DSM-IV Definition: Social Anxiety Disorder

The Diagnostic and Statistical Manual of the American Psychiatric Association currently defines social anxiety disorder in the following way.  

Please note that while this definition of social anxiety is the most definitive and clearly produced to date, there are several potential problems with this definition that will hopefully be addressed by the task forces, editors, and research coordinators of the association as time progresses. 

The Current DSM-IV  Definition (Abridged):

A.  A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or topossible scrutiny by others.

The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.  

B.  Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.  

C.  The person recognizes that this fear is unreasonable or excessive.

D.  The feared situations are avoided or else are endured with intense anxiety and distress.

E.  The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.

F.  In individuals under age 18 years, the duration is at least 6 months.

G. The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder...

Copyright 1994, The American Psychiatric Association

Problems with the DSM Definition of Social Anxiety

While this definition is clearly the most definitive and precise official definition produced so far, "social anxiety disorder" has only been officially recognized since 1980, and the problem did not become adequately explained until the 1987 version of the DSM.  Thus, the definition of social anxiety disorder is becoming clearer and more precise with each edition.  

Here is where the current DSM needs to be revised:

1.  The descriptive language is generally good, but could be more direct and precise.

2.  The reference in "B" to a situationally bound or situationally pre-disposed Panic Attack is confusing, and for the most part, inaccurate.  The use of the term "Panic Attack", which is the name of a separate anxiety disorder, is confusing and can prevent a proper diagnosis from being made.