experience their condition as something very frustrating and painful.

Associated Conditions (Comorbidity) of Social Phobia

Over half of all individuals with Social Phobia will suffer from one or more concurrent psychiatric conditions [ref]. They are over 5 times as likely to suffer from another Anxiety Disorder or a Mood Disorder than someone without Social Phobia, and are also twice as likely to have a substance use disorder [ref]. These individuals tend to use substances, especially alcohol, as a way to lower their anxieties and inhibitions in social situations [ref].

 

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