Social anxiety disorder

Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM-5-TR)[3]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

• Marked fear or anxiety in one or more social or performance situations in which the person is exposed to possible scrutiny by others. In children, anxiety must occur in peer settings and not just during interactions with adults.

• Fear that they will act in a way (or show anxiety symptoms) that will be humiliating, embarrassing, will lead to rejection or will offend others.

• Exposure to the feared social situation almost invariably provokes anxiety or a panic attack. In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations.

• The fear or anxiety is out of proportion to the actual threat of the situation and to the sociocultural context.

• Feared social or performance situations are either avoided or endured with intense anxiety or distress.

• The fear or avoidance interferes significantly with the person's normal routine, occupational functioning, relationships, or social activities.

• For children and adults, the duration of symptoms must be at least 6 months.

• The fear or avoidance is not due to the direct physiological effects of a substance or a general medical condition, and is not better accounted for by another mental disorder.

• If a general medical condition or another mental disorder is present, the social anxiety disorder is unrelated to it.

The diagnosis can be further specified as 'performance only' if the anxiety is focused specifically on public speaking or performing in public to a degree that there is marked functional impairment (e.g., interfering with ability to work).