What causes SAD?

Many patients with SAD are able to identify a specific negative social experience that initiated or exacerbated the onset of their SAD e.g. “drying up” (speech block) when giving a talk.  Patients may also have been seriously affected by repetitive, less dramatic experiences (e.g. teasing by peers because they blush) that may eventually lead to social anxiety and avoidance.

Watching the fearful reaction of another person, such as a parent, or seeing someone undergo a traumatic social experience, may lead someone to acquire the same fear in response to that specific situation.

Certain cognitive processes and behaviours may be factors in SAD.  Experiencing anxiety in anticipation of a feared situation may be related to a tendency to overestimate the possibility of a negative experience and underestimate the chances of a positive one. 

This negativity can be seen in the tendency to be extra vigilant for signs of threat and to interpret ambiguous responses as negative rather than potentially positive.