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Published in: Health and Quality of Life Outcomes 1/2013

Open Access 01-12-2013 | Research

Clinical validation of a non-heteronormative version of the Social Interaction Anxiety Scale (SIAS)

Authors: Philip Lindner, Christopher Martell, Jan Bergström, Gerhard Andersson, Per Carlbring

Published in: Health and Quality of Life Outcomes | Issue 1/2013

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Abstract

Introduction

Despite welcomed changes in societal attitudes and practices towards sexual minorities, instances of heteronormativity can still be found within healthcare and research. The Social Interaction Anxiety Scale (SIAS) is a valid and reliable self-rating scale of social anxiety, which includes one item (number 14) with an explicit heteronormative assumption about the respondent´s sexual orientation. This heteronormative phrasing may confuse, insult or alienate sexual minority respondents. A clinically validated version of the SIAS featuring a non-heteronormative phrasing of item 14 is thus needed.

Methods

129 participants with diagnosed social anxiety disorder, enrolled in an Internet-based intervention trial, were randomly assigned to responding to the SIAS featuring either the original or a novel non-heteronormative phrasing of item 14, and then answered the other item version. Within-subject, correlation between item versions was calculated and the two scores were statistically compared. The two items’ correlations with the other SIAS items and other psychiatric rating scales were also statistically compared.

Results

Item versions were highly correlated and scores did not differ statistically. The two items’ correlations with other measures did not differ statistically either.

Conclusions

The SIAS can be revised with a non-heteronormative formulation of item 14 with psychometric equivalence on item and scale level. Implications for other psychiatric instruments with heteronormative phrasings are discussed.
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Literature
1.
go back to reference McIntyre M, McDonald C: The limitations of partial citizenship: health care institutions underpinned with heteronormative ideals. ANS Adv Nurs Sci 2012, 35: 127–134. 10.1097/ANS.0b013e31824fe6caPubMedCrossRef McIntyre M, McDonald C: The limitations of partial citizenship: health care institutions underpinned with heteronormative ideals. ANS Adv Nurs Sci 2012, 35: 127–134. 10.1097/ANS.0b013e31824fe6caPubMedCrossRef
2.
go back to reference Andersen R, Fetner T: Cohort differences in tolerance of homosexuality: attitudinal change in Canada and the United States, 1981–2000. Public Opin Q 2008, 72: 311–330. 10.1093/poq/nfn017CrossRef Andersen R, Fetner T: Cohort differences in tolerance of homosexuality: attitudinal change in Canada and the United States, 1981–2000. Public Opin Q 2008, 72: 311–330. 10.1093/poq/nfn017CrossRef
3.
go back to reference Röndahl G, Innala S, Carlsson M: Heterosexual assumptions in verbal and non-verbal communication in nursing. J Adv Nurs 2006, 56: 373–381. 10.1111/j.1365-2648.2006.04018.xPubMedCrossRef Röndahl G, Innala S, Carlsson M: Heterosexual assumptions in verbal and non-verbal communication in nursing. J Adv Nurs 2006, 56: 373–381. 10.1111/j.1365-2648.2006.04018.xPubMedCrossRef
4.
go back to reference Bjorkman M, Malterud K: Lesbian women’s experiences with health care: a qualitative study. Scand J Prim Health Care 2009, 27: 238–243. 10.3109/02813430903226548PubMedCentralPubMedCrossRef Bjorkman M, Malterud K: Lesbian women’s experiences with health care: a qualitative study. Scand J Prim Health Care 2009, 27: 238–243. 10.3109/02813430903226548PubMedCentralPubMedCrossRef
5.
go back to reference Chapman R, Wardrop J, Freeman P, Zappia T, Watkins R, Shields L: A descriptive study of the experiences of lesbian, gay and transgender parents accessing health services for their children. J Clin Nurs 2012, 21: 1128–1135. 10.1111/j.1365-2702.2011.03939.xPubMedCrossRef Chapman R, Wardrop J, Freeman P, Zappia T, Watkins R, Shields L: A descriptive study of the experiences of lesbian, gay and transgender parents accessing health services for their children. J Clin Nurs 2012, 21: 1128–1135. 10.1111/j.1365-2702.2011.03939.xPubMedCrossRef
6.
go back to reference Bakker FC, Sandfort TGM, Vanwesenbeeck I, van Lindert H, Westert GP: Do homosexual persons use health care services more frequently than heterosexual persons: findings from a Dutch population survey. Soc Sci Med 2006, 63: 2022–2030. 10.1016/j.socscimed.2006.05.024PubMedCrossRef Bakker FC, Sandfort TGM, Vanwesenbeeck I, van Lindert H, Westert GP: Do homosexual persons use health care services more frequently than heterosexual persons: findings from a Dutch population survey. Soc Sci Med 2006, 63: 2022–2030. 10.1016/j.socscimed.2006.05.024PubMedCrossRef
7.
go back to reference Pachankis JE, Bernstein LB: An etiological model of anxiety in young gay men: from early stress to public self-consciousness. Psychol Men Masc 2012, 13: 107–122.CrossRef Pachankis JE, Bernstein LB: An etiological model of anxiety in young gay men: from early stress to public self-consciousness. Psychol Men Masc 2012, 13: 107–122.CrossRef
8.
go back to reference Feinstein BA, Goldfried MR, Davila J: The relationship between experiences of discrimination and mental health among lesbians and gay men: an examination of internalized homonegativity and rejection sensitivity as potential mechanisms. J Consult Clin Psychol 2012, 80: 917–927.PubMedCrossRef Feinstein BA, Goldfried MR, Davila J: The relationship between experiences of discrimination and mental health among lesbians and gay men: an examination of internalized homonegativity and rejection sensitivity as potential mechanisms. J Consult Clin Psychol 2012, 80: 917–927.PubMedCrossRef
9.
go back to reference King M, McKeown E, Warner J, Ramsay A, Johnson K, Cort C, Wright L, Blizard R, Davidson O: Mental health and quality of life of gay men and lesbians in England and Wales: controlled, cross-sectional study. Br J Psychiatry 2003, 183: 552–558. 10.1192/bjp.183.6.552PubMedCrossRef King M, McKeown E, Warner J, Ramsay A, Johnson K, Cort C, Wright L, Blizard R, Davidson O: Mental health and quality of life of gay men and lesbians in England and Wales: controlled, cross-sectional study. Br J Psychiatry 2003, 183: 552–558. 10.1192/bjp.183.6.552PubMedCrossRef
10.
go back to reference Meyer IH: Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull 2003, 129: 674–697.PubMedCentralPubMedCrossRef Meyer IH: Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull 2003, 129: 674–697.PubMedCentralPubMedCrossRef
11.
go back to reference Pachankis JE, Goldfried MR: Social anxiety in young gay men. J Anxiety Disord 2006, 20: 996–1015. 10.1016/j.janxdis.2006.01.001PubMedCrossRef Pachankis JE, Goldfried MR: Social anxiety in young gay men. J Anxiety Disord 2006, 20: 996–1015. 10.1016/j.janxdis.2006.01.001PubMedCrossRef
12.
go back to reference Rapee RM, Spence SH: The etiology of social phobia: empirical evidence and an initial model. Clin Psychol Rev 2004, 24: 737–767. 10.1016/j.cpr.2004.06.004PubMedCrossRef Rapee RM, Spence SH: The etiology of social phobia: empirical evidence and an initial model. Clin Psychol Rev 2004, 24: 737–767. 10.1016/j.cpr.2004.06.004PubMedCrossRef
13.
go back to reference Mattick RP, Clarke JC: Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behav Res Ther 1998, 36: 455–470. 10.1016/S0005-7967(97)10031-6PubMedCrossRef Mattick RP, Clarke JC: Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behav Res Ther 1998, 36: 455–470. 10.1016/S0005-7967(97)10031-6PubMedCrossRef
14.
go back to reference DeBruine LM: Facial resemblance increases the attractiveness of same-sex faces more than other-sex faces. Proc Biol Sci 2004, 271: 2085–2090. 10.1098/rspb.2004.2824PubMedCentralPubMedCrossRef DeBruine LM: Facial resemblance increases the attractiveness of same-sex faces more than other-sex faces. Proc Biol Sci 2004, 271: 2085–2090. 10.1098/rspb.2004.2824PubMedCentralPubMedCrossRef
15.
go back to reference Fergus TA, Valentiner DP, McGrath PB, Gier Lonsway SL, Kim HS: Short forms of the Social Interaction Anxiety Scale and the Social Phobia Scale. J Pers Assess 2012, 94: 310–320. 10.1080/00223891.2012.660291PubMedCrossRef Fergus TA, Valentiner DP, McGrath PB, Gier Lonsway SL, Kim HS: Short forms of the Social Interaction Anxiety Scale and the Social Phobia Scale. J Pers Assess 2012, 94: 310–320. 10.1080/00223891.2012.660291PubMedCrossRef
16.
go back to reference Kupper N, Denollet J: Social anxiety in the general population: introducing abbreviated versions of SIAS and SPS. J Affect Disord 2012, 136: 90–98. 10.1016/j.jad.2011.08.014PubMedCrossRef Kupper N, Denollet J: Social anxiety in the general population: introducing abbreviated versions of SIAS and SPS. J Affect Disord 2012, 136: 90–98. 10.1016/j.jad.2011.08.014PubMedCrossRef
17.
go back to reference Peters L, Sunderland M, Andrews G, Rapee RM, Mattick RP: Development of a short form Social Interaction Anxiety (SIAS) and Social Phobia Scale (SPS) using nonparametric item response theory: the SIAS-6 and the SPS-6. Psychol Assess 2012, 24: 66–76.PubMedCrossRef Peters L, Sunderland M, Andrews G, Rapee RM, Mattick RP: Development of a short form Social Interaction Anxiety (SIAS) and Social Phobia Scale (SPS) using nonparametric item response theory: the SIAS-6 and the SPS-6. Psychol Assess 2012, 24: 66–76.PubMedCrossRef
18.
go back to reference Carleton RN, Collimore KC, Asmundson GJG, McCabe RE, Rowa K, Antony MM: Refining and validating the Social Interaction Anxiety Scale and the Social Phobia Scale. Depress Anxiety 2009, 26: E71–81. 10.1002/da.20480PubMedCrossRef Carleton RN, Collimore KC, Asmundson GJG, McCabe RE, Rowa K, Antony MM: Refining and validating the Social Interaction Anxiety Scale and the Social Phobia Scale. Depress Anxiety 2009, 26: E71–81. 10.1002/da.20480PubMedCrossRef
19.
go back to reference Boettcher J, Andersson G, Carlbring P: Combining attention training with cognitive-behavior therapy in Internet-based self-help for social anxiety: study protocol for a randomized controlled trial. Trials 2013, 14: 68. 10.1186/1745-6215-14-68PubMedCentralPubMedCrossRef Boettcher J, Andersson G, Carlbring P: Combining attention training with cognitive-behavior therapy in Internet-based self-help for social anxiety: study protocol for a randomized controlled trial. Trials 2013, 14: 68. 10.1186/1745-6215-14-68PubMedCentralPubMedCrossRef
20.
go back to reference Boettcher J, Hasselrot J, Sund E, Andersson G, Carlbring P, Boettcher J, Hasselrot J, Sund E, Andersson G, Carlbring P: Combining attention training with internet-based cognitive-behavioural self-help for social anxiety: a randomised controlled trial. Cogn Behav Ther 2013, 43: 34–48.PubMedCentralPubMedCrossRef Boettcher J, Hasselrot J, Sund E, Andersson G, Carlbring P, Boettcher J, Hasselrot J, Sund E, Andersson G, Carlbring P: Combining attention training with internet-based cognitive-behavioural self-help for social anxiety: a randomised controlled trial. Cogn Behav Ther 2013, 43: 34–48.PubMedCentralPubMedCrossRef
21.
go back to reference First MB, Spitzer RL, Miriam G, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute; 2002. First MB, Spitzer RL, Miriam G, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute; 2002.
22.
go back to reference Rohde P, Ph D, Lewinsohn PM, Seeley JR: Comparability of telephone and face-to-face interviews in assessing axis I and II disorders. Am J Psychiatry 1997, 154: 1593–1598.PubMedCrossRef Rohde P, Ph D, Lewinsohn PM, Seeley JR: Comparability of telephone and face-to-face interviews in assessing axis I and II disorders. Am J Psychiatry 1997, 154: 1593–1598.PubMedCrossRef
23.
go back to reference Carlbring P, Brunt S, Bohman S, Austin D, Richards J, Qst LG, Andersson G: Internet vs. paper and pencil administration of questionnaires commonly used in panic/agoraphobia research. Comput Human Behav 2007, 23: 1421–1434. 10.1016/j.chb.2005.05.002CrossRef Carlbring P, Brunt S, Bohman S, Austin D, Richards J, Qst LG, Andersson G: Internet vs. paper and pencil administration of questionnaires commonly used in panic/agoraphobia research. Comput Human Behav 2007, 23: 1421–1434. 10.1016/j.chb.2005.05.002CrossRef
24.
go back to reference Hedman E, Ljótsson B, Rück C, Furmark T, Carlbring P, Lindefors N, Andersson G: Internet administration of self-report measures commonly used in research on social anxiety disorder: a psychometric evaluation. Comput Human Behav 2010, 26: 736–740. 10.1016/j.chb.2010.01.010CrossRef Hedman E, Ljótsson B, Rück C, Furmark T, Carlbring P, Lindefors N, Andersson G: Internet administration of self-report measures commonly used in research on social anxiety disorder: a psychometric evaluation. Comput Human Behav 2010, 26: 736–740. 10.1016/j.chb.2010.01.010CrossRef
25.
go back to reference Hirai M, Vernon LL, Clum GA, Skidmore ST: Psychometric properties and administration measurement invariance of social phobia symptom measures: paper-pencil vs. Internet administrations. J Psychopathol Behav Assess 2011, 33: 470–479. 10.1007/s10862-011-9257-2CrossRef Hirai M, Vernon LL, Clum GA, Skidmore ST: Psychometric properties and administration measurement invariance of social phobia symptom measures: paper-pencil vs. Internet administrations. J Psychopathol Behav Assess 2011, 33: 470–479. 10.1007/s10862-011-9257-2CrossRef
26.
go back to reference Lindner P, Andersson G, Ost L-G, Carlbring P: Validation of the Internet-Administered Quality of Life Inventory (QOLI) in different Psychiatric conditions. Cogn. Behav. Ther 2013, 42: 315–327. 10.1080/16506073.2013.806584PubMedCrossRef Lindner P, Andersson G, Ost L-G, Carlbring P: Validation of the Internet-Administered Quality of Life Inventory (QOLI) in different Psychiatric conditions. Cogn. Behav. Ther 2013, 42: 315–327. 10.1080/16506073.2013.806584PubMedCrossRef
27.
go back to reference Thorndike FP, Carlbring P, Smyth FL, Magee JC, Gonder-Frederick L, Ost L-G, Ritterband LM: Web-based measurement: effect of completing single or multiple items per webpage. Comput Human Behav 2009, 25: 393–401. 10.1016/j.chb.2008.05.006CrossRef Thorndike FP, Carlbring P, Smyth FL, Magee JC, Gonder-Frederick L, Ost L-G, Ritterband LM: Web-based measurement: effect of completing single or multiple items per webpage. Comput Human Behav 2009, 25: 393–401. 10.1016/j.chb.2008.05.006CrossRef
28.
go back to reference Peters L: Discriminant validity of the Social Phobia and Anxiety Inventory (SPAI), the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Behav Res Ther 2000, 38: 943–950. 10.1016/S0005-7967(99)00131-XPubMedCrossRef Peters L: Discriminant validity of the Social Phobia and Anxiety Inventory (SPAI), the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Behav Res Ther 2000, 38: 943–950. 10.1016/S0005-7967(99)00131-XPubMedCrossRef
29.
go back to reference Rodebaugh TL, Woods CM, Heimberg RG, Liebowitz MR, Schneier FR: The factor structure and screening utility of the Social Interaction Anxiety Scale. Psychol Assess 2006, 18: 231–237.PubMedCrossRef Rodebaugh TL, Woods CM, Heimberg RG, Liebowitz MR, Schneier FR: The factor structure and screening utility of the Social Interaction Anxiety Scale. Psychol Assess 2006, 18: 231–237.PubMedCrossRef
30.
go back to reference Baker SL, Heinrichs N, Kim H-J, Hofmann SG: The liebowitz social anxiety scale as a self-report instrument: a preliminary psychometric analysis. Behav Res Ther 2002, 40: 701–715. 10.1016/S0005-7967(01)00060-2PubMedCrossRef Baker SL, Heinrichs N, Kim H-J, Hofmann SG: The liebowitz social anxiety scale as a self-report instrument: a preliminary psychometric analysis. Behav Res Ther 2002, 40: 701–715. 10.1016/S0005-7967(01)00060-2PubMedCrossRef
31.
go back to reference Liebowitz MR: Social phobia. Mod Probl 1987, 22: 141–173. Liebowitz MR: Social phobia. Mod Probl 1987, 22: 141–173.
32.
go back to reference Svanborg P, Åsberg M: A new self-rating scale for depression and anxiety states based on the comprehensive Psychopathological rating scale. Acta Psychiatr Scand 1994, 89: 21–28.PubMedCrossRef Svanborg P, Åsberg M: A new self-rating scale for depression and anxiety states based on the comprehensive Psychopathological rating scale. Acta Psychiatr Scand 1994, 89: 21–28.PubMedCrossRef
33.
go back to reference Frisch MB, Cornell J, Villanueva M, Retzlaff PJ: Clinical validation of the quality of life inventory. A measure of life satisfaction for use in treatment planning and outcome assessment. Psychol Assess 1992, 4: 92–101.CrossRef Frisch MB, Cornell J, Villanueva M, Retzlaff PJ: Clinical validation of the quality of life inventory. A measure of life satisfaction for use in treatment planning and outcome assessment. Psychol Assess 1992, 4: 92–101.CrossRef
34.
go back to reference Paunović N, Öst L-G: Clinical validation of the swedish version of the quality of life inventory in crime victims with posttraumatic stress disorder and a nonclinical sample. J Psychopathol Behav Assess 2004, 26: 15–21.CrossRef Paunović N, Öst L-G: Clinical validation of the swedish version of the quality of life inventory in crime victims with posttraumatic stress disorder and a nonclinical sample. J Psychopathol Behav Assess 2004, 26: 15–21.CrossRef
35.
go back to reference Frisch MB, Clark MP, Rouse SV, Rudd MD, Paweleck JK, Greenstone A, Kopplin DA: Predictive and treatment validity of life satisfaction and the quality of life inventory. Assessment 2005, 12: 66–78. 10.1177/1073191104268006PubMedCrossRef Frisch MB, Clark MP, Rouse SV, Rudd MD, Paweleck JK, Greenstone A, Kopplin DA: Predictive and treatment validity of life satisfaction and the quality of life inventory. Assessment 2005, 12: 66–78. 10.1177/1073191104268006PubMedCrossRef
36.
go back to reference Carifio J, Perla RJ: Ten common misunderstandings, misconceptions, persistent myths and urban legends about likert scales and likert response formats and their antidotes. J Soc Sci 2007, 3: 106–116. Carifio J, Perla RJ: Ten common misunderstandings, misconceptions, persistent myths and urban legends about likert scales and likert response formats and their antidotes. J Soc Sci 2007, 3: 106–116.
37.
go back to reference Steiger JH: Tests for comparing elements of a correlation matrix. Psychol Bull 1980, 87: 245–251.CrossRef Steiger JH: Tests for comparing elements of a correlation matrix. Psychol Bull 1980, 87: 245–251.CrossRef
38.
go back to reference Diedenhofen B: cocor: Comparing correlations. 2013. Diedenhofen B: cocor: Comparing correlations. 2013.
39.
go back to reference Weiss BJ, Hope DA, Capozzoli MC: Heterocentric language in commonly used measures of social anxiety: recommended alternate wording. Behav Ther 2013, 44: 1–11. 10.1016/j.beth.2012.07.006PubMedCrossRef Weiss BJ, Hope DA, Capozzoli MC: Heterocentric language in commonly used measures of social anxiety: recommended alternate wording. Behav Ther 2013, 44: 1–11. 10.1016/j.beth.2012.07.006PubMedCrossRef
40.
go back to reference Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS: The yale-brown obsessive compulsive scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989, 46: 1006–1011. 10.1001/archpsyc.1989.01810110048007PubMedCrossRef Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS: The yale-brown obsessive compulsive scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989, 46: 1006–1011. 10.1001/archpsyc.1989.01810110048007PubMedCrossRef
41.
go back to reference Ruck C, Bergstrom J: Is the Y-BOCS discriminatory against gays and lesbians? Am J Psychiatry 2006, 163: 1449.PubMedCrossRef Ruck C, Bergstrom J: Is the Y-BOCS discriminatory against gays and lesbians? Am J Psychiatry 2006, 163: 1449.PubMedCrossRef
42.
go back to reference Derogatis LR Pearson Clinical Assessment. Symptom Checklist-90-Revised 1994. Derogatis LR Pearson Clinical Assessment. Symptom Checklist-90-Revised 1994.
Metadata
Title
Clinical validation of a non-heteronormative version of the Social Interaction Anxiety Scale (SIAS)
Authors
Philip Lindner
Christopher Martell
Jan Bergström
Gerhard Andersson
Per Carlbring
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2013
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-11-209

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