Is it normal to dread social situations

The Liebowitz Social Anxiety Scale Test is a measure of the degree of social phobia that a person experiences. Autistic individuals often have a social anxiety disorder diagnosis so I thought it would be interesting to see how we score on this test.

Before taking the test, I think it’s important to differentiate between autistic social anxiety and social phobia. Social phobia, the set of experiences on which a social anxiety disorder is based, is a strong fear of being judged by others and of being embarrassed. Generally the fear has to interfere with a person’s ability to work, attend school or generally function on a daily basis for it to rise to the level of a phobia.

A key feature of social anxiety disorder is that the anxiety experienced is irrational. For example, a person might become very anxious about going to work because they’re afraid that their boss will reprimand them in front of others even though they’re generally good at their job and their boss usually gives criticism to employees in private. In addition to the emotions associated with anxiety (fear, nervousness, dread), the person experiences strong physical sensations, like nausea, racing heart rate, sweating, and/or shortness of breath, in anticipation of the feared situation.

For a long time, I thought that I experienced social anxiety. Until I started reading about the experiences of others and discovered that my issues with social interaction are atypical for nonautistic people, but also atypical for those with social phobia.

Here’s how my social, um, issues manifest:

  • Realize that a social event is coming up in a few days.
  • Develop a background sense of dread.
  • Become increasingly irritable, withdrawn, restless and avoidant.
  • Resolve to go anyhow.
  • Get ready for the event way too early then sit around in my fancy clothes waiting for the precisely calculated minute at which I need to leave the house so as not to arrive too early or too late.
  • Forget five minutes after I arrive how much I dreaded the event or even why.
  • Stumble through the event with my usual atypical mix of being socially awkward, overly informative and very interested in anything on the periphery of the event.
  • Leave at the earliest opportunity.

I guess what I have is more social dread than social phobia. Which makes me curious how I’ll score on this test.

(This is not to say that no autistic people experience social phobia or that I don’t have specific fears around certain social situations, just that I don’t experience the more broadly defined social anxiety like I’d always assumed.)

Taking the Test

An online version of the Liebowitz Social Anxiety Scale Test is available here.

There are 24 situations presented, which are rated in two categories: fear and avoidance. You’re asked to rate each situation based on your experiences in the past week and to imagine how you’d react to the situation if it is one that you don’t usually experience.

For fear, the choices are: none, mild, moderate and severe. For avoidance, they are: never, occasionally, often and usually. If you don’t choose an option, it will default to none or never, so be sure you’ve made a choice for each to get an accurate score.

The test will take 3 – 10 minutes to complete, depending on how much you need to think about each answer.

Scoring the Test

You’ll receive a two part score, with one score for fear and one for avoidance, as well as an overall rating of your level of social anxiety.

My score was: 23(fear) + 17(avoidance) = 40

You do not suffer from social anxiety.

(For reference, a total score of 55 is the cutoff for social phobia.)

I found the two factor set-up of the test really helpful because it allowed me to say that I avoid something but not out of fear or that I fear something but generally do it anyhow. For example, I rated “fear of speaking in front of others” as severe but only avoid it occasionally. Returning an item is something that I don’t like doing, but I’ve never avoided taking something back for refund because the incentive of getting my money back for an item that I don’t need is pretty high. Public speaking is something that I’ll do when I have to, but it makes me incredibly nervous. On the other hand, “giving a party” got both “severe” on fear and “often” on avoidance.

Things like “resisting a high pressure” salesperson fall into “often” on avoidance but “mild” on fear. It’s one of those situations that I avoid because I just find them annoying (being observed when working) or a waste of time (small group activities, ack!), not because I fear them.

Thinking about each activity in terms of “how much do I dislike/fear this thing?” and “how does that feeling impact my daily functioning?” was helpful in identifying areas that I should probably work on (high fear/high avoidance items).

One potential problem for those of us on the spectrum, however, is that our social fears may not be irrational. For example, we might fear making phone calls to strangers because of difficulties with language pragmatics that make it hard to conduct phone conversations successfully. So even if our fears don’t fit the irrational aspect of social phobia, we could end up with a high social anxiety score. I think that in a clinical setting, if a therapist is using this scale with an autistic person as a screening instrument, items with high fear/avoidance scores should be interrogated more thoroughly for the underlying reasons to avoid misdiagnosis.

The Bottom Line

The situations presented cover a broad range of social situations in a way that makes it possible to separately identify feelings of anxiety and how much those feelings affect your actions, making it a practical way to identify general levels of social anxiety and specific anxiety-inducing situations.

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