Psychometric evaluation of the Social Anxiety Scale for Adolescents and the Social Phobia and Anxiety Inventory for Children: construct validity and normative data

This study evaluated the psychometric properties of the Social Anxiety Scale for Adolescents (SAS-A) and Social Phobia and Anxiety Inventory for Children (SPAI-C) in a sample of 1147 adolescents aged 13-17 years. The fit indices of confirmatory factor analyses were comparable to those obtained in prior studies and supported the hypothesized models of the SAS-A and SPAI-C. The internal consistency was good and 12-month test-retest reliability modest for both measures. A significant, positive correlation was found between the SAS-A and SPAI-C, showing that these measures assess related, but relatively independent constructs of social anxiety and phobia. These findings support the use of the SAS-A and SPAI-C with adolescents.     

Social anxiety level in Turkish adolescents

Social phobia is a mental disorder characterized by extreme and consistent fear of meeting new people, scrutiny in a variety of performance and/or interactional situations. The aim of this study was to investigate the level of self-reported social anxiety in a community sample of Turkish adolescents and the relationship between social anxiety and some sociodemographic parameters. This study was a school-based cross-sectional study. Students in grades 6–8 (aged 10–16) from 12 schools in Kocaeli/Turkey were screened by the Social Anxiety Scale for Adolescents (SAS-A). The correlations of sociodemographic parameters with the SAS-A scores were examined. Data from a sample of 1,713 students (865 boys 50.4% and 848 girls 49.5%) were analyzed. A significant gender difference in the SAS-A points was found. Boys reported higher SAS-A total and subscale scores (except social avoidance and distress-general subscale score) than did girls. A significant negative correlation was found between socioeconomic status and social anxiety level. SAS-A scores were higher in those with a low socioeconomic level, and who were going to rural schools. The result of this study showed that social phobic symptoms among Turkish adolescents were more severe in boys. Some factors such as low socioeconomic level, and going to a rural school had impact on the SAS-A scores. As the impairment in the school-domain was reported to be quite high, professionals and teachers need to recognize social anxiety in adolescents, so that help can be offered to overcome the difficulties social phobia causes.     

Social Anxiety Scale for Adolescents: Factorial invariance and latent mean differences across gender and age in Spanish adolescents

Little is known about the factorial invariance across gender and age for self-report measures of social anxiety in adolescence. This study examined the factorial invariance and latent mean differences of the Social Anxiety Scale for Adolescents (SAS-A) across gender and age groups in 1570 Spanish adolescents (54% girls), ranging in age from 14 to 17 years. Equality of factor structures was compared using multi-group confirmatory factor analyses. Measurement invariance for the correlated three-factor model of the SAS-A was found across gender and age samples. Analyses of latent mean differences revealed that girls exhibited higher means than boys on two SAS-A subscales, Fear of Negative Evaluation and Social Avoidance and Distress-New (SAD-New). In addition, on the SAD-New subscale, the structured means significantly diminished from 14-year olds to 16- and 17-year olds and from 15-year olds to 17-year olds. Findings are discussed in terms of the use of the SAS-A with Spanish adolescents.     

Investigating the construct validity of the SPAI-C: comparing the sensitivity and specificity of the SPAI-C and the SAS-A

Investigates the construct validity of the Social Phobia and Anxiety Inventory for Children (SPAI-C) by comparing its sensitivity and specificity with another self-report measure of social anxiety, the Social Anxiety Scale for Adolescents (SAS-A). Participants were 252 adolescents (124 males and 128 females) 13-17 years old. Adolescents completed the SPAI-C and the SAS-A and were interviewed using the Anxiety Disorders Interview Schedule for DSM-IV: Child Version (ADIS-IV:C). Parents were also interviewed and composite diagnoses were formed. Youth were classified as socially phobic or non-anxious based on these composite diagnoses. By comparing clinical cutoff scores with diagnostic group classification, the sensitivity and the specificity of the SPAI-C and SAS-A were compared. Results indicated that the SPAI-C was a more sensitive measure than the SAS-A (61.5% vs. 43.6%) providing evidence of the scale's construct validity. The two measures were similar with regard to specificity (82.7% for both). Implications of these results for assessment and research are discussed.     

Cross validation of the Social Anxiety Scale for Adolescents in a high school sample

Social anxiety disorder in adolescents is increasingly recognized as a common condition that may precede onset of other mental health problems. However, few measures are currently available to screen for adolescent social anxiety, and little is known about their psychometric characteristics in school-based samples. To this end, the present study was undertaken as a psychometric cross validation of the Social Anxiety Scale for Adolescents (SAS-A). Exploratory and Confirmatory Factor Analyses (CFA) supported the original 3-factor structure of the SAS-A but retained fewer items than in the original scale. The revised scales demonstrated good internal consistency as well as criterion and concurrent validity. Despite including fewer items, psychometric characteristics of the revised scales were equivalent to or stronger than those reported in previous studies of the measure. As such, the present study provides initial support for the utility of the revised SAS-A as a measure of social anxiety in adolescent school samples.     

The Social Anxiety Scale for Adolescents: Measurement Invariance and Psychometric Properties Among a School Sample of Portuguese Youths

Over the last decades there has been an increased interest in assessing social anxiety in adolescents. This study aims to validate the Social Anxiety Scale for Adolescents (SAS-A) to Portuguese youth, and to examine its invariance across gender as well as its psychometric properties. The participants were 782 Portuguese youths (371 males, 411 females), with an average age of 15.87 years (SD = 1.72). The results support the original three-factor structure of the SAS-A, with measurement invariance being found across gender, with females scoring higher than males on two subscales. High levels of internal consistency were found. Positive associations with empathy demonstrated that high socially anxious adolescents have elevated empathy tendencies. Mostly null or low negative associations were found with measures of psychopathic traits, callous-unemotional traits and aggression. Study findings provide evidence that the SAS-A is a psychometrically sound instrument that shows measurement invariance between genders, good reliability and positive correlations with empathy.     

Social Anxiety Scale for Adolescents (SAS-A): Measuring Social Anxiety Among Finnish Adolescents

The aim of this study was to investigate symptoms of social anxiety and the psychometric properties of the Social Anxiety Scale for Adolescents (SAS-A) among Finnish adolescents, 13–16 years of age. Study 1 (n = 867) examined the distribution of SAS-A scores according to gender and age, and the internal consistency and factor structure of the SAS-A. In a subsample (n = 563; Study 2) concurrent and discriminant validity of the SAS-A were examined relative to the Social Phobia Inventory and the Beck Depression Inventory. Test–retest stability was examined over a 30-month period by repeated measures every 6 months in another subsample (n = 377; Study 3). Results mostly revealed no gender differences in social anxiety, except that boys reported more general social avoidance and distress than girls. Older adolescents (14–16-year-olds) reported higher social anxiety than younger adolescents (12–13-year-olds). Internal consistency for the SAS-A was acceptable for both genders and for all three SAS-A subscales. Confirmatory factor analysis replicated the original 18-item three-factor structure of the SAS-A, accounting for 61% of the variance between items. Evidence for concurrent and discriminant validity was found. Test–retest stability over 6 months was satisfactory. Results support the reliability and validity of the Finnish adaptation of the SAS-A, and further indicate that gender differences in adolescents’ social anxiety may vary across Western countries.     

Psychometric properties of the Spence Children's Anxiety Scale (SCAS) in Mainland Chinese children and adolescents

This study examined the psychometric properties of the Spence Children's Anxiety Scale (SCAS) in a Mainland Chinese community sample. The 38-item Chinese version of SCAS was administered to 1878 children and adolescents. Multiple group confirmatory factor analyses supported a common 6-factor model of SCAS for children and adolescents, and for boys and girls. The internal consistency and test-retest reliability of SCAS were satisfactory. Convergent and divergent validity of SCAS were supported by significant correlations with a measure of anxiety to a greater extent than with a measure of depression. Adolescents reported higher anxiety levels than children, and girls reported higher anxiety levels than boys. Compared to other studies, anxiety symptoms of Chinese children were found at a moderate level, but anxiety symptoms of Chinese adolescents were found at a high level. Our findings suggest that the SCAS is suitable for assessing anxiety symptoms in Mainland Chinese children and adolescents.     

Functions of nonsuicidal self-injury among Chinese community adolescents

This study examined functions of nonsuicidal self-injury (NSSI) among a large sample of Chinese high school students over a six-month period. Among Chinese adolescents, we identified three factors of NSSI functions, namely, Affect Regulation, Social Influence, and Social Avoidance. Affect Regulation was the most frequently endorsed function of NSSI, followed by Social Influence and Social Avoidance. Adolescent male self-injurers were more likely to endorse the Social Influence function than their female counterparts. Moderate/Severe Self-injurers did not differ from Minor Self-injurers on the endorsement of various NSSI functions. All functions of NSSI exhibited small to moderate stability over the six-month assessment period. Findings suggest that Chinese adolescents engaged in NSSI for multiple reasons. These reasons also varied considerably over time within individuals. Assessment of NSSI should thus regularly assess functions of the behavior.     

Atypical sensory processing in adolescents with an autism spectrum disorder and their non-affected siblings

Atypical sensory processing is common in autism spectrum disorders (ASD). Specific profiles have been proposed in different age groups, but no study has focused specifically on adolescents. Identifying traits of ASD that are shared by individuals with ASD and their non-affected family members can shed light on the genetic underpinnings of ASD. Eighty adolescents with ASD (64 boys, 16 girls), 56 non-affected adolescent siblings (21 boys, 35 girls) and 33 adolescent controls (18 boys, 15 girls) filled out the Adolescent/Adult Sensory Profile, a self-report questionnaire resulting in four sensory quadrants according to Dunn's model of sensory processing. Adolescents with ASD differed significantly from controls on the quadrants Sensation Seeking and Sensation Avoidance. On quadrant 2 (Sensation Seeking) siblings scored significantly lower than controls and significantly higher than ASD. These results confirm the presence of atypical sensory processing in adolescents with ASD. We argue that reduced Sensation Seeking might be a candidate for an intermediate phenotype.     

Effects of autistic traits on social and school adjustment in children and adolescents: The moderating roles of age and gender

This study examined the associations between children's and adolescents’ autistic-like social deficits and school and social adjustment as well as the moderating roles of age and gender in these associations. The sample consisted of 1321 students (48.7% boys) in Grade 1 to Grade 8 from northern Taiwan. Children's and adolescents’ autistic-like social deficits were assessed using the Social Responsiveness Scale (SRS), and their school and social adjustment (i.e., academic performance, negative attitudes toward schoolwork/teachers/classmates, behavioral problems at schools, negative peer relationships, and problems with peers) were assessed using the Social Adjustment Inventory for Children and Adolescents (SAICA). Both measures were completed by the mothers of the participants. Results from the linear mixed models demonstrated that autistic-like social deficits were associated with poor academic performance, negative attitudes toward schoolwork, teachers, and classmates, behavioral problems at schools, negative peer relationships, and problematic peer interactions. Moreover, gender and/or age moderated the associations between autistic-like social deficits and school and social adjustment problems. For example, autistic-like social deficits were more strongly related to negative school attitude, school social problems, and negative peer relationships in boys than in girls. Further, autistic-like social deficits were more strongly related to problems with peers in older girls than in older boys or younger children (regardless of gender). In conclusion, the present study suggests that autistic-like social deficits may place children and adolescents at increased risk for social and school maladjustment and that the extent of maladjustment may vary with the child's age and gender and the domains of adjustment under discussion.     

Adolescent coping behavior when confronted with a friend with AIDS.

The coping strategies employed by adolescents (n = 871) when presented with a hypothetical situation of a friend with AIDS were examined. Adolescents reported a wide range of imagined responses that were generally adaptive. Girls more than boys and distressed students more than nondistressed students were likely to endorse adaptive coping items. Comparison of the students with a separate sample (n = 472) that responded to a hypothetical situation of a suicidal peer revealed more distress in girls for the AIDS problem and more distress in boys for the suicide problem, contrary to expectations. Adolescents were more distressed and endorsed a wider variety of coping strategies in response to the AIDS scenario than to the suicide problem. Implications for care of adolescents dealing with these significant issues are discussed.     

The relation between self-concept and social functioning in adolescence

A model of the relation between self-concept and internalizing and externalizing problem behaviours in adolescence, with the self-concept influencing problem behaviours (S-->IE), was assessed using a sample of 277 Swedish adolescents. The model was tested in a path analysis with data from Youth Self Report (YSR) and Structural Analysis of Social Behaviour (SASB) questionnaires. Consistent with the model, a positive self-concept was found to be the most important factor for adjustment and for protection against common problem behaviour. A negative self-concept combined with female gender were risk factors for internalized problems. Self-control had only a direct effect on externalizing behaviour for boys. Adolescents of 15, 16 years of age had a stronger relationship between a negative self-concept and externalizing problem behaviour than younger and older adolescents. Internalizing problem behaviours such as anxiety and depression predicted aggressive and delinquent behaviour. These findings highlight the importance of promoting of a positive self-concept in every adolescent in various psychosocial contexts.     

Reliability and Validity Evidence of Scores on the Slovene Version of the Questionnaire About Interpersonal Difficulties for Adolescents

This study analyzed the psychometric properties of scores on the Slovene version of the Questionnaire about Interpersonal Difficulties for Adolescents (QIDA) in a sample of 1,334 adolescents (44% boys), ranging in age from 12 to 18 years (M = 15.61). Confirmatory factor analyses replicated the correlated five-factor structure of the QIDA: Assertiveness, Heterosexual Relationships, Public Speaking, Family Relationships, and Close Friendships. Internal consistency and test–retest reliability were reasonable. Correlations of scores on the QIDA with scores of neuroticism, low extraversion, and low openness, as measured by the Inventory of Child/Adolescent Individual Differences, and scores of fear of negative evaluation, and tension and inhibition in social contacts, as measured by the Social Anxiety Scale for Adolescents were found, revealing differential links with QIDA subscale scores. Girls reported more difficulties than boys. Age differences showed a small but significant decrease in QIDA total score over adolescence.     

Effects of autistic traits on social and school adjustment in children and adolescents: The moderating roles of age and gender

This study examined the associations between children's and adolescents' autistic-like social deficits and school and social adjustment as well as the moderating roles of age and gender in these associations. The sample consisted of 1321 students (48.7% boys) in Grade 1 to Grade 8 from northern Taiwan. Children's and adolescents' autistic-like social deficits were assessed using the Social Responsiveness Scale (SRS), and their school and social adjustment (i.e., academic performance, negative attitudes toward schoolwork/teachers/classmates, behavioral problems at schools, negative peer relationships, and problems with peers) were assessed using the Social Adjustment Inventory for Children and Adolescents (SAICA). Both measures were completed by the mothers of the participants. Results from the linear mixed models demonstrated that autistic-like social deficits were associated with poor academic performance, negative attitudes toward schoolwork, teachers, and classmates, behavioral problems at schools, negative peer relationships, and problematic peer interactions. Moreover, gender and/or age moderated the associations between autistic-like social deficits and school and social adjustment problems. For example, autistic-like social deficits were more strongly related to negative school attitude, school social problems, and negative peer relationships in boys than in girls. Further, autistic-like social deficits were more strongly related to problems with peers in older girls than in older boys or younger children (regardless of gender). In conclusion, the present study suggests that autistic-like social deficits may place children and adolescents at increased risk for social and school maladjustment and that the extent of maladjustment may vary with the child's age and gender and the domains of adjustment under discussion.     

Determinants of adherence to methylphenidate and the impact of poor adherence on maternal and family measures

OBJECTIVE: The aim of this study was to examine the association between adherence to immediate-release methylphenidate (IR MPH) and maternal psychological distress, parenting style, parent- child relationship, and perceived family support. METHODS: The sample consisted of 307 children with attention-deficit hyperactivity disorder (ADHD) (271 boys and 36 girls), 6-17 years of age, who had been treated with IR MPH for the past 6 months. The measures included the Chinese Health Questionnaire, Parental Bonding Instrument, Family APGAR, and Home Behaviors of the Social Adjustment Inventory for Children and Adolescents. RESULTS: Reasons for poor adherence (n = 79; 25.7%) included forgetting medication (72.7%), the medication having no effect (20.0%), and refusing medication (12.7%). Increased age and three-times-daily administration were the major predictors for poor adherence to IR MPH. Poor adherence was associated with increased degree of maternal psychological distress, indifferent parenting, maternal overprotection/control, poor family support, decreased interaction with parents, and increased problems at home. CONCLUSIONS: Findings indicate that multiple daily dosing of MPH increases the likelihood of poor adherence, particularly in adolescents, and that poor adherence is associated with impaired maternal/family process. Once-daily administration of MPH is necessary to improve adherence and to decrease the possible exacerbation of tense parent-child relationships caused by poor drug adherence.     

Youth experiences with multiple types of prejudice-based harassment

Despite prejudice-based harassment's associations with serious physical and mental health risks, research examining multiple forms of harassment among children/adolescents is lacking. This study documents the prevalence of prejudice-based harassment (i.e., harassment on the basis of gender, race/ethnicity, weight or physical appearance, sexual orientation, and disability status) among a large, statewide, school-based Midwestern U.S. sample of 162,034 adolescents. Weight-/appearance-based harassment was most prevalent among both girls (25.3%) and boys (19.8%). Adolescents from certain vulnerable groups experienced higher rates of multiple types of harassment, even when controlling for other sociodemographic characteristics. Prejudice-based harassment experiences are prevalent among adolescent girls and boys. Differential rates of each type of harassment are reported across groups within the corresponding sociodemographic status (e.g., white female adolescents report a significantly lower rate of race-based harassment (4.8%), as compared to Native American (18.6%), mixed/other race (18.9%), Hispanic/Latina (21.5%), Asian/Pacific Islander (24.2%), or Black/African American (24.8%) female adolescents); but a pattern of cross-harassment also is evident, such that differences in prevalence of each harassment type emerge across a variety of statuses (e.g., disability-based harassment was statistically significantly higher among discordant heterosexual (12.7%), gay (13.0%), bisexual (15.3%), and unsure (15.3%) male adolescents than among heterosexual male (7.2%) adolescents). Adolescents from specific sociodemographic groups are particularly vulnerable to certain types of harassment.     

Age and gender differences in social anxiety symptoms during adolescence: the Social Phobia Inventory (SPIN) as a measure

The aim of the present study was to examine age and gender differences in social anxiety symptoms during adolescence, and to investigate the psychometrics of the Social Phobia Inventory (SPIN) among adolescents. The SPIN was administered to a large general population sample (n=5252) of Finnish adolescents aged 12-16 years. Age and gender trends in scores and internal consistency and factorial composition of the SPIN were examined in this sample. The test-retest reliability of the SPIN was examined in a smaller sample of adolescents (n=802). Results showed that girls scored higher than boys on the SPIN full scale and three subscales across the whole age range. Eighth graders (14- to 15-year-olds) scored higher than seventh and ninth graders on the full scale, for boys the differences were significant. Good test-retest reliability (r=0.81), and internal consistency (alpha=0.89) were found for the SPIN. An exploratory factor analysis (EFA) performed on a random half (n=2625) of the population sample yielded a one-factor model accounting for 38% of the variance between items. This one-factor model, plus an alternative three-factor model, were examined in the holdout half of the population sample (n=2627) by means of a confirmatory factor analysis (CFA). Some support was gained for both factor structures. Our results indicate that symptoms of social phobia may increase in mid-adolescence. The SPIN appears to be a reliable self-report instrument among adolescents.     

Efficacy of three treatment protocols for adolescents with social anxiety disorder: a 5-year follow-up assessment

Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy for Adolescents (CBGT-A), Social Effectiveness Therapy for Adolescents--Spanish version (SET-Asv), or Intervención en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to the majority of adolescents with social anxiety. Issues that may contribute to future research and clinical implications are discussed.     

Health-related quality of life in adolescents with well-controlled epilepsy

OBJECTIVE: The purpose of the work described in this article was to evaluate the health-related quality of life (HRQOL) of adolescents with well-controlled epilepsy. METHODS: The Quality of Life in Epilepsy Inventory for Adolescents 48 (QOLIE-AD-48) was completed by 71 subjects with uncomplicated epilepsy who had been seizure-free for more than a year. HRQOL was measured in eight domains: Health Perception, Epilepsy Impact, Memory/Concentration, Physical Functioning, Stigma, Social Support, School Behavior, and Attitudes toward Epilepsy. In addition, antiepileptic drug (AED) therapy and concern over seizures recurring were analyzed in relation to HRQOL. RESULTS: The mean HRQOL total scores were 83.9 for boys and 83.06 for girls. The highest scores were observed in the Physical Functioning and School Behavior domains; the lowest in the Attitudes toward Epilepsy domain. Girls reported more positive perceptions in the Stigma and Social Support domains. Greater intake of AEDs and concern over seizures recurring accounted for poorer HRQOL. CONCLUSIONS: Adolescents with favorable seizure control evaluated their HRQOL as satisfactory. However, they perceived their best adjustment to epilepsy to be in the Physical Functioning and School Behavior domains. AED intake and concern over seizures recurring were predictors of HRQOL in this group.