The factors governing the development and continued presence of social phobia are numerous. Born less than fifteen years ago, cognitive psychopathology has identified the implications of various cognitive dysfunctions in the appearance and persistence of the condition. Arnaud D’Argembeau and Martial Van der Linden, of the cognitive psychopathology division of the University of Liège, have devoted a chapter to the question in the first French-language Treatise on cognitive psychopathology.

Blushing and sweating when a person with whom you are not familiar tries to engage you in conversation, seeking refuge in a corner while attending a party, remaining silent during a work meeting, being paralysed with fear at the idea of having to make a public speech, not daring to ask for help when in a shop are all symptoms of how difficult life can be when affected by a (SP) social phobia. In cases of social interaction with other people, you feel that you are the object of constant scrutiny, being judged, and negatively assessed. You also have a tendency to keep your distance, to avoid contact with others. Your social and professional life can only suffer.

According to the fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatry Association, social phobia is defined as «An intense and persistent fear of one or several social situations, or performance situations during which the subject is in contact with unfamiliar people, or even perhaps subject to close observation by another. The subject is afraid to act (or to show symptoms of anxiety) in an embarrassing and humiliating way».

Social phobias are broken down into a generalised form, which touches a large spectrum of social situations, and into a specific form, which concerns one or even several well-defined situations, such as fear of speaking in public. Viewed in a global sense, social phobia is the most frequent type of anxious condition and as the second volume of the Treatise on cognitive psychopathology states (1); it is classed as the third most common psychiatric disorder after major depressive disorder and alcoholism.

SP predominantly affects females, as, according to scientific literature, it affects three women for every two men. It is a chronic disorder whose average duration is about twenty years. Moreover, it is often accompanied by other psychopathological disorders, the most frequent of which are, in decreasing order, the other anxiety disorders, mood swing disorders, and disorders linked to substance abuse.

Most of the time, social phobia has an early onset. It manifests itself at adolescence, at an average age of between 15 and 18 years. However, it has been diagnosed even earlier in children aged only eight years old, and in 2 or 3 year old children, an extreme shyness allied to social reticence is an early symptom. «In a more general way, very young children show what has been called a temperament of avoidance. They show fear, avoidance or reticence faced with certain unfamiliar situations, people, or objects, explains Arnaud D’argembeau, researcher associate at the Foundation for Strategic Research (F.R.S.-FNRS). It is established that this predisposition, classed as behavioural inhibition, increases the probability of suffering from heightened social anxiety revealing itself to be a social phobia.»

Professor Martial Van der Linden, head of the psychopathology and cognitive neuropsychology unit at the University of Geneva as well as the cognitive psychopathology sector of the University of Liège (ULg), also adds that the presence of social anxiety shows a predisposition to the development of a clinical form of social phobia such as defined by the criteria for DSM-IV. This would seem to corroborate the idea of a continuum going from simple timidity to SP.

(1) Arnaud D'Argembeau and Martial Van der Linden, Le fonctionnement cognitif dans la phobie sociale, in Traité de psychopathologie cognitive, tome II, Solal Editions, Marseille, 2008