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Study: Teen shyness or anxiety disorder?

WASHINGTON -- Does your teen show normal nerves about the weekend party, or always stay home? Nearly half of teenagers say they're shy, perhaps a bit surprising in our say-anything society.

But a government study finds that a small fraction show signs of a troubling anxiety disorder that can be mistaken for extreme shyness. The report challenges criticism that the terms "social phobia" or "social anxiety disorder" medicalize normal shyness.

"Shyness is a normal human temperament," says lead researcher Kathleen Merikangas of the National Institute of Mental Health, whose teachers noted her own childhood shyness on her report cards.

But just as it can be hard to tell when feeling sad turns into depression, "there is a blurred boundary between people who describe themselves as shy and clinically significant impairment," Merikangas adds. The difference: The shy can be drawn out and can adapt, while teens or adults with full-fledged social anxiety become so paralyzed during social situations that it interferes with daily functioning.

"I didn't go out on dates or do any of the things that other kids did," recalls Cynthia Kipp, 48, of Tehachapi, Calif., who shared her story with the Anxiety Disorders Association of America. Her first symptoms began in fourth grade, when she hid under her coat in class. In high school she tried drugs and alcohol for relief. Eventually she found treatment that worked.

The report opens a window into the broader field of temperament research. The study, published by the journal Pediatrics, is based on surveys of 10,000 teens about a variety of mental health issues. More than 6,000 parents were surveyed, too.