Are specific and generalized social phobias qualitatively distinct?

Abstract

This article reviews studies of the generalized (CSP) and specific (SSP) subtypes of social phobia, including their onset, course, etiology, comorbid conditions, types of situations feared, reactions (i.e., cognitive, physiological, and behavioral) to feared situations, and response to treatment. Because the differences between CSP and SSP seem difficult to reconcile with a strictly quantitative perspective, we propose a qualitative distinction. The characteristics of SSP are seen as similar to those of specific phobias, but those of CSP are not. We offer a speculative interpersonal model of CSP that emphasizes beliefs about the self being unlovable, behaviors that elicit negative self-evaluations in others, and a pattern of mutual social-distancing behaviors. We discuss the implications of a qualitative distinction between CSP and SSP and offer avenues for future inquiry.