The 10th version of the International Classification of Diseases (ICD-10) classifies<unk><unk>  as a mental and behavioral disorder. Cognitive aspects In cognitive models of<unk> , those with<unk>  phobias experience dread over how they will present to others. They may feel overly self-conscious, pay high self-attention after the activity, or have high performance standards for themselves. According to the<unk>  psychology theory of self-presentation, a sufferer attempts to create a well-mannered impression towards others but believes they are unable to do so. Many times, before the potentially<unk> -provoking<unk>  situation, sufferers may deliberately review what could go wrong and how to deal with each unexpected case. After the event, they may have the perception that they performed unsatisfactorily. Consequently, they will perceive anything that may have possibly been abnormal as embarrassing. These thoughts may extend for weeks or longer. Cognitive distortions are a hallmark and are learned about in CBT (cognitive-behavioral therapy). Thoughts are often self-defeating and inaccurate. Those with<unk>  phobia tend to interpret neutral or ambiguous conversations with a negative outlook and many studies suggest that<unk> ly anxious individuals remember more negative memories than those less distressed. An example of an instance may be that of an employee presenting to their co-workers. During the presentation, the person may stutter a word, upon which they may worry that other people significantly noticed and think that their perceptions of them as a presenter have been tarnished. This cognitive thought propels further<unk>  which compounds further stuttering, sweating, and, potentially, a panic attack. Behavioural aspects<unk>  is a persistent fear of one or more situations in which the person is exposed to possible scrutiny by others and fears that they may do something or act in a way that will be humiliating or embarrassing. It exceeds normal "shyness" as it leads to excessive<unk>  avoidance and substantial<unk>  or occupational impairment. Feared activities may include almost any type of<unk>  interaction, especially small groups, dating, parties, talking to strangers, restaurants, interviews, etc. Those who have<unk>  fear being judged by others in society. In particular, individuals with<unk><unk>  are nervous in the presence of people with authority and feel uncomfortable during physical examinations. People who have this disorder may behave a certain way or say something and then feel embarrassed or humiliated after. As a result, they often choose to isolate themselves from society to avoid such situations. They may also feel uncomfortable meeting people they do not know and act distant when they are with large groups of people. In some cases, they may show evidence of this disorder by avoiding eye contact, or blushing when someone is talking to them. According to psychologist B. F. Skinner, phobias are controlled by escape and avoidance behaviors. For instance, a student may leave the room when talking in front of the class (escape) and refrain from doing verbal presentations because of the previously encountered<unk>  attack (avoid). Major avoidance behaviors could include an almost pathological or compulsive lying behavior to preserve self-image and avoid judgment in front of others. Minor avoidance behaviors are exposed when a person avoids eye contact and crosses his/her arms to conceal recognizable shaking. A fight-or-flight response is then triggered in such events. Physiological aspects Physiological effects, similar to those in other<unk>  disorders, are present in<unk>  phobias. In adults, it may cause tears as well as excessive sweating, nausea, difficulty breathing, shaking, and palpitations as a result of the fight-or-flight response. The walk disturbance (where a person is so worried about how they walk that they may lose balance) may appear, especially when passing a group of people. Blushing is commonly exhibited by individuals suffering from<unk>  phobia. These visible symptoms further reinforce the<unk>  in the presence of others. A 2006 study found that the area of the brain called the amygdala, part of the limbic system, is hyperactive when patients are shown threatening faces or confronted with frightening situations. They found that patients with more severe<unk>  phobia showed a correlation with increased response in their amygdalae. People with<unk>  may avoid looking at other people, and even their surroundings, to a greater extent than their peers, possibly to decrease the risk of eye contact, which can be interpreted as a nonverbal signal of openness to<unk>  interaction.<unk>  aspects People with<unk>  avoid situations that most people consider "normal". They may have a hard time understanding how others can handle these situations so easily. People with<unk>  avoid all or most<unk>  situations and hide from others, which can affect their personal relationships.<unk>  phobia can completely remove people from<unk>  situations due to the irrational fear of these situations. People with<unk>  may be addicted to<unk>  media networks, have sleep deprivation, and feel good when they avoid human interactions.<unk>  can also lead to low self-esteem, negative thoughts, major depressive disorder, sensitivity to criticism, and poor<unk>  skills that don't improve. People with<unk>  experience<unk>  in a variety of<unk>  situations, from important, meaningful encounters, to everyday trivial ones. These people may feel more nervous in job interviews, dates, interactions with authority, or at work. Comorbidity<unk>  shows a high degree of co-occurrence with other psychiatric disorders. In fact, a population-based study found that 66% of those with<unk>  had one or more additional mental health disorders.<unk>  often occurs alongside low self-esteem and most commonly clinical depression, perhaps due to a lack of personal relationships and long periods of isolation related to<unk>  avoidance. Clinical depression is 1.49 to 3.5 times more likely to occur in those with<unk> . Research also indicates that the presence of certain<unk>  fears (e.g., avoidance of participating in small groups, avoidance of going to a party) are more likely to trigger comorbid depressive symptoms than other<unk>  fears, and thus deserve a very careful audit during clinical assessment among patients with<unk> .<unk>  disorders other than<unk>  are also very common in patients with<unk> , in particular generalized<unk>  disorder. Avoidant personality disorder is likewise highly correlated with<unk> , with comorbidity rates ranging from 25% to 89%. To try to reduce their<unk>  and alleviate depression, people with<unk>  phobia may use alcohol or other drugs, which can lead to substance use disorders. It is estimated that one-fifth of patients with<unk>  also have alcohol use disorder. However, some research suggests<unk>  is unrelated to, or even protective against alcohol-related problems. Those who have both alcohol use disorder and<unk>  are more likely to avoid group-based treatments and to relapse compared to people who do not have this combination.
Social anxiety disorder
Avoidant personality disorder
Separation anxiety disorder
Schizotypal personality disorder  Schizotypal disorder  1
Generalized anxiety disorder
Blood phobia
Body dysmorphic disorder
Somatization disorder