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The Social Anxiety Disorder Spectrum

Dan J. Stein, MD, PhD; Yutaka Ono, MD, PhD; Osamu Tajima, MD, PhD; and Jacqueline E. Muller, MB, ChB, MMed(Psych)

Published: October 1, 2004

Article Abstract

Background: Current diagnostic classifications emphasize the categorical nature of disorders suchas social anxiety disorder. Nevertheless, phenomenological and psychobiological data have led tothe hypothesis that social anxiety symptoms and disorders lie on various dimensions. Method: AMEDLINE search (1966-2003) for relevant articles on the social anxiety disorder spectrum wasundertaken using the terms shyness, behavioral inhibition, social phobia, social anxiety disorder,avoidant personality, dimension, and spectrum to aim at objective coverage, but references for thisarticle 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 thesedifferent dimensions and to investigate their underlying psychobiology.

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