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Social anxiety

Summary

Social anxiety disorder is a condition where a person has an intense fear of being judged or rejected by others in social or performance situations. This fear can be overwhelming, making it difficult to participate in everyday activities such as school, work, or social gatherings. People with social anxiety disorder often worry about being negatively evaluated by others, which can lead to avoiding social situations entirely. This condition is one of the most common mental health disorders and can greatly affect a person’s quality of life, relationships, and performance in various areas of life. It is often associated with other conditions, such as anxiety, depression, and substance use disorders.

Diagnosis and When to Seek Help

If someone is constantly worried about being judged or rejected in social situations, and this fear leads to avoiding interactions or feeling extremely uncomfortable, it may be social anxiety disorder. It’s important to seek help if these symptoms interfere with daily activities or cause distress. A doctor can diagnose the condition through a combination of self-reports, clinical interviews, and behavioral observations.

Management

Effective treatments for social anxiety disorder include:

  • Medications: Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) can help reduce anxiety and improve functioning.
  • Cognitive Behavioral Therapy (CBT): This therapy focuses on changing negative thoughts and behaviors related to social situations. It can help people gradually confront their fears in a safe, controlled way.

Follow-Up and Monitoring

Social anxiety disorder often requires long-term management. Even after initial treatment, continued follow-up with a healthcare provider is necessary to monitor progress, manage any setbacks, and adjust treatment as needed. Since relapse can happen when treatment ends, ongoing care helps reduce the risk of returning symptoms. 

History and Exam

Key diagnostic factor

  • Presence of risk factors

  • Anticipatory anxiety and worry

  • Tachycardia

  • Hyperventilation

Other diagnostic factors

  • Post-event processing

  • Attentional biases

  • Social skills deficits

  • Crying, tantrums, or ‘freezing’

Risk factors

  • Psychiatric comorbidity (e.g., anxiety, mood, and substance-use disorders)

  • Genetic

  • Temperamental factors

  • Parenting style

Diagnostic Investigations

1st investigations to order

  • Clinical diagnosis

Investigations to consider

  • Blood glucose

  • Serum thyroid-stimulating hormone

  • Toxicology screen (urine and blood)

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com