Social Anxiety Disorder (Social Phobia) 207
home, whereas those with social anxiety diso rder may be uncomforta ble when social sit-
uations occur at home or in the presence of attachment figures.
Specific phobias. Individuals with specific phobias may fear embarrassment or humil-
iation (e.g., embarrassment about fainting wh en they have their blood drawn), but they do
not generally fear negative evalua tion in other social situations.
Selective mutism. Individuals with selective mutism ma y fail to speak because of fear of
negative evaluation, but they do not fear nega tive evaluation in social situations where no
speaking is required (e.g., nonverbal play). 
Major depressive disorder. Individuals with major depre ssive disorder may be con-
cerned about being negatively evaluated by ot hers because they feel they are bad or not
worthy of being liked. In contrast, individuals with social anxiety disorder are worried
about being negatively evaluated because of ce rtain social behaviors or physical symptoms.
Body dysmorphic disorder. Individuals with body dysmorphic disorder are preoccu-
pied with one or more perceived defects or fl aws in their physical appearance that are not
observable or appear slight to others; this preoccupation often causes social anxiety and
avoidance. If their social fears and avoidance are caused only by their beliefs about their
appearance, a separate diagnosis of soci al anxiety disorder is not warranted.
Delusional disorder. Individuals with delusional disorder may have nonbizarre delu-
sions and/or hallucinations related to the delu sional theme that focus on being rejected by
or offending others. Although extent of insi ght into beliefs about social situations may
vary, many individuals with social anxiety diso rder have good insight that their beliefs are
out of proportion to the actual th reat posed by the social situation.