Mean age of onset is in the mid-teens, and the onset after age 30 is uncommon. Although prevalence of SAD is greatest among young adults, for many sufferers the disorder is quiet chronic. Prevalence is also greater among persons who are much less educated and those who are single. Additionally, SAD is usually accompanied by comorbid disorders, such as mainly depression, substance abuse, or other anxiety disorders, which can further impair functioning. SAD has been shown in many studies and investigations to be associated with impairment and disability. SAD increases the risk of dropout from school, the work absence, unemployment, and utilization of social welfare, causing significant financial costs for the society. When compared with persons with no psychiatric disorder, having SAD is allied with financial dependency and increased rates of suicidal ideation.

1. SOCIAL ANXIETY
BY Dr. SREEREMYA.S
FACULTY OF BIOLOGY

2. • INTRODUCTION
• Mean age of onset is in the mid-teens, and the onset after age 30 is
uncommon. Although prevalence of SAD is greatest among young adults,
for many sufferers the disorder is quiet chronic. Prevalence is also greater
among persons who are much less educated and those who are single.
Additionally, SAD is usually accompanied by comorbid disorders, such as
mainly depression, substance abuse, or other anxiety disorders, which can
further impair functioning. SAD has been shown in many studies and
investigations to be associated with impairment and disability. SAD
increases the risk of dropout from school, the work absence,
unemployment, and utilization of social welfare, causing significant
financial costs for the society.
• When compared with persons with no psychiatric disorder, having SAD is
allied with financial dependency and increased rates of suicidal ideation.

3. • Subjects with generalized SAD and no comorbidity reported key impairment in
terms of family relations, romantic relationships, social network, and ability to mild
alcohol use, compared to those with no diagnosis. Generalized SAD was allied with
significantly lower health-related quality of life, work productivity and earnings,
and greater utilization of the health services. During the month before
participating in the survey, 12.3 % of subjects with SAD reported having had
thoughts of suicide (Beidel et al., 2000).
• Several subtypes of SAD have been delineated. Generalized SAD has been the most
studied subtype, and it was defined in the DSM-III-R and DSM-IV by fear of most
social situations. Persons with generalized SAD tend to have more chronic
symptoms and impairment, and are more likely to seek treatment (Beidel et al.,
2007). The National Comorbidity Survey (1998) reported significantly the greater
comorbidity among persons with SAD and at least one feared situation other than
public speaking. Persons with the SAD involving three or more social fears also
evidenced the greater chronicity and impairment. Most persons with the non-
generalized type of SAD, or with the performance type newly delineated in DSM-5,
have predominantly fears of performance such as public speaking, with relative
sparing of the social interaction situations (Beidel et al., 1999).

4. • GENDER DIFFERENCES IN COMMUNITY SAMPLES
• Prevalence of the SAD among women has been found to be
elevated relative to the rate in men in most community studies. In
the NESARC study, 12-month prevalence’s were 2.2 % for men and
3.3 % for women; lifetime prevalence’s were 4.3 % for men and 5.7
% for women (Berger et al., 2010). Similarly, elevated rates of SAD
in women have been reported in the European samples. The
female-to-male ratio of 1.35 for lifetime prevalence of the SAD in
the NESARC study is within the range of previous epidemiological
studies. The ratio is lower, however, than gender ratios reported for
other anxiety disorders in the major epidemiologic studies, which
have ranged from 1.9 for generalized anxiety disorder in the
National Comorbidity Survey to 2.7 for agoraphobia in the
Epidemiological Catchment Area.

5. • Researchers sought to investigate and evaluate whether the
preponderance of women among those diagnosed with SAD by
community surveys was due to the response bias of women being more
likely to respond positively to questions about SAD (Berlin et al., 1997).
The study involved a subsample of 1,754 participants in the Australian
National Survey of Mental Health and Wellbeing who had reported at least
one of social fear. A series of factor analyses suggested that the men and
women tended to respond comparably to SAD diagnosis items. Men,
however, tended to report lower levels of the physical symptoms at low
levels of social fear, compared to women. Overall, findings supported the
legitimacy of the higher rates of SAD among women (Bjornsson et al.,
2011). Gender differences among persons with SAD were examined and
assessed in a recent cross- sectional study by MacKenzie and Fowler
(2013) of 36,984 Canadians aged approx 15–80 years. Men with SAD were
more likely to be single, unattached, and also living alone than women
with SAD.

6. • Women with SAD were more likely to be widowed, separated, or divorced, and
they were more likely to be much single parent (Birmaher et al., 1999). Women
also reported and assessed poorer mental health and greater stress levels than
men with SAD.
• Counselling—many people with the social anxiety disorder benefit from a form of
counselling called cognitive-behavioural therapy or the CBT. A mental health
professional trained in CBT can help you work through the thoughts or the beliefs
and behaviours that lead to or maintain your social anxiety. CBT helps you cope
with the social anxiety by teaching you skills to build confidence in social
situations. One can also learn how to interact with people and maintain
relationships. CBT is usually the short-term treatment. You can get the most out of
the treatment by regularly practicing CBT skills (Black et al., 1994).
• Exposure—Exposure (sometimes called desensitization) helps one “unlearn”
anxiety associated with a situation or thing (Blanco et al., 2010). With the guidance
and the support of a qualified professional, you gradually take small, planned steps
towards the situation you fear until you no longer feel overwhelmed by that
situation. It can be the very effective treatment for many different phobias,
encompassing social phobia.

7. • Journal of Trauma Management and Critical
Care Nursing, Social Anxiety , Dr.S.Sreeremya
,2019.Vol 1(2):1-7.