Core symptom pattern of social phobia

Using self-rating questionnaires, 63 patients with social phobia but without a history of spontaneous panic attacks reported on their symptoms and traits, and on the development of their social phobia. The anxiety responses were composed of many symptoms (median = 14) of marked intensity, with blushing, trembling, cognitive difficulties, communication difficulties, and fears of the impression they make on others as cardinal symptoms. In contrast to the symptom pattern seen in spontaneous panic attacks, dizziness, chest discomforts, and difficulty in getting air were infrequent. The acute responses were generally followed by prolonged reactions with depressed mood, lowered self-esteem, and increased fears of similar situations. Most often the anticipatory anxiety was both intense and of long duration. Marked childhood traits of insecurity were reported by some patients, but these traits did not seem to be a general forerunner of the social phobia. Most patients had a gradual onset of the disorder between the age of ten and twenty, with increasing traits of social insecurity and anxiety responses developing simultaneously, during a period when a group of healthy controls reported that their insecurity was decreasing.