How do different cultures experience social anxiety disorder?

As we all know, there are cultural differences in social anxiety. Research tells us that the way social anxiety disorder (SAD) manifests may vary depending on where you live and the culture you grew up in.

This makes sense, because different cultures have different social rules and expectations. What is considered “normal” in the United States may be opposed in Japan, and vice versa. In addition, research has shown that there are differences in the prevalence of SAD in different cultures.​​

Prevalence

The results of the National Comorbidity Survey and the National Comorbidity Survey Replica (NCS-R) show that different cultural groups have different rates of social anxiety. Generally speaking, social anxiety is less common in East Asian countries.

  • The survey results show that the 12-month prevalence rate in the United States is 7.1% to 7.9%, while that in Taiwan is 0.4%.
  • The prevalence in South American countries is similar to that in the United States, while the prevalence rates in South Korea, China, and Japan are 0.6%, 0.2%, and 0.8%, respectively.
  • The results of the epidemiological survey also show that Russia has a high prevalence rate
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A culture of increased risk

A national epidemiological survey of more than 40,000 people from 2001 to 2002 showed that Native Americans, young people, and low-income people have an increased risk of social anxiety disorder.

On the other hand, the following people have a lower risk of SAD:

  • male
  • Asian
  • Spanish
  • Black person
  • People living in urban areas

How culture affects diagnosis

In addition to differences in social anxiety that come directly from different cultures, research shows that the way mental health professionals diagnose social anxiety disorder may vary from culture to culture.In some cultures, there are even specific types of disorders similar to social anxiety disorder.

For example, in Japan and South Korea, there is Taijin Kyofusho (TKS), which refers to fear of being observed or offending others. People with TKS usually avoid extensive social situations.

People with SAD are afraid of embarrassing themselves, while people with TKS are afraid of embarrassing others (also known as heterocentric focus).

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There are often more men than women with TKS, and those with problems usually have only one fear. Although this may sound unusual to people from North America, it is because of cultural differences.

Difference in response to treatment

There is no research evidence to support differences in people’s response to SAD treatment in different cultures. However, research shows that Asians in North America tend to delay treatment more than people of other cultures.

Cultural expression of social anxiety

Generally speaking, many aspects of culture may affect the expression of social anxiety.

For example, the degree of individualism (an individual-centered focus) and collectivist orientation (a dissident-centered focus) may be important.

Collectivist societies tend to be more receptive to social silence, which makes sense in the context of the lower incidence of SAD in Asian countries.

In addition, people living in an individualistic culture will show social anxiety in terms of self-blame, while people living in a collectivist culture will feel more shame. A study of Chinese people’s social anxiety revealed a unique symptom: the fear of making others uncomfortable or affecting them in an unhelpful way.

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Very good sentence

In general, social fear depends on the cultural background in which you live. If you are being evaluated for social anxiety disorder, it is important that your mental health professional will make a diagnosis based on your cultural and social background.

What might be considered socially appropriate in Japan would not be in the United States. You should always consider your culture to assess social anxiety.

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