Cultural factors that have been related to social anxiety disorder include a societies attitude towards shyness and avoidance, impacting ability to form relationships or access employment or education. In China, research has indicated that shy-inhibited children are more accepted than their peers and more likely to be considered for leadership and considered competent, in contrast to the findings in Western countries. Purely demographic variables may also play a role - for example there are possibly lower rates of social anxiety disorder in Mediterranean countries and higher rates in Scandinavian countries, and it has been hypothesized that hot weather and high-density may reduce avoidance and increase interpersonal contact. There appear to be differences between more 'western' and more 'eastern' cultures. One study has suggested that the effects of parenting are different depending on the culture - American children appear more likely to develop social anxiety disorder if their parents emphasize the importance of other's opinions and use shame as a disciplinary strategy, but this association was not found for Chinese/Chinese-American children.
Problems in developing 'social skills' may be a cause of some social anxiety disorder, through either inability or lack of confidence to interact socially and gain positive reactions and acceptance from others. The studies have been mixed, however, with some studies not finding significant problems in social skills while others have. What does seem clear is that the socially anxious perceive their own social skills to be low. It may be that the increasing need for sophisticated social skills in forming relationships or careers, and an emphasis on assertiveness and competitiveness, is making social anxiety problems more common, at least among the 'middle classes'. An interpersonal or media emphasis on 'normal' or 'attractive' personal characteristics has also been argued to fuel perfectionism and feelings of inferiority or insecurity regarding negative evaluation from others. The need for social acceptance or social standing has been elaborated in other lines of research relating to social anxiety.