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Social anxiety: Definition

Social anxiety disorder is defined as social phobia in the Diagnostic and Statistical Manual of the American Psychiatric Association DSM-IV.

For the current definition of social phobia, there are 4 main criteria:

Criteria 1:

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.

(In English: You fear social situations)

Criteria 2:

Exposure to the feared social situations almost invariably provokes anxiety.

(In English: Your fear causes anxiety)

Criteria 3:

The person recognises that the fear is excessive and unreasonable.

(In English: You know the situation you fear is not dangerous. You know others are not bothered by it. But knowing this, and knowing that your suffering is unnecessary, only makes it worse)

Criteria 4:

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

(In English: You avoid, or go through with distress, the situations that make you fearful)

There are 3 additional general points from DSM IV, for the diagnosis of social phobia:

  1. The problem must interfere with the person’s life.
  2. The problem must cause a significant degree of distress.
  3. The problem must have persisted for at least 6 months.

DSM-IV also defines two types of social phobia: specific and generalised social phobia.

Specific social phobia:

For some people, the feared social situation is limited and confined to a few situations. For example:

  • Public speaking – the most common specific social phobia.
  • Talking on the telephone.
  • Prolonging a conversation.
  • Eating when others can see what you are doing.
  • Writing when others can see what you are doing.
  • Being in an intimate relationship.

Generalised social phobia:

For other people, the fear exists to most situations involving interaction with others.

Summary

In summary, social anxiety disorder is defined as social phobia by DSM IV. The diagnostic criteria include:

  1. A social situation is feared.
  2. The fear causes anxiety.
  3. The fear and anxiety is excessive.
  4. There is avoidance of the social situation, or the social situation is endured with distress.
  5. The fear interferes with a person’s life, causing a significant degree of distress, and has persisted for at least 6 months.

If you suffer with social phobia, you are in a difficult situation. Your fear response tells you to avoid or escape the frightening situation. This is your body’s physical fight or flight response. But logically, you don’t want to run away, or avoid the situation. You don’t want to be lonely and isolated. And you can’t control, or find it difficult to control, the source of your fear. So most people try to endure, or limit, the social situations, due to the distress they cause.

Take care,

Paul

Dr Paul Ogilvie
Dr Paul Ogilvie