Curriculum · Mental Health / Psychiatry
Social anxiety disorder
What it is
Social phobia is characterized by a fear of being humiliated publicly and a fear of social or performance situations. The phobias are named as specific and social in one source, and set out as three disorders in another: agoraphobia, social phobia and specific phobia. Social phobia begins in late adolescence; agoraphobia begins around 28 years and can be associated with panic; specific phobia begins at 5-9 years.
Set among the anxiety disorders, its general features are those of the group: a duration of more than 6 months, distress or impairment, and other medical or substance causes ruled out. The first-line treatment of the group is CBT with an SSRI.
How it presents
The phobia disorders share a shape: the fear comes from a certain situation, with autonomic symptoms, avoidance and anticipatory anxiety. All are more common in females except needle phobia, and all cause tachycardia except blood injury phobia, which causes bradycardia. Social phobia is of others' judgments, presentations, urination in public and foul smelling; agoraphobia is of crowds, public places, travelling alone and travelling away from home.
It is fear of judgment in social settings, with avoidance of performance, talks and eye contact. Its specifier is performance only, for the person whose fear is of performing and of nothing else. So the man who avoids presentations and eye contact with people he meets for fear of their judgment, and who has no fear away from such situations, has social anxiety disorder.