The Social Anxiety Disorder Spectrum
J Clin Psychiatry 2004;65(suppl 14):27-33
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Current diagnostic classifications emphasize the categorical nature of disorders such
as social anxiety disorder. Nevertheless, phenomenological and psychobiological data have led to
the hypothesis that social anxiety symptoms and disorders lie on various dimensions. Method: A
MEDLINE search (1966–2003) for relevant articles on the social anxiety disorder spectrum was
undertaken using the terms shyness, behavioral inhibition, social phobia, social anxiety disorder,
avoidant personality, dimension, and spectrum to aim at objective coverage, but references for this
article were chosen more subjectively to illustrate data and themes in description, pathogenesis,
pharmacotherapy, and psychotherapy of the social anxiety disorder spectrum. Results: Several different approaches to delineating a social anxiety disorder spectrum of conditions have been described.
These include (1) a spectrum of social fear and avoidance, (2) a spectrum of body-focused concerns,
(3) a spectrum of anxiety disorders and affective dysfunction, and (4) a spectrum of social deficits.
Conclusions: Social anxiety symptoms and disorders do appear to lie on a number of different dimensions. Nevertheless, additional research is necessary to determine the clinical utility of assessing these
different dimensions and to investigate their underlying psychobiology.