Social anxiety disorder (social phobia). fear of evaluation

Social Anxiety Disorder, also known as social phobia, is characterized by an intense and persistent fear or anxiety about one or more social or public performance situations in which the person feels exposed to possible scrutiny or negative evaluation by others.

Definition and Core Fear

The fundamental fear in social anxiety is not of social situations themselves, but the fear of acting in a way (or displaying symptoms of anxiety) that will be humiliating, embarrassing, lead to rejection, or offend others.

The person fears that they will be judged negatively by others.

The feared social situations can range from everyday interactions such as talking to strangers or participating in conversations, to performance situations such as public speaking, eating or drinking in front of others, or using public restrooms.

Response and Associated Behaviors

Exposure to the feared social situation almost invariably provokes an anxiety response, which may take the form of a situationally determined panic attack.

Children may express anxiety through crying, tantrums, clinging to parents, or refusing to speak in social situations.

People with social anxiety typically actively avoid these situations or endure them with intense anxiety and distress.

They often use safety behaviors to try to manage their anxiety or prevent the feared negative evaluation (e.g., mentally rehearsing what they will say, avoiding eye contact, speaking little).

They recognize that their fear is excessive or irrational (although this may not be the case in children).

Diagnostic Criteria and Impact

For diagnosis, the fear, anxiety, or avoidance is persistent (typically for six months or more) and causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

It should not be the effects of a substance or another medical condition, or is better explained by another mental disorder (such as panic disorder, body dysmorphic disorder, or autism spectrum disorder).

Social anxiety can be very limiting, leading to isolation, difficulty forming relationships, poor academic or work performance, and an overall decrease in quality of life.

It is one of the most common anxiety disorders, and fortunately, there are effective treatments, primarily cognitive behavioral therapy.