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Diagnosis of Social Anxiety Disorder

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Updated July 07, 2012

Obtaining a diagnosis of social anxiety disorder (SAD) is the first step toward receiving appropriate treatment if you believe that you may suffer with SAD. Below are various aspects of the diagnostic process to help familiarize you with the steps involved.

Getting a Diagnosis

One of the hardest parts about having SAD is getting help. It is no wonder that social anxiety goes undiagnosed so often. From calling to make an appointment, describing symptoms to a stranger, and even simply acknowledging your anxiety to another person, the process of getting help for SAD can be fraught with obstacles to overcome.

One approach to getting help involves: 1) seeking out a competent mental health practitioner who understands the unique difficulties of someone with SAD, 2) providing a detailed written account of the problems that you are experiencing, and 3) bringing along an advocate such as a family member to help communicate on your behalf when needed. If a doctor or therapist makes you feel uncomfortable or minimizes your symptoms, it is time to move on and find someone who is patient and understanding.

Screening for SAD

As part of the diagnostic process, your doctor or mental health professional may have you complete one or more screening questionnaires to assess for the presence of SAD symptoms. Although screening questionnaires cannot on their own be used to obtain a diagnosis, the results of these questionnaires will provide a clear picture as to whether further assessment is needed.

If the results of a screening questionnaire indicate the presence of SAD symptoms, your doctor or mental health professional should conduct a follow-up assessment to provide a diagnosis. A full diagnosis will usually require a clinical interview in which a comprehensive picture of your particular situation will be developed.

Diagnostic Criteria

In 1994, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was published. In this edition, social anxiety disorder (SAD) was recognized as a diagnosable mental illness. The disorder was defined as a "marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others."

As part of a diagnosis, your doctor or mental health professional will conduct a clinical interview to assess your physical, behavioral and cognitive symptoms. He will assess how much these interfere with your functioning, and will rule out other possible causes. He will also determine whether you suffer with generalized or specific SAD.

Related Disorders

If you suffer with SAD, you are at increased risk of being diagnosed with a second disorder. The most common overlapping disorders are avoidant personality disorder, panic disorder, generalized anxiety disorder, depression, alcoholism, and eating disorders. If you are diagnosed with one of these secondary disorders, your treatment plan should reflect the unique interaction of symptoms that you experience.

Sources:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Connor KM, Kobak KA, Churchill LE, Katzelnick D, Davidson JR. Mini-Spin: A brief screening assessment for generalized social anxiety disorder. Depression and Anxiety. 2001; 14:137-140.

Rosenthal J, Jacobs L, Marcus M, Katzman M. Beyond shy: When to suspect social anxiety disorder. The Journal of Family Practice. 2007; 56: 369-374.

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