psychiatric disorders
Social Anxiety Disorder
Diagnosis of Social Anxiety Disorder
Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR) criteria To meet the DSM-5-TR criteria for diagnosis ( Diagnosis reference ), patients must have Marked, persistent (≥6 months) fear of or anxiety about one or more social situations in which they may be scrutinized by others Fear must involve a negative evaluation by others (eg, that patients will be humiliated, embarrassed, or rejected or will offend others). In addition, all of the following should be present: The same social situations nearly always trigger fear or anxiety. Patients actively avoid the situation. The fear or anxiety is out of proportion to the actual threat (taking into account sociocultural norms). The fear, anxiety, and/or avoidance cause significant distress or significantly impair social or occupational functioning. Also, the fear and anxiety cannot be more correctly characterized as a different mental disorder (eg, Agoraphobia , As is true for other anxiety disorders, it is useful to identify a catastrophic spiral of cognition when diagnosing social anxiety disorder; for example, patients with social anxiety disorder might worry that if they go to a party, they will embarrass themselves, be mocked by strangers, and then will have to flee the party. Often, this anxiety begins reasonably but spirals into fears of a highly unlikely catastrophe. Patients with social anxiety disorder tend to develop avoidance strategies, such as declining party invitations or meeting new people. These strategies may become second nature, such that the avoidance behavior may not be seen as having anything to do with the anxiety. For example, they may initially report that they avoid parties because they are "boring." However, such avoidance reinforces the anxiety by allowing the threat of exaggeration to go unchallenged and deprives them of any positive experiences in the feared setting. 1.Diagnostic and Statistical Manual of Mental Disorders, 5th edition,Text Revision (DSM-5-TR), American Psychiatric Association Publishing, Washington, DC, pp 229-235. 