| Social Interaction Anxiety Scale | |
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| Purpose | measures social anxiety |
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The Social Interaction Anxiety Scale (SIAS) is a self-report scale that measures distress when meeting and talking with others [1] that is widely used in clinical settings and among social anxiety researchers. [2] The measure assesses social anxiety disorder, which is fear or anxiety about one or more social situations where the individual is subject to possible scrutiny. [3]
Questions of the SIAS assess a client's fear of interacting in social situations, gauge emotional aspects of the anxiety response, and do not refer to social apprehensiveness or concern about others' opinions in a general sense. [1] Though related, social interaction anxiety is different from social phobia which is defined as anxiety surrounding fear of being scrutinized in a social situation. [4]
The scale contains 15 items. [5] [2] [6] The client rates how much each item relates to them on a 5-point scale as follows: [2]
The point values of the chosen answer choices are then summed to produce a total measure score.
Sample items include "I worry about not knowing what to say in social situations" or "I am tense mixing in a group". [7]
The SIAS measures social interaction anxiety, which refers to distress when meeting and talking with other people, whether they be friends, members of the opposite sex, or strangers. [1] The main concerns include fears of being inarticulate, sounding boring, sounding stupid, not knowing what to say or how to respond, and being ignored. [1] The scale specifically assesses anxiety experienced while interacting with others, not social phobia, which is more specifically fear of scrutiny when performing a task or being observed by others. [6] The SIAS is similar to the Social Phobia Scale (SPS), a measure that mores specifically assesses social phobia. [1] [2] However, though the measure is not created to measure social phobia specifically, those with social phobia score high on the SIAS as social phobia and social interaction anxiety are related.
The measure is able to discriminate between a normal population and a population that experiences social interaction anxiety, giving it substantial clinical utility. [1] [2] [4] It can be used in clinics as a self-report screening tool in order to see if clients possess any social interaction anxiety. The SIAS discriminates between social anxiety and general anxiety as it has low associations with trait anxiety (a level of stress associated with an individual personality) and general distress. [8] Beyond identifying those who experience social anxiety of some form, the scale can discriminate within the social anxiety class as well. [1] Patients with social phobia score higher on the SIAS than other patients with another anxiety disorder, such as generalized anxiety disorder, or no disorder. [4] In addition, patients with panic disorder and agoraphobia score higher than patients with specific phobia. [4]
The SIAS has a normal distribution of scores, with those that experience social interaction anxiety scoring high, supporting the view that the scale identifies general fear regarding social interactions. [1]
Evaluated through Cronbach's alpha, the SIAS demonstrates high levels of internal consistency, [1] [2] [7] [8] [9] meaning that different items on the test are correlated. In addition, the scale has high test-retest reliability, as it continues to correctly identify social anxiety and phobia after a period of time has passed. [1]
The scale has high discriminant validity; [7] not only is it able to discriminate between those with social phobia and healthy volunteers, [9] but also between several different types of social phobia and anxiety. [1] [9] The SIAS is significantly correlated with the Social Phobia Scale (SPS), consistent with the observation that social interaction fears and social phobia scrutiny fears co-exist, [1] [4] although they are still two different sets of symptoms. [4] It is strongly related to other related measures of social anxiety and social phobia, [2] [9] including the Liebowitz Social Anxiety Scale (LSAS), [2] [9] Mini Social Phobia Inventory (mini-SPIN), [2] Brief Fear of Negative Evaluation Scale (BFNE), [2] the Fear of Positive Evaluation Scale (FPES), [2] and the Interaction Anxiousness Scale. [9] In addition, there are moderate to high correlations between the SIAS and other scales testing fear, depression, and locus of control, which are all related to social anxiety. [1]
In addition, the SIAS responds to change and improvement in symptoms due to treatment. [1] [2]
Although the SIAS is used widely in clinical psychology, it is not without its limitations. Because the scale is self-report subjects are able to falsify responses in order to be socially desirable. [1] In addition, most items of the scale are scored in the same direction, allowing room for response bias. [1] It is also difficult to discriminate between the fears of someone who experiences social anxiety and the more general worries of a patient with generalized anxiety disorder, as patients who suffer from both disorders score higher on the SIAS than those with just social phobias. [4]
The SIAS is highly correlated with the SPS, suggesting that subjects from the community may not discriminate between the types of situations assessed in the two scales. [9] However, this limitation is not present among undergraduates or patients with social phobia. [9]
The SIAS has not been adequately assessed among an African American population, which is necessary as some concerns addressed in the SIAS may be more related to perceived scrutiny associated with being a member of a minority group. [10]
Shyness is the feeling of apprehension, lack of comfort, or awkwardness especially when a person is around other people. This commonly occurs in new situations or with unfamiliar people; a shy person may simply opt to avoid these situations. Although shyness can be a characteristic of people who have low self-esteem, the primary defining characteristic of shyness is a fear of what other people will think of a person's behavior. This fear of negative reactions such as being mocked, humiliated or patronized, criticized or rejected can cause a shy person to retreat. Stronger forms of shyness can be referred to as social anxiety or social phobia.
Acrophobia is an extreme or irrational fear or phobia of heights, especially when one is not particularly high up. It belongs to a category of specific phobias, called space and motion discomfort, that share similar causes and options for treatment.
Cognitive restructuring (CR) is a psychotherapeutic process of learning to identify and dispute irrational or maladaptive thoughts known as cognitive distortions, such as all-or-nothing thinking (splitting), magical thinking, overgeneralization, magnification, and emotional reasoning, which are commonly associated with many mental health disorders. CR employs many strategies, such as Socratic questioning, thought recording, and guided imagery, and is used in many types of therapies, including cognitive behavioral therapy (CBT) and rational emotive behaviour therapy (REBT). A number of studies demonstrate considerable efficacy in using CR-based therapies.
Social inhibition is a conscious or subconscious avoidance of a situation or social interaction. With a high level of social inhibition, situations are avoided because of the possibility of others disapproving of their feelings or expressions. Social inhibition is related to behavior, appearance, social interactions, or a subject matter for discussion. Related processes that deal with social inhibition are social evaluation concerns, anxiety in social interaction, social avoidance, and withdrawal. Also related are components such as cognitive brain patterns, anxious apprehension during social interactions, and internalizing problems. It also describes those who suppress anger, restrict social behavior, withdraw in the face of novelty, and have a long latency to interact with strangers. Individuals can also have a low level of social inhibition, but certain situations may generally cause people to be more or less inhibited. Social inhibition can sometimes be reduced by the short-term use of drugs including alcohol or benzodiazepines. Major signs of social inhibition in children are cessation of play, long latencies to approaching the unfamiliar person, signs of fear and negative affect, and security seeking. Also in high level cases of social inhibition, other social disorders can emerge through development, such as social anxiety disorder and social phobia.
The Liebowitz Social Anxiety Scale (LSAS) is a short questionnaire developed in 1987 by Michael Liebowitz, a psychiatrist and researcher at Columbia University and the New York State Psychiatric Institute. Its purpose is to assess the range of social interaction and performance situations feared by a patient in order to assist in the diagnosis of social anxiety disorder. It is commonly used to study outcomes in clinical trials and, more recently, to evaluate the effectiveness of cognitive-behavioral treatments. The scale features 24 items, which are divided into two subscales. 13 questions relate to performance anxiety and 11 concern social situations. The LSAS was originally conceptualized as a clinician-administered rating scale, but has since been validated as a self-report scale.
Cynophobia is the fear of dogs and canines in general. Cynophobia is classified as a specific phobia, under the subtype "animal phobias". According to Timothy O. Rentz of the Laboratory for the Study of Anxiety Disorders at the University of Texas, animal phobias are among the most common of the specific phobias and 36% of patients who seek treatment report being afraid of dogs or afraid of cats. Although ophidiophobia or arachnophobia are more common animal phobias, cynophobia is especially debilitating because of the high prevalence of dogs and the general ignorance of dog owners to the phobia. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) reports that only 12% to 30% of those with a specific phobia will seek treatment.
In exposure therapy, an exposure hierarchy is developed to help clients confront their feared objects and situations in a manner that is systematic and controlled for the purpose of systematic desensitization. Exposure hierarchies are included in the treatment of a wide range of anxiety disorders.
Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger (desensitization). Doing so is thought to help them overcome their anxiety or distress. Procedurally, it is similar to the fear extinction paradigm developed for studying laboratory rodents. Numerous studies have demonstrated its effectiveness in the treatment of disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and specific phobias.
Mental health professionals often distinguish between generalized social phobia and specific social phobia. People with generalized social phobia have great distress in a wide range of social situations. Those with specific social phobia may experience anxiety only in a few situations. The term "specific social phobia" may also refer to specific forms of non-clinical social anxiety.
Social anxiety is the anxiety and fear specifically linked to being in social settings. Some categories of disorders associated with social anxiety include anxiety disorders, mood disorders, autism spectrum disorders, eating disorders, and substance use disorders. Individuals with higher levels of social anxiety often avert their gazes, show fewer facial expressions, and show difficulty with initiating and maintaining a conversation. Social anxiety commonly manifests itself in the teenage years and can be persistent throughout life; however, people who experience problems in their daily functioning for an extended period of time can develop social anxiety disorder. Trait social anxiety, the stable tendency to experience this anxiety, can be distinguished from state anxiety, the momentary response to a particular social stimulus. Half of the individuals with any social fears meet the criteria for social anxiety disorder. Age, culture, and gender impact the severity of this disorder. The function of social anxiety is to increase arousal and attention to social interactions, inhibit unwanted social behavior, and motivate preparation for future social situations.
The Beck Anxiety Inventory (BAI), created by Aaron T. Beck and other colleagues, is a 21-question multiple-choice self-report inventory that is used for measuring the severity of anxiety in adolescents and adults ages 17 and older. The questions used in this measure ask about common symptoms of anxiety that the subject has had during the past week. It is designed for individuals who are of 17 years of age or older and takes 5 to 10 minutes to complete. Several studies have found the Beck Anxiety Inventory to be an accurate measure of anxiety symptoms in children and adults.
Interoceptive exposure is a cognitive behavioral therapy technique used in the treatment of panic disorder. It refers to carrying out exercises that bring about the physical sensations of a panic attack, such as hyperventilation and high muscle tension, and in the process removing the patient's conditioned response that the physical sensations will cause an attack to happen.
Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impairing ability to function in at least some aspects of daily life. These fears can be triggered by perceived or actual scrutiny from others. Individuals with social anxiety disorder fear negative evaluations from other people.
The Generalized Anxiety Disorder 7 (GAD-7) is a self-reported questionnaire for screening and severity measuring of generalized anxiety disorder (GAD). The GAD-7 is normally used in outpatient and primary care settings for referral to a psychiatrist pending outcome.
Driving phobia, driving anxiety, vehophobia, amaxophobia or driving-related fear (DRF) is a pathological fear of driving. It is an intense, persistent fear of participating in car traffic that affects a person's lifestyle, including aspects such as an inability to participate in certain jobs due to the pathological avoidance of driving. The fear of driving may be triggered by specific driving situations, such as expressway driving or dense traffic. Driving anxiety can range from a mild cautious concern to a phobia.
Anxiety sensitivity (AS) refers to the fear of behaviours or sensations associated with the experience of anxiety, and a misinterpretation of such sensations as dangerous. Bodily sensations related to anxiety, such as nausea and palpitations, are mistaken as harmful experiences, causing anxiety or fear to intensify. For example, a person with high anxiety sensitivity may fear the shakes as impending neurological disorder, or may suspect lightheadedness is the result of a brain tumour; conversely, a person with low anxiety sensitivity is likely to identify these as harmless and attach no significance to them. The Anxiety Sensitivity Index attempts to assess anxiety sensitivity.
Fear of negative evaluation (FNE) or fear of failure, also known as atychiphobia, is a psychological construct reflecting "apprehension about others' evaluations, distress over negative evaluations by others, and the expectation that others would evaluate one negatively". The construct and a psychological test to measure it were defined by David Watson and Ronald Friend in 1969. FNE is related to specific personality dimensions, such as anxiousness, submissiveness, and social avoidance. People who score high on the FNE scale are highly concerned with seeking social approval or avoiding disapproval by others and may tend to avoid situations where they have to undergo evaluations. High FNE subjects are also more responsive to situational factors. This has been associated with conformity, pro-social behavior, and social anxiety.
Safety behaviors are coping behaviors used to reduce anxiety and fear when the user feels threatened. An example of a safety behavior in social anxiety is to think of excuses to escape a potentially uncomfortable situation. These safety behaviors, although useful for reducing anxiety in the short term, might become maladaptive over the long term by prolonging anxiety and fear of nonthreatening situations. This problem is commonly experienced in anxiety disorders. Treatments such as exposure and response prevention focus on eliminating safety behaviors due to the detrimental role safety behaviors have in mental disorders. There is a disputed claim that safety behaviors can be beneficial to use during the early stages of treatment.
The Spence Children's Anxiety Scale (SCAS) is a psychological questionnaire designed to identify symptoms of various anxiety disorders, specifically social phobia, obsessive-compulsive disorder, panic disorder/agoraphobia, and other forms of anxiety, in children and adolescents between ages 8 and 15. Developed by Susan H. Spence and available in various languages, the 45 question test can be filled out by the child or by the parent. Alternatively, an abbreviated form of the test has been developed, with only 19 questions. It has shown equally valid results while reducing stress and response burden in younger participants. There is also another 34 question version of the test specialized for children in preschool between ages 2.5 and 6.5. Any form of the test takes approximately 5 to 10 minutes to complete. The questionnaire has shown good reliability and validity in recent studies.
The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a self-report screening questionnaire for anxiety disorders developed in 1997. The SCARED is intended for youth, 9–18 years old, and their parents to complete in about 10 minutes. It can discriminate between depression and anxiety, as well as among distinct anxiety disorders. The SCARED is useful for generalized anxiety disorder, social anxiety disorder, phobic disorders, and school anxiety problems. Most available self-report instruments that measure anxiety in children look at general aspects of anxiety rather than Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizations. The SCARED was developed as an instrument for both children and their parents that would encompass several DSM-IV and DSM-5 categorizations of the anxiety disorders: somatic/panic, generalized anxiety, separation anxiety, social phobia, and school phobia.
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