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Am J Psychiatry 1994; 151:408-412
Copyright © 1994 by American Psychiatric Association
Setting diagnostic thresholds for social phobia: considerations from a community survey of social anxiety
MB Stein, JR Walker and DR Forde
Department of Psychiatry, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
OBJECTIVE: The goal of this study was to gain a broader perspective on
social anxiety in the community than has been achieved by epidemiologic
surveys to date. METHODS: The authors conducted a telephone survey of
social anxiety among 526 randomly selected respondents in a medium- sized
Canadian city. RESULTS: Sixty-one percent of the respondents reported being
much or somewhat more anxious than other people in at least one of the
seven social situations surveyed. Speaking to a large audience (i.e.,
public speaking) was the most frequently feared situation (endorsed by
55.0% of the respondents), followed by speaking to a small group of
familiar people (24.9%), dealing with people in authority (23.3%),
attending social gatherings (14.5%), speaking to strangers or meeting new
people (13.7%), and eating (7.1%) or writing (5.1%) in front of others.
When the threshold for caseness was systematically modified--by altering
the required level of psychosocial interference or distress or by including
or excluding subjects with pure public speaking phobia--the rate of "social
anxiety syndrome" in the community varied from 1.9% to 18.7%; 7.1% was the
prevalence when the criteria were set to conform with DSM-III-R.
CONCLUSIONS: Social anxiety is common in the community, but precise
delineation of the prevalence of "social phobia" depends heavily on where
the diagnostic threshold is set. If DSM-III-R criteria had been applied in
previous epidemiologic studies, it is likely that those studies would have
documented prevalences of social phobia that are several times as high as
the currently accepted rates.
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H Gundel, A Wolf, V Xidara, R Busch, and A O Ceballos-Baumann
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1693 - 1700.
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Arch Gen Psychiatry,
November 1, 2000;
57(11):
1046 - 1052.
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R. Lieb, H.-U. Wittchen, M. Hofler, M. Fuetsch, M. B. Stein, and K. R. Merikangas
Parental Psychopathology, Parenting Styles, and the Risk of Social Phobia in Offspring: A Prospective-Longitudinal Community Study
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September 1, 2000;
57(9):
859 - 866.
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R. Noyes Jr., A. J. Hartz, C. C. Doebbeling, R. W. Malis, R. L. Happel, L. A. Werner, and S. J. Yagla
Illness Fears in the General Population
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May 1, 2000;
62(3):
318 - 325.
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M. B. Stein, A. J. Fyer, J. R.T. Davidson, M. H. Pollack, and B. Wiita
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Am J Psychiatry,
May 1, 1999;
156(5):
756 - 760.
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M. B. Stein, M. R. Liebowitz, R. B. Lydiard, C. D. Pitts, W. Bushnell, and I. Gergel
Paroxetine Treatment of Generalized Social Phobia (Social Anxiety Disorder): A Randomized Controlled Trial
JAMA,
August 26, 1998;
280(8):
708 - 713.
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R. C. Kessler, M. B. Stein, and P. Berglund
Social Phobia Subtypes in the National Comorbidity Survey
Am J Psychiatry,
May 1, 1998;
155(5):
613 - 619.
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M. B. Stein, M. J. Chartier, A. L. Hazen, M. V. Kozak, M. E. Tancer, S. Lander, P. Furer, D. Chubaty, and J. R. Walker
A Direct-Interview Family Study of Generalized Social Phobia
Am J Psychiatry,
January 1, 1998;
155(1):
90 - 97.
[Abstract]
[Full Text]
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