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Social anxiety refers to the fear of being humiliated, embarrassed, negatively evaluated, or rejected in social situations. A common human experience, social anxiety exists on a continuum of severity from infrequent and mild feelings of discomfort in social situations to chronic and pervasive distress in many different social settings. An individual’s experience of social anxiety may be limited to one specific type of social situation, such as public speaking, or it may be so pervasive that anxiety and fear are experienced in nearly any situation in which other people are present. When an individual’s social anxiety is excessive and results in significant distress or impairment, the person may be diagnosed with social anxiety disorder (or social phobia).
Social anxiety disorder is the third most prevalent psychiatric condition in the United States, with a lifetime prevalence rate of approximately 13 percent in the general population. The majority of individuals with excessive social anxiety, or social anxiety disorder, also report co-morbid anxiety, mood, or substance abuse (e.g., alcohol) conditions. Although excessive social anxiety is a relatively common psychological condition, the exact cause of the phenomenon remains unclear. Several researchers have noted the possibility of a genetic predisposition for social anxiety that appears to contribute to familial patterns of the condition. Developmental researchers point to temperamental characteristics in shy, fearful, and behaviorally inhibited children and the increased likelihood that these children will develop excessive social anxiety later in life. Other researchers believe that a predisposition may interact with early learning to reinforce the perception that social interactions are threatening and that estimated costs of social failures outweigh the possible benefits (e.g., intimacy).
As a coping strategy, people with excessive social anxiety often attempt to alter or control negative feelings associated with social evaluative concerns and avoid or escape situations in which these feelings may occur. These efforts may lead to increased apprehension of future social events, increased use of alcohol and other maladaptive coping strategies (e.g., rumination), and social withdrawal and isolation. As a result, excessive social anxiety is related to functional impairment in a variety of domains including school, work, leisure, and physical health. Socially anxious individuals also report a number of interpersonal problems, including fewer friends, less perceived social support, an increased likelihood of being single, and less romantic relationship satisfaction. Thus excessive social anxiety may be what therapists call a “life-limiting” condition in that it interferes with interpersonal functioning and results in fewer positive emotional experiences and events.
Social anxiety may be treated effectively with a variety of psychological and pharmacological interventions. Evidence suggests that both individual and group cognitive-behavioral therapy may be effective in reducing symptoms and distress associated with social anxiety. Cognitive-behavioral therapies tend to target dysfunctional thoughts, beliefs, and behaviors and teach individuals different, more adaptive, ways to manage their behavior and respond effectively in social situations. In addition, several medications, including benzodiazepines and the class of antidepressants called SSRIs (selective serotonin reuptake inhibitors) appear to be effective and well-tolerated.
Bibliography:
- Heimberg, Richard G., Michael R. Liebowitz, Debra A. Hope, and Franklin R. Schneier, eds. 1995. Social Phobia: Diagnosis, Assessment, and Treatment. New York: Guilford.
- Hofmann, Stefan G., and Patricia Marten DiBartolo, eds. 2001. From Social Anxiety to Social Phobia: Multiple Perspectives. Boston: Allyn and Bacon.
- Rapee, R. M., and R. G. Heimberg. 1997. A Cognitive-Behavioral Model of Anxiety in Social Phobia. Behaviour Research and Therapy 35 (8): 741–756.
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