BOUNDARY OF SOCIAL PHOBIA - EXPLORING THE THRESHOLD

Background: Individuals with subthreshold social. phobia (SSP) in the community are characterized relative to nonphobic, healthy controls (C ), and diagnosed social phobics (SP). Methods: Data from 1488 subjects from the Duke University Epidemiological Catchment Area Study were ex amined. Bivariate and multivariate methods were used to compare the SS P, SP, and C groups on 10 sets of variables. Results: Compared with C respondents, SSP respondents were more likely to be female and unmarri ed and to report less income and education. The SSP respondents were a lso more likely to report work attendance problems, poor grades in sch ool, symptoms of conduct disturbance, impaired subjective social suppo rt, lack of self-confidence, lack of a close friend, use of psychotrop ic drugs in past year, and a greater number of life changes, chronic m edical problems, and mental health visits within the past 6 months. In a multivariate logistic regression model with group membership as the dependent variable, compared with C respondents, SSP respondents were more likely to be female, to have less education, and to report more indicators of poor school performance and symptoms of adolescent condu ct disturbance. In contrast, in a similar but separate multivariate mo del, compared with SP respondents, SSP respondents met the criteria fo r fewer DSM-III psychiatric disorders and were less likely to report i mpaired instrumental support. Conclusion: Social phobia adversely affe cts over 10% of the population. Previous epidemiologic catchment area- based prevalence estimates have probably been unrealistically low.