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Public-Speaking Fears in a Community Sample: Prevalence, Impact on Functioning, and Diagnostic Classification

Public-Speaking Fears in a Community Sample: Prevalence, Impact on Functioning, and Diagnostic... Abstract Background: Recent epidemiologic studies have revealed that social phobia is more prevalent than has been previously believed. An unresolved issue is the extent to which public-speaking fears constitute a recognizable form of social phobia in a community sample and, moreover, to what extent these fears are associated with functional morbidity. Methods: To examine the prevalence and impact of public-speaking fears and their relationship to social phobia in a community sample, we conducted a randomized telephone survey of 499 residents of Winnipeg, Manitoba, a medium-sized midwestern metropolitan area. Results: One third of the respondents reported that they had excessive anxiety when they spoke to a large audience. The onset of fears was early (ie, 50%, 75%, and 90% by the ages of 13, 17, and 20 years, respectively). Anxious cognitions about public speaking included the following fears: doing or saying something embarrassing (64%), one's mind going blank (74%), being unable to continue talking (63%), saying foolish things or not making sense (59%), and trembling, shaking, or showing other signs of anxiety (80%). In total, 10% (n=49) of the respondents reported that public-speaking anxiety had resulted in a marked interference with their work (2%), social life (1%), or education (4%), or had caused them marked distress (8%). Twenty-three persons (5%) had public-speaking anxiety in isolation (ie, without evidence of additional kinds of social fears). Conclusions: These data support the inclusion of severe forms of public-speaking fears within the social phobia construct and, furthermore, suggest that publicspeaking anxiety may have a detrimental impact on the lives of many individuals in the community. References 1. Walker JR, Stein MB. Epidemiology of social phobia . In: Stein MB, ed. Social Phobia: Clinical and Research Perspectives . Washington, DC: American Psychiatric Press Inc; 1995:43-75. 2. Pollard CA, Henderson JG. Four types of social phobia in a community sample . J Nerv Ment Dis . 1988;176:440-445.Crossref 3. Degonda M, Angst J. The Zurich Study, XX: social phobia and agoraphobia . Eur Arch Psychiatry Clin Neurosci . 1993;243:95-102.Crossref 4. Davidson JT, Hughes DL, George LK, Blazer DG. The epidemiology of social phobia: findings from the Duke Epidemiological Catchment Area Study . Psychol Med . 1993;23:709-718.Crossref 5. Schneier FR, Johnson J, Hornig CD, Liebowitz MR, Weissman MM. Social phobia: comorbidity and morbidity in an epidemiologic sample . Arch Gen Psychiatry . 1992;49:282-288.Crossref 6. Kessler RG, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen H-U, Kendler KS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey . Arch Gen Psychiatry . 1994;51:8-19.Crossref 7. Stein MB, Walker JR, Forde DR. Setting diagnostic thresholds for social phobia: considerations from a community survey of social anxiety . Am J Psychiatry . 1994;51:408-412. 8. Davidson JRT, Hughes DC, George LK, Blazer DG. The boundary of social phobia: exploring the threshold . Arch Gen Psychiatry . 1994;51:975-983.Crossref 9. Gelernter CS, Stein MB, Tancer ME, Uhde TW. An examination of syndromal validity and diagnostic subtypes in social phobia and panic disorder . J Clin Psychiatry . 1992;53:23-27. 10. Heimberg RG, Hope DA, Dodge CS, Becker RE. DSM-III-R subtypes of social phobia: comparison of generalized social phobics and public-speaking phobes . J Nerv Ment Dis . 1990;178:172-179.Crossref 11. Heimberg RG, Holt CS, Schneier FR, Spitzer RL, Liebowitz MR. The issue of subtypes in the diagnosis of social phobia . J Anxiety Disord . 1993;7:249-269.Crossref 12. Hazen AL, Stein MB. Differential diagnosis and comorbidity of social phobia . In: Stein MB, ed. Social Phobia: Clinical and Research Perspectives . Washington, DC: American Psychiatric Press Inc; 1995:3-41. 13. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines . Geneva, Switzerland: World Health Organization; 1992. 14. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . Washington, DC: American Psychiatric Press Inc; 1994. 15. Amies PL, Gelder MG, Shaw PM. Social phobia: a comparative clinical study . Br J Psychiatry . 1983;142:174-179.Crossref 16. Solyom L, Ledwidge B, Solyom C. Delineating social phobia . Br J Psychiatry . 1986;149:464-470.Crossref 17. Liebowitz MR, Fyer J, Gorman JM, Klein DF. Social phobia: review of a neglected anxiety disorder . Arch Gen Psychiatry . 1985;42:729-736.Crossref 18. Mannuzza S, Schneier F, Chapman TF, Liebowitz MR, Klein DF, Fyer AJ. Generalized social phobia: reliability and validity . Arch Gen Psychiatry . 1995;52:230-237.Crossref 19. Schneier FR, Heckelman LR, Garfinkel R, Campeas R, Fallon BA, Gitow A, Street L, Del Bene D, Liebowitz MR. Functional impairment in social phobia . J Clin Psychiatry . 1994;55:322-331. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Public-Speaking Fears in a Community Sample: Prevalence, Impact on Functioning, and Diagnostic Classification

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Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1996.01830020087010
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: Recent epidemiologic studies have revealed that social phobia is more prevalent than has been previously believed. An unresolved issue is the extent to which public-speaking fears constitute a recognizable form of social phobia in a community sample and, moreover, to what extent these fears are associated with functional morbidity. Methods: To examine the prevalence and impact of public-speaking fears and their relationship to social phobia in a community sample, we conducted a randomized telephone survey of 499 residents of Winnipeg, Manitoba, a medium-sized midwestern metropolitan area. Results: One third of the respondents reported that they had excessive anxiety when they spoke to a large audience. The onset of fears was early (ie, 50%, 75%, and 90% by the ages of 13, 17, and 20 years, respectively). Anxious cognitions about public speaking included the following fears: doing or saying something embarrassing (64%), one's mind going blank (74%), being unable to continue talking (63%), saying foolish things or not making sense (59%), and trembling, shaking, or showing other signs of anxiety (80%). In total, 10% (n=49) of the respondents reported that public-speaking anxiety had resulted in a marked interference with their work (2%), social life (1%), or education (4%), or had caused them marked distress (8%). Twenty-three persons (5%) had public-speaking anxiety in isolation (ie, without evidence of additional kinds of social fears). Conclusions: These data support the inclusion of severe forms of public-speaking fears within the social phobia construct and, furthermore, suggest that publicspeaking anxiety may have a detrimental impact on the lives of many individuals in the community. References 1. Walker JR, Stein MB. Epidemiology of social phobia . In: Stein MB, ed. Social Phobia: Clinical and Research Perspectives . Washington, DC: American Psychiatric Press Inc; 1995:43-75. 2. Pollard CA, Henderson JG. Four types of social phobia in a community sample . J Nerv Ment Dis . 1988;176:440-445.Crossref 3. Degonda M, Angst J. The Zurich Study, XX: social phobia and agoraphobia . Eur Arch Psychiatry Clin Neurosci . 1993;243:95-102.Crossref 4. Davidson JT, Hughes DL, George LK, Blazer DG. The epidemiology of social phobia: findings from the Duke Epidemiological Catchment Area Study . Psychol Med . 1993;23:709-718.Crossref 5. Schneier FR, Johnson J, Hornig CD, Liebowitz MR, Weissman MM. Social phobia: comorbidity and morbidity in an epidemiologic sample . Arch Gen Psychiatry . 1992;49:282-288.Crossref 6. Kessler RG, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen H-U, Kendler KS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey . Arch Gen Psychiatry . 1994;51:8-19.Crossref 7. Stein MB, Walker JR, Forde DR. Setting diagnostic thresholds for social phobia: considerations from a community survey of social anxiety . Am J Psychiatry . 1994;51:408-412. 8. Davidson JRT, Hughes DC, George LK, Blazer DG. The boundary of social phobia: exploring the threshold . Arch Gen Psychiatry . 1994;51:975-983.Crossref 9. Gelernter CS, Stein MB, Tancer ME, Uhde TW. An examination of syndromal validity and diagnostic subtypes in social phobia and panic disorder . J Clin Psychiatry . 1992;53:23-27. 10. Heimberg RG, Hope DA, Dodge CS, Becker RE. DSM-III-R subtypes of social phobia: comparison of generalized social phobics and public-speaking phobes . J Nerv Ment Dis . 1990;178:172-179.Crossref 11. Heimberg RG, Holt CS, Schneier FR, Spitzer RL, Liebowitz MR. The issue of subtypes in the diagnosis of social phobia . J Anxiety Disord . 1993;7:249-269.Crossref 12. Hazen AL, Stein MB. Differential diagnosis and comorbidity of social phobia . In: Stein MB, ed. Social Phobia: Clinical and Research Perspectives . Washington, DC: American Psychiatric Press Inc; 1995:3-41. 13. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines . Geneva, Switzerland: World Health Organization; 1992. 14. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . Washington, DC: American Psychiatric Press Inc; 1994. 15. Amies PL, Gelder MG, Shaw PM. Social phobia: a comparative clinical study . Br J Psychiatry . 1983;142:174-179.Crossref 16. Solyom L, Ledwidge B, Solyom C. Delineating social phobia . Br J Psychiatry . 1986;149:464-470.Crossref 17. Liebowitz MR, Fyer J, Gorman JM, Klein DF. Social phobia: review of a neglected anxiety disorder . Arch Gen Psychiatry . 1985;42:729-736.Crossref 18. Mannuzza S, Schneier F, Chapman TF, Liebowitz MR, Klein DF, Fyer AJ. Generalized social phobia: reliability and validity . Arch Gen Psychiatry . 1995;52:230-237.Crossref 19. Schneier FR, Heckelman LR, Garfinkel R, Campeas R, Fallon BA, Gitow A, Street L, Del Bene D, Liebowitz MR. Functional impairment in social phobia . J Clin Psychiatry . 1994;55:322-331.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Feb 1, 1996

References