For persons unacquainted with phobias, it is common for them to assume that they are mere irrational fears capable of being controlled by respective victims. However, individuals grappling with such conditions acknowledge their gravity and impact on their quality of life. According to the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), phobias differ greatly from common fears given that they are more severe and often persistent (American Psychiatric Association, 2013). Persons suffering from a specific type of phobia every so often describe them as an uncontrollable and overwhelming desire to avoid specific stimuli responsible for triggering them. Social anxiety disorder or social phobia one such disorder, primarily characterized by extreme distress during social interaction and an irrational fear of prejudgment and public embarrassment. It is, therefore, fundamental to describe this problem in detail, major characteristics associated with the disorder, at-risk populations and comorbidities, and the types of interventions available today.
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Social Anxiety Disorder, DSM-5 300.23 (F40.10)
Social anxiety disorder is a phobia characterized by extreme distress during social interactions. Persons suffering from the condition are overly concerned with their standing in public and frequently preoccupied by the fear of humiliation or being judged by others. According to Comer & Comer (2017), social anxiety may also encompass an irrational fear of scrutiny by others in performance scenarios, the fear of eating in front of others or registering poor results at school or within an occupational capacity. As a consequence, persons suffering from this disorder inadvertently end up being excessively judgmental of their ability to perform and thrive in public. This may, eventually, impede personal success presently and in the future.
Among one of the most common consequences of social phobia is a general inability, by competent individuals, to discharge important duties and responsibilities due to the condition. Since social anxiety disorder is normally an uncomfortable subject to broach; which explains why sufferers may end up failing to honor social invitations and obligations. This response might, therefore, be misconstrued as pride, arrogance, disinterest, or hostility towards well-meaning individuals and can have a negative impact on interpersonal relationships shared with close friends and family. Social anxiety disorder has increasingly become a major focal point in mental health owing to its severity and the very fact that this disabling fear can incapacitate sufferers to the point of inhibiting the possibility of future social contact.
Characteristics of Social Anxiety Disorder
Several diagnostic characteristics distinguish social anxiety disorder from other mental health conditions listed in DSM-5. Furthermore, these specific characteristics are also utilized as a benchmark in the evaluation of whether presenting cases satisfy the prevailing standard diagnostic criteria. The most common distinguishing attribute associated with social anxiety disorder is an extreme irrational fear and apprehension in social settings. Persons suffering from the condition may, therefore, wrongly assume that they are the center of attention, therefore warranting an urgent need to remain unnoticed in a “hostile” environment (Koyuncu et al., 2019). Such attitudes then hinder social interaction in social settings or exercising public speaking; fearing their avoidant behavior may manifest when least expected. Persons suffering from social anxiety disorder are also likely to experience extreme irrational distress over social interactions and even resort to crying or experience panic attacks. Furthermore, social phobia is also characterized by the fear of social rejection due to perceived inadequacies associated with their condition. Individuals suffering from social anxiety disorder are exceedingly self-conscious and may exhibit disproportionate anxiety over perceived physical blemishes or character traits (Lee & Lee, 2018). The condition may also impair subjects from optimal functioning in an occupational capacity resulting in strained interpersonal relationships with coworkers and fellow team members. Initially, social phobia may appear as extreme “shyness” during social interactions but later progress to avoidant behavior.
Prevalence and Comorbidities
Since SAD frequently affects a considerable cross-section of the general population at any given point in their lives, the condition is designated a “lifetime prevalence” label. The National Comorbidity Survey Replication (NCS-R), under the patronage of the National Institute of Mental Health Disorders, estimates that 7.1% of the adult population in the U.S. experienced social phobia within the past year (National Institute of Mental Health, 2020). Epidemiological studies also indicate that, if left untreated, both generalized and non-generalized SAD may become a lifelong problem for vulnerable segments of the population predisposed to developing the condition. Since the onset often begins between late childhood and early adolescence, parents are strongly advised to seek professional help from their respective healthcare providers to address the condition during its formative stages using first-line interventions approved by the Centers for Disease Control and Prevention (CDC). Although SAD’s gender distribution is relatively equal during the pre-adolescence, the condition later affects more females (8.0%) than it does males (6.1%) at a ratio of 2.5:1.2 respective (National Institute of Mental Health, 2020). This gender ratio disparity is mostly attributed to women’s propensity to express greater fear in a wide array social situations comparative to men and further cemented by existing cross-cultural variations. However, a study by Koyuncu et al., (2019) concluded that major psychiatric comorbidities associated with SAD include bipolar disorder, major depression, alcohol use disorder, and personality disorder. Their presence may, therefore, have a major impact on disease progression and ultimately impact care-seeking behavior.
Possible Interventions for Social Anxiety Disorder
Pharmacological intervention is typically recommended for patients experiencing severe bouts of social phobia. According to (Rowa et al., (2018), first-line pharmacological interventions for SAD include anticonvulsants, antidepressants, and benzodiazepine. The intention of exploiting this intervention is to improve sufferer’s quality of life and enable them to function optimally in public.
The application of psychological interventions is a popular and highly efficient solution in managing SAD. Some of the most common psychological interventions range from methods such as exposure in vivo, social skills training, cognitive behavioral therapy (CBT), supportive therapy to interpersonal psychotherapy (Rowa et al., 2018). The rationale informing their use is in their ability to equip sufferers with sufficient psychological tools to address their respective phobias on a self-help basis.
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