SOCIAL ANXIETY DISORDER PHOBIA 1

SOCIAL ANXIETY DISORDER

Social Anxiety Disorder (SAD) and social phobia: Literature Review

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LITERATURE REVIEW

Feeling

anxious in normal situations incompletely normal, getting nervous in different situations is also

normal but when the anxiousness and nervousness gets out of hand, becomes uncontrollable and

starts to interrupt a persons day to day social events then it is known as a mental health issue called

Social Anxiety Disorder (SAD). The defining feature of social anxiety disorder, also called social

phobia, is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or

performance situation. People with Social Anxiety disorder are usually found to be worrying about

people misjudging them. Having severe insecurity about not being able to live up to peoples

expectations, being shy and vulnerable can also be considered Social anxiety disorder. Fear of

judgment and analysis by other people leading to avoidance of social situations. Severe social

anxiety disorders are usually associated with low self-esteem and fear of criticism. People suffering

from social anxiety disorder might present with issue of blushing, hand tremor, nausea, or urgency

for urination, sometimes being convinced that one of these secondary manifestations of their

anxiety is the primary problem. Similar to Generalized Anxiety Disorder (GAD), social anxiety

disorder(SAD) is one of the most common anxiety disorders. People are diagnosed with social

anxiety derider in their teenage years. People usually mistaken social phobia with being shy.

Although shyness is one of the symptoms of social anxiety disorder, being shy and having this

illness are two different things. Social anxiety disorder can affect a persons life in many different

ways where it leads to not being able to speak publicly and if gotten worse to panic attacks. Lack of

confidence, being unable to meet new people are signs of social anxiety Disorder. People diagnosed

with it tend to experience high levels of anxiety, stress, distress and unreasonable fear which makes

them socially awkward ie. social and behavioral functional impairment. Unlike GAD social anxiety

disorder has no relation with gender of any sorts, it occurs in both male and female bodies.
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Individuals with social anxiety disorder are typically shy when meeting new people, quiet in groups,

and withdrawn in unfamiliar social settings. When they interact with others, they might or might not

show overt evidence of discomfort. Many victims of social anxiety disorder also experience intense

physical symptoms, such as increased heart rate, nausea, sweating, and may experience full-blown

panic attacks and episodes when confronting a feared situation. Although they themselves recognize

that their fear is excessive and unreasonable, people with social anxiety disorder often feel

powerless against their anxiety and panic attacks. “They crave the company of others, but shun

social situations for fear of being found out as unlikable, stupid, or boring. Accordingly, they avoid

speaking in public, expressing opinions, or even fraternising with peers; in some situations, this can

lead to such individuals being mistakenly labelled as snobs. People with social anxiety disorder are

typified by low self-esteem and high self-criticism” (J Affect Disord, 82 (2004), pp. 227-234).

People believes there are many reasons behind how a person develops social anxiety disorder it

could be based on their childhood and how they were brought up as well as parenting ways,

genetics and cultural acceptance. A child brought up in a non unaffectionate family will have many

problems accepting affection as well as showing affection and feelings towards others. The mindset

of the child will be completely different by the time they grow up unless external factors bring

change in their lifestyle. There is also evidence that children with Social anxiety disorder show

differences in physiological responses associated with fear pathways. For example, compared to

non-anxious children they show indicators of higher baseline sympathetic activity (heart rate,

electrodermal activity) and lower parasympathetic activation (respiratory sinus arrhythmia) (Kramer

et al., 2012). “People with social anxiety disorder fear and avoid the scrutiny of others. The concern

in such situations is that the individual will say or do something that will result in embarrassment or

humiliation. These concerns can be so pronounced that the individual shuns most interpersonal

encounters, or endures such situations only with intense discomfort. Once largely neglected by the

medical community, social anxiety disorder came to the attention of the general medical community

a decade ago” (Lancet, 347 (1996), pp. 1131-1132). “In medical settings, people with social anxiety
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disorder might speak quietly or offer only cursory answers to questions. Eye contact is often kept to

a minimum. But, more often, they will reveal their problems with social anxiety only upon direct

questioning, rarely offering their symptoms up to their caregiver without solicitation. This reticence

might be due to embarrassment about their symptoms, their belief that the practitioner would not

take their problem seriously, or it could simply reflect their discomfort with authority figures” (Gen

Hosp Psychiatry, 2005, p 155-157).

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REFERENCES

Beidel, D. C., Turner, S. M., & American Psychological Association. (2007). Shy children, phobic

adults: Nature and treatment of social anxiety disorder. Washington, DC: American

Psychological Association.

Cox, B. J., Fleet, C., & Stein, M. B. (2004). Self-criticism and social phobia in the US national

comorbidity survey. Journal of Affective Disorders, 82(2), 227-234.

Klemanski, D. H., Curtiss, J., McLaughlin, K. A., & Nolen-Hoeksema, S. (2017). Emotion

regulation and the transdiagnostic role of repetitive negative thinking in adolescents

with social anxiety and depression. Cognitive therapy and research, 41(2), 206-

219.]

Krämer, M., Seefeldt, W. L., Heinrichs, N., Tuschen-Caffier, B., Schmitz, J., Wolf, O. T., &

Blechert, J. (2012). Subjective, autonomic, and endocrine reactivity during social

stress in children with social phobia. Journal of abnormal child psychology, 40(1), 95-

104.

Mayo Clinic; https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-

causes/syc-20353561

Neumann, I. D., & Slattery, D. A. (2016). Oxytocin in general anxiety and social fear: a

translational approach. Biological psychiatry, 79(3), 213-221.

Roy-Byrne, P. P., & Stein, M. B. (2005). Social anxiety in primary care: hidden in plain view?.

General hospital psychiatry, 3(27), 155-157.

Stein, M. B., & Stein, D. J. (2008). Social anxiety disorder. The lancet, 371(9618), 1115-1125.

The Lancet, Volume 371, Issue 9618, 29 March–4 April 2008

https://adaa.org/understanding-anxiety/social-anxiety-disorder