When people with social anxiety disorder are unable to avoid situations that provoke anxiety, they typically perform safety behaviors: mental or behavioral acts that reduce anxiety in social situations by reducing the chance of negative social outcomes. For example, adults with social anxiety disorder are more likely to experience lower educational attainment and lower earnings (Katzelnick et al., 2001) perform more poorly at work be unemployed (Moitra, Beard, Weisberg, & Keller, 2011) and report greater a dissatisfaction with their family lives, friends, leisure activities, and income (Stein & Kean, 2000). If the fear is limited to performance-based situations, such as public speaking, a diagnosis of social anxiety disorder-performance only is assigned.Īlthough many people become anxious in social situations like public speaking, the fear, anxiety, and avoidance experienced in social anxiety disorder are highly distressing and lead to serious impairments in life. For example, one patient went out of her way to avoid any situation in which she might have to use a public restroom for fear that someone would hear her in the bathroom stall and think she was disgusting. The kinds of social situations in which individuals with social anxiety disorder usually have problems include public speaking, having a conversation, meeting strangers, eating in restaurants, and, in some cases, using public restrooms.Ī person with social anxiety disorder fears any situation that could potentially draw attention to the person. The heart of the fear and anxiety for a person with social anxiety disorder is that they may act in a humiliating or embarrassing way, appear foolish show symptoms of anxiety (blushing), or do or say something that might lead to rejection (such as offending others). Fears of negative evaluation might make someone repeatedly turn down invitations to social events or avoid having conversations with people, leading to greater and greater isolation. For example, a patient at one clinic compromised her perfect 4.0 grade point average because she could not complete a required oral presentation in one of her classes, causing her to fail the course. Further, the fear and avoidance of social situations must get in the way of the person’s daily life or seriously limit their academic or occupational functioning. To receive a diagnosis of social anxiety disorder, the fear and anxiety associated with social situations must be so strong that the person avoids them entirely, or if avoidance is not possible, the person endures them with a great deal of distress. Social anxiety disorder is more than exaggerated shyness (Bogels et al., 2010 Schneier et al., 1996). Yet, only a small proportion of the population fear these types of situations significantly enough to merit a diagnosis of social anxiety disorder (APA, 2013). Many people consider themselves shy, and most people find social evaluation uncomfortable at best, or giving a speech somewhat mortifying. Figure 1. Social anxiety disorder can cause people to miss even the most important events.
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