Self-Assessment Test: Do You Have Social Anxiety Disorder?

By going through the checklists below, you’ll get a good idea of how your body and mind react to the fear of disapproval, and about the range of social and performance situations that you try to avoid. If you decide to seek help from a physician or a therapist, bring this completed form with you. It will provide the professional with much useful information about you and your situation and may speed up the assessment process.

These are situations in which I’m likely to experience social anxiety:

(Check off any that apply. Put a star by the situations you’re also most likely to avoid.)

Talking on the telephone

Being introduced to others

Answering the door

Interacting with clerks at the bank, grocery store, dry cleaners, etc.

Dealing with doctor’s offices

Attending church

Buying or returning items at department stores

Driving (for fear of what other drivers are thinking of you)

Going to the gas station

Using public restrooms (not due to fear of germs)

Eating in front of other people

Writing or signing name in front of others

Attending social events

Hosting social events

Dating

Talking in a small group

Acting assertively

Expressing your opinion

Talking about yourself to others (being the center of attention)

Speaking to a large group

Performance situations, such as playing a musical instrument or taking a test

Other:

Other:

Other:

These are ways I engage in "partial avoidance behavior".

(Partial avoidance means that you may not entirely avoid a situation, but you find some way to limit or control your experience of the situation.)

I use alcohol or drugs before entering a feared social situation.

If I attend a social situation, I stay only a certain length of time.

I’m likely to set other conditions on attendance, such as staying close to certain, “safe” people or staying in a certain place. 

I frequently try to distract myself by daydreaming or thinking about other things.

I’m likely to avoid eye-contact.

Other:

Other:

Other:

 

These are the physical symptoms I’m likely to experience when I’m anxious:

Blushing

Shaking/tremors (e.g., commonly occurs with the hands, but it might be the head that shakes, or facial twitching, etc.)

Sweating

Hot flashes/cold flashes

Gastrointenstinal discomfort

Diarrhea

Muscle tension

Heart palpitations or racing heart

Shortness of breath

Tightness in chest

Feelings of weakness (e.g., legs feel like jello)

Lightheadedness/dizziness

Choking sensations, lump in throat, dry mouth                       

Feelings of unreality (almost seems like you’re in a fog)

Other:

Other:

Other:

I experience panic attacks, either in social situations, or in anticipation of them:

(A panic attack is a sudden surge of intense fear and anxiety, usually accompanied by several or many of the above physical symptoms. It will usually reach a peak in five to 20 minutes before subsiding.)

Yes No

I’m especially likely to experience panic attacks in these situations:

I experience panic attacks approximately times per week.

These are the things I’m likely to be telling myself either before, during, or after a social situation:

I’m such a loser.

I don’t fit in.

Everyone can tell how nervous I am.

I don’t have anything interesting to say.

I’m so ugly.

I’m boring.

I have to get out of here before I embarrass myself any more.

My voice is quivering.

I sound stupid.

I’m a social misfit.

People must think I’m "crazy."

Everyone thinks I’m too quiet.

If I blow it, it’s the end of the world.

Other:

Other:

Other:


Other key questions to ask about my reactions to feared social situations:

Does avoidance of these situations interfere with my normal routine?

Yes No

Does the fear and avoidance interfere with my academic (school) functioning?

Yes No

Does the fear and avoidance interfere with my occupational (work) functioning?

Yes No

Does the fear and avoidance interfere with my social activities and/or relationships?

Yes No

Does having social anxiety cause me significant pain and distress?

Yes No


Painfully Shy by Barbara Markway, Ph.D., and Gregory Markway, Ph.D.