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

Published online by Cambridge University Press:  02 November 2007

A. M. Ruscio ,
T. A. Brown ,
W. T. Chiu ,
J. Sareen ,
M. B. Stein  and
R. C. Kessler
A. M. Ruscio*
Affiliation:
Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
T. A. Brown
Affiliation:
Department of Psychology, Boston University, Boston, MA, USA
W. T. Chiu
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
J. Sareen
Affiliation:
Department of Psychiatry and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
M. B. Stein
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: Dr A. M. Ruscio, Department of Psychology, University of Pennsylvania, 3720 Walnut Street, Philadelphia, PA 19104, USA. (Email: ruscio@psych.upenn.edu)
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Abstract

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.

Keywords

Epidemiologyfunctional impairmentsocial anxiety disordersocial phobiasubtypes
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 1 , January 2008 , pp. 15 - 28
Copyright
Copyright © Cambridge University Press 2007

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