Social Anxiety Disorder

Excerpt

Social anxiety disorder (SAD) is characterized by excessive fear of embarrassment, humiliation, or rejection when exposed to possible negative evaluation by others when engaged in a public performance or social interaction. It is also known as social phobia. Over fifty years ago, in 1966, social phobia was first differentiated from agoraphobia and specific phobias. Since that time, the concept has transformed from being a relatively rare and neglected condition to one that is recognized as prevalent throughout the world. The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 described social phobia in a way that limited the diagnosis due to exclusionary criteria, including those with an avoidant personality disorder, a new category at the time. In 1985 that view was challenged, and by 1987 the DSM-III-R removed the exclusion. In 1994, DSM-IV added the alternative name of SAD due to a recognition that social phobia could be differentiated from specific phobias due to important pathophysiological and clinical factors. With the publication of DSM-5 in 2013, SAD became the primary name. With the publication of DSM-5, the diagnostic criteria for SAD have been broadened from previous editions to include fear of acting in a way or showing anxiety symptoms that offend others or lead to rejection in addition to fear of humiliation or embarrassment. Additionally, the latest edition of DSM removed the generalized subtype and added the "performance only" specifier.