Current Trends in the Understanding and Treatment of Social Phobia in Youth
Summary of article published in the Journal of Child Psychology and Psychiatry, Vol. 42, No. 1, pp. 127-140, 2001
Social phobia, a common problem in children and adolescents, has recently gained serious attention in clinical practice and research. Social phobia is defined as "a marked and persistent fear of social or performance situations in which embarrassment may occur" (according to the Diagnostic and Statistical Manual (IV) of the American Psychiatric Association, 1994, p. 411). Children or adolescents with social phobia become so disabled by the fear of other people's reactions and expectations that they avoid situations in which they fear that evaluation by others might occur.
Diagnosing social phobia in children and adolescents (DSM-IV)
A diagnosis of social phobia requires that 1) an individual, when exposed to the feared social situation, must invariably experience anxiety and must recognize that this anxiety is excessive or unreasonable, 2) the individual experiences intense distress while in the feared situation or avoids it, 3) the social phobia interferes significantly with the person's normal routine, social activities, or occupational/academic functioning, and 4) the fear or avoidance of social situations cannot be due to the direct physiological effects of a substance or general medical condition or be better accounted for by another mental disorder.
The diagnosis of social phobia in children emphasizes the following important developmental differences between children and adults:
- A child with social phobia must show the capacity for age-appropriate social relationships with familiar people, and his or her anxiety must occur in peer contexts, not just with adults.
- The anxiety brought on by social situations may be evidenced in children by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.
- Due to limitations of cognitive and perceptual skills in young children, children with social phobia need not recognize that their fear in social situations is excessive or unreasonable.
- Under the age of 18 years, there must be evidence of the social fears existing for a minimum of six months.
Reprinted with the permission of the NYU Child Study Center. © NYU Child Study Center.
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