Glossary of Cultural Concepts of Distress 837
Related conditions in DSM-5:  Major depressive disorder, posttraumatic stress disor-
der, other specified or unspecified trauma and stressor-related di sorder, somatic symp-
tom disorders.
Taijin kyofusho
Taijin kyofusho  (“interpersonal fear disorder” in Japa nese) is a cultural syndrome charac-
terized by anxiety about and av oidance of interpersonal situations due to the thought, feel-
ing, or conviction that one’s appearance and actions in social interactions are inadequate
or offensive to others. In the United States, the variant involves having an offensive body
odor and is termed olfactory reference syndrome.  Individuals with taijin kyofusho  tend to focus
on the impact of their symptoms and behavior s on others. Variants include major concerns
about facial blushing (erythrophobia), having an offensive body odor (olfactory reference
syndrome), inappropriate gaze (too much or too little eye co ntact), stiff or awkward facial
expression or bodily moveme nts (e.g., stiffening, trem bling), or body deformity.
Taijin kyofusho  is a broader construct than social an xiety disorder in DSM-5. In addition
to performance anxiety, taijin kyofusho  includes two culture-relate d forms: a “sensitive type,”
with extreme social sensitivity and anxiety about interpersonal inte ractions, and an “of-
fensive type,” in which the major concer n is offending others. As a category, taijin kyofusho
thus includes syndromes with features of body dysmorphic disorder as well as delusional
disorder. Concerns may have a delusional qualit y, responding poorly to simple reassurance
or counterexample.