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social anxiety disorder dsm 5

Social anxiety disorder DSM 5: a fear of being judged, avoided or endured with distress, out of proportion and lasting 6 months or more, that impairs work, school or social life (code F40.10).

  • 6 months or more
  • F40.10 (DSM-5, ICD-10-CM)
  • 6B04 (ICD-11)
  • Not just shyness
  • DSM-5 Diagnostic Criteria
  • Core Features
  • Impact and Exclusions
  • Special Contexts
  • Key Specifiers & Details
  • Performance Only Specifier
Want to know if what you feel fits? Yes
  1. Take our 2-minute social anxiety test and note your score.
  2. Bring it to a doctor or therapist: only a clinician can diagnose.
  3. If being watched while you speak is the hard part, practice it gently in an AmberWillo practice session: short speeches in a small, judgment-free online room with real people, from home. Free to start.
Join a free practice session
No, just show me the criteria

DSM-5 criteria for social anxiety disorder at a glance: each criterion in plain language

CriterionIn plain languageWhat it looks like
AFear of social situations where others could watch or judge youSmall talk, meeting new people, eating in front of others, giving a talk
BFear that you will act, or look anxious, in a way that gets judged badly: humiliating, embarrassing, leading to rejection, or offending othersWorrying everyone will see you blush or hear your voice shake
CThose situations almost always trigger the fearNot just one bad day, nearly every time
DThey are avoided, or endured with intense fearSkipping the party, or going and counting the minutes
EThe fear is bigger than the real threat, judged against your culture and settingDreading a routine team update for a week
FIt lasts, typically 6 months or moreA pattern, not a rough patch
GIt causes real distress or gets in the way of work, school or relationshipsTurning down a promotion that needs presenting
HIt is not caused by a drug, medication or medical conditionNot jitters from stimulants
IIt is not better explained by another mental disorderNot panic disorder, body dysmorphic disorder or autism
JIf a medical condition is present, the fear is unrelated to it or clearly excessiveNot only worry about a tremor from Parkinson's disease
SpecifierPerformance only: the fear is limited to speaking or performing in publicFine at parties, terrified at the podium

Paraphrased in our own words. The DSM-5 text is copyrighted by the American Psychiatric Association; a clinician uses the full criteria.

Recommended

AmberWillo practice sessions: face the fear of being judged in a small room first

Peer-led public speaking practice online: you give short speeches in small video rooms with real people working toward the same thing.

  • Practice the situation criterion A describes, being watched while you speak, in a judgment-free room
  • Join from home instead of avoiding: a gentler first step than a live stage
  • Feedback after every round on confidence, clarity and pace
Join a free practice session

Studies at the University of Tampa and Massachusetts General Hospital found practicing with virtual audiences at home just as effective, with much lower anxiety by the end.

How clinicians apply the social anxiety disorder DSM 5 criteria

Social anxiety disorder (formerly called social phobia) is an anxiety disorder in which fear of scrutiny and negative evaluation is strong, persistent and limiting. A clinician diagnoses it in an interview; all criteria A to J must be met.

Core features (A-D)
The fear is about being watched and judged, not about the place itself. "Offending others" is in criterion B because in some cultures the fear centers on making others uncomfortable, as in taijin kyofusho in Japan.
Out of proportion (E)
The clinician judges this, not you. DSM-IV required the person to see the fear as excessive or unreasonable; DSM-5 dropped that, because many people think their fear is justified.
Duration and impact (F, G)
Six months or more, for adults and children alike, plus clinically significant distress or impairment in work, school or social life.
Exclusions (H-J)
Substances, medical conditions and other disorders are ruled out first.
Children
The anxiety must show up with peers, not only with adults. It may look like crying, tantrums, freezing, clinging, shrinking back or not speaking.

The performance only specifier

The performance only specifier applies when the fear is limited to speaking or performing in front of others: presentations, recitals, toasts. Everyday conversations are fine. Fear of public speaking is far more common than the disorder: 29% of US adults said they were afraid of public speaking in the 2024 Chapman Survey of American Fears, while NIMH puts lifetime social anxiety disorder at about 12.1% of US adults.

Among 1,851 people who joined AmberWillo between December 2025 and October 2026, 38.5% wanted help with work presentations and 20.3% with social situations. Speaking-only fear responds well to practice out loud with real people, step by step. More in social anxiety and public speaking.

Prefer to start alone?

Confidently: practice speaking where nobody watches

An AI speaking coach app: talk for 30 seconds on two random words; the AI scores your voice and face out of 10.

  • Private to you, for when an audience of any size feels like too much
  • A custom plan of what to fix first and what to practice
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Free to start, with a 3-day free trial.

DSM-IV vs DSM-5: what changed

TopicDSM-IVDSM-5
NameSocial phobiaSocial anxiety disorder (social phobia)
Fear seen as excessiveThe person had to recognize itThe clinician judges it, with sociocultural context
6-month durationOnly under age 18All ages
SpecifierGeneralized (most social situations)Performance only
Medical conditionsFear unrelated to the conditionFear unrelated or clearly excessive

The 2022 text revision (DSM-5-TR) kept the same core criteria and code.

Differential diagnosis: what it is not

Differential diagnosis means ruling out conditions that look similar. The deciding question is usually what the person fears.

Look-alikeThe deciding question
ShynessDoes it cause real impairment? Shyness is a trait; most shy people still do what matters.
Avoidant personality disorderIs it a lifelong pattern of feeling inadequate across nearly all of life? It often occurs with social anxiety disorder. See avoidant personality disorder vs social anxiety.
AgoraphobiaIs the fear about being trapped without help, rather than being judged?
Panic disorderAre the panic attacks unexpected and feared for themselves, not only in social situations?
Autism spectrum disorderAre social difficulties due to differences in social communication rather than fear of evaluation?
Generalized anxiety disorderIs the worry about many topics, not mainly about judgment?
Body dysmorphic disorderIs the fear tied to a perceived flaw in appearance?
Selective mutismDoes a child fail to speak in specific settings while speaking normally at home?

Social anxiety disorder DSM 5 code, ICD-10 and ICD-11

SystemCodeName
DSM-5 / DSM-5-TRF40.10 (DSM-5 also listed 300.23)Social anxiety disorder
ICD-10-CM (US billing)F40.10; F40.11Social phobia, unspecified; generalized
ICD-10 (WHO)F40.1Social phobias
ICD-11 (WHO)6B04Social anxiety disorder

ICD-11 describes the same core picture: marked fear in social situations, avoidance and impairment, lasting at least several months. More on codes in social anxiety disorder ICD-10.

How common it is and how it is treated

  • Prevalence: about 7.1% of US adults in a given year and 12.1% at some point in life (NIMH). More common in women.
  • Onset: median age 13 in the US, and most cases start between ages 8 and 15. Without treatment the course is often chronic; it also occurs in older adults.
  • Common with it: depression, alcohol and substance use, other anxiety disorders and panic attacks in social settings.
  • Signs: blushing, trembling, sweating, a racing heart, a shaky voice.
  • Causes: it runs in families (genetics), plus a shy, inhibited temperament and experiences like bullying.
  • Measuring it: the APA's DSM-5 Severity Measure for social anxiety disorder has 10 items scored 0 to 40 (average 0-4, none to extreme); clinicians also use the LSAS and SPIN.
  • Treatment: cognitive behavioral therapy (CBT) with exposure is first-line; SSRIs or SNRIs are the usual medication. See CBT for social anxiety.

Before an assessment: take our social anxiety test and bring a list of the situations you avoid, how long it has been going on and what it has cost you. That maps straight onto criteria A, D, F and G.

If speaking is your trigger, start small

Give one short speech to a small, judgment-free online room, from home.

Join a free practice session

Reader questions

What are the treatment options for social anxiety disorder?

CBT with exposure is the strongest first choice, and SSRIs help many people, especially combined with therapy. The people who improve most tend to be the ones who keep doing small exposures between sessions.

Is fear of public speaking social anxiety disorder?

Not on its own. It only becomes the performance only type of social anxiety disorder when it's intense, lasts 6 months or more and costs you something real, like avoiding a job you want.

Who should I talk to about social anxiety?

Start with your doctor or a licensed therapist; either can assess you or refer you on. If that feels like too big a step, a support group is a gentler first move.

How do you survive with severe social anxiety?

Get professional help first, and don't wait for the fear to fade before acting. Pick one tiny daily exposure, like saying hello to a cashier, and build from there. If you have thoughts of harming yourself, call or text 988 in the US.

Can a child be diagnosed with social anxiety disorder?

Yes. The same criteria apply, but the fear has to show up with other kids, not just adults, and it may look like tantrums, clinging or not talking.

Sources

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), 2013.
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), 2022.
  3. American Psychiatric Association. DSM-5 Severity Measure for Social Anxiety Disorder (Social Phobia), Adult, 2013.
  4. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health, Table 3.12, 2016.
  5. Heimberg, R. G. et al. Social anxiety disorder in DSM-5. Depression and Anxiety, 2014.
  6. World Health Organization. ICD-11 for Mortality and Morbidity Statistics, 6B04 Social anxiety disorder.
  7. National Institute of Mental Health (NIMH). Social Anxiety Disorder statistics.
  8. Chapman University. Survey of American Fears 2024.
  9. AmberWillo. Onboarding survey of 1,851 people who joined AmberWillo, December 2025 to October 2026 (aggregate data).

AmberWillo editorial team · Updated November 4, 2026