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Social Phobia

(Social Anxiety Disorder)

By John H. Greist, MD

Social phobia is fear of and anxiety about being exposed to certain social or performance situations. These situations are avoided or endured with substantial anxiety.

Social phobia affects about 9% of women and 7% of men during any 12-mo period, but the lifetime prevalence may be at least 13%. Men are more likely than women to have the most severe form of social anxiety, avoidant personality disorder (see Avoidant Personality Disorder (AVPD)).

Fear and anxiety in people with social phobia often centers on being embarrassed or humiliated if they fail to meet expectations. Often, the concern is that their anxiety will be apparent through sweating, blushing, vomiting, or trembling (sometimes as a quavering voice) or that the ability to keep a train of thought or find words to express themselves will be lost. Usually, the same activity done alone causes no anxiety.

Situations in which social phobia is common include public speaking, acting in a theatrical performance, and playing a musical instrument. Other potential situations include eating with others, meeting new people, having a conversation, signing a document before witnesses, or using public bathrooms. A more generalized type of social phobia causes anxiety in a broad array of social situations.

Most people recognize that their fears are unreasonable and excessive.

* This is the Professional Version. *