Abstract
Background
Public speaking is a common situation that university students have to endure. This situation is feared or avoided by most individuals with social phobia, which has been associated with low levels of educational attainment. However, epidemiological data on social phobia in university students are scarce. The present study examined the prevalence of social phobia and its subgroups in a university student population. Demographic characteristics and avoidant behavior in educational settings were also examined.
Methods
The Social Phobia Screening Questionnaire (SPSQ)—a validated and DSM-IV compatible instrument, was distributed as a postal survey to 753 randomly selected university students in Sweden. Interpretable questionnaires were obtained from 523 students (69.5%). To investigate subgroups, students who met the SPSQ diagnostic criteria of social phobia were analyzed by hierarchical cluster analysis.
Results
The point prevalence of social phobia among the Swedish university students was 16.1%, comparable with 15.6% previously reported for the general population. Two clusters were distinguished consisting of students scoring either low (discrete subgroup) or high (generalized subgroup) on all cluster variables. The discrete subgroup was more common representing 83% of the cases. Social phobia was associated with use of dysfunctional avoidant strategies in educational situations and in anticipation of public speaking. The disorder was less common among students following a pedagogic university program.
Conclusions
Social phobia was highly prevalent among Swedish university students, most cases pertaining to a mild or discrete form of the disorder. The commonness and severity of social phobia in students did not deviate significantly from the general population suggesting that socially anxious individuals do apply for higher education. However, since avoidance and low educational attainment are commonly reported features, future studies should investigate whether sufferers of social phobia underachieve or abolish their studies prematurely.
Similar content being viewed by others
References
Furmark T (2002) Social phobia: overview of community surveys. Acta Psychiatr Scand 105:84–93
Sareen J, Stein M (2000) A review of the epidemiology and approaches to the treatment of social anxiety disorder. Drugs 59:497–509
Furmark T, Tillfors M, Everz P-O, Marteinsdottir I, Gefvert O, Fredrikson M (1999) Social phobia in the general population: prevalence and sociodemographic profile. Soc Psychiatry Psychiatr Epidemiol 34:416–424
Kessler RC, Stein MB, Berglund P (1998) Social phobia subtypes in the National Comorbidity Survey. Am J Psychiatry 155:613–619
Stein MB, Torgrud LJ, Walker JR (2000) Social phobia symptoms, subtypes, and severity: findings from a community survey. Arch Gen Psychiatry 57:1046–1052
Van Ameringen M, Mancini C, Farvolden P (2003) The impact of anxiety disorders on educational achievement. J Anxiety Disord 17:561–571
Izgic F, Akyüz G, Dogan O, Kugu N (2004) Social phobia among university students and its relation to self-esteem and body image. Can J Psychiatry 49:630–634
Stein MB, Kean YM (2000) Disability and quality of life in social phobia: epidemiologic findings. Am J Psychiatry 157:1606–1613
Wilson I (2005) Screening for social anxiety disorder in first year university students. A pilot study. Aus Fam Physican 34:983–984
Kessler RG, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen H-U, Kendler KS (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorder in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19
American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn. American Psychiatric Association, Washington, DC
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC
Heckelman LR, Schneier FR (1995) Diagnostic issues. In: Heimberg RG, Liebowitz MR, Hope DA, Schneier FR (eds) Social Phobia. Diagnosis, assessment and treatment. New York, The Guilford Press, pp 3–21
Heimberg RG, Holt CS, Schneier FR, Spitzer RL, Liebowitz MR (1993) The issue of subtypes in the diagnosis of social phobia. J Anxiety Disord 7:249–269
Eng W, Heimberg RG, Coles ME, Schneier FR, Liebowitz MR (2000) An empirical approach to subtype identification in individuals with social phobia. Psychol Med 30:1345–1357
Furmark T, Tillfors M, Stattin H, Ekselius E, Fredrikson M (2000) Social phobia subtypes in the general population revealed by cluster analysis. Psychol Med 30:1335–1344
Hofmann SG, Heinrichs N, Moscovitch DA (2004) The nature and expression of social phobia: toward a new classification. Clin Psychol Rev 24:769–797
Merckelbach H, de Jong PJ, Muris P, van den Hout MA (1996) The etiology of specific phobias: a review. Clin Psychol Rev 16:337–361
Rodebaugh TL, Holaway RM, Heimberg RM (2004) The treatment of social anxiety disorder. Clin Psychol Rev 24:883–908
Clark DM, Wells A (1995) A cognitive model of social phobia. In: Heimberg RG, Liebowitz MR, Hope DA, Schneier FR (eds) Social Phobia. Diagnosis, assessment and treatment. New York, Guilford Press, pp 69–93
Ottosson H, Bodlund O, Ekselius L, Grann M, von Knorring L, Kullgren G, Lindström E, Söderberg S (1998) DSM-IV and ICD-10 personality disorders: a comparison of a self-report questionnaire (DIP-Q) with a structured interview. Eur Psychiatry 13:246–253
Heimberg RG, Mueller GP, Holt CS, Hope DA, Liebowitz MR (1992) Assessment of anxiety in social interaction and being observed by others: the social interaction anxiety scale and the social phobia scale. Behav Ther 23:53–73
Hair JF, Anderson RE, Tatham RL, Black WC (1995) Multivariate data analysis with readings. Prentice-Hall, Upper Saddle River, NJ
Pallant J (2005) SPSS survival manual, 2nd edn. Open university Press, New York
Hazen AL, Stein MB (1995) Clinical phenomenology and comorbidity. In: Stein MB (ed) Social Phobia. Clinical and research perspectives. American Psychiatric Press, Washington, DC, pp 3–41
Otto MW, Pollack MH, Gould RA, Worthington III JJ, McArdle ET, Rosenbaum JF (2000) A comparison of the efficacy of Clonazepam and cognitive-behavioral group therapy for the treatment of social phobia. J Anxiety Disord 14:345–358
Stangier U, Heidenreich T, Peitz M, Lauterbach W, Clark DM (2003) Cognitive therapy for social phobia: individual versus group treatment. Behav Res Ther 41:991–1007
Andersson G, Carlbring P, Holmström A, Sparthan E, Furmark T, Nilsson-Ihrfelt E, Buhrman M, Ekselius L (2006) Internet-based self-help with therapist feedback and in-vivo group exposure for social phobia: a randomized controlled trial. J Consult Clin Psychol 74:677–686
First MB, Spitzer RL, Gibbon M, Williams JBW (1995) Structured clinical interview for DSM-IV Axis I Disorders (SCID-I). American Psychiatric Press, Washington, DC
Carlbring P, Gunnarsdóttir M, Hedensjö L, Andersson G, Ekselius L, Furmark T (2006) Treatment of social phobia from a distance: a randomized trial of internet delivered cognitive behavior therapy (CBT) and telephone support. Br J Psychiatry (in press)
Acknowledgments
This study was supported by the Swedish Council for Working Life and Social Research. We would like to thank the following people: Ann-Christin Bäckman, Linda Kreü, Geska Mark, Karin Thörnblom and Maria Willén for skillful assistance.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tillfors, M., Furmark, T. Social phobia in Swedish university students: prevalence, subgroups and avoidant behavior. Soc Psychiat Epidemiol 42, 79–86 (2007). https://doi.org/10.1007/s00127-006-0143-2
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-006-0143-2