Social anxiety (phobia) and East Asian culture

Lifetime comorbidities between phobic disorders and major depression in Japan: results from the World Mental Health Japan 2002–2004 Survey

“…Because interpersonal relationships are well-known risk factors of depression [Garber, 2006; Rudolph et al, 2000], this presumed greater social impairment could then lead to higher risk of secondary MDD in Japan . In a collectivism-oriented society which value social harmony, people are not required to show their contribution (e.g., expressing their ideas and opinions or doing good things) to groups [Heinrichs et al, 2006], such as the neighborhoods and workplaces to which they belong; rather, people are strongly expected to join in group activities to show their commitment and maintain group collectivism [Chang, 1997; Nakane, 1970]. Social phobia may interfere with people going to a group activity, which could result in low social support from group members and less of a feeling of belonging in the society, or even difficulty in finding a spouse/partner, which may lead to a greater risk of major depression in the long run.…”

Taijin kyofusho: a form of social anxiety disorder that responds to serotonin reuptake inhibitors?

“…The finding that TKS patients treated with SRIs invariably met modified SAD criteria supports the contention that both disorders are typified by fears that some action or appearance will be judged inappropriate by observers and associated avoidance of social interactions and performances (Kleinknecht et al, 1997) ; but whereas patients with SAD typically worry about embarrassing themselves, patients with TKS often worry about offending or embarrassing others (Kleinknecht et al, 1994). Such differences between SAD and TKS have been argued to reflect important cultural differences between West and East, particularly the value given to the group over the individual in traditional Asian thought (Chang, 1997 ;Kleinknecht et al, 1997). An interesting aspect of the data here is the finding that some TKS patients lose insight into their symptoms, with 15 % of subjects having met diagnostic criteria for delusional disorder, somatic subtype.…”

“…TKS has traditionally been considered closely related to a high level of interpersonal sensitivity, perceived as a cultural characteristic of Eastern societies (Chang, 1997 ;Kleinknecht et al, 1997 ;Takahashi, 1989) and so has also been categorized as a ' culture-bound disorder '. It is, for example, included in the DSM-IV glossary of culturebound syndromes.…”

Two‐phase survey to determine social anxiety and gender differences in Omani adolescents

“…Cultural factors influencing social phobia have been of particular interest to researchers worldwide (Okano, ; AlKhodair and Freeman, ; Chang, ; Heimberg et al ., ; Kitanishi et al ., ; Abdel‐Khalek and Al‐Damaty, ). Although studies from developing countries have generally shown a low prevalence of SAD (McIlvenny et al ., ; Ono et al ., ), in East Asia reports have revealed a social anxiety‐like condition marked with fear of distress, and even fear of harming others (Chang, ). There is some indication that the manifestation of social phobia is strongly linked to socio‐cultural factors.…”

“…In the West, the onset of social phobia is reported in the majority of cases before the age of 18 (Otto et al, 2001). Cultural factors influencing social phobia have been of particular interest to researchers worldwide (Okano, 1994;AlKhodair and Freeman, 1997;Chang, 1997;Heimberg et al, 1997;Kitanishi et al, 2002;Abdel-Khalek and Al-Damaty, 2003). Although studies from developing countries have generally shown a low prevalence of SAD (McIlvenny et al, 2000;Ono et al, 2002), in East Asia reports have revealed a social anxiety-like condition marked with fear of distress, and even fear of harming others (Chang, 1997).…”