RESPONSES OF GENERALIZED AND DISCRETE SOCIAL PHOBICS DURING PUBLIC SPEAKING

Thirty-six patients meeting DSM-IIIR social phobia criteria (28 ''generalized,'' 8 ''discrete'') and 14 controls were monitored during a 10-minute simulated speech. Both patient groups reported less overall confidence in public speaking than controls. Generalized social phobic patients also exceeded controls in both subjective and manifest anxiety during the simulated speech. Discrete social phobic patients exceeded controls in anticipatory anxiety prior to the speaking challenge and in heart rate prior to and during the challenge. Generalized patients exceeded discrete social phobic patients in lack of confidence in public speaking and in subjective anxiety during the speech, but discrete patients exceeded generalized in heart rate elevation before and during the speech. The results underline the necessity of subtyping social phobia during psychobiological study, and suggest mechanisms by which symptoms are mediated in the two subtypes.