Social Phobia  

Description

People with social phobia experience an intense fear of being embarrassed, humiliated, or negatively evaluated in social situations. Those with social phobia tend to think of others as highly socially competent and of themselves as socially incompetent. When in public, small mistakes may feel exaggerated. Blushing itself may feel embarrassing. Even during fairly routine social situations, social phobics may feel as though they are performing on stage, with all eyes focused on them. Individuals with social phobia may avoid spending time with people other than those closest to them.

For some individuals with social phobia, their fear is fairly limited and specific to one particular situation or type of situation. For example, they may feel anxious about giving a speech, interacting with a boss, or going on a date. The most common social phobia is a fear of public speaking. Sometimes social phobia involves a general fear of social situations such as parties. Less commonly, social phobia involves a fear of using a public restroom, eating out, talking on the phone, or writing in the presence of other people (e.g., signing a check.

Although social phobia is often compared with shyness, the two are not necessarily the same. People with social phobia may not be shy and in fact may be quite comfortable in a number of social situations, with the exception of their particular feared situation. For example, a socially phobic person who normally appears friendly, outgoing, and confident may only experience intense social anxiety when asked to give a speech or presentation. Shy individuals, on the other hand, would be expected to be uneasy or uncomfortable around most other people, but would not be expected to experience extreme anxiety in anticipation of social situations and may not avoid them.

People with social phobia typically experience their anxious feelings as excessive or irrational, but feel powerless to stop them. In an attempt to reduce their own anxiety, they typically avoid the social situations they fear. When they do confront feared situations, they are often quite anxious before and during the situation, and may continue to worry about their own performance and the evaluations of others long afterwards. Not surprisingly, social phobia can interfere with social, family, and career life. For example, a social phobic might turn down a prestigious promotion and a sizable raise to avoid public speaking in the new position.

Social phobia may be accompanied by depression or excessive use of alcohol or drugs. Social phobia often begins around early adolescence or younger.

Symptoms

A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.

Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed panic attack.Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.

The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.

The feared social or performance situations are avoided or else are endured with intense anxiety or distress.

Symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning.

In individuals under age 18 years, the duration is at least 6 months.

Symptoms are not caused by another psychological disorder, or by the physiological effects of a substance (e.g., drug, medication) or a medical condition (e.g., hyperthyroidism).

References:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.​