It is thought that in the Western world, 7% of the population suffer from social anxiety disorder at any given time, and that 13% experience it during their lifetime. More common in girls, social anxiety usually first manifests in adolescence and early adulthood.

Like other phenomena, social anxiety is probably multidetermined, the result of various factors. Factors to consider include: environmental and familial factors, adverse experiences in childhood, and genetics. Parenting and the existence of parental pathology influence the mental health of the child.

Risk factors include parental traits and child-rearing practices such as parental control and overprotectiveness (which may deprive the child of opportunities to learn how to cope with certain situations), anxious parenting, cross-generational attachment difficulties, behavioral rigidity, lack of warmth, neglect and rejection, criticism and shame.

Some brain imaging patterns have been found to correlate with social anxiety and anxiety in general. Specifically, two areas in the brain have been singled out: the amygdala, a part of the limbic system involved in processing emotions, including fear, and the insula, which controls autonomic functions through the regulation of the sympathetic and parasympathetic systems, also having a role in regulating the immune system. These two areas work in concert with other systems and areas.

When, during the course of the critical developmental years, the child’s autonomous nervous system experiences overwhelm (e.g., not enough resources are available to process certain experiences), social anxiety may ensue.

Often, such a diagnosis is made in conjunction with another anxiety disorder (e.g., panic disorder) and/or a depressive disorder. Self-medication via recourse to alcohol and/or other substances may occur. While this may initially bring about short term relief, long term relief is best sought via professional treatment (whether CBT or another form of psychotherapy, or medication).