Individuals with “social phobia”, also termed as “social anxiety disorder” fear being judged or embarrassing themselves in front of others. Social phobia creates severe disruption in an individual`s daily life.
Many people get nervous when speaking to an audience or joining a group already engaged in a conversation. One study of college students found that 48 percent could be classified as “shy”. However, only 18 percent of these shy students qualified for a diagnosis of social phobia (Lifetime Prevalence of Social Fears in a National Survey, Heiser, Turner, & Beidel, 2003)).
In social situations, individuals with social phobia may tremble, perspire, feel confused and dizzy, experience heart palpitations, and ultimately have a full panic attack. They think others see their nervousness and judge them as inarticulate, weak, or crazy. They avoid speaking in public and having conversations with others for fear of being judged.
People with social phobia may avoid eating or drinking in public, for fear that they will make noises when they eat, drop food and thus embarrass themselves. They may avoid writing in public, afraid that others will see their hands tremble.
Social phobia tends to develop in either the early preschool years or adolescence when many individuals become self-conscious and concerned about others’ opinions of them.
The Diagnostic and Statistical Manual of Mental Disorders, Text Revision-IV (DSM-IV-TR) provides the framework of the criteria of social phobia.
1) A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way that will be humiliating or embarrassing.
2) Exposure to the feared social situation almost invariably provokes anxiety.
3) The feared social or performance situations are avoided or else are endured with intense anxiety and the individual recognises that the fear is excessive or unreasonable.
4) The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the individual`s normal routine, academic and occupational functioning, social activities and relationships.
5) The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition or any other mental disorder.
In individuals under age 18, the duration is at least 6 months.
Understanding the development of social phobia
According to the cognitive theory,
Individuals with social phobia have excessively high standards for their social performance––for example, they believe they should be liked by everyone.
They also focus on negative aspects of social interactions and evaluate their own behaviour punitively.
They are quick to notice potentially threatening social cues (such as a grimace on the face of the person they are speaking to) and to misinterpret them in self-defeating ways.
Humiliating experiences such as extreme teasing as a child also contribute to symptoms of social phobia.
What creates these cognitive biases?
Adults with social phobia often describe their parents as having been overprotective and controlling but moreover, judgemental, and negative during their childhood.
Treatment plan-Cognitive-behavioural therapy seems particularly useful for social phobia and can be implemented in a group setting where in group members are phobic and are an audience for one another by providing exposure to the very situation each member fears. An individual can practice his/her feared behaviours in front of others while the therapist coaches him/her in the use of relaxation techniques to calm anxiety. The phobic clients are helped to identify and challenge negative, catastrophizing thoughts they have when they experience anxiety. Group cognitive-behavioural therapy effectively treats social phobia and prevents relapse.