![]() It therefore seems that although women are more likely to experience social anxiety, men may be more likely to seek treatment and to do so with less severe symptoms. Turk and colleagues ( Turk et al., 1998) reported that in a clinical sample women feared more social situations and scored higher on a range of social anxiety measures. Women and men are equally likely to seek treatment for social anxiety disorder, but community surveys indicate that women are somewhat more likely to have the condition ( Kessler et al., 2005a). Data from the National Comorbidity Survey reveals that social anxiety disorder is the third most common psychiatric condition after major depression and alcohol dependence ( Kessler et al., 2005a). Using strict criteria and face-to-face interviews in the US, the lifetime and yearly prevalence figures are halved to 5% and 3%, respectively ( Grant et al., 2005b), but it is still more common than the major autoimmune conditions (rheumatoid arthritis, ulcerative colitis, Crohn's disease, systemic lupus erythematosus, diabetes mellitus type I, multiple sclerosis, uveitis, hypothyroidism and hyperthyroidism) put together ( American Autoimmune Related Diseases Association, 2011). Twelve-month prevalence rates as high as 7% have been reported for social anxiety disorder ( Kessler et al., 2005b). Lifetime prevalence rates of up to 12% have been reported ( Kessler et al., 2005a) compared with lifetime prevalence estimates for other anxiety disorders of 6% for generalised anxiety disorder, 5% for panic disorder, 7% for post-traumatic stress disorder (PTSD) and 2% for obsessive-compulsive disorder (OCD). However, it is clear that social anxiety disorder is one of the most common of all the anxiety disorders. Prevalence estimates vary, with much of the variability probably being due to differences in the instruments used to ascertain diagnosis. There are no UK epidemiological surveys that specifically report data on social anxiety disorder in adults however, the prevalence of social anxiety disorder has been included in large general population surveys in other western European countries, the US and Australia. Particular situations that can cause difficulty for socially anxious children and young people include participating in classroom activities, asking for help in class, activities with peers (such as team sports or attending parties and clubs), participating in school performances and negotiating social challenges.Ģ.1.2. They may also be less likely to acknowledge that their fears are irrational when they are away from a social situation. As well as shrinking from interactions, they may be more likely to cry or ‘freeze’ or have behavioural outbursts such as tantrums. Usually the condition will cause significant impairment in social, occupational or other areas of functioning.Ĭhildren may manifest their anxiety somewhat differently from adults. However, this is not always feasible, and they will then endure the situation, often with feelings of intense distress. Whenever possible, people with social anxiety disorder will attempt to avoid their most feared situations. People with social anxiety disorder fear that they will say or do (involuntarily or otherwise) something that they think will be humiliating or embarrassing (such as blushing, sweating, shaking, looking anxious, or appearing boring, stupid or incompetent). While anxiety about some of the above is common in the general population, people with social anxiety disorder can worry excessively about them and can do so for weeks in advance of an anticipated social situation. These include meeting people including strangers, talking in meetings or in groups, starting conversations, talking to authority figures, working, eating or drinking while being observed, going to school, shopping, being seen in public, using public toilets and public performance including speaking. Typical social situations can be grouped into those that involve interaction, observation and performance. ![]() As set out in the International Classification of Diseases, 10th Revision (ICD-10) ( World Health Organization, 1992) and in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Text Revision (DSM-IV-TR) ( American Psychiatric Association, 2000) social anxiety disorder is a persistent fear of one or more social situations where embarrassment may occur and the fear or anxiety is out of proportion to the actual threat posed by the social situation as determined by the person's cultural norms. The term ‘social anxiety disorder’ reflects current understanding, including in diagnostic manuals, and is used throughout the guideline. Social anxiety disorder (previously termed ‘social phobia’) was formally recognised as a separate phobic disorder in the mid-1960s ( Marks & Gelder, 1965).
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