Scant information is available on the course of social phobia. In the only prospective study to date, social phobia persisted throughout adulthood. (38> Furthermore, course was unrelated to gender, age of onset, duration of illness, level of functioning at intake, lifetime history of anxiety disorders, or current comorbidity of anxiety or depressive disorders/3 39) To date, no studies have followed individuals across their entire lifespan. Most other information on course is derived from retrospective accounts of individuals with social phobia. In an epidemiological sample, individuals with social phobia had, on average, met the criteria for the disorder for 19.4 years.(2l) In ECA, 15.5 per cent of participants reported that they had experienced symptoms of social phobia throughout their whole lives. (9)
In childhood, two related conditions emerge and are relatively stable into adulthood. Individuals who had been shy as children exhibited overall lower levels of functioning when assessed 30 years later. (49 Similarly, behavioural inhibition, or the tendency to withdraw from novel people, settings, or objects, was more prevalent in the children of individuals with anxiety disorders; this remained relatively stable for over 7 years in children initially assessed between the ages of 21 and 31 months/41 These findings suggest that behavioural inhibition may be an early expression of social phobia. (41)
In sum, social phobia is a chronic disorder that is unlikely to remit without treatment. However, individuals can gain relief from social phobia with both somatic and psychological treatments. The next section describes and summarizes treatments that have demonstrated efficacy.
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