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SOCIAL PHOBIA
UNDERSTANDING
SOCIAL PHOBIA
NTRODUCTION
ANXIETY
• Often a person must undertake a strenuous search to find a therapist
who is familiar with the most effective treatments for the condition.
• ‘n Persoon moet dikwels ‘n uitputtende soektog op tou sit om ‘n
terapeut te kry wat met die mees effektiewe metodes van
behandeling vertroud is.
• Ngamaxa amaninzi kufuneka umntu enze imigudu yokuzingela
ukuze afumane ingcali yokunyanga enolwazi ngezona ndlela
zonyango zinyanga imeko ngempumelelo.
• Ngokuvamile umuntu ufuna kanzima ngaphambi kokuthola
umelaphi ozaziyo izindlela ezisebenzayo zalesi sifo.
Anxiety is a feeling of unease. Everybody experiences it when faced with
a stressful situation. It is normal to feel anxious when facing something
difficult or dangerous, and mild anxiety can be a positive and useful
experience. Excessive anxiety is often associated with other psychiatric
conditions, such as depression.
Anxiety is considered as abnormal when:
- it is prolonged or severe
- it happens in the absence of a stressful event
- it is interfering with everyday activities such as going to work or socialising.
The physical symptoms of anxiety are caused by the brain sending
messages to parts of the body to prepare for the “fight-or-flight”
response. The heart, lungs and other parts of the body work faster.
The brain also releases stress hormones.
Anxiety is the main symptom of several other mental illnesses. These
are called anxiety disorders and includes panic disorder.
SOCIAL ANXIETY DISORDER
Social Phobia (Social Anxiety Disorder) is not just shyness. It is defined
as an intense fear of scrutiny by other people in a social situation, or
a fear of doing something embarrassing or humiliating in that situation.
Social phobias may present as a fear being around other people, or
presenting a speech, talking to an authoritarian figure, dating or signing
cheques in public. The most common is speaking in public.
People suffering from Social Phobia tend to think that they are not
competent in public, every other person is. Although it is often thought
of as shyness, the two are fundamentally different. Shy people may
feel very uneasy in the presence of others, those with Social Phobia
experience extreme anxiety in anticipating a social situation – they may
be at ease with people and fearful only of particular situations. Sufferers
of Social Phobia are aware that their feelings and thoughts are irrational,
but are still prone to anxiety induced by the anticipation and dread of
a social event. If left unattended, Social phobia may continue to hinder
the sufferer’s functioning throughout the rest of their lives, and can lead
to a high risk of substance abuse, morbidity and suicide.
SOCIAL PHOBIA
HOW PREVALENT IS IT AND WHAT ARE THE CAUSES?
• Social Phobia affects between two and three people per hundred, of all
races and social groups.
• Sosiale fobie tas tussen twee en drie mense per honderd van alle rasse en
sosiale groepe aan.
• Uloyiko kwezeNtlalo (i-Social Phobia) luchaphazela zonke iintlanga namaqela
asekuhlaleni, phakathi kwesibini nesithathu sabantu ekhulwini.
• Ukwesaba umphakathi (Social Phobia) kuphatha abantu ababili kuya
kwabathathu ekhulwini labantu, kuzo zonke izinhlanga nakuwo wonke
amaqembu omphakathi.
Q: What is the average age of onset?
A: Between 15 and 20 years, but the disease can often begin during childhood.
- ± 40% of patients develop social phobia prior to the age of 10 years.
- 95% before twenty years.
It often runs in families and may be accompanied by alcoholism or depression.
Q: What are the repercussions?
A: Most social phobia sufferers do nor acquire important life and social skills.
They often develop other anxiety disorders as a result of their social isolation.
Low educational levels as well as financial problems and poor coping skills
aggravate the situation.
Q: What triggers the development of specific phobias?
A: Often traumatic events trigger phobias of specific locations, objects, situations.
Q: Is social phobia hereditary?
A: It may have a hereditary component and occurs in equal proportions of
men and women.
The exact cause is unknown but there are chemical systems in the brain that
may be responsible for the development of the disease.
SOCIAL PHOBIA
HOW DOES IT PRESENT, WHAT ARE THE SYMPTOMS AND
HOW IS IT DIAGNOSED?
• People suffering from social phobia display 3 essential features:
1. a fear of scrutiny by other people in social situation.
2. a marked and persistent fear of performance situations in which
embarrassment may occur.
3. an active avoidance of the feared situations.
• Mense wat aan sosiale fobie ly, het 3 uitstaande kenmerke:
1. ‘n vrees om in 'n sosiale situasie deur ander onder die soeklig geplaas te word.
2. ‘n duidelike en volgehoue vrees vir situasies waarin hulle moet presteer en wat
tot verleentheid kan lei.
3. ‘n aktiewe vermyding van die gevreesde situasies.
•Ukuphepha okubonakalay okweeneko ezoyikwayo:
1. abantu abanengxaki yokuhlutshwa luloyiko lwenzentlalo babonakalisa iimpawu
ezi-ezibalulekileyo:
2. uloyiko lokubuzwa ngayo yonke into ngabanye abantu kwimeko yasekuhlaleni.
3. uloyiko olubonakalayo noluzingisileyo kwiimeko zokwenza into apho
kusenokubakho.
•Abantu abaphethwe wukwesaba umphakathi bakhombisa 3 izici ezisemqoka:
1. Ukwesaba ukubhekisiswa ngabanye Abantu emphakathini
2. Ukwesaba okubonakalayo nokungapheli kwezimo izinto ezithile okungenzeka
zibe nokuphoxeka.
3.Okuzigwema kakhulu izimo eziatshwayo.
Q: How does it present?
A: It may present as:
- a generalised condition where fears involve almost all social contacts.
- non-generalised where fears relate to specific social activities or performance
situations.
Q: What are the symptoms?
A: The most obvious are those brought on by fear of becoming embarrassed
in front of other people.
People may have difficulty speaking, eating or writing in front of others.
When exposed to the feared situation or location, sufferers will frequently
experience physical symptoms such as: palpitations, trembling, sweating,
tense muscles and headache.
Additional symptoms include: sinking feeling in the stomach, hot and cold
flushes as well as dry throat and mouth.
Q: How often do the symptoms occur?
A: Physical symptoms may occur before, during and after the actual event.
The sufferer may be convinced that the secondary symptoms of anxiety such
as sweating and blushing are in fact the main problem and suffer great selfconsciousness, fear and apprehension because of them.
SOCIAL PHOBIA
COMORBID CONDITIONS
•Comorbidity is very common with over two thirds of sufferes experiencing an
additional psychiatric diorder sometime in their lifetime.
•Komorbiditeit is baie algemeen en meer as twee derdes van die lyers het een of
ander tyd in hulle lewe nog ‘n psigiatriese versteuring.
•Iingcinga ezimbi zixhaphakile kubantu abangaphezulu kwesibini esithathwini
sabantu abanoloo ngxaki eyozongeza ukuphazemiseka kwengqondo ngamanye
amaxesha kubomi babo bonke.
•Ukungaphili kuvamile kakhulu kubantu abangaphezu kwezingxenye ezimbili
kwezintathu abaphathwa enye inkinga ephathelene nomqondo kwesinye isikhathi
ezimpilweni zabo.
Q: When and why do comorbid disorders occur?
A: Symptoms of social phobia present prior to those of the comorbid disorder. This
suggests that social phobia itself precipitates the onset of other comorbid disorders.
Q: What are the comorbid disorders?
A: Panic attacks are often a very prominent feature of social phobia. Other common
comorbid disorders are: agoraphobia,alcohol abuse, major depression and drug
abuse. An association between social phobia and the onset of eating disorders has
also been demonstrated.
Q: What are the implications of comorbid disorders?
A: Comorbid sufferers appear to suffer a greater degree of distressand are likely to suffer
from the more serious consequences of the disease. Comorbid social phobia is
more likely to lead to suicide than uncomplicated social phobia.
SOCIAL PHOBIA IN CHILDREN AND ADOLESCENTS
• While social phobia typically has its onset in childhood, intense fears
appear in most children as a normal part of growing up.
• Hoewel sosiale fobie tipies in die kindertyd begin, kom intense vrees as
normale deel van grootword in die meeste kinders voor.
• Ngeli xesha uloyiko lwezentlalo liqala kanye ebuntwaneni, uloyiko
olunamandla lubonakala kubantwana abaninzi njengento eqhelekileyo
eyinxalenye yokukhula.
• Yize noma ukwesaba umphakathi ngokuvamile kuqala ebunganeni,
ukwesaba okukhulu kuvela eningini lezingane njengengxenye yokukhula.
Q: What fears and anxieties are normal in children?
A: Early in life, infants become very attached to those who care for them. If separated,
toddlers naturally become anxious and upset. Childhood fears of the dark and of
monsters are very common. It is normal and natural for children to be nervous and
to experience some anxiety about starting school, but fear and anxiety should not
continue for extended periods of time.
Q
A:
What about adolescents?
They are often moody and preoccupied with social and sexual concerns.
These common concerns usually recede after discussion and reassurance.
Any persistence of avoidant behaviour should be taken seriously. Anxiety may also
manifest itself indirectly through changes in behaviour, physical symptoms and a
decline in the level of school work.
SOCIAL PHOBIA
Q: What should one do if it is suspected that a child or adolescent may be suffering from
social phobia?
A: It is advisable to contact a doctor or psychiatrist as soon as possible. Prolonged anxiety
spoils a child’s enjoyment of life and may cause irreparable damage.
IS SOCIAL PHOBIA TREATABLE?
• Because of misdiagnosis and inappropriate treatment fewer than 25% of
social phobia sufferers receive treatment for their condition, despite the
fact that it responds extremely well to treatment.
• Vanweë verkeerde diagnose en ontoepaslike behandeling kry minder as
25% van lyers aan sosiale fobie behandeling vir hulle toestand, ten spyte
van die feit dat dit baie goed op behandeling reageer.
• Ngenxa yokungaqondwa kakuhle kwengulo kunye nonyango olungelulo
ngaphantsi kwe-25% yabantu abanengxaki yoloyiko lezentlalo, bafumana
unyango lwemeko yabo, noxa inyani iyeyokuba imeko leyo ibonakala
ihambelana kakuhle kakhulu nonyango.
• Ngenxa yodokotela abakhomba okungeyikho kanye nokwelashwa
okungafanele, zingaphansi kuka 25% iziguli zokwesaba umphakathi ezithola
ukwelashelwa izimo zazo, phezu kokuthi lesi sifo sinezinga eliphezulu
lokwelapheka.
Q: What confounds the successful treatment of social phobia?
A: 1.The perception that it is an exaggerated form of shyness or social unease.
As a result of this, many sufferers do not consider their condition to be a
disorder for which consultation with a doctor is appropriate.
2. The nature of social phobia means that sufferers are often reluctant to
seek treatment.
This is due in part to the fear of public scrutiny and the belief that nothing
can be done to help.
3. There is a low level of awareness among many doctors of the diagnosis
and treatment of social phobia.
Q: Can severe impairment and the onset of comorbid conditions be prevented
or minimised?
A: Yes by the early administration of pharmacological and psychological
therapies.
Once social phobia is diagnosed, it is imperative that treatment is introduced
without delay.
Q: What is the best way of treating social phobia?
A: Research suggests that a combination of drug and psychological therapy
yields the best treatment results as well as the most rapid recovery the fewest
relapses.
Serotonin Reuptake Inhibitors (SSRI’s)
SOCIAL PHOBIA
MEDICATION
•Social phobia responds well to drug therapy but it is important to realise
that it is a chronic condition that requires long-term management.
•Sosiale fobie reageer goed op behandeling met geneesmiddels, maar dit
is belangrik om te besef dat dit ‘n chroniese toestand is wat behandeling
oor die lang termyn nodig het.
•Uloyiko lwezentlalo luhambelana kakuhle namayeza kodwa kubalulekile
ukuqonda ukuba luyimeko engapheli efuna ulawulo lwexesha elide.
•Ukwesaba umphakathi kungahlangabezana kahle nokwelashwa
ngemishanguzo kodwa kusemqoka ukwazi ukuthi yisimo sonomphelo esidinga
ukulawulwa unomphelo.
Q: For how long should drug therapy be maintained?
A: For at least one year.
Upon completion of the drug treatment program, medication should be
withdrawn gradually, with periodic attempts to lower the dose.
Q: Which drugs are the most effective in treating social phobia?
A: The antidepressants most commonly used: Monoamine Oxidase Inhibitors
(MAOI’s),
Reversible Inhibitors of Monoamine Oxidase (RIMA’s) and Selective Serotonin.
DIFFERENT TYPES OF ANTIDEPRESSANTS
MONOAMINE OXIDASE INHIBITORS (MAOI’s)
Q: What is a MAOI?
A: An antidepressant that works by activating an enzyme called Monoamine Oxidase
They are effective for the treatment of depression and social phobia.
Q: Are they widely used?
A: No because they may have a dangerous reaction with certain foods.
They tend to be reserved for patients who have not responded to other medications.
Patients need to adhere to a strict diet and if switching to another antidepressant
there needs to be a one to two week interval for the drug to wash out.
REVERSIBLE INHIBITORS OF MONOAMINE OXIDASE (RIMA’S)
Q: What is a RIMA?
A: It’s a new class of dug which is safer and better tolerated than MAOI’s.
The drug functions by selectively binding to a specific isoenzyme of Monoamine
oxidase.
SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI’s)
Q: What is a SSRI?
A: They are among the newer antidepressants and are now the most widely used.
They tend to have fewer side-effects than the older drugs.
Although called antidepressants they are also used to treat other anxiety disorders
such as social phobia, panic disorder and obsessive compulsive disorder.
SOCIAL PHOBIA
ARE ANTIDEPRESSANTS SAFE TO TAKE?
• Antidepressants are safe to take in prescribed doses, but are not suited to everyone.
• Dit is veilig om antidepressante teen die voorgeskrewe dosis te gebruik,
maar dit is nie vir almal geskik nie.
• Izithuntubalisi zikhuselekile xa zisetyenziswa ngemilinganiselo emiselweyo,
kodwa azilungelanga wonke umntu.
• Ama-antidepressants (imishanguzo edambisa ukukhathazeka) aphephile
uma ephuzwa ngemithamo eyaleliwe, kodwa awalungele wonke umuntu.
There are some conditions where extra care will need to be taken. If any of the following
apply to you, you should discuss medication with your doctor:
•
•
•
If you are taking other prescribed or over-the-counter medication, including
antihistamines, stomach acid neutralisers, cough and cold treatments or similar
medication.
If you have any pre-existing illnesses, including diabetes, epilepsy, heart problems,
kidney or liver problems, hyperthyroidism etc.
If you are pregnant, breast feeding or hoping to fall pregnant.
Q:
A:
Will I experience side-effects?
Mild side-effects are likely to be experienced during the first weeks of treatment
but usually disappear with time.
It is important to overcome this period of having to endure side-effects in
order to allow for full recovery to take place.
Q:
A:
What are the most common side-effects?
They include nervousness, sleep problems and impaired sexual functioning.
Other typical side-effects of SSRI’s include: headache and nausea.
Other typical side-effects of MAOI’s include: dizziness and restlessness, the need
for a special diet.
Q:
A:
Are there any special precautions?
Yes with MAOI’s.
They interact with several food types including cheese and wine.
These foods must be avoided during the course of treatment with MAOI’s.
OTHER MEDICATIONS
Certain benzodiazepines are useful in the treatment of social phobia.
Beta-blockers are useful in treating performance anxiety.
NB. Continuation of treatment is important as there is a substantial rate of relapse
once therapy has been prematurely withdrawn.
For more information about any of the above medications,
please consult your Health Care Professional
All data available on file.
SOCIAL PHOBIA
PSYCHOLOGICAL TREATMENT
• Psychological intervention is an important component since it encourages the
sufferer to confront negative beliefs and feelings which are proposed by some
to be causes of their social phobia.
• Sielkundige intervensie is ‘n belangrike komponent omdat dit die lyer
aanmoedig om die negatiewe oortuigings en gevoelens te konfronteer wat
deur sommige voorgehou word as die oorsake van hulle sosiale fobie.
• Ukunceda ngokwezengqondo kuyinxalenye ebalulekileyo njengoko
kukhuthaza umguli ukujongana neenkolo ezingakhiyo nezimvo
ezikhankanywa ngabathile njengeembangi zoloyiko lwezentlalo.
• Ukungenelela kokwelapha imicabango yingxenye esemqoka ngoba
ikhuthaza isiguli ukuba sibhekane nezinkolelo nemizwa okungalungile
abanye abathi kuyizimbangela zokwesaba kwazo umphakathi.
The most important negative belief which needs to be challenged is that of failure
being inevitable in social situations.
There are 3 basic forms of psychological treatment available:
SOCIAL SKILLS TRAINING
Q: How does it work?
A: It helps people feel more relaxed and confident in the company of others.
It teaches many of the social skills taken for granted in society.
The emphasis is on practise and feedback, a process which allows the sufferer
to monitor his or her social interactions.
EXPOSURE THERAPY
Q: What does it involve?
A: It essentially involves exposure to feared situations.
It helps the sufferer to relax in a situation they perceive to be frightening.
It is usually conducted in stages according to hierarchy, bringing about gradual
desensitisation to the feared situation or location.
COGNITIVE BEHAVIOURAL THERAPY
Q: How can it help?
A: It helps sufferers to change the way they think about themselves, their surroundings
and other people.
Therapy brings about a more realistic and less worrying way of thinking about
fearful situations, while challenging anxiety-provoking thoughts and feelings.
Group therapy sessions are particularly appropriate to the treatment of certain
forms of social phobia.
ALMOST 80% OF PEOPLE SUFFERING FROM SOCIAL PHOBIA FIND RELIEF FROM THEIR
SYMPTOMS WHEN TREATED WITH A COMBINATION OF MEDICATION AND PSYCHOTHERAPY
A combination of the two treatments result in a reduced risk of relapse upon
discontinuation of medication
SOCIAL PHOBIA
REAL-LIFE DESENSITISATION
• It is the single most effective treatment available for social phobia.
• Dit is die enkele mees effektiewe behandeling beskikbaar vir sosiale fobie.
• Wukwelashwa okukodwa okuesbenza ukukwedlula konke kulabo abesaba.
• Kuphela kolona nyango lusebenzayo elikhoyo loloyiko lwezentlalo.
Q: What is it?
A: Also called exposure or in-vivo desensitisation, real-life desensitisation involves
overcoming fears and phobias through direct exposure.
Improvement usually doesn’t disappear shortly after treatment once they have
fully desensitised themselves – they can remain free of fear.
It however involves the uncomfortable prospect of having to tolerate the
unpleasantness of facing phobic situations and of having to persist with practising
it on a regular basis.
Q: What does it involve?
A: It involves the use of a basic hierarchy of phobic scenes that have been constructed
to bring about desensitisation.
Goals must be clearly defined with careful consideration given to what constitutes
full recovery.
A timeframe should be decided on.
Broad goals are fragmented into smaller, more manageable goals.
The hierarchies presented below can be used as guidelines for attaining desensitisation
to 3 of the most common social phobias:
Fear Of Speaking In Public
•
In any group situation, while sitting down, make a one-sentence comment.
•
Make a 3 to 5 minute comment while sitting with a group.
•
Standing up in a small group, make a 30 second comment.
•
Announce to a small group that you will be giving a short comment at every
break.
•
Join Toastmasters.
•
In a familiar group, stand up and make a comment.
•
In a familiar group, stand up and make a short statement.
•
Present a short talk on any subject.
•
Make a comment at any meeting you may attend.
•
Return to the group some time later and comment on your progress.
SOCIAL PHOBIA
USEFUL TIPS ON RECOVERY
• If you suspect you may be suffering from social phobia, reading through this
guide and learning about the disease is the first step to recovery.
• As u vermoed dat u aan sosiale fobie ly, is die deurlees van hierdie gids en
meer kennis oor die siekte die eerste stap na herstel.
• Ukuba ukrokrela ukuba usenokuba unengxaki yoloyiko lwezentlalo, ukufunda
esi sikhokhelo nokufunda ngesifo esi linyathelo lokuqala elisa ekuphileni.
• Uma usola ukuthi unenkinga yokwesaba umphakathi, ukufunda lo
mkhombandlela nokuthola kabanzi ngalesi sifo yisinyathelo sokuqala
esibheke ekwelulameni.
•
Seek help from a doctor if you have not yet been examined or diagnosed.
•
If you are already on treatment, continue with the prescribed treatment, taking
one day at a time.
•
Remember not to let others discourage you.
•
Don't feel ashamed about social phobia, it is a very real disease just like any other
illness.
•
Learn more about the disorder - ask your doctor, pharmacist, the Depression and
Anxiety Support Group or call Steps at the number given on the back page.
•
Seek support from others, and take an active role in your recovery.
•
Most importantly, keep in mind that you can overcome social phobia - recovery
will take work, but it will be well worth the effort.
SOCIAL PHOBIA
HOW TO HELP SOMEONE SUFFERING FROM SOCIAL PHOBIA
• The support, encouragement and understanding of family and friends helps the
recovery of a social phobia sufferer immeasurably.
• Die ondersteuning, aanmoediging en begrip van familie en vriende help
die herstel van ‘n lyer aan sosiale fobie geweldig baie.
• Inkxaso, inkuthazo nemvisiso yosapho nezihlobo inceda umntu onengxaki
yoloyiko lwezentlalo ukuphila ngokungathethekiyo.
• Ukwesekwa, ukukhuthazwa nokuqondwa ngabomndeni nabangani kusiza
ngokwedlulele ekwelulameni kwalowo onokwesaba umphakathi.
You may wish to follow the guidelines listed below if you would like to help a friend or
relative:
Learn more about the disorder.
• Acknowledge that there is a real problem - social phobia is not merely a severe
form of shyness, but a medical condition that should be taken seriously.
• Be understanding: Recognise that allowing a sufferer to explain their problems will
help him or her to feel less isolated and ashamed of their condition.
• Do not regard social phobia as the fault of any particular person. Neither you nor
the sufferer is to blame for the condition.
• Gently encourage the sufferer to seek professional help. Acknowledge that this may
be a difficult decision, keeping in mind that the very nature of social phobia often
means that sufferers are afraid to seek help from strangers.
• Once treatment is initiated, encourage the sufferer to persist and continue with
treatment. Recognise and show your appreciation for any improvement, no matter
how small.
• As treatment begins to take effect, the sufferer will be encouraged to begin facing
up to fearful situations and locations. Your support and understanding in this regard
is vital.
• While at home, sufferers should he encouraged to maintain as normal a lifestyle
as possible. Do not adapt your lifestyle to fit in with their fears and anxieties.
SOCIAL PHOBIA
SEEKING HELP FOR SOCIAL ANXIETY
• Often a person must undertake a strenuous search to find a therapist who is
familiar with the most effective treatments for the condition.
• ‘n Persoon moet dikwels ‘n uitputtende soektog op tou sit om ‘n terapeut te
kry wat met die mees effektiewe metodes van behandeling vertroud is.
• Ngamaxa amaninzi kufuneka umntu enze imigudu yokuzingela ukuze
afumane ingcali yokunyanga enolwazi ngezona ndlela zonyango zinyanga
imeko ngempumelelo.
• Ngokuvamile umuntu ufuna kanzima ngaphambi kokuthola umelaphi
ozaziyo izindlela ezisebenzayo zalesi sifo.
Q: Where can I find help?
A: In general:
•
Your family doctor.
•
Mental health specialists (including psychiatrists, psychologists and social workers.
•
Community mental health centres.
•
State hospital psychiatry departments or outpatient clinics.
•
Private hospitals and outpatient clinics.
•
University – or medical school-affiliated clinics or education programmes.
•
Medical Aid/Health insurance companies.
•
Support groups and patient advocacy organisations.
•
More specific:
The Depression and Anxiety Support Group can provide a list of professionals in
your area who specialise in the treatment of panic disorder and other anxiety
disorders.
• GSK’s Steps Care line - dial 08600 Steps or 08600 78377.
BROUGHT TO YOU BY GSK CNS DIVISION IN SUPPORT OF
MENTAL HEALTH AWARENESS
Liebowitz Social Anxiety Scale
• It is used to evaluate degree of fear and avoidance in common social situations.
• Rates fear/anxiety and avoidance on 24 commonly feared “performance” or “social.
situations”
Each phobic situation is rated on a 0 - 3 spectrum
Fear or Anxiety
0 = never
1 = mild
2 = moderate
3 = severe
ANXIETY
(S)
Avoidance
0 = never (0%)
1 = mild (1-33%)
2 = moderate (33-67%)
3 = severe (67-100%)
ANXIETY
(P)
AVOID
(S)
Telephoning in public (P)
Participating in small groups (P)
Eating in public places (P)
Drinking with others in public places (P)
Acting, performing, or giving a talk in
front of an audience (P)
Working while being observed (P)
Writing while being observed (P)
Urinating in a public bathroom
Entering a room when others are already seated (P)
Speaking up at a meeting (P)
Taking a test (P)
Giving a report to a group (P)
Trying to pick up someone (P)
Total Performance (P) Subscore
Talking to people in authority (S)
Going to a party (S)
Calling someone you don’t know very well (S)
Talking with people you don’t know very well (S)
Meeting strangers (S)
Being the centre of attention (S)
Expressing a disagreement or disapproval to people you
don’t know very well (S)
Looking at people you don’t know very well in the eyes (S)
Returning goods to a store (S)
Giving a party (S)
Resisting a high pressure sales person (S)
Total Social (P) Subscore
A score of 0 represents no fear or avoidance
A score of 144 represents a severe level of avoidance
The mean change from baseline in Total LSAS Score as a primary efficacy endpoint for the treatment of Social Anxiety
Disorder.
AVOID
(P)
GlaxoSmithKline South Africa (Pty) Ltd., (Co. reg. no. 1948/030135/07),
57 Sloane Street, Bryanston, 2021.
References available on request.