Social anxiety disorder, also known as social phobia, can be described as an extreme fear of social situations, in addition to a fear of being negatively judged or evaluated by others. The DSM-5 lists numerous criteria for the disorder such as the intense fear being out of proportion with the actual risk, avoiding social situations, and fearing negative evaluations or judgements from others. There is also performance only social anxiety disorder, which applied if the fear is limited to public speaking or performing in public.
Social anxiety disorder is typically developed between the ages of 10 and 13, the ages where puberty typically starts. The prevalence rate in ages 13-18 is 19.1% meaning the chance of developing the disorder between those years is almost 20%. Females are more likely to develop social anxiety disorder as 8% of females are diagnoses and about 6% of males.
There is no single cause that determines the disorder, but numerous factors can lead to the development of the disease. These factors include heritability, conditioning and reinforcements, and parent-child interaction. Heritability accounts for about 50% of the cases of the disorder. This is usually due to temperament being established when you are first born. Classical conditioning is when two stimuli, one neutral, are paired together and the response eventually occurs after only the neutral stimulus, without the second occurring. Negative reinforcement is taking something bad away to increase the behavior. For example, Sam went to the grocery store and had a random panic attack. Now, Sam doesn’t go to the grocery store because it is associated with the panic attack and causes fear. The classical conditioning occurs as the grocery store (neutral stimulus) is now paired with having a panic attack (response) and becomes the conditioned stimulus. By avoiding the grocery store you stay calm and relaxed, which is negative reinforcement. Parent-child interaction has shown to have a huge impact on the development of social anxiety disorder. If a parent is over-controlling, they will cause the child to fear things they shouldn’t and develop a fear of those things. For example, a mother tells her child to stay away from dogs because they will bite you. The child then fears the dog and situations with the dog because the mother reinforced that dogs were bad and you should stay away from them. All these factors and intertwine and overlap to cause the disorder, and everyone’s cause is different.
There are numerous treatments for social anxiety disorder. A short-term solution is medication. Medications are usually prescribed for one-time encounters with the stressor, rather than daily encounters, such as flying in an airplane. Some medications include beta-blockers, which people use to help control stress, benzodiazepines, and D-cycloserine. Cognitive behavior therapy is the most effective, long-term solution for the disorder. Cognitive behavioral therapy consists of challenging anxious thoughts relating to social judgement. The therapist usually places the client in an uncomfortable social situation, such as giving a speech in public, and does not let them escape from doing it. Another example would be making the client call different stores and ask about their hours if they fear having conversations on the phone. Cognitive behavior therapy allows the client to construct a fear hierarchy, which rates their fear of a certain situation and allows them to work on their rating. For example, when beginning therapy the client may rank making a phone call a 10 on the rating scale, but after they go through therapy, the rating decreases to a 3.
Social anxiety disorder can be very detrimental to those not treated. However, with the proper treatment the disorder can be managed, and the person can live a happy, normal, healthy life.