Are we overpathologizing the socially anxious? Social phobia from a harmful dysfunction perspective.

S ome social phobias are clearly genuine mental disorders. However, in just 2 decades, social phobia (or social anxiety disorder) went from “rare” (in the DSM-III) to “common” (1), amidst changing criteria and concern about caseness thresholds (2). The evidence suggests that social anxiety is a normal, species-typical, designed response to specific triggering situations, one that is roughly normally distributed in temperamental intensity (3,4). This raises the question, Is temperamentally high but nondisordered social anxiety being mislabelled a disorder? We argue that many, perhaps most, people whom the DSM-IV potentially classifies as suffering from social phobia are probably not disordered.