Social anxiety disorder is a persistent fear of one or more situations in which the person is exposed to possible scrutiny by others and fears that he or she may do something or act in a way that will be humiliating or embarrassing. It exceeds normal “shyness” as it leads to excessive social avoidance and substantial social or occupational impairment.
Feared activities may include almost any type of social interaction, especially small groups, dating, parties, talking to strangers, restaurants, etc. Possible physical symptoms include “mind going blank”, fast heartbeat, blushing, stomach ache, nausea and gagging.
Cognitive distortions are a hallmark, and learned about in CBT (cognitive-behavioral therapy).
Thoughts are often self-defeating and inaccurate.
The groundless fear of making telephone calls is typical, both answering and picking up, due to conversing’s social nature. It may appear early in childhood.
According to psychologist B.F. Skinner, phobias are controlled by escape and avoidance behaviors.
For instance, a student may leave the room when talking in front of the class (escape) and refrain from doing verbal presentations because of the previously encountered anxiety attack (avoid).
Minor avoidance behaviors are exposed when a person avoids eye contact and crosses arms to avoid recognizable shaking.
A fight-or-flight response is then triggered in such events. Preventing these automatic responses is at the core of treatment for social anxiety.
Physiological effects, similar to those in other anxiety disorders, are present in social phobics.
Faced with an uncomfortable situation, children with social anxiety may display tantrums, weeping, clinging to parents, and shutting themselves out.
In adults, it may be tears as well as experiencing excessive sweating, nausea, shaking, and palpitations as a result of the fight-or-flight response.
The walk disturbance (where you are so worried about how you walk that you lose balance) may appear, especially when passing a group of people.
Blushing is commonly exhibited by individuals suffering from social phobia.
These visible symptoms further reinforce the anxiety in the presence of others.
A 2.006 study found that the area of the brain called the amygdala, part of the limbic system, is hyperactive when patients are shown threatening faces or confronted with frightening situations.
They found that patients with more severe social phobia showed a correlation with the increased response in the amygdala.
United States 2-7%
When prevalence estimates were based on the examination of psychiatric clinic samples, social anxiety disorder was thought to be a relatively rare disorder.
The opposite was instead true; social anxiety was common but many were afraid to seek psychiatric help, leading to an understatement of the problem.
Prevalence rates vary widely because of its vague diagnostic criteria and its overlapping symptoms with other disorders.
There has been some debate on how the studies are conducted and whether the illness truly impairs the respondents as laid out in the official criteria.
Psychologist Dr. Ray Crozier argues, “it is difficult to ascertain whether the person being interviewed adheres to the DSM-III-R criteria or whether they are merely exhibiting poor social skills or shyness.”
The National Comorbidity Survey of over 8,000 American correspondents in 1994 revealed a 12-month and lifetime prevalence rates of 7.9 percent and 13.3 percent making it the third most prevalent psychiatric disorder after depression and alcohol dependence and the most apparent of the anxiety disorders.
According to U.S. epidemiological data from the National Institute of Mental Health, social phobia affects 5.3 million adult Americans in any given year.
Cross-cultural studies have reached prevalence rates with the conservative rates at 5 percent of the population.
However, other estimates vary within 2 percent and 7 percent of the U.S. adult population.
Onset of social phobia typically occurs between 11 and 19 years of age. Onset after age 25 is rare.
Social anxiety disorder occurs in females nearly twice as often as males, although men are more likely to seek help.
The prevalence of social phobia appears to be increasing among white, married, and well-educated individuals.
As a group, those with generalized social phobia are less likely to graduate from high school and are more likely to rely on government financial assistance or have poverty-level salaries.
Surveys carried out in 2002 show the youth of England, Scotland, and Wales have a prevalence rate of 0.4 percent, 1.8 percent, and 0.6 percent, respectively.
The prevalence of self-reported social anxiety for Nova Scotians older than 14 years was 4.2 percent in June 2004 with women (4.6 percent) reporting more than men (3.8 percent).
In Australia, social phobia is the 8th and 5th leading disease or illness for males and females between 15–24 years of age as of 2003.
Because of the difficulty in separating social phobia from poor social skills or shyness, some studies have a large range of prevalence.