Rosenbaum J F, Biederman J, Pollock R A, Hirshfeld D R
Department of Psychiatry, Harvard Medical School, Boston, Mass.
J Clin Psychiatry. 1994 Jun;55 Suppl:10-6.
Human beings are by nature social animals, but for some, social scrutiny is a source of extreme anguish. Those with social phobia, for example, suffer excessive and often disabling concern about potential and real social-evaluative threat. As new and effective therapies for this condition are pursued, there is a simultaneous movement to extend the understanding of this disorder's etiology. In psychiatry, as in the rest of medicine, this development of new treatments often occurs in parallel with increasing sophistication about causes of illness. Advances in one area typically inform and predictably lead to advances in the other. Social phobia is recognized as a relatively common and significantly impairing anxiety disorder. As with other psychiatric disorders, emerging models of the etiology of social phobia are derived from converging evidence of interacting biological and environmental contributions. Current theories regarding the evolution of social phobia will be addressed, including biological preparedness to fear scrutiny by others, genetically transmitted predisposition to fear acquisition, nongenetic familial and environmental factors, as well as other possible causes and antecedents. Additionally, we describe recent work on behavioral inhibition in infancy as an identifiable early marker of proneness to the development of anxiety disorders, including social phobia.
人类天生就是社会性动物，但对有些人来说，社会审视是极度痛苦的根源。例如，患有社交恐惧症的人会对潜在的和实际的社会评价威胁感到过度且常常是致残性的担忧。在寻求针对这种状况的新的有效疗法的同时，人们也在同步努力扩展对这种障碍病因的理解。在精神病学领域，与医学的其他领域一样，新疗法的发展通常与对病因认识的日益深入同时出现。一个领域的进展通常会为另一个领域提供信息，并可预见地导致另一个领域的进展。社交恐惧症被认为是一种相对常见且严重损害功能的焦虑症。与其他精神障碍一样，社交恐惧症病因的新兴模型源自生物学和环境因素相互作用的汇聚证据。本文将探讨当前关于社交恐惧症演变的理论，包括对他人审视产生恐惧的生物学准备、恐惧习得的遗传易感性、非遗传的家庭和环境因素，以及其他可能的原因和先兆。此外，我们还将描述近期关于婴儿期行为抑制作为焦虑症（包括社交恐惧症）易发性可识别早期标志物的研究。
