Social anxiety disorder: questions and answers for the DSM-V

S.M. Bögels, L.E. Alden, D.C. Beidel, L. Clark, D. Pine, M.B. Stein, M.J. Voncken

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Background: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. Method: A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V Results/Conclusions: Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a "predominantly performance" variety of SAD. A specifier based on "fear of showing anxiety symptoms" (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options. Depression and Anxiety 27:168-189, 2010.

Original languageEnglish
Pages (from-to)168-189
Number of pages22
JournalDepression and Anxiety
Volume27
Issue number2
DOIs
Publication statusPublished - Feb 2010

Keywords

  • 5-YEAR FOLLOW-UP
  • AVOIDANT PERSONALITY-DISORDER
  • DSM-V
  • NATIONAL COMORBIDITY SURVEY
  • PHOBIA SUBTYPES
  • PROSPECTIVE-LONGITUDINAL-COMMUNITY
  • PUBLIC SPEAKING ANXIETY
  • RISK-FACTORS
  • SELECTIVE MUTISM
  • SELF-FOCUSED ATTENTION
  • SEROTONIN REUPTAKE INHIBITORS
  • avoidant personality disorder
  • classification
  • interpersonal
  • performance
  • selective mutism
  • social anxiety disorder
  • social phobia
  • subtypes
  • test anxiety

Cite this

Bögels, S. M., Alden, L. E., Beidel, D. C., Clark, L., Pine, D., Stein, M. B., & Voncken, M. J. (2010). Social anxiety disorder: questions and answers for the DSM-V. Depression and Anxiety, 27(2), 168-189. https://doi.org/10.1002/da.20670