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.     

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.     

Reliability and Validity of the Chinese Version of the Social Anxiety Scale for Adolescents

This study evaluated the psychometric properties of the Chinese version of the Social Anxiety Scale for Adolescents (SAS-A) in a sample of 296 adolescents (49% boys) in Grades 7, 8, 9, 10, and 12 with a mean age of 15.52 years. Confirmatory factor analysis replicated the three-factor structure of the SAS-A in the Chinese sample: Fear of Negative Evaluation (FNE), Social Avoidance and Distress in New Situations (SAD-New), and Social Avoidance and Distress-General (SAD-General). Internal consistency and test-retest reliability were appropriate. The results also revealed a clear and predictable pattern of relationships between the SAS-A and the Questionnaire about Interpersonal Difficulties for Adolescents and the International Personality Item Pool. Chinese boys reported greater SAD-General than Chinese girls, and this difference increased with grade. The SAS-A scores were compared to previously collected data from the USA and Spain, revealing that Chinese adolescents scored significantly higher in social anxiety than American and Spanish adolescents.     

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.     

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.     

Social Anxiety in High-functioning Children and Adolescents with Autism and Asperger Syndrome

We examined social anxiety and internalizing symptoms using the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Social Anxiety Scale for Children -Revised (SASC-R), and the Child Behavior Checklist (CBCL) in a sample of fifty-four high-functioning subjects with autism or Asperger syndrome (HFA/AS) (M = 11.2 ± 1.7 years) and 305 community subjects (M = 12.2 ± 2.2 years). Children and adolescents completed the SPAI-C and SASC-R, and their parents completed the CBCL Internalizing scale. Adolescents with HFA/AS scored higher than the community sample on all measures. Behavioural avoidance and evaluative social anxiety increased by age within the HFA/AS group, whereas behavioural avoidance decreased by age in control participants. Data support that HFA/AS in adolescents may be associated with clinically relevant social anxiety symptoms.     

Psychometric properties of the Social Phobia and Anxiety Inventory for Children using a non-American population-based sample

Although previous studies have examined the factor structure of the SPAI-C, adequate factor analytic methodology has not been employed. This study explored the psychometric properties of the Social Phobia and Anxiety Inventory for Children (SPAI-C), using a non-American population-based sample of older children and young adolescents 11-14 years of age. Initially an exploratory factor analysis was conducted followed 1 year later by a confirmatory factor analysis. Five factors labeled Assertiveness, Public Performance, Physical/Cognitive Symptoms, Social Encounter, and Avoidance were retained and confirmed. The Public Performance and Assertiveness factors were the most stable and consistent factors or traits of social anxiety over a 1-year period. Results revealed adequate concurrent validity, internal consistency and moderate 12-month test-retest reliability of the SPAI-C total scale. The SPAI-C was found to assess levels of both social anxiety and social anxiety disorder according to DSM-IV criteria. Findings suggest that the SPAI-C is applicable in clinical treatment studies designed to assess sensitivity to change in various aspects of social anxiety disorder.     

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.     

Psychometric properties of the Social Phobia and Anxiety Inventory-Child version in a Swedish clinical sample

The Social Phobia and Anxiety Inventory for Children (SPAI-C) is a 26 item, empirically derived self-report instrument developed for assessing social phobic fears in children. Evidence for satisfactory psychometric properties of the SPAI-C has been found in multiple community studies. Since its development, however, no study has presented an extensive psychometric evaluation of SPAI-C in a sample of carefully diagnosed children with social phobia. The present study sought to replicate and expand previous studies by administrating the SPAI-C to a sample of 59 children that fulfilled DSM-IV criteria for social phobia, and 49 children with no social phobia diagnosis. An exploratory factor analysis resulted in a three factor solution reflecting: (1) fear of social interactions, (2) fear of public performance situations, and (3) physical and cognitive symptoms connected with social phobia. These factors appear to parallel domains of social phobia also evident in adults. The SPAI-C total scale and each factor was found to possess good internal consistency, good test–retest reliability and was generally strongly correlated with both self-report and clinician measures of anxiety and fears. The discriminative properties of the total scale were satisfactory.     

A meta-analysis of the cross-cultural psychometric properties of the Social Phobia and Anxiety Inventory for Children (SPAI-C)

Several studies have found that the Social Phobia and Anxiety Inventory for Children (SPAI-C), an empirically derived self-report instrument to assess DSM-IV social phobia in childhood and adolescence, has good psychometric properties. While these findings were replicated across different cultures, the overall strength of the psychometric properties of the SPAI-C remains unknown. We assessed the validity of the SPAI-C by meta-analytic techniques across studies collected from PubMed, PsycInfo and Eric databases, conducted in different countries, among subjects of different age, and sex. A total of 21 articles were retained, predominantly from Europe and North America. We found that the psychometric properties based on Cronbach alpha, mean score differences between sexes, and construct validity, were robust for the SPAI-C scale. Girls scored significantly higher than boys, and geographical differences played a moderating effect on sex-related score differences. These results further support the SPAI-C as an instrument to identify Social Phobia in youth.     

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.     

Screening for Adolescent Social Anxiety: Psychometric Properties of the Severity Measure for Social Anxiety Disorder

Social anxiety disorder (SAD) is a debilitating disorder that emerges during adolescence and confers a significant burden on interpersonal functioning. Currently available diagnostic interviews are lengthy and generally require clinically-trained experts to administer. Consequently, the identification of clinically valid self-report measures of social anxiety is necessary for streamlining assessment processes and routine outcome monitoring of adolescent social anxiety symptoms. Accordingly, the present study establishes the psychometric properties and predictive utility of the Severity Measure for Social Anxiety Disorder (SMSAD). Participants included 58 adolescents between 12 and 16 years of age who met diagnostic criteria for SAD. In addition to the SMSAD and other self-report measures, clinician and parent reports were obtained. Findings support the reliability and validity of the SMSAD, and highlight the clinical utility of this measure in comparison to previously validated measures of social anxiety. Overall, results indicate that the SMSAD is a valid and reliable measure for assessing and routinely tracking social anxiety symptoms in adolescents.

     

Psychometric evaluation of social phobia and anxiety inventory for children (SPAI-C) and social anxiety scale for children-revised (SASC-R)

The study evaluated the psychometric properties of Finnish versions of the Social Phobia and Anxiety Inventory for Children (SPAI-C) and the Social Anxiety Scale for Children-Revised (SASC-R). 352 students (M = 12.2 years) participated in the study and completed the SPAI-C and SASC-R. In addition, 68 participants (M = 12.2 years) and their parents were interviewed with the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL). The SPAI-C was more sensitive for identifying youth meeting criteria for social phobia (SP), whereas the SASC-R demonstrated greater specificity. The youth in this sample had lower mean total scores on the self-report questionnaires than did those in the original validitation studies of the SPAI-C and SASC-R conducted in America. These findings question whether cross-cultural differences in the expression of SP influence the clinical cut-off scores used in translated versions of social anxiety questionnaires.     

The Pediatric Quality of Life Inventory (PedsQL) 4.0 as an assessment measure for depressive symptoms: a correlational study with young adolescents

Health-related quality of life (HRQOL) is today considered an important assessment measurement, but still only a few measures assess HRQOL outcomes for children and adolescents. One of them is the Pediatric Quality of Life Inventory (PedsQL). This correlation study explored the associations between depressive symptoms in young adolescents and the PedsQL scores when controlling for known risk factors. An adolescent sample (n=425) completed a battery of measures including the PedsQL Norwegian version, the Short Mood and Feeling Questionnaire (SMFQ), the Social Phobia and Anxiety Inventory for children (SPAI-C), and the occurrence of Stressful Life Events (SLE). The results showed a mild to moderate correlation between the measures PedsQL, SMFQ, SPAI-C and SLE. The presence of depressive symptoms significantly predicted the PedsQL scores for the adolescence, and explained 17% of the variance in outcome for the PedsQL Total Scale. The findings suggest that the PedsQL is an adequate assessment instrument regarding depressive symptoms in young adolescents, and can be useful in both clinical practice and further research as an assessment measure regarding children's mental health.     

An open-label trial of escitalopram in children and adolescents with social anxiety disorder

Social anxiety disorder (SAD) is a highly prevalent and disabling disorder in children and adolescents. This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonin reuptake inhibitor, escitalopram, in the treatment of SAD in children and adolescents. Twenty outpatients with a primary diagnosis of SAD were treated in a 12-week open trial with escitalopram. The primary outcome variable was the change from baseline to end point in Clinical Global Impression-Improvement scale (CGI-I). Secondary efficacy measures included the CGI-Severity scale (CGI-S), the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Screen for Child and Anxiety Related Emotional Disorders (SCARED)-Child and Parent version, and The Youth Quality of Life Instrument-Research Version (Y-QOL-R). On the CGI-I scale, 13 of 20 patients (65%) had a score < or =2, meaning response to treatment. All symptomatic and quality of life measures showed improvements from baseline to week 12, with large effect sizes ranging from 0.9 to 1.9 (all p < 0.001). Escitalopram was generally well-tolerated. These results suggest that escitalopram may be an effective and safe treatment for pediatric SAD. Future double-blind, placebo-controlled, randomized clinical trials are warranted.     

Refining and validating the Social Interaction Anxiety Scale and the Social Phobia Scale

Background: The Social Interaction Anxiety Scale and Social Phobia Scale 6 are companion measures for assessing symptoms of social anxiety and social phobia. The scales have good reliability and validity across several samples, 3 , 6 however, exploratory and confirmatory factor analyses have yielded solutions comprising substantially different item content and factor structures. These discrepancies are likely the result of analyzing items from each scale separately or simultaneously. The current investigation sets out to assess items from those scales, both simultaneously and separately, using exploratory and confirmatory factor analyses in an effort to resolve the factor structure. Methods: Participants consisted of a clinical sample (n5353; 54% women) and an undergraduate sample (n5317; 75% women) who completed the Social Interaction Anxiety Scale and Social Phobia Scale, along with additional fear‐related measures to assess convergent and discriminant validity. Results: A three‐factor solution with a reduced set of items was found to be most stable, irrespective of whether the items from each scale are assessed together or separately. Items from the Social Interaction Anxiety Scale represented one factor, whereas items from the Social Phobia Scale represented two other factors. Conclusion: Initial support for scale and factor validity, along with implications and recommendations for future research, is provided. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Social anxiety and depression in adolescents in relation to perceived competence and situational appraisal.

The Social Anxiety and Phobia Inventory for Children (SPAI-C), the Children's Depression Inventory (CDI), Harter's (1982) Perceived Competence Scale for Children (PCSC), as well as an inventory of cost and likelihood appraisal of negative social and non-social events, were filled in by 184 adolescents (14-15 years old). It was expected that social anxiety would be specifically related to low perceived competence in the social domain and threat appraisal in the same domain, whereas depression would be related to more general perceived competence deficits. The relationships of social anxiety and depression to perceived competence and appraisal were largely supported. Social anxiety was most strongly related to perceived social competence as well as to both social cost and likelihood appraisals, whereas depression was more generally related to perceived competence, and appraisal of negative events did not improve the prediction of depression any more than the prediction based on perceived competence.     

Development and validation of a music performance anxiety inventory for gifted adolescent musicians

Music performance anxiety (MPA) is a distressing experience for musicians of all ages, yet the empirical investigation of MPA in adolescents has received little attention to date. No measures specifically targeting MPA in adolescents have been empirically validated. This article presents findings of an initial study into the psychometric properties and validation of the Music Performance Anxiety Inventory for Adolescents (MPAI-A), a new self-report measure of MPA for this group. Data from 381 elite young musicians aged 12-19 years was used to investigate the factor structure, internal reliability, construct and divergent validity of the MPAI-A. Cronbach's alpha for the full measure was .91. Factor analysis identified three factors, which together accounted for 53% of the variance. Construct validity was demonstrated by significant positive relationships with social phobia (measured using the Social Phobia Anxiety Inventory [Beidel, D. C., Turner, S. M., & Morris, T. L. (1995). A new inventory to assess childhood social anxiety and phobia: The Social Phobia and Anxiety Inventory for Children. Psychological Assessment, 7(1), 73-79; Beidel, D. C., Turner, S. M., & Morris, T. L. (1998). Social Phobia and Anxiety Inventory for Children (SPAI-C). North Tonawanda, NY: Multi-Health Systems Inc.]) and trait anxiety (measured using the State Trait Anxiety Inventory [Spielberger, C. D. (1983). State-Trait Anxiety Inventory STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press, Inc.]). The MPAI-A demonstrated convergent validity by a moderate to strong positive correlation with an adult measure of MPA. Discriminant validity was established by a weaker positive relationship with depression, and no relationship with externalizing behavior problems. It is hoped that the MPAI-A, as the first empirically validated measure of adolescent musicians' performance anxiety, will enhance and promote phenomenological and treatment research in this area.     

Factor Structure of the Liebowitz Social Anxiety Scale for Children and Adolescents

The purpose of this study was to evaluate the factor structure of the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA). The LSAS-CA was administered to 225 children and adolescents as a component of various clinical studies. In addition, other measures of psychopathology and impairment were administered to a subgroup of the sample. Confirmatory factor analyses of the social interaction and performance subscales for the anxiety and avoidance ratings yielded poor fit indices. Exploratory factor analysis supported a two-factor solution with a higher order factor for the LSAS-CA anxiety and avoidance ratings. Based on item content, factors were named Social and School Performance. The internal consistency of the factors was high and the convergent and divergent validity was supported vis-à-vis correlations with measures of depression and social anxiety, and clinician ratings of impairment and functioning. Findings suggest that the anxiety and avoidance ratings are best explained by a two-factor solution that measures social anxiety and avoidance in social and school performance interactions. This factor structure appears to be a reliable and valid framework for assessing childhood social phobia.This research was funded by a grant from SmithKline Beecham to Drs. Liebowitz and Masia-Warner. The authors would like to thank Heather Dent and Sharon Davies for their contributions to the execution of this study.     

The Factor Structure of the Liebowitz Social Anxiety Scale for Children and Adolescents: Development of a Brief Version

The Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA-SR) is a validated instrument for the assessment of social anxiety in youth. The three main objectives of the present study were to (a) examine the factor structure of the LSAS-CA-SR; (b) to validate the factors against relevant personality measures, and (c) to create a brief and reliable version of the questionnaire. A total of 1,362 adolescents completed self-report measures of social anxiety, temperament, character and personality traits. The factor structure was examined using a combination of confirmatory and exploratory factor analysis. The analysis was conducted on both the anxiety and avoidance sub-scales, and identical items for both sub-scales were maintained. Two factors emerged: social interaction and school performance. These factors demonstrated high internal consistency and a significant correlation with relevant self-report measures. A brief version comprised of 14 items was highly correlated (0.96) with the full version. The new factor structure represents advancement over the previous efforts, and holds promise for efficient utilization of the LSAS-CA.