Skip to main content
SpringerLink
Log in

Social phobia in Swedish university students: prevalence, subgroups and avoidant behavior

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Public speaking is a common situation that university students have to endure. This situation is feared or avoided by most individuals with social phobia, which has been associated with low levels of educational attainment. However, epidemiological data on social phobia in university students are scarce. The present study examined the prevalence of social phobia and its subgroups in a university student population. Demographic characteristics and avoidant behavior in educational settings were also examined.

Methods

The Social Phobia Screening Questionnaire (SPSQ)—a validated and DSM-IV compatible instrument, was distributed as a postal survey to 753 randomly selected university students in Sweden. Interpretable questionnaires were obtained from 523 students (69.5%). To investigate subgroups, students who met the SPSQ diagnostic criteria of social phobia were analyzed by hierarchical cluster analysis.

Results

The point prevalence of social phobia among the Swedish university students was 16.1%, comparable with 15.6% previously reported for the general population. Two clusters were distinguished consisting of students scoring either low (discrete subgroup) or high (generalized subgroup) on all cluster variables. The discrete subgroup was more common representing 83% of the cases. Social phobia was associated with use of dysfunctional avoidant strategies in educational situations and in anticipation of public speaking. The disorder was less common among students following a pedagogic university program.

Conclusions

Social phobia was highly prevalent among Swedish university students, most cases pertaining to a mild or discrete form of the disorder. The commonness and severity of social phobia in students did not deviate significantly from the general population suggesting that socially anxious individuals do apply for higher education. However, since avoidance and low educational attainment are commonly reported features, future studies should investigate whether sufferers of social phobia underachieve or abolish their studies prematurely.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Furmark T (2002) Social phobia: overview of community surveys. Acta Psychiatr Scand 105:84–93

    Article  PubMed  CAS  Google Scholar 

  2. Sareen J, Stein M (2000) A review of the epidemiology and approaches to the treatment of social anxiety disorder. Drugs 59:497–509

    Article  PubMed  CAS  Google Scholar 

  3. Furmark T, Tillfors M, Everz P-O, Marteinsdottir I, Gefvert O, Fredrikson M (1999) Social phobia in the general population: prevalence and sociodemographic profile. Soc Psychiatry Psychiatr Epidemiol 34:416–424

    Article  PubMed  CAS  Google Scholar 

  4. Kessler RC, Stein MB, Berglund P (1998) Social phobia subtypes in the National Comorbidity Survey. Am J Psychiatry 155:613–619

    PubMed  CAS  Google Scholar 

  5. Stein MB, Torgrud LJ, Walker JR (2000) Social phobia symptoms, subtypes, and severity: findings from a community survey. Arch Gen Psychiatry 57:1046–1052

    Article  PubMed  CAS  Google Scholar 

  6. Van Ameringen M, Mancini C, Farvolden P (2003) The impact of anxiety disorders on educational achievement. J Anxiety Disord 17:561–571

    Article  PubMed  Google Scholar 

  7. Izgic F, Akyüz G, Dogan O, Kugu N (2004) Social phobia among university students and its relation to self-esteem and body image. Can J Psychiatry 49:630–634

    PubMed  Google Scholar 

  8. Stein MB, Kean YM (2000) Disability and quality of life in social phobia: epidemiologic findings. Am J Psychiatry 157:1606–1613

    Article  PubMed  CAS  Google Scholar 

  9. Wilson I (2005) Screening for social anxiety disorder in first year university students. A pilot study. Aus Fam Physican 34:983–984

    Google Scholar 

  10. Kessler RG, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen H-U, Kendler KS (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorder in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19

    PubMed  CAS  Google Scholar 

  11. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  12. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  13. Heckelman LR, Schneier FR (1995) Diagnostic issues. In: Heimberg RG, Liebowitz MR, Hope DA, Schneier FR (eds) Social Phobia. Diagnosis, assessment and treatment. New York, The Guilford Press, pp 3–21

    Google Scholar 

  14. Heimberg RG, Holt CS, Schneier FR, Spitzer RL, Liebowitz MR (1993) The issue of subtypes in the diagnosis of social phobia. J Anxiety Disord 7:249–269

    Article  Google Scholar 

  15. Eng W, Heimberg RG, Coles ME, Schneier FR, Liebowitz MR (2000) An empirical approach to subtype identification in individuals with social phobia. Psychol Med 30:1345–1357

    Article  PubMed  CAS  Google Scholar 

  16. Furmark T, Tillfors M, Stattin H, Ekselius E, Fredrikson M (2000) Social phobia subtypes in the general population revealed by cluster analysis. Psychol Med 30:1335–1344

    Article  PubMed  CAS  Google Scholar 

  17. Hofmann SG, Heinrichs N, Moscovitch DA (2004) The nature and expression of social phobia: toward a new classification. Clin Psychol Rev 24:769–797

    Article  PubMed  Google Scholar 

  18. Merckelbach H, de Jong PJ, Muris P, van den Hout MA (1996) The etiology of specific phobias: a review. Clin Psychol Rev 16:337–361

    Article  Google Scholar 

  19. Rodebaugh TL, Holaway RM, Heimberg RM (2004) The treatment of social anxiety disorder. Clin Psychol Rev 24:883–908

    Article  PubMed  Google Scholar 

  20. Clark DM, Wells A (1995) A cognitive model of social phobia. In: Heimberg RG, Liebowitz MR, Hope DA, Schneier FR (eds) Social Phobia. Diagnosis, assessment and treatment. New York, Guilford Press, pp 69–93

    Google Scholar 

  21. Ottosson H, Bodlund O, Ekselius L, Grann M, von Knorring L, Kullgren G, Lindström E, Söderberg S (1998) DSM-IV and ICD-10 personality disorders: a comparison of a self-report questionnaire (DIP-Q) with a structured interview. Eur Psychiatry 13:246–253

    Article  Google Scholar 

  22. Heimberg RG, Mueller GP, Holt CS, Hope DA, Liebowitz MR (1992) Assessment of anxiety in social interaction and being observed by others: the social interaction anxiety scale and the social phobia scale. Behav Ther 23:53–73

    Article  Google Scholar 

  23. Hair JF, Anderson RE, Tatham RL, Black WC (1995) Multivariate data analysis with readings. Prentice-Hall, Upper Saddle River, NJ

    Google Scholar 

  24. Pallant J (2005) SPSS survival manual, 2nd edn. Open university Press, New York

    Google Scholar 

  25. Hazen AL, Stein MB (1995) Clinical phenomenology and comorbidity. In: Stein MB (ed) Social Phobia. Clinical and research perspectives. American Psychiatric Press, Washington, DC, pp 3–41

    Google Scholar 

  26. Otto MW, Pollack MH, Gould RA, Worthington III JJ, McArdle ET, Rosenbaum JF (2000) A comparison of the efficacy of Clonazepam and cognitive-behavioral group therapy for the treatment of social phobia. J Anxiety Disord 14:345–358

    Article  PubMed  CAS  Google Scholar 

  27. Stangier U, Heidenreich T, Peitz M, Lauterbach W, Clark DM (2003) Cognitive therapy for social phobia: individual versus group treatment. Behav Res Ther 41:991–1007

    Article  PubMed  CAS  Google Scholar 

  28. Andersson G, Carlbring P, Holmström A, Sparthan E, Furmark T, Nilsson-Ihrfelt E, Buhrman M, Ekselius L (2006) Internet-based self-help with therapist feedback and in-vivo group exposure for social phobia: a randomized controlled trial. J Consult Clin Psychol 74:677–686

    Article  PubMed  Google Scholar 

  29. First MB, Spitzer RL, Gibbon M, Williams JBW (1995) Structured clinical interview for DSM-IV Axis I Disorders (SCID-I). American Psychiatric Press, Washington, DC

    Google Scholar 

  30. Carlbring P, Gunnarsdóttir M, Hedensjö L, Andersson G, Ekselius L, Furmark T (2006) Treatment of social phobia from a distance: a randomized trial of internet delivered cognitive behavior therapy (CBT) and telephone support. Br J Psychiatry (in press)

    Google Scholar 

Download references

Acknowledgments

This study was supported by the Swedish Council for Working Life and Social Research. We would like to thank the following people: Ann-Christin Bäckman, Linda Kreü, Geska Mark, Karin Thörnblom and Maria Willén for skillful assistance.

Author information

Authors and Affiliations

  1. Dept. of Behavioral, Social and Legal Sciences, Örebro University, 701 82, Örebro, Sweden

    Maria Tillfors

  2. Dept. of Psychology, Uppsala University, Uppsala, Sweden

    Tomas Furmark

Authors
  1. Maria Tillfors
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomas Furmark
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Tillfors.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tillfors, M., Furmark, T. Social phobia in Swedish university students: prevalence, subgroups and avoidant behavior. Soc Psychiat Epidemiol 42, 79–86 (2007). https://doi.org/10.1007/s00127-006-0143-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-006-0143-2

Keywords

Search

Navigation