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Introduction
Social Anxiety Disorder, otherwise known as SAD, is nationally recognized as the third
most prevalent emotional disorder among all age groups today (Mekuria, et al., 2017, 2). A
review of epidemiological studies found that the lifetime prevalence of social phobia in adults
varied between 2% and 5% with a female:male ratio of 2.5:1.2 Patients typically may not consult
their family doctor until they have had the condition for many years, therefore receiving little to
no treatment. The chronic course increases the risk of comorbid conditions, which may mask the
social anxiety and lead the diagnosis to another mood disorder such as depression. The lifetime
prevalence of social phobia in young adults (mean age 18 years) was found to be 23% (Den
Boer, 1997, 797). This disorder is thought to have a long list of lifelong effects, most of which
are of little knowledge to the greater public. Several effects are possible, but one of the most
hypothesized detrimental and long lasting is its effect on the ability to adequately form and
maintain intimate relationships with others (Zaider, Heimberg, & Iida, 2010, 163). The only way
to properly understand the true effects this disorder can have, it is crucial to have an
understanding of what the definition and diagnosis of the disorder is, as well as the
environmental factors that contribute to its influence. In this paper, levels of distress in intimate
relationship for either party – not just the diagnosed – will be discussed as the overall quality of
both romantic and platonic relationships are assessed through the relationship satisfaction scale
One of the first theories on the causation of social anxiety researched was that of
Schlenker and Leary who concluded that social anxiety arises when people are motivated to
make a “preferred impression on real or imagined audiences but doubt that they will do so”
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(Schlenker & Leary, 1982, 645). The perceived failure or inability to obtain desired outcomes in
social situations has been publicly viewed as a major antecedent of anxiety – however social
anxiety specifically focuses on the aftermath of an anxiety-causing situation and the judgement
of their peers regarding their actions during it. An existing method of literature on social anxiety
has deemed that this falls into a specific model known as the Cognitive self-evaluation model. It
states that social anxiety results not from an objective skills deficit per se but from the
individual’s perception of personal inadequacies, research has shown that socially anxious
people tend to underestimate their social skills (Schlenker & Leary, 1982, 643). Feeding into
this, uncertainty has been deemed one of the most notable causes of social anxiety – and anxiety
in general – and it has been concluded that anxiety is directly related to the degree of ambiguity
in the situation to which the individual must make some “adjustive reaction” (Schlenker &
Leary, 1982, 650). Schlenker and Leary’s research discovery of the cause of uncertainty allows
them to pinpoint the specific emotions that lead to the causation of social anxiety.
The information provided through their research provides a constant theory of visible
understanding and causation of Social Anxiety Disorder, which in turn, will lead to an overall
understanding of the effect it has on forming intimate relationships – as the qualities triggering it
This journal follows the research findings of Bystritsky, Khalsa, Cameron, and Schiffman
as they discuss the prevalence of social anxiety and other anxiety disorders, continuing onward
into the diagnosis and treatment of it. Anxiety disorders are present in up to 13.3% of individuals
in the U.S. and constitute the most prevalent subgroup of mental disorders. A study entitled the
Epidemiological Catchments Area Study revealed the massive extent to which their prevalence
held in the country. Despite this, however, they are extremely hard to recognize compared to
other mood and psychotic disorders. “As a result of this management environment, anxiety
disorders can be said to account for decreased productivity, increased morbidity and mortality
rates, and the growth of alcohol and drug abuse in a large segment of the population (Bystritsky,
Khalsa, Cameron, & Schiffman, 2013, 30). Diagnostic criteria for Social Anxiety Disorder is
found within the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) and over the
past 10 years, epidemiological data has been used in the attempt to refine the boundaries of
diagnostic categories of anxiety disorders to a more specified description. This research shows
that there is a broad overlooking of social anxiety compared to that of other emotional and
mental disorders, allowing it to go undiagnosed and therefore worsen in years to come. Another
significant problem with the present classification of anxiety disorders is the absence of known
etiological factors and of specific treatments for different diagnostic categories. Studying the
Khalsa, Cameron, and Schiffman have in their journal has previously failed to produce a single
gene or a cluster of genes implicated as a causing factor for any single anxiety disorder, even
though some genetic findings exist for OCD and panic disorder. In turn, there is a clear
conclusion. Understanding how emotional reactivity, core beliefs, and coping strategies interact
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in time should lead to more precise diagnoses and better management of anxiety disorders
couples in which the female partner abided by the Diagnostic and Statistical Manual of Mental
Disorders’ criteria for a social anxiety disorder were followed and given baseline questionnaires
14 diary reports for the partners to complete separately at the end of the day regarding the quality
of their marriage. The results concluded based off of these results, 29.5% of couples in the
current sample had at least one partner who scored within the distressed range of marital
functioning. However, daily negative mood aggregated across the study period were significantly
higher for wives than husbands, which is predictable due to the wives’ disorders. Nearly 80% of
all the couples studied had one or more partner list communication as the main source of distress
in their questionnaires. Out of this percentage, over half were men. A term called ‘emotional
cognition’ was given to this, being officially defined as the tendency to “catch” another person’s
distress and troubles when emotionally intimate with them (Zaider, Heimber, Iida, 2010, 168).
This display of anxiety elicited high levels of distress, rejection, and devaluation from the
partner in the relationship and proves the hypothesis that social anxiety can directly affect the
Treatment for anxiety disorders has been speculated and tested for many years in the past,
however, it has been difficult to pinpoint one specified method that works a large sum of the
time. Drug therapy has been perceived be helpful in some cases, selective serotonin uptake
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inhibitors probably being the most promising. However, treatment has often been hampered by
substance abuse (Den Boer, 1997, 797). Selective serotonin reuptake inhibitors have been seen as
a common method of treatment for depression and panic disorder – both of which are comorbid
with social phobia – therefore allowing coexisting emotional stressors to be alleviated. Other
methods of proven treatment include monoamine oxidase inhibitors, in which many recent
studies have shown a better response in patients with social anxiety treated with phenelzine (an
irreversible monoamine oxidase inhibitor) than with alprazolam or atenolol (Den Boer, 1997,
799). Another method proven beneficial that does not affect biologic inhibition is cognitive-
behavioral therapy.
This research taken from the work of literature allows for an understanding to develop in what
can aid social anxiety and, in turn, aid the process of forming and maintaining intimate
relationships. It is heavily crucial that there is awareness of this in order to be able to provide
practical treatment for this disorder. If a patient were to go untreated, the symptoms associated
with it would rapidly worsen over time, and they may lose the ability to ever regain normal
conversational abilities.
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Conclusion
The literature reviewed throughout this paper aim to support the hypothesis that social
anxiety places negative limitations on a victim’s ability to form and maintain intimacy with
others. Support has been obtained for this hypothesis, as there has been crucial information
researched regarding the development and diagnosis, direct effects on intimacy, and treatment
for these symptoms. Social Anxiety Disorder is commonly misconstrued with agoraphobia and
the sole disorder have become clear and definitive (especially since obtaining a clear history
from the patient may be delayed by the patients' fear of social interaction) as there is clear
evidence as to the solution of reducing social anxiety and just how to do so. In conclusion, the
effects of social anxiety, while having already proven serious in generalized terms, strongly
affect the basic ability of a diagnosed patient to form strong, intimate relationships that people
strive for.
Reference List
Bystritsky, A., Khalsa, S. S., Cameron, M. E., & Schiffman, J. (2013). Current Diagnosis and
Den Boer, J. A. (1997). Social Phobia: epidemiology, recognition, and treatment. British
Mekuria, K., Mulat, H., Derajew, H., Mekonen, T., Fekadu, W., Belete, A., Yimer, S., Legas, G.,
Menberu, M., Getnet, A., & Kibret, S. (2017). High Magnitude of Social Anxiety
Zaider, T. I., Heimberg, R. G., & Iida, M. (2010). Anxiety Disorders and Intimate Relationships:
-173.