Social Anxiety Disorder Self-Reported Severity Scale Validated in English-Speaking Adults

People near the middle of social hierarchies suffer higher rates of depression and anxiety
People near the middle of social hierarchies suffer higher rates of depression and anxiety
Social anxiety disorder (SAD), also known as social phobia, is highly prevalent and is associated with a significant functional impairment.

A newly developed self-report scale to assess the severity of patients’ social anxiety demonstrated “high internal consistency, convergent validity, and discriminant validity in U.S. patients,” found a recent study.

Among the changes included in the DSM-5 were new guidelines for assessing the severity of disorders within various categories, including anxiety disorders. Accordingly, the Anxiety Disorders Workgroup developed several brief, 10-question, free, non-copyrighted self-report scales that assess the three aspects of anxiety — subjective fear experiences, physiological reactivity and avoidance behavior — with each scale adapted to the anxiety subtype.

Despite validation in U.S. undergraduates and, after translation, in adult populations in Germany, Brazil and the Netherlands, the SAD-D lacks replicated validation in another English-speaking adult population.

The authors therefore administered the SAD-D severity scale to 47 individuals who sought treatment at UCLA for a principal diagnosis of social anxiety disorder. Just over half the participants were women, just over half were white, and their average age was 29. Each patient also underwent the Anxiety Disorders Interview Schedule for DSM-IV, and completed by self-report the Liebowitz Social Anxiety Scale, the Social Phobia Scale, the Social Interaction Anxiety Scale and the depression subscale of the Mood and Anxiety Symptom Questionnaire — all previously validated.

Video news update: Dr. Anne Marie Albano, director of Columbia’s Clinic for Anxiety and Related Disorders, speaks about anxiety, its etiology, and new treatments. Watch now.

The researchers then conducted multiple statistical analyses to assess the internal consistency, convergent validity and discriminant validity of the SAD-D compared to the other scales. The patients’ mean score on the SAD-D scale was 25.7, with high internal consistency. A positive, significant correlation between the SAD-D scores and both the interviewer-rated fear and avoidance scores and the other self-report anxiety scales demonstrated convergent validity. Then, a non-significant relationship between the MASQ depression subscale and the SAD-D scale established discriminant validity.

“The results of the present study provide evidence for the validity and reliability of the English-language version of the DSM-5 dimensional assessment of SAD severity (SAD-D) in treatment-seeking individuals,” wrote Richard T. LeBeau, PhD, and his colleagues at the University of California, Los Angeles.

The study remains limited by the small sample size and the lack of data on the scale’s validity for individuals with subclinical anxiety symptoms or anxiety as a secondary condition. Future larger validation studies should conduct factor analyses and establish a cutoff score to distinguish clinical and non-clinical populations.

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LeBeau RT, Mesri B, Craske MG. The DSM-5 social anxiety disorder severity scale: evidence of validity and reliability in a clinical sample. Psychiatry Res. 2016;244:94-96.