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Cited by 526Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentPersonality Disorders and Psychopathology

Social anxiety disorder: questions and answers for the DSM-V

Open access
Bögels, Susan M., Alden, Lynn, Beidel, Deborah C., Clark, Lee Anna, Pine, Daniel S., Stein, Murray B., Voncken, Marisol·2010·Depression and Anxiety
DOI 10.1002/da.20670
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Abstract

BACKGROUND: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. METHOD: A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V. RESULTS/CONCLUSIONS: Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a "predominantly performance" variety of SAD. A specifier based on "fear of showing anxiety symptoms" (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options.

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  • Family studies indicate stronger familial aggregation in overall SAD than in performance-only SAD.

    “Family studies indicate stronger familial aggregation in overall SAD”

    From Epidemiology, genetics, neuroimaging, clinical features, and treatment between overall and performance-only social anxiety disorder: a narrative review (2026) · cites this paper as Bögels et al. 2010

    The Familial/genetic section reports higher prevalence of generalized SAD (GSAD) among first-degree relatives of people with GSAD, while specific SAD—mostly public-speaking anxiety—did not differ significantly between groups. This supports the comparison with performance-only SAD, but the source's finding concerns generalized SAD, not overall SAD as a category. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • The prevalence of overall SAD is approximately 25% among individuals with a first-degree relative who has SAD, whereas it is 5% among those without such a family history.

    “the prevalence of overall SAD is approximately 25% among individuals with a first-degree relative who has SAD, whereas it is 5% among those without such a family history”

    From Epidemiology, genetics, neuroimaging, clinical features, and treatment between overall and performance-only social anxiety disorder: a narrative review (2026) · cites this paper as Bögels et al. 2010

    The “Familial/genetic” section reports the 25% versus 5% figures, but they concern generalized SAD (GSAD) among first-degree relatives of people with GSAD versus relatives of comparison subjects without SAD. The claim applies those figures to overall SAD, which the passage does not support. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The average age of onset for performance-only SAD has been reported to fall within adolescence or early adulthood.

    “The average age of onset for performance-only SAD has been reported to fall within adolescence or early adulthood”

    From Epidemiology, genetics, neuroimaging, clinical features, and treatment between overall and performance-only social anxiety disorder: a narrative review (2026) · cites this paper as Bögels et al. 2010

    The Familial/genetic section (page unavailable) reports a mean onset of 16.9 years for specific SAD, mostly including performance anxiety, which falls in adolescence. It does not give a separate average for performance-only SAD; the paper notes that the specific-SAD group also included interactional anxiety. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • ICD-11 includes selective mutism in the classification of anxiety and fear-related disorders because it is considered to be a childhood presentation consistent with the features of anxiety and fear-related disorders.

    “So, ICD-11 includes selective mutism (called elective mutism in ICD-10) in the classification of anxiety and fear-related disorders because it is considered to be a childhood presentation that is consistent with the features of anxiety and fearrelated disorders.[52]”

    From The Classification of Anxiety and Fear-Related Disorders in the ICD-11: Review: Anxiety and Fear-Related Disorders in ICD-11 (2016) · cites this paper as [52]

    In 'Is Selective Mutism a Form of SAD?' the paper describes selective mutism as an early-onset childhood condition associated with anxiety. Its Conclusions say it may be a young child’s variant of social anxiety disorder. The paper does not establish that ICD-11 includes selective mutism among anxiety and fear-related disorders or give ICD-11’s reason for doing so. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Test anxiety is highly related to social anxiety.

    “Test anxiety is highly related to social anxiety (Bögels et al., 2010; Pires et al., 2019)”

    From THE EFFICACY OF A COMPASSION, ACCEPTANCE AND MINDFULNESS-BASED PILOT INTERVENTION FOR ADOLESCENTS’ TEST ANXIETY: A CASE STUDY USING THE ACADEMIC PROGRAM (2023) · cites this paper as Bögels et al., 2010

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Cites

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Research works printed but not linked: 12

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  8. [100]100. Beidel DC, Turner SM. Childhood Anxiety Disorders: A Guide to Research and Treatment. New York: Taylor & Francis Group; 2005. 100. Black B. Social anxiety and selective mutism. Am Psychiatr Press Rev Psychiatry 1996;15:469-495.
  9. [181]181. Renneberg B, Strohle A. Social anxiety disorders. Nervenarzt 2006;77:1123-1131.
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Authors
Bögels, S. M., Alden, L., Beidel, D. C., Clark, L. A., Pine, D. S., Stein, M. B., & Voncken, M.
Affiliations
  • University of Amsterdam (NL)
  • University of British Columbia (CA)
  • University of Iowa (US)
  • National Institute of Mental Health (US)
  • University of California San Diego (US)
  • Maastricht University (NL)
Corresponding author
Bögels, Susan M.
ORCID
Venue
Depression and Anxiety
Publisher
Hindawi Limited
Published
2010-02
Volume
27
Issue
2
Pages
168-189
ISSN
  • 1091-4269 (ISSN-L)
  • 1520-6394
DOI
10.1002/da.20670
OpenAlex
W2127232119
Semantic Scholar
230d58e3b9e72a2d93bea3f3bd6c1a7a55b82491
Cited by
526
References
234
Citations by year
2026: 14 · 2025: 25 · 2024: 52 · 2023: 26 · 2022: 29 · 2021: 35 · 2020: 29 · 2019: 34 · 2018: 35 · 2017: 23 · 2016: 35 · 2015: 35 · 2014: 50 · 2013: 35 · 2012: 24
FWCI
4.18
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 2038 d)
Locations
  • Depression and Anxiety (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
  • UvA-DARE (University of Amsterdam) (publishedVersion)
  • Journal of International Crisis and Risk Communication Research (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
social anxiety disorder, DSM-V, diagnostic criteria, avoidant personality disorder, generalized social anxiety, selective mutism, test anxiety, children and adolescents, DSM-IV
MeSH terms
Humans, Phobic Disorders, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders

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