Impact of Social Anxiety Disorder on the Routine Life of the Affected Person

Introduction

Social anxiety disorder affects children and young adults. It is characterized by high levels of distress, especially in a social environment, and inhibits a person’s tolerance for social situations. Individuals suffering from social anxiety disorder have inherent challenges in dealing with a social environment where personal interaction, assessment, or attention are required. Consequently, it presents in any situation that the patient is expected or required to interact with other people and perceives that he or she is being measured based on such interactions.

Social anxiety disorder, commonly known as social phobia, is a critical health problem that affects performance in a social situation, making it difficult for a patient to communicate or associate with other people. However, it is critical to differentiate between a person suffering from social anxiety disorder and a shy person. Essentially, a shy person may be reluctant to engage with others in a social situation, but once they have adapted to their immediate social situation, they become increasingly comfortable and are able to socialize effortlessly. However, this is not the case for children and young people suffering from social anxiety disorder, given that they illustrate high levels of fear and anxiety if an attempt is made to place them in a social environment.

Social Anxiety Disorder

Social anxiety disorder is attributed to various causes that include environmental and genetic factors. Various researches have determined that a child’s genetic predisposition can have a significant impact on the development of reserved, repressed, or inhibited traits that can result in social phobia if certain pressures and challenges occur. The impacts of environmental factors towards the presentation of social phobia have been linked to family dynamics (Van Straten et al., 2007). Issues such as parenting, family environment, upbringing, and experiences in life can influence the presentation of social phobia. In the event that parents or guardians of a child are socially repressed or exhibit anti-social behavioral tendencies, it is highly likely that the child will behave in a similar manner (Rapee & Heimberg, 1997).

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If a child or teenager is exposed to a family situation that is averse to socializing or the creation of relationships outside the home, the chances are that they will develop social anxiety disorder, causing them to become anxious whenever other people try to come close. Children and young people that are exposed to such parenting are likely to develop with the belief that socializing is precarious and places a person in potential danger of embarrassment or misjudgment (Schneier, 2003). The problem can also be caused if parents become excessively overprotective of their children, especially when they meet with challenges in the social environment such as being rejected or failing to achieve a certain social goal (Rapee & Spence, 2004). Parents may dissuade a child from attempting to socialize asserting that they do not need to be acknowledged or recognized in the social context; creating a subconscious disengagement and dissociation with the social setting. These issues result in a child or a young person leading a life in fear of social interaction conceding that failure, criticism, or negative judgment are a pre-determined outcome (Rapee & Heimberg, 1997).

Due to the examination of environmental and genetic factors that cause social phobia, it is prudent to acknowledge that the precepts of “multifinality and equifinality” are applicable in explaining the development process of social anxiety disorder (Rapee & Spence, 2004). Equifinality is a concept that implies that children and young people can be exposed to different upbringing, family and social backgrounds, yet they develop similar behavioral attributes. Meanwhile, multifinality asserts that children brought up in the same family and social environment can lead different ad separate lives characterized by significant differences in social behavior (Morgan, 2003). Therefore, though a child may develop social phobia as a result of the family environment and upbringing factors, it does not necessarily mean that all children in the family will face the same problem.

There is a high probability that some of the children will become more social and accept new people better than others (Osman et al., 1998). This illustrates that divergent development pathways are possible for children brought up in the same environment since some can adapt easily, while others require more attention and effort to modify their behavior. Though a single event or factor can have a considerable impact in influencing behavior, it does not mean that it will influence the child’s overall social behavior and attitude (Kashdan & Steger, 2006). In the case of genetic causal factors, social phobia is developed as a combination of various personal traumas that inhibit an individual’s ability to socialize with others.

The development process in children involves numerous experiences, especially prior to attaining adolescent age where complex social development processes occur. These may include the establishment of independence and life goals or creation of new relationships. A young person’s success in developing such relationships or attainment of social goals are vital towards the development and enforcement of self-control, confidence, self-esteem, and identification of socially acceptable behavior and attitudes (Osman et al., 1998). The presentation of social phobia is largely evident during the early adolescent age and has the potential to develop further as teenagers develop “higher order of cognitive skills that endorse their capacity for comparative self-evaluation to others” (Rapee & Spence, 2004, p. 737).

The identification of social phobia can be detected at an early age through the examination of a child’s social behavior. A child could present traits that indicate an aversion to social situations and unfamiliar faces, reduced communication, and disengagement from social activities (Murray et al., 2008). Consequently, as children grow older, they become more averse to social situations that may require their active participation. Avoiding others through hiding or seeking familiar environments that are isolated from the social crowd are a common phenomenon. If parents or guardians fail to recognize these indicators of social phobia, it is highly likely that a child would regress further.

In a clinical perspective, various behavioral responses in children illustrate the presence or an emerging problem of social phobias, such as aversion of eye contact with other people and a stuttering speech pattern. These are indicators that demonstrate a failure to function adequately, especially in social contexts (Boer, 1997). Consistent social dissociation, behavioral disengagement, panic attacks, somatic complaints, and progressive tantrums are among the indicators of social anxiety disorder. The emergence of social phobia at an early age could result in additional mental and psychological problems that may not be foreseen but cause significant distress to the patient. A large number of young people suffering from social phobia have been found to present with additional problems including “severe depression, suicidal ideation and antisocial behavior” (Marcel et al., 2003).

Though there may not be any distinctions in the presentation of social phobia between boys and girls, there are significant differences in the manner that they interpret their condition and react to the world. The presentation of social phobia in young girls is often associated with feelings of loneliness, fear, feelings of being secluded or left out, and detachment from peers (Schimdt & Schulin, 1999). Meanwhile, boys suffering from social phobia feel they are not good enough, they are incompetent or inadequate, and experience “self-originated perceptual aversion from that of their peers” (Rapee & Spence, 2004). Though male and female young people feel differently as a result of social phobia, they present with common issues in the attainment of life goals since the presentation of social phobia limits their vocational choices. These can result in economic and health challenges, considering that social phobia is associated with low levels of self-esteem and sensitivity to subjective judgment or evaluation.

The treatment of social phobia is dependent on how early the problem was detected and the measures that were taken to mitigate the problem. The application of cognitive-behavioral therapy has been found to solve the problem in most cases, particularly, if administered in continuous processes (Morgan, 2003). The cognitive therapy integrates training on the application of social skills towards aiding children and young people to confront their phobia and develop effective and reliable coping mechanisms. In addition, psychotherapies are also administered, and medications may be prescribed to reduce the level of anxiety. Medication can be prescribed to reduce social anxiety disorder; however, it can only be relied on to a certain degree, and other methods must be included in the overall treatment plan.

Conclusion

Social anxiety disorder is a problem that can impair a child’s life if it remains unaddressed. It has the impact of reducing the quality of life since a child or young person feels a sense of isolation and disengagement from the normal social environment. Encouraging the development of social skills is vital, especially in challenging social situations. Instances of failure or criticism should be taken as learning milestones and not causes to avoid social interaction. Parents play a significant role in ensuring that their children develop adequate social skills through encouragement and participation. Though there are various cognitive therapies and medication for social phobia, the identification of a problem at a very early age can enable the parent to help the child develop social skills that prevent the problem from occurring.

 

References

Boer, J. A. (1997). Social phobia: Epidemiology, recognition, and treatment. BMJ: British Medical Journal, 315(7111), 796–800.

Kashdan, T. B., & Steger, M. F. (2006). Expanding the topography of social anxiety: An experience-sampling assessment of positive emotions, positive events, and emotion suppression. Psychological Science, 17(2), 120–128.

Morgan, S. (2003). Phobia: A biological perspective. In: Encyclopedia of psychoanalysis: Phobia: A reassessment (pp 11-50). Karnac Books.

Murray, L., De Rosnay, M., Pearson, J., Bergeron, C., Schofield, E., Royal-Lawson, M., & Cooper, P. J. (2008). Intergenerational transmission of social anxiety: The role of social referencing processes in infancy. Child Development, 79(4), 1049–1064.

Osman, A., Gutlerrez, P. M., Barrios, F. X., Kopper, B. A., & Chiros, C. E. (1998). The social phobia and social interaction anxiety scales: Evaluation of psychometric properties. Journal of Psychopathology and Behavioral Assessment, 20(3), 249-264.

Rapee, R. M., & Spence, S. H. (2004). The etiology of social phobia: Empirical evidence and an initial model. Clinical Psychology Review, 27(7), 737-767.

Rapee, R. M., Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behavior Research and Therapy, 35(8), 741-756.

Schimdt, L.A., & Schulin, J. (1999). Extreme fear, shyness and social phobia. Oxford University Press.

Schneier, F. R. (2003). Social anxiety disorder: Is common, underdiagnosed, impairing, and treatable. BMJ: British Medical Journal, 327(7414), 515–516.

Van Straten, A., Cuijpers, P., Van Zuuren, F. J., Smits, N., & Donker, M. (2007). Personality traits and health-related quality of life in patients with mood and anxiety disorders. Quality of Life Research, 16(1), 1–8.