OBSERVATIONS
1. General Appearance & Behaviour
• The subject appeared neat, well-groomed, and appropriately dressed for the interview.
• Initially showed mild physical signs of anxiety such as fidgeting with fingers and avoiding
direct eye contact.
• Body posture was slightly tense at the beginning but relaxed gradually as rapport improved.
2. Emotional State
• Displayed heightened emotional sensitivity while discussing childhood teasing and parental
criticism.
• Signs of internal distress observed when recalling exam pressure—voice softened, shoulders
tightened.
• Demonstrated improvement in emotional regulation when talking about coping strategies like
meditation.
3. Social Behaviour & Interaction
• Showed hesitation before answering certain personal questions, indicating fear of judgment.
• Reported tendency to avoid social gatherings during childhood and early adolescence.
• A pattern of self-consciousness was evident in her verbal responses and body language.
• Presented warmth, openness, and improved sociability once comfortable.
4. Speech & Communication
• Speech was clear, coherent, and logical, but initially low in volume.
• Occasional pauses were noted before discussing emotionally sensitive topics.
• Increased fluency and confidence were observed as interview progressed.
5. Cognitive Patterns
• Shows tendency toward overthinking, especially in evaluative situations.
• Recurrent worry thoughts noted: fear of judgment, fear of failure, catastrophizing exam
outcomes.
• Exhibits reflective insight—able to identify triggers, early patterns, and coping mechanisms
effectively.
6. Physical Symptoms
• Rapid heartbeat, trembling, sweating during stressful social situations.
• Insomnia and breathlessness during peak exam stress levels.
• History of physical manifestations: pacing, hyperventilation.
7. Interpersonal Relationships
• Maintains strong emotional bonds with family.
• Prefers selective friendships.
• Avoided large gatherings earlier but improved over time.
8. Academic Behaviour
• Highly diligent but overly self-critical.
• Academic pressure resulted in anxiety, reduced sleep, physical symptoms.
9. Psychological Indicators
• Clear SAD signs: fear of judgment, avoidance, self-consciousness, physical anxiety
symptoms.
• Clear exam anxiety signs: worry, insomnia, trembling, cognitive blanking.
DIAGNOSTIC SUMMARY
Name of Subject: Jiah Dhawan
Age: 18 years
Class: XII (Bio-Maths)
Presenting Concerns: Fear of negative evaluation, social withdrawal, excessive worry about
exams, sleeplessness, trembling, breathlessness.
1. Social Anxiety Disorder (Childhood Onset)
Symptoms:
• Extreme self-consciousness
• Avoidance of meeting/greeting others
• Fear of being judged
• Shyness and withdrawal
• Trembling, sweating, rapid heartbeat
Duration: Since middle childhood
Impact: Peer relations, classroom participation
2. Test/Exam Anxiety (Adolescent Onset)
Symptoms:
• Intense fear before exams
• Insomnia
• Breathlessness, pacing, chest tightness
• Blanking out during tests
• Excessive worry about results
Impact: Reduced academic confidence, distress
3. Probable Causes
• Childhood teasing
• Overcritical parental expectations
• Excessive monitoring during puberty
• Academic pressure, fear of failure
• Perfectionism, overthinking
• Lack of autonomy in career choice
4. Strengths
• High insight and awareness
• Strong support system
• Willingness to seek help
• Good academic diligence
• Effective coping via meditation
5. Prognosis
• Good due to early identification, motivation, support system, coping skills.
ANALYSIS
Social anxiety disorder is a common anxiety disorder involving fear in social situations such as
meeting new people, interviews, classroom answering, or public interaction. People fear
humiliation, judgment, or embarrassment.
The fear often becomes uncontrollable, interfering with daily functioning such as attending
school or socializing. Many may avoid events entirely.
Some individuals experience performance anxiety only, such as stage fear or sports pressure.
Symptoms typically begin in youth among shy individuals. SAD affects ~7% of the population
and may persist lifelong without treatment.
It can severely limit opportunities, emotional growth, and academic performance.
SOCIAL ANXIETY DISORDER DETAILS
Social anxiety disorder often begins in childhood or early adolescence. It typically arises when
individuals misinterpret social cues, overestimate negative evaluation, or fear humiliation.
Without treatment, it can persist and undermine a person's educational, occupational, and
social potential.
It may also co-occur with depression, generalized anxiety, or selective mutism in younger
individuals.
SIGNS AND SYMPTOMS
• Blushing, sweating, trembling
• Rapid heartbeat, mind going blank
• Nausea or stomach discomfort
• Rigid posture, minimal eye contact, soft voice
• Fear of speaking, performing, or interacting
• Intense self-consciousness
• Fear of judgment, embarrassment
• Avoidance of social places and interactions
CAUSES
• Genetic factors—runs in families
• Brain regions associated with fear regulation involved
• Misinterpretation of neutral social cues
• Underdeveloped social skills leading to discouragement
• Stressful or traumatic social experiences
• Environmental pressures and expectations
Biological, psychological, and social factors together contribute to development of SAD.
TREATMENT
• Psychotherapy (especially Cognitive Behavioural Therapy)
• Exposure therapy
• Relaxation training
• Meditation and breathing exercises
• Medication (SSRIs or anti-anxiety medication if required)
• Lifestyle changes: adequate sleep, reduced caffeine, exercise
• Building social skills and confidence
• Identifying and reframing maladaptive thoughts
TEST ANXIETY
Test anxiety is intense distress before or during exams. It impairs learning, focus, and
academic performance.
Effects:
• Difficulty recalling information
• Difficulty concentrating
• Over-arousal leading to mistakes
• Physical symptoms (nausea, rapid heartbeat)
Examples:
• Athlete missing easy shots due to overpressure
• Music student missing notes in a recital
• Professional freezing during a presentation
Yerkes-Dodson law: Moderate stress improves performance; excessive stress reduces it.
Treatment:
• CBT
• Study strategies
• Relaxation and breathing
• Counselling
• Medication in severe cases
• Time management and self-confidence training