title: Fear and avoidance of eye contact in social anxiety disorder.
abstract: BACKGROUND
  Excessive fear of scrutiny is a defining feature of social anxiety disorder. Eye contact may trigger feelings of being scrutinized, and although eye contact is commonly feared in persons with social anxiety disorder, it has been studied little. The purpose of this study was to characterize fear and avoidance of eye contact in patients with social anxiety disorder and in nonpatient samples.
  
  
  METHODS
  Gaze fears and avoidance, social anxiety, and depression were assessed in 44 patients with generalized social anxiety disorder, 17 matched healthy comparison subjects, and 79 undergraduates. Patients were reassessed after 8 to 12 weeks of treatment with paroxetine. A new self-report instrument, the Gaze Anxiety Rating Scale (GARS), was used to assess fear and avoidance of eye contact, and its psychometric properties were analyzed.
  
  
  RESULTS
  Patients with generalized social anxiety disorder, in comparison with healthy control participants, reported significantly increased levels of fear and avoidance of eye contact, which decreased significantly after 8 to 12 weeks of treatment with paroxetine. Fear and avoidance of eye contact were significantly associated with severity of social anxiety in all 3 samples. The GARS demonstrated excellent internal consistency within each sample.
  
  
  CONCLUSIONS
  Self-reported fear and avoidance of eye contact are associated with social anxiety in both nonpatient and social anxiety disorder samples. Preliminary psychometric analyses suggest that the GARS has utility in the assessment of gaze anxiety.
authors.affiliation: Anxiety Disorders Clinic, New York State Psychiatric Institute, New York, NY 10032, USA. frs1@columbia.edu
authors.forename: Franklin R
authors.initials: FR
authors.lastname: Schneier
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Rodebaugh
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.forename: Hillary
authors.initials: H
authors.lastname: Lewin
authors.forename: Michael R
authors.initials: MR
authors.lastname: Liebowitz
mesh_terms: D016009:Chi-Square Distribution; D003863:Depression / Q000523:psychology; D005239:Fear / Q000523:psychology*; D005260:Female; D005403:Fixation, Ocular; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012919:Social Behavior; D055815:Young Adult