Book contents
- Frontmatter
- Contents
- List of tables
- Acknowledgments
- Preface
- Part I What is Social Phobia?
- Part II What is The Nature of Social Phobia?
- 3 Social Phobia as a Disorder of Social Anxiety
- 4 Social Phobia as a Disease
- 5 Social Phobia as a Hypothetical Construct
- Part III What Causes Social Phobia?
- Part IV What Helps Social Phobic Individuals?
- Part V Concluding remarks
- References
- Author Index
- Index
5 - Social Phobia as a Hypothetical Construct
Published online by Cambridge University Press: 14 January 2010
- Frontmatter
- Contents
- List of tables
- Acknowledgments
- Preface
- Part I What is Social Phobia?
- Part II What is The Nature of Social Phobia?
- 3 Social Phobia as a Disorder of Social Anxiety
- 4 Social Phobia as a Disease
- 5 Social Phobia as a Hypothetical Construct
- Part III What Causes Social Phobia?
- Part IV What Helps Social Phobic Individuals?
- Part V Concluding remarks
- References
- Author Index
- Index
Summary
Both the International Classification of Disease (10th edition) and the Diagnostic and Statistical Manual (4th edition) list social phobia as one of the “mental disorders.” As such, it ought to be a “significant behavioral or psychological pattern” associated with distress and impaired functioning. Both glossaries are primarily “field-manuals” providing checklists of identifying features to guide the spotting of individuals whose self-description matches the appropriate, (in our case the social phobic) pattern of conduct. Although the manuals might be thought of as dictionaries, this is mistaken for they do not clarify what social phobia is.
Two definitions of social phobia (DSM-IV and ICD-10) are currently available for the purpose of assessment, using somewhat different indicators (defining criteria). These may be seen in Table 5.1 below. While ICD-10 specifies various facets of fear, DCM-IV stresses impaired social functioning. (Tyrer, 1996 provides a detailed comparison.)
Most research has adopted the DSM definitions that, besides emphasising impairment since DSM-III-R, have remained, with slight changes, essentially the same.
The definitions, however, leave unanswered the question of what proof there is that what is defined actually exists? And if it does, whether it constitutes a distinct entity?
The necessity of asking such questions arises from the somewhat philosophical uncertainties as to the nature of what is defined in the classification manuals.
Frances and some of his fellow creators of the DSM-IV (Frances, Mack, First, Widiger, et al., 1994) put the dilemmas thus:
Do psychiatric disorders exist as entities in nature, or do they arise as mental constructs created in the mind of the classifiers? […]
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- Fearing OthersThe Nature and Treatment of Social Phobia, pp. 75 - 140Publisher: Cambridge University PressPrint publication year: 2007