The Nature of Social Anxiety Disorder

Abstract

The essential feature of social anxiety disorder (social phobia) is a fear of scrutiny by other people in social or performance situations. The level of anxiety experienced by the person with social anxiety disorder is excessive, and results in substantial impairment in the sufferer’s social, family, and professional life. Three distinct subtypes of the disorder have been identified: generalized social anxiety disorder, in which the individual fears a multitude of social situations; nongeneralized social anxiety disorder, in which only 2 or 3 situations are feared; and public-speaking phobia. Results from a number of studies suggest that these subtypes of social anxiety disorder may represent distinct clinical syndromes, with the generalized subtype producing the most severe disability. Despite the prevalence of social anxiety disorder and the disability it causes, this condition remains underdiagnosed, and thus undertreated, by clinicians. This review discusses the barriers that prevent people who have this disorder from seeking help, and the steps that clinicians can take to aid their recognition and treatment of the disorder. It is only by effective diagnosis and treatment that the burden of social anxiety disorder will be lifted, allowing patients to resume a normal life.
(J Clin Psychiatry 1998;59[suppl 17]:20–24)