Types of Social Phobia and Anxiety in Children
April 18, 2012 
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Anxiety in children isn’t something that is heard often. Most of the time, concerns such as anxiety disorders and social phobias are associated with adults.
Because of this, medical specialists have made it a point to learn more about children with anxiety. Despite what most people believe, panic attacks in children are possible. It is a very important concern for parents who want to make sure to give their children grow up to live long, healthy and normal lives.
When it comes to our children, it is perfectly normal to expect them to enjoy the company of other people; other children more specifically. It’s also perfectly normal for parents to want their children to have many friends, be generally well-liked as well as popular among their social circles. There is an undeniable sense of pride in seeing our children socialize with family, friends and even colleagues of their own age or even older. We like seeing them play outside and with others, be active in sports or being invited to birthday parties.
This is because socialization, for both children and adults is traditionally seen as a source of joy and happiness. We spend a great amount of effort and time talking to our children, playing and socializing with them. And sure the occasion arrive that we are too busy to, we at least try to make it a priority to make up in that regard. Traditionally for children, these social experiences are good and pleasant ones, that help build their social and interaction skills. It becomes the foundation for individuality and independence for later years.
However, not all children are born equal. For a good number of them, socializing and interaction may prove to be difficult, troublesome and even stressful. Some children have even described it as “painful”.
These children trouble have going through basic social activities such as attending school, or joining in playgroups or, often times, simply going to a friends house for some play time. Although it is quite normal for most children to not want to interact with strangers, it becomes a source of concern if our children don’t want to socialize with anyone at all, even if they are familiar and friendly faces. For most doctors and psychiatrists, these children could be exhibiting symptoms of social phobia or anxiety disorder.
Anxiety and children aren’t normally words that go together, but unfortunately, there is a very big gap amongst parents in identifying social phobias and anxiety disorders at a young age. This article aims to outline a number of social phobias and anxiety disorders that children are susceptible to.
Introversion
Various researchers and doctors have believed that personalities can be categorized into a number of different classifications, all of which being particularly relevant to anxiety and social phobia. One particular categorization has been known as introversion, and is a common diagnosis among children with anxiety disorders. Read More
Specialists have long believed that people have a variety of fundamental attitudes towards acting in specific ways. Introversion, it’s been described, is one of those ways. Loosely characterized by a stern attention towards the experiences of the self rather than that of others, introversion was trait that didn’t call for the need for social contact, friendships or long term relationships.
On the opposite end of the spectrum, extraversion is generally characterized by being socially “open” and gregarious in nature. However, extraversion can also lead to extreme restlessness, aggressiveness, anger and even impulsivity. It’s been a common to relate extreme extraversion with attention deficiency / hyperactivity disorder (ADHD). Still, a managed extraversion can lead to confidence, optimism as well as liveliness in your children.
A majority of personality theorists have expanded on different ideas on introversion and extraversion. A lot of these ideas have explored the extremes between the two personality types. Despite the many unanswered questions on the conditions that drive and mold these traits, introversion and extraversion continue to be relevant ways of describing personalities today.
Shyness
People usually understand shyness as a being socially reserved or withdrawn, especially amongst unfamiliar people. It is normally born out of worrying to much about the criticisms and nitpicking of other people. Specialists believe that shyness is a trait related to introversion. There’s been extensive documentation on the various behavioral and cognitive similarities between shyness and introversion. They both exhibit traits such as an apprehension to socialize, as well as a tendency to disconnect from social gatherings.
Shyness, however, may refer more specifically to an approach that avoids conflict (fight or flight) and worry about social criticism and evaluation. While introversion, on the other hand, refers more generally to being quiet, reserved, and socially distant. Measures of shyness and introversion have been argued to be moderate at best by a number of psychologists, without any real connection. However, others have argued that one could be both introverted and shy. In fact, shyness is sometimes viewed not as a trait but rather as a process, emotion, or as a state of being that fluctuates depending upon one’s situation. One can thus be generally introverted and occasionally shy. Emotions are shaped by our situation, and our personalities are influenced by them as well.
Different subtypes of shyness have been proposed in psychology literature. Primary examples have included ideas presenting that:
- Shyness as introverted; where a person simply preferred to be alone but could be with others, and neurotic, where a person was self-conscious around others, worried about possible negative consequences of social interactions, and inhibited socially.
- Differentiation of shy people between those who are privately shy or publicly shy. Privately shy individuals were described as socially skilled but full of self-doubt, whereas publicly shy individuals were described as less skilled, more inhibited, and very distressed in social situations
- Shy people as shy introverts or shy extraverts, depending on their level of sociability with others. Shy introverts were thought to have poorer social skills, less willingness to approach others, and fewer dating opportunities than shy extraverts. Subsequent studies have found physiological and social skills differences between shy people who are willing or less willing to be sociable.
- Differentiation between shy people who are fearful or selfconscious. Shy, fearful people were characterized by an early developing fear of new situations, autonomic reactivity (i.e., somatic anxiety symptoms), and low self-esteem, whereas shy, self-conscious people were characterized by later-developing concerns about oneself in social or public situations. Fearful shyness may be closely related to behavioral inhibition, whereas self-conscious shyness may be considered more of a cognitive phenomenon.
- Understanding shyness along a social approach-social avoidance conflict spectrum. In this conceptualization, shy, socially reticent children want to engage in social interactions with peers but are unsuccessful at doing so, perhaps because of high social anxiety about negative evaluation. On the other hand, shy, socially avoidant children want to withdraw from social interactions and may even be depressed. These children may also be thought of as conflicted (i.e., high approach-high avoidance) and avoidant (i.e., low approach-high avoidance), respectively.
- Differentiating shy people into those who are withdrawn or dependent. Shy, withdrawn people were characterized by a need for autonomy and independent interpersonal orientation, whereas shy, dependent people were characterized by a greater need for affiliation and emotional support from others. The latter subtype has been described as more anxious in social and assertive situations.
A common theme of these subtypes is that some shy people seem more socially adept, engaging, confident and comfortable with their shyness. On the other hand shy people seem to lack social skills, develop considerable worry and anxiety in social situations, and withdraw more. Parker, the boy described earlier, may resemble this latter subtype. The former group may have features that resemble a personality disorder, whereas the latter group may have features that resemble social phobia. However, enormous variability and heterogeneity is seen among people who are shy.
The heterogeneity of shyness is further demonstrated by the fact that the construct is often viewed as non problematic and possibly even adaptive in some people.
Indeed, shyness is often considered non-pathological and seems to be present in a large sample of the population. In addition, shyness may be related to several positive features in children, such as kindness, compliance, diligence, and absence of impulsivity and behavior problems. Because of this, parents shouldn’t immediately disregard shyness as something inherently negative, or even as an obvious symptom of anxiety in children.
For other people, however, especially those who are quite self conscious and anxious, shyness can interfere with attempts to function adequately in social relationships. Specialists have conceptualized shyness along a spectrum that ranges from fearlessness to normality to excessive shyness or an anxiety disorder, the latter representing a maladaptive level of shyness. Excessive shyness and resulting problems in peer relations can also lead to low self-esteem and various other emotional and behavioral disorders.
Behavioral Inhibition
Another type of temperament that is related to introversion, shyness, and social phobia is behavioral inhibition. Behavioral inhibition generally refers to a pattern of fearfulness, timidity, avoidance, and guardedness surrounding new stimuli such as strangers or novel objects or events. Behavioral inhibition was characteristic of Tamatha, the young girl described earlier.
This predisposition, which is present in a good number of youths, has been linked to a lot ideas described and documented by many specialists in panic attacks in young children. Recall from above, for example, that fear-based shyness may be most closely related to behavioral inhibition. In addition, behavioral inhibition seems predictive of social withdrawal and social phobia in some youths. Behavioral inhibition, along with certain forms of shyness, social withdrawal, and social fear, likely has some genetic predisposition and familial connection as well.
Although behavioral inhibition, shyness, and social phobia seem to have overlapping features, there may be important differences between them. Shyness, for example, may be a bit narrower construct than behavioral inhibition in that shyness tends to relate more specifically to social situations and resulting discomfort.
Behavioral inhibition, however, relates more broadly to many different kinds of new situations and does not necessarily involve withdrawal from many social situations. Others, however, see behavioral inhibition as a subtype of shyness. Finally, not all youths with behavioral inhibition necessarily develop social phobia, and many youths with social phobia are not behaviorally inhibited.
As an aside, behavioral inhibition may also be differentiated from stranger anxiety, a normal developmental phenomenon in various childrens anxiety.
Stranger anxiety at this age is often manifested by crying and turning or pulling away when encountering unfamiliar people, and is likely the result of biological predispositions and improved cognitive development. The phenomenon is not present in all children and may depend heavily on context, or the strangeness of the overall environment.
For example, many babies are particularly distressed if a stranger approaches them suddenly in an unfamiliar setting or in the absence of their primary caretaker.
Unlike behavioral inhibition, however, which tends to be stable, stranger anxiety generally declines during a child’s toddler years.
Social Withdrawal
Another construct pertinent to those described so far is social withdrawal, which may be defined as contact with peers at less than a normal rate or time alone at more than a normal rate. Indeed, social solitude does seem characteristic of introversion, shyness, and behavioral inhibition.
However, social withdrawal in children often occurs from both familiar and unfamiliar peers, whereas people who are introverted, shy, and/or behaviorally inhibited are generally more wary of unfamiliar stimuli. Social withdrawal should also be distinguished from social isolation, whereby peers actively reject a child (sometimes because of aggression) and his or her attempts to interact with them.
In addition, a child could be socially neglected, receiving few positive endorsements from peers, but not necessarily socially withdrawn (Rubin & Asendorpf, 1993). Children may be socially withdrawn for many reasons, such as introversion, shyness, behavioral inhibition, or mental disorders involving depression, anxiety, or other maladaptive behaviors. For example, behavioral inhibition does seem predictive of social withdrawal in later childhood and adolescent years, and a main aspect of internalizing disorders in youths is avoidance and withdrawal from social situations.
In addition, children suffering from anxiety may withdraw from peers because they have not developed appropriate social skills due to anger, over activity, impulsivity, inattention, or other maladaptive behavioral characteristics.
On the other hand, many children, like Alex described earlier, are socially withdrawn simply because they prefer to be alone (i.e., low approach motivation), and do not necessarily avoid others (i.e., high avoidant motivation) or have a mental disorder.
Social withdrawal in childhood tends to be stable and can be associated with many negative consequences. Chief among these include insecurity, low self-esteem, dependency, peer rejection and victimization, later anxiety and depression, and difficulty maintaining social relationships.
In addition, the negative consequences of social withdrawal seem to compound as a child ages. Long-term effects are likely mediated by certain parenting styles, family attachments and stressors, temperamental qualities, and behavior problems.
Social and Performance Anxiety
Yet another construct that seems to overlap with introversion, shyness, behavioral inhibition, and perhaps social withdrawal is social and performance anxiety. Social and performance anxiety may be defined as adverse physiological arousal in social or performance situations that involve possible evaluation by others, with accompanying worry or fear of psychological harm and a desire to escape or avoid these situations.
In children, social and performance anxiety is often similarly conceptualized as fear of negative evaluation, social distress, and social avoidance. As such, social and performance anxiety is commonly thought to comprise a wide variety of physiological, cognitive, and behavioral components, some of which are listed in various medical documents. Common social situations include starting and maintaining conversations, playing and cooperating with others, expressing affection, and negotiating solutions to problems, among others. Common performance situations include tests, recitals, games, presentations, and athletic demonstrations, among others.
Social and performance anxiety is considered to be a normal human reaction in many situations. For example, some such anxiety is usually present when meeting someone for the first time (perhaps on a blind date), interviewing for a job, taking an important test, or playing a musical instrument before others.
Even in therapeutic settings, the goal of treatment is not to eradicate social and performance anxiety but to reduce it to manageable proportions. This is not a popular belief held by various individuals, unfortunately, who believe that treatment should be able to remove all traces of any condition. But such conditions such as those mentioned prior are not easily reduced and alleviated.
In addition, most people cope with social and performance anxiety in appropriate ways, such as calming themselves or “putting aside” or “working through” anxiety to focus on a particular task or test.
Furthermore, some social and performance anxiety could be adaptive in nature, as when inappropriate behavior is inhibited or alertness is increased in key situations.
Other people, however, experience very severe levels or extreme forms of social and performance anxiety. Often these levels occur to such an extent that avoidance, escape, overdependence on familiar others, acting-out behavior problems, and other inappropriate coping strategies are present. In addition, such levels of anxiety are obviously quite distressing and usually interfere with one’s ability to enjoy a regular social life or even go to school or work. People at this extreme end of the social and performance anxiety spectrum are often considered to have social phobia, a diagnostic condition.
Understanding Children with Anxiety and Social Phobia
All of the constructs described so far (introversion, shyness, behavioral inhibition, social withdrawal, social and performance anxiety) represent characteristics that could lead to substantial difficulties in social relationships and performance before others. However, these constructs usually represent nonclinical populations, or people who still function adequately in their daily life. Furthermore, some of the constructs can be conceptualized as socially acceptable traits or cardinal features of one’s personality (introversion, shyness), whereas others may represent developmental processes (social withdrawal, behavioral inhibition, social and performance anxiety) that are expected to vary among normal youths.
In contrast, social phobia is a term that represents a clinical population because its characteristics are excessive, developmentally inappropriate, persistent, resistant to reasonable conflicting arguments, and linked to avoidance or maladaptive interference in various areas of daily life functioning.
For example, children with social and performance anxiety often become somewhat nervous when confronting a new evaluative situation, eventually become accustomed to social and evaluative situations with repeated exposures to them, and typically attend social events, albeit with some trepidation. However, children with social phobia experience debilitating and developmentally inappropriate panic attacks and other symptoms in social and performance situations, fail to become accustomed to these situations even with repeated exposures, excessively avoid these situations, and subsequently become impaired in key areas such as academic and social development.
As such, social phobia is not so much a trait as it is a mental condition. The other constructs described in this chapter could help predispose a child toward social phobia, but do not represent a formal diagnostic state as does social phobia. Social phobia has been described in different ways from a diagnostic perspective but specialists are still a long way from completely understanding anxiety and children.
In the end, it’s important that the medical field not lose steam in their pursuit of understanding more about children and anxiety. Children anxiety symptoms are still harder to identify due to the lack of verifiable medical documentation. But it is hoped that this growing concern will slowly be resolved as the research on children anxiety symptoms increases over the years.
With that collection of information and data, medical specialists can move forward with finding children anxiety treatment that can aid hundreds of thousands of families and their children, all over the world. But until then, parents are advised to continue to update themselves with the latest medical breakthroughs in an effort to understand the condition as much as they can.
