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Table 16. DSM-IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison
DSM-IV DSM-5
Disorder Class: Anxiety Disorders SAME
A. A marked and persistent fear of one or more social or
performance situations in which the person is exposed to
unfamiliar people or to possible scrutiny by others. The
individual fears that he or she will act in a way (or show
anxiety symptoms) that will be humiliating or
embarrassing.
Note: In children, there must be evidence of the capacity for
age-appropriate social relationships with familiar people
and the anxiety must occur in peer settings, not just in
interactions with adults.
A. Marked fear or anxiety about one or more
social situations in which the individual is
exposed to possible scrutiny by others.
Examples include social interactions (e.g.,
having a conversation, meeting unfamiliar
people), being observed (e.g., eating or
drinking), and performing in front of others
(e.g., giving a speech).
Note: In children, the anxiety must occur in peer
settings and not just during interactions with
adults.
The individual fears that he or she will act in a way
or show anxiety symptoms that will be
negatively evaluated (i.e., will be humiliating or
embarrassing; will lead to rejection or offend
others).
B. Exposure to the feared social situation almost invariably
provokes anxiety, which may take the form of a
situationally bound or situationally predisposed panic
attack.
Note: In children, the anxiety may be expressed by crying,
tantrums, freezing, clinging, shrinking, or failing to speak
in social situations.
C. The social situations almost always provoke
fear or anxiety.
Note: In children, the fear or anxiety may be
expressed by crying, tantrums, freezing,
clinging, shrinking, or failing to speak in social
situations.
C. The person recognizes that the fear is excessive or
unreasonable.
Note: In children, this feature may be absent.
B. The fear or anxiety is out of proportion to the
actual threat posed by the social situation and to
the sociocultural context.
D. The feared social or performance situations are avoided
or else are endured with intense anxiety or distress.
D. The social situations are avoided or endured
with intense fear or anxiety.
E. The avoidance, anxious anticipation, or distress in the
feared social or performance situation(s) interferes
significantly with the person's normal routine,
occupational (academic) functioning, or social activities
or relationships, or there is marked distress about having
the phobia.
G. The fear, anxiety, or avoidance causes clinically
significant distress or impairment in social,
occupational, or other important areas of
functioning.
F. In individuals under age 18 years, the duration is at least
6 months.
F. The fear, anxiety, or avoidance is persistent,
typically lasting for 6 months or more.
G. The fear or avoidance is not due to the direct
physiological effects of a substance (e.g., a drug of abuse,
a medication) or a general medical condition and is not
better accounted for by another mental disorder (e.g.,
panic disorder with or without agoraphobia, separation
anxiety disorder, body dysmorphic disorder, a pervasive
developmental disorder, or schizoid personality disorder).
H. The fear, anxiety, or avoidance is not
attributable to the physiological effects of a
substance (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, body
dysmorphic disorder, or autism spectrum
disorder.
H. If a general medical condition or another mental disorder
is present, the fear in Criterion A is unrelated to it (e.g.,
the fear is not of stuttering, trembling in Parkinson's
disease, or exhibiting abnormal eating behavior in
anorexia nervosa or bulimia nervosa).
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.
(continued)