Validity of Two Questionnaires to Assess Social Fears: The Dutch Social Phobia and Anxiety Inventory and the Blushing, Trembling and Sweating Questionnaire

This report evaluates some psychometric properties of the Dutch Social Phobia and Anxiety Inventory (SPAI-N) as well as a newly developed instrument to assess fear of showing somatic symptoms among social phobic, the Blushing, Trembling and Sweating Questionnaire (BTS-Q). Results support the reliability and discriminative validity of the Dutch SPAI and the BTS-Q. Both questionnaires are able to discriminate social phobics from a community sample. Social phobics with fear of blushing, trembling, and sweating as the main complaint could be discriminated from social phobics without fear of blushing, trembling, and sweating as the main complaint using the BTS-Q. In contrast with expectations derived from cognitive models of social phobia, social phobics with fear of blushing, trembling, and sweating did not have stronger dysfunctional beliefs about (the social consequences of) blushing, trembling, and sweating than social phobics without such fears.     

Concurrent validity of the Social Phobia and Anxiety Inventory

The Social Phobia and Anxiety Inventory (SPAI) is a new instrument designed to assess symptoms of social phobia. Although the scale has been shown to have a good test-retest reliability, internal consistency, and construct validity, no studies have examined its concurrent validity with respect to other measures of social anxiety and avoidance. In the present study, the relationship between the SPAI and several self-report measures of social anxiety was examined in a sample of 23 patients meeting DSM-III-R criteria for social phobia. The relationship between the SPAI and other measures of psychopathology, as well as performance during a role play test and an impromptu speech, was also examined. The results strongly support the concurrent validity and the specificity of the SPAI. The Social Phobia subscale may be a better index of social anxiety symptoms than the Difference subscale.This research was supported, in part, by NIMH grants MH 38636 and MH 41577 to the second author.     

The social phobia and anxiety inventory: Construct validity

The Social Phobia and Anxiety Inventory (SPAI) is a new instrument composed of social phobia and agoraphobia subscales. The latter scale is used to detect social anxiety that may result from agoraphobia. The SPAI's construct validity was assessed through several procedures. First, confirmatory factor analyses were conducted to validate the existence of the two subscales. Second, exploratory factor analyses examined the underlying structure of the social phobia subscale. Third, a Q factor procedure determined if different anxiety diagnostic groups could be differentiated by their SPAI response pattern. The results confirmed the utility of the two SPAI subscales and identified a number of dimensions contained within the social phobia subscale which differed depending upon the specific subject sample. In addition, the complaints of social phobies appeared more homogeneous than those of an agoraphobic comparison group. The results are discussed in terms of construct validity and the sensitivity of the SPAI to various dimensions of social phobia fears.This study was supported in part by NIMH Grants 41852, 30915, 18269, and 16884.     

Social phobia features across the DSM-III-R anxiety disorders

One hundred sixty subjects meeting DSM-III-R criteria for the five major anxiety disorders were compared on the extent to which they reported features characteristic of social phobia. The results indicated that many patients in the anxiety disorder categories experience some degree of social anxiety. The differences between subjects with a primary diagnosis of social phobia and subjects with other anxiety disorders appear to be chiefly quantitative on this feature. Compared to the other anxiety disorders, social phobics report fear and avoidance in response to a greater number of social situations and report greater interference in their lives due to social phobic concerns. Among the anxiety disorders, generalized anxiety disorder appears to be associated with the greatest degree of social anxiety, and simple phobia with the least.     

A comparison of repeated exposure to fearful and disgusting stimuli among spider phobics

This study examined the role of fear and disgust in repeated exposure among spider phobics. Thirty spider phobics were randomly assigned to one of two experimental groups. Both groups completed measures of fear and disgust and performed two initial standardized Behavioral Avoidance Tests (BATs; one with a fear stimulus – live tarantula, and one with a disgust stimulus – dead rat). One group was then repeatedly exposed to the tarantula and the other to the dead rat. Results of the study indicated that exposure to either the disgust stimulus or the live tarantula was associated with significant decreases in fear, avoidance, and disgust. However, it was found that repeated exposure to the fear stimulus produced a greater decrease in avoidance behavior. Results suggest that both types of exposure can be effective in alleviating associated symptoms and provide additional evidence that disgust sensitivity plays a role in the treatment of spider phobia. Copyright © 2010 John Wiley & Sons, Ltd.     

Avoidant personality disorder and the generalized subtype of social phobia.

Social phobia and avoidant personality disorder (APD) may be given as comorbid diagnoses. However, it is not known if the labels provide independent, useful diagnostic information. We classified social phobics by social phobia subtype and presence of APD. Generalized social phobics with and without APD (ns = 10 and 10) and nongeneralized social phobics without APD (n = 10) were distinguished on measures of phobic severity. The generalized groups also showed earlier age at onset and higher scores on measures of depression, fear of negative evaluation, and social anxiety and avoidance than did the nongeneralized group. APD criteria of general timidity and risk aversion were more frequently endorsed by social phobics with APD. The data suggest that both the generalized subtype of social phobia and the presence of APD do provide useful diagnostic information but the additional diagnosis of APD may simply identify a severe subgroup of social phobics.     

The social phobia and anxiety inventory: Further validation in two nonclinical samples

The Social Phobia and Anxiety Inventory (SPAI) has been developed to assess specific symptoms of social phobia and agoraphobia. Although the SPAI was developed with both clinical and nonclinical populations, research with this measure is currently focused primarily on clinical samples. We examined the factor structure and psychometric properties of the SPAI in adult community and college undergraduate samples. We found that single-sample and multisample confirmatory factor analyses provided support for extending use of the correlated two-factor SPAI subscales to our nonclinical samples. In addition, we found evidence for the internal consistency reliability of the SPAI subscales in both samples. Limitations and suggestions for future research are discussed.     

Development of an abbreviated Social Phobia and Anxiety Inventory (SPAI) using item response theory: the SPAI-23

An abbreviated version of the Social Phobia and Anxiety Inventory (SPAI) was developed using methods based in nonparametric item response theory. Participants included a nonclinical sample of 1,482 undergraduates (52% female, mean age = 19.4 years) as well as a clinical sample of 105 individuals (56% female, mean age = 36.4 years) diagnosed with either generalized (73%) or specific social phobia (27%). Twenty-three of the 45 SPAI items demonstrated good discrimination along the social anxiety continuum. In addition, option characteristic curves (OCCs) indicated that the SPAI's 7-point scale may generate errors in ranking individuals. Thus, options were collapsed to improve item performance. No gender differences emerged between any of the items' OCCs, suggesting that items function similarly among men and women. The abbreviated version also correlated highly with the original 45-item SPAI and exhibited similar patterns of correlations with measures of social anxiety. The SPAI-23 has considerable practical benefits, including a screening of both social and agoraphobic anxiety as well as decreased assessment and scoring time.     

Daily Peer Hassles and Non-Suicidal Self-Injury in Adolescence: Gender Differences in Avoidance-Focused Emotion Regulation Processes

This study aimed to examine the mediating role of rumination, experiential avoidance, dissociation and depressive symptoms in the association between daily peer hassles and non-suicidal self-injury among adolescents. Additionally, this study explored gender differences in these associations and tested whether the proposed model was invariant across genders. The sample consisted of 776 adolescents, of them 369 are males (47.6%) and 407 are females (52.4%), aged between 12 and 18 years old from middle and high schools in Portugal. Participants completed self-report questionnaires to assess daily peer hassles, rumination in its severe component (i.e., brooding), experiential avoidance, dissociation, depressive symptoms and non-suicidal self-injury. Path analysis showed that daily peer hassles indirectly impact on non-suicidal self-injury through increased levels of brooding, experiential avoidance, dissociation, and depressive symptoms. Results indicated significant gender differences in mean scores and path analysis. Male adolescents were more likely to engage in brooding and experiential avoidance in response to external distress (particularly, daily peer hassles), whereas female adolescents were more likely to engage in non-suicidal self-injury in response to internal distress (particularly, depressive symptoms). These findings suggest relevant preventive and intervention actions to address emotion dysregulation in adolescence, by teaching them acceptance and mindfulness skills as a way of coping with stressful experiences and internal distress.     

Disgust sensitivity and contamination fears in spider and blood-injection-injury phobias

Disgust has been implicated in the onset and maintenance of blood-injection-injury (BII) and animal phobias. Research suggests that people with these phobias are characterized by an elevated sensitivity to disgust-evoking stimuli separate from their phobic concerns. The disgust response has been described as the rejection of potential contaminants. Disgust-motivated avoidance of phobic stimuli may therefore be related to fears of contamination or infection. The present study compared BII phobics, spider phobics and nonphobics on two measures of disgust sensitivity and two measures of contamination fears. Positive correlations were found between disgust sensitivity and contamination fear. Specific phobics scored higher than nonphobics on all scales and BII phobics scored higher than spider phobics on contamination fear measures. Furthermore, the contamination fear scales were correlated with the blood phobia measure, but not correlated with the spider phobia measure. The results suggest that while both phobias are characterized by elevated disgust sensitivity, contamination fear is more prominent in BII than spider phobia.     

Peer victimization and social anxiety in adolescence: a prospective study

This study reports a one‐year prospective investigation of the relations between overt and relational victimization and social anxiety and phobia in a sample of adolescents. The Social Experience Questionnaire—Self Report Form (SEQ‐S), Social Anxiety Scale for Adolescents (SAS‐A), and Social Phobia and Anxiety Inventory for Children (SPAI‐C) were administered to 144 ninth grade adolescents. A follow‐up assessment with the SEQ‐S, SAS‐A, and SPAI‐C was conducted one year later. Results indicated that relational victimization predicted symptoms of social phobia but not general social anxiety and avoidance one year later. Overt victimization was not a significant predictor of social anxiety and phobia one year later. Social anxiety and phobia did not predict peer victimization one year later. However, increases in social anxiety and social phobia symptoms (for boys) over time were positively associated with increases in relational victimization over time. Implications of these findings for peer victimization and social anxiety in the development of social phobia and negative peer experiences are discussed. Aggr. Behav. 00:1–16, 2005. © 2005 Wiley‐Liss, Inc.     

Influence of response time frame on mood assessment

Abstract

Dental anxiety and the related avoidance of dental treatment can result in severe impairment of health. We investigated the influence on avoidance behavior of phobic severity, gender, characteristics related to generalized anxiety and depression, such as dysfunctional cognitions and sensitivity of bodily symptoms, as well as personality traits of self-efficacy and locus of control. Forty-eight dental phobics were given an initial assessment and avoidance behavior was determined by the degree of observance of three subsequent dental appointments. Principal component analysis revealed separate factors for trait and phobic anxiety as well as for avoidance and dysfunctional cognitions. Women showed a higher degree of avoidance than men. Regression analysis revealed a high desire for control over dental treatment combined with a low level of perceived control as the only significant predictor variable of avoidance. The results suggest that avoidance behavior in dental phobia could be reduced by extending patients’ control over treatment conditions.     

情绪调节困难对大学生手机成瘾的影响:相貌负面身体自我和社交回避与苦恼的链式中介作用

为考察相貌负面身体自我、社交回避与苦恼在情绪调节困难和手机成瘾关系中的链式中介效应,使用情绪调节困难量表、相貌负面身体自我量表、社交回避与苦恼量表和大学生手机成瘾倾向量表对734名大学生进行问卷调查。研究显示：（1）情绪调节困难会正向预测大学生手机成瘾;（2）相貌负面身体自我是情绪调节困难与大学生手机成瘾之间关系的中介变量;（3）社交回避与苦恼是相貌负面身体自我与大学生手机成瘾之间关系的中介变量;（4）社交回避与苦恼是情绪调节困难与大学生手机成瘾之间关系的中介变量。因此,相貌负面身体自我和社交回避与苦恼在情绪调节困难与大学生手机成瘾之间起链式中介作用,这些结果对于大学生手机成瘾的预防与干预具有重要的价值。     

Psychometric appraisal of the Scale for Interpersonal Behavior (SIB) in France.

The present study was carried out in France to evaluate the reliability and validity of the Scale for Interpersonal Behavior (SIB), a multidimensional measure of difficulty and distress in assertiveness that was originally developed in The Netherlands. This appraisal was conducted with a clinical sample (N = 166) and a general population sample (N = 150). The clinical series comprised 115 patients with social phobia and 51 patients with personality disorder, 28 of whom were of the avoidant type. Support was found for internal consistency and test-retest reliability of the French SIB. Compared to controls, both social phobics and patients with an avoidant personality disorder had significantly lower mean scores on all performance scales and significantly higher ones on all distress scales, with the social phobics occupying a position in between. Findings in relation to convergent and divergent validity were quite satisfactory. Sensitivity of the French SIB for detecting change was demonstrated in a subgroup of the clinical Ss who had undergone 15 sessions of cognitive-behavioral group therapy for underassertiveness.     

Every cloud has a silver lining: interpersonal and individual differences determinants of anger-related behaviors

Two studies examined the effect of status and liking of the anger target on anger behavior and individual differences in anger-related behavior. Participants recalled anger instances in which the anger target was of higher/equal/lower status and/or liked/ unfamiliar/disliked; subsequently, they indicated which behaviors they had displayed. In both studies, anger behaviors could be grouped into behaviors that imply approaching the target (anger-out, assertion, reconciliation) and behaviors that reflect avoidance/anger-in or social sharing. The results demonstrated that approach behaviors more likely occur toward lower status or liked targets; avoidance behaviors and social sharing more likely occur when the target is of higher status or disliked. On an individual differences level, an approach and an avoid/social sharing person class were identified. The findings suggest that anger may motivate prosocial behavior or social sharing, depending on the individual and type of relation with the target. Only few gender differences were found.     

Cognitive Avoidance in Phobia

It is suggested that anxious individuals would have a processing bias for threat only in the initial processing stage, whereas in the consecutive stages the more elaborate analysis of the stimulus would be inhibited. The purpose of this study was to investigate the stage in which the bias changed into avoidance and whether cognitive avoidance of threat is restricted to information that refers to the anxiety response as opposed to the threatening stimulus. Therefore, 37 spider phobics and 34 controls were administered a negative priming task and a free recall task, using threat words and neutral words, both divided into stimulus-related and response-related words. There was no indication of cognitive avoidance of the response-related threat words as assessed by the negative priming task. Recall findings indicated an incomplete memory bias in phobics, with a better recall of stimulus-related threat words instead of a worse recall of response-related threat words. This suggests a passive cognitive avoidance mechanism, which may still impede the processing of response-related information, crucial for the success of exposure therapy.     

Blood phobics and nonphobics: psychological differences and affect during exposure.

This study compared psychological dimensions of blood phobics and nonphobic controls, examined affect in response to phobic and neutral stimuli, and investigated the relationship between reported feelings of faintness and blood pressure. Blood phobics (24 adults with extreme Mutilation Questionnaire scores) and 24 nonphobics completed several psychological measures and viewed one of two 60 sec surgery scenes and a 60 sec neutral scene in counterbalanced order. Subjective, psychophysiologic, and motoric measures of affect were assessed. On questionnaires, phobics reported greater anxiety sensitivity, empathic distress, fear and insecurity, and nightmares, but no difference in autonomic arousal, muscle tension, motion sickness, or other empathy domains. During surgery scenes, phobics had more negative affect than controls; however, phobics were more anxious during only one of the two surgeries, and often only when the surgery was presented prior to the neutral scene. Fainting did not occur, and self-reported feelings of faintness were unrelated to blood pressure changes. The findings highlight the lack of information on blood phobic stimulus properties, fainting's relationship to self-reports and blood pressure, and the specific emotion experienced in blood phobia.     

Isolation-induced social pecking in domestic chicks: Contemporary correlates and sequelae

Aspects of the social pecking of domestic chicks in a free response situation were examined in a series of experiments. It was proposed that a dual pattern of responses involving (a) a preponderance of pecks at the head of a conspecific, and (b) heightened emotionality (as indicated by the emission of distress calls) might be taken to reflect an aggressive tendency, and evidence was reviewed that showed that a brief period of isolation was a sufficient condition to elicit such a pattern. The main questions asked in this paper are: (a) whether the gender of a chick had a material influence on the incidence of such social pecking, and (b) whether orders established in pecking exchanges reflected a unidimensional social ordering among chicks. In the 1st set of studies the effect of the sex of subject on rates of social pecking was tested. While an isolation procedure clearly produced the dual pattern of heightened head pecking and calling, reliable sex differences were not in evidence. In a 2nd study, concerned with the generality of social orders as observed in social pecking exchanges, the isolation procedure again was sufficient to produce apparently aggressive reactions but the resulting peck orders between chicks did not predict success in later tests when the same 2 subjects were pitted against one another in either approach or avoidance competitive tasks. These results are discussed in terms of the relationship of infant aggression to adult aggression, and suggestions are made for a revised view of the development of the aggressive behavior of fowl.     

Filipino Americans and racism: A multiple mediation model of coping

Although the literature on Asian Americans and racism has been emerging, few studies have examined how coping influences one's encounters with racism. To advance the literature, the present study focused on the psychological impact of Filipino Americans' experiences with racism and the role of coping as a mediator using a community-based sample of adults (N = 199). Two multiple mediation models were used to examine the mediating effects of active, avoidance, support-seeking, and forbearance coping on the relationship between perceived racism and psychological distress and self-esteem, respectively. Separate analyses were also conducted for men and women given differences in coping utilization. For men, a bootstrap procedure indicated that active, support-seeking, and avoidance coping were mediators of the relationship between perceived racism and psychological distress. Active coping was negatively associated with psychological distress, whereas both support seeking and avoidance were positively associated with psychological distress. A second bootstrap procedure for men indicated that active and avoidance coping mediated the relationship between perceived racism and self-esteem such that active coping was positively associated with self-esteem, and avoidance was negatively associated with self-esteem. For women, only avoidance coping had a significant mediating effect that was associated with elevations in psychological distress and decreases in self-esteem. The results highlight the importance of examining the efficacy of specific coping responses to racism and the need to differentiate between the experiences of men and women.     

The Role of Cardioprotective Avoidance Beliefs in Noncardiac Chest Pain and Associated Emergency Department Utilization

This study examined cardioprotective avoidance beliefs and general panic/agoraphobia variables among 45 Emergency Department patients with a primary complaint of noncardiac chest pain (NCCP) in the absence of coronary artery disease or other medical explanation. Cardioprotective beliefs about the dangerousness of work and physical activity were assessed with the Fear-Avoidance Beliefs Questionnaire (FABQ). Additional measures assessed complaints of cardiac distress and panic, anxiety sensitivity, panic-related beliefs, agoraphobic avoidance, and depressive symptoms. Hierarchical regression analysis indicated that cardiac distress symptoms are a function of panic symptoms and cardioprotective beliefs concerning both physical activity and work, with 62% of the total variance explained. The predictors also explained 57% of the variance in Emergency Department utilization, which was significantly related to cardiac distress symptoms, number of illnesses, and work-avoidance beliefs. Neither outcome was related to demographics, depression symptoms, general anxiety sensitivity, general panic cognitions, or agoraphobic avoidance. Results suggest that current behavioral understandings of NCCP might be advanced by further examination of cardiac-specific avoidance beliefs and behavior and the potential role these factors play in both symptom experience and medical utilization.