Jane has profuse anxiety when she has to give a presentation at work, provide training, or speak to the organization. Jane sweats, her heart pounds in her chest, and she has vomited on multiple occasions prior to her task. She fears she will be negatively appraised and is certain she will be humiliated, though she is highly competent and professional. Jane has passed up at least one promotion because she would have to do even more public speaking and engagements. Jane's symptoms are consistent with: