[Case study--relationship between prevalence of shyness, social phobia and avoidant personality in male sexual...

Social phobia, avoidant personality disorder and shyness are very akin disorders, despite the fact that the first two are mental disorders, whereas the third is found mainly in lay or psychological literature. The relationship between these disorders and male sexual disorders can only be hypothesized from clinical studies and psychopathological theories. Social phobia, avoidant personality disorder, and shyness, share a probable indirect responsibility in sexual disorders because they impair the ability of subjects to meet partners. There are only a few direct studies of the negative impact of shyness on sexual behavior.

The objective of this study was to compare males with sexual disorders to non-sexual disorder males on diagnosis of social phobia, avoidant personality disorder and shyness.

We conducted a case-control study comparing a group of male patients seeking care for sexual disorders (n = 87) and a control group of male subjects without sexual disorder (n = 87), regarding the diagnosis of social phobia, avoidant personality disorder and shyness. Diagnoses were appreciated with a structured diagnostic interview (CIDI for the diagnosis of social phobia) or a list of criteria (DSM IV criteria for avoidant personality disorder) and through standardized scales (Fear Questionnaire, CBSHY, Cottraux male sexual problems questionnaire). Severity of shyness was evaluated through visual analog scales.

We found strong significant statistical differences between cases and controls regarding the percentage in each group of social phobia, avoidant personality disorder and shyness. For shyness, the mean score at CBSHY was 16.2 (+/- 12.63) for the cases and 6.07 (+/- 6.67) for the controls (p < 0.0001), whereas the percentage of cases with a score of > 19.5 was 41.4% vs 6.9% for the controls (p < 0.001); 27.6% of the cases had a CIDI diagnosis of social phobia vs 8% of the controls (p < 0.001); 31% of the cases implemented DSM IV criteria for the diagnosis of avoidant personality disorder vs 6.9% of the cases (p < 0.001).

Our results are in favor of one or several factors in common between social phobia, avoidant personality disorder and shyness, which would be strongly related to male sexual disorders.