This article is being co-published by Depression and Anxiety and the American Psychiatric Association.
Article first published online: 8 FEB 2010
© 2010 Wiley-Liss, Inc.
Depression and Anxiety
Volume 27, Issue 2, pages 168–189, February 2010
How to Cite
Bögels, S. M., Alden, L., Beidel, D. C., Clark, L. A., Pine, D. S., Stein, M. B. and Voncken, M. (2010), Social anxiety disorder: questions and answers for the DSM-V. Depress. Anxiety, 27: 168–189. doi: 10.1002/da.20670
The authors report they have no financial relationships within the past 3 years to disclose.
- Issue published online: 8 FEB 2010
- Article first published online: 8 FEB 2010
- Manuscript Accepted: 5 JAN 2010
- Manuscript Revised: 29 DEC 2009
- Manuscript Received: 5 OCT 2009
- social anxiety disorder;
- social phobia;
- test anxiety;
- selective mutism;
- avoidant personality disorder
Background: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. Method: A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V. Results/Conclusions: Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a “predominantly performance” variety of SAD. A specifier based on “fear of showing anxiety symptoms” (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc.