Children with social phobia are highly fearful of social or performance situations in which they are exposed to unfamiliar people or possible evaluation. They fear that they will do something or act in a way that will result in humiliation or embarrassment. In brief, they fear that others will negatively evaluate them. For example, one sixteen year old boy was very anxious about asking a girl out on a date. He worried that he would make mistakes and stutter while asking her out. He thought that she would reject him and think he was a fool, resulting in total humiliation. Older children and adolescents are typically able to recognise that their fears are excessive or unrealistic. This is not always the case with younger children, who may lack insight into the extreme nature of their fears.
When faced with social or performance situations, socially phobic children experience intense anxiety and distress. Younger children will cry, freeze, withdraw, or hide behind people to whom they are emotionally attached. The anxiety in social situations is associated with physiological changes such as nausea, stomach aches, blushing, sweating, trembling, heart palpitations, and dizziness. Young people with social phobia are so fearful of negative evaluation that they avoid social or performance situations in any way they can. Commonly avoided situations include public speaking, meeting new people, eating in public, playing sports, attending parties, speaking in class, and speaking to authority figures. When avoidance is not possible, the situations are endured with intense daily functioning, and in some children may hinder social-emotional development. Children and adolescents with severe social phobia tend to have few friends, be involved in few recreational or extracurricular activities and may have poor social skills.
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