Objective: To demonstrate the prevalence of social phobia and its relation to body image and self-esteem.
Method: Study participants were 1003 students recruited from Cumhuriyet University as a randomized sample. Subjects were administered the Diagnostic Interview Schedule-III-Revised (DIS-III-R) Social Phobia Scale, the Rosenberg Self-Esteem Scale, and the Multidimensional Body-Self Relations Questionnaire (MBSRQ). We analyzed the data, using Fisher's exact chi-square test.
Results: Lifetime prevalence of social phobia among university students was 9.6% and past-year prevalence was 7.9%. Self-esteem was lower (P < 0.05) among those with social phobia than among those without social phobia. Students with social phobia had lower scores on the MBSRQ than did those without social phobia (P < 0.0001).
Conclusions: The results show that persons with social phobia have lower self-esteem and more distorted body image than do those without social phobia.
(Can J Psychiatry 2004;49:630-634)
Information on author affiliations appears at the end of the article.
* Physical appearance affects a person's body image and mental image, which is particularly important in cognitive therapy.
* Disturbed body image and low self-esteem are important factors to consider when treating patients with social phobia.
* It is important that patients with social phobia develop a positive change in their self-imagination for successful psychological therapy.
* This study does not represent the general population.
* This study does not represent the changes in outpatients' body image and self-esteem before and after therapy.
Key Words: social phobia, self-esteem, body image, Rosenberg Self-Esteem Scale, Multidimensional Body-Self Relations Questionnaire, Diagnostic Interview Schedule-III-Revised, DSM-III-R
There has been a recent increase in interest regarding social phobia because of higher-than-expected incidences of social phobia, and because social phobia leads to disrupted relationships, severe anxiety, depression, substance abuse, and loss of natural faculties at an important level in patients (1). Until recently, the concept of self-esteem in psychiatry literature, in broadest terms, has been a judgement that shows "how a person values him/herself (2). Rosenberg examined adolescents to determine whether the orientation of a person was of positive or negative value to their self-esteem. Individuals with a positive internal orientation were found to have high self-esteem while those with a negative internal orientation were found to have low self-esteem (3).
Body image is most simply defined as the mental image that we have formed concerning how we see our physical self. Sensations from both outside and within our bodies teach us the totality of our bodies (4).
A specific meaning is given to the perception of one's own physical body and the body's individual parts, which is closely related to self-confidence, self-respect, self-image, and identity. Moreover, individuals with a positive and realistically defined body image are more secure in their interpersonal relationships and are more successful in their jobs. These individuals' attitudes and behaviours are also healthier and more realistic (4).
According to the cognitive and emotive models of social phobia, negative expectations that patients with social phobia develop about social situations form the foundation for social phobia. Typically, patients' fear negative social performance, negative evaluation by others, and uncontrollable anxiety (5).
It has been reported that body image affects self-perception and negative thinking among persons with social phobia and that a negative and distorted self-image plays an important role in fostering social phobia (6).
Material and Methods
Subjects were selected from among students enrolled in university programs on the Cumhuriyet University campus. …