The social anxiety disorder spectrum
Background: Current diagnostic classifications emphasize the categorical nature of disorders such as social anxiety disorder. Nevertheless, phenomenological and psychobiological data have led to the hypothesis that social anxiety symptoms and disorders lie on various dimensions. Method: A MEDLINE search (1966-2003) for relevant articles on the social anxiety disorder spectrum was undertaken using the terms shyness, behavioral inhibition, social phobia, social anxiety disorder, avoidant personality, dimension, and spectrum to aim at objective coverage, but references for this article were chosen more subjectively to illustrate data and themes in description, pathogenesis, pharmacotherapy, and psychotherapy of the social anxiety disorder spectrum. Results: Several different approaches to delineating a social anxiety disorder spectrum of conditions have been described. These include (1) a spectrum of social fear and avoidance, (2) a spectrum of body-focused concerns, (3) a spectrum of anxiety disorders and affective dysfunction, and (4) a spectrum of social deficits. Conclusions: Social anxiety symptoms and disorders do appear to lie on a number of different dimensions. Nevertheless, additional research is necessary to determine the clinical utility of assessing these different dimensions and to investigate their underlying psychobiology. © Copyright 2004 Physicians Postgraduate Press, Inc.