Greater than 95 - Very severe social phobia Accuracy Studies have shown the LSAS to be an effective and cost-efficient way to identify people with problems with social anxiety. A clinical diagnosis of SAD can only be made based on an interview conducted by a trained mental health professional such as a psychologist, psychiatrist, or social worker. If you complete the test and find the results concerning, be sure to check with your doctor about what they might mean. If this feels hard to do, consider making an appointment for general mental health concerns, and then when you meet with your doctor, bring along a copy of the LSAS as well as a written statement of what you have been experiencing.
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Overall, the original LSAS subscales showed excellent internal consistency and temporal stability. Similar to previous reports, fear and avoidance subscales were so highly correlated that they yielded redundant information.
Confirmatory factor analyses for three previously proposed models failed to demonstrate an excellent fit to our data. However, a four-factor model showed minimally acceptable fit. Exploratory factor analyses are warranted to determine whether a better factor structure exists for African Americans. The LSAS comprises 24 social situations that are each rated for level of fear and avoidance.
The original scale was developed as a clinician administered measure, although a self-report version has also been validated Fresco et al. The LSAS differs from most other social anxiety measures in that it assesses anxiety and avoidance in specific social situations e. In social anxiety disorder SAD patients, the LSAS showed good internal consistency, test-retest reliability, convergent and discriminant validity, and sensitivity to treatment Heimberg et al.
First, a total score is created by summing all 48 responses. Second, fear ratings for all situations are summed to create a Fear subscale. Third, avoidance ratings for all situations are summed to create an Avoidance subscale. Additionally, responses to the 11 social-interaction and 13 performance situations may be summed separately for fear and avoidance, creating four subscales: social interaction fear, social interaction avoidance, performance fear, and performance avoidance. The original scoring instructions implied two-factors social interaction, performance separately for fear and avoidance.
Although the measure was designed to provide separate fear and avoidance scores, studies show that these subscales are highly correlated, suggesting significant redundancy between subscales Heimberg et al.
Thus, studies have tested the original 2-factor model social interaction, performance examining only fear ratings. Factor analyses have not supported the original 2-factor model and have instead supported a different four-factor structure.
This structure was preferred in a sample of treatment seeking individuals diagnosed with SAD Safren et al. One study that provided data on racial composition of their sample included only five African Americans Baker et al. Thus, while there are mixed findings for the factor structure of the LSAS in European American samples, our understanding is even less clear in non-European samples. Examining commonly used measures in a cross-cultural manner is crucial to ensure that research based on such measures in these samples yields reliable and valid data.
Moreover, examining the factor structure of measures in diverse samples may inform about whether the construct of social anxiety differs across ethnic and racial groups in clinically meaningful ways. Given the large population of African Americans and the high prevalence of anxiety disorders in the United States, there is a need to examine the psychometric properties of commonly used measures of anxiety in this population. To this end, Chapman and colleagues compared African American and European American samples on several measures of anxiety in a series of studies.
There is minimal data characterizing social anxiety in African Americans Chapman et al. Whereas the original factor structures generally held for the European American sample, several items needed to be dropped for the models to fit the African American sample.
The original measures yielded significant differences in anxiety level between the groups. When the ill-fitting items were dropped, groups no longer differed in their level of social anxiety on the SADS. These findings highlight the implications of interpreting data obtained from measures that have not been validated for the population under examination. Given the findings of variance across ethnic groups for multiple measures of anxiety, it is important to examine the structure of the LSAS in an African American sample.
The current study had two primary aims. First, we sought to evaluate basic psychometric properties of the clinician-administered LSAS in a sample of African Americans with a range of anxiety disorders. Second, we sought to compare the fit of previously proposed factor structures of the LSAS.
Based on psychometric examination of other anxiety measures in African Americans, we expected that previous factor structures identified in mostly European samples would not fit well in our sample. Method 2. During the early phases of recruitment, participants were referred to the study by site collaborators and affiliated treatment providers. We then added postings in newspapers and on the internet to recruit directly from the community.
All participants provided written informed consent prior to enrollment in the study. Once enrolled, participants were contacted for an in-person or telephone follow-up interview annually. The LSAS was administered during the annual follow-up assessments between and To be eligible for the study, participants needed to be at least 18 years of age and English speaking.
Participants were excluded from the study if they were diagnosed with schizophrenia, suffering from active psychosis, or had an organic mental disorder. Only participants who had both a month and a month follow-up LSAS were included in the one-year temporal stability analyses. Interviews were conducted by trained, experienced clinical interviewers whose educations range from B. An intensive program for training interviewers has been developed and successfully used for the past 15 years.
The training consists of a graduated set of tasks and experiences, beginning with reading relevant papers, studying instruments and instruction booklets, watching training tapes, and reviewing suggestions for handling common interviewing problems. New interviewers discuss videotapes of interviews and conduct mock interviews with experienced interviewers.
They are closely supervised during training sessions and initial actual interviews by training supervisors. Senior clinical staff reviewed interview data for clinical and clerical errors, which were corrected before the data were entered on the computer master file. Inter-rater reliability estimates for HARP interviews have been good to excellent, with intraclass correlation coefficients ICC ranging from.
We examined the concurrent validity by comparing the scores on each proposed LSAS subscale for participants with and without a diagnosis of SAD.
To examine the factor structure, we estimated the sample covariance matrices using a maximum-likelihood solution in AMOS. In line with previous reports and a high correlation between fear and avoidance ratings in our own sample, we tested each model including only fear ratings for each LSAS situation.
Three confirmatory factor analyses were conducted: Original 2-factor model social interaction, performance ; Safren 4-factor model social interaction, speaking, observation by others, eating and drinking ; and the Baker 5-factor model social interaction, nonverbal performance, ingestion, public performance, assertiveness.
For each model, factors were allowed to correlate. A significant Chi-Square indicates that the data significantly differ from the proposed model. Smaller AIC scores are preferred among competing models.
Results 3. All of the subscales demonstrated normal skew and kurtosis, suggesting normal distributions. They each demonstrated excellent internal consistency, with exception of one Safren subscale observation by others and two Baker subscales nonverbal performance, assertiveness. We examined the 1-year temporal stability of LSAS scores in the 76 participants who had month and month data Table 1.
Liebowitz Social Anxiety Scale (LSAS)
Introduction[ edit ] To assess social phobia, psychologists and clinicians need to distinguish between performance anxiety and social interaction anxiety in order to make an accurate diagnosis. However, lack of empirical data made it difficult to differentiate and relate different types of feared situations and social interactions. Since its invention, the LSAS has been used in many cognitive-behavioral treatments of social phobia. The LSAS is the most frequently used form of social anxiety assessment in research, clinical-based, and pharmacotherapy studies.
Liebowitz social anxiety scale