Social Anxiety Disorder (Social Phobia) 203
E. The fear or anxiety is out of proportion to t he actual threat posed by the social situation
and to the sociocultural context.
F. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more. 
G. The fear, anxiety, or avoidance causes clin ically significant distress or impairment in
social, occupational, or other important areas of functioning.
H. The fear, anxiety, or avoidance is not attributable to the physiological effects of a sub-
stance (e.g., a drug of abuse, a medication) or another medical condition.
I. The fear, anxiety, or avoidance is not better explained by the symptoms of another
mental disorder, such as panic disorder, bod y dysmorphic disorder, or autism spectrum
disorder.
J. If another medical condition (e.g., Parkinson’ s disease, obesity, disfigurement from burns
or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive. 
Specify if: 
Performance only: If the fear is restricted to speaking or performing in public.
Specifiers
Individuals with the performanc e only type of social anxiety disorder have performance
fears that are typically most impairing in thei r professional lives (e.g., musicians, dancers,
performers, athletes) or in roles that requir e regular public speaking. Performance fears
may also manifest in work, school, or academic  settings in which regular public presenta-
tions are required. Individuals with performance only social anxiety disorder do not fear
or avoid nonperformanc e social situations. 
Diagnostic Features
The essential feature of social an xiety disorder is a marked, or in tense, fear or anxiety of so-
cial situations in which the individual may be scrutinized by others. In children the fear or