Cognitive Aspects
Individuals experiencing social anxiety disorder tend to avoid initiating contact with others and shy away from situations where others might scrutinize them due to fear. Their perception of social situations may involve an exaggerated fear of being judged, negatively evaluated, or ridiculed, whether real or imagined. They are concerned about how others perceive them and often closely monitor their appearance and behavior, holding themselves to high standards. While striving to make a positive impression and present themselves in a standard light, they believe they fall short of achieving this. Before encountering social situations, they often mentally rehearse potential anxiety-provoking scenarios and contemplate how to handle them. Even after the event, they scrutinize embarrassing possible outcomes, often blaming themselves for perceived mistakes and shortcomings. Those with social anxiety disorder tend to interpret ordinary or ambiguous conversations in a negative light. Research also indicates that they have a better recall of negative memories compared to others.
Other characteristics of these individuals include trying to read others’ thoughts, focusing on adverse events, downplaying their strengths, making excessive generalizations about problems, and avoiding intimate relationships. Some situations that trigger anxiety in those affected include:
1. Receiving negative judgments from others
2. Lack of approval or criticism from others
3. Meeting others for the first time
4. Being the center of attention (e.g., entering a room where others are seated)
5. Being monitored while performing tasks
6. Extending or receiving invitations
7. Specific social situations, such as confrontations or arguments
8. Situations requiring firm responses or opinions
9. Making phone calls in the presence of others
10. Eating or drinking in the presence of others
Behavioral Aspects
Social anxiety involves persistent fear of one or more situations in which an individual is exposed to scrutiny by others, fearing that their actions or behaviors might be socially unacceptable, embarrassing, or humiliating. This fear extends beyond typical embarrassment, often leading to avoidance of significant social and occupational situations. Anxiety-provoking situations may include almost any social interaction, particularly participation in small groups, parties, conversations with strangers, hotels, and similar settings. Physical symptoms may include mental blankness, palpitations, blushing, stomach discomfort, and agitation.
Anxiety is usually managed through escape or avoidance behaviors. For example, a student might leave a class when speaking in front of a group (escape) or refrain from giving an oral presentation because of prior experiences of severe anxiety or panic attacks. Minor avoidance behaviors might include avoiding eye contact or choosing a seat where there is no face-to-face interaction with others. In extreme cases, individuals may altogether avoid any social situations that trigger anxiety. Such avoidance behaviors significantly impair the individual’s quality of life and worsen the condition. Hence, individuals with social anxiety disorder should earnestly avoid avoidance behaviors.
Physiological Aspects
Physiological reactions, similar to other anxiety disorders, are observed in social anxiety disorder. Children with the disorder might display symptoms such as clinginess, crying, or silence when facing anxiety-inducing situations. In adults, observable symptoms may include teary eyes, excessive sweating, palpitations, tremors, and flushing, all indicative of the fight-or-flight response to stress—increased anxiety results from these visible reactions.
Recent research indicates that the amygdala, a part of the limbic system in the brain, is overly active in individuals with social anxiety disorder when confronted with angry faces or frightening situations. This heightened response correlates directly with the severity of social anxiety.
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