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
- Take our 2-minute social anxiety test and note your score.
- Bring it to a doctor or therapist: only a clinician can diagnose.
- 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.
DSM-5 criteria for social anxiety disorder at a glance: each criterion in plain language
| Criterion | In plain language | What it looks like |
|---|---|---|
| A | Fear of social situations where others could watch or judge you | Small talk, meeting new people, eating in front of others, giving a talk |
| B | Fear that you will act, or look anxious, in a way that gets judged badly: humiliating, embarrassing, leading to rejection, or offending others | Worrying everyone will see you blush or hear your voice shake |
| C | Those situations almost always trigger the fear | Not just one bad day, nearly every time |
| D | They are avoided, or endured with intense fear | Skipping the party, or going and counting the minutes |
| E | The fear is bigger than the real threat, judged against your culture and setting | Dreading a routine team update for a week |
| F | It lasts, typically 6 months or more | A pattern, not a rough patch |
| G | It causes real distress or gets in the way of work, school or relationships | Turning down a promotion that needs presenting |
| H | It is not caused by a drug, medication or medical condition | Not jitters from stimulants |
| I | It is not better explained by another mental disorder | Not panic disorder, body dysmorphic disorder or autism |
| J | If a medical condition is present, the fear is unrelated to it or clearly excessive | Not only worry about a tremor from Parkinson's disease |
| Specifier | Performance only: the fear is limited to speaking or performing in public | Fine at parties, terrified at the podium |
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
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
Free to start, with a 3-day free trial.
DSM-IV vs DSM-5: what changed
| Topic | DSM-IV | DSM-5 |
|---|---|---|
| Name | Social phobia | Social anxiety disorder (social phobia) |
| Fear seen as excessive | The person had to recognize it | The clinician judges it, with sociocultural context |
| 6-month duration | Only under age 18 | All ages |
| Specifier | Generalized (most social situations) | Performance only |
| Medical conditions | Fear unrelated to the condition | Fear 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-alike | The deciding question |
|---|---|
| Shyness | Does it cause real impairment? Shyness is a trait; most shy people still do what matters. |
| Avoidant personality disorder | Is 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. |
| Agoraphobia | Is the fear about being trapped without help, rather than being judged? |
| Panic disorder | Are the panic attacks unexpected and feared for themselves, not only in social situations? |
| Autism spectrum disorder | Are social difficulties due to differences in social communication rather than fear of evaluation? |
| Generalized anxiety disorder | Is the worry about many topics, not mainly about judgment? |
| Body dysmorphic disorder | Is the fear tied to a perceived flaw in appearance? |
| Selective mutism | Does a child fail to speak in specific settings while speaking normally at home? |
Social anxiety disorder DSM 5 code, ICD-10 and ICD-11
| System | Code | Name |
|---|---|---|
| DSM-5 / DSM-5-TR | F40.10 (DSM-5 also listed 300.23) | Social anxiety disorder |
| ICD-10-CM (US billing) | F40.10; F40.11 | Social phobia, unspecified; generalized |
| ICD-10 (WHO) | F40.1 | Social phobias |
| ICD-11 (WHO) | 6B04 | Social 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 sessionReader questions
What are the treatment options for social anxiety disorder?
Is fear of public speaking social anxiety disorder?
Who should I talk to about social anxiety?
How do you survive with severe social anxiety?
Can a child be diagnosed with social anxiety disorder?
Sources
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), 2013.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), 2022.
- American Psychiatric Association. DSM-5 Severity Measure for Social Anxiety Disorder (Social Phobia), Adult, 2013.
- 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.
- Heimberg, R. G. et al. Social anxiety disorder in DSM-5. Depression and Anxiety, 2014.
- World Health Organization. ICD-11 for Mortality and Morbidity Statistics, 6B04 Social anxiety disorder.
- National Institute of Mental Health (NIMH). Social Anxiety Disorder statistics.
- Chapman University. Survey of American Fears 2024.
- AmberWillo. Onboarding survey of 1,851 people who joined AmberWillo, December 2025 to October 2026 (aggregate data).
AmberWillo editorial team · Updated November 4, 2026