The Gift of Introversion

way that will be embarrassing or humiliating, avoidance and anxiety
symptoms. Standardized rating scales can be used to screen for social anxiety disorder
and measure the severity of anxiety.
The first line treatment for social anxiety disorder is cognitive behavioral therapy (CBT)
with medications recommended only in those who are not interested in therapy. CBT is
effective in treating social phobia, whether delivered individually or in a group
setting. The cognitive and behavioral components seek to change thought patterns and
physical reactions to anxiety-inducing situations. The attention given to social anxiety
disorder has significantly increased since 1999 with the approval and marketing of
drugs for its treatment. Prescribed medications include several classes
of antidepressants: selective serotonin reuptake inhibitors (SSRIs), serotoninnorepinephrine
reuptake inhibitors (SNRIs), and monoamine oxidase
inhibitors (MAOIs). Other commonly used medications include beta
blockers and benzodiazepines. It is the most common anxiety disorder with up to 10%
of people being affected at some point in their life.
Signs and Symptoms
Blushing is a physiological response unique to humans and is a hallmark physiological
response associated with social anxiety. Blushing is the involuntary reddening of the
face, neck, and chest in reaction to evaluation or social attention. Blushing occurs not
only in response to feelings of embarrassment but also other socially-oriented emotions
such as shame, guilt, shyness, and pride. Individuals high in social anxiety perceive
themselves as blushing more than those who are low in social anxiety. Three types of
blushing can be measured: self-perceived blushing (how much the individual believes
he or she is blushing), physiological blushing (blushing as measured by physiological
indices), and observed blushing (blushing observed by others). Social anxiety is
strongly associated with self-perceived blushing, weakly associated with blushing as
measured by physiological indices such as temperature and blood flow to the cheeks
and forehead, and moderately associated with observed blushing. The relationship
between physiological blushing and self-perceived blushing is small among those high
in social anxiety, indicating that individuals with high social anxiety may overestimate
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