Zaburzenie lękowe społeczne (fobia społeczna)
Diagnostyka i diagnoza
Zaburzenie lękowe społeczne (ZLS), wcześniej określane jako fobia społeczna, charakteryzuje się trwałym i nieproporcjonalnym lękiem przed sytuacjami społecznymi, w których pacjent może być oceniany lub obserwowany. Diagnoza opiera się na kryteriach DSM-5, które wymagają obecności objawów przez co najmniej 6 miesięcy oraz wykluczenia innych zaburzeń psychicznych i medycznych. ZLS dotyka 5-10% populacji i może manifestować się zarówno uogólnionym lękiem dotyczącym większości sytuacji społecznych, jak i specyficznym lękiem ograniczonym do wystąpień publicznych. W diagnostyce stosuje się narzędzia takie jak Social Phobia Inventory (SPIN) z wartością predykcyjną dodatnią 88% i ujemną 90%, Mini-SPIN (90% dokładności diagnostycznej) oraz Liebowitz Social Anxiety Scale (LSAS). W procesie diagnostycznym istotne jest wykluczenie zaburzeń neurorozwojowych, zaburzeń paniki, agorafobii, zaburzeń dysmorficznych ciała oraz zaburzeń osobowości.
- Diagnostyka zaburzenia lękowego społecznego (fobia społeczna)
- Kryteria diagnostyczne według DSM-5
- Specyficzne podtypy diagnozy
- Proces diagnostyczny
- Narzędzia diagnostyczne do oceny zaburzenia lękowego społecznego
- Diagnozy różnicowe
- Specyficzne wyzwania diagnostyczne
- Ewolucja diagnostyczna zaburzenia
- Zmiany terminologiczne
- Ewolucja kryteriów diagnostycznych
- Zaburzenie lękowe społeczne a fobia społeczna
- Objawy i oznaki kliniczne
- Znaczenie wczesnej diagnozy
Diagnostyka zaburzenia lękowego społecznego (fobia społeczna)
Zaburzenie lękowe społeczne, znane również jako fobia społeczna, to stan medyczny charakteryzujący się intensywnym i długotrwałym lękiem przed sytuacjami społecznymi, w których osoba może być oceniana lub obserwowana przez innych. Jest to powszechne zaburzenie lękowe, dotykające około 5-10% populacji na całym świecie. 12 Kluczowym elementem tego zaburzenia jest strach przed osądem, odrzuceniem i/lub upokorzeniem, co może prowadzić do znacznego pogorszenia jakości życia i funkcjonowania społecznego.1
Kryteria diagnostyczne według DSM-5
Diagnoza zaburzenia lękowego społecznego opiera się na kryteriach zawartych w Podręczniku Diagnostycznym i Statystycznym Zaburzeń Psychicznych (DSM-5) opublikowanym przez Amerykańskie Towarzystwo Psychiatryczne. Diagnoza może być postawiona przez lekarza, psychologa, psychiatrę lub terapeutę.12 Zgodnie z DSM-5, aby zdiagnozować zaburzenie lękowe społeczne, muszą być spełnione następujące kryteria:
- Wyraźny i trwały lęk lub niepokój związany z jedną lub wieloma sytuacjami społecznymi, w których osoba jest narażona na możliwą ocenę ze strony innych. Przykłady obejmują interakcje społeczne (np. rozmowa, spotkanie z nieznajomymi), bycie obserwowanym (np. jedzenie lub picie) oraz występowanie przed innymi (np. wygłaszanie przemówienia).12
- Osoba obawia się, że będzie działać w sposób (lub pokaże objawy lęku), który będzie upokarzający lub żenujący.12
- Sytuacje społeczne prawie zawsze wywołują lęk lub niepokój.11
- Sytuacje społeczne są aktywnie unikane lub znoszone z intensywnym lękiem czy dyskomfortem.11
- Lęk lub niepokój jest nieproporcjonalny do rzeczywistego zagrożenia stwarzanego przez sytuację społeczną i kontekst społeczno-kulturowy.12
- Lęk, niepokój lub unikanie utrzymują się, zwykle przez co najmniej 6 miesięcy.11
- Lęk, niepokój lub unikanie powodują klinicznie znaczące cierpienie lub upośledzenie funkcjonowania w obszarach społecznych, zawodowych lub innych ważnych dziedzinach życia.11
- Lęk, niepokój lub unikanie nie wynikają z bezpośrednich efektów fizjologicznych substancji (np. narkotyków, leków) lub innego stanu medycznego.11
- Lęk, niepokój lub unikanie nie są lepiej wyjaśniane przez objawy innego zaburzenia psychicznego, takiego jak zaburzenie paniki, zaburzenia dysmorficzne ciała czy zaburzenia ze spektrum autyzmu.11
- Jeśli występuje inny stan medyczny (np. choroba Parkinsona, otyłość, zniekształcenie spowodowane oparzeniami lub urazem), lęk, niepokój lub unikanie są wyraźnie niezwiązane lub są nadmierne.11
Specyficzne podtypy diagnozy
W DSM-5 możliwe jest określenie podtypu zaburzenia lękowego społecznego jako „tylko występy”, gdy lęk jest ograniczony do mówienia lub występowania publicznie.11 Jest to istotne rozróżnienie, ponieważ podtyp „tylko występy” może wymagać nieco innego podejścia terapeutycznego, w tym potencjalnego zastosowania beta-blokerów jako leczenia objawowego.1
Zaburzenie lękowe społeczne można również podzielić na uogólnione i nieuogólnione. Uogólniona fobia społeczna (GSP) odnosi się do przypadków, gdy lęk dotyczy większości lub wszystkich sytuacji społecznych, podczas gdy fobia społeczna specyficzna ogranicza się do jednej lub kilku konkretnych sytuacji, takich jak przemawianie publiczne.11
Proces diagnostyczny
Proces diagnostyczny zaburzenia lękowego społecznego jest wieloetapowy i może obejmować różne metody oceny:11
- Wywiad kliniczny: Lekarz zbiera szczegółowe informacje na temat historii medycznej pacjenta i przeprowadza badanie fizyczne, aby wykluczyć stany zdrowotne, które mogą powodować podobne objawy (np. nadczynność tarczycy).11
- Pytania o objawy: Lekarz pyta o sytuacje wywołujące lęk i unikanie, jak pacjent czuje się w tych sytuacjach oraz czy jego lęk lub niepokój uniemożliwiają mu pełne życie.1
- Zastosowanie narzędzi diagnostycznych: Profesjonaliści mogą wykorzystywać wystandaryzowane kwestionariusze lub instrumenty do oceny objawów zaburzenia.11
- Ocena nasilenia i wpływu: Ocena, jak bardzo lęk wpływa na codzienne funkcjonowanie, pracę i relacje społeczne.1
- Wykluczenie innych zaburzeń: Ważne jest wykluczenie innych stanów psychicznych, które mogą powodować podobne objawy, takich jak zaburzenie paniki, agorafobia, zaburzenia dysmorficzne ciała, zaburzenia ze spektrum autyzmu, zaburzenia osobowości schizoidalnej czy zaburzenia osobowości unikającej.11
Narzędzia diagnostyczne do oceny zaburzenia lękowego społecznego
Istnieje kilka wystandaryzowanych narzędzi, które pomagają profesjonalistom w ocenie i diagnozie zaburzenia lękowego społecznego:11
- Social Phobia Inventory (SPIN): Standardowe narzędzie samooceny zaprojektowane do pomiaru objawów zaburzenia lękowego społecznego. SPIN ma dodatnią wartość predykcyjną około 88% i ujemną wartość predykcyjną 90%, co czyni go wiarygodnym narzędziem do identyfikacji osób z zaburzeniem lękowym społecznym.11
- Mini-SPIN: 3-pytaniowe narzędzie przesiewowe, które ma 90% dokładność diagnostyczną dla uogólnionego zaburzenia lękowego społecznego.1
- Liebowitz Social Anxiety Scale (LSAS): Narzędzie oceniające nasilenie lęku i unikania w różnych sytuacjach społecznych.11
- Liebowitz Self-Rated Disability Scale: Ocenia stopień niepełnosprawności związanej z zaburzeniem lękowym społecznym.1
- Brief Social Phobia Scale (BSPS): Skrócona skala do oceny objawów fobii społecznej.11
- Social Phobia Safety Behaviors Scale: Ocenia zachowania zabezpieczające związane z fobią społeczną.1
- Self Statements During Public Speaking Scale: Koncentruje się na samookreśleniach podczas wystąpień publicznych.1
- Screen for Child Anxiety Related Disorders (SCARED): Pomocna w potwierdzeniu diagnozy u dzieci i młodzieży.1
- Severity Measure for Social Anxiety Disorder: Ocenia nasilenie objawów zaburzenia lękowego społecznego.1
Diagnozy różnicowe
Podczas diagnozowania zaburzenia lękowego społecznego ważne jest rozważenie i wykluczenie innych stanów, które mogą powodować podobne objawy:11
- Zaburzenia neurorozwojowe, takie jak zaburzenia ze spektrum autyzmu.11
- Zaburzenie paniki i agorafobia: W przeciwieństwie do zaburzenia lękowego społecznego, osoby z agorafobią boją się sytuacji, z których trudno się wydostać lub w których pomoc może być niedostępna w przypadku ataku paniki.11
- Zaburzenia depresyjne: Które mogą współwystępować z zaburzeniem lękowym społecznym, ale stanowią odrębne zaburzenie.11
- Zaburzenia związane z substancjami i uzależnieniami: Osoby z zaburzeniem lękowym społecznym są narażone na wysokie ryzyko nadużywania alkoholu lub innych substancji.11
- Zaburzenie dysmorficzne ciała: Charakteryzuje się nadmiernym zaabsorbowaniem postrzeganymi defektami lub wadami w wyglądzie fizycznym.11
- Zaburzenia osobowości, takie jak zaburzenie osobowości schizoidalnej i zaburzenie osobowości unikającej.11
Specyficzne wyzwania diagnostyczne
Diagnozowanie zaburzenia lękowego społecznego może być skomplikowane z kilku powodów:11
Współwystępowanie z innymi zaburzeniami
Zaburzenie lękowe społeczne często współwystępuje z innymi zaburzeniami psychicznymi, co może utrudniać diagnozę:11
- Zaburzenie lękowe społeczne ma jeden z najwyższych wskaźników współwystępowania wśród zaburzeń psychicznych. Szacuje się, że do 90% osób z tym zaburzeniem ma współistniejącą diagnozę.1
- Około połowa pacjentów z zaburzeniem lękowym społecznym ma współistniejące problemy psychiczne, narkotykowe lub alkoholowe.1
- Zaburzenie to zwiększa około czterokrotnie ryzyko rozwoju depresji w ciągu życia.1
- Zaburzenie lękowe społeczne często pozostaje niezauważone u pacjentów z innymi współistniejącymi ostrymi stanami psychiatrycznymi, takimi jak depresja czy tendencje samobójcze.1
Wyzwania w rozpoznawaniu
Zaburzenie lękowe społeczne często pozostaje niezdiagnozowane lub nieprawidłowo zdiagnozowane z kilku powodów:11
- Wiele osób z zaburzeniem lękowym społecznym nie zdaje sobie sprawy, że ma uleczalną chorobę, i dlatego nie szuka leczenia.1
- Rozpoznanie zaburzenia lękowego społecznego jest słabe i wymaga więcej wysiłku ze strony pracowników służby zdrowia, ponieważ osoby z tym zaburzeniem rzadko same zgłaszają swoje objawy.1
- Mniej niż 5% osób z zaburzeniem lękowym społecznym szuka leczenia w ciągu roku od wystąpienia objawów.1
- Tylko połowa osób z zaburzeniem lękowym społecznym kiedykolwiek szuka jakiejkolwiek formy leczenia, a dla tych, którzy szukają pomocy, średni czas między wystąpieniem problemów a zwróceniem się o pomoc wynosi między 15 a 20 lat.1
Różnice kulturowe i kontekstowe
Podczas diagnozowania zaburzenia lękowego społecznego należy wziąć pod uwagę kontekst kulturowy i społeczny:11
- Lęk lub niepokój musi być nieproporcjonalny do rzeczywistego zagrożenia stwarzanego przez sytuację społeczną i kontekst społeczno-kulturowy.1
- Normalny lęk społeczny lub unikanie, jakiego doświadcza większość populacji, takie jak strach związany z publicznym przemawianiem, niekoniecznie uzasadnia diagnozę fobii społecznej, jeśli lęk nie zakłóca społecznego lub zawodowego funkcjonowania jednostki.1
- Osoba nie otrzymałaby diagnozy fobii społecznej, gdyby bała się mówić publicznie, ale nie napotykała tej sytuacji regularnie i nie była szczególnie zaniepokojona tym faktem.1
Ewolucja diagnostyczna zaburzenia
Koncepcja i diagnostyka zaburzenia lękowego społecznego znacząco ewoluowały na przestrzeni lat:11
Zmiany terminologiczne
Terminologia używana do opisania tego zaburzenia zmieniała się w kolejnych wydaniach DSM:11
- Fobia społeczna została po raz pierwszy sklasyfikowana jako zaburzenie psychiczne w DSM-III w 1980 roku.11
- W DSM-III opis fobii społecznej ograniczał diagnozę ze względu na kryteria wykluczające, w tym osoby z zaburzeniem osobowości unikającej, nową kategorią w tym czasie.1
- Gdy w 1994 roku opublikowano DSM-IV, termin „fobia społeczna” został zastąpiony „zaburzeniem lęku społecznego”. Nowy termin został wprowadzony, aby opisać szeroki i uogólniony charakter lęków, które są częścią tego zaburzenia.1
- W DSM-5 termin „fobia społeczna” został zaktualizowany do „zaburzenie lękowe społeczne”, ponieważ „fobia” nie artykułuje jasno stopnia upośledzenia spowodowanego tym stanem.1
Ewolucja kryteriów diagnostycznych
Kryteria diagnostyczne zaburzenia lękowego społecznego również ewoluowały:11
- DSM-5 (2013) wprowadził bardzo niewielkie zmiany w definicji zaburzenia lękowego społecznego. Zmiana definicji: z „Czas trwania wynosi co najmniej 6 miesięcy” na „Strach, lęk lub unikanie są trwałe, zazwyczaj trwające 6 lub więcej miesięcy”.1
- Pierwszą zmianą jest nazwa zaburzenia. W DSM-IV jest określane jako Fobia Społeczna (Zaburzenie Lękowe Społeczne), podczas gdy w DSM-5 proponuje się zmianę nazwy na Zaburzenie Lękowe Społeczne (Fobia Społeczna).1
Zaburzenie lękowe społeczne a fobia społeczna
Ważne jest zrozumienie różnicy między zaburzeniem lękowym społecznym a fobią społeczną:11
- Lęk społeczny i fobia społeczna są często używane zamiennie, ale istnieje pewna różnica między nimi, szczególnie w sytuacjach, które wywołują reakcje stresowe.1
- Fobia społeczna odnosi się do strachu przed byciem ocenianym i osądzanym podczas wykonywania jakiegoś zadania publicznie, podczas gdy lęk społeczny opisuje uczucia intensywnego zdenerwowania i samoświadomości, których cierpiący doświadczają podczas indywidualnych spotkań lub grupowych zgromadzeń towarzyskich.1
- Objawy obu są obecnie objęte ogólnym terminem zaburzenie lękowe społeczne, które jest oficjalną diagnozą dla osób cierpiących na nadmierny lęk społeczny w szerokim spektrum sytuacji.1
- Kiedy zaburzenie lękowe społeczne zastąpiło fobię społeczną jako kategorię diagnostyczną, włączyło objawy zarówno lęku społecznego, jak i fobii społecznej pod swoim szerokim diagnostycznym parasolem.1
Objawy i oznaki kliniczne
Zaburzenie lękowe społeczne manifestuje się poprzez różnorodne objawy fizyczne, emocjonalne i behawioralne:11
Objawy fizyczne
Zaburzenie lękowe społeczne może powodować następujące objawy fizyczne:11
- Zaczerwienienie (rumieńce)
- Jąkanie się
- Pocenie się
- Objawy żołądkowo-jelitowe
- Suchość w ustach
- Kołatanie serca
- Drżenie
- Nagła potrzeba oddania moczu
- Ataki paniki
- Bóle głowy
- Zawroty głowy
- Duszności
Objawy emocjonalne i poznawcze
Zaburzenie lękowe społeczne charakteryzuje się określonymi wzorcami myślenia i reakcjami emocjonalnymi:11
- Intensywny strach przed sytuacjami, w których można być ocenianym negatywnie
- Obawa o zawstydzenie lub upokorzenie
- Intensywny strach przed interakcją lub rozmową z nieznajomymi
- Strach, że inni zauważą oznaki lęku
- Emocje w fobii społecznej to głównie lęk i wstyd, a czasem wstręt do siebie lub gniew
- Typowe przekonania u osoby z fobią społeczną koncentrują się na postrzeganej negatywnej ocenie ze strony innych dotyczącej ujawnienia wady lub nieakceptowalnego zachowania
Objawy behawioralne
Zaburzenie lękowe społeczne prowadzi do charakterystycznych zachowań:11
- Aktywne unikanie sytuacji społecznych
- Rozwój strategii unikania, takich jak odmawianie zaproszeń na imprezy lub spotkania z nowymi ludźmi
- Fobia społeczna zwykle prowadzi do unikania sytuacji takich jak publiczne przemówienia lub rozmowy z grupą, imprezy, spotkania, jedzenie lub picie w miejscach publicznych, praca lub pisanie pod obserwacją, rozmowy telefoniczne, intymność lub randki
- Płacz, napady złości lub „zamrożenie” (szczególnie u dzieci)
- Selektywny mutyzm
Znaczenie wczesnej diagnozy
Wczesna diagnoza i leczenie zaburzenia lękowego społecznego są kluczowe z kilku powodów:11
Konsekwencje nieleczonego zaburzenia
Nieleczone zaburzenie lękowe społeczne może prowadzić do poważnych konsekwencji:11
- Nieleczone zaburzenie lękowe społeczne może być wyniszczające i może skutkować gorszymi wynikami w edukacji, pogorszeniem wydajności w pracy, gorszą jakością relacji i ogólnym obniżeniem jakości życia.11
- DSM-5 zauważa, że ogólna jakość życia może być dotknięta z powodu wycofania społecznego i izolacji.1
- Osoby z fobią społeczną są narażone na wysokie ryzyko nadużywania alkoholu lub innych substancji.1
Opcje leczenia
Po zdiagnozowaniu zaburzenia lękowego społecznego dostępne są skuteczne opcje leczenia:11
- Psychoterapia: Terapia poznawczo-behawioralna (CBT) z naciskiem na ekspozycję może zmniejszyć objawy fobii społecznej.11
- Leki:
- Selektywne inhibitory wychwytu serotoniny (SSRI) są leczeniem pierwszego wyboru w fobii społecznej.1
- Inhibitory wychwytu serotoniny i noradrenaliny (SNRI) są również skuteczne.1
- Beta-blokery mogą być używane przy lęku związanym z występami.1
- Benzodiazepiny są leczeniem drugiego rzutu, ale mogą być stosowane w dowolnym momencie, jeśli występuje ostre i ciężkie zaostrzenie pobudzenia lub lęku u osób z zaburzeniem lękowym społecznym, które nie mają współistniejącego nadużywania alkoholu lub substancji.1
- Podejście łączone: Leczenie będzie zależeć od wyboru pacjenta i dostępności terapii, ale podobnie jak w przypadku innych zaburzeń lękowych, CBT jest początkowym wyborem leczenia fobii społecznej, ponieważ jest zwykle bardziej akceptowalne i ma zmniejszone ryzyko nawrotu.1
Znaczenie regularnej oceny
Regularna ocena stanu pacjentów z zaburzeniem lękowym społecznym jest istotna dla skutecznego leczenia:11
- Test SPIN może być wykorzystywany do oceny, jak dobrze działają leczenie, takie jak terapia akceptacji i zaangażowania (ACT) lub terapia poznawczo-behawioralna (CBT), u osób z diagnozą lęku społecznego.1
- Jeśli odpowiedź na lek jest nieadekwatna, należy zoptymalizować dawkowanie i ocenić zgodność przed przejściem na inny lek.1
- U pacjentów, którzy mają nieadekwatną odpowiedź na optymalne dawki leku pierwszego rzutu lub u których lek nie jest tolerowany, należy przejść na inny lek pierwszego rzutu.1
- Około 50% pacjentów nawraca po przerwaniu stosowania SSRI, dlatego leczenie jest kontynuowane przez co najmniej 12 miesięcy.1
Diagnoza zaburzenia lękowego społecznego to kompleksowy proces, który wymaga dokładnej oceny objawów, wzorców zachowania i wpływu na życie. Choć zaburzenie to może być wyniszczające, wczesna diagnoza i odpowiednie leczenie mogą znacząco poprawić jakość życia pacjentów. Ważne jest, aby pracownicy służby zdrowia byli świadomi wyzwań związanych z diagnozowaniem tego zaburzenia i aktywnie poszukiwali jego objawów, szczególnie u pacjentów z innymi współistniejącymi zaburzeniami psychicznymi.11
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Materiały źródłowe
- #1 Social Anxiety Disorder: Symptoms, Tests, Causes & Treatmentshttps://my.clevelandclinic.org/health/diseases/22709-social-anxiety
Social anxiety disorder (social phobia) is a medical condition that causes fear and anxiety when you’re around people in social situations. People with social anxiety fear being judged or watched by others. This disorder is treatable with talk therapy and medications such as antidepressants. […] Social anxiety disorder (formerly known as social phobia) is a mental health condition where you experience intense and ongoing fear of being judged negatively and/or watched by others. […] Social anxiety disorder is a common anxiety disorder. […] A core feature of social anxiety disorder is that you’re afraid of being judged, rejected and/or humiliated. […] Social anxiety disorder is a common mental health condition that can affect anyone. […] Social anxiety disorder isn’t uncommon. Approximately 5% to 10% of people across the world have social anxiety disorder.
- #1 Social Anxiety Disorder: Symptoms, Tests, Causes & Treatmentshttps://my.clevelandclinic.org/health/diseases/22709-social-anxiety
A person with social anxiety disorder can have a mild, moderate or extreme form of it. […] It’s important to seek treatment because this type of anxiety affects your quality of life. […] A healthcare provider such as a clinician, psychologist, psychiatrist or therapist can diagnose a person with social anxiety disorder based on the criteria for social anxiety disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. […] The criteria for social anxiety disorder under the DSM-5 includes: Experiencing continuing, intense fear or anxiety about social situations because you believe you may be judged negatively or humiliated by others. […] A person typically has to have had symptoms of social anxiety disorder for at least six months in order to be diagnosed.
- #1 Table 16, DSM-IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison – DSM-5 Changes – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t12/
A. 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. […] A. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation, meeting unfamiliar people), being observed (e.g., eating or drinking), and performing in front of others (e.g., giving a speech). […] B. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed panic attack. […] C. The social situations almost always provoke fear or anxiety.
- #1 Social Anxiety Disorder > Fact Sheets > Yale Medicinehttps://www.yalemedicine.org/conditions/social-anxiety-disorder
The social situations almost always provoke fear or anxiety. […] The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context. […] The social situations are avoided or endured with intense fear or anxiety. […] The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. […] The fear, anxiety, or avoidance is persistent, typically lasting for six months or more. […] The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a substance use disorder or medication) or another medical condition. […] The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder.
- #1 Table 16, DSM-IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison – DSM-5 Changes – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t12/
D. The feared social or performance situations are avoided or else are endured with intense anxiety or distress. […] E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the persons normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia. […] G. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. […] F. In individuals under age 18 years, the duration is at least 6 months. […] G. The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., panic disorder with or without agoraphobia, separation anxiety disorder, body dysmorphic disorder, a pervasive developmental disorder, or schizoid personality disorder).
- #1 Social Anxiety Disorder: Causes, Symptoms, and Diagnosishttps://www.healthline.com/health/anxiety/social-phobia
Social anxiety disorder sometimes known as social phobia is a type of anxiety disorder that causes anxiety or fear in social settings. […] According to the Anxiety and Depression Association of America (ADAA), around 15 million American adults have social anxiety disorder. It often starts during the teenage years. […] Theres no medical test to check for social anxiety disorder, but a doctor will likely use criteria from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) to establish if social anxiety disorder is likely. […] The criteria for assessing social anxiety disorder, according to the DSM-5, are: a fear of one or more social situations that could involve scrutiny from others; having a fear of acting in a way that will lead to a negative evaluation by others, or upset or offend others; a specific situation nearly always provokes fear or anxiety; the person either avoids the situation or attends with intense anxiety or fear; fear is out of proportion to the threat; fear or anxiety is persistent, usually lasting 6 months or more; fear and anxiety disrupt daily living; other symptoms or health conditions cannot explain the fear and anxiety the person feels. […] Counseling, medication, and lifestyle remedies are all options. Social anxiety disorder seems to respond well to a combination of counseling and antidepressants, such as SSRIs and SNRIs.
- #1 Table 16, DSM-IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison – DSM-5 Changes – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t12/
H. The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. […] I. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder. […] J. If another medical condition (e.g., Parkinsons disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive.
- #1https://www.pediatriconcall.com/calculators/dsm-5-social-phobia-social-anxiety-disorder
The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder. […] If another medical condition (e.g., Parkinsons disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive. […] If the fear is restricted to speaking or performing in public.
- #1 300.23 Social Anxiety Disorder (Social Phobia) Symptoms And Related Diagnosis – Senior Care Psychological Consultinghttps://seniorcarepsychological.com/300-23-social-anxiety-disorder-social-phobia-symptoms-and-related-diagnosis/
Social phobia was first classified as a mental disorder in the DSM-III. More recently it has been reclassified in the DSM-5 (Diagnostic And Statistical Manual of Mental Disorders-Fifth edition) as social anxiety disorder. It is one of the most common anxiety disorders with some researchers believing that it has a lifetime prevalence rate of a little more than 10%. Most people are diagnosed with social anxiety disorder in childhood or in the earlier adolescent years. This anxiety disorder is frequently comorbid with other mental health disorders such as major depressive disorder, substance use disorders and other anxiety disorders. […] Some of the treatments available for social anxiety disorder include both psychological treatments and medication. […] Social anxiety disorder has only one diagnostic code: 300.23 (F40.10). However, a performance only specifier may also be included with this disorder if it is specifically related to speaking or performing in public. […] The specific symptoms of social anxiety disorder follow below. […] The fear, anxiety, or avoidance is persistent, typically lasting for six months or more. […] Specify if: Performance only: If the fear is restricted to speaking or performing in public.
- #1 Social Anxiety Disorder (Social Phobia) – PsychDBhttps://www.psychdb.com/anxiety/social-anxiety
The Social Phobia Inventory (SPIN) demonstrates solid psychometric properties and shows promise as a measurement for the screening of, and treatment response to, social phobia. […] The Mini-Social Phobia Inventory (Mini-SPIN) is a 3-question screening tool that has a 90% screening accuracy for diagnosing generalized social anxiety. […] Cognitive behavioural therapy with exposure is a first-line, gold-standard treatment for social anxiety disorder. […] In performance-type social anxiety disorder only, beta-blockers have been used for performance anxiety. […] If response to a medication is inadequate, dosing should be optimized and compliance assessed before switching to another agent. […] In patients who have inadequate response to optimal dosages of a first line agent or in whom the agent is not tolerated, switch to another first-line agent. […] While benzodiazepines are a second-line treatment, they may be used at any time if there is an acute and severe exacerbation of agitation or anxiety in individuals with SAD who do not have co-morbid alcohol or substance abuse.
- #1 Social Anxiety Disorder: A Common, Underrecognized Mental Disorder | AAFPhttps://www.aafp.org/pubs/afp/issues/1999/1115/p2311.html
To meet the diagnostic criteria for this disorder, the symptoms must be severe enough to cause significant distress or disability. […] Social phobia can be generalized, meaning that the patient fears many or most social interactions, or it can be limited to one or a few situations, such as public speaking or performing. […] Approximately one half of patients with social phobia have comorbid mental, drug or alcohol problems. […] The disorder increases a patient’s lifetime risk of depression approximately fourfold. […] Although these data underscore the need for early detection, social phobia often goes undetected. […] In a recent epidemiologic study of 2,096 primary care patients in France, it was found that approximately 5 percent of those detected through screening met the criteria for social phobia.
- #1 Treatment of social phobia | Advances in Psychiatric Treatment | Cambridge Corehttps://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/treatment-of-social-phobia/C14381FCAF92BA6E5BD08A820AB33484
There tend to be two sub-types of social phobia generalised and non-generalised. […] A person afraid of speaking in public would not receive a diagnosis of social phobia if public speaking was not routinely encountered and the person was not particularly distressed about it. […] It is usually the degree of distress or impairment that warrants a diagnosis of social phobia, and the possible indicators need to be considered in the appropriate context. […] Social phobia might be confused with agoraphobia. […] Typical beliefs in an individual with social phobia focus on the perceived negative evaluation by others of revealing a flaw or unacceptable behaviour (for example, the person believes that her hands will shake or she will sound stupid or boring). […] The emotions in social phobia are predominantly those of anxiety and shame, and sometimes self-disgust or anger (which will depend on beliefs and safety behaviours).
- #1 Social Anxiety Disorder > Fact Sheets > Yale Medicinehttps://www.yalemedicine.org/conditions/social-anxiety-disorder
Social anxiety disorder is a type of anxiety disorder that makes people intensely fearful of participating in social situations. […] The diagnosis of social anxiety disorder requires that the symptoms persist for six months or longer. […] Doctors may diagnose social anxiety disorder after learning about a person’s medical history and performing a physical exam to rule out health conditions that may have similar symptoms. […] If the patient acknowledges a fear of social situations, the doctor will ask about their symptoms, including what situations cause fear and anxiety, how they feel when they’re in those situations, and whether their fear or anxiety prevents them from living their life fully. […] The following criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a diagnostic tool published by the American Psychiatric Association, may be used to diagnose social anxiety disorder: Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.
- #1 Social Anxiety Disorder: Symptoms, Tests, Causes & Treatmentshttps://my.clevelandclinic.org/health/diseases/22709-social-anxiety
Healthcare professionals and psychologists can use certain tools or tests usually a series of questions to learn more about what you’re experiencing to gauge whether or not you could have social anxiety disorder. […] Social anxiety disorder is highly treatable with cognitive behavioral therapy (CBT) and/or medication such as antidepressants (typically selective serotonin reuptake inhibitors also known as SSRIs or beta-blockers). […] Evidence has shown that cognitive behavioral therapy (CBT) and medications like antidepressants are very successful in treating and managing social anxiety disorder. […] If left untreated, social anxiety disorder can be debilitating and can result in poor education outcomes, declining job performance, lower-quality relationships and an overall decreased quality of life. […] It’s very important to contact your healthcare provider and seek treatment if you have symptoms of social anxiety.
- #1 Social Anxiety Disorder | Kaiser Permanentehttps://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.social-anxiety-disorder.hw177276
Social anxiety disorder (also called social phobia) is a condition in which a person is extremely anxious about what they will say or do in front of other people. […] To diagnose social anxiety disorder, your doctor will ask about your symptoms and past health. The doctor may ask other questions to see how you are doing emotionally. Blood or urine tests may also be done. They can rule out other medical conditions that can cause similar symptoms (such as hyperthyroidism). […] Treatment of social anxiety disorder includes counseling and sometimes medicine. Whether you need medicine depends on how much the condition affects your daily life. […] To diagnose social anxiety disorder, your doctor will ask about your symptoms and past health. The doctor may ask other questions to see how you are doing emotionally. Blood or urine tests may also be done. They can rule out other medical conditions that can cause similar symptoms (such as hyperthyroidism).
- #1 Social Anxiety Disorder – Definition, Symptoms, and Causeshttps://www.mentalhealth.com/library/social-anxiety-disorder
Social anxiety disorder is a mental health condition that leads to fear in social situations where a person might be subject to evaluation or rejection by others. […] The condition was once called social phobia, but with newer editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), it is now referred to as social anxiety disorder, because mental health experts have determined that social anxiety disorder differs clinically from a specific phobia. […] When a person presents with symptoms of social anxiety disorder, a mental health professional like a psychologist or clinical social worker will diagnose the condition using criteria in the DSM. […] A clinician making a diagnosis of social anxiety disorder may use standardized questionnaires or instruments that capture symptoms of the condition.
- #1 Social Anxiety Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK555890/
Evaluation of SAD must include its diagnostic criteria as classified in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). […] The fear must not be attributable to the effects of a substance or medical condition or the symptoms of a different mental disorder. […] A core feature of SAD is the fear of negative evaluation. […] Instruments that assess for SAD include but are not limited to the Social Phobia Inventory (SPIN), Mini-SPIN, Liebowitz Social Anxiety Scale (LSAS), Liebowitz Self-Rated Disability Scale, Disability Profile, Brief Social Phobia Scale (BSPS), and Social Phobia Safety Behaviors Scale and Self Statements During Public Speaking Scale. […] There is a large amount of evidence supporting the efficacy of medications and cognitive behavioral therapy (CBT) in SAD. […] Evidence shows that SAD is highly treatable with either cognitive behavioral therapy (CBT) or pharmacotherapy in the form of SSRIs and SNRIs or beta-blockers.
- #1 Social Anxiety Disorder – Mental Health Disorders – Merck Manual Consumer Versionhttps://www.merckmanuals.com/home/mental-health-disorders/anxiety-and-stressor-related-disorders/social-anxiety-disorder
Social anxiety disorder is characterized by fear or anxiety about certain social or performance situations. These situations are often avoided or endured with much distress. […] Doctors diagnose social anxiety disorder when people have fear or anxiety that involves all of the following: Is intense and has been present for 6 months or longer; Concerns one or more social situations; Nearly always occurs in the same situation or situations; Involves fear of a negative evaluation by others; Leads the person to avoid the situation or uncomfortably endure it; Is out of proportion to the actual danger; Causes significant distress or significantly impairs functioning. […] Also, doctors rule out other mental health disorders that can cause similar symptoms, such as agoraphobia, panic disorder, or body dysmorphic disorder.
- #1 Social Anxiety Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK555890/
SAD must be differentiated from other disorders, including neurodevelopment disorders such as autism spectrum disorder, panic disorder and agoraphobia, depressive disorders, substance-related and addictive disorders, body dysmorphic disorder, and personality disorders such as schizoid personality disorder and avoidant personality disorder. […] As indicated in the DSM-5 criteria, to make a diagnosis of SAD, the individual’s symptoms must not be better explained by symptoms of another mental disorder. […] Left untreated, SAD is recognized as a debilitating and highly prevalent disorder that may result in lower educational attainment, worse occupational performance, hampered social interaction, lower-quality relationships, and decreased quality of life. […] Many individuals with SAD are not aware of their mental health problems and, therefore, do not seek treatment. […] Many patients with SAD do not realize they have a treatable illness and, therefore, do not seek treatment. […] Recognition of SAD is poor and requires more effort from healthcare professionals to recognize it, as individuals with the disorder are unlikely to self-report it due to their symptoms.
- #1 Comprehensive Social Phobia Test and Anxiety Assessment Tools – The Kingsley Clinichttps://thekingsleyclinic.com/resources/comprehensive-social-phobia-test-and-anxiety-assessment-tools/
In addition to aiding diagnosis, social phobia inventories are valuable tools for tracking progress over time. […] Another significant benefit of social phobia inventories is their accessibility. […] Furthermore, social phobia inventories empower patients by offering a clearer understanding of their condition. […] Social phobia inventories, such as the Social Phobia Inventory (SPIN) or the Liebowitz Social Anxiety Scale (LSAS), are specialized tools designed to assess and diagnose mental health conditions related to social anxiety. […] Social phobia inventories are highly effective in diagnosing SAD. […] The SPIN has a PPV of approximately 88% and an NPV of 90%, making it a reliable tool for identifying individuals with SAD. […] The Social Phobia Inventory (SPIN) is a standardized self-assessment tool designed to measure symptoms of social anxiety disorder.
- #1 Social Anxiety Disorder Diagnosis: Tests, Screening, and Criteriahttps://www.verywellhealth.com/social-anxiety-disorder-diagnosis-5111865
In the DSM-5, the term „social phobia” was updated to „social anxiety” since phobia does not clearly articulate the degree of impairment caused by this condition. […] To make a diagnosis, a mental health professional (psychiatrist, psychologist, or clinical social worker) will administer a social anxiety assessment, such as LSAS, BSPS, or Severity Measure for Social Anxiety Disorder. […] Based on these findings, a mental healthcare provider can make a diagnosis of social anxiety disorder and help you manage your condition.
- #1 Social Phobia Differential Diagnoseshttps://emedicine.medscape.com/article/290854-differential
Social phobia can occur comorbid with other disorders such as major depression and posttraumatic stress disorder. […] The use of diagnostic scales such as the Screen for Child Anxiety Related Disorders (SCARED) can assist with confirming diagnosis.
- #1 Social Anxiety Disorder – Psychiatric Disorders – Merck Manual Professional Editionhttps://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/social-anxiety-disorder
Also, the fear and anxiety cannot be more correctly characterized as a different mental disorder (eg, agoraphobia, panic disorder, body dysmorphic disorder, avoidant personality disorder). […] As is true for other anxiety disorders, it is useful to identify a catastrophic spiral of cognition when diagnosing social anxiety disorder. […] Patients with social anxiety disorder tend to develop avoidance strategies, such as declining party invitations or meeting new people. […] However, there are multiple therapeutic options available for patients. […] Cognitive-behavioral therapy (CBT) involves teaching patients to recognize and control their distorted thinking and false beliefs as well as instructing them on how to use exposure therapy. […] SSRIs and benzodiazepines are also effective for social anxiety. […] For patients who experience distress when they need to perform in public, beta-blockers may be prescribed to reduce the increased heart rate, trembling, and sweating.
- #1 Social Phobia: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/290854-overview
Social phobia often goes undiagnosed in patients with other coexisting acute psychiatric conditions such as depression or suicidality but should not be overlooked, as it can contribute to a lack of symptom remission. […] Social phobia can also be comorbid with autistic spectrum disorder. […] Social anxiety can occur in the presence of autism and can have a poorer prognosis, especially if major depression develops in adulthood.
- #1 Social anxiety disorder: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000957.htm
Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as at parties and other social events. […] People with social anxiety disorder fear and avoid situations in which they may be judged by others. […] People with social phobia are at high risk for alcohol or other substance misuse. […] People with social anxiety disorder become very anxious and self-conscious in everyday social situations. […] Social anxiety disorder is different from shyness. […] Your health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends. […] The goal of treatment is to help you function effectively. […] Certain medicines, often also used to treat depression, may be very helpful for this disorder. […] Contact your provider if fear is affecting your work and relationships with others. […] Phobia – social; Anxiety disorder – social; Social phobia; SAD – social anxiety disorder.
- #1 Social Anxiety Disorder – BDDFFacebook iconTwitter iconInstagram iconhttps://bddfoundation.org/information/bdd-related-conditions/social-anxiety-disorder/
BDD is often associated with social anxiety and fears of being judged negatively by others. […] Compared to BDD, individuals with social phobia fear that they would act in a way that would be humiliating, embarrassing or offend others. […] An additional diagnosis of social anxiety disorder can only be made when the person displays a broader fear that he or she will show anxiety symptoms (e.g. go red, shake) or act inappropriately (for example âbe boringâ) in a way that will then be judged negatively. […] Many people with BDD have also suffered from social anxiety in the past.
- #1 Social anxiety disorder – Wikipediahttps://en.wikipedia.org/wiki/Social_anxiety_disorder
Social anxiety disorder is distinct from the personality traits of introversion and shyness. […] Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impairing ability to function in at least some aspects of daily life. […] According to ICD-10 guidelines, the main diagnostic criteria of social phobia are fear of being the focus of attention, or fear of behaving in a way that will be embarrassing or humiliating, avoidance and anxiety symptoms. […] Standardized rating scales can be used to screen for social anxiety disorder and measure the severity of anxiety. […] The DSM-5 notes that for social anxiety disorder, the fear must be attributed or correlated to social situations and not another condition.
- #1 Social anxiety disorder ICD 10https://www.theraplatform.com/blog/1055/social-anxiety-disorder-icd-10
Further adding to the social anxiety disorder ICD 10 confusion is that certain disorders can present with similar symptoms to social anxiety. […] Comorbidity presents a particular problem for accurate diagnosis and treatment and proper use of social anxiety disorder ICD 10. […] Social anxiety disorder has one of the highest rates of comorbidity of any mental health problem. It is estimated that up to 90 percent of people with the disorder have a co-occurring diagnosis. […] What is disheartening for professionals in the mental health field is that fewer than five percent of people with social anxiety disorder have sought treatment after a year of experiencing symptoms. And that is despite there being many effective treatments: CBT is the most well-researched treatment for social anxiety disorder. It involves changing maladaptive thoughts, as well as learning behavioral interventions aimed at reducing anxiety.
- #1 Social Phobia | Abnormal Psychologyhttps://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/social-phobia/
As with all the other anxiety disorders, there has been significant progress in understanding the biological, psychological, and social causes of SP over the last several decades. […] Only half of persons with SP ever seek treatment of any kind, and for those who do seek treatment, the average amount of time between onset of problems and seeking help is between 15-20 years. […] The first line medical treatments for SP are the SSRIs, with the exception of fluoxetine, and the SNRIs. […] The first change is the name of the disorder. In the DSM-IV, it is referred to as Social Phobia (Social Anxiety Disorder) while in the DSM-5 it is proposed to be renamed Social Anxiety Disorder (Social Phobia).
- #1 Social Anxiety Disorder – Psychiatric Disorders – Merck Manual Professional Editionhttps://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/social-anxiety-disorder
Social anxiety disorder is characterized by fear of and anxiety about being exposed to certain social or performance situations. […] Diagnosis is based on clinical criteria. […] To meet the DSM-5-TR criteria for diagnosis, patients must have marked, persistent (6 months) fear of or anxiety about one or more social situations in which they may be scrutinized by others. […] Fear must involve a negative evaluation by others (eg, that patients will be humiliated, embarrassed, or rejected or will offend others). […] The same social situations nearly always trigger fear or anxiety. […] Patients actively avoid the situation. […] The fear or anxiety is out of proportion to the actual threat (taking into account sociocultural norms). […] The fear, anxiety, and/or avoidance cause significant distress or significantly impair social or occupational functioning.
- #1 Social Phobia | CRUfADhttps://crufad.org/for-clinicians/social-phobia/
Social phobia, the fear of being judged negatively, is often not recognised because patients do not like to talk about their fears. […] Social phobia is not uncommon and should be considered whenever someone says that people make me anxious. […] The key feature of social phobia is the fear of being scrutinised or being evaluated negatively by other people. […] According to the World Health Organizations (WHO) International Classification of Diseases (ICD)-10th Edition, social phobia is diagnosed when the individual displays the following features: A marked and persistent fear of being scrutinised by others in one or more social or performance situations. […] The fear leads to marked distress during exposure to the social situation, or may lead to avoidance of that situation. […] Normal social anxiety or avoidance as experienced by most of the population, such as the fear associated with public speaking, does not necessarily justify a diagnosis of social phobia if the fear does not interfere with the individuals social or occupational functioning.
- #1 Social Anxiety Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK555890/
Social anxiety disorder (SAD) includes the essential feature of marked fear or anxiety of one or more social situations during which the individual may or may not be under scrutiny by others. […] This activity describes the evaluation and treatment of social anxiety disorder and reviews the role of the interprofessional team in managing patients with this condition. […] Social anxiety disorder (SAD) is characterized by excessive fear of embarrassment, humiliation, or rejection when exposed to possible negative evaluation by others when engaged in a public performance or social interaction. It is also known as social phobia. […] The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 described social phobia in a way that limited the diagnosis due to exclusionary criteria, including those with an avoidant personality disorder, a new category at the time.
- #1 Social Phobia vs. Social Anxiety Disorderhttps://www.verywellmind.com/social-phobia-or-anxiety-disorder-3024447
Social phobia is just a different name for social anxiety disorder. […] The difference between social phobia and social anxiety disorder (SAD) is largely chronological, in that social phobia is the former term and SAD is the current term for the disorder. However, there are differences in the symptoms used to diagnose the two conditions. […] The official psychiatric diagnosis of social phobia was introduced in the third edition of the Diagnostic and Statistical Manual (DSM-III). […] When the DSM-IV was published in 1994, the term social phobia was replaced by social anxiety disorder. The new term was introduced to describe the broad and generalized nature of the fears that are a part of this disorder. […] The DSM-5 specifies that social situations almost always provoke anxiety and fear.
- #1 What Is the Difference Between Social Anxiety and Social Phobia? â Bridges to Recoveryhttps://www.bridgestorecovery.com/social-anxiety/difference-social-anxiety-social-phobia/
Despite its ubiquity, it was not until 1994 that the term âsocial anxiety disorderâ was mentioned in the official medical literature (in the American Psychological Associationâs Diagnostic and Statistical Manual of Mental Disorders, 4th edition, also known as the DSM-IV). Before that, the only clinically diagnosable form of social anxiety was known as social phobia, and even that was only mentioned for the first time in the DSM-III, which was published in 1980. […] When social anxiety disorder replaced social phobia as a category for diagnosis, it incorporated the symptoms of both social anxiety and social phobia under its broad diagnostic umbrella. […] Nevertheless, there is a difference between social anxiety and social phobia. The former refers to the fear and anxiety experienced before and during conversations and other direct social interactions, while the latter covers fears and insecurities connected to public performance.
- #1 DSM-IV-R Definition of Social Anxiety Disorder | Social Anxiety Institutehttps://socialanxietyinstitute.org/dsm-definition-social-anxiety-disorder
The DSM-5 (2013) has made very minor changes in the definition of social anxiety disorder. The definitional change: from The duration is at least 6 months to The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months. The rest of the diagnostic definition remains the same. […] The Diagnostic and Statistical Manual of the American Psychiatric Association (APA) currently defines social anxiety disorder as follows: A. A 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 embarrassing and humiliating. […] F. The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months. […] There needs to be a clear distinction between these terms, as many people are misdiagnosed as a result of the current language in the DSM-5. […] Social Anxiety is Commonly Misdiagnosed. […] The Problem with Using the Terminology „Panic” for Social Anxiety Disorder.
- #1 What Is the Difference Between Social Anxiety and Social Phobia? â Bridges to Recoveryhttps://www.bridgestorecovery.com/social-anxiety/difference-social-anxiety-social-phobia/
Social anxiety and social phobia are often used interchangeably. But there is some distinction between social anxiety and social phobia, specifically in the situations that trigger stress responses. Social phobia refers to the fear of being scrutinized and judged while performing some type of task in public, while social anxiety describes feelings of intense nervousness and self-consciousness that sufferers experience during one-on-one meetings or group social gatherings. The symptoms of both are now included under the umbrella of social anxiety disorder, which is the official diagnosis for people who suffer from excess social anxiety in a broad variety of situations. […] Social anxiety disorder is a condition that affects 15 million men and women, which represents about seven percent of the adult population in the United States. Millions of children and adolescents also suffer from severe social anxiety symptoms, since the disorder tends to develop at relatively young ages (the average age of onset is 13).
- #1 Social anxiety disorder (social phobia) – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561
It’s normal to feel nervous in some social situations. […] But in social anxiety disorder, also called social phobia, everyday interactions cause significant anxiety, self-consciousness and embarrassment because you fear being scrutinized or judged negatively by others. […] In contrast to everyday nervousness, social anxiety disorder includes fear, anxiety and avoidance that interfere with relationships, daily routines, work, school or other activities. […] Social anxiety disorder typically begins in the early to mid-teens, though it can sometimes start in younger children or in adults. […] Signs and symptoms of social anxiety disorder can include constant: Fear of situations in which you may be judged negatively, Worry about embarrassing or humiliating yourself, Intense fear of interacting or talking with strangers, Fear that others will notice that
- #1 Social Anxiety Disorder (Social Phobia) – PsychDBhttps://www.psychdb.com/anxiety/social-anxiety
The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more. […] The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. […] The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance or another medical condition. […] The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder. […] The fear, anxiety, or avoidance is clearly unrelated or is excessive if another medical condition is present. […] Common physical symptoms of social anxiety disorder include: blushing, stammering, sweating, gastrointestinal symptoms, dry mouth, palpitations, trembling, urgency of micturition, and panic attacks.
- #1 Social phobia vs. social anxiety: Similarities, differences, and morehttps://www.medicalnewstoday.com/articles/social-phobia-vs-social-anxiety
Social anxiety disorder may also have associations with physical experiences, such as headaches, upset stomach, heart palpitations, dizziness, shortness of breath, sweating, trembling. […] Mental health specialists give a formal diagnosis of social anxiety disorder in the DSM-5-TR when a person meets specific diagnostic criteria. […] Treatment options for anxiety disorders such as social anxiety disorder generally include medications and psychotherapy. […] As a type of anxiety disorder, treatment for social anxiety disorder can include specific psychotherapy approaches and medication.
- #1 Treatment of social phobia | Advances in Psychiatric Treatment | Cambridge Corehttps://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/treatment-of-social-phobia/C14381FCAF92BA6E5BD08A820AB33484
Social phobia (or social anxiety disorder) manifests as a marked and persistent fear of negative evaluation in social or performance situations. […] Social phobia (or social anxiety disorder) consists of a marked and persistent fear of social or performance situations. […] Social phobia is the third most common mental disorder in adults worldwide, with a lifetime prevalence of at least 5% (depending on the threshold for distress and impairment). […] Although common, social phobia is often not diagnosed or effectively treated. […] The core psychopathology in social phobia is a fear of negative evaluation in social and performance situations. […] Social phobia usually leads to avoidance of situations such as public speaking or talking to a group, parties, meetings, eating or drinking in public, working or writing while being observed, telephone calls, intimacy or dating.
- #1 Social anxiety disorder – Symptoms, diagnosis and treatment | BMJ Best Practicehttps://bestpractice.bmj.com/topics/en-gb/1120
Social anxiety disorder is characterised by an excessive fear of social and performance situations where the individual is afraid of being negatively evaluated or rejected by others. […] Assessment is based on self-reporting, clinical interview, and behavioural observation. […] The condition involves an excessive fear of social or performance situations. The individual will often fear being rejected or negatively evaluated by others. […] Key diagnostic factors include presence of risk factors, anticipatory anxiety and worry, tachycardia, hyperventilation, sweating, flushing, and muscle tension. […] Other diagnostic factors include post-event processing, attentional biases, social skills deficits, crying, tantrums, or 'freezing’, and selective mutism. […] 1st investigations to order include clinical diagnosis.
- #1 Social Anxiety Disorder (Social Phobia) DSM-5 300.23 (F40.10)https://www.theravive.com/therapedia/social-anxiety-disorder-(social-phobia)-dsm–5-300.23-(f40.10)
Comorbidity occurs with other anxiety disorders, depression and substance abuse disorders according to the DSM- 5 (American Psychiatric Association, 2013). […] CBT (Cognitive Behavioral Therapy) with an emphasis on exposure can reduce symptoms of social phobia. […] The DSM-5 notes that overall quality of life can be affected due to social withdrawal and isolation (American Psychiatric Association, 2013). […] There are a number of rule-outs that the clinician must consider to arrive at an accurate diagnosis.
- #1 Social anxiety (social phobia) – NHShttps://www.nhs.uk/mental-health/conditions/social-anxiety/
Social anxiety disorder, also called social phobia, is a long-term and overwhelming fear of social situations. […] It’s important to get help if you are having symptoms. There are treatments that can help you manage it. […] It’s a good idea to see a GP if you think you have social anxiety, especially if it’s having a big impact on your life. […] If they think you could have social anxiety, you’ll be referred to a mental health specialist to have a full assessment and talk about treatments. […] A number of treatments are available for social anxiety. […] CBT is generally considered the best treatment, but other treatments may help if it does not work or you do not want to try it. […] Treatments for social anxiety in children are similar to those for teenagers and adults, although medicines are not normally used.
- #1 Treatment of social phobia | Advances in Psychiatric Treatment | Cambridge Corehttps://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/treatment-of-social-phobia/C14381FCAF92BA6E5BD08A820AB33484
Therapy begins with a detailed assessment and formulation of the problem, which is developed collaboratively between therapist and patient. […] Medication is indicated if it is the patient’s first choice, CBT has failed, there is a long waiting-list for CBT or there is significant comorbidity of depression. […] The treatment of choice in social phobia is a selective serotonin reuptake inhibitor (SSRI). […] About 50% of patients relapse on discontinuation of an SSRI and treatment is therefore continued for a minimum of 12 months. […] As always, treatment will depend upon patient choice and availability of therapy, but in common with other anxiety disorders, CBT is the initial choice of treatment for social phobia, as it is usually more acceptable and has a reduced risk of relapse.
- #1 Social anxiety disorder – Signs, symptoms and treatment | healthdirecthttps://www.healthdirect.gov.au/social-anxiety-disorder
While psychological therapies are the most effective treatment, medicines may also be given for severe social anxiety. […] The medicines most often used to treat social anxiety disorder are antidepressants specifically SSRIs (selective serotonin reuptake inhibitors). […] If you think you may have social anxiety disorder, seek help from your doctor or a mental health professional. […] They can diagnose you and give you advice on treatments and coping strategies.
- #1 Social Phobia Inventory Test for Social Anxietyhttps://www.verywellhealth.com/social-phobia-inventory-test-5271967
The social phobia inventory scale, or SPIN, is a way of measuring a persons level of social phobia or social anxiety. Developed at Duke University, it contains 17 expert questions that are said to assist in the diagnosis of social anxiety disorder. […] The SPIN test is a tool that healthcare providers can consider when diagnosing and treating social anxiety. It also can be used to evaluate how well treatment, such as acceptance and commitment therapy (ACT) or cognitive behavioral therapy (CBT), is working for people diagnosed with social anxiety. […] By self-reporting and reviewing your answers, you may see where social anxieties pop up in your life and to what degree theyre causing you distress. Keep in mind, though, that although SPIN test results are generally reliable, they do not stand alone as a diagnosis.
- #1 Social Anxiety Disorder: A Common, Underrecognized Mental Disorder | AAFPhttps://www.aafp.org/pubs/afp/issues/1999/1115/p2311.html
These data reemphasize the importance of comprehensive psychiatric screening and highlight the need to screen for social phobia, particularly in patients who present with other common mental health disorders, such as depression or substance abuse. […] Treatment planning should consider the patient’s preference, the severity of presenting symptoms, the degree of functional impairment, psychiatric and substance-related comorbidity, and long-term treatment goals. […] There is no empirically derived algorithm for the treatment of social phobia, although evidence-based options include cognitive behavioral therapy, pharmacotherapy, or both. […] Expert consensus guidelines are consistent with consideration of cognitive behavioral therapy alone for mild to moderate cases and combined cognitive behavioral therapy and pharmacotherapy for moderate to severe cases of generalized social phobia.
- #2 Social Anxiety Disorder – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK555890/
Social anxiety disorder (SAD) includes the essential feature of marked fear or anxiety of one or more social situations during which the individual may or may not be under scrutiny by others. […] This activity describes the evaluation and treatment of social anxiety disorder and reviews the role of the interprofessional team in managing patients with this condition. […] Social anxiety disorder (SAD) is characterized by excessive fear of embarrassment, humiliation, or rejection when exposed to possible negative evaluation by others when engaged in a public performance or social interaction. It is also known as social phobia. […] The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 described social phobia in a way that limited the diagnosis due to exclusionary criteria, including those with an avoidant personality disorder, a new category at the time.
- #2 Social Anxiety Disorder Diagnosis: Tests, Screening, and Criteriahttps://www.verywellhealth.com/social-anxiety-disorder-diagnosis-5111865
Social anxiety disorder, also known as social phobia, is a type of anxiety disorder characterized by intense emotional distress around social interactions in which you may be scrutinized by others. […] Mental health professionals diagnose social anxiety disorder by using specific criteria from the „Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” (DSM-5). The diagnosis can be made by a psychiatrist, psychologist, or clinical social worker. […] Your healthcare provider will use the DSM-5 criteria to determine whether you have social anxiety disorder. The DSM-5 criteria for social anxiety disorder include the following: Marked fear of social situations where the person may be scrutinized by others; examples include conversations with unfamiliar people, eating in front of others, or giving a presentation.
- #2 Social Anxiety Disorder > Fact Sheets > Yale Medicinehttps://www.yalemedicine.org/conditions/social-anxiety-disorder
Social anxiety disorder is a type of anxiety disorder that makes people intensely fearful of participating in social situations. […] The diagnosis of social anxiety disorder requires that the symptoms persist for six months or longer. […] Doctors may diagnose social anxiety disorder after learning about a person’s medical history and performing a physical exam to rule out health conditions that may have similar symptoms. […] If the patient acknowledges a fear of social situations, the doctor will ask about their symptoms, including what situations cause fear and anxiety, how they feel when they’re in those situations, and whether their fear or anxiety prevents them from living their life fully. […] The following criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a diagnostic tool published by the American Psychiatric Association, may be used to diagnose social anxiety disorder: Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.
- #2 Social Anxiety Disorder (Social Phobia) – PsychDBhttps://www.psychdb.com/anxiety/social-anxiety
Social Anxiety Disorder (also known as social phobia), is an anxiety disorder characterized by a significant amount of fear in one or more social situations, causing significant distress and impaired ability to function in some aspects of daily life. These fears can be triggered by perceived or actual scrutiny, or negative evaluation from others. […] The DSM-5 Diagnostic Criteria includes marked fear or anxiety about 1 or more social situations in which the individual is exposed to possible scrutiny by others. […] The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated. […] The social situations almost always provoke fear or anxiety. […] The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.