The Social Phobia Inventory: screening and cross-cultural validation in Spanish adolescents

Validation and Cross-Cultural Adaptation of the Diabetes Self-Management Questionnaire (DSMQ) and the Social Phobia Inventory (SPIN) in Romanian Patients with Diabetes Mellitus

Background and Objectives: Anxiety disorders are common in individuals with diabetes mellitus (DM) and have a negative impact on diabetes-related self-management and, therefore, on patients’ evolution and prognosis. In this context, it becomes necessary to accurately and easily assess anxiety and self-management behaviours. Thus, the aim of this research was translation and cultural adaptation for Romanian patients and validation of two instruments used for assessing diabetes self-management and anxiety, namely the Diabetes Self-Management Questionnaire (DSMQ) and the Social Phobia Inventory (SPIN). Materials and Methods: The Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) and the DSMQ instruments for assessing diabetes self-management, as well as the Generalised Anxiety Disorder Scale (GAD-7) and the SPIN instruments for assessing anxiety, have been administered to 117 patients from Timisoara, Romania, previously diagnosed with DM. Results: The SPIN has proven to have good internal consistency, excellent acceptability of its questions without non-responders and a median completion time of 3 min and 10 s, an excellent test−retest performance (Spearman’s rho = 0.971, p < 0.001 between two administrations of the test) and good validity in comparison with the GAD-7, a previously validated and comprehensive instrument. The DSMQ has also proven to have acceptable internal consistency, excellent acceptability of its questions without non-responders and a median completion time of 2 min and 28 s; however, it has shown a weak, positive correlation without statistical significance in comparison with the SDSCA, a previously validated questionnaire. Conclusions: The SPIN, translated in Romanian and culturally adapted, is a valid tool for the screening of social phobias in individuals with DM. The DSMQ requires additional data for its validation in DM patients from Romania.

Screening Social Anxiety in Adolescents Through the Eyes of Their Carers

Despite the availability of efficacious treatment and screening protocols, social anxiety disorder (SAD) in adolescents is considerably under-detected and undertreated. Our main study objective was to examine a brief, valid, and reliable social anxiety measure already tested to serve as self-report child measure but administered via Internet aimed at listening to the ability of his or her parent to identify social anxiety symptomatology in his or her child. This parent version could be used as a complementary measure to avoid his or her overestimation of children of social anxiety symptomatology using traditional self-reported measures. We examined the psychometric properties of brief and valid social anxiety measure in their parent format and administered via the Internet. The sample included 179 parents/legal guardians of adolescents (67% girls) with a clinical diagnosis of SAD (mean age: 14.27; SD = 1.33). Findings revealed good factor structure, internal consistency, and construct validity. Data support a single, strength-based factor on the SPAIB-P, being structure largely invariant across age and gender. The limited number of adolescents with a performance-only specifier prevented examining the utility of scale to screen for this recently established specifier. It is crucial to evaluate if these results generalize to different cultures and community samples. The findings suggest that the SPAIB-P evidences performance comparable with child-reported measure. Parents can be reliable reports of the social anxiety symptomatology of the adolescent. The SPAIB-P may be useful for identifying clinically disturbed socially anxious adolescents.

Magnitude and correlates of alcohol use disorder in south Gondar zone, northwest Ethiopia: A community based cross-sectional study

BACKGROUND

Alcohol use disorder is the major public health problem in low- and middle-income countries that account for up to 70% of alcohol related premature mortality in the region. Therefore, the aim of this study was to assess the magnitude of alcohol use disorder and its associated factors among adult residents in south Gondar zone, Northwest Ethiopia.

METHODS

A community-based cross-sectional study was conducted among 848 adult residents of the south Gondar zone from January 13 to February 13, 2020. A multistage sampling technique was used to recruit study participants. We assessed alcohol use disorder (AUD) using the alcohol use disorder identification test (AUDIT). A binary logistic regression model was employed to identify factors associated with AUD.

RESULTS

The prevalence of alcohol use disorder over the last 12-months was found to be 23.7% (95% CI: 20.9, 26.7). Being male (AOR = 4.34, 95 CI; 2.800, 6.743), poor social support (AOR = 1.95, 95 CI: 1.098, 3.495), social phobia (AOR = 1.69, 95 CI; 1.117, 2.582), perceived high level of stress (AOR = 2.85, 95 CI; 1.829, 34.469), current cigarette smoking (AOR = 3.06, 95 CI; 1.764, 5.307) and comorbid depression (AOR = 1.81, 95 CI; 1.184, 2.778) were significantly associated with alcohol use disorder.

CONCLUSION

The prevalence of alcohol use disorder is high among adult residents of the south Gondar zone and associated with many factors. So, it needs public health attention to decrease the magnitude of alcohol use disorder in Ethiopia.

Psychometrics of the Spanish Version of the Screen for Adult Anxiety Related Disorders (SCAARED)

Objectives: To translate and validate the Screen for Adult Anxiety Related Disorders (SCAARED) questionnaire into Spanish. Method: The original SCAARED was translated into Spanish and administered to a non-clinical sample of 131 university students (92.4% women, mean age 22 years) in Valencia, Spain. To assess the concurrent validity of the SCAARED, the Depression, Anxiety and Stress Scale-21(DASS) and the Beck's Anxiety Inventory (BAI) were also administered. Test-retest reliability was evaluated 2 weeks after the first administration. Results: The internal consistency of SCAARED was high (α = 0.91) and the stability of the measurement was also high (test-retest 0.81). The results of the Exploratory Factor Analysis showed four factors comparable to the original SCAARED (generalized anxiety disorder, social phobia disorder, panic disorder, and separation anxiety disorder). The Area Under the Curve was excellent (0.88). Conclusions: The Spanish version of the SCAARED showed good psychometric properties comparable to the original SCAARED suggesting that it may be a useful instrument to screen for anxiety disorders in Spanish-speaking adult populations. Future studies are needed to replicate these findings in larger community and clinical samples.

The prevalence and correlates of social phobia among undergraduate health science students in Gondar, Gondar Ethiopia

OBJECTIVE

Social phobia is highly prevalent among university students. The lowest and highest point prevalence of social phobia among undergraduate university students was estimated at 7.8% and 80%, respectively. However, research into social phobia and associated factors among undergraduate university students in low and middle-income countries has been limited. Therefore, this study aimed to assess social phobia and associated factors among university students in Ethiopia to contribute an attempt to ensure optimal care for students.

RESULT

A total of 503 participants were interviewed with a response rate of 100%. The mean age of the respondents was 22.17 (± 10) years. The prevalence of social phobia symptoms among students was found to be 31.2% with (95% CI 27.3 to 35.6%). In the multivariable analysis, poor social support (AOR = 2.8, 95% CI 1.40, 5.60), female sex (AOR = 2.3; 95% CI 1.50, 3.60), 1st-year students (AOR = 5.5; 95% CI 1.80, 17.20), and coming from a rural residence (AOR = 1.6; 95% CI 1.00, 2.40) were factors significantly associated with social phobia symptoms.

Prevalence and associated factors for social phobia among school-going adolescents in a rural area of Puducherry, South India

BACKGROUND

The World Health Organisation has reported that mental disorders are one of the leading causes of disability worldwide. Social phobia is one such mental disorder that can have significant impact on the livelihood of adults if not detected at an early stage. There have been very few studies done on social phobia among adolescents in South India. Hence, this study was done to determine the prevalence of social phobia and factors associated with it among the school-going adolescents in rural Puducherry.

METHODOLOGY

A community-based cross-sectional study was conducted among 1018 school going adolescents from December 2017 to January 2018 in rural Puducherry. Information on socio-demographic characteristics was collected by a pre-tested semi-structured questionnaire and social phobia was assessed using the validated Social Phobia Inventory (SPIN) questionnaire.

RESULTS

Among 1018 participants, 738 (72.5%) belonged to early adolescence (10-13 years); 520 (51.1%) were boys; 557 (54.7%) were studying in a middle class; 931 (91.5%) were Hindus; 978 (96.1%) had siblings.The prevalence of social phobia among adolescents was found to be 22.9% (95% CI: 20.4-25.5%). The prevalence of mild social phobia was 18% [95% confidence interval (CI): 15.7-20.4%], moderate social phobia was 4% (95% CI: 2.9-5.4%), severe social phobia was 0.7% (95% CI: 0.3-1.3%) and very severe social phobia was 0.2% (95% CI: 0.03-0.64%). Higher age, female gender, lack of counselling services and specialist visits at school were found to be determinants of social phobia.

CONCLUSION

The current study showed that one in every five adolescents was at risk of developing social phobia. Health education for students, teachers and family members needs to be given to make them aware of the importance of social phobia.

Evidencias de validez de la versión en español del Inventario de Fobia Social (SPIN)

El objetivo del presente estudio fue analizar en muestras mexicanas las propiedades psicométricas del Inventario de Fobia Social (Social Phobia Inventory, SPIN). Los participantes consistieron en estudiantes universitarios, pacientes diagnosticados con trastorno de ansiedad social, y pacientes con trastorno de ansiedad generalizada. El SPIN mostró una alta consistencia interna, una buena confiabilidad test-retest, y una adecuada validez convergente y discriminante. Al analizar la estructura interna, el modelo que manifestó mejores indicadores de ajuste fue el de tres factores correlacionados. El análisis de curvas ROC indicó que el SPIN es capaz de discriminar entre los trastornos de ansiedad social y de ansiedad generalizada; un punto de corte de 25 representó el mejor balance entre sensibilidad y especificidad. Se concluye que la versión en español del SPIN demuestra propiedades psicométricas sólidas, por lo que puede ser potencialmente utilizado como instrumento de cribado para detectar el trastorno de ansiedad social en población mexicana.

Validation and Diagnostic Efficiency of the Mini-SPIN in Spanish-Speaking Adolescents

OBJECTIVES

Social Anxiety Disorder (SAD) is one of the most common mental disorders in adolescence. Many validated psychometric tools are available to diagnose individuals with SAD efficaciously. However, there is a demand for shortened self-report instruments that identify adolescents at risk of developing SAD. We validate the Mini-SPIN and its diagnostic efficiency in overcoming this problem in Spanish-speaking adolescents in Spain.

METHODS

The psychometric properties of the 3-item Mini-SPIN scale for adolescents were assessed in a community (study 1) and clinical sample (study 2).

RESULTS

Study 1 consisted of 573 adolescents, and found the Mini-SPIN to have appropriate internal consistency and high construct validity. Study 2 consisted of 354 adolescents (147 participants diagnosed with SAD and 207 healthy controls). Data revealed that the Mini-SPIN has good internal consistency, high construct validity and adequate diagnostic efficiency.

CONCLUSIONS

Our findings suggest that the Mini-SPIN has good psychometric properties on clinical and healthy control adolescents and general population, which indicates that it can be used as a screening tool in Spanish-speaking adolescents. Cut-off scores are provided.

Psychometric properties of the Japanese version of the Social Phobia Inventory

AIM

The aim of the current study was to study the psychometric properties of the Japanese version of the Social Phobia Inventory (SPIN-J) among Japanese subjects with social anxiety disorder (SAD).

METHOD

The sample consisted of 86 subjects with SAD and 86 controls. Diagnosis was based on a modified version of the Structured Clinical Interview for the DSM-IV. In addition to the SPIN-J, clinician-administered and self-rating scales, including the Japanese versions of the Liebowitz Social Anxiety Scale, the Social Phobia Scale, and the Social Interaction Anxiety Scale, were used.

RESULTS

The SPIN-J showed adequate internal consistency (0.82-0.96) for the total and subscales. Correlations between the SPIN-J and the Liebowitz Social Anxiety Scale, the Social Phobia Scale, and the Social Interaction Anxiety Scale ranged from 0.83 to 0.89 and indicated adequate concurrent validity. A cut-off point of 22 between subjects with SAD and controls showed a sensitivity of 96.5% and specificity of 87.2%, indicating robust discriminant validity.

CONCLUSION

The SPIN-J showed adequate reliability and validity for use as a screening tool for social anxiety disorder in Japanese clinical settings.

Peer victimization and social phobia: a follow-up study among adolescents

OBJECTIVE

This study examined longitudinal associations between direct and relational peer victimization (DV/RV) and self-reported social phobia (SP) among adolescents from 15 to 17 years of age, controlling for depression and family socioeconomic covariates.

METHODS

A total of 3,278 Finnish adolescents with a mean age of 15.5 years were surveyed at baseline (T1), and followed up 2 years afterwards (T2) their mean age being 17.6 years. In all, 2,070 adolescents were reached for the follow-up. Both types of victimization were assessed with structured questions, SP with the Social Phobia Inventory, and depression with the 13-item Beck Depression Inventory. Socioeconomic covariates were assessed with items from the Life Events Checklist. Frequency of victimization and SP were assessed at T1 and T2, and incidence and persistence from T1 to T2. Longitudinal associations between victimization and SP were examined with three logistic regression analyses with depression and socioeconomic covariates controlled for, with SP, DV, and RV in turn as the dependent endpoint (T2) variables.

RESULTS

Among boys a bidirectional association between DV and SP was found with DV both predicting SP [Odds Ratio (OR) 2.6] and being predicted by SP (OR 3.9). Among girls RV predicted SP (OR 2.8), but not vice versa, while depression in turn predicted DV (OR 4.3).

CONCLUSIONS

Direct victimization and SP have a bidirectional association among boys, while among girls RV increases the risk of subsequent SP.

Evidence based clinical assessment of child and adolescent social phobia: a critical review of rating scales

Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social anxiety scales for children and adolescents were identified. An overview about the scientific support accumulated by these scales is offered. Our main results are consistent with recent reviews that consider the Social Phobia and Anxiety Scale for Children (SPAI-C) and the Social Anxiety Scale for Adolescents (SAS-A) among the most pertinent and empirically supported measures of social anxiety for youngsters. However, after considering the existing evidence, we highly recommend another couple of scales that proved to be empirically supported (i.e., the Social Phobia Inventory-SPIN, and the Liebowitz Social Anxiety Scale for Children and Adolescents-LSAS-CA).

Screening utility of the social anxiety screening scale in Spanish speaking adolescents

The aim of this study was to analyse the screening utility of the Social Anxiety Screening Scale (SASS/EDAS) in a sample of 227 adolescents with social anxiety disorder and 156 Without it (14-17 years). Results showed that the EDAS subscales (Avoidance, Distress and Interference) scores were reliable in terms of internal consistency (alpha > .80). All the subscales discriminated between adolescents with and without the disorder. They also showed a positive and significant correlation with other empirically validated measures of social anxiety. The three subscales indicated relevant sensitivity (69.16-84.14%), specificity (63.46-66.03%) and areas under the curve (.74-.81%). Binary logistic regression analyses indicated the adequate predictive utility of EDAS subscales, with the Distress subscale as the best diagnostic predictor. The data provide empirical evidence of the usefulness of EDAS as a screener for adolescent social anxiety disorder in terms of reliability, convergent and discriminant validity, diagnostic accuracy and clinical usefulness.

Psychometric update of the Social Anxiety Screening Scale (SASS/EDAS) in a Spanish adolescent population

The aim of this work was to update the validation of the Social Anxiety Screening Scale (SASS/EDAS) in a sample of Spanish adolescents. To achieve this, one study with a sample of 1489 students in secondary education, of ages 14 to 17 years, were carried out. The psychometric properties of EDAS were examined through confirmatory factor analysis, reliability (Cronbach's alpha), temporal stability (test-retest), and concurrent criterion validity. The results supported the three-independent-factor structure (avoidance, distress and interference), that showed best fit indices compared to alternative models. They also showed that the scores of participants on EDAS scales were reliable in terms of internal consistency (alpha > .80) and moderately reliable concerning temporal stability (r = .48-.60) over a five-week period. The correlations between the EDAS factors and other social anxiety measures were positive and significant. Data provide empirical evidence of the estimation of reliability and validity of this scale. Future work should extend the validation of the EDAS in clinical samples.