Contents
Social phobia: what is it?
Social phobia, also called “social anxiety”, is an anxiety disorder, as is the state of post-traumatic stress and OCD (Obsessive Compulsive Disorders).
It is characterized by a intense fear situations in which the phobic person is confronted with looks from others. This fear quickly becomes a deep anguish when it is called upon to speak in front of a group of people or simply when it is observed by people not belonging to its entourage.
The fact ofto be exposed et in the judgment of others creates, for the person suffering from social phobia, a significant anxiety fueled by the fear of acting in a way humiliating ou embarrassing. It s islands so little by little in order toto avoid these situations which cause her significant discomfort.
Social phobia could be likened to a extreme and pathological shyness having a significant impact on social life, family and et Professional of people who have it. People with social phobia seek to avoid distressing situations where they have to come into contact with other individuals. They are fully aware of their difficulty and will often be slow to consult because they are often ashamed of their disorder. They very often have low self-esteem.
Prevalence
According to recent studies, 2 to 4% of the population is affected by social phobia. It would affect women more than men and would start in adolescence1.
Diagnostic
To make the diagnosis of social phobia, it is necessary to make sure that the person presents persistent fear situations in which she is exposed to the eyes of others.
The person with social phobia is terrified of saying or doing something that might cause others to have a negative judgment against him. This fear will quickly become a permanent anxiety which will lead the person to to avoid these situations through avoidance behaviors.
The healthcare professional may refer to the diagnostic criteria for social phobia appearing in the DSM IV (Diagnostic and Statistical Manual of Mental Disorders – 4st edition) or ICD-10 (International Statistical Classification of Diseases and Related Health Problems – 10st revision). He will lead a precise clinical interview to check for signs of this disorder.
Many scales such as the Liebowitz Social Phobia Scale2, are available to doctors and psychologists. They will be able to use them to objectively validate their diagnosis and to assess the intensity of the social phobia presented by the patient.
Social phobia or stage fright? When we do not practice a profession that requires us to speak regularly, to debate or to argue in public, we are all confronted with stage fright. Who does not remember being very afraid on the day of an oral exam or a defense? This state is quite normal. Moreover, this important anxiety which appears before the event in question disappears quickly after its occurrence. In the context of social phobia, anxiety does not decrease, but it can increase during the event and can even sometimes lead to a panic attack causing loss of all means and all possibility of performance and success. Shame invades the person after the presentation. Finally, the fear that this unfortunate event will repeat itself invades the thoughts of the social phobic person even long after the event. |
Causes
At present, it seems that neurobiological factors, educational, environmental et psychological come into play in the onset of social anxiety.
Although no gene has not been clearly identified, studies highlight a family risk. If one of the members of a family suffers from a social phobia, it is more likely that another member of this family is affected by this disorder, than in a family where no one is affected. A study3 carried out on identical (monozygotic) twins shows that if one of the twins suffers from social anxiety, there is a 12,6% chance that his twin will also have it. This probability increases to 9,8% if they are different twins (dizygotes).
Other studies highlight hormonal disturbances in people with social phobia. They reveal a hormonal level of cortisol (= stress hormone) disturbed in social phobic4.
Research has also focused on the disturbance of neurotransmitters in social phobias; they reveal hyperfunction of the noradrenergic system and hypoactivity of the dopaminergic system5,6.
L’education and environment also seem to play a role in the occurrence of social phobia. Studies show that social phobias often come from families in which there is few interactions with the environment video shooting. In their childhood, they would often have benefited from a parental overprotection which would not have encouraged them to go into contact with others. Finally, we often find a traumatic experience in connection with exposure to the gaze and evaluation of others which may have precipitated the onset of this disorder.
Associated disorders
People who suffer from social phobia often have other associated psychological disorders, such as:
- another anxiety disorder such as ereutophobia (= fear of blushing in public) or agoraphobia (= fear of crowds)7 ;
- depression8 ;
- low self-esteem;
- excessive consumption of substances with anxiolytic properties, such as alcohol9 ;
- a personality disorder of the “avoidant personality” type.
Complications
The impact of this phobia on the social sphere (reduction in leisure activities or difficulties in having romantic relationships) and on the sphere Professional (difficulty attending meetings or interacting with colleagues) is notable. The quality of life of these people is degraded13.
In rare cases, this disorder, normally present in very specific situations, such as speaking in front of an audience or eating in public, may generalize to all situations of social interaction and performance in public. We then speak of generalized social phobia.
Social phobia is the cause of great suffering for people who have it. The risk of switching tosuicidal act is important11.