Social anxiety disorder, also known as social phobia, is characterized by an intense, persistent, and excessive fear of negative evaluation by others. Youth with social anxiety disorder greatly fear that others will judge them negatively and that they will embarrass or humiliate themselves in front of others. For some youth, social anxiety disorder can be selective, such that it occurs in a few specific settings, such as during oral presentations. For others, social anxiety disorder is more generalized, spanning across many social situations. Youth with social anxiety disorder exhibit anxiety in anticipation of the social situation. Often times, they may attempt to avoid social situations, which may interfere with academic performance or peer relations. For example, some youth may refuse to attend school or play-dates. When they endure a social situation, they often do so with extreme discomfort or distress. They may be observed crying, freezing, or becoming upset. They may experience intense physiological symptoms, such as blushing, sweating, a fast-beating heart, lightheadedness, or difficulty breathing.
Social anxiety disorder affects approximately 7% of youth. It is more common in adolescents than children and is more common in females than males. Typical onset occurs in early to mid-adolescences. Of note, unlike adults with social anxiety disorder, youth may not recognize that their social fear is excessive or unreasonable. Also, in order for a youth to meet criteria for social anxiety disorder, they must evidence the capacity for age-appropriate social relationships. Their social anxiety must occur in peer settings, not only during interactions with adults.
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