Social Anxiety Disorder (also known as social phobia), is an anxiety disorder characterized by a significant amount of fear in one or more social situations, causing significant distress and impaired ability to function in some aspects of daily life. These fears can be triggered by perceived or actual scrutiny, or negative evaluation from others.
Marked fear or anxiety about 1
or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions (e.g. - having a conversation, meeting unfamiliar people), being observed (e.g. - eating or drinking), and performing in front of others (e.g. - giving a speech).
The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e. - will be humiliating or embarrassing: will lead to rejection or offend others).
The social situations almost always provoke fear or anxiety.
The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.
The fear, anxiety, or avoidance is persistent, typically lasting for 6
months or more.
The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g. - a drug of abuse, a medication) or another medical condition.
The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder.
If another medical condition (e.g. - Parkinson’s disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive.
Specify if:
Specify if:
4
of the following symptoms occur (Note: The abrupt surge can occur from a calm state or an anxious state):Name | Rater | Description | Download |
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Liebowitz Social Anxiety Scale (LSAS) | Clinician | The LSAS is a 24-item scale that assesses for social anxiety symptoms. | Link |
The Social Phobia Inventory (SPIN) demonstrates solid psychometric properties and shows promise as a measurement for the screening of, and treatment response to, social phobia.[15]
The Mini-Social Phobia Inventory (Mini-SPIN) is a 3-question screening tool that has a 90% screening accuracy for diagnosing generalized social anxiety.[16]:
The following treatment recommendations are based on the 2014 Canadian Clinical Practice Guidelines for anxiety, posttraumatic stress and obsessive-compulsive disorders:[18]
Cognitive behavioural therapy with exposure is a first-line, gold-standard treatment for social anxiety disorder. Importantly, the gains from CBT are longer lasting and more enduring than those achieved through medication treatment. and includes several components:
2
failed trials of first-line.1st line | Monotherapy: escitalopram, fluvoxamine, fluvoxamine CR, paroxetine, paroxetine CR, pregabalin, sertraline, venlafaxine XR |
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2nd line | Monotherapy: alprazolam, bromazepam, citalopram, clonazepam, gabapentin, phenelzine |
3rd line | Monotherapy: atomoxetine, bupropion SR, clomipramine, divalproex, duloxetine, fluoxetine, mirtazapine, moclobemide, olanzapine, selegiline, tiagabine, topiramate. |
Adjunctive therapy | Aripiprazole, buspirone, paroxetine, risperidone |
Not recommended | Monotherapy: atenolol*, buspirone, imipramine, levetiracetam, propranolol*, quetiapine Adjunctive therapy: clonazepam, pindolol |