Alone with your fears.

Severe anxiety disorders such as panic disorder and agoraphobia have been the objects of a number of recent research projects (SN: 3/30/85, p. 199). But an anxiety disorder with promising research possibilities -- social phobia -- remains largely unstudied, assert psychiatrist Michael R. Liebowitz and colleagues of Columbia University in New York City.

Social phobics fear scrutiny or evaluation by others, they explain, and feel more comfortable if they can be alone. Fears of eating, drinking, shaking, speaking or vomiting in the presence of others are often part of their phobia. People with panic disorder may have similar fears but also have anxiety reactions in nonsocial situations such as in subways or tunnels; they tend to avoid places where a quick exit is difficult and feel comforted by the presence of familiar people.

There are "major uncertainties," note the researchers in the July ARCHIVES OF GENERAL PSYCHIATRY, concerning the definition, prevalence, causes and treatment of social phobia. In the United States, only behavior therapists have paid much attention to treating the disorder. British researchers have found that alcoholism and depression are commonly associated with socila phobia.

While social phobics are often extremely disabled by their fears, preliminary data indicate they may improve with social skills training, relaxation instruction or the use of beta blocker medication, according to the investigators.

Furthermore, they point out, social phobics are an important comparison group for studies of other anxiety patients. Contrasting more than one phobic group with healthy controls may lead to the identification of a "core vulnerability" among anxiety patients, maintain the psychiatrists.