126 Safren et al. © 1997 WILEY-LISS, INC. DEPRESSION AND ANXIETY 4:126–133 (1996/1997) QUALITY OF LIFE IN SOCIAL PHOBIA Steven A. Safren, Richard G. Heimberg,* Elissa J. Brown, and Christian Holle The person’s perception of his or her quality of life has been neglected in stud- ies of mental health in general and anxiety disorders in particular. However, the judgement of the impact of a mental disorder based on symptomatic dis- tress while ignoring one’s overall quality of life is incomplete. In the present study, we examined social phobic patients’ judgments of their satisfaction with various domains of life they deem important using the Quality of Life Inven- tory (QOLI; Frisch, unpublished). Social phobics judged their overall quality of life lower than Frisch’s (unpublished) normative sample. Quality of life was inversely associated with various measures of severity of social phobia (espe- cially social interaction anxiety), functional impairment, and depression. It was not, however, related to performance anxiety or trait anxiety. Quality of life also varied across combinations of subtype of social phobia and the presence/absence of avoidant personality disorder, and as a function of marital status. Patients showed significant improvement in quality of life scores after completion of cognitive-behavioral group therapy for social phobia. Depression and Anxiety 4:126–133, 1996/1997. © 1997 Wiley-Liss, Inc. Key words: social phobia; quality of life; life satisfaction; cognitive-behavioral treatment; avoidant personality disorder INTRODUCTION Social Phobia Program, Center for Stress and Anxiety Disor- ders, Department of Psychology, University at Albany, State University of New York. *Correspondence to: Richard G. Heimberg, Temple University Dept. of Psychology, Weiss Hall, Rm. 418, 1701 N. 13th Street, Philadelphia, PA 19122. Received for publication 24 April 1996; Accepted 7 September 1996 The DSM-IV defines social phobia as “a marked and persistent fear of one or more social or perfor- mance situations in which the person is exposed to un- familiar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embar- rassing” (American Psychiatric Association [APA], 1994, p. 416). Social phobia is the third most prevalent mental disorder in the United States (Kessler et al., 1994) and, using DSM-III-R (APA, 1987) criteria, estimates of lifetime prevalence have ranged from 7% to 16% (Kessler et al., 1994; Stein et al., 1994; Wacker et al., 1992). Although, by definition, social phobia involves significant symptomatic distress and functional im- pairment (APA, 1987, 1994), little is known about the impact of social phobia symptoms or consequent func- tional impairment on an individual’s perception of his or her quality of life. Self-perceived quality of life (also referred to as life satisfaction), a person’s judgment of whether his or her goals, needs, and wishes have been fulfilled, is an important aspect of psychological well-being (Frisch, 1994a; Frisch et al., 1992; Lewinsohn et al., 1991). Historically, studies of the efficacy of treatments of mental disorder have focused on symptom reduction, while emphasis on the promotion of life satisfaction has been rare (Cowen, 1991; Herron et al., 1994; Strack et al., 1991). However, there is growing con- sensus that psychologists should assess quality of life or life satisfaction in evaluating both mental health and treatment outcome (Frisch, 1994b; Hollandsworth, 1987; Howard et al., 1993; Kazdin, 1993; Seligman, 1995). While clinicians may judge outcome based on diagnostic and symptom measures, patients may judge outcome based on their subjective feelings of well-being/quality of life (Hollandsworth, 1987). Thus, life satisfaction may tap the clinical signifi- cance of symptomatology and treatment outcome. Few published studies, however, have implemented these ideas. Research has documented significant functional im- pairment among patients with anxiety disorders. Data from the Epidemiologic Catchment Area (ECA) stud- ies revealed that subjects who met DSM-III (APA,