DSM-III-R subtypes of social phobia. Comparison of generalized social phobics and public speaking phobics.

Social phobic patients who fear most or all social interaction situations are labeled generalized social phobics in DSM-III-R. Thirty-five patients who met this criterion were compared with 22 social phobic patients whose fears were restricted to public speaking situations. Generalized social phobics were younger, less educated, and less likely to be employed, and their phobias were rated by clinical interviewers as more severe than those of public speaking phobics. Generalized social phobics appeared more anxious and more depressed and expressed greater fears concerning negative social evaluation. They performed more poorly on individualized behavioral tests and differed from public speaking phobics in their responses to cognitive assessment tasks. The two groups showed marked differences in their patterns of heart rate acceleration during the behavioral test. The implications of these findings for the classification and treatment of social phobic individuals are discussed.