Differentiating social phobia from shyness

This paper is dedicated to Samuel M. Turner, Ph.D. whose untimely death cut short his dedication to understanding the etiology and treatment of anxiety disorders to improve the lives of so many.
https://doi.org/10.1016/j.janxdis.2008.10.002Get rights and content

Abstract

To clarify the relationship between social phobia and shyness, this study examined the characteristics of highly shy persons with social phobia, highly shy persons without social phobia, and non-shy persons. Those with social phobia reported more symptomatology, more functional impairment, and a lower quality of life than those without social phobia. About one-third of the highly shy without social phobia reported no social fears, highlighting heterogeneity of the shy. The social phobia group reported similar levels of anxiety as the shy without social phobia during analogue conversation tasks, but they reported more anxiety during a speech task. The social phobia group performed less effectively across tasks than those without social phobia. All groups’ perceptions of anxiety and effectiveness during behavioral tasks were consistent with ratings of independent observers. None of the groups differed on psychophysiological measures. Results are discussed in the context of theoretical models of social phobia.

Introduction

From the time social phobia was introduced as a psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition in 1980 (DSM-III; APA, 1980), researchers and clinicians have theorized about the relationship between social phobia and shyness. Social phobia is a well-defined clinical disorder in the DSM-IV (APA, 1994), whereas shyness is a less well-defined lay term (Harris, 1984). The defining features of both are strikingly similar, however, and include somatic symptoms (e.g., trembling, sweating, blushing), cognitive symptoms (e.g., fear of negative evaluation), and behavioral symptoms (e.g., avoidance of social situations). Despite these shared features, the relationship between social phobia and shyness remains unclear. Furthermore, shyness is a condition many view as a normal personality trait that should not be confused with social phobia (see Carducci, 1999, Stein, 1996).

One hypothesis about the relationship between shyness and social phobia places both conditions on a continuum or spectrum with social phobia conceptualized as “extreme shyness” (Marshall & Lipsett, 1994; McNeil, 2001, Stein, 1999). Accordingly, those with social phobia have more severe symptoms and are more impaired by their discomfort in social situations than shy persons. This conceptualization is consistent with the notion that shyness is a subclinical condition or a normal facet of personality that is not pathological (Carducci, 1999). The second hypothesis is that shyness and social phobia are partly overlapping conditions, with shyness being a broader construct than social phobia (Beidel & Turner, 1999; Heckelman & Schneier, 1995; Heiser, Turner, & Beidel, 2003). According to this hypothesis, shyness and social phobia may be qualitatively different in some regards, rather than varying only in degree.

Some empirical investigations have begun to define the boundary between shyness and social phobia. In one study (Chavira, Stein, & Malcarne, 2002), rate of social phobia was significantly higher among a highly shy sample compared to a normative shy sample, providing partial support for the continuum hypothesis. However, only half of the highly shy persons in the study had generalized social phobia, lower than would be expected based on a continuum model. Similarly, when rates of social phobia and other psychiatric disorders were examined among a population who self-identified as shy (Heiser et al., 2003), shyness was associated with psychopathology in general and not solely with social phobia. In addition, a significant proportion of shy persons had no psychiatric diagnoses.

Both prior studies suggest that higher levels of shyness are associated with increasing rates of social phobia, but that the conditions are not the same. Both studies also suggest that the relationship between shyness and social phobia is limited to those with generalized social phobia, with little to no association between shyness and specific social phobia. This finding is consistent with clinical observations of persons with speech anxiety, for example, who do not appear to be shy or report being shy and of persons with generalized social phobia who typically report that they “have always been shy” (Beidel & Turner, 1998; Turner, Beidel, & Townsley, 1990).

In summary, past research indicates that, although shyness and social phobia are related, most shy persons do not meet criteria for social phobia. The pertinent question becomes: are there dimensions that distinguish the subset of highly shy persons with generalized social phobia from other highly shy persons who do not meet criteria for social phobia? The purpose of this study was to determine what factors, if any, discriminate generalized social phobia from shyness, restricting the analysis to highly shy individuals. Because shyness has been shown to be associated with multiple psychological problems, the shy group in this study consisted of those without psychiatric diagnoses so that comparisons between a “purely” shy group and those with social phobia could be made.

Section snippets

Participants

The sample for this study consisted of 78 individuals. Most of the participants (n = 61; 78.2%) were students at the University of Maryland, College Park who were enrolled in introductory psychology courses. The other 17 participants were recruited from persons seeking participation in a social phobia treatment study being conducted at the Maryland Center for Anxiety Disorders at the University of Maryland, College Park. Ten of these treatment seeking participants were also students at the

Participant recruitment

The shyness scale (the RCBS) was completed by 1303 introductory psychology students. The mean score was 33.0 (SD = 9.5). Students with a shyness score equal to one standard deviation above or below the mean (scores of 24 and below and 43 and above) were eligible to participate in the study. Students were informed of their eligibility for the study by electronic mail and if interested, they volunteered for the study using an electronic system. Informed consent was obtained from all participants

Demographic characteristics

Comparisons of demographic characteristics across the three groups were conducted. No significant relationship was found between group membership and sex (χ2 (2, N = 78) = 4.57, p > .05). The percentage of females was 40.0% in the social phobia group, 30.8% in the shy group, and 59.3% in the non-shy group. There was a significant relationship, however, between group membership and race/ethnicity (χ2 (2, N = 78) = 8.57, p < .05). Slightly over half (57.7%) of the shy group was non-white, compared to 29.6%

Discussion

This study was designed to better understand the relationship between shyness and social phobia. Some researchers have hypothesized that these conditions rest on a continuum with social phobia being conceptualized as “extreme shyness” (e.g., Marshall & Lipsett, 1994; McNeil, 2001, Stein, 1999), while others have suggested that the conditions are overlapping, with shyness being a broader, more heterogeneous category (e.g., Beidel & Turner, 1999; Heckelman & Schneier, 1995; Heiser et al., 2003).

Acknowledgements

This study was based on a dissertation by Nancy Heiser under the direction of Dr. Samuel Turner. The study was supported in part by NIMH grant number MH53703 to Drs. Turner and Beidel.

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