338 TREATMENT OF SPECIFIC ANXIETY DISORDERS
and counseling psychologists whereas social phobia is a research topic in clinical psy-
chology; and (4) their differences may be more quantitative than qualitative in nature
(Bruch & Cheek, 1995; Heckelman & Schneier, 1995; Rapee, 1995b).
Shyness is a normal personality trait that involves some degree of nervousness,
inhibition, and self- consciousness in social interaction. Butler (2007) described shyness
as a sense of shrinking back from social encounters and retreating into one’s self due
to physical discomfort (e.g., tension, sweating, trembling), feeling anxious, inhibition,
or inability to express yourself, and excessive self- focused attention. Zimbardo defined
shyness as “a heightened state of individuation characterized by excessive egocentric
preoccupation and overconcern with social evaluation... with the consequence that the
shy person inhibits, withdraws, avoids, and escapes” (cited in Henderson & Zimbardo,
2001, p. 48). Despite the similarities with social phobia, there are important differences.
Compared to social phobia, shyness is much more pervasive in the general population,
it may be less chronic or enduring, it is associated with less avoidance and functional
impairment, and shy individuals may be more able to engage in social interaction when
necessary (Beidel & Turner, 2007; Bruch & Cheek, 1995).
Table 9.3 presents some important differences between shyness and social phobia
(Turner, Beidel, & Townsley, 1990).
Social phobia is undoubtedly a more severe condition than shyness, with severe
and pervasive avoidance of social situations being one of the most important distinc-
tions. Although the differences are more quantitative than qualitative in nature (Rapee,
1995b), Beidel and Turner (2007) concluded in their review that social phobia should
not be considered an extreme form of shyness. Studies that have directly compared
prevalence of shyness and social phobia confirm the distinctiveness of the two syn-
dromes. Chavira, Stein, and Malcane (2002) found that only 36% of individuals who
had high levels of shyness met criteria for generalized social phobia compared to 4%
of individuals with average or normative shyness. In another study only 17.7% of shy
university students met diagnostic criteria for social phobia (Heiser et al., 2003) and
analysis of the NCS data set revealed a lifetime prevalence for social phobia of 28% for
women and 21% for men who reported excessive childhood shyness (Cox, MacPherson,
& Enns, 2005). Conversely only 51% of women and 41% of men with lifetime complex
(generalized) social phobia had excessive childhood shyness. Together these findings
table 9.3. Distinguishing features of shyness and social phobia
Shyness Social phobia
••Normal personality trait ••Psychiatric disorder
••Primarily social inhibition and reticence ••Presence of marked anxiety, even panic, in social
evaluative situations
••Can socially engage when necessary ••More likely to exhibit poor social performance
••Less likely to avoid social situations ••Avoidance of social situations more frequent and
pervasive
••Highly prevalent in population ••Lower prevalence rate
••More transitory course for many individuals ••Longer duration, more chronic, and unremitting
••Earlier onset perhaps in preschool years ••Later onset in early to midadolescence
••Less impairment in daily living ••Greater social and occupational impairment