Part Three of Anxiety Disorders
Part Three of Anxiety Disorders compares and contrasts Social Anxiety Disorder (Social Phobia) and Specific Phobia, and it also details Agoraphobia. Anxiety Disorders is the fifth diagnostic class being covered in the Mental Health Diagnosis blog series. Click HERE to read Part One of Anxiety Disorders, which describes the specific characteristics of anxiety and worry.
Do Social Phobia, Specific Phobia, and Agoraphobia have any similarities?
Yes! These disorders have several commonalities. First, each disorder has a similar presentation when seen in children. Children’s expression of fear and anxiety can present as “crying, tantrums, freezing, clinging, shrinking, or failing to speak” (Diagnostic and Statistical Manual of Mental Disorders, 2013). Second, the individual either avoids the object and/or situation or they experience intense fear and anxiety while enduring the object or situation. Third, the intense fear or anxiety is “out of proportion to the actual danger posed by the specific object or situation”; and fourth, the “fear, anxiety, or avoidance is persistent,” six months or more (Diagnostic and Statistical Manual of Mental Disorders, 2013).
What is the difference between Social Phobia and Specific Phobia?
Social Phobia involves fear and/or anxiety regarding a social situation and Specific Phobia involves fear and/or anxiety concerning an object or a situation that is not social in nature. Details about each disorder are described below.
Social Anxiety Disorder (Social Phobia)
The Social Phobia diagnosis is reserved for fear or anxiety that almost always occurs during a social situation and it disrupts the individual’s ability to function. This experience of fear and anxiety in social situations is not due to the effects of a drug of abuse and it is not better explained by the symptoms of “Panic Disorder, Body Dysmorphic Disorder, or Autism Spectrum Disorder” (Diagnostic and Statistical Manual of Mental Disorders, 2013).
In addition to the previously mentioned symptoms, an individual is diagnosed with Specific Phobia when they immediately experience fear and/or anxiety when presented with a particular object, or when they are in a certain situation. Objects and situations include, but are not limited to, “seeing blood, receiving an injection, flying [or boarding a plane], and animals” (Diagnostic and Statistical Manual of Mental Disorders, 2013).
Differential diagnosis involves the clinician distinguishing symptoms of phobia from the individual’s response to feared social situations, objects, and/or traumatic events; their fear of separation from an attachment figure; and/or their symptoms of anxiety.
The fifth edition of the Diagnostic and Statistical Manuel describes five situations that cause some persons to experience significant fear or anxiety:
- “Using public transportation (automobiles, buses, trains, ships, planes)
- Being in open spaces (parking lots, marketplaces, bridges)
- Being in enclosed places (shops, theaters, cinemas)
- Standing in line or being in a crowd
- Being outside of the home alone” (Diagnostic and Statistical Manual of Mental Disorders, 2013).
Diagnosis for Agoraphobia requires that an individual experience fear and/or anxiety in two or more of the above situations. Persons with Agoraphobia avoid these situations because they develop “panic-like symptoms”, become incapacitated, and/or they experience embarrassing symptoms, such as incontinence.
The response to these situations disrupts the individual’s typical functioning in school, at work, or in other important settings; and, the intensity of their response is heightened in the presence of medical conditions, such as Parkinson’s disease or Irritable Bowel Syndrome.
Differential Diagnosis requires that the clinician rule out Specific Phobia, Social Anxiety Disorder, Obsessive-Compulsive Disorder, Body Dysmorphic Disorder, Posttraumatic Stress Disorder, and Separation Anxiety Disorder.
Part Four of Anxiety Disorders, which describes Substance/Medication Induced Anxiety Disorder, Anxiety Disorder Due to Another Medical Condition, Other Specified Anxiety Disorder, and Unspecified Anxiety Disorder!
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Web. [access date: 16 June 2018]. dsm.psychiatryonline.org