affecting approximately 13.7% of Irish adults at any one point in time.
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Social Anxiety: Diagnostic Criteria / Definitions
ICD-10 Definition of Social Anxiety Disorder. F40.1 Social Phobias
Social anxiety often start in adolescence and are centred around a fear of scrutiny by other people in comparatively small groups (as opposed to crowds), leading to avoidance of social situations. Unlike most other anxieties, social anxiety is equally common in men and women. They may be discrete (i.e. restricted to eating in public, to public speaking, or to encounters with the opposite sex) or diffuse, involving almost all social situations outside the family circle. A fear of vomiting in public may be important. Direct eye-to-eye confrontation may be particularly stressful in some cultures. Social anxiety is usually associated with low self-esteem and fear of criticism.
They may present as a complaint of flushing, hand tremor, nausea, or urgency of micturition, the individual sometimes being convinced that one of these secondary manifestations of anxiety is the primary problem; symptoms may progress to panic attacks. Avoidance is often marked, and in extreme cases may result in almost complete social isolation.
Diagnostic Guidelines All of the following criteria should be fulfilled for a definite diagnosis:
- (a) the psychological, behavioural, or autonomic symptoms must be primarily manifestations of anxiety and not secondary to other symptoms such as delusions or obsessional thoughts;
- (b) the anxiety must be restricted to or predominate in particular social situations; and
- (c) avoidance of the phobic situations must be a prominent feature. Includes: * anthropophobia * social neurosis Differential Diagnosis Agoraphobia and depressive disorders are often prominent, and may both contribute to sufferers becoming “housebound”.
If the distinction between social anxiety and agoraphobia is very difficult, precedence should be given to agoraphobia; a depressive diagnosis should not be made unless a full depressive syndrome can be identified clearly.
The ICD-10 Classification of Mental and Behavioural Disorders World Health Organization,
DSM-IV Definition of Social Anxiety Disorder
- A. A marked and persistent fear of one or more social and 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. Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.
- B. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.
- C. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
- D. The feared social or performance situation are avoided or else are endured with intense anxiety or distress.
- E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(S) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
- F. In individuals under age 18 years, the duration is at least 6 months G. The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., Panic Disorder With or Without Agoraphobia, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, or Schizoid Personality Disorder).
- H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson’s disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa Copyright 1994,
The American Psychiatric Association
CBT Group Treatment
The programme, which largely adopts a cognitive
behavioural model, is conducted over fourteen weeks.
If you wish to apply for a place on our Social Anxiety
Programme please read and follow the instructions in
the section ‘Process of applying for a place in our
Social Anxiety Programme.’
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