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Features

• Excessive and unreasonable fears of being the centre of attention in case of negative evaluation because of looking anxious or doing something embarrassing
• Situations that could lead to scrutiny or evaluation (social functions, being in a crowd, speaking to others) are avoided or endured with intense anxiety

• Education about nature of disorder
• Specialist referral to a cognitive behavioural program is recommended

A 35-year-old man presented with anxiety at his workplace. Since a recent promotion, he had been having difficulty attending meetings where he might have to present information to his peers. He found the symptoms of pounding heart, trembling, sweating, and blushing so unpleasant that he had excused himself from many meetings and begun avoiding as many as possible. He was seeking help because his avoidance was beginning to be noticed by his superiors at work. When asked about other situations that caused anxiety, he said he had avoided many social activities since his adolescence, particularly if there was a chance that he might be the centre of attention. He did not get anxious when at home with his wife or with close friends. He was particularly worried about the possibility that he might do or say something foolish or embarrassing at work or at social gatherings, and worried that others would notice him sweating or blushing and know that he was anxious. He believed that they would evaluate him negatively because of this.

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