Social Anxiety Disorder Related Conditions Asperger's Disorder vs. Social Anxiety Disorder: What Are the Differences? While often confused, Asperger's and social anxiety are different By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on December 19, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Facebook LinkedIn Twitter Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change. Learn about our Medical Review Board Print Universal Images Group / Getty Images Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatment Prevention Asperger's disorder, also known as Asperger's syndrome, is a pervasive developmental disorder that involves impairment in certain basic aspects of communication and relationships. Though Asperger's was originally a standalone diagnosis, the DSM-5 has retired it and now uses the diagnosis of autism spectrum disorder (ASD) instead. Although people with both ASD and social anxiety disorder (SAD) experience difficulty in social situations, they are completely different disorders; the diagnostic criteria and symptoms of the disorders are very different. Those with SAD are capable of forming relationships but are impaired by anxiety; on the other hand, people with ASD have difficulty with the nuts and bolts of communication that make relationships possible. Symptoms Social anxiety disorder is characterized by fear and anxiety of social interactions or performance situations. Your ability to function is limited by your anxiety in those circumstances. Asperger's disorder, now known as autism spectrum disorder, does not require the presence of anxiety. Behavior in social situations is instead impaired because of trouble reading and understanding social and emotional cues. Autism Misunderstand social signals Have trouble taking hints or understanding humor Have trouble interpreting nonverbal signals Trouble understanding and expressing emotions Difficulty adjusting to routine changes Trouble taking and understanding others' perspectives Social Anxiety Anxiety in social situations Physical symptoms of fear such as blushing, sweating, trembling High levels of self-consciousness Fear of being judged Avoidance of social situations Always expecting the worst in social situations Causes The exact causes of ASD and social anxiety disorder are not entirely clear, but researchers believe that several factors are involved. Autism Spectrum Disorder There is no single cause of autism spectrum disorder. Studies suggest that autism is hereditary. Research has also shown that people who are described as having Asperger's, also sometimes called 'high-functioning autism,' are even more likely to have family members with behavioral characteristics of autism. Environmental variables, such as medical conditions, exposure to certain chemicals during the prenatal period, and premature birth, have also been linked to Asperger's and autism. However, more research is needed to clarify these connections. Social Anxiety Disorder Social anxiety disorder is influenced by many factors, including genetics, brain structure, and environment. Factors that may increase the risk of developing the condition include a family history of anxiety, negative experiences with rejecting or bullying, having a shy or withdrawn temperament, and stressful life events. Research on Brain Function Neuroimaging research may shed some light on how the brains of people with SAD and ASD differ. Studies of brain function show that for most people, the amygdala—the emotion center of the brain—is activated when understanding facial expressions. For those with ASD, the prefrontal cortex—the center for judgment and planning—becomes active when processing facial images.This means that people with ASD try to logically figure out the meaning of a facial expression rather than experiencing an automatic emotional reaction. Studies have also shown heightened sensitivity of the amygdala in those with SAD; this makes it even more clear that the two disorders are very different. Diagnosis In order to diagnose ASD or social anxiety disorder, a doctor will evaluate the symptoms and behaviors that you or your child are experiencing. They may ask questions or utilize screening assessments. They may also perform a physical exam and conduct lab tests to rule out other conditions. Autism Spectrum Disorder ASD is usually diagnosed in childhood. If your child has been diagnosed with this disorder, they might: Engage in restricted and repetitive patterns of behavior, such as becoming excessively preoccupied with interests, routines and rituals, the parts of objects, or repetitive motor mannerisms such as hand twisting Experience significant impairment in social interaction, such as problems with eye contact, facial expressions, and body postures Have trouble developing friendships, sharing interests, and understanding the social and emotional perspectives of others Due to changes in how the condition is classified, people who would have previously been diagnosed with Asperger's are now diagnosed with autism spectrum disorder. Social Anxiety Disorder Social anxiety disorder is often diagnosed in childhood, but the condition affects people of all ages. To be diagnosed with the condition, a person must: Have intense fear and anxiety about social situationsAvoid social situations or endure them with great anxietyExperience feelings of fear that are out of proportion to the threat These symptoms must create distress or disruption in a person's life and cannot be caused by other conditions. Treatment While Asperger's disorder and social anxiety share some similarities, the treatments for autism and social anxiety disorder differ. Autism Spectrum Disorder Asperger's or autism is a form of neurodivergence. When a person is neurodivergent, it means that their brain learns and processes differently than people who are considered neurotypical. Interventions usually focus on helping people manage behaviors and develop skills that help them function more effectively in different environments. There is no one-size-fits-all approach, so what works best often depends on an individual's characteristics and needs. The goal is to help people build skills and develop their strengths. Social Anxiety Disorder Treatments for social anxiety, however, are focused on helping people change the thoughts and behaviors that contribute to feelings of fear. Cognitive-behavior therapy (CBT) can be highly effective, particularly when it incorporates specific strategies such as desensitization and exposure therapy. Co-Occurring Asperger's and Social Anxiety Research has found that it is common for children and adults diagnosed with ASD to also experience social anxiety. This means that it is possible for a child to have both ASD and SAD. Whether or not a child has one disorder or both, social skills training is one form of treatment that may offer promise for both SAD and ASD. Although the cause of social impairment in ASD and SAD differs, many of the same symptoms are present in both disorders. If you have ASD or SAD, you likely have a host of social skills deficits, such as problems with: Body postures Eye contact Speech qualities, such as tone, volume, and rate Social skills training has been shown effective in treating social anxiety symptoms and may also offer promise for those with ASD in terms of developing basic skills for interacting socially. Prevention Because the exact causes of Asperger's disorder is not known, there is no way to prevent it. Similarly, there is no sure-fire way to prevent social anxiety, but people can take steps to address the condition when symptoms first emerge. Early treatment for social anxiety can prevent symptoms from worsening and causing more significant life disruptions. Summary SAD and ASD are separate problems that show some overlap and may share some treatments. Once you've identified your specific issues, treatment can be devised to help you overcome your difficulties in social situations. A Word From Verywell Whether you have a child who is showing signs of anxiety or trouble with social situations, or you are struggling yourself, it is important to consult a doctor to learn the meaning of your particular array of symptoms. The Relationship Between Asperger's and Depression 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Faras H, Al Ateeqi N, Tidmarsh L. Autism spectrum disorders. Ann Saudi Med. 2010;30(4):295–300. doi:10.4103/0256-4947.65261 National Institute of Mental Health. Social anxiety disorder: more than just shyness. Faridi F, Khosrowabadi R. Behavioral, cognitive and neural markers of Asperger syndrome. 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Neuroimage Clin. 2020;26:102247. doi:10.1016/j.nicl.2020.102247 American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022. Maddox B, White S. Comorbid social anxiety disorder in adults with autism spectrum disorder. J Autism Developm Disord. 2015;45:3949-60. doi:10.1007/s10803-015-2531-5 Langdon PE, Murphy GH, Wilson E, et al. Asperger syndrome and anxiety disorders (PAsSA) treatment trial: a study protocol of a pilot, multicentre, single-blind, randomised crossover trial of group cognitive behavioural therapy. BMJ Open. 2013;3(7):e003449. Published 2013 Jul 30. doi:10.1136/bmjopen-2013-003449 Additional Reading American Psychiatric Association. Diagnostic and Statistical Manual of Mental Illnesses, 5th edition. 2013. By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." 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