Prevalence of Social Phobia among Medical Students at Syrian Private University

doi:10.21203/rs.3.rs-1987600/v1

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Prevalence of Social Phobia among Medical Students at Syrian Private University

https://doi.org/10.21203/rs.3.rs-1987600/v1

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Introduction:

Social anxiety disorder (SAD), also called social phobia, is an uncontrollable fear of social situations, which involve fear of observation or making contact with strangers. So, helping individuals with social anxiety, which is among the factors affecting mental health, can significantly influence a students’ mental health and prevent other problems.

Methods:

A cross- sectional study was conducted using a convenience sampling method among medicine college students at the Syrian Private University (SPU). Using the Liebowitz Social Anxiety Scale Test (LSAS) students were tested for possible social anxiety disorders and divided into four subcategories. Chi- square test was applied to assess the relationship between social phobia and socio- demographic variables. (p < 0.05) was adopted as statistical significance.

Results:

A total of 492 medicine college students participated in this study, 52% were males, and 48% were females. Most of the students were at their final years of study. 65% studied at private schools, and 62.6% at unmerged schools. 62.6% were non-smokers and 66.7% were from good economic background. The prevalence of possible social phobia was 49.6%, of them 28.5% moderate social phobia, 14.6% marked social phobia, 4.1% severe social phobia, and 2.4% very severe social phobia. Socio- demographic factors and previous mental trauma were significantly associated with social phobia.

Conclusion:

Social phobia is prevalent among the sampled population, and different associated factors were identified. Current results could raise the awareness of faculty members and healthcare providers towards early detection and management of these cases.

Psychiatry

Social

Phobia

Anxiety

University students

Social anxiety is an excessive fear of embarrassment or rejection by others. People can openly express their feelings, such as worry and anger toward another person. It is one of the psychological disorders that were classified among the phobic avoidance anxiety disorders [1] and it is considered an important and vital variable in the psychological and social adjustment process for students, as it falls within the social fears of the person, living in a state of isolation and fear of people, which negatively affects the person's self-confidence and his social relationships. It also shows avoidance of social situations by the individual before entering into social situations [2], but he may find himself compelled to deliver a speech in front of a crowd of people where he is afraid of failure or thinking about the possibility of making a mistake while speaking in front of them, or confusion from the looks of others who are inside the social situation and knows Public anxiety is part of social anxiety [3], and these emotional feelings are associated with physiological symptoms such as dry mouth, trembling, heart palpitations and trembling hands [4].

This study was conducted on university students because the youth stage [5] is a vital and crucial stage in the life of the individual in which he goes through many problems and pressures and attempts to identify his identity and take responsibility and is linked to psychological pressures and emotional feelings, including anxiety arising from social relations. Studies have indicated that the biggest problems facing young people of both types, social anxiety is [6] as a pathological phenomenon that has become clearly defined, with its prevalence among young people (14 − 7%), where social phobia is the third most common mental illness after depression and alcohol addiction [7].

University students are considered the elite of any society that seeks progress,[8] as they are the youth group on whom the society depends, and they represent an important element and a strong pillar in its growth and development. It is striking that the manifestations of social anxiety became evident among university students in situations that require them to perform [3], initiative, discussion and dialogue in the classroom, which leads to their confusion and avoidance of many social situations that require skills of confrontation, communication, speaking and social integration. If the student avoids the situation that puts him in the face of a group, this results in poor achievement performance, which further complicates the matter and increases the difficulty of continuing his scientific and practical career. Social anxiety becomes an obstacle to the individual’s progress in his normal life.

Several studies have also indicated a high prevalence of social phobia among medical students [9] It helps medical students suffer from mental illnesses, especially depression and anxiety, is that the doctors’ society is in which there is intense competition between doctors, [9] and a desire for excellence, which puts students in particular under severe psychological pressure, as the pressure of scientific material and time for study takes most of the student’s daily time, making him in Somewhat isolated from his family and relatives, and this is the fact that makes him under a kind of pressure to meet all the requirements, whether academic, which constitute the largest or social part of them [9]. Assistance in treating a person one day, and this point makes him under greater and greater pressure in order to obtain information, and these pressures may affect the student, sometimes they may have a positive impact and give a moral boost to diligence and distinguished educational achievement, and often may affect him negatively as a result of social isolation, which results in academic failure [10]

The objectives of this study were: (1): Assessing the prevalence and degree of social phobia among medical students at the Syrian Private University. (2): Evaluating the relationship between social phobia and demographic factors of the sample. (3): Evaluating the relationship between social phobia and previous exposure to psychological trauma.

Study preparation, participants

This cross-sectional study was conducted in March 2022 using the appropriate sampling pattern on a sample of students of the Faculty of Human Medicine at the Syrian Private University. Participants were asked to participate voluntarily, and written informed consent was obtained from all participants. The inclusion criteria included age 18 years and over. The sample size 340 was calculated based on a margin of error of 5% and a confidence factor of 95%, for a population of 1,200 medical students using the sample size calculator. Ethical approval was obtained from the Institutional Review Board (IRB), Faculty of Human Medicine, Syrian Private University.

Study tools

A self-filling questionnaire was used in Arabic language, and this survey was adopted from previously published studies in the appendix. The validity and reliability were checked by measuring Cronbach's α-Cronbach to verify the stability of the study tool, and the reliability was estimated at (0.83).

The questionnaire includes two parts:

1- Socio-demographic information: including questions about gender, school year, cumulative average, place of residence, school status prior to entering university, number and upbringing of siblings, smoking status, economic status, and questions about parents’ family status, academic status, and personality type.

2- Social Anxiety Disorder Scale: The Arabic version of the Liebowitz Social Anxiety Scale Test (LSAS) was used to detect social phobia among participants.

Statistical analysis:

The statistical study was conducted using SPSS software. The demographic characteristics were described, and the sample distribution according to the study variables was described. Fear of social contact is rated on a four-point scale (0–3), with 0 = no anxiety, one = little anxiety, two = moderate anxiety, and three = severe anxiety. The response to avoidance or avoidance and distancing in social situations was also evaluated on a four-point scale (0–3), where: zero = never, one = sometimes, two = often, and three = always. To determine the severity of social phobia, scores were combined: no social phobia ≤ 54, moderate social phobia = 55–65, marked social phobia = 66–80, severe social phobia = 81–95, very severe social phobia ≥ 96. The Chi-Square independence test was also used to test the independence of qualitative variables, and correlation tests according to the Krams coefficient to study the relationship between qualitative variables, and the Spearman coefficient to study the relationship between quantitative variables. A value of (p < 0.05) was adopted as a statistical significance.

The demographic characteristics of the sample:

Out of 492 students from the Syrian Private University who participated in the questionnaire, 52% were males, compared to 48% were females. Most of the students were in their last five and sixth years of schooling, with the same percentage of 19.5%. And 40.7% of the students had a good GPA of 2.25–2.74. The majority of students studied in private schools (65%) and in non-mixed schools (62.6%). The majority had three brothers (32.5%), and most of them were ranked in the middle among their brothers 44.7%. Most of the students were 62.6% non-smokers, and 66.7% had good economic standards. The students described their father's personality as permissive 26.8%, normal 56.9%, and authoritarian 16.3%. The mother's personality was permissive 30.9%, normal 60.2%, and authoritarian 8.9%. (Table. 1)

Exposure to psychological trauma:

48% of the students reported having experienced a psychological trauma less than 6 months ago, of whom 29.3% have experienced more than two traumas, and 16.3% have experienced one or two traumas with the same percentage. And 32.5% stated that the shock was related to the current crisis in the country, compared to 67.5% whose shocks were not related to trauma.

Assessment of the presence of fear and anxiety in social situations:

The participating students reported fear and anxiety in several social situations as follows:

Whereas, the following social situations significantly caused little anxiety such as: talking on the mobile phone in public 26.8%, engaging in small group discussion 32.5%, eating in public 26.8%, smoking a hookah or drinking in front of others 21.1%, talking to people in power 41.5% Speaking in front of a group of people 39% Going to parties you are invited to 28.5% Doing things while others are watching you 43.1% Writing while others are watching 30.9% Contacting someone you don't know well 43.1% Chatting with people You don't know them well 39% Meeting strangers 34.1% Entering rooms where others are present (such as a doctor's waiting room) 35.8% Being the center of attention (Lecture or tell a story in front of others) 43.1% Speaking in a meeting or during clinical interviews 42.3% Taking a theory exam 39.9% Expressing your disagreement in front of people you don't know 43.9% Looking into the eyes of people you don't know well 30.9% Reporting to a group 49.6%, trying to make friends 35.8%, returning goods to the store if you don't like it 40.7%, doing a party 29.3%, resisting seller pressure when trying to sell you unconvinced merchandise 29.3%. (Table. 2)

While 26.8% reported moderate anxiety when using public restrooms.

Assessment of reaction as avoidance, avoidance, or distancing in social situations:

The participating students reported the reaction, such as evasion, avoidance, or turning away in several social situations, as follows:

Whereas, the following social situations significantly caused little anxiety, such as: talking on the mobile phone in public 30.1%, engaging in small group discussion 42.3%, eating in public 29.3%, smoking a hookah or drinking in front of others 27.6%, talking with individuals Powerful 48% Speaking in front of a group of people 40.7% Going to parties you are invited to 35% Doing things while others are watching you 51.2% Writing while others are watching 30.9% Contacting someone you don't know well 42.3% Chatting with people You don't know them well 45.5% Meeting strangers 42.3% Entering rooms where others are present (such as the doctor's waiting room) 35.8% Being the center of attention (Lecture or tell a story in front of others) 40.7% Speaking in a meeting or during clinical interviews 44.7% Taking a theory exam 31.7% Expressing your disagreement in front of people you don't know 39% Looking into the eyes of people you don't know well 38.2% Reporting to a group 43.1% Trying to make friends 39.8% Returning merchandise to the store if you don't like it 40.7% Throwing a party 33.3% Resisting seller pressure when trying to sell you unconvinced merchandise 37.4%. (Table. 3)

Social Anxiety Disorder Scale Scores:

The mean score for the Social Anxiety Disorder Scale was 49.2 with a standard deviation of 27.1. The prevalence of social anxiety disorder was 49.6%, of whom 28.5% had moderate social anxiety, 14.6% had significant social anxiety, 4.1% had severe social anxiety, and 2.4% had very severe social anxiety.

Studying the relationship between the social anxiety disorder scale and sociodemographic factors:

When studying the relationship between the social anxiety disorder scale and social factors, the results showed a statistically significant relationship between them as follows:

The female gender 63.9% showed a significant association with the presence of social anxiety disorder compared to the male gender 36.1%. (P < 0.001)

Also, students who reside in the city (75.4%) showed a significant association with the presence of social anxiety disorder compared to those who reside in the countryside (24.6%). (P < 0.001)

Most of the students who attended non-coeducational schools 77% had a significant association with the presence of social anxiety disorder versus those who attended coeducational schools 23%. (P < 0.001)

Also, students who studied in public schools showed a significant association with the presence of social anxiety disorder compared to those who studied in private schools 44.3%. (P < 0.001)

Students with 3 siblings also had a significant association with having and having social anxiety disorder 39.3%. (P < 0.001).

Most of the students who were non-smokers, 73.8%, had a significant association with having and having social anxiety disorder. (P < 0.001).

Most of the students with good economic standards had a significant association with having and having social anxiety disorder. (P < 0.05).

Most students who had both college-level parents did not suffer from social anxiety disorder. (P < 0.001).

Most of the students whose mothers worked as a housewife did not significantly suffer from social anxiety disorder. (P < 0.001). (Table. 4)

Studying the relationship between social anxiety disorder scale and exposure to psychological trauma:

When studying the relationship between the social anxiety disorder scale and exposure to psychological trauma, the results showed a statistically significant relationship between them. Most of those who were exposed to psychological trauma less than 6 months ago were significantly present with social anxiety disorder 57.4% compared to 42.6% of those who were not exposed to trauma. (P < 0.001). Students who had experienced more than two traumas had a significant association with having social anxiety disorder (41%). (P < 0.001).

The study aimed to determine the level of social phobia among medical students at the Syrian Private University and the factors affecting its occurrence. The percentage was 49.6%, which is almost double the rate of social anxiety disorder in a previous report at 21.8% [12] at the Syrian Private University. While the prevalence rate in many international studies ranged between 9.3% [16] in the Arab Republic of Egypt to 51% in a recent report conducted in the Kingdom of Saudi Arabia [11,15], while the Saudi study conducted at Jazan University [19] found that their social phobia rate was 25.8 In a similar study conducted at a Turkish university, the prevalence of phobia was 20.9% [18,17], and in another study conducted at a university in Sweden [20], the prevalence of phobia was 16.1%, while it was 37.6% in India [19].

In explanation of the above, it can be said that the spread of social phobia among Syrian private university students may be attributed to multiple factors, most notably the university environment, especially in an Arab society like ours, where the student’s entry into university life constitutes a qualitative leap in terms of the nature of teaching, the nature of social relations, and the nature of relations Between male and female students, cultural, class and economic diversity, and therefore these qualitative variables may constitute psychological and societal pressures in the form of withdrawal symptoms that some students resort to because they are unable to keep pace with the new reality, in addition to the “mechanisms of indoctrination” that still prevail in some academic courses Not encouraging the student to participate during the study process.

Studies have also found an increase in anxiety among university students to be at high levels during the COVID-19 pandemic. Although knowledge of the preventive measures for COVID- 19, knowledge of the diagnosis of the disease are protective factors of concern. While the prevalence was global, the impact on social contact were risk factors for health concern. This may explain an increase in the proportion of social anxiety disorder in our study compared to a previous study of the same sample conducted before the outbreak of the pandemic.

The rate of social phobia among medical students at the Syrian Private University was higher for females than for males, and this is similar to a previous study at the same university and another study conducted in Iraq [21]. In studies in other regions [22], researchers explain that there are differences in the way of upbringing and the family and society’s treatment of females. Females to some extent, especially in eastern societies, have distinctly different roles from males, and their social roles are determined strictly. Females are allowed to express their feelings naturally, if a female feels upset or faces any difficulty, you see her crying easily, or her face blushing, and this in eastern societies is not considered a defect, but rather it is acceptable and may be desirable for its connection to the concept of tenderness and femininity, and also, females in our eastern societies avoid difficult or painful situations and experiences In the interest of their gentle nature and subject to scratching, and based on the foregoing, it can be said that the nature of women, their privacy, composition, and femininity put them in a sensitive position in the face of social situations in which they may be less strong and adapted than men.

As for the number of siblings per year, our study found a relationship between the increase in the number of siblings and the occurrence of social phobia, and this is similar to the previous study of the same sample, but in contrast to a study conducted in Malaysia [23], and this result can be attributed in our study to the fact that the small family has a greater opportunity and possibility for social communication, Their family relationships are of a strong nature, and their psychological, economic and environmental pressures are less, and the reason for this relationship may be that when parents have many children, they may have to follow a domineering personality pattern so that they can control all the children.

Looking at the student’s academic average, we found that there is no statistical relationship between him and the occurrence of social phobia, and this result is in contradiction to the study conducted at a Brazilian university [13], which explained that students who suffer from social phobia complain of shyness that leads to locking up information and not participating in the halls, especially when He asks them a question during the lesson, as well as his lack of confidence in his answer, although it is sometimes correct, but his feeling of dread and that all eyes are directed at him makes him reveal the answer, and he cannot ask questions related to inquiring about some ambiguous information, which may lead to poor academic achievement.

While in another study conducted at the University of Makkah Al Mukarramah [24], I found a similar result to our study, where the degree of phobia did not affect academic achievement, as this relationship between phobia and academic achievement was explained by the reality of traditional education at the university, which is concerned with the process of indoctrination and information delivery rather than focusing on knowledge generation. Or pay attention to questions and activities that require social interaction, as academic achievement needs to be memorized only and not skills that require social communication.

Another risk factor that had a statistically significant relationship with the occurrence of phobia is the student’s exposure to a previous psychological trauma, which confirms the psychological effects that both the crisis and the Covid-19 pandemic have had on the psyche of students and their contribution to raising the incidence of many psychological diseases, including social phobia. The finding is similar to what the Vietnamese study found [26,25], where traumatized people were more likely to develop social phobia.

The prevalence of social phobia is high among the participants. in addition, important significant risk triggers for social phobia have been identified including gender, academic year, smoking, number of siblings and mother educational level, the association between social phobia and the academic average was not proved to be significant.

Ethics approval and consent to participate

This study was approved by the Institutional Review Board (IRB) at Syrian Private University. Written consent was obtained from all participants. Participation in the study was voluntary and participants were assured that there would be no victimization of anyone who did not want to participate or who decided to withdraw after giving consent.

Consent for publication:

Not applicable.

Availability of data and materials:

All data related to this paper’s conclusion are available and stored by the authors. All data are available from the corresponding author on reasonable request.

Competing interests:

None of the authors have any competing interests. The authors alone are responsible for the content and writing of the article. No conflict of interest is declared.

Funding:

This research received no specific grant from SPU or any other funding agency in the public, commercial or non-profit sectors.

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Table. 1 sociodemographic characteristic: N= 492
256 (52%)	Male	sex
236 (48%)	Female	sex
12 (2.4%)	1^st	Year of study
28 (5.7%)	2^nd
56 (11.4%)	3^rd
72 (14.6%)	4^th
96 (19.5%)	5^th
96 (19.5%)	6^th
132 (26.8%)	Graduated
12 (2.4%)	<2	GPA
116 (23.6%)	2-2.24
200 (40.7%)	2.25-2.74
152 (30.9%)	2.75-3.24
12 (2.4%)	3.5-4
412 (83.7%)	City	Residence
80 (16.3%)	Suburb	Residence
308 (62.6%)	No	Smoking
100 (20.3%)	< 10
84 (17.1%)	> 10

Table. 2 social anxiety scale.
	Never	Occasionally	Often	Usually
Talking on a mobile phone in public	328 (66.7%)	132 (26.8%)	20 (4.1%)	12 (2.4%)
Participate in the discussion in a small group	272 (55.3%)	160 (32.5%)	40 (8.1%)	20 (4.1%)
Eating in public	292 (59.3%)	132 (26.8%)	48 (9.8%)	20 (4.1%)
Smoking hookah or drinking in front of others	304 (61.8%)	104 (21.1%)	36 (7.3%)	48 (9.8%)
Talking to powerful people	124 (25.2%)	204 (41.5%)	120 (24.4%)	44 (8.9%)
Speaking in front of a group of people	152 (30.9%)	192 (39%)	108 (22%)	40 (8.1%)
Go to parties you are invited to	196 (39.8%)	140 (28.5%)	112 (22.8%)	44 (8.9%)
Doing things while others are watching you	96 (19.5%)	212 (43.1%)	120 (24.4%)	64 (13%)
Writing while others are noticing you	180 (36.6%)	152 (30.9%)	116 (23.6%)	44 (8.9%)
Contact someone you don't know well	144 (29.3%)	212 (43.1%)	88 (17.9%)	48 (9.8%)
Chat with people you don't know well	172 (35%)	192 (39%)	92 (18.7%)	36 (7.3%)
strangers’ interview	176 (35.8%)	168 (34.1%)	96 (19.5%)	52 (10.6%)
Use of public restrooms	168 (34.1%)	104 (21.1%)	132 (26.8%)	88 (17.9%)
Entering the rooms where there are others (Like the waiting room at the doctor)	264 (53.7%)	176 (35.8%)	40 (8.1%)	12 (2.4%)
Being the center of attention (Lecture or tell a story in front of others)	80 (16.3%)	212 (43.1%)	136 (27.6%)	64 (13%)
Speaking at a meeting or during clinical interviews	88 (17.9%)	208 (42.3%)	132 (26.8%)	64 (13%)
Take a theory test	148 (30.1%)	196 (39.8%)	104 (21.1%)	44 (8.9%)
Expressing your disagreement with people you don't know	172 (35%)	216 (43.9%)	80 (16.3%)	24 (4.9%)
Looking into the eyes of people you don't know well	188 (38.2%)	152 (30.9%)	124 (25.2%)	28 (5.7%)
Report to a group	148 (30.1%)	244 (49.6%)	92 (18.7%)	8 (1.6%)
trying to make friends	208 (42.3%)	176 (35.8%)	80 (16.3%)	28 (5.7%)
Return the goods to the store if you do not like it	120 (24.4%)	200 (40.7%)	128 (26%)	44 (8.9%)
do a party	180 (36.6%)	144 (29.3%)	112 (22.8%)	56 (11.4%)
Resist seller pressure when trying to sell you an unconvinced merchandise	228 (46.3%)	144 (29.3%)	88 (17.9%)	32 (6.5%)

Table 3. avoidance attitudes.
	None	Mild	Moderate	Severe
Talking on a mobile phone in public	272 (55.3%)	148 (30.1%)	52 (10.6%)	20 (4.1%)
Participate in the discussion in a small group	192 (39%)	208 (42.3%)	72 (14.6%)	20 (4.1%)
Eating in public	272 (55.3%)	144 (29.3%)	68 (13.8%)	28 (5.7%)
Smoking hookah or drinking in front of others	256 (52%)	136 (27.6%)	48 (9.8%)	52 (10.6%)
Talking to powerful people	116 (23.6%)	236 (48%)	100 (20.3%)	40 (8.1%)
Speaking in front of a group of people	140 (28.5%)	200 (40.7%)	116 (23.6%)	36 (7.3%)
Go to parties you are invited to	184 (37.4%)	172 (35%)	96 (19.5%)	40 (8.1%)
Doing things while others are watching you	104 (21.1%)	252 (51.2%)	88 (17.9%)	48 (9.8%)
Writing while others are noticing you	156 (31.7%)	152 (30.9%)	144 (29.3%)	40 (8.1%)
Contact someone you don't know well	140 (28.5%)	208 (42.3%)	104 (21.1%)	40 (8.1%)
Chat with people you don't know well	140 (28.5%)	224 (45.5%)	84 (17.1%)	44 (8.9%)
strangers’ interview	152 (30.9%)	208 (42.3%)	96 (19.5%)	36 (7.3%)
Use of public restrooms	168 (34.1%)	144 (29.3%)	80 (16.3%)	100 (20.3%)
Entering the rooms where there are others (Like the waiting room at the doctor)	224 (45.5%	176 (35.8%)	56 (11.4%)	36 (7.3%)
Being the center of attention (Lecture or tell a story in front of others)	116 (23.6%)	200 (40.7%)	132 (26.8%)	44 (8.9%)
Speaking at a meeting or during clinical interviews	112 (22.8%)	220 (44.7%)	108 (22%)	52 (10.6%)
Take a theory test	204 (41.5%)	156 (31.7%)	60 (12.2%)	72 (14.6%)
Expressing your disagreement with people you don't know	152 (30.9%)	192 (39%)	100 (20.3%)	48 (9.8%)
Looking into the eyes of people you don't know well	136 (27.6%)	188 (38.2%)	116 (23.6%)	52 (10.6%)
Report to a group	176 (35.8%)	212 (43.1%)	88 (17.9%)	16 (3.3%)
trying to make friends	176 (35.8%)	196 (39.8%)	80 (16.3%)	40 (8.1%)
Return the goods to the store if you do not like it	116 (23.6%)	200 (40.7%)	140 (28.5%)	36 (7.3%)
do a party	184 (37.4%)	164 (33.3%)	84 (17.1%)	60 (12.2%)
Resist seller pressure when trying to sell you an unconvinced merchandise	172 (35%)	184 (37.4%)	92 (18.7%)	44 (8.9%)

Table. 4 Association between social phobia and sociodemographic factors
		Social phobia		P- value
		Yes	No
Sex	Male	88 (36.1%)	148 (59.7%)	0.000
Sex	Female	156 (63.9%)	100 (40.3%)	0.000
GPA	<2	8 (3.3%)	4 (1.6%)	0.476
	2-2.24	56 (23%)	60 (24.2%)
	2.25-2.74	96 (39.3%)	104 (41.9%)
	2.75-3.24	80 (32.8%)	72 (29%)
	3.5-4	4 (1.6%)	8 (3.2%)
Residence	City	184 (75.4%)	228 (91.9%)	0.000
Residence	Suburb	60 (24.6%)	20 (8.1%)	0.000
Social style Pre-university school	Merged	56 (23%)	128 (51.6%)	0.000
Social style Pre-university school	Unmerged	188 (77%)	120 (48.4%)	0.000
The school before you entered the university	Public	136 (55.7%)	184 (74.2%)	0.000
The school before you entered the university	Private	108 (44.3%)	64 (25.8%)	0.000
Number of Siblings	None	4 (0%)	4 (1.6%)	0.000
	1	20 (8.2%)	24 (9.7%)
	2	44 (18%)	80 (32.3%)
	3	96 (39.3%)	64 (25.8%)
	4	48 (19.7%)	52 (21%)
	5	24 (9.8%)	16 (6.5%)
	6	4 (1.6%)	0 (0%)
	7	8 (3.3%)	4 (1.6%)
	8	0 (0%)	4 (1.6%)
Smoking	No	180 (73.8%)	128 (51.6%)	0.000
	< 10	40 (16.4%)	60 (24.2%)
	> 10	24 (9.8%)	60 (24.2%)
Father educational level	Primary	16 (6.6%)	8 (3.2%)	0.014
	Elementary	32 (13.1%)	24 (9.7%)
	Secondary	56 (23%)	40 (16.1%)
	University	140 (57.4%)	176 (71%)
Mother educational level	Primary	24 (9.8%)	4 (1.6%)	0.000
	Elementary	44 (18%)	28 (11.3%)
	Secondary	72 (29.5%)	68 (27.4%)
	University	104 (42.6%)	148 (59.7%)
Mother working status	Yes	88 (36.1%)	52 (21%)	0.000
Mother working status	No	156 (63.9%)	196 (79%)	0.000

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Prevalence of Social Phobia among Medical Students at Syrian Private University

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Abstract

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Conclusion:

Introduction

Methods

Study preparation, participants

Study tools

Statistical analysis:

Results

The demographic characteristics of the sample:

Exposure to psychological trauma:

Assessment of the presence of fear and anxiety in social situations:

Assessment of reaction as avoidance, avoidance, or distancing in social situations:

Social Anxiety Disorder Scale Scores:

Studying the relationship between the social anxiety disorder scale and sociodemographic factors:

Studying the relationship between social anxiety disorder scale and exposure to psychological trauma:

Discussion

Conclusion

Declarations

References

Tables

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