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Comfort levels in social situations will depend on personality traits, life experiences, and can vary significantly, as some young people are naturally reserved, and others are more outgoing. Social anxiety disorder (SAD), also known as social phobia, is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic mental health condition that extends beyond typical shyness. In contrast to everyday nervousness, the defining feature of social anxiety disorder is extreme anxiety or fear of being judged, negatively evaluated, or rejected in one or more social or performance situation. Social anxiety disorder is not uncommon and is estimated to affect 9.1% of adolescents in America.

SUDs Rating Scale

The SUDs Rating Scale, otherwise known as the Subjective Units of Distress Scale (SUDs), is a self-assessment tool used to measure the intensity of distress in people with social anxiety, and can be used with people of all ages. SUDs ratings is a self-report measure that requires both child and adult clients to indicate their level of anxiety on a scale ranging from “no distress” to “extreme distress.” While the original version relies on a scale ranging from 0 to 100 (0 indicating complete relaxation and 100 signifying the most severe distress imaginable), to simplify the rating system and ease decision making the use of a smaller scale range (e.g., 0 to 10) with personalized anchors (e.g., 0 denoting not at all scary, and 10 being the scariest) for children is often implemented. 

To more clearly explain the SUDs rating system to children, it is not uncommon to rely on a visual analogue scale such as a feelings thermometer. Each item included asks the child to consider thoughts, feelings, and behaviors that they may have had about social situations (e.g., public speaking, attending social events or parties, introducing yourself to others, having conversations, giving, and receiving compliments, making requests of others, eating in public, etc.) in the past 7 days. Each item on the measure is rated by the child, and the scoring is based on the sum of the answers where, regardless of the scale range, higher scores indicate greater severity. This tool is often used with children upon receiving a diagnosis of social anxiety disorder (or clinically significant social anxiety symptoms) and thereafter, to gauge the severity of one’s symptoms and track progress throughout treatment. 

Further Information and Support

For most of us, life can be very stressful, leading us to feel emotionally charged, which can cause anxiety, panic attacks, depression, and getting stuck in a cycle of being burdened with negative thoughts. Navigating through the challenges and emotional turmoil of life can be overwhelming, but you do not have to go through it alone. Engage Treatment is a Joint Commission Accredited professional psychological practice. We specialize in treating children, teens, and young adults struggling with depression and anxiety through community-focused treatment plans that incorporate a carefully selected combination of therapeutic interventions. Our compassionate, multidisciplinary practitioners are devoted to providing the highest quality of care that helps ignite positive change and enables clients to reach optimal health and well-being. Please do not hesitate to reach out for guidance. We are happy to answer questions and provide you with any additional information. Feel free to call us at 805-497-0605 or email us at [email protected]. You are also welcomed to get in touch by filling out our contact form. We look forward to connecting and having the opportunity to discuss how we might best be able to support you.

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