Cognitive theory and therapy of social phobia

Abstract

Introduction Social phobia (social anxiety disorder) is defined in the Diagnostic and Statistical Manual of Mental Disorders , – fourth edition (DSM-IV; American Psychiatric Association, 1994) as “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 (or show anxiety symptoms) that will be humiliating or embarrassing” (p. 416). Situations which people with social phobia commonly fear include public speaking, interacting with unfamiliar people, social gatherings such as parties, meetings, speaking to authority figures and situations requiring assertive behavior (Rapee, 1995). Fears may encompass most social situations (generalized social phobia), or may be restricted to one or a few social or performance situations (nongeneralized social phobia) (American Psychiatric Association, 1994). Regardless of the range of feared situations, social phobia is only diagnosed when fears result in significant functional impairment or marked distress (American Psychiatric Association, 1994). Research indicates that the onset of social phobia frequently occurs during childhood or adolescence (Schneier et al., 1992), and suggests that the disorder tends to follow a chronic, stable course (Solyom et al., 1986). The anxiety and avoidance associated with social phobia can lead to considerable impairment in many aspects of life functioning, including education, employment, interpersonal relationships, and recreational interests (Schneier et al., 1994).