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social phobia clinical features of Epidemiology
Social anxiety and reports of shyness in general populations are particularly common; they occur in around 40% of college students. In addition, social anxiety is a common accompaniment of all of the anxiety disorders. Based on DSM-III-R criteria, social phobia has a lifetime prevalence of 13.3% in the general adult population and a point prevalence of around 2–4% in adolescents. Sex Distribution.Both epidemiological and questionnaire studies of the general population reported higher levels of social anxiety and social phobia in females than males. Yet, clinical studies regularly report a relatively equal gender distribution or even a preponderance of males. It is likely that Western cultural factors result in greater interference from social avoidance for males than for females, and result in a greater proportion of socially anxious males who seek treatment. Onset.
Studies reported signs of onset for social phobia that range from early to late adolescence, and the most common consensus is that social phobia begins, on average, in late childhood or early adolescence. Nevertheless, extreme shyness and social reticence can be seen by the time a child is 2 or 3 years of age, and many people report shyness for as long as they can recall. As with GAD, the onset is generally gradual, and clinically, many social phobics report that they cannot specifically remember the beginning of their symptoms. However, there are certainly some social phobics who report specific traumatic experiences before the onset of their disorder. It may be that these latter individuals are more likely to develop a fear of a few circumscribed situations rather than a broad range of situations (designated as ‘‘generalized social phobia’’ in the DSM-IV).
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