Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication.

  • Ruscio A
  • Brown T
  • Chiu W
 et al. 
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BACKGROUND: Despite heightened awareness of the clinical significance of social phobia, information is still lacking about putative subtypes, functional impairment, and treatment-seeking. New epidemiologic data on these topics are presented from the National Comorbidity Survey Replication (NCS-R). METHOD: The NCS-R is a nationally representative household survey fielded in 2001-2003. The World Health Organization (WHO) Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) was used to assess 14 performance and interactional fears and DSM-IV social phobia. RESULTS: The estimated lifetime and 12-month prevalence of social phobia are 12.1% and 7.1% respectively. Performance and interactional fears load onto a single latent factor, and there is little evidence for distinct subtypes based either on the content or the number of fears. Social phobia is associated with significant psychiatric co-morbidity, role impairment, and treatment-seeking, all of which have a dose-response relationship with number of social fears. However, social phobia is the focus of clinical attention in only about half of cases where treatment is obtained. Among non-co-morbid cases, those with the most fears were least likely to receive social phobia treatment. CONCLUSIONS: Social phobia is a common, under-treated disorder that leads to significant functional impairment. Increasing numbers of social fears are associated with increasingly severe manifestations of the disorder.

Author-supplied keywords

  • Adolescent
  • Adult
  • Anxiety Disorders
  • Anxiety Disorders: diagnosis
  • Anxiety Disorders: epidemiology
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disord
  • Fear
  • Fear: psychology
  • Health Surveys
  • Humans
  • Interpersonal Relations
  • Mental Disorders
  • Mental Disorders: diagnosis
  • Mental Disorders: epidemiology
  • Patient Acceptance of Health Care
  • Phobic Disorders
  • Phobic Disorders: classification
  • Phobic Disorders: diagnosis
  • Phobic Disorders: epidemiology
  • Prevalence
  • Psychiatric Status Rating Scales
  • Psychiatric Status Rating Scales: statistics & num
  • Severity of Illness Index
  • Survival Analysis
  • United States
  • United States: epidemiology

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  • Ayelet R Ruscio

  • Timothy A. Brown

  • W T Chiu

  • J Sareen

  • Murray B Stein

  • R C Kessler

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